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APPLICATION FORM |
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| Name: Sergey | Surname: Bugerya | ||||||
| Date of birth: 25.09.1962 | Place of birth: Ukraine, lugansk | ||||||
| Permanent address: Lugansk, Ukraine | |||||||
| Passport (OVIR): AK860819 | Place of issue: Odessa | Date of issue: 16.11.2005 | Valid until: 16.11.2015 | ||||
| Seaman’s book: AB335456 | Place of issue: Odessa | Date of issue: 05.10.2005 | Valid until: 05.10.2010 | ||||
| Citizenship: Ukrainian | Expiry date of U.S. visa: NO | ||||||
| Marital Status | Divorced | ||||||
| Next of kin: (name, pas. No) | sister - Frolova Olga EM998006 | ||||||
| Supported children under age of 18 | son - Bugerya Ivan 18.03.1996 | ||||||
| (name, surname, date of birth) | |||||||
| Knowledge of English language | Fair | ||||||
| Education: | Qualification: | Date of Issue: | |||||
| Sakhalin Marine College | 3-rd class engineer | 03.10.2005 | |||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 01220 | Odessa |
03.10.2005 |
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| Endorsement STCW | 01220 | Odessa |
03.10.2005 |
13.09.2010 |
| Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1) | 81273 | Odessa |
13.09.2005 |
13.09.2010 |
| Advanced Fire Fighting (A-VI/3) | 39500 | Odessa |
13.09.2005 |
13.09.2010 |
| Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 43501 | Odessa |
14.09.2005 |
14.09.2010 |
| Medical First Aid (A-VI/4-1) | 29065 | Odessa |
13.09.2005 |
13.09.2010 |
| Refresher and updating courses (II/1) | 111054 | Odessa |
13.09.2005 |
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Sea service (during five last years):
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Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| 1. Geroi Shipki | Ukrferry | 20000 | Ukraine | Ferry |
4-th engineer |
01.04.2006 |
17.06.2006 |
| 2. Geroi Shipki | Ukrferry | 20000 | Ukraine | Ferry |
4-th engineer |
29.12.2005 |
15.03.2006 |
| 3. Sakhalin-4 | Sakhalin sh. comp. | 15000 | Russia | Ferry |
4-th engineer |
15.04.2005 |
12.10.2005 |
| 4. Naderibokovaite | Sakhalin sh. comp. | 3000 | Russia | Dry Cargo |
4-th engineer |
05.07.2004 |
01.01.2005 |
| 5. Nakhodka | Sakhalin sh. comp. | 12000 | Russia | Bulker |
4-th engineer |
20.09.2003 |
12.03.2004 |
| 6. Sakhalin-5 | Sakhalin sh. comp. | 15000 | Russia | Ferry |
4-th engineer |
25.12.2002 |
07.06.2003 |
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Automation (A1/A2) |
Main Eng. Maker/Model |
Engine Stroke |
Engine Total HP |
Aux. Engine Maker/Number |
Aux. Engine H.P. / KW |
Unmanned |
Without El.Eng. |
| 1. A2 |
B&W - GF |
900 |
2x8800 |
3 Zulcer |
1180/880 |
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| 2. A2 |
B&W - GF |
900 |
2x8800 |
3 Zulcer |
1180/880 |
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| 3. A2 |
Rus diesel |
610 |
4x2500 |
3 rus diesel |
470/350 |
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| 4. A2 |
NVD |
480 |
1000 |
2 NVD |
540/400 |
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| 5. A2 |
SKL |
630 |
2x4100 |
3 Zulcer |
675/500 |
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| 6. A2 |
Rus diesel |
610 |
4x2500 |
3 rus diesel |
470/350 |
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| Experience at sea: Since 1998 | Knowledge Personal Computer (Yes / No): | |||
| Medical Certificate | ¹ 00781 | Issued: 13.12.2005 | Place: Odessa | Exp.date: 13.12.2006 |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 14.12.2015 | |||