REGULATIONS FOR THE PROVISION OF ELECTRONIC SERVICES BY ELMARK AUTOMATYKA S.A.

I. Making the regulations available

  1. Pursuant to Article 8 (2) of the Act on Providing Services by Electronic Means, ELMARK AUTOMATYKA SPÓŁKA AKCYJNA shall make available the Regulations on Providing Services by Electronic Means at: www.elmark-automation.com/shop-regulations.
  2. The Regulations are available for download at the link: link.

II.  Seller designation

  1. The Seller is ELMARK AUTOMATYKA SPÓŁKA AKCYJNA with its registered office in Warsaw, ul. Bukowińska 22 lok. 1B, 02-703 Warsaw, Poland, entered in Rejestr Przedsiębiorców Krajowego Rejestru Sądowego kept by Sąd Rejonowy dla M. St. Warszawy w Warszawie, XIII Wydział Gospodarczy Krajowego Rejestru Sadowego under KRS number KRS 0000803828, NIP 5252072585, REGON 01314430600000, with share capital of 600 000,00 PLN (fully paid up).
  2. The Seller can be contacted at the following email address: elmark@elmark.com.pl or telephone number: +48 22 773-79-37
  3. The Seller has two offices:
    1. ELMARK Automatyka S.A., ul. Bukowińska 22 lok. 1B, 02-703 Warszawa, Poland, which is the registered office of the Seller,
    2. ELMARK Automatyka S.A., ul. Rzeczna 8, 03-794 Warszawa, Poland.

III. Processing of personal data (GDPR)

  1. The Seller is the Administrator of Customers' Personal Data
  2. The processing of personal data is carried out on the basis of GDPR.
  3. Detailed information on the processing of Customers' personal data can be found in the Privacy Policy located on the Website under the Privacy policy, which is an integral part of the Regulations.

IV. Definitions

  1. For the purposes of the Regulations, the following definitions of the following terms are adopted:
    1. Password - a security code which is a sequence of characters (letter, digital or other) specified by the Customer, enabling the Registered Customer to access the created Customer Account and serving to protect against unauthorized access to the Account by third parties,
    2. Customer - Entrepreneur or Consumer,
    3. Civil Code - the Act of April 23, 1964 Kodeks cywilny (t.j. Dz. U. z 2020 r. poz. 1740 ze zm.),
    4. Civil Procedure Code - the Act of November 17, 1964 Kodeks postępowania cywilnego (t.j. Dz. U. z 2020 r. poz. 1575 ze zm.),
    5. Consumer - a natural person from the territory of the European Union making a legal transaction with an entrepreneur that is not directly related to his/her economic or professional activity,
    6. Customer Account - an individual panel of a Registered Customer available after registration and logging in, marked with an individual login (e-mail) and password, which allows the Registered Customer to make purchases through the Store, as well as to view order history,
    7. Shopping cart - a service provided by the Seller, which allows the Customer to view the Products that the Customer has added to the order, as well as to place the order itself and make changes within the ordered Products,
    8. Logistics fee - a flat fee that includes the cost of preparing documents and goods for shipment, the cost of packaging the goods and the cost of shipping by courier. It is included on the invoice under the item "Transport",
    9. Product - a movable item available in the Store (equipment), intended for sale under a sales contract concluded between the Seller and the Customer, using the functionality of the Store, the product is also understood as software or access to a service (such as access to the cloud).
    10. Entrepreneur - a natural person, a legal person and an organizational unit referred to in Article 331 1 Kodeks Cywilny, conducting a business or professional activity on its own behalf,
    11. Discount - a reduction in the price indicated next to the product on the Seller's website, visible in the order summary in the shopping cart. Discount is not given to Elmatic industrial computers, drives, processors, memory, OS and accessories assembled by the Seller,
    12. Registration - a one-time action carried out by the Customer in the Seller's Store, consisting of filling out a registration form in order to establish a Customer Account,
    13. Regulations - the terms and conditions for the provision of electronic services by ELMARK AUTOMATYKA S.A.,
    14. GDPR - Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data and repealing Directive 95/46/EC (General Data Protection Regulation) (Dz. U. UE. L. z 2016 r. Nr 119, str. 1 ze zm.),
    15. Website - the websites available at www.elmark.com.pl, www.elmatic.net, www.rugged.com.pl, www.elmark-automation.com, www.elmark.com.ro, www.elmark-automation.bg owned and administered by the Seller,
    16. Store - online stores operated by the Seller available at www.elmark.com.pl,  www.elmatic.net, www.rugged.com.pl, www.elmark-automation.com,  www.elmark.com.rowww.elmark-automation.bg
    17. Seller - ELMARK AUTOMATYKA SPÓŁKA AKCYJNA with its registered office in Warsaw, ul. Bukowińska 22 lok. 1B, 02-703 Warsaw, Poland, entered in Rejestr Przedsiębiorców Krajowego Rejestru Sądowego kept by Sąd Rejonowy dla M. St. Warszawy w Warszawie, XIII Wydział Gospodarczy Krajowego Rejestru Sadowego under KRS number KRS 0000803828, NIP 5252072585, REGON 01314430600000, with share capital of 600 000,00 PLN (fully paid up).
    18. Provision of service by electronic means - the performance of a service provided without the simultaneous presence of the parties (at a distance), through the transmission of data at the individual request of the recipient of the service, sent and received by means of equipment for electronic processing, including digital compression, and storage of data, which is entirely transmitted, received or transmitted via a telecommunications network within the meaning of the Act of July 16, 2004. - Prawo telekomunikacyjne,
    19. Copyright Act - the Act of February 4, 1994 on Copyright and Related Rights (i.e. Dz. U. z 2019 r. poz. 1231 ze zm.),
    20. Consumer Rights Act - The Law of May 30, 2014 on Consumer Rights (i.e. Dz. U. z 2020 r. poz. 287 ze zm.),
    21. The Law on Provision of Electronic Services - the Law of July 18, 2002 on Providing Services by Electronic Means (i.e. Dz. U. z 2020 r. poz. 344),
    22. Law - Industrial Property Law - the Act of June 30, 2000 Industrial Property Law (i.e. Dz. U. z 2020 r. poz. 286 ze zm.),
    23. Registered Customer - a Customer using the Online Store who has registered and established a Customer Account.

