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\rsid8408839\rsid8523822\rsid8587953\rsid8592285\rsid8668607\rsid8668826\rsid8716464\rsid8741071\rsid8748775\rsid8863292\rsid8863812\rsid8867857\rsid8990280\rsid8993514\rsid9052993\rsid9062629\rsid9067495\rsid9203192\rsid9241735\rsid9319028\rsid9386008 \rsid9513459\rsid9521078\rsid9572248\rsid9575189\rsid9597647\rsid9634210\rsid9663979\rsid9726407\rsid9778577\rsid9792550\rsid9903503\rsid9903897\rsid9917818\rsid9919561\rsid10107261\rsid10226796\rsid10251742\rsid10301772\rsid10321412\rsid10452022 \rsid10508461\rsid10511758\rsid10567709\rsid10569498\rsid10578013\rsid10632486\rsid10699546\rsid10700766\rsid10710677\rsid10756653\rsid10838132\rsid10839559\rsid10885373\rsid10889112\rsid10974974\rsid11086903\rsid11221478\rsid11230770\rsid11235752 \rsid11236586\rsid11431922\rsid11482047\rsid11495884\rsid11541381\rsid11606516\rsid11620889\rsid11621556\rsid11676606\rsid11740004\rsid11753024\rsid11755483\rsid11759924\rsid11800520\rsid11818104\rsid12060073\rsid12061966\rsid12146859\rsid12150022 \rsid12274243\rsid12282090\rsid12388035\rsid12525375\rsid12530776\rsid12586030\rsid12667807\rsid12723512\rsid12811273\rsid12849215\rsid12851227\rsid12867323\rsid12942827\rsid13063731\rsid13262632\rsid13310683\rsid13370316\rsid13393229\rsid13395399 \rsid13396118\rsid13526016\rsid13585012\rsid13707410\rsid13769102\rsid13775646\rsid13847962\rsid13858901\rsid13893765\rsid13896158\rsid13905051\rsid13910058\rsid13925688\rsid13984506\rsid14051689\rsid14111532\rsid14293675\rsid14434116\rsid14436665 \rsid14488682\rsid14499485\rsid14503072\rsid14578670\rsid14682048\rsid14763346\rsid14769497\rsid14818114\rsid14877975\rsid14951524\rsid14953667\rsid15029522\rsid15078868\rsid15164144\rsid15231531\rsid15365325\rsid15413894\rsid15541959\rsid15558506 \rsid15562319\rsid15614584\rsid15615285\rsid15619077\rsid15628069\rsid15692827\rsid15693002\rsid15733942\rsid15734406\rsid15737399\rsid15750124\rsid15804477\rsid15809571\rsid15820258\rsid15861581\rsid15871249\rsid15940291\rsid15945278\rsid15951346 \rsid16074368\rsid16139750\rsid16147651\rsid16151405\rsid16207445\rsid16266256\rsid16454458\rsid16475019\rsid16477966\rsid16480613\rsid16516711\rsid16521872\rsid16676760\rsid16729093}{\mmathPr\mmathFont34\mbrkBin0\mbrkBinSub0\msmallFrac0\mdispDef1 \mlMargin0\mrMargin0\mdefJc1\mwrapIndent1440\mintLim0\mnaryLim1}{\info{\author Remigiusz St\'eapie\'f1}{\operator Anna Skrzypiec}{\creatim\yr2021\mo4\dy1\hr12\min26}{\revtim\yr2024\mo3\dy21\hr13\min29}{\printim\yr2021\mo3\dy29\hr10\min44}{\version23} {\edmins21}{\nofpages2}{\nofwords556}{\nofchars3336}{\nofcharsws3885}{\vern57455}}{\*\xmlnstbl {\xmlns1 http://schemas.microsoft.com/office/word/2003/wordml}}\paperw11906\paperh16838\margl1134\margr1134\margt1134\margb1134\gutter0\ltrsect \deftab708\widowctrl\ftnbj\aenddoc\hyphhotz425\trackmoves0\trackformatting1\donotembedsysfont1\relyonvml0\donotembedlingdata0\grfdocevents0\validatexml1\showplaceholdtext0\ignoremixedcontent0\saveinvalidxml0 \showxmlerrors1\aftnnar\noxlattoyen\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\formshade\horzdoc\dgmargin\dghspace180\dgvspace180\dghorigin1134\dgvorigin1134\dghshow1\dgvshow1 \jexpand\viewkind1\viewscale100\pgbrdrhead\pgbrdrfoot\splytwnine\ftnlytwnine\htmautsp\nolnhtadjtbl\useltbaln\alntblind\lytcalctblwd\lyttblrtgr\lnbrkrule\nobrkwrptbl\snaptogridincell\allowfieldendsel\wrppunct \asianbrkrule\rsidroot12849215\newtblstyruls\nogrowautofit \fet0{\*\wgrffmtfilter 2450}\ilfomacatclnup0{\*\ftnsep \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3679007 \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f37\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3938465 \chftnsep \par }}{\*\ftnsepc \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3679007 \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f37\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 { \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3938465 \chftnsepc \par }}{\*\aftnsep \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3679007 \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f37\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 { \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3938465 \chftnsep \par }}{\*\aftnsepc \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3679007 \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f37\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 { \rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3938465 \chftnsepc \par }}\ltrpar \sectd \ltrsect\linex0\headery709\footery709\colsx708\endnhere\sectlinegrid360\sectdefaultcl\sectrsid8748775\sftnbj\saftnnar {\footerr \ltrpar \pard\plain \ltrpar\s24\qr \li0\ri0\widctlpar \tqc\tx4536\tqr\tx9072\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f37\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 {\field{\*\fldinst {\rtlch\fcs1 \af39\afs18 \ltrch\fcs0 \f39\fs18\insrsid14293675\charrsid3407962 PAGE \\* MERGEFORMAT}}{\fldrslt {\rtlch\fcs1 \af39\afs18 \ltrch\fcs0 \f39\fs18\lang1024\langfe1024\noproof\insrsid5656000 2}}}\sectd \ltrsect\linex0\headery708\footery708\colsx708\endnhere\sectdefaultcl\sftnbj { \rtlch\fcs1 \af39\afs18 \ltrch\fcs0 \f39\fs18\insrsid14293675\charrsid3407962 \par }\pard \ltrpar\s24\ql \li0\ri0\widctlpar\tqc\tx4536\tqr\tx9072\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14293675 \par }}{\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang {\pntxta )}} {\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl8 \pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}\pard\plain \ltrpar\ql \li0\ri0\sl360\slmult1 \widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1136778 \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f37\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\insrsid1136778\charrsid11740004 ZP/220/}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\insrsid5656000 31}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\insrsid11740004\charrsid11740004 /24}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\insrsid1136778 \tab \tab \tab \tab \tab \tab \tab \tab }{\rtlch\fcs1 \af39\afs18 \ltrch\fcs0 \f39\fs18\insrsid1592828\charrsid1920648 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid1136778 Za\'b3\'b9cznik nr }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid5656000 5}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid1136778\charrsid1136778 do SWZ}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \par }\pard \ltrpar\ql \li4956\ri-851\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin-851\lin4956\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 Zamawiaj\'b9cy: \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid1136778 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid12851227 Uniwersytecki}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid1136778 Szpital Kliniczny Nr 2 \par PUM w Szczecinie \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 Al. Powsta\'f1c\'f3w Wlkp. 72}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15871249\charrsid16151405 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 70-111 Szczecin \par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 Wykonawca: \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \par \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid3167296\charrsid16151405 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid3167296\charrsid16151405 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid3167296\charrsid16151405 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \par }\pard \ltrpar\ql \li0\ri-1\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin-1\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid1592828\charrsid16151405 (pe\'b3na nazwa/firma, adres oraz }{ \rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid15619077\charrsid16151405 w zale\'bfno\'9cci od podmiotu: NIP/PESEL, KRS/CEiDG) \par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\ul\insrsid15619077\charrsid16151405 reprezentowany przez: \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \par \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85. \par }\pard \ltrpar\ql \li0\ri-1\sl360\slmult1\widctlpar\tx9638\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin-1\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid15619077\charrsid16151405 (imi\'ea, nazwisko, stanowisko/ }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid3167296\charrsid16151405 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid15619077\charrsid16151405 podstawa do}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid3167296\charrsid16151405 r}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid15619077\charrsid16151405 eprezentacji) \par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \par }\pard \ltrpar\qc \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid1136778 WST\'caPNE }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid1592828\charrsid16151405 O\'8cWIADCZENIE WYKONAWCY }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid1592828\charrsid16151405 DOTYCZ\'a5CE PRZES\'a3ANEK WYKLUCZENIA Z POST\'caPOWANIA}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid275205 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \par }\pard \ltrpar\qc \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5066981 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 Na potrzeby post\'ea powania o udzielenie zam\'f3wienia publicznego pn.}{\rtlch\fcs1 \af37\afs20 \ltrch\fcs0 \b\fs20\insrsid5066981 \par }\pard \ltrpar\ql \li0\ri0\sa160\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10885373 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\expnd0\expndtw-2\lang1045\langfe2052\langfenp2052\insrsid10885373\charrsid10885373 Dostawa }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\expnd0\expndtw-2\lang1045\langfe2052\langfenp2052\insrsid5656000 mebli oraz wyposa\'bfenia medycznego}{ \rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\expnd0\expndtw-2\lang1045\langfe2052\langfenp2052\insrsid10885373\charrsid10885373 dla USK-2}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\expnd0\expndtw-2\lang1045\langfe2052\langfenp2052\insrsid10885373 w Szczecinie, }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid12851227 prowadzonego przez USK}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 -2}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15562319\charrsid16151405 w}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid3167296\charrsid16151405 Szczecinie}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid7677463 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 o\'9cwiadczam, co nast\'eapuje:}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\expnd0\expndtw-2\lang1045\langfe2052\langfenp2052\insrsid2453762\charrsid10885373 \par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 \cbpat17 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid6162127\charrsid16151405 I. }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 O\'8cWIADCZENIA DOTYCZ\'a5CE WYKONAWCY: \par }\pard\plain \ltrpar\s15\qj \li720\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid1592828\contextualspace \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f37\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs19 \ltrch\fcs0 \b\f37\fs19\lang1045\langfe1033\langfenp1033\insrsid2240732\charrsid2240732 \hich\af37\dbch\af0\loch\f37 1.