{\rtf1\adeflang1025\ansi\ansicpg1250\uc1\adeff0\deff0\stshfdbch0\stshfloch31506\stshfhich31506\stshfbi31506\deflang1045\deflangfe1045\themelang1045\themelangfe0\themelangcs0{\fonttbl{\f0\fbidi \froman\fcharset238\fprq2{\*\panose 02020603050405020304}Times New Roman{\*\falt Times New Roman};}
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{\f754\fbidi \fswiss\fcharset204\fprq2 Tahoma Cyr{\*\falt Tahoma};}{\f756\fbidi \fswiss\fcharset161\fprq2 Tahoma Greek{\*\falt Tahoma};}{\f757\fbidi \fswiss\fcharset162\fprq2 Tahoma Tur{\*\falt Tahoma};}
{\f758\fbidi \fswiss\fcharset177\fprq2 Tahoma (Hebrew){\*\falt Tahoma};}{\f759\fbidi \fswiss\fcharset178\fprq2 Tahoma (Arabic){\*\falt Tahoma};}{\f760\fbidi \fswiss\fcharset186\fprq2 Tahoma Baltic{\*\falt Tahoma};}
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{\fdbmajor\f31522\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}{\fdbmajor\f31523\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}
{\fdbmajor\f31524\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic){\*\falt Times New Roman};}{\fdbmajor\f31525\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic{\*\falt Times New Roman};}
{\fdbmajor\f31526\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}{\fhimajor\f31530\fbidi \fswiss\fcharset0\fprq2 Calibri Light;}{\fhimajor\f31529\fbidi \fswiss\fcharset204\fprq2 Calibri Light Cyr;}
{\fhimajor\f31531\fbidi \fswiss\fcharset161\fprq2 Calibri Light Greek;}{\fhimajor\f31532\fbidi \fswiss\fcharset162\fprq2 Calibri Light Tur;}{\fhimajor\f31535\fbidi \fswiss\fcharset186\fprq2 Calibri Light Baltic;}
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{\fbimajor\f31539\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}{\fbimajor\f31541\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}
{\fbimajor\f31542\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}{\fbimajor\f31543\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}
{\fbimajor\f31544\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic){\*\falt Times New Roman};}{\fbimajor\f31545\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic{\*\falt Times New Roman};}
{\fbimajor\f31546\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}{\flominor\f31550\fbidi \froman\fcharset0\fprq2 Times New Roman{\*\falt Times New Roman};}
{\flominor\f31549\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}{\flominor\f31551\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}
{\flominor\f31552\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}{\flominor\f31553\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}
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{\flominor\f31556\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}{\fdbminor\f31560\fbidi \froman\fcharset0\fprq2 Times New Roman{\*\falt Times New Roman};}
{\fdbminor\f31559\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}{\fdbminor\f31561\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}
{\fdbminor\f31562\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}{\fdbminor\f31563\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}
{\fdbminor\f31564\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic){\*\falt Times New Roman};}{\fdbminor\f31565\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic{\*\falt Times New Roman};}
{\fdbminor\f31566\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}{\fhiminor\f31570\fbidi \fswiss\fcharset0\fprq2 Calibri{\*\falt Gentium Book Basic};}
{\fhiminor\f31569\fbidi \fswiss\fcharset204\fprq2 Calibri Cyr{\*\falt Gentium Book Basic};}{\fhiminor\f31571\fbidi \fswiss\fcharset161\fprq2 Calibri Greek{\*\falt Gentium Book Basic};}
{\fhiminor\f31572\fbidi \fswiss\fcharset162\fprq2 Calibri Tur{\*\falt Gentium Book Basic};}{\fhiminor\f31575\fbidi \fswiss\fcharset186\fprq2 Calibri Baltic{\*\falt Gentium Book Basic};}
{\fhiminor\f31576\fbidi \fswiss\fcharset163\fprq2 Calibri (Vietnamese){\*\falt Gentium Book Basic};}{\fbiminor\f31580\fbidi \froman\fcharset0\fprq2 Times New Roman{\*\falt Times New Roman};}
{\fbiminor\f31579\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}{\fbiminor\f31581\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}
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\par }\pard \ltrpar\ql \li0\ri5953\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin5953\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid6905763\charrsid3170437 (imi\'ea, nazwisko, stanowisko/podstawa\line 
do reprezentacji)