V. Subject matter of the Regulations

  1. The Regulations define the rights and obligations of the parties to a contract for the provision of services by electronic means, the subject of which is a contract for the sale of Products available on the Website, the establishment of a Customer Account, the sending of the Newsletter, the use of the functionality of the Store that allows the use of a specific electronic service.
  2. If the Seller does not conclude a separate agreement with the Customer, the Regulations constitute an agreement for the provision of electronic services, the subject of which is a contract for the sale of Products available on the Website.
  3. If the Seller enters into a separate sales contract with the Customer (in written or documentary form, e.g. in the form of an exchange of email correspondence, a telephone conversation), these Regulations shall be an integral part of it, unless the concluded contract provides otherwise. In the event of a dispute over the content of the separate contract and the Regulations, the provisions of the contract linking the Seller and the Customer shall take precedence.
  4. Information placed on the Website does not constitute an offer within the meaning of the Civil Code, but is only an invitation to conclude an agreement.
  5. The contract for the provision of electronic services is concluded:
    1. when the Customer creates a Customer Account,
    2. at the moment of signing up for the newsletter service,
    3. at the moment of commencement of use of a given functionality of the Store that allows the use of a particular electronic service.
  6. The contract referred to in paragraph 5 items  1) and 2) is concluded for an indefinite period of time and may be terminated at any time without indication of the reason by the Client, by writing an email to the Seller at the email address: elmark@elmark.com.pl ( regarding the agreement under paragraph 5 items 1) and 2)) or by clicking on the link in each email message (regarding the agreement under paragraph 5 item 2))
  7. The contract referred to in paragraph 5 item 3.) shall be concluded for an indefinite period of time and shall be terminated when the Customer ceases to use the given service provided electronically.

VI. Customer Account

  1. Customer may register and create a Customer Account in the Store.
  2. Customers who choose to establish a Customer Account will be entitled to enjoy additional rights.
  3. In order to create a Customer Account, the Customer must register using the form, providing the data referred to in Section VI, paragraph 4.
  4. The Password is entered individually by each Client and should consist of at least 8 letters, digits or special characters. The Client may change the Password in the Client's Account by entering the current password and entering the new password twice.
  5. The user's login is the e-mail address provided by the customer.
  6. The establishment of a Customer Account is free of charge and voluntary.
  7. Account applications are reviewed and approved on business days, from 8:00 a.m. to 4:00 p.m. Polish time. The condition for approval of the application is to provide the data needed to invoice for purchases made:
    1. for consumers: name, address, e-mail,
    2. for entrepreneurs: first and last name or name (company), address, tax identification number (NIP), e-mail.

