ÐÏࡱá>þÿ 
24
þÿÿÿ1ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥ÁÀð¿Lbjbj4ç4ç:V
V
˜ÿÿÿÿÿÿ·²²ÿÿÿÿ+++8c+oà“““““n„âääääää$O!²
$b!˜nn˜˜““Û)***˜F““â*˜â**.V“ÿÿÿÿ :/»€Ô
ÿÿÿÿÞFÎ?0oNc$ÞLc$VVc$jd*˜˜˜*˜˜˜o˜˜˜˜ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿc$˜˜˜˜˜˜˜˜˜²+Ý:

ZaB

cznik nr 4 do ogB
oszenia (piecz

Wykonawcy) Dotyczy post
powania o udzielenie zamówienia na zadanie pn.:  Z
wiadczenie usB
ug opiekuD
czych na rzecz podopiecznych Miejskiego O[
rodka Pomocy SpoB
ecznej w Czarnej Wodzie OZ
WIADCZENIE O[
wiadczam, |
e osoby, które b
d
uczestniczy
w wykonywaniu zamówienia, posiadaj
wyksztaB
cenie, kwalifikacje zawodowe i uprawnienia zgodne z wymaganiami okre[
lonymi przez Zamawiaj
cego w ogB
oszeniu. & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & .  &:<DnpéÒ¹ ‡kR9+hñ4QCJOJQJ^JaJ0hñ4Q6>*
B*
CJOJPJQJ]^JaJph0hJê6>*
B*
CJOJPJQJ]^JaJph6hJêhñ4Q6B*
CJOJPJQJ\]^JaJph0hŽ°6B*
CJOJPJQJ\]^JaJph0hñ4Q6B*
CJOJPJQJ\]^JaJph0hJê6B*
CJOJPJQJ\]^JaJph,hãY6B*
CJOJQJ\]^JaJph,hñ4Q6B*
CJOJQJ\]^JaJph <>@BDlnprìZ È Ê Ì æ è ê ì ÷ëëëëëëéá×Åž´¬¬¬¬$
a$
gdÏ$ $
dd¤a$
$¤a$$
„
„äþ¤^„
`„äþa$
gd‹ÿ $
¤a$
gd‹ÿ$
$
¤a$

$dd¤j¤a$ddgd‹ÿprêÆ È Ê Ì ì fz~”ÄHd˜œ*.îÜËǸ«¦¢ž¢Ž~Ž|ŽhT@Th8hñ4QB*
ph'hJêB*
CJOJPJQJ^JaJph'hñ4QB*
CJOJPJQJ^JaJph'hñ4QB*
CJOJPJQJ^JaJphU
hJêB*
OJPJQJ^Jphhñ4QB*
OJPJQJ^JphhThÏ$ hÏ$5hñ4Q5CJOJQJ^Jhñ4Q5>*
CJOJQJ^Jh‹ÿ!h‹ÿ5CJOJPJQJ^JaJ#h‹ÿB*
CJOJQJ^JaJph!hñ4Q5CJOJPJQJ^JaJì ~€‚,.046:<@BFHFHJLðâââÖÌÁ·µ·µ·µ·µ°µµÁgd›3Í
dð
¤gd‹ÿ„\„¤ì7$^„\`„¤ì $$
¤x¤a$$dNÿ¤¤a$ Æ> ;dd¤[¤$dh

7$8$H$a$gdÏ$ Miejsce i data Podpis (y) i piecz

osób/y uprawnionych do reprezentowania Wykonawcy     ZP.271.1.2018.MOPS Z
wiadczenie usB
ug opiekuD
czych na rzecz podopiecznych Miejskiego O[
rodka Pomocy SpoB
ecznej w Czarnej Wodzie .0268<>BDHVbè(DFHJLåÝÙÝÙÝÙÝÙŴŴŦ¢ÙåhG›h›3Íh‹ÿ>*
OJQJ^J!h›3Í>*
CJOJPJQJ^JaJ'h‘Šh›3Í>*
CJOJPJQJ^JaJhíWÁjhíWÁU
3hñ4Q56>*
B*
CJOJPJQJ\^JaJph80p1h
:pJê°‚. °ÆA!°‰"°‰#‰$‰%°°Ä°ÄÄ^#

˜žž˜žžžžž666666666vvvvvvvvv666666>666666666666666666666666666¨6666666666¸666666666666h
H
66666666666666666666666666666666666666666666666666666666666666666°62ÀÐàð 0@P`p€ÀÐàð2(Ø
è
0@P`p€ÀÐàð 0@P`p€ÀÐàð 0@P`p€ÀÐàð 0@P`p€ÀÐàð 0@P`p€ÀÐàð 0@P`p€8
X
ø
V~_H
mHnHsHtHf`ñÿfNormalnyd

¤È*$
,CJKH
OJPJQJ^J_H
aJmHsHtH
r@
R
r NagB
ówek 4!@& &F
&F
$
¤È¤$
!B*phO½OJQJ6
5
^J]
\
JA òÿ¡J Domy[
lna czcionka akapituTióÿ³T 0Standardowy :Vö4Ö
4Ö
laö,k ôÿÁ, 0 Bez listy4þoòÿñ4 WW8Num2z0 5
>*CJLþ/òÿ

