CG-5148 International Certificate of Fitness for the Carriage of

OMB No. 1625-0094

DEPARTMENT OF HOMELAND SECURITY
U.S. Coast Guard

INTERNATIONAL CERTIFICATE OF FITNESS FOR THE
CARRIAGE OF LIQUEFIED GASES IN BULK
Issued under the provisions of the International Code for the Construction and
Equipment of Ships Carrying Liquefied Gases in Bulk
Under the Authority of the Government of:

THE UNITED STATES OF AMERICA
by the

U.S. Coast Guard

Name of Ship

Official Number

Port of Registry

Cargo Capacity
(m 3 )

Type of Ship

(Code Paragraph 2.1.2)

Date on which keel was laid; Date ship was at a similar stage of construction; OR Date on which conversion to a gas
carrier was commenced (in the case of a converted ship):
The ship also complies fully with the following amendments to the Code:

The ship is exempted from compliance with the following provisions of the Code:

THIS IS TO CERTIFY THAT:
1.1 The ship has been surveyed in accordance with the provisions of 1.5 of the Code.
1.2 The survey showed that the structure, equipment, fittings, arrangements, and materials of the ship and the
conditions thereof are in all respects satisfactory, and that the ship complies with the relevant provisions of
the Code.
The ship is suitable for carriage in bulk of the products on the annexed, signed, and dated Product and
2
Conditions List (Enclosure 1A) provided that all relevant operational provisions of the Code are observed.
3
The following design criteria has been used:
3.1 Ambient air temperature
°C;
°C
3.2 Ambient water temperature
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB
control number.
The Coast Guard estimates that the average burden for this report is about 6 minutes. You may submit any comments concerning the accuracy
of this burden estimate or any suggestions for reducing the burden to: Commandant (CG-CVC), U.S. Coast Guard Stop 7501, 2703 Martin
Luther King Jr Ave SE, Washington, DC 20593-7501 or Office of Management and Budget, Paperwork Reduction Project (1625-0094),
Washington, DC 20503.

CG-5148 (05/20)

Reset

Page 1 of 8

THIS IS TO CERTIFY THAT (continued):
3.3 Complete the following table:
Tank Type & Number**

A

Stress Factors
B
C

Material

D

MARVS

Cargo Piping
** Tank Numbers are identified on the annexed, signed, and dated Tank Plan (Enclosure 2A).

4.
5.

3.4 Mechanical properties of the cargo tank material were determined at:
°C ,
°F .
In accordance with 1.41 and 2.8.2 1 , the provisions of the Code are modified in respect to the ship in the
manner shown on the annexed, signed, and dated Enclosure 3A.
The ship must be loaded:
5.1 In accordance with the loading conditions provided in the approved loading manual, stamped, and
dated
, and signed by a responsible officer of the Administration, or of
organization recognized by the Administration1 ;
5.2

In accordance with the loading limitations to this Certificate 1 .

Where it is required to load the ship other than in accordance with the above instruction, then the necessary
calculations to justify the proposed loading conditions should be communicated to the certifying Administration
which may authorize in writing the adoption of the proposed loading condition 2 .
This Certificate is valid until

3

subject to surveys in accordance with 1.5 of the Code.

Issued at

, on
(Place Certificate was Issued)

(Date Issued)

The undersigned declares that he/she is duly authorized by the said Government to issue this Certificate.

(Signature of Official Issuing Certificate &/or Seal of Issuing Authority)

Notes:
1. Delete as appropriate.
2. Instead of being incorporated in the Certificate, this text may be appended to the Certificate if duly signed and stamped.
3. Insert the date of expiry as specified by the Administration in accordance with 1.5.6.1 of the Code. The day and month of this date
corresponds to the anniversary date as defined in 1.3.3.3 of the Code, unless amended in accordance with 1.5.6.8 of the Code.
Other Helpful Notes on Completion of Certificate:
•
"Type of Ship": Any entry under this line must be related to all relevant recommendations (e.g., any entry "Type 2G" should mean type
2G in all respects prescribed by the Code).
•

Paragraph 2.1 & 2.2: The ambient temperatures accepted or required by the Administration for the purposes of 4.8.1 of the Code to be
inserted.

•

Paragraph 2.3: Stress factors and materials accepted or required by the Administration for the purposes of 4.5.1.4 and 4.5.1.6 of the
Code to be inserted.

•
•

Paragraph 2.4: Temperature accepted by the Administration for the purposes of 4.5.1.7 of the Code to be inserted.
Paragraph 3: Only products listed in chapter 17 of the Code or those which have been evaluated by the Administration in accordance
with paragraph 1.1.6 of the Code or of their compatible mixtures having physical properties within the limitations of tank design should be
listed. In respect of the latter "new" products, any special requirements provisionally prescribed should be noted.

