BAYPORT Berth Application

Date of Application*
Date Format: MM slash DD slash YYYY
Vessel/Barge Name*
Voyage*
Call Sign*
Flag*
L.O.A.*
Max Air Draft This Call (ft & in.)*
Beam*
Vessel Owner / Operator / Charterer / Line*
Max Draft This Call (ft. & In.)*
P&I Local Contact*
Lloyd's Number*
P&I Club
Estimated Boarding Date*
Estimated Boarding Hour*
Estimated Departure Date*
Estimated Departure Hour*
Will you be loading bulk liquids?*
- Yes
- No
Berth Requested*
Appointed Stevedore*
Inbound Cargo Commodity*
Inbound Tonnage*
Outbound Cargo Commodity*
Layberth*
- Yes
- No
Fresh Water*
- Yes
- No
Lighter*
- Yes
- No
Bunker Tonnage / Barrels*
Fresh Water*
Layberth*
Lighter*
Name of representative submitting application*
Name of agent assigned to vessel*
Vessel Agent Phone*
Applicant Company Name*
Billing Address
Contact Email Address*
*
- THE UNDERSIGNED COMPANY, AGENTS FOR THE ABOVE-NAMED VESSEL OR BARGE, IN CONSIDERATION FOR APPROVAL OF THE BERTH APPLICATION, AGREES TO BE BOUND AND REPRESENTS THAT ALL “USERS” AS DEFINED IN THE PORT OF HOUSTON AUTHORITY TARIFFS, FOR WHICH IT HOLDS ITSELF OUT AS AGENTS OR ACTS AS AGENTS, AGREE TO BE BOUND BY ALL RULES, REGULATIONS, TERMS, CONDITIONS AND CHARGES AS PUBLISHED IN THE PORT OF HOUSTON AUTHORITY TARIFF(S), INCLUDING ACCEPTANCE OF FINANCIAL RESPONSIBILITY THEREFOR.
Name
This field is for validation purposes and should be left unchanged.