wg załączonego wzoru

Transkrypt

wg załączonego wzoru
! " #" $!#%&$' "
"()&" ' !" "%" &* "#+(& " %# ,"* -.&$&/ 01
!"#$%&' ()!('*+,! -./'% ,#%0.'1%!
23 %&-4#5
#% ! -!, ! #" "%-)& & !# - #% ! & !# - #% "% & " -!, ! " "". *#" &(%"#%.
!# - ,
63 )!('*+,! -./'% ,#%0.'1%!
2"3
4#3
5-& !.#%% &"3
6$#&")7 % &"3
8 9*#" &(%"#%
:- :!( <-
=&$
;
6-
@"
!,-% ;#%
>#
A"
2-
!.!
C("
?&$
A!%#.,!
4!#
C("&$
2.&
#
(&/
B 9-#%
9! -
?-
C"&$
8 2!. -D!3
2!. D%#!3
1/10
4# & -%&$3
2!. D&$ "#%!3
#% -E 7 . "#%."#%. &.F #B!$&.F
!..F. D&$.F3
G#, "- " #"3
2"#% .B .3
2!. -D!3
8 4# & -%&$3
73 #)('%! -./'% ,#%0.'1%!
8 2"3
8 4#3
8 5-& !.#%% &"3
8 6$#&")7 % &"3
88 9*#" &(%"#%
:- :!( <-
=&$
;
6-
!.!
@"
!,-% ;#%
>#
A"
2-
C("
?&$
A!%#.,!
4!#
C("&$
2.&
#
(&/
B 9-#%
9! -
?-
C"&$
83 -59:#%0! )'$+,)-%# ;<= >- (%&-459 ( ".)!"'>59 />! -.)#,)#%&# (!>'%- ( "'?40(&# ,)$-%5-(45&:
# &! #"$%!.! !B" "& &! #"$%!.! !B" " #& D.!- %)- "
(&%! <' <<' <<< -!, <H
#-&$ -!, (!.& )& D.!- %)- " (&%! <' <<' <<< -!, <H
" ". %! I # &$ #"$&$ "%-)7
%!. "#%!$& %"B - (&/ ()& B' " %+$ % ,-&
%!. #"$&' E "+ #%#( .& "$ -!, "- %#+" "%+"
2/10
%!. #"$&' E "+ !&#&( " ,(. #B"! .
.#&$. " *#" &(%"#%. &/ E #( "!% D#" !"$& #%# .& "$ -!, "- %#+" "%+"
%!. $& " !,-&.! !" "# " -E)& !(!
)"&* "(&&/ "&-" )"&$& "(B %&/ )"&*
#B "#%73
@3 -59:#%0! )'$+,)-%# ;<= >- (%&-459 ( ".)!"'>59 />! -.)#,)#%&# (!>'%- ( "'?40(&# 0.)#,&:
( %# &
##& -!, "& & # "()&" *#" &/
%!. #"$& "%-)7 &$ " *#" &/ ' " %! &$
! .#&$ ' %!. #"$&' E #( ". " " !#
8 J"&$ /#%$ %!
$E- " "( #B " #+ #. ,( " &# #B" "
*#" &/ I %!. -!, %!. )"&$&F' E " #( -E&
". #B"! .( .E-")7 #" !" -!, E #( -E&
". &! .( .E-")7 "# #&"! -!, )% #%E " )"-
D%+" "
%!. "#%!$& %"B - (&/ ()& B' " %+$ % ,-&
%!. "$& D.&$ !E& " "&/ ,-&* "
%! & "!$& !.& %#&$B
%!. "#%!$& %#' " $%. "+ !#%( " ,($ .& "$ "
*#" &(%"#%. &/
#B "#%73
A+,)%' 1&,)B' >-59:#%0C( )'$+,)-%!,D >- E-.:91'.)' (%&-459
"-.)+>)-%- (
>%&'
;>>F::F....=
')(&45- & "->"&4 9"-('G%&-%#/- 9.)H>%&5' ()!('*+,#/- -./'%9 ,#%0.'1%#/-
3/10
!"#$%&' (%&-45->'(,' 19B ( ->"-(&#>%&: ".)!"'>59 -4-B'F-./'%
9"-('G%&-%! (# ()!('*+,!: "'?40(&# ,)$-%5-(45&: >- (!"#$%&#%&' E-.:91'.)'
( &:&#%&9 (%&-45->'(,!
I3 %&-4#5
#% ! -!, ! #" "%-)& &
9#" "#%! $#3
( <H #%&$ J"&$ /#% %!
"#%7 #"B ! "% .& J"&$ /#%$ %!3
9" ,( ,& -!, " &# #B" " *#" &/3
%
8
" %$" "" *#" &(%"#% < #B "#%73
#% "% & " -!, ! " "". *#"
&(%"#%.
J3 .)#,)#%&#
K !. D&$3
2" #! &/3
K3 %&-45->'(,'
G#, D&
2"#% .B .3
K .. .$#& !3
4/10
8 2!. D%&$ -!, !,& #(& LL3
G,"-#"3
M"+3
C &"-3
4#3
B&*
"#% .B . LLL
5-& !.#%% &"3
8 6$#&")7 % &"3
9*#" &(%"#%
:- :!( <-
=&$
;
@"
6-
!,-% ;#%
>#
A"
2-
!.!
?&$
A!%#.,!
