SCHEDULE 3

(Paragraph 36(2)(b))
DECLARATION FOR A SHIP THAT IS IN WATERS NORTH OF THE 60TH PARALLEL
OF NORTH LATITUDE
Under subparagraph 660.2(2)(c)(i) of the Canada Shipping Act, I declare that, with
respect to pollution insurance coverage, the ship's insurer is:

(Name, address telephone, and fax or telex number)

(Signed by the master or owner)

(Date)