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https://www.fia.com/regulation/category/762

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This declaration shall be supplied on letterhead paper of the applicant company and signed (full

name and position within the company required).

Mr/Ms as at

(the company) declares that the management of the company ensures that

quality objectives have been defined and communicated throughout the company. The company

follows a Quality Management System in order to ensure that production and procurement are

carried out under controlled conditions and to ensure that the final product conforms to the

requirements of the FIA standard for which they are homologated.

The company maintains objective evidence of the following:

• Procurement process control The company has processes in place to ensure that the products and services incorporated in

the final product and supplied externally comply with the requirements and specification of

the original homologated product.

• Client order review and control The company reviews the products that are going to be offered to customers in order to

ensure that the requirements of FIA standard 8859-2015 are still complied with, and that no

modification has been made with respect to the originally homologated product without

authorisation by the FIA.

• Production order review and control

• Staff training (including new staff)

• Internal audits

In addition, the company maintains documented information of the following:

• Production processes, including drawing controls and process change records

• Non-conformities management

This Quality Management System has been in place in the company since

Date:

Version 02.1 22.04.2020 Page 5 of 8

This declaration shall be supplied on letterhead paper of the applicant company and signed (full

name and position within the company required).

Mr/Ms as at

(the company) declares that the company retains documented information

that allows all key materials of the products to be traced including information on the following:

o Supplier,

o Purchase date,

o Batch number,

o Controls or checks performed on arrival at the company.

It is possible to link this information to a unique identification of each product so that, given the

number of the FIA hologram used on a helmet, the manufacturer is able to provide the above

information on the following materials used in that specific helmet:

o Fibres and resins,

o Energy absorbing materials,

o Comfort foam,

o Linen material,

o Chin straps.

This traceability system has been in place in the company since

Date:

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This declaration shall be supplied on letterhead paper of the applicant company and signed (full

name and position within the company required).

Mr/Ms as at

(the company) declares that given the number of the FIA hologram used on a

specific helmet, the company will be able to provide the batch number of the following materials used

in that specific premium helmet:

• Fibres and resins,

• Energy absorbing materials,

• Comfort foam,

• Linen material,

• Chin straps.

This traceability system has been in place in the company since

Date:

Version 02.1 22.04.2020 Page 7 of 8

This declaration shall be supplied on letterhead paper of the applicant company and signed (full name

and position within the company required).

Mr/Ms as at

(the company) declares that the below information is descriptive of the

controls carried out on every helmet produced according to FIA standard 8859-2015.

Controls

Visual inspection

Weight

Objective information of these controls is maintained and can be provided if necessary.

These controls have been in place in the company since

Date:

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This declaration shall be supplied on letterhead paper of the applicant company and signed (full name and position within the company required).

Mr/Ms as at (the Company) declares that the information below is descriptive of the random

tests done during the production of helmets according to FIA standard 8859-2015.

Tests How often? Where are the tests done?

Geometrical dimensions % of production

Flame resistance according to Snell SA2015 or Snell SA2020

% of production Or

Test every

Impact management tests according to Snell SA2015 or SA2020 using revised impact velocities and limit values presented in Appendix B of the FIA standard 8859-2015 (testing on a single sample but covering all anvils)

% of production Or

Test every

Penetration tests according to Snell SA2015 or Snell SA2020 (they can be performed on the same sample of the linear impact test)

% of production Or

Test every

Mechanical strength test for the Helmet-M6-Termnals according to art. 4.2 of the FIA standard 8859-2015

% of production Or

Test every

Documented information of these controls is retained and can be provided if necessary.

These controls have been in place in the company since

Date:

Family name: Family nametests#0_1: 00tests#0_2: 00tests#0_3: 00tests#0_4: 00Frequency scale#0_1: [Selec frecuency scale]location tests#0_: [Select where the tests are carried out]location tests#0_2: [Select where the tests are carried out]location tests#0_3: [Select where the tests are carried out]location tests#0_4: [Select where the tests are carried out]location tests_5: [Select where the tests are carried out]Frequency scale_4: [Selec frecuency scale]Frequency scale#0_3: [Selec frecuency scale]Frequency scale#0_2: [Selec frecuency scale]frecuency: 00tests#0_8: 00tests#0_7: 00tests#0_9: 00tests#0_10: 00tests#0_6: 00tests#0_5: 00tests_12: 00tests#0_11: 00YEAR-MONTH_5: YEAR-MONTH when the controls startedsignature_5: signature date_: Signature DATEcompany name: Company namePosition in the company: Position in the companyChoose Yes/No_1: [choose Yes/No]Choose Yes/No_2: [choose Yes/No]YEAR-MONTH_4: YEAR-MONTH when the controls startedsignature_4: signature date_4: Signature DATEFull name of person signing: Full nameYEAR-MONTH_3: YEAR-MONTH when the controls startedsignature_3: signature date_3: Signature DATEYEAR-MONTH_2: YEAR-MONTH when the controls startedsignature_2: signature date_2: Signature DATEsignature_1: YEAR-MONTH_1: YEAR-MONTH when the controls startedsignature date_1: Signature DATE