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anexos 3 - formularios appendixes 3 - forms
-
rally guide 1www.rallydeportugal.pt
17/20 MAIO 201817/20 MAIO 2018
tm
2018 Accommodation Form / Formulário de Alojamento
Hotel
Twin / Duplo Arrival / Chegada Pax
Single Departure / Partida Basis
Credit Card / Cartão de Crédito
Visa MasterCard Eurocard American Express
Please complete this form and return to: Por favor complete este formulario e envie-o para:
ACP Viagens
e-mail: [email protected] - Tel. + 351 21 384 1072
Team / Equipa
Surname / Apelido Name / Nome
Country / País Fax
Mobile / Telemóvel e-mail
Card Nr. / Número
Good Thru / Validade
Card Holder / Titular
Amount / Total €
Date / Data Signature /
Assinatura
ACP – Viagens e Turismo, Lda. Rua Rosa Araújo, 24 - 1250-195 Lisboa
Tel: 21 351 38 30 [email protected] www.acp.pt/viagens Contribuinte nº 501179488 Capital Social 199.519,16€ R.C.L.nº 1499 RNT 1859
VODAFONERALLYDEPORTUGALHOTELACCOMMODATION/ALOJAMENTO
17–20.05.2018 Location
LocalCategoryCategoria
TwinDuplo
SingleIndividual
CROWNEPLAZAPORTO Porto 5 191€ 182€BESSABOAVISTA Porto 4 155€ 144€URBANAMADEOS Matosinhos 3 120€ 108€
PARKPORTOAEROPORTO Porto 2 87€ 79€PARKPORTOGAIA V.N.Gaia 2 71€ 63€
Conditions/Condições:
Allpricesareperroompernightincludingbreakfastandtaxes.AllreservationsmustberequestedtoACPViagensbyemailtopaula.rodrigues@acp.pt
Paymentscanbemadebybanktransferorcreditcard.
Todosospreçossãoporquartoenoite,incluindopequeno-almoçoetaxas.TodasasreservastêmdesersolicitadasaoACPViagensporemailpara:[email protected]
Opagamentopodeserfeitoportransferênciabancáriaoucartãodecrédito.
Paymentandcancellationconditions/Condiçõesdepagamentoecancelamento:
Payment/Pagamento:
40%depositwithconfirmation/comaconfirmação+40%until16February/até17deFevereiro
+20%until16March/até17deMarço
Changes/Cancellation/Alterações/Cancelamento:Changesand/orcancellationsdependontherulesofeachhotel/Qualqueralteraçãoe/ou
cancelamentodependedasregrasdecadahotel.
Service Park Application Form / Formulário de Pedido Especial Parque de Assistência
Team / Equipa:
Drivers / Pilotos:
Car Make:
Marca:
Type / Modelo:
Group, Class / Grupo, Classe:
Type of Entry / Tipo de Inscrição FIA Priority Driver / Piloto
Prioritário FIA
Yes / Sim – No / Não
Other / Outro
Yes / Sim – No / Não 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:
10 x 10m (1 Car / 1 Carro)
10 x 20m (2 Cars / 2 carros)
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: [email protected]
Competitors are allowed to enter the Service Park from Monday 14th May at 09:00
Concorrentes são autorizados a entrar no Parque de Assistência a partir de segunda-feira 14 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
Tota ADSL + Router 1100,00€
Single VIP WC / WC VIP 175,00€
1 Daily Maintenance / Limpeza diária 30,00€
Country WC 2+1 (Trailer / Atrelado) 2.250,00€
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 and Collect)
Delivery / Entrega Collect / Recolha Quantity / Quant. Total
Fork Lift / Empilhador 2 ton 80,00€ 240,00 €
Forklift Telescopic / Empilhador Telescópico 6 mts
110,00 € 240,00 €
Forklift Telescopic / Empilhador Telescópico 14 mts
120,00 € 240,00 €
Scissor Lift / Tesoura 8 mts 65,00 € 240,00 €
Articulation Boom Lift / Plataforma Articulada 12 mts
90,00 € 240,00 €
Generator / Gerador 100 Kva 120,00 € 240,00 €
Other type of equipment contact [email protected] Please send this Form with proof of paument before 30.04.2018 to: Por favor envie este Formulário com comprovativo de pagamento até 30.04.2018 para: ACP - Motorsport (Automóvel Club Portugal – Motorsport Dept.) Rua General Humberto Delgado, nº3 – 2685-340 Prior Velho – Portugal Phone / Telefone: +351 21 942 91 87, Fax: +351 21 942 91 92 – Email: [email protected]
2018 Application Form Two-Way Radio / Formulário Rádio 2018
Team / Equipa
Contact person for license matters Pessoa de contacto
Tel Fax
e-mail Mobile
Requested frequencies / Frequências solicitadas
Full information concerning the address for delivery of the licenses Morada completa para envio das licenças
Team address Morada da equipa
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: + 351 21 721 10 06 E-mail: [email protected]
2018 Reconnaissance Registration Form
Any driver taking part in reconnaissance must respect the relevant regulations (see 2018 FIA WRC Sporting Regulations and 2018 Rally Vodafone Rally de Portugal Supplementary Regulations). Registration for reconnaissance will take place on Monday 14th May 2018 between 15:00 -21:00 at the Accreditation Centre – Exponor.
