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Walutowy [0]g Warning Text hZBe9ZBe  %XTableStyleMedium2PivotStyleLight1683ffff̙̙3f3fff3f3f33333f33333\`4|ZaBcznik nr 2 do SIWZ00!  ;?7 Excel_BuiltIn__FilterDatabase;2 Excel_BuiltIn_Print_Area;6 Excel_BuiltIn_Print_Area_1_1;58 Excel_BuiltIn_Print_Area_1_1_1;5  ; 4fVf@ @bZ  3  @@  I Nr pakietu Nr pozycji Nazwa lekuNazwa handlowaJ.M.Cena jednostkowa nettoWarto[ bruttoCena jednostkowa brutto ProducentKod EANBevacizumabum 100mg fiolszt.Bevacizumabum 400mg fiolHEpoetin beta 30.000 r-r do wstrzyk (30.000jm/0,6ml) x 1amp.-strzyk 0,6mlErlotinib 150mg x 30tablopakErlotinib 100mg x 30tablzsBownie warto[ brutto: ..................................................................................................FObinutuzumabum koncentrat do sporzdzania roztworu do infuzji, 1000 mgsztRituximabum 100mg/10ml x 2fiolRituximabum 500mg/50ml fiol,Rituximabum roztwr do wstrzykiwaD, 1400 mgPertuzumabum 420mg 1fiolTrastuzumabum 150mg fiolTrastuzumabum 600mg x 1fiolPemetreksedum 100mg fiol Pemetreksedum 500mg fiolGefitynibum 250mg x30tablPasopanib 400 mg x 60 tablPasopanib 200 mg x 30 tabl/Cetuximabum (dostawy w dawkach 100,500 mg) fiolmgPanitumumabum 100mg fiolPanitumumabum 400mg fiolImatinibum 400mg x 90tabl*Sunitinibum 12,5mg x 28kapsSunitinibum 25mg x 28kapsSunitinibum 50mg x 28kapsEverolimusum 10mg x 30tablEverolimusum 5mg x 30tablAxitinib 1mg x 56tablAxitinib 5mg x 56tablLapatynibum 250mg tabl$Brentuximabum vedotinum 50mg x 1fiolOlaparibum 50mg x 448kapsop-Docetaxelum 80mg koncentrat/roztwr x 1 fiol.-Docetaxelum 20mg koncentrat/roztwr x 1 fiol.Bendamustinum 100mg x 5fiolBendamustinum 25mg x 5fiolChlorambucilum 2mg x 25tablCyclophosphamidum 200mg fiolCyclophosphamidum 1000mg fiolCyclophosphamidum 50mg x 50dra|Melphalanum 2mg x 25tablIfosfamidum 1000mg fiolIfosfamidum 2000mg fiolDacarbazinum 100mg fiolCladribinum 10mg fiol1Fludaribini phosphas 50mg fiol koncentrat/roztwr"'Fludaribini phosphas 10mg x 20tabl oral+Cytarabinum 1000mg fiol koncentrat/ roztwr.Fluorouracilum 5000mg fiol koncentrat/roztwr "-NL-folinian disodu 218,6mg fiol (Kwas L-folinowy 200mg/4ml) koncentrat/roztwr<"Gemcitabinum 200mg fiolGemcitabinum 1000mg fiolVinblastini sulfas 5mgx10fiolVincristini sulfas 1mg fiolx10Vinorelbinum 20mg oralkapsVinorelbinum 30mg oral$Vinorelbinum 50mg koncentrat/roztwr"(Etoposidum 200mg fiol koncentrat/roztwr"+Doxorubicinum 100mg fiol koncentrat/roztwr'Doxorubicinum liposomanum 50mg x 2zest.EDoxorubicinum liposomanum pegylatum 20mg/10ml fiol koncentrat/roztwr27Epirubicini hydrochloridum 10mg fiol koncentrat/roztwr%"7Epirubicini hydrochloridum 50mg fiol koncentrat/roztwr%"Mitomycinum 10mg fiol*Carboplatinum 50mg fiol koncentrat/roztwr+Carboplatinum 150mg fiol koncentrat/roztwr"+Carboplatinum 450mg fiol koncentrat/roztwr"(Cisplatinum 10mg fiol