MB02-M-73-01

BUNKER ON/OFF-HIRE CHECKLIST No.: ........................................

Date:

To: C/Engineer of M/v. “_______________________________”

We, as the Marine surveyor of The Inspection J.S Company, for and on behalf of the
Shipowners & Charterers, did attend on board the vessel M/v. “___________________________” for
a joint bunker on/off-hire survey. We would like the vessel Master/Chief Officer to supply us the
following information and copies of documents in your convinence.

1. Bunker consumption:

Consumption/ day: H.F.O M.D.O

 At sea ........................... MT ............................... MT

 At anchorage ........................... MT ............................... MT

 At port ............................... MT ............................... MT

2. Lastest bunker supplied: (Copies of bunker receipt)

 Place of supply: 1.................................................................... 2....................................................................

 Date/ Time of 1................................................................... 2....................................................................

supply:

 Quantity: 1................................................................... 2....................................................................

 Log-book quant. F.O________________ Mts D.O_________________ Mts

3. Participants by fascimile / telex by Charterer /Owner instruction (Copies not

avail. or avail.)
No In name of Name of company Remakrs
.

1 Ship’s owners

2 Ship’s operators

3 Charterer (Disponent
onwers)

4 1st sub-charterer

5 2nd sub-charterer

4. Place/ Time of : Delivery Re-delivery by fascimile / telex (Copies not avail.

or avail.)
Place of: delivery / re-delivery Date/ time of: delivery / re-delivery
Local time GMT Date

Acknowleged by Surveyor
 No.
………….M/HCM
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