CG-2736 (Rev.5-96)
MODEL NUMBER - Enter the engine(s) model number(s)
YEAR - Enter the year the engine(s) was (were) installed in the vessel.
HORSEPOWER - Enter the total horsepower of the engine(s).
TYPE FUEL - Enter the type of fuel the engine(s) require, (example: gasoline or diesel).
FUEL CAPACITY - Enter the total fuel capacity in U.S. gallons.
AUX. GENERATOR MFG. - If auxiliary generator is installed, indicate the
manufacturer's name. If no auxiliary generator is installed, indicate "Not
Applicable" or N/A.
MODEL NUMBER - Enter the model number of the auxiliary generator.
K.W. CAPACITY - Enter the output in kilowafts of the auxiliary generator.
VOLTAGE(S) - Enter the voltage and type (AC/DC) of the auxiliary generator
FUEL CONSUMPTION - Indicate the fuel consumption per hour and speed in knots
for economical, cruise, and maximum.
(NOTE: ONE (1) KNOT = 1.15 STATUTE MILES PER HOUR.)
NAVIGATION EQUIPMENT - Enter the manufacturer and model number for the
navigational equipment.
RADIO EQUIP - Enter manufacturer's name, model number, output in watts, and
government channels/frequencies available for the radio equipment. If
synthesized, so state in lieu of listing all frequencies. (NOTE: Indications
such as Channel 16, Channel 83, etc. is acceptable.)
OTHER SPECIAL EQUIP - In the space provided list other equipment or attach a
separate sheet that lists other special equipment, if necessary. (Example:
EPIRB, strobe light, inflatable life raft, cell phone, CB radios, etc).
TOTAL VALUE OF VESSEL - Enter the total fair market value of the vessel and
all of its equipment. If the vessel and all of the equipment is new enter
the cost price.
VALUE-HULL - Enter the fair market value of the hull. If the vessel is new
enter the cost price.
VALUE-MACHINERY - Enter the fair market value of the vessel's engine(s),
auxiliary generator, and any other machinery installed on the vessel. If they
are all new, enter the cost price.
VALUE-ELECTRONICS - Enter the fair market value of all radios, depthfinders,
radar, etc. installed on the vessel. If all are new, enter the cost price.
VALUE-OTHER EQUIP - Enter the fair market value of all other equipment
installed in the vessel. (example: life raft, boathooks, anchors, etc.) If
all are new, enter the cost price.
(NOTE: The sum total of the values of the hull, machinery, electronics, and
other equipment cannot exceed the total value listed for the vessel.)
SECTION III- OWNER, STATEMENT AND SIGNATURE
Check the appropriate box but be sure you fully understand the statements before checking
thestatement which best describes the owner's intentions on the OFFER FOR USE. Any
question(s) should be answered to the owner's(s) complete satisfaction prior to signing
and dating the form. For corporate owned facilities, the appropriate designated officer
of the corporation is to sign as the owner. Remember, before any facility can be
accepted for use, ALL appropriate information must be provided to and approved by the
director.
SECTION IV - VE's ENDORSEMENT (To be completed by VE only).
Check the appropriate boxes.
If facility does not meet requirements, return VE signed form to owner - don't
forward to director for signature.
Enter date of inspection. Enter your member number.
Print VE name and sign the form.
Give Copy 2 to owner and, if requirements met, forward remaining copies to director.
SECTION V - DIRAUX ENDORSEMENT (To be completed by director only).
Make sure required documents are attached before checking box or signing.
Check the appropriate boxes.
Confirm (or issue) district call sign in Section I
Sign and date the form.
Forward Copy I to owner and, if accepted, forward Copy 3 to AUXMIS Input site.
SECTION VI - CME and Additional Federal Requirements (completed by VE only).
Check the appropriate boxes.
SECTION VII - Requirements for an Auxiliary Facility (Non-operational). (To be
completed by VE only).
Check the appropriate boxes.
Items marked by an asterisk (*) are recommended but may be waived by the
district commander.
SECTION VIII - Requirements for an Operational Auxiliary Facility. (To be
completed by VE only).
Check the appropriate boxes.
Items marked by an asterisk (*) are recommended but may be waived by the
district commander.
Attach required district requirements check-off list. (see item #31)
Make sure required documents are attached. See Section I instructions.
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