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\b\insrsid3609655\charrsid7553996 SERVIZIO DI GESTIONE E MANUTENZIONE ORDINARIA E URGENTE DEGLI IMPIANTI DI PUBBLICA ILLUMINAZIONE DEL COMUNE DI TURI.}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid3609655 
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\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
Il sottoscritto ___________________________________, nato a _____________________ (_____) il ___________________, CF _______________________________________________________ residente a _______________________ in Via ________________________________ n\'b0
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\insrsid10124234\charrsid1522798 _______________________________________
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_________________del ________________  a rogito del notaio__________________________________________________________________
\par autorizzato a rappresentare legalmente l\rquote Impresa }{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid10124234\charrsid1522798 (Denominazione/ Ragione Sociale)}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798  :
\par ________________________________________________________________________________ con sede in _____________________________, Via _________________________ n\'b0
 ________, codice fiscale __________________________  partita I.V.A. ______________________________, 
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\par }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 MANIFESTA IL PROPRIO INTERESSE
\par 
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\af0 \ltrch\fcs0 \insrsid1522798 offerta sul MePa di Consip}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16143189\charrsid1522798  per l\rquote affidamento della fornitura }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 in oggetto.
\par 
\par A tal fine dichiara di voler partecipare in qualit\'e0 di}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1522798  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\i\insrsid1522798\charrsid1522798 (Selezionare la fattispecie che interessa)}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\b\i\insrsid10124234\charrsid1522798 :}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
\par {\listtext\pard\plain\ltrpar \s15 \rtlch\fcs1 \af0 \ltrch\fcs0 \f2\fs32\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af2\dbch\af0\hich\f2 \u9633\'3f\tab}}\pard \ltrpar
\s15\qj \fi-357\li714\ri0\sb120\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\ls5\adjustright\rin0\lin714\itap0\pararsid10124234 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 Impresa individuale
\par {\listtext\pard\plain\ltrpar \s15 \rtlch\fcs1 \af0 \ltrch\fcs0 \f2\fs32\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af2\dbch\af0\hich\f2 \u9633\'3f\tab}Societ\'e0 commerciale
\par {\listtext\pard\plain\ltrpar \s15 \rtlch\fcs1 \af0 \ltrch\fcs0 \f2\fs32\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af2\dbch\af0\hich\f2 \u9633\'3f\tab}Societ\'e0 Cooperativa }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid10124234\charrsid1522798 iscritta all\rquote Albo delle cooperative}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 
\par {\listtext\pard\plain\ltrpar \s15 \rtlch\fcs1 \af0 \ltrch\fcs0 \f2\fs32\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af2\dbch\af0\hich\f2 \u9633\'3f\tab}Consorzio stabile}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid10124234\charrsid1522798 
\par {\listtext\pard\plain\ltrpar \s15 \rtlch\fcs1 \af0 \ltrch\fcs0 \f2\fs32\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af2\dbch\af0\hich\f2 \u9633\'3f\tab}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 
Riunione Temporanea di Imprese o Consorzio, costituiti o da costituire }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 (}{\rtlch\fcs1 \af0 \ltrch\fcs0 \i\insrsid10124234\charrsid1522798 
indicare denominazione, ragione sociale e sede legale di ciascun soggetto partecipante al RTI o consorzio,}{\rtlch\fcs1 \af0 \ltrch\fcs0 \i\insrsid9786412\charrsid1522798  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \i\insrsid10124234\charrsid1522798 
la ditta individuata quale mandataria, le parti del servizio eseguite dalle singole imprese)_________________________________________________________________}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
e che nessuna delle imprese indicate partecipa in qualsiasi altra forma alla presente gara;
\par {\listtext\pard\plain\ltrpar \s15 \rtlch\fcs1 \af0 \ltrch\fcs0 \f2\fs32\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af2\dbch\af0\hich\f2 \u9633\'3f\tab}}\pard \ltrpar
