Старший помощник капитана исследовательского судна

Описание

Name of Applicant:
Konokhov
Andrei


o

(Surname)
(Given Name)
(Middle Name)


Rank Applied for:
Chief Officer


Date of Application:
01.11.2022


Direct Application:
Yes No (if No, indicate below the agency name)


Agency Name:



Availability:




Basic Information
--------------------------------------------------------------------------------
Nationality
Russian
Mother Full Name
Evgeniya Konokhova
--------------------------------------------------------------------------------
Religion
Christian
Sector / Sub caste

--------------------------------------------------------------------------------
Date of Birth & Age
12 November 1968 /53
--------------------------------------------------------------------------------
Place & Country of Birth
Korenovsk/USSR
--------------------------------------------------------------------------------
Height & Weight
178 Cms 75 Kgs
--------------------------------------------------------------------------------
BMI

--------------------------------------------------------------------------------
Permanent Address
Budionogo Street,apt 628,Krasnodar ,Russian Fediration
--------------------------------------------------------------------------------
Telephone Numbers
+79898020333
--------------------------------------------------------------------------------
Mobile Number
+79898020333
--------------------------------------------------------------------------------
Email
Scorpius1313@mail.ru
Skype ID

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Marital Status (please mark)
Married √ Single Other:
--------------------------------------------------------------------------------
Next of kin / Relative to be contacted (in case of emergency)
--------------------------------------------------------------------------------
Name: Gurchenko Marina Relation: Sister
--------------------------------------------------------------------------------

--------------------------------------------------------------------------------
Contact Details: mobile number +79181888801
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Nearest International Airport, Country
Sochi Russia
--------------------------------------------------------------------------------
Passport Number
750548385
--------------------------------------------------------------------------------
Date Issued
12.11.2014
--------------------------------------------------------------------------------
Country of Issue
Russia
--------------------------------------------------------------------------------
Expiry Date
12.11.2024
--------------------------------------------------------------------------------
Seaman Book Number
MK 0156367
--------------------------------------------------------------------------------
Date Issued
10.04.2015
--------------------------------------------------------------------------------
Country of Issue
Russia
--------------------------------------------------------------------------------
Expiry Date
Nil
PPE Details
Boiler Suite Size
M
Safety Shoe Size
41,5
Certificate of Competency Details
--------------------------------------------------------------------------------
Certificate Grade
Master Unlimited
--------------------------------------------------------------------------------
Expiry Date
11.06.2025
--------------------------------------------------------------------------------
Certificate Number
ASF204615965
--------------------------------------------------------------------------------
Country Of Issue
Russia
--------------------------------------------------------------------------------
STCW Regulation
?????
--------------------------------------------------------------------------------
Revalidation Date

Endorsement Number
Not applicable
--------------------------------------------------------------------------------
Expiry Date
NIL
GMDSS Certificate Details
--------------------------------------------------------------------------------
Certificate Number
ASF204615954
--------------------------------------------------------------------------------
Expiry Date
28.12.2020
--------------------------------------------------------------------------------
Endorsement Number
Not applicable
--------------------------------------------------------------------------------
Expiry Date
NIL


Flag Documents (If the document is available, provide the expiry date)

COC
Endorsement
Seaman's Book

Available
Expiry Date
Available
Expiry Date
Available
Expiry Date
St. Vincent
Yes No

Yes No

Yes No

Bahrain
Yes No

Yes No

Yes No

Panama
Yes No

Yes No

Yes No

Client Approval
Do you have the valid document for the below? If yes, indicate the issue date.
ADNOC Approval
Yes No Issue Date:
ARAMCO Approval
Yes No Issue Date:
Qatar Gas Approval
Yes No Issue Date:
QP Approval
Yes No Issue Date:
STCW Certificate Details
All must be valid - If validity of certificate is not mentioned on the certificates, expiry dates to be considered as 3 years from date of issue of certificate.
--------------------------------------------------------------------------------

