
PRE-SURVEY INFORMATION/DIRECTIVES/AGREEMENT ******************************************************************************************************
NAME OF HIRING PERSON:_____________________________________________________________________
ADDRESS:_____________________________________________________________________________________
OFFICE:______________________FAX:______________________HOME:_________________________________
CURRENT OWNER/SELLING PARTY:______________________________________________________________
SELLING PARTIES REP/BROKER:__________________________________________________________________
DESCRIPTION OF THE VESSEL:___________________________________________________________________
_______________________________________________________________________________________________
REFERRED BY:_________________________________________________________________________________
DATE INTRODUCTORY INFO WAS SENT:_________________________________________________________
DATE SURVEY SCHEDULED:______________________WILL OWNER BE PRESENT______________________
SERVICES TO BE PERFORMED:__________________________________________________________________
_______________________________________________________________________________________________
PRICE AGREED ON FOR SURVEY:_______________________BILL/CASH/CHECK:_______________________
********************************************************************************************
While conducting the detailed inspection of a vessel known as a marine
survey it is necessary for the surveyor to open and/or remove all hatch
covers and to open compartments, possibly including electrical enclosures
containing energized circuits. Safety guards for rotating machinery and
various other safety interlocks and switches may be disabled during the
survey. These procedures are inherently dangerous and make movement around,
or presence aboard the vessel extremely hazardous. I clearly understand
the dangers inherent on being aboard or around the vessel under survey,
and by my signature below, I certify that I release Walke Point Marine
Consultants, Inc. and Lawrence P. Leonardson, USSA Marine Surveyor from
all responsibility and liability for my safety, without limit and without
reservation. It is understood and agreed by the undersigned, that the services
to be conducted by Lawrence Leonardson, as the attending Surveyor will
be performed to the best of his ability. Any reports furnished, either
oral or in writing, will be accepted as his best judgement. They are not
intended as a representation or warranty as to the condition of vessel
or any of its parts. It is further understood and agreed that he will be
held harmless and not responsible in any way for any loss or damages, direct
or consequential arising out of the condition of the vessel, or by reason
of any error or omission on his part as the Surveyor. I further agree that
this release must apply fully to my estate and heirs without limit or reservation.
Payment constitutes this agreement. SIGNED:_______________________________________________DATE:____________