GENERAL AVERAGE FOR ENGINE FIRE ACCIDENT ABOARD "MV  _________ VOY. ___ ON _____________ We are the time charterers of the MV __________ and understand that you have shipping cargo onboard that vessel. We wish to inform you that an engine fire accident occurred on board the vessel on ___________after she sailed Tokyo for Los Angeles. ______Shipping Co., Inc., the owners of the vessel declared General Average on _____________. Enclosed is a letter from the vessel's owners, the contents of which should be self explanatory. As described in the attached letter, the owners nominated ____ as its Average Adjusters and we, as time charterers, were requested in the U.S. and Canada to perform the collection of necessary documents required by the adjuster, the blank forms for some of which are enclosed herewith and are; 1. Average Bond with Non separation  Agreement (NOTE 1) .................... 1 set 2. Valuation Form (NOTE 2) ............... 1 set   NOTE 1: Average bond is the agreement between owners of the vessel and consignees regarding the general average and  the contribution of G.A. expenditure and sacrifice. Non separation agreement is the agreement between owners and consignees in which it is agreed that cargo,  which is carried to the destination by a substitute vessel, is deemed to have been carried by the original vessel in the adjustment of General Average. NOTE 2: In case consignees cannot submit a copy of Commercial Invoice, consignees are requested to state CIF cargo value by utilizing this Valuation Form. The documents which the adjuster of G.A. needs to collect are; (a) Average bonds with Non-separation Agreement............ 1 set (b) Commercial Invoice copy  1 set      (If not available, Valuation Form shall be used instead) (c) Unlimited Letter of Guarantee signed by Cargo Underwriters (NOTE 3) ............................1 set NOTE 3: If the cargo was not insured, or if the above Letter of Guarantee cannot be submitted, a cash deposit may be acceptable. We would request you send the above mentioned documents or substitutes back to the following office: (time charterers) Address: We have also enclosed herewith the samples of relevant documents, which are; sample   A: AVERAGE BOND sample   B: VALUATION'FORM sample C1: LETTER OF GUARANTEE (AVERAGE GUARANTEE) sample C2: CASH DEPOSIT FORM (GENERAL AVERAGE DEPOSIT RECEIPT) If you have   any further question, please send it to the above department by a fax. The vessel now is being towed by a tug boat and is presently scheduled to arrive at Los Angeles on or around ___________. It is our great regret to have to inform you of this inconvenience. Sincerely, Time charterer Click here to view a non separation agreement _ _ _ _ _ _  _ _ _ _ _ _ _ _ _ _ _ _ Sample A Messrs. Aurora Shipping cq., Inc.                                    Owner(s) of the M/V "KUROBE"                                       Voyage and date  No.  30 December 1989 - Janury  1990                       Port of shiprnent   Tokyo, Japan                                   Port of destination/discharge  Los Angeles, CA, U.S.A.                     Bill of Lading or waybill number(s)  NYKSxxxxxxxxx, NYKxxxxxxxx,NYXSxxxxxx:        NYKSxxxxxxxxx Ouantity and description of goods (EXAMPLE) 550 cartons of T.V. sets In consideration of the delivery to us or to our order, on payment of the freight due, of the goods noted above we agree to pay the proper proportion of any salvage andior general average and/or special charges which may hereafter be ascertained to be due from the Foods or the shippers or ownors thereof under an adjustment prepared in accordance with the provisions of the contract of affreightment governing the carriage of the goods or, failing any such provision, in accordance with the law andpractice of the place where the common maritime adventure ended and which is payable in respect of the goods by the shippers or owners thereof. We also agree to: (i) furnish particulars of the velue of the goods, supported by a copy of the commercial invoice, rendered to us or, if there is no such invoice, details of the shipped value and (ii) make a payment on account of such sum as is duty certified by the average adjusters to be due from the goods and which is payable in respect of the goods by the shippers or owners thereof. it is agreed that in the evetit of the vessel's cargo or part thercof being forwarded to original destination by other vessel, vessels or conveyances, rights, and liabilities in general average shall not be affected by such forwarding, it being the intention to place the parties concerned as nearly as possible in the same position In this respect as they would have been in the abience of such forwarding and with the adventure continiiing by the original vessel for so long as justifiable under the law applicable or under the Contract of Affreightment. The basis of contribution to generai average of the property involved shall be the values on delivery at original destination unless sold or otherwise disposed of short of that destination but where none of her cargo is carried forward in the vessel she shall contribute on the basis of her actual value on the date she completes discharge of her cargo. Date January XX 1990     Signature of receiver of goods   (SIGNATURE)                  Full finme and address   ABC Co., Ltd. / (Address)