Certificate For Payment: Losari Kebon Kopi, Grabag Magelang, Jateng 20 July 1999

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CERTIFICATE

FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\01N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 20 July 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date July 20, 1999, ref.No. 002/LP-I/VII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00 100.00%
months by Employer - TOTAL before PPN 10%
b. Total approved VO 0 0.00%
Update contract value 2,600,000,000.00 100.00%
SUBSEQUENT CHARGE ORDER before PPN 10%

c. Last Month Progress 0.00 0.00%


NUMBER APPROVED d. This Month Progress 259,778,583.71 9.99%
e. Achieved progress (d - c) 259,778,583.71 9.99%
V.O. (DATED) f. Deduct advanced payment -51,955,716.74 (-e% x DP.)
g. Retention 5% -12,988,929.19 (-5% x e.)
Total recommended to be paid 194,833,937.78 (e+f+g)

By word:
Thirty four million nine hundred ninety seven thousand and fifty rupiah

TOTAL

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO
Update contract value 2,600,000,000.00
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 259,778,583.71


V.O. (DATED) d. This Month Progress 488,455,432.91
e. Achieved progress (d - c) 228,676,849.20
f. Deduct advanced payment -45,735,369.84
g. Retention 5% -11,433,842.46
Total recommended to be paid 171,507,636.90

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

100.00%

0.00%
100.00%

9.99%
18.79%
8.80%
(-e% x DP.) Teruskan
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO
Update contract value 2,600,000,000.00
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 488,455,432.91


V.O. (DATED) d. This Month Progress 849,921,363.77
e. Achieved progress (d - c) 361,465,930.86
f. Deduct advanced payment -72,293,186.17
g. Retention 5% -18,073,296.54
Total recommended to be paid 271,099,448.15

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

100.00%

0.00%
100.00%

18.79%
32.69%
13.90%
(-e% x DP.) Teruskan
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO
Update contract value 2,600,000,000.00
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 849,921,363.77


V.O. (DATED) d. This Month Progress 1,180,282,726.50
e. Achieved progress (d - c) 330,361,362.73
f. Deduct advanced payment -66,072,272.55
g. Retention 5% -16,518,068.14
Total recommended to be paid 247,771,022.05

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

100.00%

0.00%
100.00%

32.69%
45.40%
12.71%
(-e% x DP.) Teruskan
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO
Update contract value 2,600,000,000.00
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 1,180,282,726.50


V.O. (DATED) d. This Month Progress 1,246,205,440.15
e. Achieved progress (d - c) 65,922,713.65
f. Deduct advanced payment -13,184,542.73
g. Retention 5% -3,296,135.68
Total recommended to be paid 49,442,035.24

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

100.00%

0.00%
100.00%

45.40%
47.93%
2.54%
(-e% x DP.) Teruskan
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO 441,841,777.50
Update contract value 3,041,841,777.50
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 1,246,205,440.15


V.O. (DATED) d. This Month Progress 1,482,470,326.12
e. Achieved progress (d - c) 236,264,885.97
f. Deduct advanced payment -40,389,260.75
g. Retention 5% -11,813,244.30
Total recommended to be paid 184,062,380.92

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

85.47%

14.53%
100.00%

40.97%
48.74%
7.77%
(-e% x DP.) Teruskan
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO 441,841,777.50
Update contract value 3,041,841,777.50
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 1,482,470,326.12


V.O. (DATED) d. This Month Progress 1,587,388,579.69
e. Achieved progress (d - c) 104,918,253.57
f. Deduct advanced payment -17,935,677.08
g. Retention 5% -5,245,912.68
Total recommended to be paid 81,736,663.81

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

85.47%

14.53%
100.00%

48.74%
52.19%
3.45%
(-e% x DP.) Teruskan
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO 970,212,071.36
Update contract value 3,570,212,071.36
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 1,587,388,579.69


V.O. (DATED) d. This Month Progress 1,896,520,724.90
e. Achieved progress (d - c) 309,132,145.21
f. Deduct advanced payment -45,024,976.75
g. Retention 5% -15,456,607.26
Total recommended to be paid 248,650,561.20

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

72.82%

27.18%
100.00%

44.46%
53.12%
8.66%
(-e% x DP.) Teruskan
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO 1,494,109,071.36
Update contract value 4,094,109,071.36
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 1,896,520,724.90


V.O. (DATED) d. This Month Progress 2,293,129,810.37
e. Achieved progress (d - c) 396,609,085.47
f. Deduct advanced payment -50,374,018.10
g. Retention 5% -19,830,454.27
Total recommended to be paid 326,404,613.10

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

63.51%

36.49%
100.00%

46.32%
56.01%
9.69%
(-e% x DP.) Teruskan
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO 1,494,109,071.36
Update contract value 4,094,109,071.36
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 2,293,129,810.37


V.O. (DATED) d. This Month Progress 3,276,793,162.47
e. Achieved progress (d - c) 983,663,352.10
f. Deduct advanced payment -117,034,979.29
g. Retention 5% -49,183,167.61
Total recommended to be paid 817,445,205.20

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

63.51%

36.49%
100.00%

56.01%
80.04%
24.03%
(-e% x DP.) Oke
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO 1,494,109,071.36
Update contract value 4,094,109,071.36
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 3,276,793,162.47


