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Port Captain, Marine superintendent, Marine Specialist, Master Mariner

Location:
Abu Dhabi, United Arab Emirates
Salary:
TBN
Posted:
September 15, 2022

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Application Form

Deck & Engineering Officers

Section 1

Position

Position Applied for

Master

Lowest Position Acceptable

Date of Availability

/ / 2022 dd/mm/yyyy

Section 2

Personal Details

Family name / Surname

Gordienko

First Name / Given Name

Pavel

Date & Place of Birth

Date - 03.03.1970 /USSR/

Nationality

Russian

Permanent Address

Karandina str.,89 Astrakhan, Russia

Present Address

Karandina str.,89 Astrakhan, Russia

PPE information

SAFETY SHOES SIZE

43

COVERALL SIZE

XXL

Blood Group Information

-IV/ -AB/

Present Contact Number

+790********

Mobile Number

+790*-***-**-**; whats app/ viber

Skype address

Login: pavgordienko

Email Address

adsk1r@r.postjobfree.com

Nearest Airport (and Distance)

Astrakhan, alternative-,Moscow

Section 3

Passport and VISA details

Country of Issue

RUSSIAN

USA Visa - Type

n/a

Date Issued

21.05.2014

USA VISA Expires

n/a

Place Issued

ASTRAKHAN

USA Visa - Type

n/a

Passport Number

73 2800008

USA VISA Expires

Passport –Expires

21.05.2024

Other Country Visa

n/a

Secondary passport or Dual nationality

n/a

Visa Expiry

Section 4 ( hi-light as required )

Seaman book / Discharge book / Seaman Record Book / CDC

Issuing Country & Place

Russia

Date Issued

28.04.2011

Number

RUS 0511819

Expiry Date (if any)

10.12.2025

Section 5

Next of Kin – this is important information we require- Don’t ignore it

Full Name / Relationship

Gordienko Tatyana / Wife

Any dependents / Children (incl age )

Address

Karandina str.,89 Astrakhan, Russia

Contact Numbers

Mob. +7-906-**-**-***

Section 6 STCW95 Highest Certificate of Competency / Licence Held ( also list Flag State Endorsements)

Class / Grade/Capacity

Issuing Country

Certificate No.

Date Issued

Expiry

Details of Limitations

Master II/2

Russia

ASF 203532909

07.06.2019

11.04.2024

None fishing vessels only

ALSO ENTER ABOVE DETAILS OF ANY OTHER FLAG STATE CERTIFICATES HELD

Section 7 STCW95 Dangerous Cargo Endorsements

Petroleum

Liquefied Gas

Liquid Chemicals…….

Certificate No.

Date Issued

Expires

Details of Limitations/ Grade

Section 8 STCW95 related Courses Attended and Certificates Obtained

Name of Course / Certificate

STCW Code

Place

Issue Date

Cert No

Expiry Date

Basic Safety Training

A-VI/1

Astrakhan/Russia

11.04.2019

1267869

11.04.2024

Basic Sea Survival / Personal Survival Techniques

A- VI/1-1

Astrakhan/Russia

11.04.2019

1267869

11.04.2024

Fire Prevention & Fire Fighting

A-VI/1-2

Astrakhan/Russia

11.04.2019

1267869

11.04.2024

Elementary First Aid

A-VI/1-3

Astrakhan/Russia

11.04.2019

1267869

11.04.2024

Personal Safety & Social Responsibility

A-VI/ 1-4

Astrakhan/Russia

11.04.2019

1267869

11.04.2024

Proficiency in Survival Craft & Rescue Boats

A-VI/ 2-1

Astrakhan/Russia

12.04.2019

1268630

12.04.2024

Proficiency in RESCUE CRAFTS

n/a

n/a

n/a

n/a

n/a

Proficiency in FAST RESCUE BOATS

A-VI/ 2

n/a

n/a

n/a

n/a

Advanced Fire Fighting

A-VI/ 3

Astrakhan

13.04.2019

1268176

13.04.2024

Medical & First Aid

A-VI/ 4-1

Astrakhan

24.04.2019

1289265

24.04.2024

Radar & ARPA Simulator Trg- Management level

A-II/ 1-2

Astrakhan

10.05.2019

1312111

10.05.2024

Electronic chart Display and Information System course (ECDIS)

