Ordonator (Denumirea solicitantului, obiectul de activitate, forma juridica)
_______________________________________________________________________________________________________ ___________________________________________________________________________________ Sediul ____________________________________________________________________________________________ Numar de nregistrare la Registrul Comertului _______________________________________________________ Reprezentanti legali: calitatea acestora si domiciliul _______________________________________________________________________________________________________ ___________________________________________________________________________________ Telefon _______________________ Fax. __________________ Cont curent ____________________________________ detinut la _____________________________________ 2. Suma scrisorii de garantie _______________________________________________________________________ (suma in cifre si litere) Valuta ____________ 3. Tipul garantiei : garantie plata (payment guarantee) ; Garantie restituire avans (advance payment guarantee) ; garantie buna executie (performance bond); garantie participare la licitatie (tender guarantee, bid bond); acreditiv standby (standby letter of credit) contragarantie (counterguarantee); alt tip ...................................................... 4. Beneficiar (denumire) ___________________________________________________________________________ Adresa ____________________________________________________________________________________ Cont/IBAN ________________________________________________________________________________ 5. Banca beneficiarului ___________________________________________________________________________ 6. Data valabilitatii ______________________________________________________________________________ 7. Modalitatea de garantare cash colateral; credit; altele; 8. Modalitatea de transmitere: swift ; letric 9. Comisioanele aferente emiterii OUR; SHA BEN 10. Documente anexate contract comercial factura proforma Caiet sarcini altele ................... 11. La data solicitarii Scrisorii de garantie avem contul de baza deschis la Banca _________________________ si avem / nu avem credite angajate la urmatoarele banci: Banca ____________________ n suma de ______________ lei Banca ____________________ n suma de ______________ lei Declaram prin prezenta ca societatii........... nu i s-a executat nicio Scrisoare de Garantie Bancara care a fost emisa din ordinul sau. Mentionam ca am luat la cunostinta de prevederile Codului Penal privind falsul in declaratii. Semnatura si stampila firmei