V.O. (DATED) d. This Month Progress 3,665,323,518.40
e. Achieved progress (d - c) 388,530,355.93
f. Deduct advanced payment 0.00
g. Retention 5% -19,426,517.80
Total recommended to be paid 369,103,838.13

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

63.51%

36.49%
100.00%

80.04%
89.53%
9.49%
(-e% x DP.) Oke
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO 1,494,109,071.36
Update contract value 4,094,109,071.36
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 3,665,323,518.40


V.O. (DATED) d. This Month Progress 3,895,523,714.03
e. Achieved progress (d - c) 230,200,195.63
f. Deduct advanced payment 0.00
g. Retention 5% -11,510,009.78
Total recommended to be paid 218,690,185.85

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

63.51%

36.49%
100.00%

89.53%
95.15%
5.62%
(-e% x DP.) Oke
(-5% x e.)
(e+f+g) Teruskan

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


CERTIFICATE
FOR PAYMENT
PROJECT: LOSARI COFFEE PLANTATION RESORT AND SPA CERTIFICATE NO.: LS\02N
(Name, Address) LOSARI KEBON KOPI, GRABAG
MAGELANG, JATENG DATE OF ISSUANCE: 03 August 1999
PROJECT NO.: 10
TO: PT. LUPITA AMANDA CONTRACTOR: BP. ANDY PRASETYO
(Employer) SETIA BUDI BUILDING I, 4 FL, BLOCK D-2 CONTRACT FOR: LOSARI COFFEE PLANTATION RESORT & SPA
JL. H.R. RASUNA SAID, KUNINGAN PROJECT PHASE I
JAKARTA - INDONESIA CONTRACT DATE: 28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP. DEDUCTION RP.
Change order approved in previous a. Original Contract 2,600,000,000.00
months by Employer - TOTAL before PPN 10%
b. Total approved VO 1,494,109,071.36
Update contract value 4,094,109,071.36
SUBSEQUENT CHARGE ORDER before PPN 10%

NUMBER APPROVED c. Last Month Progress 3,895,523,714.03


V.O. (DATED) d. This Month Progress 4,094,109,071.36
e. Achieved progress (d - c) 198,585,357.33
f. Deduct advanced payment 0.00
g. Retention 5% -9,929,267.87
Total recommended to be paid 188,656,089.46

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
TOTAL 0.00

SUPERVISOR: CONTRACTOR: EMPLOYER:


PT. CARATWARSA HANGANDANA PT. LUPITA AMANDA

Signed: Signed: Signed:

Name: Name: Name:

Date: Date: Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:

The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.
TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

e Contractor is entitled

63.51%

36.49%
100.00%

95.15%
100.00%
4.85%
(-e% x DP.) Oke
(-5% x e.)
(e+f+g) Oke

of the Employer or Contractor


d DOES NOT ACCOMPANY

amounts have been paid for


Certificate Payment ( Non PPN )

No. Progress Pot. Uang Muka Pot. Retensi Total Total Pot.
% Nilai (Rp) ( Rp ) ( Rp ) ( Rp ) Uang Muka s/d

1 9.99% 259,778,583.71 51,955,716.74 12,988,929.19 194,833,937.78 51,955,716.74


2 8.80% 228,676,849.20 45,735,369.84 11,433,842.46 171,507,636.90 97,691,086.58
3 13.90% 361,465,930.86 72,293,186.17 18,073,296.54 271,099,448.15 169,984,272.75
4 12.71% 330,361,362.73 66,072,272.55 16,518,068.14 247,771,022.05 236,056,545.30
5 2.54% 65,922,713.65 13,184,542.73 3,296,135.68 49,442,035.24 249,241,088.03
6 7.77% 236,264,885.97 40,389,260.75 11,813,244.30 184,062,380.92 289,630,348.78
7 3.45% 104,918,253.57 17,935,677.08 5,245,912.68 81,736,663.81 307,566,025.86
8 8.66% 309,132,145.21 45,024,976.75 15,456,607.26 248,650,561.20 352,591,002.61
9 9.69% 396,609,085.47 50,374,018.10 19,830,454.27 326,404,613.10 402,965,020.71
10 24.03% 983,663,352.10 117,034,979.29 49,183,167.61 817,445,205.20 520,000,000.00
11 9.49% 388,530,355.93 0.00 19,426,517.80 369,103,838.13 520,000,000.00
12 5.62% 230,200,195.63 0.00 11,510,009.78 218,690,185.85 520,000,000.00
13 4.85% 198,585,357.33 0.00 9,929,267.87 188,656,089.46 520,000,000.00

Total 121.48% 4,094,109,071.36 520,000,000.00 204,705,453.57 3,369,403,617.79

Uraian Nilai (Rp.) DP 20% Retensi 5% Yg harus dibayarkan

Kontrak 2,600,000,000.00 520,000,000.00 130,000,000.00 1,950,000,000.00

VO 1,494,109,071.36 0.00 74,705,453.57 1,419,403,617.79

Total 4,094,109,071.36 520,000,000.00 204,705,453.57 3,369,403,617.79

Selisih 0.00 0.00 0.00 0.00


Total

194,833,937.78
366,341,574.68
637,441,022.83
885,212,044.88
934,654,080.11
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