A-II / 1

Astrakhan

27.04.2019

1270312

27.04.2024

GMDSS + ENDORSEMENT

A-IV/ 2

Astrakhan

07.06.2019

ASF 203532914

07.06.2024

Ship Security Officers Course (SSO)

Issued under STCW95

A-VI/ 5

Astrakhan

17.05.2019

1311594

17.05.2024

Proficiency in Security Awareness

A-VI/6

n/a

n/a

n/a

n/a

Proficiency in Designated Security Duties

A-VI

n/a

n/a

n/a

n/a

Medical Certificate / HEALTH Certificate

MLC Compliant

Policlinik no 3 Astrakhan city

13.01.2022

604-20

13.01.2023

YELLOW FEVER

N/A

Astrakhan

21.01.20

21.01.30

Drug and Alcohol test certificate

Policlinik no 3 Astrakhan city

13.01.2022

604-20

13.01.2023

Bridge Team Management

A-II/2

Astrakhan

24.05.2019

00000787

24.05.2024

Bridge Resources Management

B-VIII/2

Astrakhan

24.05.2019

00000787

24.05.2024

Section 9 OFFSHORE INDUSTRY COURSES

Please enter below any other certificates held or courses done, ie offshore, DP certs etc or Any other not already mentioned

Name of Course / Certificate

APPROVALS

Place

Issue Date

Cert No

Expiry

BOSIET

N/A

N/A

N/A

N/A

N/A

HUET

OPITO

Abu Dhabi

07.08.2019

52515858070819327364

06.08.2023

FOET

OPITO

Abu Dhabi

07.08.2019

52515858070819327364

06.08.2023

H2S

OPITO

Abu Dhabi

04.08.2019

52519014040819327013

03.08.2021

ADNOC Induction Course

ETSDC-167087/2019

14.08.2019

n/a

n/a

ADNOC MEDICAL CERT

Capital Health Screening Centre Abu Dhabi

07/08/2019

n/a

07.08.21

ADMA Approval Initial

Abu Dhabi ADMA OPCO

31.05.2016

n/a

n/a

Initial Standby vessel crews training ( ITSO )

CAA (Civil Aviation Authorities – Helicopter)

Advanced Medical Aider ( AMA )

Helicopter Landing Operator (HLO)

MARLIN’s English Test

Score: 100 %

Astrakhan Technical University

11.04.11

N/A

CES 5.0 English Test

Score: %

DP Maintenance Courses

HIGH VOLTAGE COURSE

Dynamic Positioning Induction Course

Odessa Maritime Training center

25.01.13

0019/2013

Dynamic Positioning Simulator Course

DPO Full certificate

DPO Advance certificate

Dynamic Positioning Log book Details

IMCA

Odessa Maritime Training center

25.01.13

Naut.Institute

Section 10 Hours done with various DP system

SYSTEM DETAILS

Approx Hours as SDPO / Approx Days in case of Senior ETO / Senior Engineer

Approx Hours as DPO / Approx Days in case of Junior ETO / Junior Engineer

APPROXIMATE Total DP Hours in Various Operations

SAT DIVING

CABLE LAYING

AIR DIVING

SURVEY

ROV

PIPE LAYING

WELL STIMULATION / INTERVENTION / ACTIVATION

DRILL SHIP / SEMI SUB

AHTS

PSV

FPSO

SHUTTLE TANKER

CONSTRUCTION

ROCK DUMPING / MATTRESSING

CORING

TRENCHING

HEAVY LIFT

ACCOMMODATION / GANGWAY

STAND BY

Section 11 Medical History

YES

NO

Have you ever signed off a ship due medical reason ?

no

Have you undergone any medical operations in past ?

no

Have you consulted a doctor during the past 12 months for an illness / Accident

no

Do you have any health or disability problem now ?

no

If answer to any of above is YES then give further details below or on a separate sheet

Section 12 General

YES

NO

Have you ever been involved in a maritime accident, ie grounding, fire, Explosion, Collision, etc

no

Have you ever been the subject of a court of enquiry or involved in a maritime accident

no

Have you ever had a professional licence suspended or revoked

no

Have you ever been convicted of any criminal offence?