VII. Types and scope of services provided electronically

  1. The Seller offers the following services provided electronically:
    1. enabling to place an order and conclude a sales contract,
    2. setting up and maintaining a Customer Account in the Store,
    3. enabling the use of the Shopping Cart,
    4. newsletter,
    5. providing information about the Products in the Store
    6. making possible to send messages via the contact form available within the Store.
  2. The Seller concludes contracts with Consumers and Customers who are not Consumers under the terms of the Regulations.

VIII. Terms and conditions for the provision of electronic services

  1. Use of the service is possible with the following web browsers: Microsoft Internet Explorer 8+, Mozilla Firefox 16.0.2+, Google Chrome 22.0.1229+.
  2. In order to complete the order, it is necessary for the customer to have access to the Internet and access to e-mail.

IX. Terms and conditions for the conclusion and termination of contracts for the provision of electronic services

  1. Technical activities comprising the procedure for concluding a sales contract
    1. The condition for placing an order is to read and accept the Regulations by checking the checkbox before placing the order.
    2. Purchase in the online store is possible in two formulas:
      1. without registration (as a "guest")
      2. with registration by creating a Customer Account (as a Registered Customer).
    3. In order to make a purchase in the store, it is needed to select a Product from the available categories (subcategories) in which the goods sold by the Seller are classified.
    4. The Product contains a description of a specific model, a description of the Product and its technical specifications. The Customer selects the Product by pressing the "Add to cart" button, selecting the quantity of ordered Products beforehand. Next to each Product, both the gross price and the net price are visible (in order to change the price from gross to net or net to gross, change the parameter next to the "Price" button).
    5. Adding a product to the Cart is not tantamount to placing an order, until the order is placed Products can be freely added and removed from the Cart.
    6. After the Product is added to the cart, a message (pop-up) appears confirming that the Product has been added to the cart.
    7. Next, the customer selects the available form of payment. To proceed to the next stage of the order, click the "Next" button.
    8. Next, the Customer enters the data necessary to place the order, i.e. data identifying him and the delivery address, as well as selects the method of delivery (DHL or UPS or Inpost parcel service). The Order Summary will show the Products selected by the Customer and the gross and net price of the order. To proceed to the next stage of the order, click the "Next" button.
  2. Confirmation by the Seller of receipt of the Customer's offer
    1. The condition for placing an order is reading and accepting these Regulations, which the customer confirms before placing the order by checking the appropriate checkbox in the order form.
    2. The placement of an order occurs only when you use the button of placing the order.
    3. Placement of the order referred to in paragraph 2 is equivalent to the submission of an offer by the Customer.
    4. After placing an order (after using the button referred to in paragraph 2, a message with a summary of the order placement is sent to the e-mail address indicated by the Customer. This message does not yet constitute acceptance of the offer by the Seller, and therefore the conclusion of the contract of sale does not yet occur.
    5. An order confirmation email will then be sent to the customer, in which the customer will receive information about the acceptance of the order for processing, the date of shipment and the start of the order, or with information about the processing of the order in the case of equipment available in stock
    6. The sales contract is concluded upon acceptance of the offer by the Seller in the manner described in item 5.
    7. In the event that the Seller is unable to accept the Customer's offer in whole or in part, the Seller will send the Customer a message with information about refusal of the order placed by the Customer and cancellation of the order (in whole or in part). If the order is canceled only in part, the contract of sale is concluded in the remaining part, in which case the Customer may cancel the order in the remaining part as well.
    8. In the event of refusal of the offer by the Seller and cancellation of the order, the Seller shall immediately refund to the customer all payments made by the customer for the order.
  3. Payments
    1. The Seller accepts the following forms of payment:
      1. cash on delivery for delivery via courier (cash),
      2. traditional transfer (on the basis of an issued accounting document),
      3. deferred transfer,
      4. transfer via PayU.
    2. Payments referred to in paragraph 3 items. 1), 2) and 3) are available to customers depending on the available conditions and may be rewarded with a Discount.
    3. In the event that payment by bank transfer has been selected before shipment of the Product (paragraph 3, item 2)), the Seller will send the Customer a separate email containing in the attachment a proforma invoice, on the basis of which payment should be made.
    4. The lead time of the order depends on whether the Product (equipment) is in stock. If the ordered equipment (Product) is in stock, orders are shipped on the same or the next business day from the day the order is placed. The seller (order processing department) will provide the customer in a separate e-mail with the expected delivery date of the order. In case of ordering goods (Product) that are not in stock, it is not possible to make prepayment.
    5. Orders paid by bank transfer prior to shipment (paragraph 3, items 2) and 4)), are shipped on the same or the next business day on which the payment is credited or proof of transfer is sent to the Seller at the e-mail address: zamowienia@elmark.com.pl.
  4. Delivery