--------------------------------------------------------------------------------
Issue Date
--------------------------------------------------------------------------------
Expiry Date
--------------------------------------------------------------------------------
Issued At
--------------------------------------------------------------------------------
Basic Safety Training
13.06.2020
13.06.2025
Russia
--------------------------------------------------------------------------------
Personal Survival Techniques



--------------------------------------------------------------------------------
Proficiency in Survival Crafts & Rescue Boats
14.06.2020
14.06.2025
Russia
--------------------------------------------------------------------------------
Basic / Advanced Fire Fighting
11.06.2020
11.06.2025
Russia
--------------------------------------------------------------------------------
Basic First Aid / Medical Care / Medical First Aid
03.07.2020
03.07.2025
Russia
--------------------------------------------------------------------------------
Personal Safety & Social Responsibility



--------------------------------------------------------------------------------
Automatic Radar Plotting Aid [ARPA]
14.07.2020
14.07.2025
Russia
--------------------------------------------------------------------------------
Radar Observer Course [ROC]
11.07.2020
11.07.2025
Russia
--------------------------------------------------------------------------------
Ships Security Awareness / Officer
21.07.2020
21.07.2025
Russia
--------------------------------------------------------------------------------
ECDIS
08.07.2020
08.07.2025
Russia
--------------------------------------------------------------------------------
Bridge/Engine resource management
15.05.2020
15.05.2025
Ukraine
Offshore Training Certificate Details
--------------------------------------------------------------------------------

--------------------------------------------------------------------------------
Issue Date
--------------------------------------------------------------------------------
Expiry Date
--------------------------------------------------------------------------------
Issued At
--------------------------------------------------------------------------------
Basic/Advanced Offshore Safety



--------------------------------------------------------------------------------
BOSIET - OPITO /HUET
25.05.2020
25.05.2025
Ukraine
--------------------------------------------------------------------------------
H2S - OPITO
15.07.2022
15.07.2025
UAE
--------------------------------------------------------------------------------
Safe Lifting



--------------------------------------------------------------------------------
Safety Welding




With UAE Work Experience? Yes No
If yes, From to
Type of Visa:
No. of Years in UAE:

Have you done vaccination against COVID √ Yes No
If yes: Name of Vaccine Gam-COVID-Vac
No of Doses: 2
Date of last Jab: July7,2022
If No: Reason:

Reference from Last Two Employers [All details are Mandatory]
Company 1
--------------------------------------------------------------------------------
Company Name (not the manning agents, must be Owners)
--------------------------------------------------------------------------------
Contact Person Name
Glenn Carlsen Glenn.Karlsen@osm.no
--------------------------------------------------------------------------------
Designation
Technical Superintendent
--------------------------------------------------------------------------------
Contact Numbers
+4741237427
--------------------------------------------------------------------------------
Country
Norway
Company 2
Company Name (not the manning agents, must be Owners)
--------------------------------------------------------------------------------
Contact Person Name
I worked for OSM during 10 years
--------------------------------------------------------------------------------
Designation

--------------------------------------------------------------------------------
Contact Numbers

--------------------------------------------------------------------------------
Country




RECORD OF SEA SERVICE
(Recent Vessel First)
Vessel Name
Company (Owners)
Rank
Type of Vessel
Propulsion type
AZ, CPP
Flag
Area of operation
GT

Type of Engine
BHP
Bollard Pull
Sign on Date
(DD:MM:YYYY
Sign of Date
(DD:MM:YYYY)
Duration (Days: Month)
Topaz Mamlaka
Topaz Energy and Marine LTD
Chief Officer SDPO
AHTS DP2
AZD
Marshal Island
Persian Gulf
2131

5220

01.09.20222
23.09.2022
23
Hermit Baron
Hermit Baron Shipping Company/ Thome Offshore Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Nigeria
2428

12000
153
10.05.2021
20.07.2021
72
Hermit Baron
Hermit Baron Shipping Company/OSM Maritime AS
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Nigeria
2428

12000
153
13.08.2020
14.12.2020
124
Hermit Baron
Hermit Baron Shipping Company/OSM
Maritime AS
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Nigeria
2428

