Transport Canada
www.tc.gc.ca
Common menu bar links
Institutional links
Marine Transportation
Browse Marine Resources
Marine Contact Information
Browse By Mode
Browse By Subject
About Us
Application Process
The form provided below allows you to apply for both the Civil Liability Convention (CLC) and Bunkers Convention certificates. There is no cost to industry to apply for either certificate.
-
Form #85-0345
Application For Certificate Of Insurance Or Other Financial Security (PDF Version, 117.5 KB)
The information requested in the form must be typed; however, the form cannot be saved. Handwritten applications will not be accepted. Once completed, please print and fax the form, along with proof of insurance, to the following number: 613-949-4224.
Alternatively, scanned images of the application form and the supporting documents may be emailed to: mi-am@tc.gc.ca.
Your insurer should provide evidence that insurance or other financial guarantee is in place. This evidence is usually in the form of a Blue Card* and should contain the following information:
- Name of Ship
- Distinctive Number or Letters
- IMO Number (Bunkers Convention Certificates only)
- Flag and Port of Registry
- Gross Tonnage
- Name and Address of Owner
- Name and Address of Insurer
- Type of Security
- Duration of Security
*If you do not have a Blue Card, please refer to Frequently Asked Question #9.
Should you require further information, there are two ways you can contact us:
- E-mail: mi-am@tc.gc.ca
- Fax: (613) 949-4224
