Mnnncrepcrno Poccnftcrcoft Oe4epaqlru rro AerraM rpalr(AaHcrcoft oboponrr,,
rrpe3Bbrqafrnsrpr crrryallrrflM rr JrrrKBrrAaqnn [ocJreAcrnufr crnxnfinrrx 6eAcrnufi
I.nannoe ynpaBJreHne MIIC Poccun no Pocroscrcofi o6nacrn
floqtosHft aApec: nep. ,{ororrranoncrcvfi, 132, r. Pocros-Ha-[ouy,344018. Teler[onu: Cerperapr: (363) 240-63-08.
@arc: (863) 244-27 -85. E-mail: gumchsro@donpac.ru

Or[srenne naA:opHofi AeqrerbHocrn n npoQmarrnqecrcofi pa6orur no Op.noocrcouy pafiony
Iloqrosrrfi aapec:347512, Pocroncrar o6nacrr, n. Oplorcrr,rfi, nep. Orrr6prcrrfi, 8.
EAzrufi  nos6pn202l r.
(Aara cocrasreHur

}

arra)

<09> qac. <00> uun.
(epenrr cocrarlenz.r axra)

AKT IIPOBEPKI4,
opraHoM focyAapcTBeHHofo KoHTpoJrfl (na4ropa), opraHoM MyHrrrlunaJrbHoro KoHTpors
ropllAl|qecKoro Jrrrqa, rrHAnBrrAyaJrbHofo npeAnpnH[MaTers

J\b 84
IIo

aqpecy / alpecau: Pocroncrcas o6nacrr, Oproncrurfi pa"fion, x. KypraHurrfi, ynnqa

flouronar,

4

(Mecr0 fipoBeAenzr nporepxu)

Ha ocnonaHrrn: pacropqrrceHr.rff (npnnasa)

J\b 84

or (25> orrr6pr 202I r.6rrna rpoBeAeHa

(BLII AoLyMeHTa c yKa3aHaeM perBn3umB (uorr,rep, aara), (ruranoraa / exerrJraHoBar, AoKyMelrrapnalr / ene:gHar)

rIJIaHoBtuI Bbre3Alruu npoBepKa B ornorrreHr{r{: Qunnan

ro o6pa3oBaTeJrbHoro

MynzqunaJrbHoro 6ro4xernoro AorrrKoJrbHofa" x. KypraHnrrfi

AercKr.rfi ca,u.Ilb 10 "

(Ha[MeHoBaHHe Iopt4ll4qecKoro auqa, t[arur.urr.rr, ItMt, orqecrBo (nocle4nee npu

,{ara

r.r

(-))

BpeMfl rrpoBeAeHrrfl npoBepKrr:
20_r. c ((_)) qac. (_) MLIH. Ao

(:anolruetcr

(_)

nanruu) [rrAr{BnlyaJrlHoro npegnpnnnruare.ru)

qac. ((_)) Mr{H. IlpoqorxnreJrbHocrb

(_)

qac.

(_)

Mr{H.

Qluruaaor, npe.qcraBzre:rBcrs o6oco6renublx crpyrryprcrx no4pag.qeneHufi ropr4Ar{qecKor nrarla
npu ocyqecTBJleHnu AerreJrbHocr[ UHII{BuAiaJrbHofo npeAnpr,rHr.rMaTeJlt rlo HecKonbKlllr agpecaru)

B cJlyqae npoBe.qeHnr nponeporc

-

rrlu

O6qaq npoAoJrlr(nreJrbHocrb npoBepKrr:

8 pa6ouux 4nefi
(pa6ovmr 4nefi / vacon)

Axr cocraBien:

oTAeneHrreM H4A3OpHOfi .4eSTenbHOCTlr n

rpoibrraKTuqeoKoft pa6Orrr no

(uaulrleroeaHue opraHa rocyAapcrBeHHoFo KoH'rpoJrr (naasopa) rlil,r opraHa MyHrrqrrnaJrbHoro

VHA u fIP fnannoro
C ronnefi

r4s,

rourpolr)

zs lvIrIC Poccr,rn no PocroBcnoft o6nacrr

I

10.rac. 00

ulrm---

(sanolurerc.r rrpn rrpoBeaeHun

2A2l

<<25>>

r.H

o.H.
(Qaunnnu

[arau

r,rHuuuanbr,

noA[r4cl,

HoMep pertreHzr rrpoKypopa (ero sarrlecrr,rrenr) o
(sanolnrercr

cor

rrpoBeAeHr-rr npoBepKlr

:

B cJryqae

n
jlnqo(a), npoBoAnBrtrne
rpoBepKy
(Qauulu, t{Mt, orqecrBo (nocle4nee - npu uatwtun),
B cnyqae

