Shipping Port Request Form

SHIPPING PORT REQUEST FORM AND SERVICE AGREEMENT

WHEREAS

WHEREAS, Requesting Party: (hereinafter "Requesting Party") requires port services for the arrival, berthing, cargo operations and departure of specified vessel(s); and

WHEREAS, Port Operator: (hereinafter "Port Operator") operates the requested port facilities and is willing to provide such services under the terms set forth in this Request Form and Service Agreement.

NOW, THEREFORE, Requesting Party and Port Operator (collectively "Parties") agree to the following terms and conditions to govern the requested port services.

REQUEST SUMMARY

VESSEL & VOYAGE DETAILS

Vessel Name:   IMO Number:

Flag:   Call Sign:

Estimated Time of Arrival (ETA):   Estimated Time of Departure (ETD):

Requested Berthing Date/Time:   Preferred Berth:

CARGO & OPERATIONS DETAILS

Cargo Type:   Total Weight / Volume:

Number of Containers (if applicable):   Container Types/Sizes:

Hazardous Cargo: Yes    If yes, provide IMDG class and declaration below.

SERVICES REQUIRED

Please select services requested (check all that apply):

Pilotage

Tug assistance

Mooring / unmooring

Stevedoring / cargo handling

Customs clearance coordination

Shore power / electrical connection

DOCUMENTATION & ATTACHMENTS

The following documents will be provided by Requesting Party prior to arrival (check all that will be supplied):

Manifest

Bill of Lading

Dangerous Goods Declaration

Cargo list / stowage plan

SCOPE OF WORK

Describe the full scope of port services requested, specifying tasks, limits of liability requested, and any required sequencing or deadlines. This description will form the operative scope for services to be performed by Port Operator under this Request Form and Service Agreement.

PAYMENT TERMS

Agreed Fees / Estimated Charges:

Payment Schedule:

Late Payment Fee:   Invoice Delivery Email:

All charges are due in cleared funds in the currency specified on the invoice. Disputes on invoiced amounts must be submitted in writing within seven (7) days of receipt; undisputed amounts remain payable when due.

TERM AND TERMINATION

Service Start Date:   Service End Date:

Either Party may terminate this Request Form and Service Agreement for convenience by providing written notice to the other Party at least days prior to the intended termination date. Termination for material breach is permitted where the breaching Party fails to cure within a reasonable period after written notice of breach.

CONFIDENTIALITY

Each Party shall maintain as confidential all non-public business or technical information disclosed in connection with this Request Form and Service Agreement and shall not disclose such information to any third party except to employees, agents or subcontractors who have a need to know and are bound by confidentiality obligations no less protective than those herein. Confidential information does not include information that is publicly available through no fault of the receiving Party or is required to be disclosed by law, regulation, or valid order of a court or governmental authority, provided that the disclosing Party is given prompt notice and an opportunity to seek protective measures.

LIABILITY & INSURANCE (SUMMARY)

Port Operator will perform services with reasonable care and in accordance with industry standards. Requesting Party shall remain responsible for accurate cargo documentation and for costs arising from incorrect or incomplete information. Each Party shall maintain insurance coverage appropriate to its operations; evidence of such insurance shall be provided upon reasonable request.

GOVERNING LAW; ENTIRE AGREEMENT

Governing Law: The validity, interpretation and enforcement of this Request Form and Service Agreement shall be governed by the laws of the jurisdiction of , without regard to conflict of law principles.

Entire Agreement: This Request Form and Service Agreement, together with any attached schedules or confirmed written variations signed by both Parties, constitutes the entire agreement between the Parties with respect to the subject matter herein and supersedes all prior negotiations, representations and agreements, whether written or oral.

ADDITIONAL TERMS & SPECIAL INSTRUCTIONS

CERTIFICATION

The undersigned certifies that the information provided in this Request Form is true and accurate to the best of their knowledge, that they are authorized to request the services described, and that they accept the terms and conditions set forth in this Request Form and Service Agreement.

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