\tab}}\pard\plain \ltrpar\qj \fi-284\li284\ri0\sl360\slmult1 \widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls15\adjustright\rin0\lin284\itap0\pararsid2240732\contextualspace \rtlch\fcs1 \af0\afs22\alang1025 \ltrch\fcs0 \f37\fs22\lang1045\langfe1033\cgrid\langnp1045\langfenp1033 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\insrsid2240732\charrsid2240732 O\'9cwiadczam, \'bfe nie podlegam wykluczeniu z post\'eapowania}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \fs19\insrsid2240732\charrsid2240732 na podstawie }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\insrsid2240732\charrsid2240732 art. 108 oraz art. 109 ust. 1 pkt 4, 5, 7 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \fs19\insrsid2240732\charrsid2240732 Ustawy z dnia 11 wrze\'9cnia 2019 r. \endash Prawo zam\'f3wie\'f1 publicznych (Dz.U.2019.2019 t.j. z dnia 2019.10.24, zwanej dalej PZP), jak r\'f3wnie\'bf }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\fs19\insrsid2240732\charrsid2240732 art. 7 ust. 1 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \fs19\insrsid2240732\charrsid2240732 ustawy z dnia 13 kwietnia 2022 r. o szczeg\'f3lnych rozwi\'b9zaniach w zakresie przeciwdzia\'b3ania wspieraniu agresji na Ukrain\'ea oraz s\'b3u\'bf\'b9cych ochronie bezpiecze\'f1 stwa narodowego (Dz.U.2022.835 z dnia 2022.04.15). \par }\pard \ltrpar\qj \li5103\ri0\sl360\slmult1\widctlpar\tx4820\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin5103\itap0\pararsid2104653 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2240732 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid6160869 \'85\'85\'85\'85\'85.\'85\'85.\'85\'85\'85\'85\'85\'85. \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85 \par }\pard \ltrpar\qj \li5103\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin5103\itap0\pararsid2104653 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid664647 miejscowo\'9c\'e6, }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653 data podpis }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid664647 \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1920648 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid16151405\charrsid16151405 \par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0\afs19 \ltrch\fcs0 \b\f31506\fs19\lang1045\langfe1033\langfenp1033\insrsid15619077\charrsid16151405 \hich\af31506\dbch\af0\loch\f31506 1.\tab}}\pard \ltrpar\qj \fi-284\li284\ri0\sl360\slmult1 \widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls7\adjustright\rin0\lin284\itap0\pararsid9062629 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 O\'9cwiadczam, \'bfe zachodz\'b9 w stosunku do mnie podstawy wykluczenia z post\'eapowania}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid1920648\charrsid16151405 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 na podstawie}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid16151405 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 art. }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid9062629 \'85\'85\'85\'85\'85}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 ustawy }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid1136778 PZP}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid15619077\charrsid16151405 (poda\'e6 maj\'b9c\'b9 zastosowanie podstaw\'ea wykluczenia spo\'9cr\'f3d wymienionych}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid1592828\charrsid16151405 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid15619077\charrsid16151405 w art. }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \fs19\insrsid9062629\charrsid9062629 108 ust. 1 pkt 1, 2, 5}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid15619077\charrsid9062629 ).}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid1592828\charrsid9062629 \par }\pard \ltrpar\qj \li284\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin284\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 Jednocze\'9cnie o\'9cwiadczam, \'bf e w zwi\'b9zku z ww. okoliczno\'9cci\'b9, na podstawie art. }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid9062629 110 ust. 2}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 ustawy P}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid9062629 ZP}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 podj\'b9\'b3em nast\'eapuj\'b9ce \'9crodki naprawcze: }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid9062629\charrsid16151405 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid16521872\charrsid16151405 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{ \rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid1592828\charrsid16151405 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \par }\pard \ltrpar\qj \li5103\ri0\sl360\slmult1\widctlpar\tx4820\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin5103\itap0\pararsid2104653 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid9062629 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid6160869 \'85\'85\'85\'85\'85.\'85\'85.