STATEMENT OF FACT

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 4,999.942 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi & PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

TIME SHEET DATE TIME

Ship’s / Barge Arrival Pilot Station : 11/21/20 at 6:00 PM Hours
Notice of Readiness Tendered : 11/22/20 at 6:00 PM Hours
Ship’s / Barge Arrival Dumai : 11/22/20 at 5:20 AM Hours
Dropped Anchore : 11/22/21 at 5:20 AM Hours
Anchored Up : 11/22/22 at 9:30 AM Hours
First Line Ashore : 11/22/23 at 10:45 AM Hours
All Fast (Jetty B, Dumai) : 11/22/24 at 11:00 AM Hours
Gangway Down : 11/22/25 at 11:15 AM Hours
Surveyor on Board : 11/22/26 at 11:20 AM Hours
Safety Meeting / Free Fratique : 11/22/27 at 11.25 AM - 11.40 AM Hours
Checking Seal of all Ship’s Compartment : 11/22/28 at 11.40 AM - 12.00 AM Hours
Ship’s Tanks Sampling : 11/22/29 at 2.35 PM - 1.30 PM Hours
Ship’s Tanks Measurement/Sounding : 11/22/30 at 12.00 PM - 1.30 PM Hours
Ship’s Tanks Calculations : 11/22/31 at 1.35 PM - 2.35 PM Hours
Hose Connected : 11/22/32 at 12:00 PM Hours
Commenced Discharging : at Hours
Commenced Blowing/Pigging/Vacum : at Hours
Completed Blowing/Pigging/Vacum : at Hours
Ship’s Dry Tanks Inspection : at Hours
Notice of Readiness Accepted : at Hours
Completed Discharging : at Hours
Hose Disconnected : at Hours
Completed Document : at Hours
Estimated Time Vessel Unberth/Sailed : at Hours
Remarks :

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya
 Surveyor Chief Officer/Master Consignee Representative

STATEMENT OF FACT

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 2,299.989 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

TIME SHEET DATE TIME

Ship’s / Barge Arrival Pilot Station : at Hours
Notice of Readiness Tendered : at Hours
Ship’s / Barge Arrival Dumai : at Hours
Dropped Anchore : at Hours
Anchored Up : at Hours
First Line Ashore : at Hours
All Fast (Jetty B, Dumai) : at Hours
Gangway Down : at Hours
Surveyor on Board : at Hours
Safety Meeting / Free Fratique : at Hours
Checking Seal of all Ship’s Compartment : at Hours
Ship’s Tanks Sampling : at Hours
Ship’s Tanks Measurement/Sounding : at Hours
Ship’s Tanks Calculations : at Hours
Hose Connected : at Hours
Commenced Discharging : at Hours
Commenced Blowing/Pigging/Vacum : at Hours
Completed Blowing/Pigging/Vacum : at Hours
Completed Discharging : at Hours
Ship’s Dry Tanks Inspection : at Hours
Notice of Readiness Accepted : at Hours
Hose Disconnected : at Hours
Completed Document : at Hours
Estimated Time Vessel Unberth/Sailed : at Hours
Remarks : All Time Sheet above abaout Parcel of #2.299.989 MT (PT. Karya Makmur Abadi)

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya
 Surveyor Chief Officer/Master Consignee Representative

STATEMENT OF FACT

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 2,699.953 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

TIME SHEET DATE TIME

Ship’s / Barge Arrival Pilot Station : at Hours
Notice of Readiness Tendered : at Hours
Ship’s / Barge Arrival Dumai : at Hours
Dropped Anchore : at Hours
Anchored Up : at Hours
First Line Ashore : at Hours
All Fast (Jetty B, Dumai) : at Hours
Gangway Down : at Hours
Surveyor on Board : at Hours
Safety Meeting / Free Fratique : at Hours
Checking Seal of all Ship’s Compartment : at Hours
Ship’s Tanks Sampling : at Hours
Ship’s Tanks Measurement/Sounding : at Hours
Ship’s Tanks Calculations : at Hours
Hose Connected : at Hours
Commenced Discharging : at Hours
Commenced Blowing/Pigging/Vacum : at Hours
Completed Blowing/Pigging/Vacum : at Hours
Ship’s Dry Tanks Inspection : at Hours
Notice of Readiness Accepted : at Hours
Completed Discharging : at Hours
Hose Disconnected : at Hours
Completed Document : at Hours
Estimated Time Vessel Unberth/Sailed : at Hours
Remarks : All Time Sheet above abaout Parcel of #2.699.953 MT (PT. Mulia Agro Permai)

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya
Surveyor Chief Officer/Master Consignee Representative
 TO : Whom it may concerned

NOTICE OF APPARENT DISCREPANCY

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 4,999.942 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi & PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

Dear sir

We, the undersigned, have been appointed as surveyors by our principal, for discharging inspection of
C.P.O. We have to inform you a difference between BL quantity (at loading port) and received quantity
delivered to shore tank terminal (by shore line/weighbridge scale) as follows:

Ships Figures Quantity (Loading Port) : 5,054.121 Metric Tons

Ships Figures Quantity (Discharging port) : 5,014.711 Metric Tons
Difference : -39.410 Metric Tons
Percentage : -0.780 %

Bill Of Lading Quantity : 4,999.942 Metric Tons

Ships Figures Quantity (Discharging port) : 5,014.711 Metric Tons
Difference : 14.769 Metric Tons
Percentage : 0.295 %

Bill of Lading Quantity : 4,999.942 Metric Tons

Received Quantity : Metric Tons
Difference : Metric Tons
Percentage : %

We hereby would like to draw your attention on behalf of our principal for the above discrepancy
presently ascertained and reserve the right of our principal to revert to you at a later date.