\s15\qj \fi-357\li714\ri0\sb120\keepn\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin714\itap0\pararsid10124234 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 Consorzio }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid10124234\charrsid1522798 \endash  anche stabile \endash }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \i\insrsid10124234\charrsid1522798 (indicare denominazione e sede legale delle ditte cons
orziate per le quali si concorre e di quelle indicate quali esecutrici del servizio)}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 __________________________}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
 e che nessuna delle imprese indicate partecipa in qualsiasi altra forma alla presente gara;
\par {\listtext\pard\plain\ltrpar \s15 \rtlch\fcs1 \af0 \ltrch\fcs0 \f2\fs32\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af2\dbch\af0\hich\f2 \u9633\'3f\tab}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 
Consorzio di Cooperative }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 iscritte all\rquote Albo delle cooperative}{\rtlch\fcs1 \af0 \ltrch\fcs0 \i\insrsid10124234\charrsid1522798 ;}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid10124234\charrsid1522798 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \f2\fs32\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af2\dbch\af0\hich\f2 \u9633\'3f\tab}}\pard\plain \ltrpar
\qj \fi-357\li714\ri0\sb120\keepn\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin714\itap0\pararsid10124234 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1040\langfe1025\cgrid\langnp1040\langfenp1025 {\rtlch\fcs1 
\af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 Riunione Temporanea di cooperative }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 iscritte all\rquote Albo delle cooperative;
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \f2\fs32\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af2\dbch\af0\hich\f2 \u9633\'3f\tab}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 
Concorrente che si avvale di impresa ausiliaria}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \f2\fs32\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af2\dbch\af0\hich\f2 \u9633\'3f\tab}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 
Operatore economico stabilito in altro Stato membro }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10124234 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10124234 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 In conformit\'e0
 alle disposizioni di cui agli artt. 46 e 47 del D.P.R. 445/2000 e s.m.i., consapevole della responsabilit\'e0 penale cui pu\'f2 andare incontro nel caso di affermazioni mendaci e delle relative sanzioni penali di cui all\rquote 
art. 76 del medesimo D.P.R. 445/2000 e s.m.i.
\par 
\par }\pard \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10124234 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 DICHIARA}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid10124234\charrsid1522798 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10124234 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
\par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \af31506 \ltrch\fcs0 \f31506\lang1040\langfe1025\langfenp1025\insrsid6382284\charrsid1522798 \hich\af31506\dbch\af0\loch\f31506 1.\tab}}\pard \ltrpar\qj \fi-357\li714\ri0\widctlpar\jclisttab\tx720\wrapdefault{\*\pn 
\pnlvlbody\ilvl0\ls3\pnrnot0\pndec\pnb0\pnf-10\pnstart1\pnindent360\pnsp120\pnhang {\pntxta .}}\hyphpar0\aspalpha\aspnum\faauto\ls3\adjustright\rin0\lin714\itap0\pararsid10124234 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6382284\charrsid1522798 
di essere in possesso  dei requisiti richiesti in se}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11483518 de di abilitazione al MePa }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3609655\charrsid7553996 \'93Servizi\'94 - \'93
Servizi agli impianti  - manutenzione e riparazione\'94;}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6382284\charrsid1522798 \'94,  ed in particolare  dichiara :
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \f3\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \ltrpar
\qj \fi-709\li1418\ri0\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\ls6\adjustright\rin0\lin1418\itap0\pararsid1522798 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 l\rquote inesistenza dei motivi di esclusione di cui all\rquote 
art. 80 del D.Lgs. 50/2016}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4421840\charrsid1522798 e ss.mm.ii.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6382284\charrsid1522798 ;}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
\par {\listtext\pard\plain\ltrpar \rtlch\fcs1 \af0 \ltrch\fcs0 \f3\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \loch\af3\dbch\af0\hich\f3 \'b7\tab}di essere in possesso }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6382284\charrsid1522798 
