ࡱ> GvLbjbjjWiiz 8tO4'*v&x&x&x&x&x&x&$*u-t&ww"&'<v&v&V$@n%Pa('d$ b&Y'<'$x--n%-n%&&%'- c U:ZaBcznik Nr 1 do zaproszenia ZP.271-1.72.2023 (piecz Wykonawcy) FORMULARZ OFERTOWY W odpowiedzi na zaproszenie do zBo|enia oferty cenowej na  Remont drg gruntowych w ramach funduszu soBeckiego na rok 2023 w Gminie Po[witne & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & ....& & & & & & & & & (peBna nazwa Wykonawcy) posiadajcego siedzib & & & & & & & & & & & & & & & ......& & & & & & & & & & & & & & & & & & & & & & & & (ulica nr domu kod pocztowy miejscowo[) & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & .. (adres e-mail, telefon) & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & (NIP, REGON) Oferuj wykonanie przedmiotu zamwienia w zakresie oraz zgodnie z wymogami okre[lonymi w Zaproszeniu do zaBo|enia oferty cenowej, za cen w wysoko[ci: warto[ brutto za caBo[ zamwienia w zB: & ...........................................................................zB sBownie: & ........................................................................................................................................ VAT 23 % warto[ netto za caBo[ zamwienia w zB: & ............................................................................. zB warto[ brutto za 1 m2/ 1 mb w zB: & & & & & & & & & & & & & & & & & & & & & .& & zB W tym cena brutto za: - UzupeBnienie ubytkw, wyrwnanie i walcowanie drogi gminnej gruntowej na odcinku od Ko[cioBa do cmentarza dz. ew. 2, 895 w ZabraDcu:& & & & & & & & ..& & & & & & & & & & & & ..& PLN; - Remont drogi gminnej nr. 533 w Nadbieli :& & & & & & & & & & & & & & & & & & & & & PLN; - Remont drogi dz. ew. nr. 3 w Jzefinie:& & & & & & & & & & & & & & & & .& & ..& & .......PLN; - Remont drogi dojazdowej do wiejskich Bk i pastwisk w miejscowo[ci Helenw:& & & & & & & & & & & & & & & & & & & ...& & & & & & & & & ...& & & .& & PLN; - Remont drg gminnych dz. ew. 218, 282, 311 w Midzypolu:& & & & & & & ...& & & & .& PLN; - Naprawa gruntowych drg gminnych w Woli Cygowskiej: & & & & & & & & & & & & & & PLN; - Remont drogi gminnej w miejscowo[ci Str|ki: & & & & & & & & & & & & & & & & & & .PLN; 2. TERMIN WYKONANIA ZAMWIENIA: do 70 dni od dnia podpisania umowy. 3. WARUNKI PAATNOZCI: zostaBy okre[lone we wzorze umowy stanowicym ZaBcznik nr 2 do Zaproszenia. 4. GWARANCJA na wykonane zadanie 36 miesicy. 5. OZWIADCZAM, |e O[wiadczam/my |e zapoznaBem/li[my si ze szczegBowymi warunkami zapytania ofertowego zawartymi w zapytaniu ofertowym oraz wzorze umowy , i |e akceptujemy je bez zastrze|eD. O[wiadczam/my, |e niniejsz ofert przygotowaBem/li[my zgodnie z wymaganiami okre[lonymi w zapytaniu ofertowym. O[wiadczam/my, |e posiadam/ posiadamy niezbdne uprawnienia, umiejtno[ci, wiedz, [rodki i sprzt i do[wiadczenie do wykonania umowy i zobowizuje si wykona j z nale|yt staranno[ci oraz aktualnym poziomem wiedzy i techniki. O[wiadczam/my, |e zamwienie zobowizuje/my si wykona w terminie okre[lonym w zapytaniu ofertowym. 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O[wiadczam/my, |e zobowizuje/my si w przypadku wyboru mojej/naszej oferty zawrze umow o tre[ci jak w ZaBczniku Nr 2 do zapytania ofertowego. O[wiadczam/my, |e nie podlegam/y wykluczeniu z postpowania na podstawie art. 7 ust. 1 ustawy z dnia 13 kwietnia 2022 r. o szczeglnych rozwizaniach w zakresie przeciwdziaBania wspieraniu agresji na Ukrain oraz sBu|cych ochronie bezpieczeDstwa narodowego ( Dz. U. z 2022 r. poz. 835). Wszystkie informacje podane w powy|szych o[wiadczeniach s aktualne i zgodne z prawd oraz zostaBy przedstawione z peBn [wiadomo[ci konsekwencji wprowadzenia zamawiajcego w bBd przy przedstawianiu informacji. 7. OZWIADCZENIE wymagane od Wykonawcy w zakresie wypeBnienia obowizkw informacyjnych przewidzianych w art. 13 lub art. 14 RODO  potwierdzi lub skre[li. O[wiadczam, |e wypeBniBem obowizki informacyjne przewidziane w art. 13 lub art. 14 RODO1) wobec osb fizycznych, od ktrych dane osobowe bezpo[rednio lub po[rednio pozyskaBem w celu ubiegania si o udzielenie zamwienia publicznego w niniejszym postpowaniu.* 1) rozporzdzenie Parlamentu Europejskiego i Rady (UE) 2016/679 z dnia 27 kwietnia 2016 r. w sprawie ochrony osb fizycznych w zwizku z przetwarzaniem danych osobowych i w sprawie swobodnego przepBywu takich danych oraz uchylenia dyrektywy 95/46/WE (oglne rozporzdzenie o ochronie danych) (Dz. Urz. UE L 119 z 04.05.2016, str. 1). * W przypadku gdy Wykonawca nie przekazuje danych osobowych innych ni| bezpo[rednio jego dotyczcych lub zachodzi wyBczenie stosowania obowizku informacyjnego, stosownie do art. 13 ust. 4 lub art. 14 ust. 5 RODO tre[ci o[wiadczenia Wykonawca nie skBada (usunicie tre[ci o[wiadczenia np. przez jego wykre[lenie). & ..& .................................................. podpis Wykonawcy     GMINA POZWITNE ul. 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