LayBerth Request Form

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(*) - Required Fields.

Vessel Information

Berth Desired

Vessel

Vessel Owner/Line

Vessel Charterer

Agency Agent

Authorized Individual

Voyage No.

LOA (ft.)

Vessel Draft (ft.)

ETA

ETD

Note 1: This Layberth Request/Application for Berth Reservation, and any vessel granted a berth pursuant hereto, is subject to all provisions of the Port's current Marine Terminal Tariff (available at http://portofportland.com/Marine/Tariff) ("Tariff"), including without limitation all terms, conditions, rates, charges, rules and regulations contained in the Tariff. Without limitation, each vessel owner/line, or operator or charterer, ocean carrier (whether vessel operating or non-vessel operating), stevedore, and other applicant hereunder shall be deemed a Facility User under the Tariff.

Note 2: Failure to provide a work plan (if applicable) and to timely provide a Statement of Financial Responsibility in the form as set forth in the Tariff, may result in the Layberth Request/Application for Berth Reservation being deemed incomplete. Each Layberth Request, Statement of Financial Responsibility, and work plan, if applicable, will be reviewed by the Port on a case-by-case basis to determine whether, in the Port’s judgment, the applicant is financially responsible and has demonstrated that any work will be performed in compliance with environmental standards. The Port reserves the right to deny permission to berth or perform any work; to order the discontinuance of work altogether, or stop a particular job, as the Port determines is necessary.

Note 3: This request form may only be submitted in connection with Layberth requests. For requests involving a working berth, please submit an Application for Berth Reservation in the form attached to the Port’s Tariff.

Supplement to Application for Vessel Berth Reservation

Select Category of port charges

Man-Hour/Equiptment Rental

Utilities

Other

Requester Information

Pursuant to the instructions in Part I Section 18 of the Tariff, the undersigned hereby seeks the arrangement of berthing facilities on behalf of the above-named vessel, represents and warrants that they are duly authorized to execute this application on behalf of the vessel, and attests to the accuracy of the information provided to the extent set forth in Part I Section 18 of the Tariff.

Name

E-Mail

Phone

Cost Preview

Category of Port Charges	Estimated Dollar Amount
Dockage - Layberth	$- For lay berth purposes, to qualify for 25% of the regular dockage rate the vessel must be idle at a non-working berth. A vessel may be permitted to moor at idle port marine terminal berths when such berths are available. Lay status for non-working berths must be submitted by agent to the Port Operations Director or their designee prior to vessel arrival on berth.
Vessel Security Fees	$-
MFSA Fee	$-
Total Estimated Charges:	$0
Additional Notes