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["Sprawa nr.ZP.16.PN.2018                                                                                                                                                                                                                                 Załącznik nr.3/1,6"]
["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,"pyrantel","0,25g","tabl.","op.",2,"op.3szt"]
[2,"pyrantel","0,05g/1ml","zaw.doustna","op.",1,"op.15ml"]
[3,"mebendazol","0,1g","tabl.","op.",2,"op.6szt"]
[4,"krotamiton",{"v":0.1,"d":"10%"},"płyn","op.",1,"op.100g"]
[5,"Szmpon vel pianka  p.wszawicy pipi",null,null,"op.",1,"op.150ml"]
[6,"delacet lub podobne",null,"płyn","op.",1,"op.100g"]
[7,"Szmpon lecznicz  p.wszawicy typu Sora Forte",null,null,"op.",5,"op.50 ml."]
[{"$nulls":4},"Razem (zł)"]
["SŁOWNIE (zŁ)"]
[]
["Netto:…………………………………………………………………………………………………………………….........................                                                 "]
[]
["VAT:……………………………………………………………………………………………………………………..........................."]
[]
["Brutto:…………………………………………………………………………………………………………………............................"]
[]
[{"$nulls":7},"………………………………………………"]
[{"$nulls":7},"Pieczęć i podpis wykonawcy"]