Appendix 2

LOCAL FUEL OIL SUPPLIERS INITIAL DECLARATION

1Name of Company                                                                                                        
2AddressBuilding:
Street:
Town:
County:
Country:
Post Code:
3Contact Name  
4Telephone Number  
5Fax Number  
6E. mail Address  
     
7Fuel oil supplier  
8Local fuel oil supplier  
9Date registered as
Local fuel oil supplier		  
10Date of declaration  
11Ports supplied  
12Delivery by bunker
supply vessel		  
13Delivery by road tanker  
14Delivery from direct
shore supply		  
15Supplier of HFO  
16Supplier of MGO  
17Supplier of Diesel  

 

Signature ______________________________                      
     
Name ______________________________  Date _______________