ࡱ> LOIJKC,Hbjbj7RhhL 8d1L/l}}}}}.......$"24j/i/}}4p/!!!F}}.!.!!r*T*}Eְc:g*./0/u*zB51dB5**JB59+!//!:/B5 c G: ZaBcznik nr 6 do SWZ WYKAZ ROBT BUDOWLANYCH wykonanych nie wcze[niej ni| w okresie ostatnich 5 lat, a je|eli okres prowadzenia dziaBalno[ci jest krtszy  w tym okresie, wraz z podaniem ich rodzaju, warto[ci, daty i miejsca wykonania oraz podmiotw, na rzecz ktrych roboty te zostaBy wykonane. Dotyczy postpowania:  Nadbudowa o dwie kondygnacje budynku o funkcji leczniczo-rehabilitacyjnej Wojewdzkiego Szpitala Rehabilitacyjnego dla dzieci w Ameryce Wykonawca: ......................................................................................... (nazwa i adres Wykonawcy) LP.Rodzaj robt budowlanych o zakresie wymaganym i opisanym w SWZ Warto[ zrealizowanej roboty budowlanej (Bcznie z podatkiem VAT) Miejsce wykonania zamwienia Data wykonania zamwienia (dzieD/miesic/rok) Podmioty, na rzecz ktrych roboty zostaBy wykonaneDo[wiadczenie wBasne Wykonawcy/ do[wiadczenie oddane do dyspozycji przez podmiot udostpniajcy zasoby1234561.WBasne/ * oddane do dyspozycji2.WBasne/oddane do dyspozycji** niepotrzebne skre[li Uwaga! 1. Na |danie zamawiajcego nale|y dostarczy dowody okre[lajce, czy roboty budowlane wymienione w niniejszym zaBczniku zostaBy wykonane nale|ycie, przy czym dowodami, o ktrych mowa, s referencje bdz inne dokumenty sporzdzone przez podmiot, na rzecz ktrego roboty budowlane zostaBy wykonane, a je|eli wykonawca z przyczyn niezale|nych od niego nie jest w stanie uzyska tych dokumentw  inne odpowiednie dokumenty. 2. W ofercie musi znajdowa si informacja na zasadach opisanych w SWZ o podstawie do dysponowania przedstawionymi zasobami. 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Wykonawca w takiej sytuacji zobowizany jest udowodni Zamawiajcemu, i| bdzie dysponowaB zasobami niezbdnymi do realizacji zamwienia, w szczeglno[ci przedstawiajc w tym celu pisemne zobowizanie tych podmiotw do oddania mu do dyspozycji niezbdnych zasobw na okres korzystania z nich przy wykonywaniu zamwienia. 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