Attachment 5 - Self Certification for Antimafia Communication.pdf

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Supply of Liquid Gas at Camp Darby, Tirrenia, Pisa. Italy
Solicitation number
W912PF25QLIQU
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This document is a combined synopsis/solicitation for a commercial item contract opportunity issued by the Department of the Army Materiel Command Army Contracting Command. The purpose is to establish a Blanket Purchase Agreement (BPA) for the supply of liquid gas to fill tanks at USAG Italy DMC, Camp Darby, Tirrenia, Pisa, Italy. The required period of performance is from 7 January 2025 to 6 January 2030. Quotes are due by 15 November 2024 at 12:00 p.m. local time in Rome, Italy. Award will be made to the lowest priced responsive offeror that meets the mandatory certification requirements. Pricing must be provided in Euro currency without IVA tax, as the U.S. government is tax-exempt. Key required attachments include a pricing table, BPA terms and conditions, and a self-certification for Antimafia communication.

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Other files

File Type Posted
Attachment 2 - Rev2_Revised Purchase Description for the Supply of Liquid Gas_20241204.pdf PDF
Attachment 2 - Rev1_Revised Purchase Description for the Supply of Liquid Gas_20241105.pdf PDF
Attachment 4 - BPA Terms and Conditions.pdf PDF
Attachment 1 - LPG tank map.pdf PDF
Attachment 3 - Quoter Pricing Table.xlsx XLSX spreadsheet
Attachment 2 - Purchase Description for the Supply of Liquid Gas.pdf PDF

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Self-certification for Antimafia communication

Autocertificazione della comunicazione antimafia

Dichiarazione sostitutiva di certificazione (D.P.R. n. 445 del 28.12.2000)

Il/la sottoscritto/a (nome e cognome) _______________________________ C.F._________________ nato/a _______________________________ Prov. _________ il ______________ residente a

________________________ Prov. _____ in via/piazza ____________________

_______________________________ n. ____, in qualità di (carica ricoperta) ___________ dell’impresa (indicare la denominazione) _______________________________________________ C.F. __________________ avente la sede in _________________________ Prov. di __________ Via ___________________________ n. ______ consapevole delle sanzioni penali in caso di dichiarazioni false e della conseguente decadenza dai benefici eventualmente conseguiti (ai sensi degli artt. 75 e 76 D.P.R. 445/2000) sotto la propria responsabilità

DICHIARA

che nei propri confronti non sussistono le cause di divieto, di decadenza o di sospensione di cui all’art. 67 del D.lgs. n. 159 del 06/09/2011.

Il/la sottoscritto/a dichiara inoltre di essere informato/a, ai sensi del D.Lgs. n. 196/2003 (codice in materia di protezione di dati personali) che i dati personali raccolti saranno trattati, anche con strumenti informatici, esclusivamente nell’ambito del procedimento per il quale la presente dichiarazione viene resa.

data firma leggibile del dichiarante (2)

ATTACHMENT 5

W912PF25QLIQU - Supply of Liquid Gas

File details come from the government source that posted it. Updated .