koncentrat/roztwr"(Cisplatinum 50mg fiol koncentrat/roztwr")Cisplatinum 100mg fiol koncentrat/roztwr"*Oxaliplatinum 50mg fiol koncentrat/roztwr"+Oxaliplatinum 100mg fiol koncentrat/roztwr"$Irinotecani hydrochloridum 40mg fiol&Irinotecani hydrochloridum 100mg fiol Mitotanum 500mg x 100tablTopotecanum 0,25mg x 10kapsTopotecanum 1mg x 10kapsTopotecanum 1mg fiolTopotecanum 4mg fiol!Fulvestrantum 250mg x 2ampstrzyk.Tamoxifenum 20mg x 30tablBicalutamidum 50mg x 28tablFilgrastimum 48mln ampstrzyk.Filgrastimum 30mln ampstrzyk.Pegfilgrastimum 6mg/0,6ml Rasburicasum 1,5mg x 3fiolMesnum 400mg/4ml x 15amp.Calcium folinate 200mg fiol koncentrat/roztwr"'Darbepoetinum alfa 500mcg/ml ampstrzykFluorouracyl 1000mg fiolAcidum zoledronicum 4mg fiolOndansetronum 4mg x 5ampOndansetronum 8mg x 5ampOndansetronum 8mg x 10tabl"Lipegfilgrastimum 0,6ml amp-strzykBortezomib 3,5mg fiol&Posaconazole 40mg/1ml 105 ml zawiesina)Megestroli acetas 40mg/ml 240ml zawiesina Goserelinum ampuBkostrzyk. 3,6mg!Goserelinum ampuBkostrzyk. 10,8mgAnastrazolum 1mg x 28 tablLetrozolum 2,5mg x 30 tablCiclosporinum 25mg x 50kapsCiclosporinum 50mg x 50kapsCiclosporinum 100mg x 50kapsFlutamidum 250mg x 100tabl Palonosetron 250mikrogramw fiol& & & & & & & & & & & & & & & & & & & ..piecz adresowa Wykonawcy]sBownie warto[ brutto: .....................................................................:Osoby upowa|nione do podpisania oferty w imieniu WykonawcyImie i NazwiskoDataCzytelny Podpis Warto[ nettoStawka podatku VAT [%] Warto[ VAT8 = 7 + warto[ VAT 9 = 6 x 7 11 = 9 x 10 12 = 9 + 11RAZEMCapecitabinum 500mg x 120tabl+Paclitaxelum 100 mg fiol koncentrat/roztwr"ZaBcznik nr 2 do SIWZFORMULARZ ASORTYMENTOWO-CENOWY  Ilo[ szacunkowa na 12 - mcy'(Atezolizumab 1200mg/20ml fiol/koncentrat>Temozolomidum (dostawy w dawkach 5, 20, 100, 140, 180 mg) kapsMethotrexat 50mg fiol*Cytarabinum 500mg fiol koncentrat/ roztwr*Cytarabinum 100mg fiol koncentrat/ roztwr(Etoposidum 100mg fiol koncentrat/roztwr"Bleomycin sulphas 15000 lU fiolPamidronian 90mg fiolPamidronian 30mgx2 fiolPamidronian 60mg fiol'Sorafenibum 200mg x 112tabl powlekanychLPaclitacselum albuminatum proszek do sporzdzania zawiesiny do infuzji 100mg9Netupitantum+Palonosetronum kaps twarde 300mg+0,5mgx1szt.Anagrelidum 0,5mgx100kapsAnagrelidum 1mgx100kapsNivolumab 10mg/ml 4 ml fiol$Pembrolizumab 25mg/ml-4ml-100mg fiolAfatinib 20mgx28 tabl powlAfatinib 30mgx28 tabl powlAfatinib 40mgx28 tabl powlAzacytydyna 100mg fiolKryzotinib 200mgx60 kapsKryzotinib 250mgx60 kapsTemsirolimus 30mg/1,2mlEnzalutamid 40mgx112 kapsOzymertynib 80mgx30 tablPiksantron 29mg fiolIbrutynib 140mgx90 kaps twardeIdarubicini h/chl 5mg fiolIdarubicini h/chl 10mg fiolMitoxantronum 20mg fiolTioguaninum 40mgx25tablMelfalan 50mg amp!Wemurafenib 240mg x 56 tabl powl. 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