LDomy[
lna czcionka akapitu1Dþ/òÿ
DDefault Paragraph FontXþoòÿ!
XNagB
ówek 4 Znak!5
6
B*OJQJ\
]
^JphO½>þoòÿ1
>ListLabel 15
CJ^JaJRþO
R
R NagB
ówek2 ¤ð¤x$
OJQJCJPJ^JaJDB@
R
DTekst podstawowy ¤¤x*/@Q
b
*Lista^JHþO
r
HPodpis2 ¤x¤x$
CJ6
^JaJ]
0þO
‚
0Indeks$
^JRþO
R
R NagB
ówek1 ¤ð¤x$
OJQJCJPJ^JaJHþO
¢
HPodpis1 ¤x¤x$
CJ6
^JaJ]
@þO
²
@Zawarto[

tabeli$
JþO±
Â
JNagB
ówek tabeli$
a$
$
5
\
8@
Ò
8‹ÿ0NagB
ówek  Ƹp#
Rþoòÿá
R‹ÿ0 NagB
ówek Znak CJKH
OJPJQJ^JaJtH
4
ò
4 ‹ÿ0Stopka  Ƹp#
Nþoòÿ
N‹ÿ0Stopka Znak CJKH
OJPJQJ^JaJtH
P™@
P "‹ÿ0Tekst dymka!dð
¤CJOJ QJ ^J aJXþoòÿ!X
!‹ÿ0Tekst dymka Znak CJKH
OJ PJQJ ^J aJtH
PK!éÞ¿ÿ[Content_Types].xml¬‘ËNÃ0E÷Hüƒå-Jœ²@%é‚ÇŽÇ¢|ÀÈ™$Éز§Uû÷LÒTB¨ l,Ù3÷ž;ãr½µÃ˜œ§J¯òB+$ëG]¥ß7OÙ­V‰F<ùæÅÃ/ªñÒÅÿúÃ'¿üüy5ªh®Îó/ÿöôñó¯>ýý»‡ðMG.|H"Ñ rˆöx†¯øš“‘x5ŠaŒ©K±™F§XK©àßS±‡¾1Ã,Ž§G‡ø¼- ‹T
¯Nïz b1U´Bòµ8ñ€;œ³•^¸¦e9nNÓ¨Z¸˜º¸=ŒªdwqêÅ·7Í ‹iéލ‰§æ.éÂI‰Búß'¤Âº;”z~Ý¡¡à’OºCQÓJ—éÈ˦9Ñ6M .³*›!Þžovn£gUVo‘ UY…òCÂ<7^ÅS…“*–Cœ0×á×±Š«”ÌDèâzRA¤#Â8ꍉ”U47Øëý†ÆUö6K|¤Pt¿Šçu̹‹ÜâûÝ'Yv@ÓØÅ~ ÷!E1Úåª ¾Ãý ÑÏœžîÛ°¿»Nï·hä©4Oýf**by•p/36ÁÄ´èí^¯Nhúw›QèÜVÂù5nh•Ï¿~T¡÷ÛÚ²7a÷ªª™ícú$ÜñöÜåbLßþî¼…§é.‚XÜ¢Þ5çwÍ9øÏ7ç“êùü[ò¼CƒÖ³ˆ·Íôœ6|O(c5cäº4ó·„-h܇EMnŽ£¤<“e1üÔ r<\$°¡A‚«¨Š1Î`v¯šI$sÖ‘D—pt4Ë•¼5æežM}$± DbµÃÇvyE/'’Ñ*2§ÜBЊfpVa+—r¦`Ûë«k¥Î,­nT3½Ñ“Vš¬]lNêàòÒ4X,½ ³ ‚‰¼¼ Z4œy0#cíw£",& ç"ã1Éc¤í^ŒQÝ©È•C´6ô1ò¯9ÒZšíH;K\qÄÑ{“(<p;^Ž,u‹“¥è°´šËÍ…8k8.ÃÏ$ƒ¨K=NbÁMT¨„MûS‹ÙTù<š­Â0¿êpbý¾`°×2!Õ–±M ó*O
–jIVÿå&¸õ¼¨èFgÓbe ’á_Óü臖L&$Tn°í;û˜·R>UDâñ!±©ØÃ~ª`ϘJ¸õ0A?ÀMö¶yå7ç¼èÜû1ƒ³ë˜e1ÎÛ­.Ñ¢’-Ü4¤Ró䨶UênŒ{uSLÉŸ“)nÿÏLÑû \B¬ŒuB¸7éJi\¨˜CÊbö̦w@¶Àm/¼†¤‚Ûkó_ýßÖœåaÊÎ’jFHP؏T,Ù…¶d²ïfõ|ï²,YÎÈd”£®Ì¬Ú#r@ØP÷ÀU½·(†T7Ý$ow<ÿü缂F‘rÜzó:Y¹÷Úø§'[Ì`”߇Í@Sø¿T±滪¥7äÅÞë¢_ÌǬFQ ÌÙ ZyÙ¿¦ ¯¸ÕÚŽµ`ñr³P¢¸h1,–QWIðDAN„T„Ì~ÑêïAoEð)C3ƒ´¬¾`¤¤]Áàdm2iVÖµù褽VlÖç<é–r9[kv–x¿¢³ËáÌçÕây:;÷°çk»v¢«!²ÇK–&ÅyÆÆ|Cs?oñÑ]ô|:˜2%M2ÁW+a†˜:€â· éÆ_ÿÿPK! ѐŸ¶
'theme/theme/_rels/themeManager.xml.rels„M Â0„÷‚wooÓº‘&݈ЭÔ„ä5 6?$Qìí ®,.‡a¾™i»—Éc2Þ1hª:é•qšÁm¸ìŽ@RN‰Ù;d°`‚Žo7íg‘K(M&$R(.1˜r'J“œÐŠTù€®8£Vä"£¦AÈ»ÐH÷u} ñ›
|Å$½b{Õ–Pšÿ³ý8‰g/]þQAsÙ…(¢ÆÌà#›ªLÊ[ººÄßÿÿPK
-!éÞ¿ÿ[Content_Types].xmlPK
-!¥Ö§çÀ6
0
_rels/.relsPK
-!ky–ƒŠtheme/theme/themeManager.xmlPK
-!íõ€³ÁÖtheme/theme/theme1.xmlPK
-! ѐŸ¶
'½ theme/theme/_rels/themeManager.xml.relsPK]
¸ &ÿÿÿÿ ŒŒŒŒŒp.Lì L ð8ð


