rally guide 1 - WRC Vodafone Rally de Portugal 19 a 22 de Maio 2016

19/22.05.2016
rally guide 1
www.rallydeportugal.pt
anexos 3 - formularios
appendixes 3 - forms
2016 Accom m odation Form / Form ulário de Alojam ento
Team / Equipa
Surname / Apelido
Name / Nome
Country / País
Fax
Mobile / Telemóvel
e-mail
Hotel
Twin / Duplo
Arrival / Chegada
Pax
Single
Departure / Partida
Basis
Credit Card / Cartão de Crédito
Visa
MasterCard
Eurocard
Card Nr. /
Número
Good Thru /
Validade
Card Holder /
Titular
Amount /
Total
Date / Data
Signature /
Assinatura
Please complete this form and return to:
Por favor complete este formulario e envie-o para:
ACP Viagens
e-mail: paula.rodrigues@acp.pt - Tel. + 351 21 384 1072
American Express
VODAFONE RALLY DE PORTUGAL
HOTEL ACCOMMODATION / ALOJAMENTO
19 – 22.05.2016
Hotel
Location
Local
Category
Estrelas
Crowne Plaza Porto Hotel
Porto
5
125
Porto Palácio Congress Hotel & Spa
Porto
5
165
150
Sheraton Porto Hotel & Spa
Porto
5
135
120
Belver Beta Porto Hotel
Porto
4
98
86
Bessa Porto Hotel
Porto
4
Musica Hotel
Porto
4
Amadeos Hotel
Matosinhos
3
74
Star Inn Porto Hotel
Porto
3
58
52
Park Hotel Porto Aeroporto
Porto
2
85
80
2
62
55
Park Hotel Porto Gaia
Twin
110
102
133
92
(*)
!
Conditions / Condições:
All prices are per room per night including breakfast and taxes.
All reservations must be requested to ACP Viagens by email to: paula.rodrigues@acp.pt
Payment can be made by bank transfer or credit card.
Todos os preços são por quarto e noite, incluindo pequeno-almoço e taxas.
Todas as reservas têm de ser solicitadas ao ACP Viagens por e-mail para: paula.rodrigues@acp.pt
O pagamento pode ser feito por transferência bancária, ou cartão de crédito
Payment and cancellation conditions / Condições de pagamento e cancelamento:
Payment / Pagamento:
40% deposit with confirmation / com a confirmação
+ 40% until 19 February / até 19 de Fevereiro
+ 20% until 18 March / até 18 de Março
Changes/Cancellation / Alterações/Cancelamento:
Cancellation and changes policies may vary depending on hotel rules and dates of the request. / As políticas de
alteração/cancelamento podem variar dependendo do hotel e datas solicitados.
ACP – Viagens e Turismo, Lda.
Rua Rosa Araújo, 24 - 1250-195 Lisboa
Tel: 21 351 38 30 geral@acp-viagens.pt www.acp.pt/viagens
Contribuinte nº 501179488 Capital Social 199.519,16 R.C.L.nº 1499 RNT 1859
Single
122
68
Service Park Application Form / Formulário de Pedido Especial Parque de Assistência
Team / Equipa:
Drivers / Pilotos:
Car Make:
Marca:
Type / Modelo:
Group, Class / Grupo, Classe:
FIA Priority Driver / Piloto
Prioritário FIA
Type of Entry / Tipo de Inscrição
Cross out as appropriate / Assinalar com uma cruz o tipo
Yes / Sim – No / Não
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)
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
th
Competitors are allowed to enter the Service Park from Monday 16 May at 09:00
Concorrentes são autorizados a entrar no Parque de Assistência a partir de segunda-feira 16 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
ADSL + Router
900,00€
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
325,00€
(1000L)
Daily rental / Aluguer diário
Price / Preço Transport / Transporte
Fork Lift / Empilhador 2 ton
75,00€
200,00 €
Forklift Telescopic / Empilhador
Telescópico 6 mts
100,00 €
200,00 €
Forklift Telescopic / Empilhador
Telescópico 14 mts
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 €
Delivery / Entrega Collect / Recolha Quantity / Quant.
Total
Tota
Delivery / Entrega Collect / Recolha Quantity / Quant.
Total
Other type of equipment contact nuno.vieira@acp.pt
Please send this Form with proof of payment before 01.05.2016 to:
Por favor envie este Formulário com comprovativo de pagamento até 01.05.2016 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: nuno.vieira@acp.pt
!
!
2016 Application Form Two-Way Radio / Formulário Rádio 2016
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: vitor.guerreiro@anacom.pt
2016 Reconnaissance Registration Form
Any driver taking part in reconnaissance must respect the relevant regulations (see 2016 FIA WRC
Sporting Regulations and 2016 Rally Vodafone Rally de Portugal Supplementary Regulations).
Registration for reconnaissance will take place on Monday 16th May 2016 between 15:00 -21:00 at the
Accreditation Centre – Rally HQ (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:
2016 Registration Form Reconnaissance Only
Any driver taking part in reconnaissance must respect the relevant regulations (see 2016 FIA WRC Sporting
Regulations and 2016 Rally Vodafone Rally de Portugal Supplementary Regulations).
Registration forms must be returned to Vodafone Rally de Portugal Secretariat by Friday 06th 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 16th May 2016 between 15:00 -21:00 at the
Accreditation Centre – Rally HQ (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:
!
!
!
!
2016 Helicopter Registration Form
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
POSSIBILITY FOR PATIENT TRANSPORT:
yes: !
no: !!
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: 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
- Receipt compulsory
- Cheques are not accepted
(VAT included)
This application form should be completed and forwarded
with Entry Fees receipt before: Wednesday 27 t h April
2016
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: nuno.vieira@acp.pt - Website: www.rallydeportugal.pt
2016 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
Auxiliary Plate
475,00
Road Book
100,00
Number Required
Includes 3 Service Passes, 1 Route Map
Total Payment Enclosed
Please complete this form and return it to: acpmotorsport@acp.pt
until the 01.05.2016
FUEL ORDER FORM WRC 2016
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 nonEuropean Union Companies.
For long haul events no VAT is applicable.
DETAILS FOR INVOICING
COMPANY NAME
VAT CODE
ADDRESS
CONTACTS
CONTACT
PERSON
STREET
PHONE
NAME
CITY
POST CODE
FAX
MOBILE
E.MAIL
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PAYMENT
! Bank transfer
( please attach a copy)
Account Owner:
PANTA DISTRIBUZIONE S.p.A.
Bank:
BANCA POPOLARE DI SONDRIO
IBAN Code:
IT58U0569620300000002103X34
BIC=SWIFT CODE: POSOIT22
! Credit Card (only VISA or MASTERCARD)
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:
fuelorder@panta.it
FAX 0039 0373 235123
For further information please do not hesitate to contact us
monico.luca@panta.it Tel. 0039 0373 235141
saine.baak@panta.it Tel. 0039 0373 235142
cristofanilli.giovanni@panta.it
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