wheel manufacturers form v1 pdf form

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HEADQUARTERS 11 ROUTE DE SUISSE CH – 1295 MIES SWITZERLAND TEL +41 22 950 95 00 FAX +41 22 950 95 01 [email protected] WWW.FIM-LIVE.COM FOUNDED 1904 FIM Road Racing World Championship Grand Prix Racing Wheels Wheel Manufacturers self-certification form RETURN TO & FOR MORE INFORMATION: MotoGP Technical Director DANNY ALDRIDGE [email protected] FIM CTI Coordinator CHARLES HENNEKAM [email protected] The Manufacturer Manufacturer's name: Manufacturer's address (Country): Manufacturer's address (city): Manufacturer's address (road...): Manufacturer's address (ZIP code): Manufacturer's representative (last name, name): Manufacturer's representative (e-mail): Manufacturer's representative (telephone): Wheel information Test Certification number (generated by manufacturer) Design model / Part number Material Front / Rear Location of serial number on wheel Sizes Weight of wheel Application (racing class / classes) The wheel manufacturer confirms that the above specification of wheel conforms to the homologation standard for FIM Road Racing World Championship Grand Prix racing wheels, current as at this date. Signed by the manufacturer's legal representative _____________________________________ On ____/____/____ _____________________________________________________ The Wheel Manufacturer's legal representative (see above) A copy of this compliance certificate for each wheel design/model is to be sent to the MotoGP Technical Director (Danny Aldridge [email protected] ) and to the FIM International Technical Commission (CTI) co-ordinator (Charles Hennekam [email protected] ). A copy of this certificate should also be sent to customers together with homologated wheels purchased.

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  • HEADQUARTERS 11 ROUTE DE SUISSE CH 1295 MIES SWITZERLAND

    TEL +41 22 950 95 00 FAX +41 22 950 95 01 [email protected] WWW.FIM-LIVE.COM

    FOUNDED 1904

    FIM Road Racing World Championship Grand Prix Racing Wheels

    Wheel Manufacturers self-certification form RETURN TO & FOR MORE INFORMATION: MotoGP Technical Director DANNY ALDRIDGE [email protected]

    FIM CTI Coordinator CHARLES HENNEKAM [email protected]

    The Manufacturer

    Manufacturer's name:

    Manufacturer's address (Country):

    Manufacturer's address (city):

    Manufacturer's address (road...):

    Manufacturer's address (ZIP code):

    Manufacturer's representative (last name, name):

    Manufacturer's representative (e-mail):

    Manufacturer's representative (telephone):

    Wheel information

    Test Certification number (generated by manufacturer)

    Design model / Part number

    Material

    Front / Rear

    Location of serial number on wheel

    Sizes

    Weight of wheel

    Application (racing class / classes) The wheel manufacturer confirms that the above specification of wheel conforms to the homologation standard for FIM Road Racing World Championship Grand Prix racing wheels, current as at this date. Signed by the manufacturer's legal representative _____________________________________

    On ____/____/____

    _____________________________________________________ The Wheel Manufacturer's legal representative (see above) A copy of this compliance certificate for each wheel design/model is to be sent to the MotoGP Technical Director (Danny Aldridge [email protected] ) and to the FIM International Technical Commission (CTI) co-ordinator (Charles Hennekam [email protected] ). A copy of this certificate should also be sent to customers together with homologated wheels purchased.

    Manufacturers name: Manufacturers address Country: Manufacturers address city: Manufacturers address road: Manufacturers address ZIP code: Manufacturers representative last name name: Manufacturers representative email: Manufacturers representative telephone: Test Certification number generated by manufacturer: Design model Part number: Material: Front Rear: Location of serial number on wheel: Sizes: Weight of wheel: Application racing class classes: Signed by the manufacturers legal representative: On: undefined: undefined_2: The Wheel Manufacturers legal representative see above: