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["Sprawa nr ZP.16.PN.2019                                                                                                                             Załącznik nr.3/1,8"]
["FORMULARZ ASORTYMENTOWO-CENOWY"]
["(zamawiający zastrzega sobie prawo do zakupu mniejszych ilości towaru)"]
[null,"Nazwa asortymentu","dawka","postać leku","J.m.","Ilość","Uwagi","Cena jedn. Netto (zł)","Wart. netto (zł)","VAT %","VAT (zł)","Wartość brutto (zł)"]
[1,"aqua pro injectione","10 ml","inj.","op.",60,"op.100amp"]
[2,"aqua pro injectione","5ml","inj.","op.",25,"op.100amp"]
[3,"glukoza 10ml",0.2,"inj.","op.",5,"op.10amp"]
[4,"glukoza 10ml",0.4,"inj.","op.",5,"op.10amp"]
[5,"natrium bicarbonicum 20ml",0.084,"inj.","op.",3,"op.10amp."]
[6,"natrium chloratum 10ml",0.009000000000000001,"inj.","op.",80,"op.100amp"]
[7,"natrium chloratum 5ml",0.009000000000000001,"inj.","op.",20,"op.100amp"]
[8,"natrium chloratum 10ml",0.1,"inj.","op.",5,"op.100amp"]
[]
["SŁOWNIE (zŁ)"]
[]
["Netto:…………………………………………………………………………………………………………………….........................                                                 "]
[]
["VAT:……………………………………………………………………………………………………………………..........................."]
[]
["Brutto:…………………………………………………………………………………………………………………............................"]
[]
[{"$nulls":7},"………………………………………………"]
[{"$nulls":7},"Pieczęć i podpis wykonawcy"]