\par }\pard \ltrpar\qc \li0\ri0\sb240\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\ul\insrsid12849215\charrsid3170437 O\'9cwiadczeni}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \b\f0\fs24\ul\insrsid2382258\charrsid3170437 a}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\ul\insrsid12849215\charrsid3170437  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\ul\insrsid12586461\charrsid3170437 wykonawcy}{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \b\f0\fs24\ul\insrsid1393355\charrsid3170437 /wykonawcy wsp\'f3lnie ubiegaj\'b9c}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\ul\insrsid9446602\charrsid3170437 ego}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\b\f0\fs24\ul\insrsid1393355\charrsid3170437  si\'ea o udzielenie zam\'f3wienia}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\ul\insrsid2501985\charrsid3170437 
\par }\pard \ltrpar\qc \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\ul\insrsid7160168\charrsid3170437 UWZGL\'caDNIAJ\'a5CE PRZES\'a3
ANKI WYKLUCZENIA Z ART. 7 UST. 1 USTAWY }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\caps\f0\fs24\ul\insrsid7160168\charrsid3170437 o szczeg\'f3lnych rozwi\'b9zaniach w zakresie przeciwdzia\'b3ania wspieraniu agresji na Ukrain\'ea oraz s\'b3u\'bf\'b9
cych ochronie bezpiecze\'f1stwa narodowego
\par }\pard \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid5374324\charrsid3170437 s}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\b\f0\fs24\insrsid12849215\charrsid3170437 k\'b3adane na pod}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid8408839\charrsid3170437 stawie art. }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid13393047\charrsid3170437 1}{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid8408839\charrsid3170437 25 ust. 1 ust}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid2501985\charrsid3170437 awy }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid7817720\charrsid3170437 Pzp }{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid8408839\charrsid3170437 
\par }\pard \ltrpar\qj \fi426\li0\ri0\sb240\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8847482 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6905763\charrsid3170437 Na potrzeby post\'eapowania o udzielenie zam\'f3
wienia publicznego pn. }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid16664870\charrsid3170437 \'84}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid7241415\charrsid3170437 Dostawa }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 
\b\f0\fs24\insrsid13720385\charrsid3170437 fabrycznie nowego samochodu specjalistycznego do}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid3170437\charrsid3170437  odbioru i }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 
\b\f0\fs24\insrsid13720385\charrsid3170437  wywozu odpad\'f3w komunalnych}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid16664870\charrsid3170437 \'94}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid6357454\charrsid3170437  (znak post
\'eapowania:}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid14233170\charrsid3170437  }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid8847482 02/DGO/2023}{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid6357454\charrsid3170437 
)}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6905763\charrsid3170437  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid6905763\charrsid3170437  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8847482 prowadzonego przez }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8847482\charrsid8847482 Zak\'b3ad Wodoci\'b9g\'f3w }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8847482 Kanalizacji i Us\'b3ug Komunalnych  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid8847482\charrsid8847482 Sp\'f3\'b3ka z ograniczon\'b9  odpowiedzialno\'9cci\'b9 w \'8cwiebodzinie}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8847482  o}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6905763\charrsid3170437 
\'9cwiadczam, co nast\'eapuje:
\par }\pard \ltrpar\ql \li0\ri0\sb240\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 \cbpat20 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid11863051\charrsid3170437 O\'8cWIADCZENIA DOTYCZ\'a5
CE PODSTAW WYKLUCZENIA:
\par {\listtext\pard\plain\ltrpar \s15 \rtlch\fcs1 \af0\afs21 \ltrch\fcs0 \b\fs21\insrsid11863051\charrsid3170437 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard\plain \ltrpar
\s15\qj \fi-360\li350\ri0\sb240\widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls7\adjustright\rin0\lin350\itap0\pararsid3170437\contextualspace \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f31506\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 {
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11863051\charrsid3170437 O\'9cwiadczam, \'bfe nie podlegam wykluczeniu z post\'eapowania na podstawie \line art. 108 ust}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid8077932\charrsid3170437 .}{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11863051\charrsid3170437  1 ustawy Pzp.