4!#
C("
C("&$
2.&
#
(&/
B 9-#%
9! -
?-
C"&$
N-D# & -%&$3
G#, 3
!#%( .& "3
%
#( "- %#+" "%+"3
%
8 !&#&( " ,(. #B"! . .#&$. ".. "
(&%! O 3
%
". %! "#%' .B . # #"&- "#%"&
"%& " P3
5/10
<#!&$ !,-&
2"3
4#3
5-& !.#%% &"3
6$#&")7 % &"3
8 9*#" &(%"#%
:- :!( <-
=&$
;
6-
!.!
@"
!,-% ;#%
>#
A"
2-
?&$
A!%#.,!
4!#
C("
#
(&/
B 9-#%
C("&$
2.&
9! -
?-
C"&$
8 N-DD%## & -%&$3
2"#% #, !$&$ #!&$B " #B"&/ LLLL3
G#, "- " #"3
2"#% .B .3
2!. -D!3
8 2!. D%#!3
4# & -%&$3
L3 -)('%!
2"#% .B .3
K .. .$#& ! L3
8 2!. D%&$ -!, !,& #(& L3
6/10
G,"-#" L3
M"+ L3
C &"- L3
4# L3
5-& !.#%% &"3
6$#&")7 % &"3
8 9*#" &(%"#%
:- :!( <-
=&$
;
@"
6-
!.!
!,-% ;#%
>#
A"
2-
?&$
A!%#.,!
4!#
C("
C("&$
2.&
#
(&/
B 9-#%
9! -
?-
C"&$
2M3 4)#15&# &%%# &%E-.:',*# 50C.# :-/+ "-:C, ( 940'1#%&9 :&#*4,' "-B!09 "-)('%#/-
223 4-B';N!= %' .)#,) 50C.#*;N!,D= :'*+ )-40'O ".)!)%'%# P(&'>,)#%&' '1&:#%0',!*%# 19B 50C.#*;N!:=
P(&'>,)#%&' 0# 4+ %'1#G%# ;<<<<<=
#. #, & "#%"& %)- " % #. #, & " %)- " % 8
"#%"&
"
$# #"&-. !#"". LLLLLL !$&. # #B!$&$ #, -!, #+,3
2237323 4-B' 8 2"#% .B .3
7/10
8 K .. .$#& !3
88 2!. D%&$ -!, !,& #(& LLLLLLL3
8 G,"-#" LLLLLLL3
8 M"+ LLLLLLL3
8
C &"- LLLLLLL3
2237363 4-B' 8 2"#% .B .3
8 K .. .$#& !3
88 2!. D%&$ -!, !,& #(& LLLLLLL3
8 G,"-#" LLLLLLL3
8 M"+ LLLLLLL3
8
C &"- LLLLLLL3
2237373 4-B' 88 2"#% .B .3
88 K .. .$#& !3
888 2!. D%&$ -!, !,& #(& LLLLLLL3
88 G,"-#" LLLLLLL3
88 M"+ LLLLLLL3
88
C &"- LLLLLLL3
263 $9G%&5
#. #, & "#%"& %)- " % 8
#. #, & " %)- " % 8/10
8
"#%"&
"
$# #"&-. !#"". LLLLLL !$&. # #B!$&$ #,3
8 2"#% .B .3
8 K .. .$#& !3
88 2!. D%&$ -!, !,& #(& L3
8 G,"-#" L3
8 M"+ L3
8
C &"- L3
273 %E-.:',*# >-0!,)+,# "$'0%-P,& *#G#1& ) (%&-45&#: (!40H"9*# (&#.)!,&#1
8 9()7 -%&
8 2" ,%!3
8 J D%&$ ,%! C<?N -!, " % ,%"3
88 9#& &/!%!3
8 6B" !. &/!%! ,%" <:423
8 9()7 &%.
8 ;% "#" "#%3
8 ;% &
8 2"#% .B .3
8 4#3
8 5-& !.#%% &"3
8 6$#&")7 % &"3
88 9*#"3
9/10
283 %E-.:',*# >->'05-(# ;( ->"-(&#>%&,D ".)!"'>5',D=
"-.)+>)-%- (
>%&'
->"&4 (%&-45->'(,!
;>>F::F....=
19B ( ->"-(&#>%&,D ".)!"'>5',D
')(&45- & "->"&4 -4-B!F-./'%9 9"-('G%&-%#/- (# ()!('*+,!: "'?40(&# ,)$-%5-(45&: >(!"#$%&#%&' E-.:91'.)' ( &:&#%&9 "-(->'
Q2R )33 J ) 2M3236MML 43 23
;<= .-4)H )')%',)!O ($'P,&(# "-1' & "-%9:#.-('O >-59:#%0! ( 5-1#*%-P,& ( *'5&#* 4+ )'$+,)-%#3
;<<= #P1& >'%# 0# 4+ >-40H"%#3
;<<<= ".)!"'>59 ".)#:-,! >-:-(#* ;)-B3 '.03 @J 9403 7 .-)"-.)+>)#%&' ;= %. 8F6MML=3
;<<<<= ->"-(&#>%&,D ".)!"'>5',D3
;<<<<<= #G#1& -4CB 0!,D *#40 (&H,#* %&G 0.)! %'1#G! >-$+,)!O >->'05-(! '.594)3
;<<<<<<= ' ".)!5$'> -4-B' 4".'(9*+,' ($'>)H .->)&,&#145+ 19B -"&#59% -4-B! >-.-4$#*3
;<<<<<<<= ->"-(&#>%&,D ".)!"'>5',D & *#P1& >'%# 0# 4+ >-40H"%#3
10/10