12000
153
14.12.2019
06.03.2020
84
Hermit Baron
Hermit Baron Shipping Company/OSM
Maritime AS
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
14.07.2019
14.09.2019
63
SOI Baron
Scorpio Baron Shipping Company Ltd/OSM Maritime AS
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
12.03.2019
14.05.2019
64
SOI Baron
Scorpio Baron Shipping Company Ltd/OSM Maritime AS
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
14.11.2018
11.01.2019
59
SOI Baron
Scorpio Baron Shipping Company Ltd/OSM Maritime AS
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
07.07.2018
10.09.2018
66
SOI Baron
Scorpio Baron Shipping Company Ltd/OSM Maritime AS
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
05.03.2018
04.05.2018
61
SOI Baron
Scorpio Baron Shipping Company Ltd/OSM Maritime AS
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
05.11.2017
05.01.2018
62
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
22.06.2017
23.08.2017
61
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
15.02.2017
19.04.2017
65
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
07.10.2016
08.12.2016
61
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
26.05.2016
30.07.2016
65
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
16.01.2016
17.03.2016
61
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428

12000
153
03.09.2015
03.11.2015
61
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



30.04.2015
01.06.2015
61
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



03.12.2014
25.02.2015
55
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



18.06.2014
30.09.2014
60
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



09.03.2014
15.05.2014
67
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



25.10.2013
05.01.2014
68
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



25.05.2013
27.08.2013
62
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



10.02.2013
03.04.2013
57
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



06.06.2012
09.08.2012
63
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



10.02.2013
03.04.2013
56
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



06.06.2012
09.08.2012
63
Sanko Baron
Far East Offshore AS/OSM Ship Management Pte Ltd
Chief Officer SDPO
AHTS DP2
CPP
Liberia
Atlantic Ocean/West Africa
2428



23.01.2012
06.04.2012
60
Bourbon Liberty 217
Bourbon Offshore Ukraine
Chief Officer SDPO
AHTS DP2
AZD
Malta
Atlantic Ocean/West Africa
1733



08.10.2011
05.12.2011
57

Note: Type of Engines & BHP: Mandatory for Engineers

I hereby confirm that all the above furnished details are true.

Name: Rank: Signature:


DECK OFFICERS EXPERIENCE
Vessel Name
Charterer
Area of Operation
(Oil field)
Period of Operation (in Months)



Supply
Survey
Anchor handling
Towing
Self elevating barge





Anchor type
Anchor weight
Barges
Rig move
Propelled
None Propelled
Hermit Baron
TOTAL
West Africa/Gabon/Congo/Nigeria
13
1



2

2
SOI Baron
TOTAL/BW Energy/COPREMAR
West Africa/Gabon/Congo/Nigeria/
10
1
Delta Flipper,
7t/5t

3

3
Sanko Baron
TOTAL/TECHNIP/Canadian Natural Resources/Amni International Petroleum Development Company/IMMA Terminal (Nigeria)
West Africa/Gabon/Congo/Nigeria
10
1
Stevin,Delta Flipper
15t/7t/5t
2
4

4
Bourbon Liberty 217
Bourbon Offshore Surf
Nigeria
2







Bourbon Liberty 212
Bourbon Offshore Surf
West Africa/Gabon
6

Delta Flipper,
5t

2

2
Burch Williams
Tidewater Crewing Limited
West Africa /Cmeroon
2







Sea Eagle 1
Dess Sea Eagle LTD
Pacific Ocean
3

Delta Flipper
5t

2

2
SASI TIDE
Tidewater Crewing Limited
West Africa /Cameroon
1,5

Delta Flipper
7t/5t

1

1
ATLAS TIDE
Tidewater Crewing Limited
West Africa /Cameroon
1

Delta Flipper,
5t

1

1
Sea Hero
Tidewater Crewing Limited
West Africa/Congo
1







London Service
Tidewater Crewing Limited
West Africa/Cameroon
2







Constitution Service
Tidewater Crewing Limited
West Africa/Cameroon
3







Duniazad
White Sea Shipping Supply LLC
Persian Gulf/Qatar
5










Name: Rank: Signature: