rally guide 2 appendixes 6 - forms anexos 6 - formularios

Transcrição

1 18/ rally guide 2 appendixes 6 - forms anexos 6 - formularios - tm

2 18/ APPENDIX CONTENTS / ÍNDICE DE ANEXOS Appendix 6 - Forms / Anexo 6 - Formulários Accommodation Form / Formulário de Alojamento 1 Service Park Application Form / Formulário de Pedido Especial Parque de Assistência 2 Application Form Two-Way Radio / Formulário Rádio 3 Reconnaissance Registration Form 4 Registration Form Reconnaissance Only 5 Helicopter Registration Form 6 Additional Plate / Document Order Form 7 Oil Spill Kit Order Form 8 Fuel Order Form WRC 9

3 2017 Accommodation Form / Formulário de Alojamento Team / Equipa Surname / Apelido Country / País Mobile / Telemóvel Name / Nome Fax Hotel Twin / Duplo Arrival / Chegada Pax Single Departure / Partida Basis Credit Card / Cartão de Crédito Visa MasterCard Eurocard American Express Card Nr. / Número Card Holder / Titular Date / Data Good Thru / Validade Amount / Total Signature / Assinatura Please complete this form and return to: Por favor complete este formulario e envie-o para: ACP Viagens paula.rodrigues@acp.pt - Tel

4 Team / Equipa: Drivers / Pilotos: Service Park Application Form / Formulário de Pedido Especial Parque de Assistência Car Make: Marca: Type / Modelo: Group, Class / Grupo, Classe: Type of Entry / Tipo de Inscrição Cross out as appropriate / Assinalar com uma cruz o tipo Reminder / Atenção Size of service area for competitors entered: / Dimensão do espaço de assistência do concorrente inscrito: FIA Priority Driver / Piloto Prioritário FIA Yes / Sim No / Não 10 x 10m (1 Car / 1 Carro) 10 x 20m (2 Cars / 2 carros) Other / Outro Yes / Sim No / Não 10 x 10m (1 Car / 1 Carro) 10 x 15m (2 Cars / 2 carros) For shared service space, please contact: / Para espaços de assistência comuns, contactar: nuno.vieira@acp.pt Competitors are allowed to enter the Service Park from Monday 15 th May at 09:00 Concorrentes são autorizados a entrar no Parque de Assistência a partir de segunda-feira 15 de Maio às 09:00 Service Vehicles / Viaturas de Assistência Make / Marca Type / Modelo Qty / Qtd Length / Width / Registration Nº / Matrícula Layout with dimensions (Mandatory) / Plano do espaço com dimensões (Obrigatório) Facilities requested in the Service Park / Serviços Extra para o Parque de Assistência Event rental / Aluguer para o evento Price / Preço Delivery / Entrega Collect / Recolha Quantity / Quant. Total ADSL + Router 900,00 Tota Single VIP WC / WC VIP 150,00 1 Daily Maintenance / Limpeza diária 25,00 Country WC 2+1 (Trailer / Atrelado) 2.000,00 1 Daily Maintenance / Limpeza diária 325,00 Hospitality water drainage / Vazamento de água (1000L) 325,00 Daily rental / Aluguer diário Price / Preço Transport / Transporte Delivery / Entrega Collect / Recolha Quantity / Quant. Total Fork Lift / Empilhador 2 ton 75,00 200,00 Forklift Telescopic / Empilhador Telescópico 6 mts Forklift Telescopic / Empilhador Telescópico 14 mts 100,00 200,00 120,00 200,00 Scissor Lift / Tesoura 8 mts 60,00 200,00 Articulation Boom Lift / Plataforma Articulada 12 mts 80,00 200,00 Generator / Gerador 100 Kva 100,00 200,00 Other type of equipment contact nuno.vieira@acp.pt Please send this Form with proof of paument before to: Por favor envie este Formulário com comprovativo de pagamento até para: ACP - Motorsport (Automóvel Club Portugal Motorsport Dept.) Rua General Humberto Delgado, nº Prior Velho Portugal Phone / Telefone: , Fax: nuno.vieira@acp.pt

5 2017 Application Form Two-Way Radio / Formulário Rádio 2017 Team / Equipa Contact person for license matters Pessoa de contacto Tel Fax Mobile Requested frequencies / Frequências solicitadas Team address Morada da equipa Full information concerning the address for delivery of the licenses Morada completa para envio das licenças Team Hotel Hotel da Equipa Other Outra Please send this Application to: / Por favor envie este Formulário para: Vítor Guerreiro Direcção Gestão do Espectro by: Fax: vitor.guerreiro@anacom.pt

6 2017 Reconnaissance Registration Form Any driver taking part in reconnaissance must respect the relevant regulations (see 2017 FIA WRC Sporting Regulations and 2017 Rally Vodafone Rally de Portugal Supplementary Regulations). Registration for reconnaissance will take place on Monday 15 th May 2017 between 15:00-21:00 at the Accreditation Centre Exponor. First Driver Co Driver Surname: Name: Postal Address: Date of Birth: Mobile Number: Address: Licence Number: Issuing ASN: Driving Licence Number: Issuing Country: Details of the car Make: Model: Registration Number: Colour: The undersigned acknowledge that they have duly read, understood and agree to be bound by the above terms and conditions: Driver: Co-driver: Date: Date:

7 2017 Registration Form Reconnaissance Only Any driver taking part in reconnaissance must respect the relevant regulations (see 2017 FIA WRC Sporting Regulations and 2017 Rally Vodafone Rally de Portugal Supplementary Regulations). Registration forms must be returned to Vodafone Rally de Portugal Secretariat by Friday 05 th May 2016 the latest. The registration application will only be accepted if accompanied by the «Reconnaissance Only» fees or a receipt issued by the competitor s National Sporting Authority. Registration for reconnaissance will take place on Monday 15 th May 2016 between 15:00-21:00 at the Accreditation Centre Exponor. First Driver Co Driver Surname: Name: Postal Address: Date of Birth: Mobile Number: Address: Licence Number: Issuing ASN: Driving Licence Number: Issuing Country: Details of the car Make: Model: Registration Number: Colour: The undersigned acknowledge that they have duly read, understood and agree to be bound by the above terms and conditions: Driver: Co-driver: Date: Date:

8 2017 Helicopter Registration Form HELICOPTER Helicopter s Registration Type and Make Colours OWNER Company / Name Address Phone OPERATION What will be the use of the Helicopter on the Rally Overnight Parking Location PILOT Name Address (all info will be by ) Address and Phone Address and mobile phone during the event FLYING UNDER CONTRACT FROM Name Address Phone POSSIBILITY FOR PATIENT TRANSPORT: yes: c no: c I, the pilot of the above helicopter, agree to follow the rules notified to me regarding the Rally. SIGNATURE: Payment should be done by Swift bank transfer: Bank: BPI Banco Português de Investimento NIB: Account Nr: IBAN: PT Swift: BBPIPTPL Registration Fee: 2.460,00 (VAT included) - Receipt compulsory - Cheques are not accepted This application form should be completed and forwarded with Entry Fees receipt before: Wednesday 26 th April 2017 Please send this application to: ACP Motorsport (Automóvel Clube de Portugal Motorsport Dept.) Rua General Humberto Delgado, nº Prior Velho Portugal Phone: Fax: nuno.vieira@acp.pt - Website:

9 2017 Additional Plate / Document Order Form Please complete in block capitals Contact Details Contact Name Company / Team Name Tel No Fax No address Postal Address Price Number Required Auxiliary Plate 475,00 Includes 3 Team Passes, 1 Route Map Road Book 100,00 Total Payment Enclosed Please complete this form and return it to: acpmotorsport@acp.pt until the

10 OIL SPILL KIT Order Form Please complete in block capitals Contact Details Contact Name Company / Team Name / Mobile phone no. address Price Number Required Oil Spill Kit 50,00 Total Payment Enclosed: Payment details: Entity ACP - Automóvel Club de Portugal Bank BPI - Banco Português de Investimento BAN IBAN PT SWIFT BBPIPTPL Please complete this form and return it to: acpmotorsport@acp.pt until the Oil Spill Kits will be delivered at the Secretariat at the beginning of the event.

11 FUEL ORDER FORM WRC 2017 RACE: TEAM: DRIVER AND NUMBER 25 LT DRUMS (SHAKE DOWN) PANTA MAX WRC RON 102 FUEL DISPENSED PRICE PER LITRE: 5,00 + VAT PLEASE NOTE THAT: In Italy 22% VAT is applicable to all Competitors. In France 20% VAT is applicable to all Competitors with the exception of French Teams. In Spain 21% VAT is applicable to all Competitors. For all the other European destinations, 22% VAT is applicable only to Private Citizens, Italian Companies and non- European Union Companies. For long haul events no VAT is applicable. DETAILS FOR INVOICING COMPANY NAME VAT CODE ADDRESS CONTACTS STREET CITY POST CODE PHONE FAX MOBILE CONTACT PERSON NAME E.MAIL pag. 1