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["Załącznik nr 3/8               "]
["nr sprawy ZP.12.PN.2017"]
["FORMULARZ ASORTYMENTOWO-CENOWY"]
["(zamawiający zastrzega sobie prawo do zakupu mniejszych ilości towaru)"]
[null,"Nazwa asortymentu","j.m.","ilość","Uwagi","Cena jedn. Netto (zł)","Wart. netto (zł)","Wartość VAT","Wartość \nbrutto \nw zł.","Wartość brutto (zł)"]
[1,"Paski do oznaczania glukozy","op",363]
[2,"Glukometry ","szt",10]
[{"$nulls":4},"Razem (zł)"]
[]
["SŁOWNIE (zŁ)"]
[]
["Netto:…………………………………………………………………………………………………………………….........................                                                 "]
[]
["VAT:……………………………………………………………………………………………………………………..........................."]
[]
["Brutto:…………………………………………………………………………………………………………………............................"]
[{"$nulls":5},"………………………………………………"]
[{"$nulls":5},"Pieczęć i podpis wykonawcy"]