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["Sprawa nr.ZP.16.PN.2018                                                                                                                                                                                                                                 Załącznik nr.3/1,3"]
["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,"dziurawiec ziele",null,"zioła fix","op.",1,"1,5g sasz./30szt"]
[2,"glukoza",null,"substancja","op.",1,"op.1000g"]
[3,"krople miętowe",null,"krople doustne","op.",6,"op.35g"]
[4,"krople żołądkowe",null,"krople doustne","op.",14,"op.35g"]
[5,"len nasiona mielone odtł.",null,"zioła mielone","op.",14,"op. 200g"]
[6,"melisa liść",null,"zioła fix","op.",1,"2 g.sasz./30szt."]
[7,"mięta pieprzowa liść",null,"zioła fix","op.",45,"3 g.sasz/30szt"]
[8,"neospasmina",null,"syrop","op.",48,"op.1250g"]
[9,"normosan",null,"zioła fix","op.",6,"1,4 g sasz/20szt"]
[10,"rumianek koszyczek",null,"zioła fix","op.",7,"1,5g sasz./30szt"]
[11,"szałwia liść",null,"zioła fix","op.",14,"1,5g. Sasz./30 szt."]
[12,"neospasmina",null,"syrop","op.",2,"op.119 ml."]
[{"$nulls":4},"Razem (zł)"]
["SŁOWNIE (zŁ)"]
[]
["Netto:…………………………………………………………………………………………………………………….........................                                                 "]
[]
["VAT:……………………………………………………………………………………………………………………..........................."]
[]
["Brutto:…………………………………………………………………………………………………………………............................"]
[]
[{"$nulls":7},"………………………………………………"]
[{"$nulls":7},"Pieczęć i podpis wykonawcy"]