Ifpn

fipllBreqesut

nrx m.ru), npouo4r.raruero(m<) rporeprcy;
yr(436rBarorcr Qauwtzu, uMeHa, orqecrBa (noc,re4lree - npll ua-nuvr,ra),
ur6bqlrfi c yraaaHneM peKBr,r3rrroB cBnrereJlbcrBa
arfpe4uraquu, BrrraBruero csurer€mcrno)

AoJrxHocrB aoJrrrHocruoro nuqa (4orxnoc,

I
nponeAeHnrr upoBepKrr np[cyrcrBoBaJrrr:

($arulm,rr,I{M',ofecTBo(uocrregxee-nprua.nr,nr,rr,r)'.qolxrrocT6pyKoBo.qI,ITeI',I4Horo.qoJDKHocTHorortr,tlIa(Aooclg
npe.qcTaBHT€JIt lopHll4qecKoro ntqa, ynonHoMoqeHHofo npeAcTaBr{T€JIt r.rltauBr.r.{yan6Horo npeAnpr4Hr,rMaTejrr, y[onHoMoqeHHoto npeAcTaBHTent

caMoperynnpyeMoE opraHl,Baqnr (u crryvae npoBeAeHr{r npoBeprn qneua caMoperyJrr pyeruod opram:aqr,u,r),

npxcyrcrBoBaBrrrb(rrpunpoBe.qeur,[rMeponputruitnonponepre)
\
B xoAe rrpoBeAeHrrfl trpoBepKrr:
r BbrflBJreHbr HapymeHrrfl Tpe6oBarr[fi w[lu rpedoBaHrrft, ycranonJreHHbrx MyHrrrl[rraJrbHbrMrr
rlpaBoBbrMrr aKTaMH (c yrcararureM rroJroxeHrrft (nopuarnnHbrx) [paBoBbrx aKToB):--I BbrflBJreHbr HecooTBeTcrBrrfl cBeAeHrrft, coAepll(aqllxcs B yBeAoMJreHrrrr o HarraJre ocyuecTBJreHIIq oTAeJIbHbrx BIIAOB npeAnprrHrrMaTeJrbcKoft AeffTeJrbHocTn, o6s3aTeJrbHbrM Tpe6oBaHlrflM (c yKasaHrreM noJroxeHrrfi (uopuarrrBHbrx) rpaBoBbrx aKToB): ----I BbIqBJreHbr oaKTbr HeBBrnoJrHeH[s [peArrrrcaHrrfi opfaHoB rocyAapcrBeHHofo KoHTpors (naqropa) (c yna3aHrreM peKBr{3r{ToB BbrAaHHbrx rrpeArrr.rcaHrfi) :
I Hapy[reHufi ne BbrqBreHo:

3aKona

or 22.07.2008 N 123-03) upu rpoBeAeHrrr{ rpoBepKrr

He BhurBneHo.

n Xypnan yqera rpoBepoK roprr.ullrrecKoro Jrr,rqa, r,rHAr4Br{AyaJr6
npoBoAlrMbx oprilraM
KoHTpoJrf, (na4sopa),

3auprcr

KoHTponr BHeceHa (

rrpeAIIpr.rHrrMareJLs,

MyHII[]rnanbHofo

lpoBeAeHlrr.r Bbre3AHofi uponepru):
(noAr[acB ynonHoMoqeHHono npeAcraBilTenr roprl'.recKoro nruIa,
r.rHArBnA/aJrlHOrO npeAnpr.rnxMareJrr, ero ynoJrHoMoqeur{oro npeacranu,e.ru)

(no.ururcs

3auucr n Xypna-n yqera rrpoBepoK ropuAurrecKofo Jrlrqa, lrHAlrBlrAyalbHoro [peAnp]rHr.rMareJrr,
npoBoA]rMbx opraHaM]r rocyAapcrBeHHofo KoHTpoJrf, (na4sopa), oprdtrQ3rtrr MyHr,rquranbHoFo
KoHTponf, orcyrcrByer (sanomrrercr npu [poBeAeHr,rr.r Bbre3AHoft uponepru]u
(nogrmcr ynolHoMoqenaoro npeacraBr{T€n, }opuAriqecKoro rr4qa,
I,rHIABrrIyanlHOrO EpeAIrpAHr.rMaTeJIt, efo yrrOIHOMOTT€HHOTO npe4Craerrelr)

Iloauncn
Bpno HaqarbHr,rKa OH,{uIIP ro OpnoBcKoMy pafiony yHA
la fIP fnannoro yrpaBneHr{r Mr{C Poccuu rto PocroBcKoft
o6nacru - rocyAapcrnennrrfi rrHcrreKTop Opnoncr>

nosdpn2021roya

florraerna o6 orr