@ñÿÿÿ€€€÷ð’ð

ð0ð(
ð ððB ð
Sð¿
Ë
ÿ
 ?

ð
ÿÿ
_GoBack7'7'˜š›ž ¡£¤$'"˜š›ž ¡£¤$'


ÿÿÿÿÿÿÿÿÿ
ÿ„è„PþÆ
^„è`„Pþ
ÿ„x„ÀýÆ
^„x`„Àý
ÿ„„0ýÆ
^„`„0ý
ÿ„˜„ üÆ
^„˜`„ ü
ÿ„(„üÆ
^„(`„ü
ÿ„¸„€ûÆ
^„¸`„€û
ÿ„H „ðúÆ
^„H `„ðú
ÿ„Ø „`úÆ
^„Ø `„`ú
ÿ„h „ÐùÆ
^„h `„Ðù

ÿÿÿÿÿÿ
ÿÿ

ì}þ|
åTÏ$qV5$'þM-I9=žROñ4QãYG› \œèc­Ž°íWÁ›3ÍJêoTëÓsú‹ÿ˜š
ÿ@€


&ØØÿÿ
Unknownÿÿ
ÿÿ
ÿÿÿÿÿÿÿÿG
îÿ.à[xÀ ÿ
Times New Roman5


€Symbol3.
îÿ.à[xÀ ÿ
Arial_&
ArialMT 'Arial Unicode MS'7.
îÿ*à{$À ÿ
Calibri7
îÿàÿ$BŸ
CambriaI
î
Times New RomanG.
†‡€P<Ï*Microsoft YaHeiO

 MangalCambria Math5.
îÿ.á[`À)ÿ

TahomaA
îÿàÿ$BŸ
Cambria Math"ÁŒ Äh
­ëKG×¢kGZ«Ig ^:

ƒ^:

! 0—— Kƒq ÿý
Pð ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ \œ²! xx ÜÿÿWioletta Rostankowskaawegner
þÿ
à…ŸòùOh«‘+'³Ù0x

˜¤°ÐÜì ü
(
4
@
L
X
`
h
p
âWioletta RostankowskaNormalawegner9Microsoft Office Word@^в@<˜OÒ
@–[ÇFJÒ
@»€Ô

^:þÿÕÍÕœ.“—+,ù®DÕÍÕœ.“—+,ù®,
è
hp|„Œ”œ¤¬´ ¼Éâ
—

Tytu³
@
P
Þæö

&
.
6
AppVersionCompanyDocSecurityHyperlinksChangedLinksUpToDate ScaleCrop ShareDocâ14.0000Hewlett-Packard Company
  þÿÿÿ þÿÿÿ"#$%&'(þÿÿÿ*+,-./0þÿÿÿýÿÿÿ3þÿÿÿþÿÿÿþÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿRoot Entry
ÿÿÿÿÿÿÿÿ ÀF@L9»€Ô
5€1Table
ÿÿÿÿÿÿÿÿs$WordDocument

ÿÿÿÿÿÿÿÿ:SummaryInformation(
ÿÿÿÿ!DocumentSummaryInformation8
ÿÿÿÿÿÿÿÿÿÿÿÿ)
CompObjÿÿÿÿÿÿÿÿÿÿÿÿ{ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ
þÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ
þÿ ÿÿÿÿ ÀF)Dokument programu Microsoft Word 97–2003 MSWordDocWord.Document.8ô9²q