Vessel Berth Reservation

Application for Vessel Berth Reservation

Vessel

LOA

ETA

ETD

Vessel Owner/Line

Berth Desired

Vessel Charterer

To Load

To Discharge

Terms of Affreightment

Port Charges

1. Dockage

Dockage

Name of Party

Address

Phone

Estimated Dollar Amount

2. Line Handlers

Line Handlers

Name of Party

Address

Phone

Estimated Dollar Amount

3. Fresh Water

Fresh Water

Name of Party

Address

Phone

Estimated Dollar Amount

4. Security

Security

Name of Party

Address

Phone

Estimated Dollar Amount

Total Estimated Charges

Agreement

Line Item No. 1

Name of Authorizing Party

Line Item No. 2

Name of Authorizing Party

Line Item No. 3

Name of Authorizing Party

Line Item No. 4

Name of Authorizing Party

Berthing Agreement

Pursuant to the instructions set forth in the Conditions of Berth Reservation, I hereby seek the arrangement of the berthing facilities on behalf of the above named vessel, and attests to the accuracy of the information provided to the extent set forth in paragraph C.

Acceptance of Financial Responsibility for Payment

Accept financial responsibility

In connection with the APPLICATION FOR VESSEL BERTH RESERVATION dated 04/25/2019 the below hereby accepts responsibility, on it's behalf, for payment of the Port charges listed under the line items as designated below which correspond with those designated in the above APPLICATION FOR VESSEL BERTH RESERVATION, in a maximum amount not to exceed 125% of the aggregate estimated dollar amount shown above for the relevant line items or 125% of such other sum as the Port of Anacortes after review and revision of such estimates, has provided to the undersigned in writing, in which latter case a copy of such writing is physically attached hereto.

Note: Pursuant to Port of Anacortes Tariff Rule, in all instances, where the ``Party Responsible for Payment`` listed above has not established credit worthiness with the Port of Anacortes and where responsibility for Port of Anacortes charges has not been accepted by another credit worthy entity, the Port of Anacortes shall require payment of cash in advance or posting of acceptable security prior to vessel berthing

Vessel Berth Reservation

Application for Vessel Berth Reservation

Port Charges

Agreement

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