no

Have you ever been dismissed

no

If yes to any of above then please full details below or on separate sheet of paper

Section 13 References (Last Two Recent Employers)

Name of company

Anglo Eastern Offshore/ Honk Kong/

Name Person to be contacted

HR Manager

Maxim Kremenetskiy

Address

As Barge Master Fortuna

Tel No

mob: +791********

Fax

Email

adsk1r@r.postjobfree.com

Name of company

iPS - Powerful People

Name Person to be contacted

Emilie Stratenus Crew Manager

Address

Tameem House Suite 1203 & 1204

Barsha Heights TECOM Dubai

United Arab Emirates as Port Captain

Tel No

P: +971 (0)44 509 606

M: +971 (0-58-814-****

Fax

Email

E: adsk1r@r.postjobfree.com

Section 14 Any other information, you wish to add in support of your application

Section 15 Declaration – MUST BE SIGNED BY ALL APPLICANTS

I hereby declare that the above particulars are true and I authorize you to contact the referees listed above

And confirm that All my certificates / Licences are Authentic / SEASERVICE RECORD is ACCURATE / And I confirm accepting Companies DRUG & ALCOHOL Policy

Signed ………Pavel Gordienko Date 06.07.2021

Section 16 Record of Sea Service (All Dates to be entered as dd/mm/yy)

Please give full record of sea service STARTING FROM LAST VESSEL FIRST

VESSEL

COMPANY

Type of Vessel

And Type of operation in case of DP vessels

DWT or GRT

(please delete as reqd)

