ŠĻą”±į>ž’ ’ž’’’ŒŽ’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ģ„Į'` šæĪ>bjbjöąöą Ž”Š”Šķm@’’’’’’¤€€€€€€€tō¼ä¼ä¼äȄå ęĢōŌ/~xčxč:²č²č²čéęsźD·ź$3.5.5.5.5.5.5.$R4hŗ6lY.5€ ķéé ķ ķY.€€²č²čŪŽ/}ś}ś}ś ķ€²č€²č3.}ś ķ3.}ś}ś¦sx€€/!²člč `åó”»Ń¼ä)īŅ ė$‡(¬¤/0Ō/  &7ūų&7H/!/!&7€C!DŪź„_ė^}ś½ėL ģŪźŪźŪźY.Y.śdŪźŪźŪźŌ/ ķ ķ ķ ķōōōDh8„eōōō8ōōō€€€€€€’’’’ CAPITOLUL III - FORMULARE Capitolul III concine formularele destinate, pe de o parte, s faciliteze elaborarea _i prezentarea ofertei _i a documentelor care o īnsocesc. Fiecare ofertant care particip, īn mod individual sau ca asociat, la procedura pentru atribuirea contractului de achizicie public are obligacia de a prezenta formularele prevzute īn cadrul acestui capitol, completate īn mod corespunztor _i semnate de persoanele autorizate. Formular 1  Scrisoare de īnaintare; Formular 2A  Declaracie privind eligibilitatea; Formular 2C  Declaracie privind conflictul de interese Formular 4  Instrument de garantare/scrisoare emis() de o societate bancar sau de o societate de asigurri pentru participare cu ofert la procedura de atribuire a contractului de achizicie public; Formular 6  Formularul de ofert + Anexa la formularul de oferta Formular 7  Lista principalelor servicii prestate īn ultimii 3 ani Formular 14  Declaratie privind lista asociacilor si a subcontractorilor _i partea/partile din contract care sunt īndeplinite ctre ace_tia precum _i specializarea acestora Formular 15  Acord de asociere Formular 16  Garancie de bun execucie (Instrument de garantare/scrisoare emis() de o societate bancar sau de o societate de asigurri) Formular 19 - Declaratie privind respectarea obligatiilor relevante din domeniile mediului, social si al relatiilor de munca Formular nr. 1 OFERTANTUL Īnregistrat la sediul autoritcii contractante ______________________ nr. _________ / __ . __ . 2016 (denumirea/numele) SCRISOARE DE ĪNAINTARE Ctre _______________________________________________ (denumirea autoritcii contractante _i adresa complet) Ca urmare a invitaciei dumneavoastr privind aplicarea procedurii pentru atribuirea contractului ________________________________________ (denumirea contractului de achizicie public) noi ____________________________ v transmitem alturat urmtoarele: (denumirea/numele ofertantului) 1. Coletul sigilat _i marcat īn mod vizibil, concinānd, īn original _i īntr-un numr de _____ copii: a) oferta; b) documentele care īnsocesc oferta. Avem speranca c oferta noastr este corespunztoare _i v satisface cerincele. Data completrii __ . __ . 2016 Cu stim, Operator economic, ___________________ (semntura autorizat) Formular nr. 2A OPERATOR ECONOMIC ____________________ (denumirea/numele) DECLARAbIE PRIVIND ELIGIBILITATEA Subsemnatul, reprezentant īmputernicit al _______________________________, (denumirea/numele _i sediul/adresa operatorului economic) declar pe propria rspundere, sub sancciunea excluderii din procedur _i a sancciunilor aplicate faptei de fals īn acte publice, c nu ne aflm īn situacia prevazut la art. 164, 165, 167 din Legea nr. 98/2016 privind achiziciile publice. Subsemnatul declar c informaciile furnizate sunt complete _i corecte īn fiecare detaliu _i īnceleg c autoritatea contractant are dreptul de a solicita, īn scopul verificrii _i confirmrii declaraciilor orice documente doveditoare de care dispunem. Totodat, declar c am luat la cuno_tinc de prevederile art 292 « Falsul īn Declaracii » din Codul Penal referitor la « Declararea necorespunztoare a adevrului, fcuta unui organ sau institucii de stat ori unei alte unitci īn vederea producerii unei consecince juridice, pentru sine sau pentru altul, atunci cānd, potrivit legii ori īmprejurrilor, declaracia fcuta serve_te pentru producerea acelei consecince, se pedepse_te cu īnchisoare de la 3 luni la 2 ani sau cu amenda » Data completrii ...................... Operator economic, _________________ (semntura autorizat) Formular nr. 2C OPERATOR ECONOMIC/ASOCIAT/SUBCONTRACTANT/TERb SUSbINTOR ____________________ (denumirea/numele) DECLARATIE PRIVIND CONFLICTUL DE INTERESE Subsemnatul(a)........................................................................, reprezentant al ............................. (denumirea operatorului economic/asociat/subcontractant), participant in calitate de ofertant la procedura de achizitie publica ,,....................................” avand ca obiect: ,,……………………………………………………………..”, cod CPV: ………………. …………………….., criteriu de atribuire ,,......................................... , organizat de ........................................., declar in numele ofertantului, sub sancciunea falsului īn declaracii, urmtoarele: - nu avem membri īn cadrul consiliului de administracie/organului de conducere sau de supervizare _i/sau nu avem accionari ori asociaci semnificativi persoane care sunt soc/socie, rud sau afin pān la gradul al doilea inclusiv ori care se afl īn relacii comerciale cu persoane cu funccii de decizie īn cadrul autoritcii contractante sau al furnizorului de servicii de achizicie implicat īn procedura de atribuire; - nu avem nominalizate printre principalele persoane desemnate pentru executarea contractului persoane care sunt soc/socie, rud sau afin pān la gradul al doilea inclusiv ori care se afl īn relacii comerciale cu persoane cu funccii de decizie īn cadrul autoritcii contractante sau al furnizorului de servicii de achizicie implicat īn procedura de atribuire. Īn cazul īn care pe parcursul derulrii procedurii de achizicie public ne vom afla īn una dintre situaciile mencionate mai sus, ne obligam s anuncam aceast situacie imediat ce a aprut. Īnceleg c īn caz contrar vom suporta sancciunile legii. Totodat, declar c am luat la cuno_tinc de prevederile art 292 « Falsul īn Declaracii » din Codul Penal referitor la « Declararea necorespunztoare a adevrului, fcuta unui organ sau institucii de stat ori unei alte unitci īn vederea producerii unei consecince juridice, pentru sine sau pentru altul, atunci cānd, potrivit legii ori īmprejurrilor, declaracia fcuta serve_te pentru producerea acelei consecince, se pedepse_te cu īnchisoare de la 3 luni la 2 ani sau cu amenda » Data Ofertant, Numele si prenumele & & & & & & & (semntur) Lista cu persoanele ce decin funccii de decizie īn autoritatea contractant cu privire la organizarea, derularea _i finalizarea procedurii de atribuire: Prof. Univ. Dr. Cezar Ionuc Spīnu - Rector Prof.univ.dr. ^tefan-Cristian Gheorghe - Pre_edintele Senatului Universitcii din Craiova Prof.univ.dr.ing. Romulus Lungu - Prorector Prof. univ. dr. Magdalena Mihai - Prorector Prof. univ. dr. Nicu Panea - Prorector Prof. univ. dr. Aurel Clina - Prorector Conf. univ. dr. Dorel Berceanu - Prorector Prof. univ. dr. Nicu Bīzdoac - Prorector Prof. univ. dr. Sevastian Cercel - Decan Facultatea de Drept _i ^tiince Administrative Prof. univ. dr. Dan Seli_teanu -Decan Facultatea de Automatic, Calculatoare _i Electronic Prof. univ. dr. Nicolae Sichigea - Decan Facultatea de Economie _i Administrarea Afacerilor Conf. univ. dr. Nicolae Rzvan Stan - Decan Facultatea de Teologie, Istorie, ^tiince ale Educaciei Conf.univ.dr. Anamaria- Magdalena Preda - Decan Facultatea de Litere Prof.univ. dr.Gabriela Eugenia Iacobescu - Decan Facultatea de ^tiince Conf. univ. dr. Ionuc Virgil ^erban - Decan Facultatea de ^tiinte Sociale Prof. univ. dr. Marian Dragomir - Decan Facultatea de Educacie Fizic _i Sport Prof. univ. dr. Nicolae Dumitru - Decan Facultatea de Mecanic Prof. univ. dr. Ing. Ciontu Marian - Decan Facultatea de Inginerie Electric Prof. univ. dr.ing. Sina-Niculina Cosmulescu - Decan Facultatea de