202608241153_EBK000455913.pdf

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3. Delcgtfie seria 
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dt(a dclccatul
Aara 4elerupoaarrnurfi
4. Docuntente arexate
flpularaelrrre noxyuerrrcr
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Dcnunrirea nrlrfuriloty'sctivelor,
serviciilor Si codul poziliei tariftrc al
nrf,rfii/actil'ului
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kotr roBapHoii no3nuilrr rcBnpa/acrrrBa
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13. Permls ellberarea: director CORNELIU STAHI
Ornycx
l)roDeurun
14. Predat mlrfurile/activelc (seruiciile); director CORNEI-lU STAHI
Cau ronapr/axrqstr (ycryrH)
Ftrnc{ix, nunrcle, prrnilnrcle , scmnlhrrr xuocm, rfranrurrrr. rntr. nonnlcu
Aplicatd semnltura electronice de citre Furnizot\\flprueHeua
3[exrpoHHa, noAnxcr Ilocranruura 23.07.2026
Aplicati semnitua electronici de citre Furtizor\\llpurreuetra
srexrpoHHa, noAnBcr Ilocrasqura 23.07.202(r
l0.l
Dcnumirea merfurilor/sctiYelor,
seryiciilor ti codul pozitiei tsrifare .l
mtrr6i/activuhi
arrrrcroaarrc rotapoo/aronBoB, J/cnyr
rion rosapxoii no3uqIrtr rcBapa/acrxBa
I 99 I 8. SULFACIL DE NATRIU
IO ML PIC. OFT. N1

rilor/sctiYelor,
seryiciilor ti codul pozitiei tsrifare .l
mtrr6i/activuhi
arrrrcroaarrc rotapoo/aronBoB, J/cnyr
rion rosapxoii no3uqIrtr rcBapa/acrxBa
I 99 I 8. SULFACIL DE NATRIU
IO ML PIC. OFT. N1
I t9,31Manusi n/ster. L NI00 (0)
1907 l. Degetare Rorned Nl00 (0)
3405 I , SOLUTIE DE PEROXID
2862I. LEVOMECOL 750 MC + 4
I0145823. /PARACETAMOL Atb
)595. EMPLASTRU SANPLAST
sCM.X 5M. (0)
I I573, TRAUMEEL S 50 G UNG.
r (2000510022)
I 3609. SUPRASTIN 25 MG
18566. Betisoare N100 ipek (0)
30628, SERVETELE DE TIFON
l0xl0 cM (0)
30193. Servetele de tifon STERILE
5157 IBAHTLE N r00 (0)
Ipek discuri Nl20 (0)
53 L Servetele cu alcool Nl00
I0I47899. TIFON ELASTIC
FuDctir, numele, prenumele , semn{tura \ Aon)xHocrl, oaNInnnr, llM, , f,oaflnc6
r,.s.
I5. M'lLit rnlrfurilc/activele intermedirrul (transportrtorul):
flpunrn ronapt/axrrru nocpeqrrx (nepeno:'tlx)
Func(ie, uurnele, Frenrrnele , semnlhrra \ Aorxirrocrr. rfarrrrrr. u\r, . noafrnct
16. Pr0dat mlrfurilc/actiyele intcrmcdi{rul
(t rrnsportato rul):;
Cgar roeapu/arrrreu rocpe.luur (nepeno:'tur)
1?. I'rinrit mlrfurile/activele (serviciilc)
cunr piritorul/benefi ciarul I
llpanu roaapt/arru86I (ycnyrH)
norlrnarelr/no4 rarelt
Functia, nurnele, prerunrele , semni(trri \AoDxttoctr. {larrurttr. nNl, , noAnilc6
Aplicatl senrndhlra clecttonici de cittc CumpetltoA\flpl6terlella
3reKrpouraf, noAnuct florynarell I 1.08.2026dircctor tLIE ISAC
Fnnclia, nnfrele, prcnnmele , scmn:ltnra \ AonxHocrE, (baMurnr, rir, I nontrilcL
Pagina 2 din 3
I 2. 'l'O'fAL (pe factura tiscali) / Bcero (no ttuororofi
I,'ACTURA FISCALi
HArroroBA,,AKrrAAHArr Slljl;,\i; 8BK000455913
18. Tinrpul de stalionare a rnijlocului dc transport
Bpeur npocror rpaHctropraoro cpcAc'rBa
9. Ruta $i distantr dc trflnsport, km
Ivlapupyr,[BuxeHtrx ff paccrorHHe trcpcBo3KH, K\l
Operalir
Onepaunr
Ziua. Iuna, ora, minutele la
Aesl, rrecru, cac, NrfllyTbl
Senrnitura
flornxcb
Sosirc
flpu6rrrrr
Pleclre
V6urprr
Stafionare
flpocror
incdrcarc
florpy:xa
Descircrre
Paarpy:xa
20. Forua de platl
Bua onlatt
l. Mcntiuni
)TMerKI
I60
2. Calculul prestaliilor dc transport
Pacver rpaucnopnrsrx yctqtr
.!. Docurnente anexatc
Ilpuaaraenure gonyueurrt
Pagirra 3 din 3