    1. Customer shall make a choice of delivery from among those available on the Seller's website, i.e.:
      1. courier DHL
      2. courier UPS
      3. parcel: in post (available only in Polish services with shipment on Polish territory).
    2. Delivery is made to the delivery address indicated in the delivery form. Deliveries are made on working days from Monday to Friday.
    3. In case of personal collection of the order in one of the offices of the Seller ( „Warszawa Mokotów”: ELMARK AUTOMATYKA S.A. ul. Bukowińska 22 Lok. 1B, 02-703 Warszawa, Polska), due to the need to transport the equipment from the shipping warehouse, the readiness to hand over the equipment is confirmed by e-mail.
    4. Product delivery costs (in addition to the price of the Product) are provided to the Customer at the stage of order placement. In the case of orders:
      1. at www.elmark.com.pl with delivery on the territory of Poland and below the amount of PLN 615 gross (calculated on the basis of list prices before discounts) a Logistics Fee of PLN 30.75 gross (applies only to shipments by DHL or UPS courier) or PLN 12.30 gross (applies only to shipments in post) shall be added. For orders above the amount indicated in the preceding sentence, shipping is free of charge for the Customer (it is carried out at the expense of the Seller). In case of orders with delivery in other European Union countries, a Logistics Fee of PLN 172.20 gross will be added.
      2. at www.elmark-automation.com with delivery within the European Union countries and below the amount of 300 EUR net (calculated on the basis of list prices before discounts are taken into account) a Logistics Fee of 30 EUR net is added. For orders above the amount indicated in the preceding sentence, shipping is free of charge for the Customer (it is carried out at the expense of the Seller).
      3. at www.elmark.com.ro with delivery in Romania and below the amount of RON 500 net (calculated on the basis of list prices before discounts are taken into account) a Logistics Fee of RON 75 net is added. For orders above the amount indicated in the preceding sentence, shipping is free of charge for the Customer (it is carried out at the expense of the Seller). For orders with delivery to other countries of the European Union, a Logistics Fee of 150 RON net will be added.
      4. at www.elmatic.net with delivery on the territory of Poland and below the amount of PLN 615 gross (calculated on the basis of list prices before discounts) a Logistics Fee of PLN 30.75 gross (applies only to shipments by DHL or UPS courier) or PLN 12.30 gross (applies only to shipments in post) shall be added. For orders above the amount indicated in the preceding sentence, shipping is free of charge for the Customer (it is carried out at the expense of the Seller). For orders shipped within the European Union countries and below the amount of 300 EUR net (calculated on the basis of list prices before discounts) a Logistics Fee of 30 EUR net is added. For orders above the amount indicated in the preceding sentence, shipping is free of charge for the Customer (it is carried out at the expense of the Seller). For orders with delivery in Romania and below the amount of EUR 100 net (calculated on the basis of list prices before discounts), a Logistics Fee of EUR 15 net is added. For orders above the amount indicated in the preceding sentence, shipping is free of charge for the Customer (it is carried out at the expense of the Seller).
      5. at www.rugged.com.pl with delivery on Polish territory and below the amount of PLN 615 gross (calculated on the basis of list prices before discounts) a Logistics Fee of PLN 30.75 gross is added (this applies only to shipments by DHL or UPS courier). For orders above the amount indicated in the preceding sentence, shipping is free of charge for the Customer (realized at the expense of the Seller). For orders with delivery within the territory of other countries of the European Union, a Logistics Fee of EUR 30 net is added. For orders with delivery in countries other than the European Union, a Logistics Fee is added according to the price list depending on the value of the order and the country of delivery.
      6. at www.elmark-automation.bg with delivery in Bulgaria and below the amount of EUR 100 net (calculated on the basis of list prices before discounts are taken into account) a Logistics Fee of EUR 15 net is added. For orders above the amount indicated in the preceding sentence, shipping is free of charge for the Customer (it is carried out at the expense of the Seller). For orders with delivery to other countries of the European Union, a Logistics Fee of EUR 30 net will be added.
    5. In cases described in paragraph 4, orders on Polish territory are shipped via DHL or UPS courier service using the account of DHL or UPS Elmark Automatyka S.A. or by in-post mail. In cases of orders outside the territory of Poland, shipment is carried out through DHL or UPS courier mail using the account of DHL or UPS Elmark Automatyka S.A.
    6. Upon delivery of the Product, the benefits and burdens of the thing and the danger of accidental loss or damage to the thing shall pass to the Customer, subject to paragraph 8.
    7. If the Product is to be shipped to the Consumer, the danger of accidental loss of or damage to the item shall pass to the Consumer at the time of delivery to the Consumer.
    8. Issuance of an item (Product) is considered to be its entrustment by the Seller to the Customer, carrier or forwarder, if the Seller had no influence on the choice of the carrier by the Customer. In the case of a Consumer, the release of an item is considered to be the receipt by the Consumer of the Product from the carrier or forwarder.
    9. The Customer who is an Entrepreneur is obliged to check the condition of the Product and in the presence of an employee (representative) of the carrier or freight forwarder. If any damage to the shipment with the Product is found, the Entrepreneur is obliged to write a protocol. In the case of a Customer who is a Consumer, the action described in sentences 1 and 2 is only a recommendation.

