Form FMC-150 Information Form for Agreements

FMC Form 150 – Information Form For Filed Agreements

Agreement Name:

List of Agreement Parties and FMC Organization Number(s):

Brief description of Agreement purpose:

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Significant changes expected after the agreement takes effect:

List all authority relied on for the proposition that the proposed agreement is within the scope of
chapter 403 of Title 46 of the U.S. Code:

List of names and FMC Organization Number(s) for all regulated entities that share a parent company
with any agreement party:

For agreements among Vessel Operating Common carriers that the include the authority to discuss or
agree on any kind of rate or charge; rationalize capacity; establish a joint service; pool authority; or
discuss or agree on any service contract matter, include a narrative on anticipated changes to vessel
calls and/or vessel capacity:

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For Marine Terminal Operator agreement parties, list any joint terminal service agreements with vessel
operating common carriers:

Data Attachments required for all agreements subject to Part 535, Subpart E
Vessel Operating Common Carriers
Please complete the VOCC tabs in the Excel template for all VOCC parties to the agreement. The
specific data requirements are based on agreement scope. The “VOCC_Port Calls” tab must be
completed for all VOCC agreement parties.
Agreements that contain the authority to discuss or agree on any kind of rate or charge;
rationalize capacity; establish a joint service; pool authority; or discuss or agree on any service
contract matter are subject to the data requirement for all VOCC spreadsheet tabs. The
attachment submitted with this form must be the FMC-provided Excel template and conform
with the structure and requirements of the template. Other file formats will not be accepted.
Please enter the filename(s) of the data attachment(s) below:

If the agreement parties assert that the agreement does not include the authority to discuss or
agree on any kind of rate or charge; rationalize capacity; establish a joint service; pool authority;
or discuss or agree on any service contract matter, please indicate this in the box below:

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Marine Terminal Operators
Please complete the MTO tabs in the Excel template for all MTO parties to the agreement. The
specific data requirements are based on agreement scope. The “MTO_Overview” tab must be
completed for all MTO agreement parties. For port authorities, this information may be
aggregated across all container terminals.
Agreements that contain the authority to discuss or agree on rates or charges; collectively
allocate or regulate terminal services; establish joint service; or pool or apportion cargo traffic,
earnings, revenues, or losses are subject to the data requirement for all MTO spreadsheet tabs.
The attachment submitted with this form must be the FMC-provided Excel template and
conform with the structure and requirements of the template. Other file formats will not be
accepted.
Please enter the filename(s) of the data attachment(s) below:

If the agreement parties assert that the agreement does not include the authority to discuss or
agree on rates or charges; collectively allocate or regulate terminal services; establish joint
service; or pool or apportion cargo traffic, earnings, revenues, or losses, please indicate this in
the box below:

Documents required for all agreements subject to Part 535, Subpart E
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For entities other than port authorities, submit two years of annual reports, audit reports, or
other financial reports for each agreement party.
For port authorities, submit the most recent annual report and description of marine terminal
operations and governance structure.
All studies, surveys, analyses and reports that were prepared by or for any officer(s), director(s),
or other individuals exercising similar functions, for the purposes of evaluating or analyzing any
activity contemplated under the proposed agreement or modification thereto with respect to
market shares, competition, competitors, markets, potential for growth or expansion into
product or geographic markets. In the alternative, please indicate if no documents responsive to
this request are within the party’s custody, possession, or control.
Please enter the filename(s) of the document attachments(s) below:

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Agreement Party Points of Contact. Please provide information for the point(s) of contact for FMC
communication regarding the agreement.
Contact Information

Contact 1

Name
Title
Business Name
Telephone Number
Email Address
Designee for purpose of
receiving notice of an
issuance of a request for
additional information or
documents (yes/no)

Contact 2 (if
applicable)

Contact 3 (if
applicable)

Certification
This information form, together with attachments thereto, was prepared and assembled in accordance
with instructions issued by the Federal Maritime Commission. This information is, to the best of my
knowledge, true, correct, and complete.

Name
Title
Relationship to agreement parties
Telephone Number
Email address

Signature
Date

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