Type of Engines

BHP

Type & Class of DP system

RANK

Sign on DATE

Sign off DATE

N/A

PT Saipem Karimun Indonesia

n/a

n/a

n/a

n/a

Port Captain

06.05.2021

Still here

dd / mm / yy dd / mm / yy

N/A

Boskalis Westminster Co

n/a

n/a

n/a

n/a

Port Captain

03.08.2019

03.09.2019

PLB Fortuna

Anglo Eastern Offshore

Pipe layer barge

40.000t

Master

10.02.2019

25.03.2019

Atlantic Supporter

Vimar Offshore LCC

PSV DP-2

3186t

MAK

4000

Master

23.03.2018

08.06.2018

SCOUT

Trelco Marine Co

AHTS

1690t

Caterpillar

4800

Master

06.04.2016

21.06.2016

Topaz Legend

Topaz Marine Kazakhstan branch

AHTS DP-1

1678t

Caterpillar

5150

Master

17.06.2015

23.09.2015

Jean Charcot

Brasbunker Co

Brazil

Ocean geographically

Research vessel

2141t

Mans

3600

Master

25.05.2014

27.08.2014

PLB-648, Mutawa-13

ADMA OPCO Abu Dhabi Co

Heavy lift ship, Multy Purpose vessel

7060t

1120t

3500

ADMA Marine Advisor

23.05.2013

20.08.2013

Jean Charcot

Brasbunker Co

Brazil

Ocean geographically

Research vessel

2141t

Mans

3600

Master

29.08.2012

08.11.2012

TB PEARLY

Thong Yong Marine

TUG

320t

Cummins

3200

Master

30.12.2011

31.01.2012

OHSU

Thong Yong Marine

SRV

294t

Cummins

2400

Master

01.12.2011

29.12.2011

OHSU

Thong Yong Marine

SRV

294t

Cummins

2400

Master

17.08.2011

23.10.2011

Afon Cefni

Kaspiiskiy Buksir

AHTS

210 t

Cummins

2000

Master

24.04.2011

01.08.2011

Valentine-2

Valentine Maritime Gulf LCC

AHTS

GRT/494

Yanmar

4000

Master

01.05.2010

01.08.2010

Sara Maatje-IX

Caspian Services Group ltd

AHTS

340t

Mitsubishi

1837

Master

18.02.2008

07.07.2009

Sara Maatje-XV

Caspian Services Group ltd

Research vessel

240 T

Caterpillars

2000

Ch.mate

04.06.2007

05.12.2007

CS Marina

Caspian Services Group ltd

AHT

200 T

Caterpillars

1000

Master

26.08.2006

10.05.2007

Afon Cefni

Silverbern co

AHTS

210 t

Cummins

2000

Ch.mate

01.06.2006

19.08.2006

Grigoriy Nosov

Sovfraht

General cargo

3660t

n/a

2200

Ch.mate

05.11.2005

07.03.2006

Grigoriy Nosov

Sovfraht

General cargo

3660t

n/a

2400

Ch.mate

23.04.2005

08.07.2005

Rasul Gamzatov

Commercial

Sea-port of Makhachkala

General cargo

6200t

SKL

2640

Ch.mate

01.12.2003

18.08.2004

Dyurso

Commercial

Sea-port of Makhachkala

General cargo

6200t

SKL

2640

Ch.mate

16.12.2002

31.05.2003

Alex-II

AGMOS

General cargo

1200t

n/a

1100

Ch.mate

19.01.2002

26.07.2002

Vladimir Pravik

Commercial

Sea-port of Makhachkala

tanker

7080t

n/a

2740

Ch.mate

18.06.2001

21.11.2001

Ali Aliev

Commercial

Sea-port of Makhachkala

General cargo

4200t

n/a

2400

Ch.mate

01.12.2000

17.03.2001

Ali Aliev

Commercial

Sea-port of Makhachkala

General cargo

4200t

n/a

2400

2 –nd mate

18.07.2000

01.12.2000

Dagestan

Commercial

Sea-port of Makhachkala

General cargo

4200t

n/a

2400

2 –nd mate

07.01.1999

07.01.2000

Dagestan

Commercial

Sea-port of Makhachkala

General cargo

4200t

n/a

2400

2 –nd mate

09.06.1998

23.10.1998

Volgo-Balt-13

Kaspmorput co ltd

General cargo

2700t

n/a

1320

2 –nd mate

23.11.1996

13.04.1998

RDOS Bakhtemirskiy

JSC Derzhava

Fishing

670t

n/a

1100

3-d mate

05.11.1995

05.11.1996

Volgoneft-164

Volgotanker,co

tanker

5500t

n/a

2400

3-d mate

16.03.1994

15.07.1995

ADDITIONAL INFORMATION SHEET

VESSEL TYPE YOU ARE INTERESTED IN (please list in order of priority)

1.AHTS

2.PSV

3.RSV

4.Towing tug

5.OSV

MAXIMUM ACCEPTABLE CONTRACT PERIOD (Please indicate below)

Please Quote –Consolidated MINIMUM MONTHLY SALARY ( no leave pay ) payable for time onboard only or Working DAY RATE EXPECTATION ( no leave pay) ( please quote below in US$ -preferred or Euro or GBP£ )

discussible

Languages Spoken / Written / Understood (1-poor 5-Fluent)

Spoken

Written

Understood

ENGLISH

4

4

4

DRUG & ALCOHOL POLICY

ALL Our Clients have very strict NO DRUG and ALCOHOL POLICY, Which is required to be complied with at all times, which means “””ZERO TOLERENCE on ALCOHOL & DRUG”””

Your body must NOT have any ALCOHOL or DRUG substances from the time you board your flight or commence your travel to join vessel, and Must remain so Until you have completed full contract and returned to your home Airport / Town

If during the said period you are found under the influence of DRUG or ALCOHOL then ALL EXPENCES incurred which will include all your travel and recruiting costs, And your relief’s Travel and recruiting costs, And Any other costs whatsoever incurred due to your NON-COMPLIANCE will be deducted from your salary, Which will include but not limited to “damage to vessel her equipments and machineries, loss of charter, and any other costs Directly or indirectly connected with your NON-COMPLIANCE

Sign & CONFIRM ACCEPTANCE OF ABOVE POLICY

FOLLOWING DOCUMENTS COPIES MUST BE SENT TO US- send to us In separate Email

All Certificates / Courses Listed in this form + Licence or Certificate of competency, Any tanker endorsements, GMDSS showing expiry date in case of Deck Officers, Medical Fitness / Examination Certificate, Passport Main page, Seaman book or Discharge book Main pages, In case of DPO – DPO Cert, DP LOG Pages

FOLLOWING ADDITIONAL DOCUMENTS will ALSO BE REQUIRED – Send to us in separate email

All short courses certificates ( STCW95 ), SSO certificate, Last 3-5 years ships entries in Discharge book or Seaman book, Certificate of Equivelant Competency from other flag states



Contact this candidate