\'85\'85\'85\'85\'85\'85. \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85 \par }\pard \ltrpar\qj \li5103\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin5103\itap0\pararsid2104653 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid664647 miejscowo\'9c\'e6, }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653 data podpis \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid5527403 \par \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 \cbpat17 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid6162127\charrsid16151405 II. }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 O\'8cWIADCZENIE DOTYCZ\'a5CE PODMIOTU, NA KT\'d3REGO ZASOBY POWO\'a3UJE SI\'ca WYKONAWCA: \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2453762 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\i\f31506\fs19\cf6\insrsid2453762\charrsid16151405 Wype\'b3ni\'e6 tylko w przypadku powo\'b3ywania si\'ea na zasoby innych podmiot\'f3w. \par \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 O\'9cwiadczam, \'bfe w stosunku do nast \'eapuj\'b9cego/ych podmiotu/t\'f3w, }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\ul\insrsid15619077\charrsid16151405 na kt\'f3rego/ych zasoby}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\ul\insrsid16477966\charrsid16151405 powo\'b3uje si\'ea w niniejszym }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\ul\insrsid15619077\charrsid16151405 post\'eapowaniu}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 ,\~tj.:}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\ul\insrsid1592828\charrsid16151405 \par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid1592828\charrsid16151405 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid1592828\charrsid16151405 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85..}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2453762\charrsid16151405 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid15619077\charrsid16151405 (poda\'e6 pe\'b3n\'b9 nazw\'ea/firm\'ea, adres, a tak\'bfe w zale\'bfno\'9cci od podmiotu: NIP/PESEL, KRS/CEiDG)}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid1592828\charrsid16151405 \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid1592828\charrsid16151405 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 nie zachodz\'b9 podstawy wykluczenia z post\'eapowania o udzielenie zam\'f3wienia. \par \par }\pard \ltrpar\qj \li5103\ri0\sl360\slmult1\widctlpar\tx4820\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin5103\itap0\pararsid2104653 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid6160869 \'85\'85\'85\'85\'85.\'85\'85. \'85\'85\'85\'85\'85\'85. \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85 \par }\pard \ltrpar\qj \li5103\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin5103\itap0\pararsid2104653 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid664647 miejscowo\'9c\'e6, }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653 data podpis \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid664647 \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 \cbpat17 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid6162127\charrsid16151405 III. }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 O\'8cWIADCZENIE DOTYCZ\'a5CE PODWYKONAWCY NIEB\'caD\'a5CEGO PODMIOTEM, NA KT\'d3REGO ZASOBY POWO\'a3UJE SI\'ca WYKONAWCA: \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \b\f31506\fs19\insrsid15619077\charrsid16151405 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 O\'9cwiadczam, \'bfe w stosunku do nast\'eapuj\'b9cego/ych podmiotu/t\'f3w, b\'ead\'b9cego/ych podwykonawc\'b9/ami: }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid16475019\charrsid16151405 \par \par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16475019 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85..\'85.\'85\'85}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid16475019\charrsid16151405 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85 \'85\'85..}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2453762\charrsid16151405 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \i\f31506\fs19\insrsid15619077\charrsid16151405 (poda\'e6 pe\'b3n\'b9 nazw\'ea/firm\'ea, adres, a tak\'bfe w zale\'bfno\'9cci od podmiotu: NIP/PESEL, KRS/CEiDG)}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 ,}{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid16475019\charrsid16151405 \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid16475019\charrsid16151405 \par }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid15619077\charrsid16151405 nie zachodz\'b9 podstawy wykluczenia z post\'eapowania o udzielenie zam\'f3wienia. \par \par }\pard \ltrpar\qj \li5103\ri0\sl360\slmult1\widctlpar\tx4820\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin5103\itap0\pararsid2104653 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid6160869 \'85\'85\'85\'85\'85.\'85\'85. \'85\'85\'85\'85\'85\'85. \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85 \par }\pard \ltrpar\qj \li5103\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin5103\itap0\pararsid2104653 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653 }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid664647 miejscowo\'9c\'e6, }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653 data podpis }{\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 \f31506\fs19\insrsid2104653\charrsid664647 \par }\pard \ltrpar\qj \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1592828 {\rtlch\fcs1 \af37\afs19 \ltrch\fcs0 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