Noble Carl Norberg

Assured or Principle______MODU ______Dry Ocean Transport Onboard ______Voyage Arrival and Offloading Survey

MD Ref: S-______

To: ______

Attn: Mr. ______

Matthews-Daniel (INSERT YOUR OFFICE NAME) (INSERT ADDRESS)

Voyage Arrival and Offloading Survey MD/CORP/AF/5202/02 A4, 7/2006 Date: ______

(Company Name______) MODU ______Dry Ocean Transport Onboard ______Voyage Arrival and Offloading Survey

MD Ref: ______

A MatthewsDaniel surveyor did, on (date______) and subsequent dates, attend the offloading of the (Name of MODU______) from the (name of vessel______) at (name of location______).

The purpose of our attendance was to witness the offloading of the unit (name of vessel______) from (name of l ocation______) to (name of location ______).

The survey was assigned by (individual's name ______) on behalf of (Interested Underwriters, whom it may concern, Customer: ______) and for the account of (Interested Underwriters, whom it may concern, Customer: ______).

ATTENDING REPRESENTING

Name: ______Title: ______Company: ______

Voyage Arrival and Offloading Survey MD/CORP/AF/5202/02 A4, 7/2006 Page 2

Name: ______Marine Surveyor MatthewsDaniel

(NAME OF HEAVYLIFT VESSEL______) DETAILS

The (name of vessel______) is a ______and has the following particulars. Particulars

Official Name Official Number Call Sign Owners Operators Home Port Flag Gross Tons Net Tons Draft Built By / At Year Built Dimensions (As per the International L.O.A. Convention of Tonnage Measurements of Beam Ships 1969) Depth Classification Last Drydocking Last Underwater Inspection

Certification

Certificate No. Issued by Date Expires Class Hull

Class Machinery Certificate of Registry / Documentation

International Load Line Certificate

Certificate of Inspection

Stability Letter/Document

Safety Construction Certificate

International Tonnage Certificate

Other Certificates:______

Construction

Type : All welded steel with (longitudinal / transverse / combination) framing system.

Hull Form : ______

Compartmentation : ______watertight compartments consisting of (tanks and spaces)______divided by _____ longitudinal and _____ transverse watertight bulkheads.

Outfitting

Navigation Equipment : The H/L ______is equipped with the following navigation equipment:

______.

Navigation Lights : ______.

Communications Equipment : The H/L ______is equipped with the following communications equipment: ______

______.

Propulsion Machinery : The H/L ______is powered by ______

The engineering spaces are certified and equipped for unmanned operation with ______

Propellers : ______

Bow Thrusters : The H/L ______is equipped with ______.

Steering System : ______.

Generators : ______.

______.

Services Systems : ______.

______.

Ballast/Deballast System : ______.

______.

Anchors Forward: ______

______

Aft: ______

DECK FITTINGS

Main Deck

______

Fo'c'sle

Centerline Bow Forward : ______

Port and Starboard Bow : ______

Port and Starboard Sides : ______

Port and Starboard Aft : ______

Deck Winches : ______

Caissons Port and Starboard: ______

Cranes: ______

Accommodations : ______

Lifesaving Equipment : ______

Intended Service : ______

Capacities

Fuel, Diesel No. of Tanks: ______Total Capacity: ______Amount Onboard: ______

Fuel, Heavy No. of Tanks: ______Total Capacity: ______Amount Onboard: ______

Lube Oil No. of Tanks: ______Total Capacity: ______Amount Onboard: ______

Ballast Water No. of Tanks: ______Total Capacity: ______Amount Onboard: ______

Potable Water No. of Tanks: ______Total Capacity: ______Amount Onboard: ______As (reported to / witnessed by) surveyor at: ______hours on (date:______)

Fuel Consumption Approximately (______) (gallons) (liters)(tons)(cubic meters) (per hour)(per day).

Draft at Time of Departure: Forward: Starboard: ______Port: ______Aft: Starboard: ______Port: ______Trim: ______

General Condition

As sighted afloat (date______) and subsequent dates, at (name of location ______), the H/L (name of vessel ______) is considered satisfactory for offload.

Suitability to Offload Rig from Transport Vessel

MatthewsDaniel conducted an independent stability review and investigation which indicated that the plans and procedures were adequate to offload the MODU ______from the H/L (name of vessel______), offshore (name of location______).

The MODU ______and the H/L (name of vessel______) were inspected afloat offshore (name of location______) on (date ______) and subsequent dates, and the vessel design characteristics, outfitting and general condition were considered to be satisfactory for offloading of subject cargo, and the vessel was approved by MatthewsDaniel.

MODU (NAME OF MODU______) DETAILS

The (Name of MODU______) is a ______and has the following particulars.

