ࡱ> 13./0q";bjbjzLzL4F&\&\ T~&~& 44*4*4*4>4>4>48v4<4L>4"<44444555e;g;g;g;g;g;g;$ACb;Q*455555;*4*444;Y6Y6Y65d*44*44e;Y65e;Y6Y6::,1;4 56뤅=6;Q;;0"<'; &D=6&D1;&D*41; Y6555;;Y6555"<5555&D555555555~&R 2: ZaBcznik nr 5 do SWZ WYKAZ OSB SKIEROWANYCH PRZEZ WYKONAWC DO REALIZACJI ZAMWIENIA PUBLICZNEGO  Nazwa Wykonawcy: .................................................................................................& .& & ..... Adres: .................................................................................................................................... Tel/fax : ........................................................ NIP : .......................... Regon: ......................., nr KRS:....................... (je|eli dotyczy) Ubiegajc si o udzielenie zamwienia publicznego w trybie podstawowym na zadanie: Zaprojektowanie i budowa budynku |Bobka w ramach zadania pn. Utworzenie 100 nowych miejsc opieki nad dziemi do lat 3 w nowej instytucji |Bobka pod adresem Grabwki w ramach  Maluch+ o[wiadczam, |e do realizacji zamwienia publicznego skieruj nastpujce osoby: Imi i nazwiskoKwalifikacje zawodowe/uprawnienia/do[wiadczenie/wyksztaBcenieZakres wykonywanych czynno[ci w realizacji zamwieniaInformacja o podstawie dysponowania osobami& & & & & & & & & & ...* Uprawnienia budowlane w specjalno[ci architektonicznej bez ograniczeD ktre uprawniaj do projektowania, w odniesieniu do architektury obiektu (uprawnienia o ktrych mowa w art. 15a ust. 2 uPb) nr uprawnieD & & & & & & & & & & & & data wydania & & & & & & & & & & ...& . lub * odpowiadajce im uprawnienia rwnowa|ne: .....& & & & & & & & & & & & & & & & & & & & & & ..& ...& & & & & & & & & & & & & & & & & & & & & & & .& ...& & & & & & & & & & & & & & & & & & & & & & ....&  nr uprawnieD & & & & & & & & & & & & data wydania & & & & & & & & & & & oraz do[wiadczenie jako projektant przy realizacji minimum 1 projektu budowlanego |Bobka lub przedszkola.ProjektantDysponowanie bezpo[rednie/ dysponowanie po[rednie**& & & & & & & & & & ...* Uprawnienia budowlane w specjalno[ci konstrukcyjno-budowlanej bez ograniczeD (uprawnienia o ktrych mowa w art. 15a ust. 4 uPb): nr uprawnieD & & & & & & & & & & & & data wydania & & & & & & & & & & ...& . lub * odpowiadajce im uprawnienia rwnowa|ne: .....& & & & & & & & & & & & & & & & & & & & & & ..& ...& & & & & & & & & & & & & & & & & & & & & & & .& ...& & & & & & & & & & & & & & & & & & & & & & ....