ࡱ> =?<` bjbj 4" L   8B$faaa$Rh!Xaaaaa   ad a   z .q p ~ "5p" "  aa aaaaadaaaaaaadF F   Dear ____________________, Pacific-Gulf Marine, Inc. (PGM) has dedicated itself to continuously improve its efforts to protect the environment. As part of our corporate environmental plan, we have established an Environmental Stewardship Program whereby PGM, with the cooperation of our Contractors, makes a commitment to working toward a measurable reduction in pollution and the generation of waste. Recognizing that contractors can impact our efforts to protect the environment, a commitment must also be made to mitigate the generation of waste, and more importantly, to ensure the proper disposal of all waste, garbage and hazardous materials that may be generated as a part of a particular repair, upgrade or regulatory-required task on board one of our vessels. To facilitate this process, we attach herewith our form PG-933, Affidavit of Environmental Stewardship, containing PGMs Health, Safety and Environmental Policy, as well as a statement that persons requesting permission to board one of our vessels have read this policy, and agree to comply with same. Additionally, there are statements concerning the disposal of waste, the option for requesting information, and a pledge to be a good steward of the environment and to obey all regulatory requirements. Todays regulatory emphasis on zero tolerance towards pollution does not apply only to ships and their crews; it applies to all who visit and work on ships at all times. We are confident that once you have read the attachment, you will agree that it is to your companys benefit to sign this form and to have your personnel read, understand and act in accordance with the procedures incorporated therein. Kindly review the attached and ensure our form PG-933 and policy is discussed with any of your personnel that you may be sending to work on board one of PGMs vessels. Please complete the bottom of this page, and sign and return a copy as our record that you have read the form and agree with its intent, and have explained it to your personnel, requesting that each one sign the form as they pass through the security at the top of the gangway. Feel free to contact this office with any questions. Thank you for your cooperation in this matter. William Richards Corporate Compliance Manager Office: 504-362-8121 Ext.211 Fax: 504-364-6484 Mobile: 504-289-2517 The undersigned has read PGMs Affidavit of Environmental Stewardship provided to me by Pacific-Gulf Marine, Inc. (PGM) and agree with its content. I will discuss this issue with all personnel that may attend any of the vessels managed by PGM and request them to sign the affidavit as they board the vessel. __________________________________________ ____________________________ Signed Date __________________________________________ ______________________________________ Printed Name & Title Company Form PG-933a (Rev. 1) Oct. 2010     PACIFIC-GULF MARINE, INC. 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Dear XXXXXXX; Title  !"#$%&'()*+-./012356789:;>Root Entry F|3q@Data 1Table"WordDocument4"SummaryInformation(,DocumentSummaryInformation84CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q