CG-5148 (05/20)

Reset

Page 2 of 8

ENDORSEMENT FOR ANNUAL AND INTERMEDIATE SURVEYS
THIS IS TO CERTIFY THAT, at a survey required by 1.5.2 of the Code, the ship was found to comply with the
relevant provisions of the Code.

Annual Survey:

Signed:
(Signature of Authorized Official)

Place:
Date:
(Seal or Stamp of Authority, as appropriate)

Annual/Intermediate 1 Survey:

Signed:
(Signature of Authorized Official)

Place:
Date:
(Seal or Stamp of Authority, as appropriate)

Annual/Intermediate 1 Survey:

Signed:
(Signature of Authorized Official)

Place:
Date:
(Seal or Stamp of Authority, as appropriate)

Annual Survey:

Signed:
(Signature of Authorized Official)

Place:
Date:
(Seal or Stamp of Authority, as appropriate)

Note:
1.

Delete as appropriate.

CG-5148 (05/20)

Reset

Page 3 of 8

Annual/Intermediate Survey in Accordance with 1.5.6.8.3
THIS IS TO CERTIFY THAT, at an annual/intermediate 1 survey in accordance with 1.5.6.8.3 of the Code, the ship
was found to comply with the relevant provisions of the Code.

Signed:
(Signature of Authorized Official)

Place:
Date:
(Seal or Stamp of Authority, as appropriate)

Endorsement to Extend the Certificate if Valid for Less Than 5 Years Where 1.5.6.3 Applies
The ship complies with the relevant provisions of the Code, and this Certificate should, in accordance with 1.5.6.3 of
the Code, be accepted as valid until
.

Signed:
(Signature of Authorized Official)

Place:
Date:
(Seal or Stamp of Authority, as appropriate)

Endorsement Where the Renewal Survey has been Completed and 1.5.6.4 Applies
The ship complies with the relevant provisions of the Code, and this Certificate should, in accordance with 1.5.6.4 of
the Code, be accepted as valid until
.

Signed:
(Signature of Authorized Official)

Place:
Date:
(Seal or Stamp of Authority, as appropriate)

Note:
1.

Delete as appropriate.

CG-5148 (05/20)

Reset

Page 4 of 8

Endorsement to Extend the Validity of the Certificate Until Reaching the Port of Survey
1
or a Period of Grace Where 1.5.6.5/1.5.6.6 Applies
This certificate should, in accordance with 1.5.6.5/1.5.6.6 1 of the Code, be accepted as valid until

.

Signed:
(Signature of Authorized Official)

Place:
Date:
(Seal or Stamp of Authority, as appropriate)

Endorsement for Advancement of Anniversary Date Where 1.5.6.8 Applies
In accordance with 1.5.6.8 of the Code, the new anniversary date is

.

Signed:
(Signature of Authorized Official)

Place:
Date:
(Seal or Stamp of Authority, as appropriate)

In accordance with 1.5.6.8 of the Code, the new anniversary date is

.

Signed:
(Signature of Authorized Official)

Place:
Date:

Note:
1.

Delete as appropriate.

CG-5148 (05/20)

Reset

Page 5 of 8

ENCLOSURE 1A to the International Certificate of Fitness
for the Carriage of Liquefied Gases in Bulk
PRODUCTS & CONDITIONS LIST
Conditions of Carriage

Products

(tank numbers, minimum temperature, MARVS,
maximum density, tank loading conditions, etc.)

Tank numbers referred to in this list are identified on the annexed, signed, and dated Tank Plan (Enclosure 2A).

(Signature of Official Issuing the Certificate
&/or Seal of Issuing Authority)

(Date of Issue)

CG-5148 (05/20)

Reset

Page 6 of 8

ENCLOSURE 2A to the International Certificate of Fitness
for the Carriage of Liquefied Gases in Bulk
TANK PLAN
Cargo Tanks Above/Below Main Deck

(Signature of Official Issuing the Certificate
&/or Seal of Issuing Authority)

(Date of Issue)

CG-5148 (05/20)

Reset

Page 7 of 8

ENCLOSURE 3A to the International Certificate of Fitness
for the Carriage of Liquefied Gases in Bulk
EQUIVALENTS TO THE PROVISIONS, PROCEDURES, OR
ARRANGEMENTS REQUIRED BY THE CODE

(Signature of Official Issuing the Certificate
&/or Seal of Issuing Authority)

(Date of Issue)

CG-5148 (05/20)

Reset

Page 8 of 8