1. Rank applied for: 1st Choice:
Chief Engineer
2nd Choice:
Single Engineer
Personal Data
Surname, First name, Middle Name:
Orloff Valery Vitalievich
Height: 180 cm
11.08.1972
Citizenship:
Weight: 74 kg
Overall Size: 52
89176563548
E-mail:
Shoe Size: 41
Marital Status (Single,Married,Divorced):
Maried
Children/Age:
Collar Size:
Next of Kin (Name/Relation):
Orlova Ekaterina / wife
Cap: 56
Emergency Contact/NOK/ Address:
89877606653
Hair Colour: dark
Nearest Airport/Station:
Cheboksary (domestic)
Eye Colour: brown
Personal ID / Documents/Visa
Type of Document/ID
Country of issue
No.
Issued
Place
Valid until
Seaman's Book (Seafarer's ID)
Russian Fed.
237517
05.12.2013
Murmansk
04/122018
National Passport
Russian Fed.
258 910
05.07.2001
Murmansk
11.08.2017
Travel Passport
Russian Fed.
716 193 154
20.09.2011
Murmansk
20.09.2021
Personal Tax ID
Bank Account Details
US Visa C1/D
Yellow Fever Vaccination
The Netherlands
J5127-10
07.09.2013
Den Helder
07.09.2023
Medical Fitness Certificate
Italy
04.06.2014
Ravenna
04.06.2015
Drug/Alcohol Test
Educational Background ( including pre-sea training )
Name of Schools/Colleges/Institutes
Country/City
From
To
Degree/Diploma/Qualification
Lomonosov Maritime college
Russia/S-Pb.
01.09.1990
21.12.1994
Foreign Language Level
exellent
good
fair
poor
Remarks
English
X
Other
Computer Skills
X
CES 4.1 Test
Marlins Test
Multinational Crew Experience
STCW-78/95 Compliant Certificates/Courses and other Qualifications (National Certificates)
Description of Certificate/Course
Country of Issue
No.
Issued
Place
Valid until
Basic Safety: Personal Survival Techniques
Russian Fed.
345988
17/052012
MSC
17.05.2017
Elementary First Aid
Fire Fighting& Fire Prevention
Personal Safety& Social Resp.
Additional:
Proficiency in Surv.Craft&R.B.
Russian Fed.
255493
24.05.2012
MSC
24.05.2017
Fast Rescue Boat
Advanced Fire Fighting
Russian Fed.
164132
30.05.2012
MSC
30.05.2017
Medical First Aid
Russian Fed.
154559
04.06.2012
MSC
04.06.2017
Designated security duties (A-VI)
Russian Fed.
228834
12.12.2013
MSC
1212/2018
Officer's Certificate of Competency (including Flag State Endorsements)
Country of Issue
No.
Issued
Place
Valid until
First Class Engineer
Russian Fed.
1031103586
11.03.2008
Murmank
01.01.2017
First class Engineer Eendorsement
Italy
SP №13/2012
24.09.2012
S-Peterburg
01.01.2017
GMDSS Certificates ( including Flag State Endorsements )
Other mandatory Certificates / Courses
Country of Issue
No.
Issued
Place
Valid until
ARPA
Marpol/Solas
Radar Simulator ( Deck Officers )
Radar Observing Certificate
ECDIS
Bridge Team/Resource Management
HAZMAT (US-49CFR)
Shiphandling/Ship Manoeuvering Simulator
Safety Officer Certificate ( ISM Code )
Shipboard Security Officer ( ISPS Code )
Engine Room Simulator ( Engineers )
Electronic & Electrical Maintenance
Photo
Ship's Engineer III class
Orlova Olga - 10
Orlova Polina - 3
94%
Date of Birth:
23 Chernyshevskogo-str.apt.16, Cheboksary, Russian Federation
Permanent Address:
Contact phones:
Rus.
lerio755V@yandex.ru
Page 1 of 2

2. Engine Team Management
Special Requirements for Tankers
Country of Issue
No.
Issued
Place
Valid until
Tanker Endorsement-Oil/Chem/Gas
Oil Tanker Familiarization Course
Crude Oil Washing/Inert Gas/Specialized
Chem.Tanker Familiarization Course
Specialized Chem.Tanker Training Program
Liquified Gas Tanker Familiarization Course
Specialized Liq.Gas Tanker Training Progr.