Horticultur  Prof.univ.dr.ing. Tudor Alexandru - Decan Facultatea de Agricultur Ec. Dr. Maria Bu_e - Director General Administrativ _i Director Direccia Resurse Umane Salarizare Ing. Georgic  Petru_ Ancuca - Director Directia Administrativ Cmine _i Cantine Ing. Bogdan Ghic - Director Direccia Tehnica Ec. Ionela Mic - Director Direccia Economic Ec. Floarea Stoian - Compartiment CFP Ec. Ion Belcineanu - Compartiment CFP Ec. Radu Naon Ciorbagiu - Compartiment CFP Manuela Gust - Director Tele U Ing. Ion Stan - Director Grdina Botanica Consilier Juridic Anca Udrea - ^ef Birou Juridic Consilier Juridic Laurenciu Ciobanu - Birou Juridic Ec. Demetra Lupu Vi_nescu - Director Direccia Achizicii Publice Ec. Maria Eugenia Mocanu - ^ef Serviciu Achizitii Publice Ec. Iulia Maria Dragomir - Serviciul Achizitii Publice Ing. Electra Diana Drgan - Serviciul Achizitii Publice Ec. Ctlin Viorel Vlad - Serviciul Achizitii Publice 37 Ing. Gruescu Ciprian  Sef Paza 38 Ing. Cosmeleata Codrut  Sef Compartiment SUSPP Formular nr. 4 Banca/Societate de asigurri ___________________ (denumirea) Instrument de garantare/scrisoare emis() de o societate bancar sau de o societate de asigurri pentru participare cu ofert la procedura de atribuire a contractului de achizicie public Ctre ___________________________________________ (denumirea autoritacii contractante _i adresa complet) Cu privire la procedura pentru atribuirea contractului avānd ca obiect achizitia de servicii de paza umana/ securitate la obiectivele Universitatii din Craiova............................................ (denumirea bncii/societcii de asigurri), avānd sediul īnregistrat la .................................................. (adresa sediului social al bncii/ societcii de asigurri ), ne obligm īn mod condicionat/necondicionat (dup caz) _i irevocabil fac de ............................................ (denumirea Autoritcii contractante) īn calitate de Autoritate Contractant, s pltim suma de ....................... (īn litere _i īn cifre), corespunztoare garanciei pentru participarea & & & & & & & & & . (denumirea/numele ofertantului) cu ofert la procedura de atribuire pentru contractul sus-mencionat. Plata va fi efectuat īn & & & & & & . (moneda garanciei), īn contul specificat de ctre Autoritatea Contractant _i se va executa: 1. Condicionat, respectiv dup constatarea culpei persoanei garantate, īn conformitate cu contractul garantat, Sau 2. Necondicionat, respectiv la prima cerere a beneficiarului, pe baza declaraciei acestuia cu privire la culpa persoanei garantate, cu condicia ca īn cererea sa Autoritatea Contractant s specifice c suma cerut de ea _i datorat ei este din cauza existencei uneia sau mai multora dintre situaciile urmtoare: a) ofertantul ..................................................... (denumirea/numele) _i-a retras oferta īn perioada de valabilitate a acesteia; b) oferta sa fiind stabilit cā_tigtoare, ofertantul ..................................................... (denumirea/numele) nu a constituit garancia de bun execucie īn perioada de valabilitate a ofertei; c) oferta sa fiind stabilit cā_tigtoare, ofertantul ..................................................... (denumirea/numele) a refuzat s semneze contractual de achizicie public īn perioada de valabilitate a ofertei. Prezenta garancie este valabil pān la data de ______________________. Parafat de Banca/Societate de asigurri ____________ īn ziua ______ luna ________ anul _____ (semntura autorizat) Formular nr. 6 OPERATOR ECONOMIC __________________ (denumirea/numele) FORMULAR DE OFERTA Ctre .................................................................................................... (denumirea autoritcii contractante _i adresa complet) 1. Examinānd documentacia de atribuire, subsemnacii, reprezentanci ai ofertantului ............................................... (denumirea/numele ofertantului) ne oferim ca, īn conformitate cu prevederile _i cerincele cuprinse īn documentacia mai sus mencionat, s prestam servicii de paza umana/ securitate la obiectivele Universitatii din Craiova pentru suma de ................., (suma īn litere _i īn cifre, precum _i moneda ofertei) pltibil conform contractului, la care se adaug TVA īn valoare de ............ (suma īn litere _i īn cifre, precum _i moneda). 2. Ne angajam ca, īn cazul īn care oferta noastra este stabilita castigatoare, sa īncepem prestarea serviciului cat mai curand posibil si sa prestm serviciile īn conformitate cu graficul de prestare anexat īn & & & & & & & & luni. (perioada īn litere si īn cifre) 3. Ne angajm s mencinem aceasta ofert valabil pentru o durat de ............. zile, (durata īn litere _i cifre) respectiv pān la data de ....................... _i ea va rmāne obligatorie pentru noi (ziua/luna/anul) _i poate fi acceptat oricānd īnainte de expirarea perioadei de valabilitate. 4. Am īnceles _i consimcim c, īn cazul īn care oferta noastr este stabilit ca fiind cā_tigtoare, s constituim garancia de bun execucie īn conformitate cu prevederile din documentacia de atribuire. 5. Precizm c:(se bifeaz opciunea corespunztoare): |_| depunem ofert alternativ, ale crei detalii sunt prezentate īntr-un formular de ofert separat, marcat īn mod clar  alternativ / alt ofert . |_| nu depunem ofert alternativ. 6. Pān la īncheierea _i semnarea contractului de achizicie public aceasta ofert, īmpreun cu comunicarea transmis de dumneavoastr, prin care oferta noastr este acceptat ca fiind cā_tigtoare, vor constitui un contract angajant īntre noi. 7. Īncelegem c nu sunteci obligaci s acceptaci oferta cu cel mai sczut prec sau orice sau orice ofert primit. Data _____/_____/_____ ..............................................................................., (nume, prenume _i semntur), L.S. īn calitate de ............................................ legal autorizat s semnez oferta pentru _i īn numele ...................................................... (denumirea/numele operatorului economic) Anexa 1 Paza umana Nr. crtObiectivTarif lei/ora fara TVANumar de ore/lunaTarif lei/luna fara TVA (col 3 x col 4)Nr. luniTotal (col 5 x col 6)12345671Camin nr. 08, Complex Mecanica, bd. Calea Bucuresti nr.107, Craiova 52Cladire laboratoare, extindere Camin nr. 08, Complex Mecanica, bd. Calea Bucuresti nr.107, Craiova53Cladire INCESA Bd. Decebal, nr.107 5TOTAL OFERTA (lei fara TVA) Cont Trezorerie: ............................................................. Adresa de corespondenta, tel/fax, e-mail.................................................................. Persoane responsabile pentru īndeplinirea contractului: .......................................... 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ʤ<a$gd:¬dhgdt8pputernicit s semneze contractul: .............................................................. Adresa de corespondenc, telefon, fax, e-mail: ................................................. Data completrii ...................... Operator economic, _________________ (semnatura autorizat) Formular nr. 7 OPERATOR ECONOMIC __________________ (denumirea/numele) Data: [introduceci ziua, luna, anul] Achizitia de servicii de de paza umana/ securitate la obiectivele Universitatii din Craiova . DECLARATIE PRIVIND LISTA PRINCIPALELOR SERVICII PRESTATE IN ULTIMII 3 ANI [Urmtorul tabel va fi completat pentru contractele executate de ctre Ofertant _i fiecare partener īn Asociere] [Identificaci contractele care demonstreaz cerincele minime de calificare . Listaci contractele īn ordine cronologic, dup data de īnceput.] Noi, subsemnacii, reprezentanci autorizaci