&  nr uprawni,0:<D~uX:6$"h ACJOJQJ^JaJmHsHh A;h A56@<B*CJOJQJ\]^JaJmHphsH9h A5@<B*CJOJPJQJ\^JaJmHphsH,h A5@<CJOJQJ\^JaJmHsH4h A0J5@<CJOJPJQJ\^JaJmHsH0h A0J5@<CJOJQJ\^JaJmHsH5h A5@<B*CJOJQJ\^JaJmHphsH9h A0J5B*CJOJPJQJ\^JaJmHphsHh AmHsH .0F {jd]$ Hdh]a$7kd$$If''47a7p $  $7$G$If^ a$ $$Ifa$$  $G$If^ a$ $ Hdha$ Hdh q " $ :<x> G$$If^a$$5x^5`a$$ 91$^9a$$*$7$a$ $dd9D]a$ dh9D]]  ]^  $ 8<RTXҵ쟂bN8N8N8N*h A0JCJOJPJQJ^JaJmHsH&h A0JCJOJQJ^JaJmHsH?h AB*CJKHOJPJQJ^J_HaJmHnHphsHtH8h A5CJKHOJQJ\^J_HaJmHnHsHtH*h ACJOJPJQJ^J_HaJmHsH8h A6CJOJPJQJ]^J_HaJmHnHsHtH2h ACJOJPJQJ^J_HaJmHnHsHtH&h ACJOJPJQJ^JaJmHsHvx,.<@Z\^T^b̳̕i*h A0JCJOJPJQJ^JaJnH9tH9*h A0JCJOJPJQJ^JaJnH9tH9:h A0JB*CJOJPJQJ\^J_H aJnH9phtH90h A0J5CJOJPJQJ\^JaJnH9tH9h A0h A0J5CJOJPJQJ\^JaJmHsH,h A0J5CJOJQJ\^JaJmHsH'>@\V`[J>>>>> h 9$Ifh$ 9$G$Ifa$kdY$$If4o\y  }&n   "          @@@@(44  af4p(bdflnH&DZkQM6M.h A0JCJOJQJ^JaJmHnH sHtH ,h A0J5CJOJQJ\^JaJmHsHh A3h$Yh$Y0J5CJOJPJQJ^JaJnH9tH9*h$Y0JCJOJPJQJ^JaJnH9tH9*h A0JCJOJPJQJ^JaJnH9tH93jh A0JCJOJPJQJU^JaJnH9tH9*h A0JCJOJPJQJ^JaJnH9tH9:h A0JB*CJOJPJQJ\^J_H aJnH9phtH93h A0JB*CJOJPJQJ^JaJnH9phtH9 0p( $x$G$Ifa$$ i9$1$Ifa$j 9$If^ h 9$Ifi 9$If^(*FN]L@@@@@ h 9$Ifh$ 9$G$Ifa$kdn$$If4\y  }&n   "          (44  af4p(&*DFHL.P.T.//"/$/ůůecL,h A0J5CJOJQJ\^JaJmHsHU3jh A0JCJOJPJQJU^JaJnH9tH93h A0JB*CJOJPJQJ^JaJnH9phtH9*h A0JCJOJPJQJ^JaJnH9tH9*h A0JCJOJPJQJ^JaJnH9tH9:h A0JB*CJOJPJQJ\^J_H aJnH9phtH90h A0J5CJOJPJQJ\^JaJnH9tH9h A$b .R.T./$// $x$G$Ifa$$ i9$1$Ifa$j 9$If^i 9$If^ h 9$If eD & & & & & & & & & & & & data wydania & & & & & & & & & & & oraz do[wiadczenie jako kierownik budowy przy budowie minimum 2 obiektw kubaturowych.Kierownik budowyDysponowanie bezpo[rednie/ dysponowanie po[rednie** Prawdziwo[ powy|szych danych potwierdzam [wiadomy odpowiedzialno[ci karnej z art. 297 1 KK. Z dysponowaniem bezpo[rednim mamy do czynienia, gdy tytuBem prawnym do powoBania si przez wykonawc na dysponowanie osobami zdolnymi do wykonania zamwienia jest stosunek prawny istniejcy bezpo[rednio pomidzy wykonawc a osobami, na dysponowanie ktrymi wykonawca si powoBuje. Bez znaczenia jest tutaj charakter prawny takiego stosunku, tj. mo|e to by umowa o prac, umowa zlecenia, umowa przedwstpna, czy te| z samozatrudnienie si osoby fizycznej prowadzcej dziaBalno[ gospodarcz. Z po[rednim dysponowaniem osobami zdolnymi do wykonania zamwienia mamy do czynienia, gdy osoby te udostpniane s wykonawcy za po[rednictwem (i zgod) podmiotu trzeciego. W takich przypadkach tytuBem prawnym do powoBania si przez wykonawc na dysponowanie osobami zdolnymi do wykonania zamwienia jest zobowizanie podmiotu udostpniajcego zasoby do oddania mu do dyspozycji niezbdnych zasobw na potrzeby realizacji danego zamwienia lub inny podmiotowy [rodek dowodowy potwierdzajcy, |e wykonawca realizujc zamwienie, bdzie dysponowaB niezbdnymi zasobami tych podmiotw * Zaznaczy wBa[ciwe **Niepotrzebne skre[li  W przypadku uprawnieD rwnowa|nych nale|y je opisa oraz wskaza podstaw ich wydania.  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