First Driver Co Driver
Surname:
Name:
Postal Address:
Date of Birth:
Mobile Number:
Email Address:
Licence Number:
Issuing ASN:
Driving Licence Number:
Issuing Country:
Details of the car
Make: Registration Number:
Model: Colour:
The undersigned acknowledge that they have duly read, understood and agree to be bound by the above terms and conditions:
Driver: Date:
Co-driver: Date:
2018 Registration Form Reconnaissance Only
Any driver taking part in reconnaissance must respect the relevant regulations (see 2018 FIA WRC
Sporting Regulations and 2018 Rally Vodafone Rally de Portugal Supplementary Regulations).
Registration forms must be returned to Vodafone Rally de Portugal Secretariat by Friday 04th May 2018
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 14th May 2018 between 15:00 -21:00 at the
Accreditation Centre – Exponor.
First Driver Co Driver
Surname:
Name:
Postal Address:
Date of Birth:
Mobile Number:
Email Address:
Licence Number:
Issuing ASN:
Driving Licence Number:
Issuing Country:
Details of the car
Make: Registration Number:
Model: Colour:
The undersigned acknowledge that they have duly read, understood and agree to be bound by the above terms and conditions:
Driver: Date:
Co-driver: Date:
2018 Helicopter Registration Form
POSSIBILITY FOR PATIENT TRANSPORT: yes: c no: cI, the pilot of the above helicopter, agree to follow the rules notified to me regarding the Rally.
SIGNATURE:
HELICOPTER OWNER
Helicopter’s Registration
Company / Name
Type and Make Address
Colours Phone
OPERATION
What will be the use of the
Helicopter on the Rally
Overnight Parking Location
PILOT
Name
E-mail Address (all info will be by e-mail)
Address and Phone
Address and mobile phone during the event
FLYING UNDER CONTRACT FROM
Name
Address
Phone
Payment should be done by Swift bank transfer:
Bank: BPI – Banco Português de Investimento NIB: 0010 0000 26738780006 57 Account Nr: 3-2673878.000.006 IBAN: PT50 0010 0000 2673 8780 0065 7 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: Tuesday 24th April 2018 Please send this application to: ACP – Motorsport (Automóvel Clube de Portugal – Motorsport Dept.) Rua General Humberto Delgado, nº3 2685-340 Prior Velho – Portugal Phone: +351 21 942 9187 - Fax: +351 21 942 9192
Email: [email protected] - Website: www.rallydeportugal.pt
2018 Additional Plate / Document Order Form
Please complete in block capitals
Contact Details
Contact Name
Company / Team Name
Tel No Fax No
Email address
Postal Address
Price Number Required
Auxiliary Plate 500,00 € Includes 3 Team Passes, 1 Route Map
Road Book 100,00 €
Total Payment Enclosed
Please complete this form and return it to: [email protected] until the 30.04.2018
OIL SPILL KIT Order Form
Please complete in block capitals
Contact Details
Contact Name
Company / Team Name /
Mobile phone no.
Email 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 0010 0000 26738780013 36
IBAN PT50001000002673878001336
SWIFT BBPIPTPL
Please complete this form and return it to: [email protected]
until the 01.05.2017. Oil Spill Kits will be delivered at the Secretariat at the beginning of the event.
pag. 1
FUEL ORDER FORM WRC 2018
RACE:_____________________________
TEAM:_____________________________
DRIVER AND NUMBER PANTA MAX WRC RON 102
25 LT DRUMS
(SHAKE DOWN) 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 STREET CITY POST CODE
CONTACTS PHONE
FAX MOBILE
CONTACT
PERSON
NAME E.MAIL
pag. 2
PAYMENT
� Bank transfer
( please attach a copy) � Credit Card (only VISA or MASTERCARD)
Account Owner:
PANTA DISTRIBUZIONE S.p.A.
Bank:
BANCA POPOLARE DI SONDRIO
IBAN Code:
IT58U0569620300000002103X34
BIC=SWIFT CODE: POSOIT22
Number:
Expiry date:
Holder:
Signature:
DEADLINES
EUROPEAN EVENTS: 2 WEEKS BEFORE THE EVENT
LONG HAUL EVENTS: 6 WEEKS BEFORE THE EVENTS
AFTER DEADLINES THE ORDERS ARE NOT GUARANTEE
PLEASE RETURN THIS FORM TO:
FAX 0039 0373 235156
For further information please do not hesitate to contact us
[email protected] Tel. 0039 0373 235141
[email protected] Tel. 0039 0373 235159
[email protected] Tel. 0039 0373 235142