ai.......................................... ............... [introduceci numele īntreg al Ofertantului] declarm, sub rezerva sancciunilor aplicate pentru declaraciile false īn acte publice, c: datele prezentate īn tabelul de mai jos reflect realitatea. informaciile furnizate sunt corecte _i complete īn fiecare detaliu am īnceles c Universitatea din Craiova are dreptul de a solicita orice informacii suplimentare, īn scopul verificrii _i confirmrii declaraciilor _i documentelor anexate . autorizm orice entitate s furnizeze, reprezentancilor autorizaci ai Universitcii din Craiova , date cu privire la oricare din informaciile prezentate īn legtur cu experienca noastr. Pentru fiecare contract prezentat se ata_eaz la prezentul tabel copii ale procesului verbal de recepcie Semntura [persoana sau persoanele autorizate s semneze īn numele Ofertantului] Totodat, declar c am luat la cuno_tinc de prevederile art 292 « Falsul īn Declaracii » din Codul Penal referitor la « Declararea necorespunztoare a adevrului, fcuta unui organ sau institucii de stat ori unei alte unitci īn vederea producerii unei consecince juridice, pentru sine sau pentru altul, atunci cānd, potrivit legii ori īmprejurrilor, declaracia fcuta serve_te pentru producerea acelei consecince, se pedepse_te cu īnchisoare de la 3 luni la 2 ani sau cu amenda » Operator Economic & & & & & & & & & & . (semnatura autorizata ) Data .............. Ofertant, Nr. Crt.  Denumirea si obiectul contractului  Codul CPV Denumirea/numele beneficiarului/clientului Adresa Calitatea prestatorului in contract*) Pretul total al contractului (lei)Procent executat (%) Cantitatea Perioada de derulare a contractului**)012345678 1  2  .....   Operator Economic , ...................... (semnatura autorizata) ________ *) Se precizeaza calitatea in care a participat la indeplinirea contractului care poate fi de: contractant unic sau contractant conducator (lider de asociatie); contractant asociat; subcontractant. **) Se va preciza data de īncepere _i de finalizare a serviciilor. Formular nr. 14 OPERATOR ECONOMIC __________________ Data: [introduceci ziua, luna, anul] Achizitia de servicii de de paza umana/ securitate la obiectivele Universitatii din Craiova . DECLARATIE PRIVIND LISTA ASOCIAbILOR SI A SUBCONTRACTORILOR ^I PARTEA/PARTILE DIN CONTRACT CARE SUNT ĪNDEPLINITE CTRE ACE^TIA PRECUM ^I SPECIALIZAREA ACESTORA     1. Subsemnatul, reprezentant īmputernicit al ______________________________, (denumirea/numele _i sediul/adresa candidatului/ofertantului) declar pe propria rspundere, sub sancciunile aplicate faptei de fals īn acte publice, c datele prezentate īn tabelul anexat sunt reale. 2. Subsemnatul declar c informaciile furnizate sunt complete _i corecte īn fiecare detaliu _i īnceleg c autoritatea contractant are dreptul de a solicita, īn scopul verificrii _i confirmrii declaraciilor, situaciilor _i documentelor care īnsocesc oferta, orice informacii suplimentare īn scopul verificrii datelor din prezenta declaracie. 3. Subsemnatul autorizez prin prezenta orice institucie, societate comercial, banc, alte persoane juridice s furnizeze informacii reprezentancilor autorizaci ai autoritcii contractante Universitatea din Craiova cu privire la orice aspect tehnic _i financiar īn legtur cu activitatea noastr. 4. Prezenta declaracie este valabil pān la data de _______________________. (se precizeaz data expirrii perioadei de valabilitate a ofertei) Ofertant, & & & & & & & & & & . (semntur autorizat ) Nume entitate legala (asociat sau subcontractor)Activitci din contractValoarea aproximativa% din valoarea contractuluiAdresaAcord asociat/ subcontractor cu specimen semnturaLiderul asociacieiAsociat 1Asociat 2Subcontractor 1Subcontractor 2& .Se va include īn acest tabel o list a activitcilor _i valoarea lor corespunztoare pentru fiecare asociat _i pentru care se propune utilizarea subcontractorilor, īmpreuna cu numele _i adresele subcontractorilor propu_i. Data completrii :[ZZ.LLLL.AAAA] Ofertant,& & ....