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["Sprawa nr     ZP.13.PN.2020                                                                                                                                      Załącznik nr.3/1.10"]
["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,"furagin","0,05g","tabl.","op.",115,"op.30szt"]
[2,"urosept",null,"draż.","op.",5,"op.30szt"]
[3,"wyciąg ze śliwy afrykańskiej","zaw. 6mg beta-sitoste-rolu","tabl.","op.",1,"op.30szt"]
[{"$nulls":4},"Razem (zł)"]
["SŁOWNIE (zŁ) "]
[]
["Netto:…………………………………………………………………………………………………………………….........................                                                 "]
[]
["VAT:……………………………………………………………………………………………………………………..........................."]
[]
["Brutto:…………………………………………………………………………………………………………………............................"]
[]
[{"$nulls":7},"………………………………………………"]
[{"$nulls":7},"Pieczęć i podpis wykonawcy"]