X. Statutory guarantees for defects

  1. The Seller is obliged to deliver the Product without defects. In the case of a physical or legal defect, the Consumer may take advantage of the Statutory guarantee by submitting a statement to reduce the price or withdraw from the contract (if the defect is significant), or demand removal of the defect or demand replacement of the item with a defect-free one. Failure by the Seller to respond within 14 days w means that the Consumer's demand was considered justified.

XI. Consumer's right to withdraw from the contract  

  1. The consumer shall have the right to withdraw from the contract within 14 days without giving any reason and without incurring costs, except for the costs specified in paragraphs 6, 8 and 9.
  2. To meet the deadline it is sufficient to send a statement of withdrawal from the contract before its expiration by mail to the address: ELMARK AUTOMATYKA S.A. ul. Bukowińska 22 lok. 1B, 02-703 Warszawa, Poland, being the registered office of the Seller, by e-mail to: elmark@elmark.com.pl.
  3. The deadline for withdrawal from the contract expires after 14 days from the day on which the Consumer took possession of the thing (Product) or on which a third party other than the carrier and indicated by the Consumer took possession of the thing (Product).
  4. The consumer may use the model withdrawal form located at the end of the Regulations or the model withdrawal form contained in Appendix No. 2 to the Law on Consumer Rights. The consumer may use the model withdrawal form, but it is not mandatory.
  5. The seller may withhold reimbursement until it receives the item or until it provides proof of return, whichever event occurs first.
  6. In the event of withdrawal from this contract, the Consumer shall be refunded all payments received from him, including the costs of delivery of the goods (except for additional costs resulting from the method of delivery chosen by the Consumer other than the cheapest ordinary method of delivery offered by the Seller), immediately, and in any case no later than 14 days from the day on which the Seller was informed of the Consumer's decision to exercise his right of withdrawal from this contract. We will return the payment using the same means of payment that were used by the Consumer in the original transaction, unless the Consumer expressly agrees to a different solution; in any case, the Consumer will not incur any fees in connection with this return subject to paragraph 8.
  7. Return of items should be made to the address: ELMARK AUTOMATYKA S.A. ul. Bukowińska 22 lok. 1B, 02-703 Warszawa, Poland, being the registered office of the Seller immediately, and in any case no later than 14 days from the day on which the Consumer informed the Seller about withdrawal from the contract. The deadline is met if the Consumer sends back the item before the expiry of the 14-day period.
  8. The consumer shall bear the direct cost of returning the item to the Seller.
  9. The consumer shall be liable only for the diminution in value of the thing resulting from using it in a manner other than necessary to ascertain the nature, characteristics and functioning of the thing.