& & & & & & & & .. Formular nr. 15 ACORD DE ASOCIERE īn vederea participrii la procedura de atribuire a contractului de achizicie public Conform __________________________________________________________________. (īncadrarea legala) Noi, prci semnatare: S.C. _______________________ S.C. _______________________ ne asociem pentru a realiza īn comun contractul de achizicie public  _________________ ____________________________________________________________ . (denumire obiect contract) Activitci contractuale ce se vor realiza īn comun: 1. ___________________________________ 2.____________________________________ & ___________________________________ Se vor menciona pentru fiecare asociat īn parte activitcile pe care fiecare asociat le va presta īn concret _i pentru care devine direct rspunztor īn faca autoritcii contractante _________________________ . Se va menciona c toci asociacii ī_i asum rspunderea solidar pentru execucia contractului. Se vor menciona rspunderile pentru fiecare asociat īn parte, īn caz de neīndeplinire a obligaciei asumate privind contribucia financiar. Totodat, se vor menciona rspunderile asociaciei, īn caz de neīndeplinire a acestor obligacii. Condiciile de administrare _i conducere a asociaciei: liderul asociaciei S.C. _____________ preia responsabilitatea _i prime_te instrucciuni de la autoritatea contractanta īn folosul partenerilor de asociere. Odat cu preluarea responsabilitcii liderul asociaciei va prezenta autoritcii contractante modalitcile īn care īncelege s ī_i asume īn mod concret responsabilitatea activitcii care se va desf_ura īn comun. Se vor prezenta autoritcii contractante modalitatea īn care oferta comun va fi realizat cu contribucia fiecrui asociat. Se va menciona c toci asociacii ī_i asum rspunderea solidar pentru execucia contractului. Modalitatea de īmprcire a rezultatelor activitcii economice desf_urate: conform procentelor de participare a fiecrei prci la activitatea de realizare a sarcinilor convenite de comun acord. Cauzele īncetrii asociaciei _i modul de īmprcire a rezultatelor: Īncetarea asociaciei īn cazul denuncrii unilaterale a unui asociat a contractului de asociere. Denuncarea contractului de asociere fcut unilateral de unul dintre asociaci nu īi poate fi opus autoritcii contractante _i nu īl elibereaz pe asociatul denunctor de obligaciile asumate prin ofert. Denunctorul va rmāne obligat _i responsabil fac de achizitor pān la īndeplinirea efectiv _i cu bun-credinc a tuturor obligaciilor pe care _i le-a asumat fac de achizitor. Modul de īmprcire a rezultatelor este conform procentului de participare a fiecrei prci pān la data īncetrii asociaciei. Repartizarea fizica, valoric _i procentuala a contractului de achizicie public preluate de fiecare asociat pentru execucia obiectivului supus licitaciei: _______ % S.C. ___________________________ _______ % S.C. ___________________________ Membrii asociaciei īl garanteaz pe achizitor c neīncelegerile care s-ar pute ivi īn legtur cu obligaciile pe care _i le-au asumat īn comun prin candidatura comun nu īl vor afecta īn nici un mod īn procesul de executare īntocmai _i cu bun-credinc a obligaciilor asumate. Liderul asociaciei: S.C. ______________________ Alte clauze: __________________________________________________________ ___________________________________________________________________ Data completrii: LIDERUL ASOCIATIEI, ______________ __________________ ASOCIAT, ___________________ Nota: Liderul asociaciei va prezenta autoritcii contractante īmputernicirea expres _i autentic īn baza cruia accioneaz īn numele _i pentru