B08-SOL_W912PF21Q0018_Attachment4_SelfCertificationForAntimafiaCommunication.docx

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Maintenance and Repair of USAG Italy Generators in Vicenza and Poggio Renatico, Italy.
Solicitation number
W912PF21Q0018
Issued by

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This document contains a self-certification form and details of a federal contract solicitation. The solicitation is for maintenance and repair services of generators located in Vicenza and Poggio Renatico, Italy. The contractor will be responsible for providing all necessary personnel, equipment, supplies, transportation, tools and materials to perform maintenance and repairs according to the standards defined in the contract. The solicitation was issued by the Department of the Army Materiel Command Army Contracting Command for generator maintenance and repair services at USAG Italy locations. The self-certification form requires the contractor to attest that they are not prohibited from contracting with the federal government according to Italian law.

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File Type Posted
B08-AMENDMENT0002_GenMaint_20210719.pdf PDF
B08-AMENDMENT0001_GenMaint_20210624.pdf PDF
B08-SOL_W912PF21Q0018_GenMaint_20210624_Final.pdf PDF
B08_SOL_W912PF21F0018_Attachment1_CatalogOfPrices.xlsx XLSX spreadsheet
B08-SOL_W912PF21Q0018_Attachment5_SuitabilityKTR.pdf PDF
B08-SOL_W912PF21Q0018_Attachment3_PPQuestionnaireRevised.rtf RTF text file
B08-SOL_W912PF21Q0018_Attachment6_AttributionQaulificationExpertPerson.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 4

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