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Imi i nazwiskoUprawnienia budowlane nr & & & & & & & & & & & & & & & & ..& do kierowania robotami w specjalno[ci: & & & & & & & & & & & & & & ..& & & & & & & & & & w zakresie: & & & & & & & & & & & & & & & ..& & & & & & & & & Data wydania uprawnieD: & & & & & & & & & & & & & & & ..dysponuj* bd dysponowaB O[wiadczam/y* |e: poz. & & & . wykazu stanowi zdolno[ techniczn lub zawodow Wykonawcy skBadajcego ofert, poz. & & & . wykazu jest zdolno[ci techniczn lub zawodow oddan do dyspozycji przez inny/inne* podmiot/y*, O[wiadczam, |e wszystkie informacje podane w powy|ej o[wiadczeniach s aktualne i zgodne z prawd oraz zostaBy przedstawione z peBn [wiadomo[ci konsekwencji wprowadzenia zamawiajcego w bBd przy przedstawianiu informacji. & & & .& & & & & & & & & & & & & & & & Dokument powinien by podpisany elektronicznie przez osob/y upowa|nione do reprezentowania Wykonawcy * Niepotrzebne skre[li GMINA STAWIGUDA 11-034 Stawiguda, ul. 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