membrii asociaciei. Īmputernicirea va trebui s cuprind īn mod explicit puterile care i-au fost īncredincate liderului asociaciei de ctre membrii asociaciei, _i va cuprinde īn concret toate responsabilitcile liderului asumate īn numele asociaciei fac de autoritatea contractanta. Īn cazul neprezentrii acestei īmputerniciri asociacia nu va putea dovedi modalitatea īn care īncelege s accioneze pentru īndeplinirea candidaturii comune care va fi semnat de fiecare candidat īn parte _i asumat īn mod corespunztor. Formular nr. 16 Banca/Societate de asigurari _______________________ (denumirea) Garancie de bun execucie (Instrument de garantare/scrisoare emis() de o societate bancar sau de o societate de asigurri) Ctre (denumirea autoritcii contractante _i adresa complet) _________________________ Cu privire la contractul de achizicie public (denumirea contractului)__________________, īncheiat īntre __________________, īn calitate de contractant, _i __________________, īn calitate de achizitor, ne obligm prin prezenta s pltim īn favoarea achizitorului, pān la concurenca sumei de _____________ reprezentānd ______% din valoarea contractului respectiv, orice sum cerut de acesta. Plata va fi efectuat īn & & & & & & . (moneda garanciei), īn contul specificat de ctre Autoritatea Contractant _i se va executa: 1. Condicionat, respectiv dup constatarea culpei persoanei garantate, īn conformitate cu contractul garantat, Sau 2. Necondicionat, respectiv la prima cerere a beneficiarului, pe baza declaraciei acestuia cu privire la culpa persoanei garantate, cu condicia ca īn cererea sa Autoritatea Contractant s specifice c suma cerut de ea _i datorat ei este din cauza neīndeplinirii obligaciilor ce revin contractantului, astfel cum sunt acestea prevazute īn contractul de achizicie public mai sus mencionat. Prezenta garancie este valabil pān la data de ____________________. Īn cazul īn care parcile contractante sunt de acord s prelungeasc perioada de valabilitate a garanciei sau s modifice unele prevederi contractuale care au efecte asupra angajamentului bncii, se va obcine acordul nostru prealabil; īn caz contrar prezenta scrisoare de garancie ī_i pierde valabilitatea. Parafat de Banca/Societate de asigurari _________________ īn ziua ___ luna____anul ____ (semntura autorizat) Formularul nr. 19 Operator economic ___________________ (denumirea/numele) DECLARATIE PRIVIND RESPECTAREA OBLIGATIILOR RELEVANTE DIN DOMENIILE MEDIULUI, SOCIAL SI AL RELATIILOR DE MUNCA Subsemnatul, & & & & & & & reprezentant legal al............................................................................................. (denumire/numele _i sediul/adresa ofertantului) declar pe propria raspundere, ca pe toata durata de prestare /executie a serviciilor / lucrarilor, conform graficului fizic _i valoric pentru īndeplinirea sarcinilor specifice prezentat īn ofera financiara, voi respecta legislatia din domeniile mediului, social si al relatiilor de munca, īn vigoare, pentru tot personalul angajat īn prestarea /executia serviciilor /lucrarilor. Prezenta declaratie este valabila pana la data de finalizare a serviciilor/lucrarilor. Totodat, declar c am luat la cuno_tinc de prevederile art 292 « Falsul īn Declaracii » din Codul Penal referitor la « Declararea necorespunztoare a adevrului, fcuta unui organ sau institucii de stat ori unei alte unitci īn vederea producerii unei consecince juridice, pentru sine sau pentru altul, atunci cānd, potrivit legii ori īmprejurrilor, declaracia fcuta serve_te pentru producerea acelei consecince, se pedepse_te cu īnchisoare de la 3 luni la 2 ani sau cu amenda » Data completrii OFERTANT, .................................. Semntura autorizat _____________________________ L.S..     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