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Ko[ciuszki 96; 64-700 Czarnkw Wykonawca  ( nazwa) & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & Adres& & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & ... NIP............................................................ nr KRS (je|eli dotyczy) ..................................................................... nr telefonu* ................................................................................. adres e-mail*................................................... * Pola wypeBniane nieobowizkowo. WypeBnienie ktregokolwiek z powy|szych pl (telefon lub e-mail) oznacza, |e wyra|asz zgod na przetwarzanie przez Zamawiajcego podanych danych w celu kontaktu w zwizku z prowadzon warto[ci szacunkow. Zgod mo|na wycofa w dowolnym momencie, przy czym wycofanie zgody nie bdzie miaBo wpBywu na zgodno[ z prawem. 1. 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