\par {\listtext\pard\plain\ltrpar \s15 \rtlch\fcs1 \af0\afs21 \ltrch\fcs0 \b\fs21\insrsid11863051\charrsid3170437 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \ltrpar
\s15\qj \fi-284\li284\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls7\adjustright\rin0\lin284\itap0\pararsid16531143\contextualspace {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11863051\charrsid3170437 O\'9cwiadczam, \'bf
e nie podlegam wykluczeniu z post\'eapowania na podstawie \line art. }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1539114\charrsid3170437 109}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11863051\charrsid3170437  ust. }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1539114\charrsid3170437 1}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11863051\charrsid3170437  ustawy Pzp.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1539114\charrsid3170437 
\par {\listtext\pard\plain\ltrpar \s15 \rtlch\fcs1 \af0\afs21 \ltrch\fcs0 \b\fs21\insrsid1539114\charrsid3170437 \hich\af0\dbch\af0\loch\f0 3.\tab}}\pard \ltrpar
\s15\qj \fi-294\li284\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls7\adjustright\rin0\lin284\itap0\pararsid16531143\contextualspace {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1539114\charrsid3170437 O\'9cwiadczam, \'bfe zachodz\'b9
 w stosunku do mnie podstawy wykluczenia z post\'eapowania na podstawie art. }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6905763\charrsid3170437 .........}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1539114\charrsid3170437  ustawy Pzp }{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid1539114\charrsid3170437 (poda\'e6 maj\'b9c\'b9 zastosowanie podstaw\'ea wykluczenia spo\'9cr\'f3d wymienionych w art. }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid15882692\charrsid3170437 108 
}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid1539114\charrsid3170437 ust. 1 }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid15089227\charrsid3170437 pkt 1, 2 i 5 }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\i\f0\fs24\insrsid1539114\charrsid3170437 lub art.}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid4472583\charrsid3170437  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid15882692\charrsid3170437 109}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\i\f0\fs24\insrsid1539114\charrsid3170437  ust. }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid15882692\charrsid3170437 1}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid1539114\charrsid3170437  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\i\f0\fs24\insrsid15089227\charrsid3170437 pkt 2-5 i 7-10 }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid1539114\charrsid3170437 ustawy Pzp).}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1539114\charrsid3170437  Jednocze\'9cnie o\'9c
wiadczam, \'bfe w zwi\'b9zku z ww. okoliczno\'9cci\'b9, na podstawie art. }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15882692\charrsid3170437 110}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1539114\charrsid3170437  ust. }{\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15882692\charrsid3170437 2}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1539114\charrsid3170437  ustawy Pzp podj\'b9\'b3em nast\'eapuj\'b9ce \'9crodki naprawcze}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid15602777\charrsid3170437  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid16456235\charrsid3170437 i}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15602777\charrsid3170437  zapobiegawcze}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid1539114\charrsid3170437 : }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid6905763\charrsid3170437 ......................................................}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid14233170\charrsid3170437 
.......................................................................................................}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid1539114\charrsid3170437 
\par {\listtext\pard\plain\ltrpar \s35 \rtlch\fcs1 \af0\afs21 \ltrch\fcs0 \b\fs21\insrsid3747847\charrsid3170437 \hich\af0\dbch\af0\loch\f0 4.\tab}}\pard\plain \ltrpar
\s35\qj \fi-392\li392\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls7\adjustright\rin0\lin392\itap0\pararsid3170437 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid3747847\charrsid3170437 O\'9cwiadczam, \'bfe nie zachodz\'b9 w stosunku do mnie przes\'b3anki wykluczenia z post\'eapowania na podstawie art.  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang1045\langfe1045\langfenp1045\insrsid14684707\charrsid3170437 
7 ust. 1 ustawy }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14506480\charrsid3170437 z dnia 13 kwietnia 2022 r.}{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid14506480\charrsid3170437  }{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\cf21\insrsid14506480\charrsid3170437 
