Formular tipizat

$QH[DOD2UGLQXO0LQLVWHUXOXL)LQQDQĠHORUDO5HSXEOLFLL0ROGRYD
nr.118 din 28 august 2017
Ɍɢɩɨɜɚɹɮɨɪɦɚ
ɉɪɢɥɨɠɟɧɢɟɤɩɪɢɤɚɡɭɆɢɧɢɫɬɟɪɫɬɜɚɎɢɧɚɧɫɨɜɊɟɫɩɭɛɥɢɤɢɆɨɥɞɨɜɚ
ʋɨɬɚɜɝɭɫɬɚɝ

)$&785Ă),6&$/Ă Seria, Nr.

ɇȺɅɈȽɈȼȺəɇȺɄɅȺȾɇȺə ɋɟɪɢɹʋ EAA005731793
8. Foaia de parcurs seria: QXPăU data:
'DWDHOLEHUăULLGDWDOLYUăULL07.06.2021 / 07.06.2021 ɉɭɬɟɜɨɣɥɢɫɬɫɟɪɢɹ ɧɨɦɟɪ ɞɚɬɚ
Ⱦɚɬɚɜɵɩɢɫɤɢɞɚɬɚɩɨɫɬɚɜɤɢ 9. Transportator VIPROAGRO S.R.L., c.f./ nr.TVA 1015600038491 /
ɉɟɪɟɜɨɡɱɢɤ SEC.BUIUCANI George Calinescu ɮɤɤɨɞɇȾɋ0507533
nr.2 of.18
1. Furnizor: VIPROAGRO S.R.L., SEC.BUIUCANI George Calinescu nr.2 of.18 Cont MD46CM000225104980142613, c.f./ nr.TVA 1015600038491 /
ɉɨɫɬɚɜɳɢɤ BC'COMERTBANK'S.A., CMTBMD2X ɮɤɤɨɞɇȾɋ0507533

&XPSăUăWRUEHQHILFLDU FOOD PLANET RESTAURANTS S.R.L., SEC.CENTRU Stefan cel Mare si Sfant bd. nr.134 bl.1 c.f./ nr.TVA 1003600137218 /
ɉɨɤɭɩɚɬɟɥɶɩɨɥɭɱɚɬɟɥɶ ɮɤɤɨɞɇȾɋ7800042

'HOHJDĠLHseria QXPăU data delegatul 4. Documente anexate

Ⱦɨɜɟɪɟɧɧɨɫɬɶ ɫɟɪɢɹ ɧɨɦɟɪ ɞɚɬɚ ɞɟɥɟɝɢɪɨɜɚɧɧɵɣ ɉɪɢɥɚɝɚɟɦɵɟɞɨɤɭɦɟɧɬɵ

3XQFWvQFăUFDUH 3XQFWGHVFăUFDUH 5HGLULMăUL

ɉɭɧɤɬɩɨɝɪɭɡɤɢ ɉɭɧɤɬɪɚɡɝɪɭɡɤɢ ɉɟɪɟɚɞɪɟɫɨɜɤɢ

10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12
'HQXPLUHDPăUIXULORUDFWLYHORUVHUYLFLLORUúLFRGXOSR]LĠLHL Unitate Cantitatea 3UHĠXQLWDU 9DORDUHDWRWDOă Cota 6XPDWRWDOăD Valoarea $OWă Tip ambalaj 1XPăU Masa
WDULIDUHDOPăUILLDFWLYXOXL de PăUIXULORUDF IăUă79$OHL IăUă79$OHL TVA,% TVA, lei PăUIXULORUDFWLYHORU LQIRUPDĠLH Ɍɢɩɭɩɚɤɨɜɤɢ locuri EUXWăWRQH
ɇɚɢɦɟɧɨɜɚɧɢɟɬɨɜɚɪɨɜɚɤɬɢɜɨɜɭɫɥɭɝɢɤɨɞɬɨɜɚɪɧɨɣ PăVXUă tivelor, ɐɟɧɚ Ɉɛɳɚɹɫɭɦɦɚ ɋɬɚɜɤɚ Ɉɛɳɚɹɫɭɦɦɚ , serviciilor, lei Ⱦɪɭɝɚɹ Ʉɨɥɢ Ɇɚɫɫɚ
ɩɨɡɢɰɢɢɬɨɜɚɪɚɚɫɬɢɜɚ ȿɞɢɧɢɰ volumul ɟɞɢɧɢɰɵɛɟɡ ɛɟɡɇȾɋɥɟɟɜ ɇȾɋ ɇȾɋɥɟɟɜ ɋɬɨɢɦɨɫɬɶ ɢɧɮɨɪɦɚɰɢɹ ɱɟɫɬɜɨ ɛɪɭɬɬɨ
ɚ serviciilor ɇȾɋɥɟɟɜ ɬɨɜɚɪɨɜɚɤɬɢɜɨɜ ɦɟɫɬ ɬɨɧɧ
ɢɡɦɟɪɟ Ʉɨɥɢɱɟɫɬɜɨ ɭɫɥɭɝɥɟɟɜ
ɧɢɹ ɬɨɜɚɪɨɜɚɤɬɢ
ɜɨɜɨɛɴɟɦ
ɭɫɥɭɝ
ROSII kg 181 23,15 4190,14 8 335,21 4525,36
727$/SHIDFWXUDILVFDOăȼɫɟɝɨɩɨɧɚɥɨɝɨɜɨɣɧɚɤɥɚɞɧɨɣ 4190,14 X 335,21 4525,36 X X X 0,00

