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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 wniniejszym postpowaniu.** 1) rozporzdzenie Parlamentu Europejskiego i Rady (UE) 2016/679 zdnia 27kwietnia 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 z04.05.2016, str. 1) Rodzaj Wykonawcy (nale|y wybra wBa[ciwe):  FORMCHECKBOX  mikroprzedsibiorstwo  FORMCHECKBOX  maBe przedsibiorstwo  FORMCHECKBOX  [rednie przedsibiorstwo  FORMCHECKBOX  prowadzenie jednoosobowej dziaBalno[ci  FORMCHECKBOX  osoba fizyczna nie prowadzca dziaBalno[ci gospodarczej  FORMCHECKBOX  inny rodzaj Por. zalecenie Komisji z dnia 6 maja 2003 r. dotyczce definicji mikroprzedsibiorstw oraz maBych i [rednich przedsibiorstw (Dz.U. L 124 z 20.5.2003, s. 36). Te informacje s wymagane wyBcznie do celw statystycznych. Mikroprzedsibiorstwo: przedsibiorstwo, ktre zatrudnia mniej ni| 10 osb i ktrego roczny obrt lub roczna suma bilansowa nie przekracza 2 milionw EUR. MaBe przedsibiorstwo: przedsibiorstwo, ktre zatrudnia mniej ni| 50 osb i ktrego roczny obrt lub roczna suma bilansowa nie przekracza 10 milionw EUR. Zrednie przedsibiorstwa: przedsibiorstwa, ktre nie s mikroprzedsibiorstwami ani maBymi przedsibiorstwami iktre zatrudniaj mniej ni| 250 osb i ktrych roczny obrt nie przekracza 50 milionw EUR lub roczna suma bilansowa nie przekracza 43 milionw EUR. & & & & & & & & & & & & & & miejscowo[, data (nale|y opatrzy kwalifikowanym podpisem elektronicznym lub podpisem zaufanym lub podpisem osobistym osoby uprawnionej lub osb uprawnionych do reprezentowania Wykonawcy) * niewBa[ciwe skre[li ** 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).      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