╨╧рб▒с>■  ')■   &z                                                                                                                                                                                                                                                                                                                                                                                                                                            ье┴Yр°┐P'bjbj[╔[╔7:9г \9г \~)      ╖М М     ,,,8d\└4,й0■ЇpdzzЎ╤я √40606060606060з3╢]6Z60-╤╤60zЎ█c0   RzЎ40 40  Оо*░ъ+z|    pо╕Aшe╪    UЇ^+ 0y00й0n+|╖6I╖6 ъ+ъ+&╖6, 6060aй0                                                                    ╖6М R ▐:ZaBcznik nr 5 do SWZ DPS.240.2.2022. Zamawiajcy: Dom Pomocy SpoBecznej w Piotrkowie Kujawskim ul. PoznaDska 98 88  230 Piotrkєw Kujawski Wykonawca: & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & (peBna nazwa/firma, adres) WYKAZ ROB╙T BUDOWLANYCH skBadany w postpowaniu o udzielenie zamєwienia publicznego na zaprojektowanie i wykonanie robєt budowlanych w ramach realizacji zadania pod nazw  Przebudowa, rozbudowa i termomodernizacja budynku Domu Pomocy SpoBecznej oraz przebudowa budynku hydroforni na budynek kotBowni z niezbdn infrastruktur  . L.p.Rodzaj wykonanych robєt (wraz z podaniem nazwy inwestycji i informacj o wykonaniu robєt konstrukcyjnych w zakresie robєt murowych i |elbetowych) Rodzaj budynku (zaznaczy wBa[ciwe) Kubatura budynku (w m3)Warto[ wykonanych robєtData i miejsce wykonaniaPodmiot na rzecz ktєrego roboty zostaBy wykonane  CONTROL Forms.CheckBox.1 budynek u|yteczno[ci publicznej;  CONTROL Forms.CheckBox.1 budynek zamieszkania zbiorowego; ,26:<>FJPRl& < и ю Ё э┌э╨├╨├╨├╢├иЦЖtcUEh╩vhА`5Б>*OJQJ^JhЧ HhЧ H6БOJQJ^J hЧ HhЧ HCJOJQJ^JaJ#h█┌hЧ H5БCJOJQJ^JaJh█┌hож5БOJQJ\Б^J#h∙lEhЧ H5БCJOJQJ^JaJhGhЧ H5БOJQJ^JhGhGOJQJ^JhGhЧ HOJQJ^Jhq №OJQJ^J%hЧ H5БCJOJQJ^JaJmHsH#hC┘hЧ H5БCJOJQJ^JaJ,RlЬ╩ю& < ` Д и ю Ё " И К Ўэ▌╨╨╨╨╚╝╝│кЯЯФМdgdG $ & Fa$gdG $da$gdА`ДA]ДAgdЧ HДB]ДBgdЧ H ДBdh]ДBgdЧ HdрgdЧ H Д%Дв^Д%`ДвgdожД■#Д─dр^Д■#`Д─gdЧ HД/^Д/gdЧ HД/^Д/gdЧ HЁ " Ш Ъ Ю а $ 4 F H 2 ь█╔╖йШЕmWA++h█┌hG5БB*CJOJQJ\БaJph +h|TРh(w25БB*CJOJQJ\БaJph +hGh(w25БB*CJOJQJ\БaJph .hGh(w25БB*CJOJQJ\Б]БaJph %hF"th(w25БCJOJQJ\Б]БaJ hC┘h(w2CJOJQJ^JaJh(w2CJOJQJ^JaJ#h(w2h(w25БCJOJQJ^JaJ#h(w2h(w2CJOJQJ\Б^JaJ h(w25Б>*CJOJQJ^JaJ&hЧ HhomS5Б>*CJOJQJ^JaJ 2 4 Ж И К Ф ┬ ─ ╞ ╚ ╓ ф ц  щ╙╛кРv_E5$5$5!hN ┴5БCJOJQJaJmHsHhlF┐hlF┐5БCJOJQJaJ3hlF┐hlF┐5БCJOJQJ^JaJmHnHsHtH-hlF┐5БCJOJQJ^JaJmHnHsHtH3hlF┐hЧ H5БCJOJQJ^JaJmHnHsHtH3hЧ HhЧ H5БCJOJQJ^JaJmHnHsHtH&hЧ Hh~j┤5Б>*CJOJQJ^JaJ(h█┌hG5БB*CJOJQJaJph +h█┌hG5БB*CJOJQJ\БaJph +h█┌h=5БB*CJOJQJ\БaJph  К Ф ─ ║ ╝ 6hЪ№■ВА В Д Ж И яяяууууу╫╫╥╔└╔╔╔╔╔╔╔╔ $IfgdF╛ $IfgdIbыFf| $$Ifa$gdЁE $$Ifa$gdЁE$дд$Ifa$gdЁE  ( < B F ` f ╢ ╕ ║ ╪ .