Medical Engineer
Resume:
PHOTO
APPLICATION FOR POSITION AS
CHIEF ENGINEER
OTHER POSITION (IF ANY)
1. PERSONAL DETAILS
TITLE MR/MRS/MISS
MR
SEX
MALE X
FEMALE
SURNAME
BHAKARE
FIRST NAME
SADASHIV
OTHERS NAMES
DATE OF BIRTH
29/01/1969
PLACE OF BIRTH
MUMBAI
NATIONALITY
INDIAN
MARITAL STATUS
MARRIED
COLOUR OF EYES
BLACK
COLOUR OF HAIR
BLACK
MOTHER’S NAME
VAIJANTA
FATHER’S NAME
MAHADEO
MOTHER’S MAIDEN NAME
HEIGHT (CM)
178
WEIGHT (KG)
76
NEAREST INTERNATIONAL AIRPORT:
MUMBAI
2. ADDRESS
ADDRESS (TEMP.) FROM/TO:
NO & STREET
104,DARSHAN CHS LTD, KOKAN NAGAR,JOGESHWARI EAST
NO & STREET
CITY
MUMBAI
CITY
POST CODE
400060
POST CODE
COUNTRY
INDIA
COUNTRY
TEL. NO.
TEL. NO.
MOBILE
MOBILE
*****************@*****.***
FAX
FAX
3. NEXT OF KIN
FULL NAME
NANDINI SADASHIV BHAKARE
RELATIONSHIP
WIFE
ADDRESS
SAME AS ABOVE
CITY
MUMBAI
COUNTRY
INDIA
TEL. NO.
MOBILE
FAX NO.
4. CHILDREN
FULL NAME OF CHILD
DATE OF BIRTH
SEX
SAGAR SADASHIV BHAKARE
03/01/2000
M X
F
SAURABH SADASHIV BHAKARE
13/12/2001
M X
F
M
F
M
F
5. TRAVEL DOCUMENTS
TYPE
DOCUMENT NO.
ISS.DATE
EXP. DATE
ISS. BY (AUTHORITY)
PLACE OF ISSUE
PASSPORT
H9757817
27/01/2010
26/01/2020
INDIA
MUMBAI
SEAMAN BOOK
BY68197
26/01/2012
25/03/2022
INDIA
MUMBAI
OTHER SEAMAN BOOK
F0183129
29/08/2017
31/12/2019
US C1/D VISA
J4750634
23/06/2014
19/06/2019
MUMBAI
OTHER VISAS
6. BANK ACCOUNT INFORMATION
BANK NAME
STATE BANK OF INDIA
BRANCH
ANDHERI EAST
BANK ADDRESS
CITY
MUMBAI
COUNTRY
INDIA
SORT CODE
ACCOUNT NO
BANK SWIFT CODE
BANK TEL. NO
ACCOUNT OWNER’S NAME
SADASHIV MAHADEO BHAKARE
ACCOUNT OWNER’S ADDRESS
104,DARSHAN 2 CHS LTD. KOKAN NAGAR, JOGESHWARI EAST MUMBAI 400060
7. EDUCATION
SCHOOL NAME
DIPLOMA IN MECH ENG
FROM
1984
TO
1988
SCHOOL NAME
FROM
TO
8. PROFESSIONAL QUALIFICATION / CERTIFICATE OF COMPETENCY
CERTIFICATE NAME
NUMBER
ISSUE DATE
EXPIRY DATE
ISSUED BY (AUTHORITY)
ISSUED AT
CLASS1 MOTOR
CoC0068196
18/03/2015
31/12/2019
UK
DANGEROUS CARGO ENDORSEMENT
NUMBER
ISSUE DATE
EXPIRY DATE
PETROLEUM
CoC0068196
18/03/2015
31/12/2019
CHEMICAL
GAS
9. LANGUAGES
ENGLISH
FLUENT
X
GOOD
FAIR
POOR
GERMAN
FLUENT
GOOD
FAIR
POOR
FRANCH
FLUENT
GOOD
FAIR
POOR
SPANISH
FLUENT
GOOD
FAIR
POOR
ITALIAN
FLUENT
GOOD
FAIR
POOR
RUSSIAN
FLUENT
GOOD
FAIR
POOR
MARLIN’S TEST / LEVEL
ISSUED DATE
RESULT %
ISSUED BY (AUTHORITY)
ISSUED AT
10. HEALTH CERTIFICATES & VACCINATIONS
FLAGE STATE
NUMBER
ISSUE DATE
EXPIRY DATE
ISSUED BY (AUTHORITY)
ISSUED AT
INTERNATIONAL
LIBERIAN
NORWEGIAN
PANAMANIAN
NAME
ISSUE DATE
EXPIRY DATE
ISSUED BY (AUTHORITY)
ISSUED AT
YELLOW FEVER
07/12/2010
06/12/2020
INDIA
MUMBAI
11. SAFETY CLOTHING
BOILERSUIT SIZE
XL
BOOTS SIZE
44
12. MARINE COURSES
COURSE NAME
NUMBER
ISSUE DATE
EXPIRY DATE
ISSUED BY (AUTHORITY)
ISSUED AT
PERSONAL SURVIVAL
BASIC FIRE FIGHTING
ADV. FIRE FIGHTING
BPMA/AFF/RF222/2016
18/01/2016
17/01/2021
BP MARINE
MUMBAI
ELEMENTARY FIRST AID
MEDICAL FIRST AID
RMFA D228/2014
21/04/2014
20/04/2019
MTI
MUMBAI
MEDICAL CARE
PERS. SAFETY & SOC. RESP.
MMTI/PSSR/16761/2018
06/01/2018
MMTI
MUMBAI
PROF. IN SURVIVAL CRAFT & RESCUE BOATS
BPMA/PSCRB/RF/1538/2016
20/01/2016
19/01/2021
BP MARINE
MUMBAI
FAST RESCUE CRAFT
G.M.D.S.S.
A.R.P.A. (Management level)
RADAR OBSERVATION
HAZMAT
OIL TANKER
ADVANCE OIL TANKER
CHEMICAL TANKER
ADVANCE OIL TANKER
BPMA/ATOTCO/330/2017
04/08/2017
03/08/2022
BP MARINE
MUMBAI
GAS TANKER
ADVANCE GAS TANKER
CRUDE OIL WASHING
INERT GAS PLANT
ISM CODE
SHIP SECURITY OFFICER
MMTI 350(RT)543
23/04/2014
22/04/2019
MMTI
MUMBAI
BRIDGE TEAM MANAGEMENT
DP INDUCTION
DP SIMULATOR
BRIDGE / ENGIINE ROOM RESOURCE MANAGEMENT.
SHIP HANDLING
INTERNAL AUDITORS COURSE
12. MARINE COURSES (CONTD……)
COURSE NAME
NUMBER
ISSUE DATE
EXPIRY DATE
ISSUED BY (AUTHORITY)
ISSUED AT
13. SPECIALISED EXPERIENCE
TYPE
FROM
TO
COMMENTS
NEW BUILDING
SPECIALISED PROJECTS
SPECIAL TRADES
SHORE EXPERIENCE
COMPLETE SEA – SERVICE DETAILS
( LAST VESSELS FIRST )
NAME:
SADASHIV BHAKARE
RANK:
AVALIABILITY DATE:10/3/2018
COMPANY NAME
RANK
VESSEL NAME
SIGNED
ON
SIGNED OFF
PERIOD IN MONTHS
(eg 4.2)
TYPE OF VESSEL
G.R.T.
ENGINE TYPE
( ENGINEERS ONLY)
BHP
KW
OSM
2/E
MT SOL
18/04/2017
26/12/2017
4.9
TANKER
81479
MAN B&W
16846
SELANDIA
2/E
MT GENER8 DEFIANCE
21/04/2016
17/08/2016
3.26
TANKER
56225
SULZER6 RTA 58T
16300
OSM
2/E
MT DIAMEND
09/09/2015
09/01/2016
4.0
VLCC
165784
SULZER RT-FLEX
31640
OSM
2/E
MT GENMAR MANIATE
09/07/2014
26/10/2014
3.16
TANKER
MAN B&W 6S 70MC-C7
OSM
2/E
MT GENMAR ULYSSES
11/06/2012
27/10/2012
4.17
VLCC
160889
MAN B&W 6S90 MC-C
35910
OSM
2/E
MT SIMA
10/09/2011
16/02/2012
5.6
TANKER
85462
MAN B&W 6S 70MC-C7
18660
OSM
2/E
MT MARBAT
22/06/2010
24/11/2010
5.2
VLCC
163257
MAN B&W 6S 90MC-C7
39900
OSM
2/E
MT NESA
30/06/2009
01/12/2009
5.1
VLCC
156809
SULZER RTA 84T
36960
OSM
2/E
MT NAJM
03/01/2009
06/03/2009
2.2
VLCC
156809
SULZER RTA 84T
OSM
2/E
MT NABI
12/07/2008
17/11/2008
4.5
VLCC
156809
SULZER RTA84T
OSM
2/E
MT GULF SCANDIC
13/07/2007
08/01/2008
5.25
TANKER
80187
MANB&W 6S70 MC
OSM
2/E
MT GULF SCANDIC
14/07/2006
13/01/2007
6.0
TANKER
80187
MAN B&W 6S 70 MC
REFERENCE CONTACT DETAILS
COMPANY NAME
ADDRESS
PHONE NO.
FAX/E-MAIL
CONTACT PERSON
I declare that the information I have given is, to the best of my knowledge, true and complete. I also declare that the documents submitted are genuine, given and sign by persons whose names appear on them.
DATE
SIGNATURE
Officer Application Form
Ref .No
(For Official Use)
Medical History
Have you ever signed off from a ship due to medical reasons?
(If yes give details)
*yes/no
Name of Vessel
Date of occurrence (dd-mmm-yyyy)
Brief Description Of illness/Injury/Accident
Details
Have you ever suffered from any ailment or disease in the past that is likely to render you unfit for sea service or likely to endanger the health /well being of others onboard?
(If Yes give details)
*Yes/No
Details
Do you have any bodily defects or deficiencies?
(If Yes give details)
*Yes/No
Details
Are you currently suffering from any ailment or disease that is likely to render you unfit for sea service or likely to endanger the healthy /well being of others onboard?
(If Yes give details)
*Yes/No
Details
Are you addicted to alcohol or drug of any kind?
(If Yes give details)
*Yes/No
Details
Are you suffering from an ailment that requires you to be on a long -term treatment/medication?
(If Yes give details)
*Yes/No
Details
Have you ever deported or banned from entering any country?
(If Yes give details)
*Yes/No
Details
Have you ever been convicted of a criminal or drug offence or have any pending offences?
(If Yes give details)
*Yes/No
Details
Do you have any obligations towards your current/previous employers?
(If Yes give details)
*Yes/No
I hereby affirm that all the information provided by me in this application is true and correct to the best of my knowledge and belief; further, that no certificate of competency or License issued to me has ever been Revoked or Suspended. I also certify that my medical history contained above is true and any false statement or undisclosed Material information about past illness or injury will disqualify me from any employment benefits and claims.
dd-mmm-yyyy (Format) Signature
Contact this candidate