ࡱ>  bjbj&z&z4DPgDPgaUBBOOOOOOOO8P45P$OqXYPYP(PPPTTT̻λλλλλλ$n9OT T T|TTOOPP+I[I[I[TOPOP̻I[T̻I[I[jP([iYx"A0qYd,O̓'TTI[TTTTTZTTTqTTTTTTTTTTTTTBc {N:ZaBcznik Nr 2 do SWZ Wykonawca: & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & (peBna nazwa/firma, adres, NIP/PESEL, KRS/CEiDG) reprezentowany przez: & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & (imi, nazwisko, stanowisko/podstawa do reprezentacji) O[wiadczenie Wykonawcy skBadane na podstawie art. 125 ust. 1 ustawy z dnia 11 wrze[nia 2019 r. Prawo zamwieD publicznych (dalej jako: ustawa Pzp), DOTYCZCE PODSTAW DO WYKLUCZENIA Z POSTPOWANIA Na potrzeby postpowania o udzielenie zamwienia publicznego pn. & & & & & & & & & & & & .& & & & . (nazwa postpowania),prowadzonego przez Powiat Lborski, ul. CzoBgistw 5, 84-300 Lbork o[wiadczam, co nastpuje: OZWIADCZENIA DOTYCZCE WYKONAWCY: O[wiadczam, |e nie podlegam wykluczeniu z postpowania na podstawie art. 108 ust 1 ustawy Pzp. O[wiadczam, |e nie podlegam wykluczeniu z postpowania na podstawie art. 109 ust. 1 pkt. 4 ustawy Pzp. 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Jednocze[nie o[wiadczam, |e w zwizku z ww. okoliczno[ci, na podstawie art. 110 ust. 2 ustawy Pzp podjBem nastpujce [rodki naprawcze & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & .& & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & ..& & & & & & & & & & & & & & & & & & & .. OZWIADCZENIE DOTYCZCE PODANYCH INFORMACJI: O[wiadczam, |e wszystkie informacje podane w powy|szych o[wiadczeniach s aktualne i zgodne z prawd oraz zostaBy przedstawione z peBn [wiadomo[ci konsekwencji wprowadzenia Zamawiajcego w bBd przy przedstawianiu informacji.      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