Attachment 5 SELF-CERTIFICATION of AntiMafia Information.docx

DOCX document 14 KB Posted

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NSA Naples Capodichino Office Furniture
Solicitation number
N6817123Q0103
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File Type Posted
Attachment 6_A0003_ROOM 308.pdf PDF
N6817123Q0103 A0003 N4 FURNITURE.pdf PDF
N6817123Q0103 A0002 NSA NAPLES CAPODICHINO FURNITURE.docx.pdf PDF
N6817123Q0103 A0001 NSA NAPLES CAPODICHINO FURNITURE.pdf PDF
Attachment 2 Sample Furniture.pdf PDF
Attachment 1 Room Schematic - Dimensions.pdf PDF
N6817123Q0103 NSA NAPLES CAPODICHINO FURNITURE.pdf PDF
Attachment 4 SELF-CERTIFICATION of AntiMafia Communication.docx DOCX document
Attachment 3 Unified Facilities Criteria UFC.pdf PDF

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SELF-CERTIFICATION OF THE ANTI-MAFIA INFORMATION

(Art. 85 of Legislative Decree 06/09/2011 n.159)

The undersigned (Last name, Name) ______________________________________________________________

Date and place of BirthFISCAL CODE or VAT NumberPlace of residenceProv.
Street_____________________________________________________________________n•_____________

Fully aware of the criminal liability faced, pursuant to and by effect of articles 75 and 76 of the Presidential Decree 445 of 28 December 2000, in the event of false declarations or the formation, exhibition or use of false documents, or documents containing data that no longer correspond to the truth, declares and attests under his/her own responsibility:

That are no causes of prohibition, forfeiture or suspension pursuant to art. 67 of Legislative Decree 06/09/2011 No. 159, for the undersigned and/or cohabiting family members aged 18 or more (whose data are made available below).

FIRST NAME
LAST NAME
Date of Birth
Place of Birth
Fiscal Code

The undersigned also declares to be fully informed, pursuant to Legislative Decree No. 196/2003 (Code regarding the protection of personal data), that the data collected will be processed, even with IT tools, exclusively within the purpose of the procedure for which this declaration is made.

Date

Signature

Provide copy of the Identity document of the subscriber.

This declaration does not require the authentication of the signature and replaces, for all the intents and purposes, the normal certifications required by a Public Administration, as well as for managers of public services and the private sector who allow it.

Legislative Decree 06/09/2011 n. 159, art. 85 https://def.finanze.it/DocTribFrontend/decodeurn?urn=urn:doctrib::DLG:2011-09-06;159_art85

Attachment 5

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