XII. Rights of a sole proprietor

  1. The provisions of Section XI of the Regulations shall apply mutatis mutandis to an individual who enters into a contract directly related to his business activity, when it is clear from the content of the contract that it does not have a professional character for him, arising in particular from the subject of his business activity, made available on the basis of the provisions on the Centralna Ewidencja i Informacja o Działalności Gospodarczej.
  2. The person referred to in paragraph (1) may use the model withdrawal form located at the end of the Regulations or the model withdrawal form contained in Appendix No. 2 to the Law on Consumer Rights.
  3. With respect to the person referred to in paragraph 1, Statutory guarantee claims shall be excluded.

XIII. Change of Regulations

  1. The Regulations are effective as of 2024-10-29.
  2. Archived versions of the Regulations will be available at the following link: link along with an indication of the period in which they were in effect.
  3. Customers will be informed of changes to the Regulations by posting the new Regulations in a dedicated tab on the Seller's website. Customers may be informed of changes to the Regulations by email.
  4. Amendments to the regulations shall be implemented at no additional cost to the customer.
  5. In the case of contracts concluded before the effective date of the new Regulations, the provisions of the existing Regulations shall apply, unless the changes introduced are more favorable to the Customer.

XIV. Final Provisions

  1. The provisions of section IX clause 7, 8 sentence 2, clause 9 sentence 3, and section XIV paragraph 4, section XIV paragraph 6-7 shall apply mutatis mutandis to an individual who enters into a contract directly related to his business activity, when it is evident from the content of the contract that it does not have a professional character for him, arising in particular from the subject of his business activity, made available on the basis of the provisions on Centralna Ewidencja i Informacja o Działalności Gospodarczej.
  2. In relation to the Entrepreneur, the Seller excludes the Statutory Guarantees.
  3. The court having jurisdiction to resolve disputes shall be the court having jurisdiction according to the registered office of the Seller.
  4. The provision of section XIV paragraph 3 does not apply to the consumer. In such a case, the competent court to resolve the dispute shall be a common court of competent jurisdiction in accordance with the provisions of the Code of Civil Procedure.
  5. In the case of a contract for the sale concluded with a Customer who has a habitual residence in Poland at the time of conclusion of the contract, the Polish courts shall have jurisdiction, and the applicable law shall be Polish law.
  6. For the contract of sale concluded with the Customer, who is not a Consumer, and any disputes arising therefrom, the Seller and the Customer, having ordinary residence in the European Union (except Denmark) at the time of conclusion of the contract, choose the jurisdiction of the Polish court.
  7. For the contract of sale of Goods concluded with the Customer having a habitual residence in the European Union (except Denmark) at the time of conclusion of the contract and any disputes arising therefrom, the Seller and the Customer shall choose Polish law. Except that for the contract of sale, concluded with the Customer who is a consumer, and any disputes arising therefrom, the provisions of the law of the place of habitual residence of the Consumer, which cannot be excluded by contract according to the law of the place of habitual residence of the Consumer, more favorable for the Consumer than the provisions of Polish law, shall apply.
  8. If any of the provisions of the Regulations shall be deemed illegal, invalid or otherwise unenforceable to the extent provided by mandatory provisions of law, it shall to that extent be excluded. To the remaining extent, it shall remain in effect.
  9. The applicable law shall be Polish law and the jurisdiction of Polish courts, subject to paragraphs 5-7 above.

 

 

 

 FORM - Declaration of withdrawal from the contract

 

………………..(city), date: …………

……………………………………..

First name and surname

…………………………………….

Address

……………………………………

TAX number (if applicable)

 

ELMARK AUTOMATYKA S.A.

Bukowińska 22 lok. 1B
02-703 Warszawa

Poland

 

I hereby inform that I withdraw from the contract of sale:....................................(enter the name of the product) concluded on .................. invoice number (if applicable) / transaction number from the receipt..............................................

 

Order number:...............................................................

Date of receipt of order:............................................................

 

I request reimbursement to the following bank account number:........................................................

 

………………………………………

First name and surname

 

 

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