| PRE-SURVEY INFORMATION/DIRECTIVES/AGREEMENT **********************************************************************************************
NAME OF HIRING PERSON:______________________________________________________________________
ADDRESS:____________________________________________________________________________________
OFFICE:______________________FAX:______________________HOME:________________________________
CURRENT OWNER/SELLING PARTY:____________________________________________________________ SELLING PARTIES REP/BROKER:_____________________________________________________________ DESCRIPTION OF THE VESSEL:__________________________________________________________________ ____________________________________________________________________________________________ REFERRED BY:____________________________________________________________________________ DATE INTRODUCTORY INFO WAS SENT:________________________________________________________ DATE SURVEY SCHEDULED:______________________WILL OWNER BE PRESENT_______________________ SERVICES TO BE PERFORMED:___________________________________________________________________ ____________________________________________________________________________________________ PRICE AGREED ON FOR SURVEY:_______________________BILL/CASH/CHECK:______________________ ******************************************************************************************** While conducting the detailed inspection of a vessel known as a marine survey it is necessary for the surveyor to open and/or remove all hatch covers and to open compartments, possibly including electrical enclosures containing energized circuits. Safety guards for rotating machinery and various other safety interlocks and switches may be disabled during the survey. These procedures are inherently dangerous and make movement around, or presence aboard the vessel extremely hazardous. I clearly understand the dangers inherent on being aboard or around the vessel under survey, and by my signature below, I certify that I release Walke Point Marine Consultants, Inc. and Lawrence P. Leonardson, USSA Marine Surveyor from all responsibility and liability for my safety, without limit and without reservation. It is understood and agreed by the undersigned, that the services to be conducted by Lawrence Leonardson, as the attending Surveyor will be performed to the best of his ability. Any reports furnished, either oral or in writing, will be accepted as his best judgement. They are not intended as a representation or warranty as to the condition of vessel or any of its parts. It is further understood and agreed that he will be held harmless and not responsible in any way for any loss or damages, direct or consequential arising out of the condition of the vessel, or by reason of any error or omission on his part as the Surveyor. I further agree that this release must apply fully to my estate and heirs without limit or reservation. Payment constitutes this agreement. SIGNED:_______________________________________________DATE:____________ |