Special Tanker Safety- Oil/Chem/Gas
Sea Experience ( last 10 years,starting with the most recent )
DD/MM/YY
Months
Vessel Name & Flag
GRT/DWT
Engine
kw/bhp
Position/Rank
from/to:
Onboard
Owner/Operator
29.04.2014 / 15.07.2014
2,5
VOS Hestia/Italy/Vroon Italy Srl
2009 / AHTS
1578
2 x Catepillar 3516B
3940kw/ 5280
Chief Engineer
28.01.2014 / 13.03.2014
1
VOS Hera/Italy/Vroon Italy Srl
2009 / AHTS
1578
2 x Catepillar 3516B
3940kw/ 5280
Chief Engineer
16.08.2013 / 15.11.2013
3
VOS Hera/Italy/Vroon Italy Srl
2009 / AHTS
1578
2 x Catepillar 3516B
3940kw/ 5280
Chief Engineer
14.03.2013 / 16.05.2013
2
Statia Star/Italy/Somara SAS
2008/Tug boat
490
2 x Wartsilaa 9L20
3600kW/ 2686bhp
Chief Engineer
05.11.2012 / 10.01.2013
2
Statia Star/Italy/Somara SAS
2008/Tug boat
490
2 x Wartsilaa 9L20
3600kW/ 2686bhp
Chief Engineer
28.09.2012 / 25.10.2012
1
MCS Zara/UK/Maritime Craft Services
2005/ Tug boat
139
Caterpillar 3412
2238kW/ 3000bhp
Single Engineer
25.07.2012 / 28.08.2012
1
Statia Star/Italy/Somara SAS
2008/ Tug boat
490
2 x Wartsilaa 9L20
3600kW/ 2686bhp
Chief Engineer
22.03.2012 / 02.05.2012
1,5
MCS Gemma / UK/ Maritime Craft Services
2011/ Tug boat
167
3 x Caterpillar 3412
1791kW/ 2400Bhp
Single Engineer
24.01.2012 / 23.02.2012
1
MCS Ailsa /UK/ Maritime Craft Services
1996/ Tug
479
2 x Caterpillar 3508
1640kW/ 2200bhp
Single Engineer
02.10.2011 / 16/11/2011
1,5
Avon / Cyprus/ Royal Boskalis
1978/ Split hopper barge
1543
2 x Blackstone
1500kW/ 2010bhp
Chief Engineer
28.06.2011 / 10.08.2011
1,5
Avon / Cyprus/ Royal Boskalis
1978/ Split hopper barge
1543
2 x Blackstone
1500kW/ 2010bhp
Chief Engineer
09.04.2011 / 18.05.2011
1,5
Avon / Cyprus/ Royal Boskalis
1978/ Split hopper barge
1543
2 x Blackstone
1500kW/ 2010bhp
Chief Engineer
19.11.2010 / 28/01/2011
2
Frisian Summer / Dutch/ Bumsms Shipping
2008/ Gen.cargo
4087 GRT
ME Wartsila 6L26
2040kW/ 2773Bhp
Chief Engineer
20.04.2010 / 12.07.2010
2,5
Citadel / Dutch/ Flinter Menagement
2008/ Gen.cargo
3990/ 6000
MaK 8M25
2640kW/ 3537
Chief Engineer
11.11.2009 / 13.01.2010
2
Transwing/ Dutch/ KVB Moerman BV
Gen.cargo
3990/ 6000
MAK 8M25
2640kW/ 3537
Single Engineer
15.04.2009/ 11.08.2009
4
UAL Tycoon/ Ned.Antilles/
2008/ Deck cargo
1681/ 2310
Cummins KTA 38-M2
2014kW/ 2698Bhp
Chief Engineer
11.11.2008/ 13/01/2009
2
Flinter Bothnia/ Dutch/ Flinter Groningen
2004/ Gen.cargo
2474/
MaK 6M25
1850kW/ 2479
Single Engineer
04.06.2008/ 16.09.2008
3
Flinter Bothnia/ Dutch/ Flinter Groningen
2004/ Gen.cargo
2474/
MaK 6M25
1850kW/ 2479
Single Engineer
04.01.2008/ 21.02.2008
1,5
Colee Tide/ Vanuatu/ Tidewater
AHTS
2 x EMD 16- 645C
2910kW/ 3900
Chief Engineer
28.06.2007/ 06.10.2007
3,5
Gulf Fleet 68/Vanuatu/ Tidewater
AHTS
486
2 x EMD 16- 645C
2910kW/ 3900
Chief Engineer
12.12.2006/ 17.04.2007
4
Hanseatic Star/ Gibraltar/ Norregarde Marstal
1985/ Gen.cargo
1590/ 1738
TBD 440-6K
Single Engineer
03.03.2006/ 23.07.2006
4
Bella/ St.Vincent/ Rivmar navigation
Gen.cargo
998
Caterpillar 3512DITA
876bhp
Single Engineer
05.07.2005/ 25.12.2005
6
Artemis/ St.Vinc./ Rivmar navigation
Gen.cargo
998
Caterpillar 3512DITA
876bhp
Single Engineer
Give Details below of two recent Employers who we may contact for references:
Name of Ship Owner / Crewing Agent
1.
Ship's Personnel Menagement Group Lv
2.
Lowland International Lv
Name of Person to contact
1.
Marina Potapchuk
2.
Andrey Tatarinov
Address
1.
Maskavas str.17/19, Riga, Latvia
2.
Kugu str.26-90, Riga LV1048, Latvia
Telephone
1.
3 7 1 6 7 2 1 0 0 2 6
2.
3 7 1 6 7 9 6 9 7 6 9
I hereby affirm that all information provided by me in this Form is true and correct and I understand that my
working contract will be cancelled without notifying if any of submitted information and documents are voted
as false.
Place:
Cheboksary
Date:
29.08.2014
Signature:
Year of built Type
Page 2 of 2