ࡱ> k#bjbj,\\v\BBBBBVVV8<VC!"$! 0!SCUCUCUCUCUCUC$G:JByC-B8! "8!8!yCBBC"""8!FBBSC"8!SC""nCABfɟx~!KB ?CC0CkBD|J~!|J@B|JBB8!8!"8!8!8!8!8!yCyC"8!8!8!C8!8!8!8!|J8!8!8!8!8!8!8!8!8!R :Nr Sprawy: IM.271.2.2021 ZaBcznik nr 4 do SWZ Podmioty, w imieniu ktrych skBadane jest o[wiadczenie: & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & (peBna nazwa/firma, adres, w zale|no[ci od podmiotu: NIP/PESEL, KRS/CEIDG)& & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & (peBna nazwa/firma, adres, w zale|no[ci od podmiotu: NIP/PESEL, KRS/CEIDG)reprezentowane przez:& & & & & & & & & & & & & & & & & & & ..& ..& & & &  (imi, nazwisko, stanowisko/podstawa do reprezentacji) O[wiadczenie o realizacji robt przez poszczeglnych wykonawcw wsplnie ubiegajcych si o zamwienie na podstawie art. 117 ust. 4 ustawy z dnia 11 wrze[nia 2019 r. Prawo zamwieD publicznych na zadaniu pn.:  Rewitalizacja obszaru parkowego z przeznaczeniem na rozwj dziaBalno[ci Inkubatora Kultury w Malborku O[wiadczam, |e nastpujce roboty: & & & & & & & & &0   j l n Z ^ J N x õéshZOBhX\%h_ 5>*\^JhYh_ CJaJhYh_ 6CJ^JaJhYh_ CJaJhYh_ 6CJ^JaJ hX\%h_ hX\%h_ CJOJQJaJhX\%h_ ^Jh_ 5>*^JhX\%h_ 5>*^JhYh_ \^JnHtHhYh_ ^J h<h~d h<ha!h h 5 hv5h<ha!5\^JnHtHh<ha!^J l n \ ^ KFkdc$$If7bb tb47a7p yt)$ p#$1$Ifa$gd)Fkd$$If7bb tb47a7p yt) &$Ifgd)gd_ dgd_  L N z aK$ p#$1$Ifa$gd)Fkd)$$If7bb tb47a7p yt)$ p#$1$Ifa$gd)Fkd$$If7bb tb47a7p yt)x z | & * . !!"Ƚ~omoaoN>h_ B*OJPJQJ^Jph%h,h_ B*OJPJQJ^Jphh_ B*PJ^JphUh-=h_ B*PJ^Jph h7mh_ h7mh_ 5]^Jh7mh_ 5^J h_ 5^JhX\%h_ 5^J h_ 5hYh_ 5h_ hYh_ CJaJhYh_ 6CJ^JaJhYh_ 6CJPJ^JaJhX\%h_ ^J hX\%h_ hX\%h_ 5\z | ( aFkd$$If7bb tb47a7p yt)$ p#$1$Ifa$gd)Fkd$$If7bb tb47a7p yt)( * , . 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