ю▐╩╣гМгМг▐r`N9`(hЧ HhЧ HCJOJQJ^JaJmHsH"h/╖CJOJQJ^JaJmHsH"hЧ HCJOJQJ^JaJmHsH3hlF┐hЧ H5БCJOJQJ^JaJmHnHsHtH-hlF┐5БCJOJQJ^JaJmHnHsHtH+hlF┐hlF┐5БCJOJQJ^JaJnHtH!hlF┐5БCJOJQJaJmHsH'hlF┐hlF┐5БCJOJQJaJmHsHhlF┐hlF┐5БCJOJQJaJ!hN ┴5БCJOJQJaJmHsH.0246h■:<>@э┘╞▒ЬЛ~t]K5%]j╔h/╖5БOJQJU^J*jоЎ#d hM3єh/╖5БOJQJUV^J#hM3єh/╖5БCJOJQJ^JaJ,jhM3єh/╖5БCJOJQJU^JaJhЧ HOJQJ^Jh╩vhЧ HOJQJ^J hЧ HhЧ HCJOJQJ^JaJ(hЧ HhЧ HCJOJQJ^JaJmHsH(hКЛhЧ HCJOJQJ^JaJmHsH%hКЛ5БCJOJQJ^JaJmHsH&hКЛhЧ HCJH*OJQJ\Б^JaJ#hКЛhЧ HCJOJQJ\Б^JaJ @~АВД╕║╝╛╠╬№■  6 8 э▐╧╕жРА╕n_M▐MK╕ж5*jмЎ#d hM3єh/╖5БOJQJUV^JU#h/╖h/╖CJOJQJ\Б^JaJh/╖5БCJOJQJ^JaJ#hЧ Hh/╖CJOJQJ\Б^JaJjПh/╖5БOJQJU^J*jнЎ#d hM3єh/╖5БOJQJUV^J#hM3єh/╖5БCJOJQJ^JaJ,jhM3єh/╖5БCJOJQJU^JaJhЧ HCJOJQJ\Б^JaJh/╖CJOJQJ\Б^JaJ#hЧ HhЧ HCJOJQJ\Б^JaJ CONTROL Forms.CheckBox.1 budynek mieszkalny wielorodzinny;  CONTROL Forms.CheckBox.1 budynek u|yteczno[ci publicznej;  CONTROL Forms.CheckBox.1 budynek zamieszkania zbiorowego;  CONTROL Forms.CheckBox.1 budynek mieszkalny wielorodzinny;UWAGA: Do wykazu robєt budowlanych Wykonawca zaBcza dowody okre[lajce, czy te roboty budowlane zostaBy wykonane nale|ycie, przy czym dowodami, o ktєrych mowa, s referencje bdz inne dokumenty sporzdzone przez podmiot, na rzecz ktєrego roboty budowlane zostaBy wykonane, a je|eli wykonawca z przyczyn niezale|nych od niego nie jest w stanie uzyska tych dokumentєw  inne odpowiednie dokumenty. & & & & & .& & & & & .& . (miejscowo[), dnia & & & & & & 2022 r. UWAGA: Wykaz skBada si w formie elektronicznej lub w postaci elektronicznej opatrzonej kwalifikowanym podpisem elektronicznym, podpisem zaufanym lub podpisem osobistym.     PAGE \* MERGEFORMAT2 8 : < J L | ~ А О Р Т ╞ ╚ ╩ ╠ !!!D!Ё┘╟╕жЧЙ|r┘`J:┘╟Ч┘`jю h/╖5БOJQJU^J*jлЎ#d hM3єh/╖5БOJQJUV^J#hM3єh/╖5БCJOJQJ^JaJh/╖OJQJ^Jh╩vhЧ HOJQJ^JhЧ Hh/╖OJQJ\Б^Jh/╖CJOJQJ\Б^JaJ#h/╖h/╖CJOJQJ\Б^JaJh/╖5БCJOJQJ^JaJ#hЧ Hh/╖CJOJQJ\Б^JaJ,jhM3єh/╖5БCJOJQJU^JaJjUh/╖5БOJQJU^JИ К М ) $IfgdIbы╒kd $$IfЦF╓ФХ╓Ю║ ╕Ф9!▐'h-(5LА▓▄ееК└╓0      Ўn5ЎЎ╓       ╓       ╓       ╓       4╓ FaЎyt/╖М О Р !М! """""Ўээээфффф $IfgdIbы $Ifgd/╖ $IfgdF╛ D!F!H!J!X!Z!И!К!М!О!┬!─!╞!╚!╓!╪!" 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hКЛhY|┐CJOJQJ^JaJ#hКЛhY|┐6БCJOJQJ^JaJ'@'B'D'F'H'J'L'N'P'їц╘цї╨╠╚╗h┼joh0FOJQJ^JhKM[hnuьh/╖#hq №hq №OJQJmHnHsHujh/╖h/╖OJQJUh/╖h/╖OJQJ 51Рh0:p(w2░╞A ░В.!░Й"░Й#Р№$РЙ%░░─░─ Р─z$$IfЦ!vh#vL#v▓#v▄#vе#vК#v└:V ЦFФ; ╓╓F ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘╓0      Ўn5Ў,╓,╓5╓L5╓▓5╓▄5╓е5╓К5╓└4╓4╓ Fp╓F ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘yt/╖Kkd$$IfЦF╓Ф;╓Ю║ ╕Ф9!▐'h-(5АLА▓▄еАеАКА└ ╓╓F ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘╓0      Ўn5ЎЎ╓       ╓       ╓       ╓       4╓ FaЎp╓F ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘ ┘┘┘yt/╖╞Dd h├шшЁb▓ Ё c Ё$ААA?┐  ?3"ё┐`┐А?ЁА2ЁQ?.ё &ы/ЁIыэр▀ ь `!ЁфQ?.ё &ы/ЁIыэр▀№ °|▒у▓■xэR╗ B1є%|▐<╤╥А@╨└ мУ%Ш%▒ 0╥aЗКЁ@╘X╩┼I▀щC ─УЖ #0рИ╓`╚y┤#6 цИdKМo@T?AGBCDEFHJIKPLMNOQSRU[kVWXYZ\^]_e`abcf■   hgijlx■   mnopqrstuvwy■   ■   ¤   |}~АRoot Entry        5 └F└И╩Aшe╪*└xData             WordDocument7        7:ObjectPool4 @ц░Aшe╪└И╩Aшe╪_1680078510        @╥ЛBь╬Ю к`є@ц░Aшe╪@ц░Aшe╪PRINT            OCXDATA     ,CompObj            v ■   ■   ■   ■   ■   ■    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