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["Załącznik nr 3/2         "]
["nr sprawy ZP.15.PN.2017"]
["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)","Wartość VAT","Wartość \nbrutto \nw zł.","Wartość brutto (zł)"]
["INSULINY  KRÓTKODZIAŁAJĄCE","deksametazon","4mg/1ml","inj.","op.",8,37.84,302.72,null,326.93760000000003]
[1,"Insulin Neutral inj. Typu Actrapid","300j.m./3ml","inj.","op,",20,"op.5 wkładów"]
[2,"Insulin Neutral inj. Typu Gensulin R","300j.m./3ml","inj.","op,",15,"op.5 wkładów"]
["INSULINY O POŚREDNIM CZASIE DZIAŁANIA"]
[3,"Insulinum Isophane typu Gensulin N","300j.m./3ml","inj.","op,",10,"op.5 wkładów"]
[4,"Insulinum Isophane typu Insulatard","300j.m./3ml","inj.","op,",20,"op.10 wkładów"]
["  ANALOGI  SZYBKODZIALAJĄCE"]
[5,"Insulin Aspart typu NovoRapid","300j.m./3ml","inj.","op,",50,"op.10 wkładów"]
["  ANALOGI  DŁUGODZIAŁAJĄCE"]
[6,"Insulin Detemir typu Levemir","300j.m./3ml","inj.","op,",4,"op.10 wkładów"]
["MIESZANKI INSULINY KRÓTKODZIAŁAJĄCEJ I O PRZEDŁUŻONYM DZIAŁANIU  30/70%"]
[7,"Insulinum Biphasic typu Mixtard 30","300j.m./3ml","inj.","op,",10,"op.5 wkładów"]
[8,"Insulinum Biphasictypu Gensulin M30","300j.m./3ml","inj.","op,",5,"op.5 wkładów"]
["MIESZANKI INSULINY KRÓTKODZIAŁAJĄCEJ I O PRZEDŁUŻONYM DZIAŁANIU 40/60%"]
[9,"Insulinum Biphasictypu Mixtard 40","300j.m./3ml","inj.","op,",1,"op.5 wkładów"]
[10,"Insulinum Biphasic  typu Gensulin M 40","300j.m./3ml","inj.","op,",1,"op.5 wkładów"]
["MIESZANKI INSULINY KRÓTKODZIAŁAJĄCEJ I O PRZEDŁUŻONYM DZIAŁANIU 50/50%"]
[11,"Insulinum Biphasic typu Mixtard 50","300j.m./3ml","inj.","op,",2,"op.5 wkładów"]
[12,"Insulinum Biphasic typu Gensulin M 50","300j.m./3ml","inj.","op,",3,"op.5 wkładów"]
["MIESZANKI  ANALOGOWE"]
[13,"Insulinum Aspart typuNovoMix 30","300j.m./3ml","inj.","op,",25,"op.10wkładów"]
[14,"Insulinum Aspart typu NovoMix 50","300j.m./3ml","inj.","op,",5,"op.10wkładów"]
[15,"Insulin Lispro typu Humalog MIX 25","300j.m./3ml","inj.","op,",2,"op.5 wkładów"]
[16,"Insulin Lisprotypu Humalog MIX 50","300j.m./3ml","inj.","op,",2,"op.5 wkładów"]
[{"$nulls":7},"Razem (zł)"]
["SŁOWNIE (zŁ)"]
[]
["Netto:…………………………………………………………………………………………………………………….........................                                                 "]
[]
["VAT:……………………………………………………………………………………………………………………..........................."]
[]
["Brutto:…………………………………………………………………………………………………………………............................"]
[{"$nulls":7},"………………………………………………"]
[{"$nulls":7},"Pieczęć i podpis wykonawcy"]