 dei Requisiti di idoneit\'e0 professionale e di capacit\'e0 economica e finanziaria ;}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
\par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \af31506 \ltrch\fcs0 \f31506\lang1040\langfe1025\langfenp1025\insrsid10124234\charrsid1522798 \hich\af31506\dbch\af0\loch\f31506 2.\tab}}\pard \ltrpar\qj \fi-357\li720\ri0\widctlpar\tqc\tx709\wrapdefault{\*\pn 
\pnlvlbody\ilvl0\ls3\pnrnot0\pndec\pnb0\pnf-10\pnstart1\pnindent360\pnsp120\pnhang {\pntxta .}}\hyphpar0\aspalpha\aspnum\faauto\ls3\adjustright\rin0\lin720\itap0\pararsid10124234 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
di essere informato, ai sensi e per gli effetti del D.Lgs. n. 196/2003, che i dati personali raccolti saranno trattati, anche con strumenti informatici, esclusivamente nell\rquote ambito del procedimento per il quale la presente dichiarazione viene resa}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 
\par }\pard\plain \ltrpar\s19\qj \li0\ri0\widctlpar\tqc\tx360\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10124234 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1040\langfe1025\cgrid\langnp1040\langfenp1025 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
\par }\pard\plain \ltrpar\s15\qc \li0\ri0\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10124234 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1040\langfe1025\cgrid\langnp1040\langfenp1025 {\rtlch\fcs1 
\ab\af0 \ltrch\fcs0 \b\insrsid10124234\charrsid1522798 COMUNICA
\par }\pard \ltrpar\s15\qj \li0\ri0\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10124234 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
\par I dati necessari per le eventuali successive comunicazioni relative alla procedura  di cui in oggetto:
\par 
\par Denominazione ___________________________________________________________________
\par 
\par Indirizzo ________________________________________________________________________
\par 
\par Telefono __________________ Cell. ______________________E-mail______________________
\par 
\par Referente ______________________________________________Cell: _____________________
\par 
\par e-mail }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1522798 __________________________________________________________________________}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
\par 
\par PEC____________________________________________________________________________
\par }\pard \ltrpar\s15\ql \li0\ri0\sl360\slmult1\widctlpar\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10124234 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 
\par Fax n.___________________________________________________________________________
\par }\pard\plain \ltrpar\qj \li0\ri0\widctlpar\tx1080\tx4680\tx5040\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10124234 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1040\langfe1025\cgrid\langnp1040\langfenp1025 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 \tab 
\par }\pard \ltrpar\qr \fi-1080\li1080\ri0\widctlpar\tx1080\tx4680\tx5040\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin1080\itap0\pararsid10124234 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10124234\charrsid1522798 \tab \tab 
IL LEGALE RAPPRESENTANTE
\par }\pard \ltrpar\qj \fi-1080\li1080\ri0\widctlpar\tx1080\tx4320\tx5040\tqr\tx9638\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin1080\itap0\pararsid4601711 {\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid10124234\charrsid1522798 \tab \tab 
                               }{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid4601711 \tab Firma digitale}{\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid10124234\charrsid1522798 
\par }\pard \ltrpar\qr \fi-1080\li1080\ri0\widctlpar\tx1080\tx4320\tx5040\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin1080\itap0\pararsid1522798 {\rtlch\fcs1 \ai\af0 \ltrch\fcs0 \i\insrsid10124234\charrsid1522798  }{\rtlch\fcs1 
\ai\af0\afs20 \ltrch\fcs0 \i\fs20\insrsid10124234\charrsid1522798 
\par }\pard \ltrpar\qr \fi-1080\li1080\ri0\widctlpar\tx1080\tx3780\tx4320\tx4680\tx5040\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin1080\itap0\pararsid12327567 {\rtlch\fcs1 \ai\af0\afs20 \ltrch\fcs0 \i\fs20\insrsid10124234\charrsid1522798 
         (}{\rtlch\fcs1 \ai\af0\afs20 \ltrch\fcs0 \i\fs20\ul\insrsid10124234\charrsid1522798 con allegata copia fotostatica di documento di identit\'e0}{\rtlch\fcs1 \ai\af0\afs20 \ltrch\fcs0 \i\fs20\insrsid10124234\charrsid1522798 )}{\rtlch\fcs1 \af0 
\ltrch\fcs0 \b\insrsid10124234\charrsid1522798 
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