o szczeg\'f3lnych rozwi\'b9zaniach w zakresie przeciwdzia\'b3ania wspieraniu agresji na Ukrain\'ea oraz s\'b3u\'bf\'b9cych ochronie bezpiecze\'f1stwa narodowego}{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\cf21\insrsid1777357\charrsid3170437  }{\rtlch\fcs1 
\ai\af0 \ltrch\fcs0 \cf21\insrsid1777357\charrsid3170437 (Dz. U. poz. 835)}{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \cs21\i\cf21\super\insrsid4276099\charrsid3170437 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\qj \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11020644 \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f31506\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 
\cs21\f1\fs16\super\insrsid4276099\charrsid11020644 \chftn }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f1\fs16\insrsid4276099\charrsid11020644  }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f1\fs16\cf21\insrsid11020644\charrsid11020644 Zgodnie z tre\'9cci\'b9
 art. 7 ust. 1 ustawy z dnia 13 kwietnia 2022 r. }{\rtlch\fcs1 \ai\af1\afs16 \ltrch\fcs0 \i\f1\fs16\cf21\insrsid11020644\charrsid11020644 o szczeg\'f3lnych rozwi\'b9zaniach w zakresie przeciwdzia\'b3ania wspieraniu agresji na Ukrain\'ea oraz s\'b3u\'bf
\'b9cych ochronie bezpiecze\'f1stwa narodowego, }{\rtlch\fcs1 \ai\af1\afs16 \ltrch\fcs0 \i\f1\fs16\cf21\insrsid1777357 zwanej dalej \'84ustaw\'b9\'94,}{\rtlch\fcs1 \ai\af1\afs16 \ltrch\fcs0 \i\f1\fs16\cf21\insrsid11020644\charrsid11020644  }{\rtlch\fcs1 
\af1\afs16 \ltrch\fcs0 \f1\fs16\cf21\insrsid11020644\charrsid11020644 z }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f1\fs16\cf21\lang1045\langfe1045\langfenp1045\insrsid11020644\charrsid11020644 post\'eapowania o udzielenie zam\'f3
wienia publicznego lub konkursu prowadzonego na podstawie ustawy Pzp wyklucza si\'ea:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f1\fs16\cf21\insrsid11020644\charrsid11020644 
\par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f1\fs16\cf21\lang1045\langfe1045\langfenp1045\insrsid11020644\charrsid11020644 1) wykonawc\'ea oraz uczestnika konkursu wymienionego w wykazach okre\'9clonych w rozporz\'b9dzeniu 765/2006 i rozporz\'b9dzeniu
 269/2014 albo wpisanego na list\'ea na podstawie decyzji w sprawie wpisu na list\'ea rozstrzygaj\'b9cej o zastosowaniu \'9crodka, o kt\'f3rym mowa w art. 1 pkt 3 ustawy;
\par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f1\fs16\cf21\insrsid11020644\charrsid11020644 2) }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f1\fs16\cf21\lang1045\langfe1045\langfenp1045\insrsid11020644\charrsid11020644 wykonawc\'ea oraz uczestnika konkursu, kt\'f3
rego beneficjentem rzeczywistym w rozumieniu ustawy z dnia 1 marca 2018 r. o przeciwdzia\'b3aniu praniu pieni\'eadzy oraz finansowaniu terroryzmu (Dz. U. z 2022 r. poz. 593 i 655) jest osoba wymieniona w wykazach okre\'9clonych w rozporz\'b9
dzeniu 765/2006 i rozporz\'b9dzeniu 269/2014 albo wpisana na list\'ea lub b\'ead\'b9ca takim beneficjentem rzeczywistym od dnia 24 lutego 2022 r., o ile zosta\'b3a wpisana na list\'ea na podstawie decyzji w sprawie wpisu na list\'ea rozstrzygaj\'b9
cej o zastosowaniu \'9crodka, o kt\'f3rym mowa w art. 1 pkt 3 ustawy;}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f1\fs16\cf21\insrsid11020644\charrsid11020644 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7740651 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f1\fs16\cf21\lang1045\langfe1045\langfenp1045\insrsid11020644\charrsid11020644 3) wykonawc\'ea
 oraz uczestnika konkursu, kt\'f3rego jednostk\'b9 dominuj\'b9c\'b9 w rozumieniu art. 3 ust. 1 pkt 37 ustawy z dnia 29 wrze\'9cnia 1994 r. o rachunkowo\'9cci (Dz. U. z 2021 r. poz. 217, 2105 i 2106), jest podmiot wymieniony w wykazach okre\'9c
lonych w rozporz\'b9dzeniu 765/2006 i rozporz\'b9dzeniu 269/2014 albo wpisany na list\'ea lub b\'ead\'b9cy tak\'b9 jednostk\'b9 dominuj\'b9c\'b9 od dnia 24 lutego 2022 r., o ile zosta\'b3 wpisany na list\'ea na podstawie decyzji w sprawie wpisu na list
\'ea rozstrzygaj\'b9cej o zastosowaniu \'9crodka, o kt\'f3rym mowa w art. 1 pkt 3 ustawy.}}}{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\cf21\insrsid14506480\charrsid3170437 .}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cf21\insrsid14506480\charrsid3170437  }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid7677331\charrsid3170437 
\par }\pard \ltrpar\s35\qj \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15539872\charrsid3170437 
\par }\pard\plain \ltrpar\qj \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 \cbpat20 \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f31506\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 {
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid6505233\charrsid3170437 {\*\bkmkstart _Hlk99009560}O\'8cWIADCZENIE DOTYCZ\'a5CE PODANYCH INFORMACJI:
\par }\pard \ltrpar\qj \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13778749\charrsid3170437 {\*\bkmkend _Hlk99009560}O\'9cwiadczam, \'bf