Particulars

Official Name Official Number Call Sign Owners Operators Home Port Flag Gross Tons Net Tons Draft Built By / At

Year Built Dimensions (As per the International L.O.A. Convention of Tonnage Measurements of Beam Ships 1969) Depth Classification Last Drydocking Last Underwater Inspection

Certification

Certificate No. Issued by Date Expires

Certificate of Class - Hull

Certificate of Class - Machinery Certificate of Registry / Documentation

International Load Line Certificate

Certificate of Inspection

Stability Letter / Document

Safety Construction Certificate

International Tonnage Certificate

Other Certificates:______

ARRIVAL AND OFFLOADING PREPARATIONS

Offload Location

The offloading location is approximately nautical miles off the (name of location ______). The vessel's final anchor position was:

Latitude º ' " North/South Longitude º ' " West/East Water Depth m Depth Under Keel m

Preparation of Heavylift Name of Vessel______

______.

______

Assist Vessel (NAME OF VESSEL______)

(description of vessel)______

Particulars

Official Name Official Number Call Sign Owners Operators Flag/Registry Home Port Registered Dimensions Length: ______Breadth:______

Depth: ______Tonnages Gross: ______Net: ______Built By / At ______/______Year Built Hull Number Intended Service Certificate of Registry / Documentation Certificate No.: ______Issued by: ______Issued Date: ______Expires: ______Master (Name______) License No. ______License Type: ______No. of Crew Main Engines #______x Builder______Model No. ______Horsepower (Brake / Indicated / Class) Generators #______x Builder______Model No. ______Tow Winch Bollard Pull Main Tow Wire Length: ______Diameter:______Bridles Towing Spring Pendant / Fuse Wire Shackles in Use Spares and Equipment Draft (At Time of Survey) Date of Survey

______

Particulars

Official Name Official Number Call Sign Owners Operators Flag/Registry Home Port Registered Dimensions Length: ______Breadth:______Depth: ______Tonnages Gross: ______Net: ______Built By / At ______/______Year Built Hull Number Intended Service Certificate of Registry / Documentation Certificate No.: ______Issued by: ______Issued Date: ______Expires: ______Master (Name______) License No. ______License Type: ______No. of Crew Main Engines #______x Builder______Model No. ______Horsepower (Brake / Indicated / Class) Generators #______x Builder______Model No. ______Tow Winch Bollard Pull Main Tow Wire Length: ______Diameter:______

Bridles Towing Spring Pendant / Fuse Wire Shackles in Use Spares and Equipment Draft (At Time of Survey) Date of Survey

Particulars

Official Name Official Number Call Sign Owners Operators Flag/Registry Home Port Registered Dimensions Length: ______Breadth:______Depth: ______Tonnages Gross: ______Net: ______Built By / At ______/______Year Built Hull Number Intended Service Certificate of Registry / Documentation Certificate No.: ______Issued by: ______Issued Date: ______Expires: ______

Master (Name______) License No. ______License Type: ______No. of Crew Main Engines #______x Builder______Model No. ______Horsepower (Brake / Indicated / Class) Generators #______x Builder______Model No. ______Tow Winch Bollard Pull Main Tow Wire Length: ______Diameter:______Bridles Towing Spring Pendant / Fuse Wire Shackles in Use Spares and Equipment Draft (At Time of Survey) Date of Survey

Particulars

Official Name Official Number Call Sign Owners Operators Flag/Registry Home Port Registered Dimensions Length: ______Breadth:______Depth: ______Tonnages Gross: ______Net: ______Built By / At ______/______Year Built Hull Number Intended Service Certificate of Registry / Documentation Certificate No.: ______Issued by: ______Issued Date: ______Expires: ______Master (Name______) License No. ______License Type: ______No. of Crew Main Engines #______x Builder______Model No. ______Horsepower (Brake / Indicated / Class) Generators #______x Builder______Model No. ______

Tow Winch Bollard Pull Main Tow Wire Length: ______Diameter:______Bridles Towing Spring Pendant / Fuse Wire Shackles in Use Spares and Equipment Draft (At Time of Survey) Date of Survey

OFFLOADING OPERATIONS

Synopsis of Events ______

Damages Sustained During Offloading

______.

SURVEYOR'S COMMENTS

1. ______.

2. ______

RECOMMENDATIONS

1. ______.

2. ______.

CONCLUSION

Arrangements were found to be satisfactory for the offload of the MODU ______from the H/L ______following dry ocean transport from (name of l ocation______) to (n ame of location______) at ______hours on (date______).

THIS REPORT IS SUBMITTED WITHOUT PREJUDICE.

MatthewsDaniel

______Attending Surveyor

/ / :( ) c/s

ATTACHMENTS

1. Photographs

Surveyor's Log (Available Upon Request)

Voyage Arrival and Offloading Survey MD/CORP/AF/5202/02 A4, 7/2006 PHOTO CAPTIONS

Voyage Arrival and Offloading Survey MD/CORP/AF/5202/02 A4, 7/2006