13. Permis eliberarea: director ECATERINA DOBRITA $SOLFDWăVHPQăWXUDGLJLWDOăGHFăWUH)XUQL]RU?ɉɪɢɦɟɧɟɧɚ

Ɉɬɩɭɫɤ ɰɢɮɪɨɜɚɹɩɨɞɩɢɫɶɉɨɫɬɚɜɳɢɤɚ
ɪɚɡɪɟɲɢɥ
)XQFĠLDQXPHOHSUHQXPHOHVHPQăWXUD \ Ⱦɨɥɠɧɨɫɬɶɮɚɦɢɥɢɹɢɦɹɩɨɞɩɢɫɶ

143UHGDWPăUIXULOHDFWLYHOHVHUYLFLLOH director ECATERINA DOBRITA $SOLFDWăVHPQăWXUDGLJLWDOăGHFăWUH)XUQL]RU?ɉɪɢɦɟɧɟɧɚ

ɋɞɚɥɬɨɜɚɪɵɚɤɬɢɜɵɭɫɥɭɝɢ ɰɢɮɪɨɜɚɹɩɨɞɩɢɫɶɉɨɫɬɚɜɳɢɤɚ

)XQFĠLDQXPHOHSUHQXPHOHVHPQăWXUD \ Ⱦɨɥɠɧɨɫɬɶɮɚɦɢɥɢɹɢɦɹɩɨɞɩɢɫɶ
/ù

Ɇɉ
153ULPLWPăUIXULOHDFWLYHOHLQWHUPHGLDUXOWUDQVSRUWDWRUXO

ɉɪɢɧɹɥɬɨɜɚɪɵɚɤɬɢɜɵɩɨɫɪɟɞɧɢɤɩɟɪɟɜɨɡɱɢɤ

)XQFĠLDQXPHOHSUHQXPHOHVHPQăWXUD\ Ⱦɨɥɠɧɨɫɬɶɮɚɦɢɥɢɹɢɦɹɩɨɞɩɢɫɶ
163UHGDWPăUIXULOHDFWLYHOHLQWHUPHGLDUXO
(transportatorul)::
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)XQFĠLDQXPHOHSUHQXPHOHVHPQăWXUD \ Ⱦɨɥɠɧɨɫɬɶɮɚɦɢɥɢɹɢɦɹɩɨɞɩɢɫɶ
3ULPLWPăUIXULOHDFWLYHOHVHUYLFLLOH 9DOLGăQXPDLFXVHPQăWXULOHRORJUDIHDOH&XPSăUăWRUXOXL
FXPSăUăWRUXOEHQHILFLDUXO \Ⱦɟɣɫɬɜɢɬɟɥɶɧɚɬɨɥɶɤɨɩɪɢɧɚɥɢɱɢɢɝɨɥɨɝɪɚɮɢɱɟɫɤɢɯɩɨɞɩɢɫɟɣ
ɉɪɢɧɹɥɬɨɜɚɪɵɚɤɬɢɜɵɭɫɥɭɝɢ ɉɨɤɭɩɚɬɟɥɹ
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)XQFĠLDQXPHOHSUHQXPHOHVHPQăWXUD\ Ⱦɨɥɠɧɨɫɬɶɮɚɦɢɥɢɹɢɦɹɩɨɞɩɢɫɶ

Pagina 1 din 2
)$&785Ă),6&$/Ă Seria, Nr.
ɇȺɅɈȽɈȼȺəɇȺɄɅȺȾɇȺə ɋɟɪɢɹʋ EAA005731793
187LPSXOGHVWDĠLRQDUHDPLMORFXOXLGHWUDQVSRUW 195XWDúLGLVWDQĠDGHWUDQVSRUWNP
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2SHUDĠLD Ziua, luna, ora, minutele la 6HPQăWXUD

Ɉɩɟɪɚɰɢɹ Ⱦɟɧɶɦɟɫɹɰɱɚɫɦɢɧɭɬɵ ɉɨɞɩɢɫɶ

Sosire Plecare 6WDĠLRQDUH

ɉɪɢɛɵɬɢɹ ɍɛɵɬɢɹ ɉɪɨɫɬɨɹ
ÌQFăUFDUH
ɉɨɝɪɭɡɤɚ
'HVFăUFDUH
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)RUPDGHSODWă
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0HQĠLXQL

Ɉɬɦɟɬɤɢ

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Ɋɚɫɱɟɬɬɪɚɧɫɩɨɪɬɧɵɯɭɫɥɭɝ

4. Documente anexate
ɉɪɢɥɚɝɚɟɦɵɟɞɨɤɭɦɟɧɬɵ

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