e wszystkie informacje podane w powy\'bfszy}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15539872\charrsid3170437 m}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13778749\charrsid3170437  o\'9cwiadczeni}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid15539872\charrsid3170437 u}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13778749\charrsid3170437  s\'b9 aktualne }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid16666155\charrsid3170437 \line }{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid13778749\charrsid3170437 i zgodne z prawd\'b9 oraz zosta\'b3y przedstawione z pe\'b3n\'b9 \'9cwiadomo\'9cci\'b9 konsekwencji wprowadzenia zamawiaj\'b9cego w b\'b3\'b9d przy przedstawianiu informacji.}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid10360592\charrsid3170437 
\par }\pard \ltrpar\qj \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 \cbpat20 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \b\f0\fs24\insrsid11154286\charrsid3170437 INFORMACJA DOTYCZ\'a5CA DOST\'ca
PU DO PODMIOTOWYCH \'8cRODK\'d3W DOWODOWYCH:
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437 Wskazuj\'ea}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid9769340\charrsid3170437  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11023576\charrsid3170437 nast\'eapuj\'b9ce }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437 podmiotow}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid11023576\charrsid3170437 e}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437  \'9crodk}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11023576\charrsid3170437 i}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437  dowodow}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11023576\charrsid3170437 e}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid9769340\charrsid3170437 , kt\'f3re mo\'bfna uzyska\'e6
 za pomoc\'b9 }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437 bezp\'b3atnych i og\'f3lnodost\'eapnych baz danych}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11023576\charrsid3170437 , oraz dane umo\'bfliwiaj\'b9
ce dost\'eap do tych \'9crodk\'f3w}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437 :
\par 1)}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3018337\charrsid3170437  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437 
..............................................................................................................}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3018337\charrsid3170437 ........................................
\par }\pard \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid13334168\charrsid3170437 (wskaza\'e6 podmiotowy \'9c
rodek dowodowy, adres internetowy, wydaj\'b9cy urz\'b9d lub organ, dok\'b3adne dane referencyjne dokumentacji)}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437 2)}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\f0\fs24\insrsid3018337\charrsid3170437  }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid11154286\charrsid3170437 ..............................................................................................................................}{
\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid3018337\charrsid3170437 .........................}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid13778749\charrsid3170437 
\par }\pard \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid5059135\charrsid3170437 (wskaza\'e6 podmiotowy \'9c
rodek dowodowy, adres internetowy, wydaj\'b9cy urz\'b9d lub organ, dok\'b3adne dane referencyjne dokumentacji)}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \i\f0\fs24\insrsid5377936\charrsid3170437 
\par }\pard \ltrpar\qj \li5600\ri0\sb240\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin5600\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid14233170\charrsid3170437 
\par 
\par }\pard \ltrpar\qj \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang1045\langfe1045\langfenp1045\insrsid4128813\charrsid3170437 Miejscowo\'9c\'e6 i data:\'85\'85\'85\'85\'85\'85\'85
\'85\'85\'85\'85\'85\'85\'85\'85\'85
\par 
\par 
\par 
\par 
\par 
\par                                                        }{\rtlch\fcs1 \ab\af0\afs24 \ltrch\fcs0 \b\f0\fs24\lang1045\langfe1045\langfenp1045\insrsid4128813\charrsid3170437 Podpisano kwalifikowanym podpisem elektronicznym
\par              }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang1045\langfe1045\langfenp1045\insrsid4128813\charrsid3170437                                                     Podpis osoby figuruj\'b9cej lub os\'f3b figuruj\'b9cych}{\rtlch\fcs1 \af0\afs24 
\ltrch\fcs0 \strike\f0\fs24\cf6\lang1045\langfe1045\langfenp1045\insrsid4128813\charrsid3170437 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3170437 {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\lang1045\langfe1045\langfenp1045\insrsid4128813\charrsid3170437 
                                                            w rejestrach uprawnionych do zaci\'b9gania zobowi\'b9za\'f1
\par                                                         w imieniu wykonawcy lub we w\'b3a\'9cciwym pe\'b3nomocnictwie
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