Please acknowledge receipt by signing and returning the duplicate

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya
 Surveyor Chief Officer/Master Consignee Representative

TO : Whom it may concerned

NOTICE OF APPARENT DISCREPANCY

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 2,299.989 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

Dear sir

We, the undersigned, have been appointed as surveyors by our principal, for discharging inspection of
C.P.O. We have to inform you a difference between BL quantity (at loading port) and received quantity
delivered to shore tank terminal (by shore line/weighbridge scale) as follows:

Ships Figures Quantity (Loading Port) : 2,324.912 Metric Tons

Ships Figures Quantity (Discharging port) : 2,306.783 Metric Tons
Difference : -18.129 Metric Tons
Percentage : -0.780 %

Bill Of Lading Quantity : 2,299.989 Metric Tons

Ships Figures Quantity (Discharging port) : 2,306.783 Metric Tons
Difference : 6.794 Metric Tons
Percentage : 0.295 %

Bill of Lading Quantity : 2,299.989 Metric Tons

Received Quantity : Metric Tons
Difference : Metric Tons
Percentage : %

We hereby would like to draw your attention on behalf of our principal for the above discrepancy
presently ascertained and reserve the right of our principal to revert to you at a later date.

Please acknowledge receipt by signing and returning the duplicate

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya
 Surveyor Chief Officer/Master Consignee Representative

TO : Whom it may concerned

NOTICE OF APPARENT DISCREPANCY

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 2,699.953 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

Dear sir

We, the undersigned, have been appointed as surveyors by our principal, for discharging inspection of
C.P.O. We have to inform you a difference between BL quantity (at loading port) and received quantity
delivered to shore tank terminal (by shore line/weighbridge scale) as follows:

Ships Figures Quantity (Loading Port) : 2,729.209 Metric Tons

Ships Figures Quantity (Discharging port) : 2,707.928 Metric Tons
Difference : -21.281 Metric Tons
Percentage : -0.780 %

Bill Of Lading Quantity : 2,699.953 Metric Tons

Ships Figures Quantity (Discharging port) : 2,707.928 Metric Tons
Difference : 7.975 Metric Tons
Percentage : 0.295 %

Bill of Lading Quantity : 2,699.953 Metric Tons

Received Quantity : Metric Tons
Difference : Metric Tons
Percentage : %

We hereby would like to draw your attention on behalf of our principal for the above discrepancy
presently ascertained and reserve the right of our principal to revert to you at a later date.

Please acknowledge receipt by signing and returning the duplicate

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya
Surveyor Chief Officer/Master Consignee Representative
 ULLAGE / SOUNDING REPORT
(BEFORE DISCHARGE)

NAME OF VESSEL : BG. Kahuripan 502 / TB. Surya Perkasa 502

COMMODITY : Crude Palm Oil in Bulk
QUANTITY (B/L) : 4,999.942 MT
LOADING PORT : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah INITIAL DRAUGHT
DISCHARGING PORT : Jetty B Pelindo , Port of Dumai, Indonesia FWD
SHIPPER : PT. Karya Makmur Abadi & PT. Mulia Agro Permai AFT
CONSIGNEE : PT. KreasiJaya Adhikarya TRIM
APPLICANT : PT. KreasiJaya Adhikarya FINAL DRAUGHT
DATE / PLACE : FWD
AFT
SHIP'S ULLAGE REPORT BEFORE DISCHARGE TRIM
Ship's Ullage/ Trim Corrected Temp.
Ullage Volume Observed Temp. Density QTTY in
Tank Sounding Corrn. Corrected Volume METRIC
TONS
No. (M) (mm) (M) (K/L) Factor (M3) °C

TOTAL QUANTITY BIFORE DISCHARGE 5,014.711

REMARK :

R1 : BL to SFAL R2 : SFAL to SFBD BL to SFBD

BL 4,999.942 M/TONS SFAL 5,054.121 M/TONS BL 4,999.942 M/TONS
SFAL 5,054.121 M/TONS SFBD 5,014.711 M/TONS SFBD 5,014.711 M/TONS
DIFF 54.179 M/TONS DIFF -39.410 M/TONS DIFF 14.769 M/TONS
PCT 1.084 % PCT -0.780 % PCT 0.295 %

Your Faithfully Acknowledge by,

PT. Cotecna Inspection Indonesia
 Surveyor Chief Officer/Master

ULLAGE / SOUNDING REPORT

(BEFORE DISCHARGE)

NAME OF VESSEL : BG. Kahuripan 502 / TB. Surya Perkasa 502

COMMODITY : Crude Palm Oil in Bulk
QUANTITY (B/L) : 2,299.989 MT
LOADING PORT : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah INITIAL DRAUGHT
DISCHARGING PORT : Jetty B Pelindo , Port of Dumai, Indonesia FWD
SHIPPER : PT. Karya Makmur Abadi AFT
CONSIGNEE : PT. KreasiJaya Adhikarya TRIM
APPLICANT : PT. KreasiJaya Adhikarya FINAL DRAUGHT
DATE / PLACE : 0 FWD
AFT
SHIP'S ULLAGE REPORT BEFORE DISCHARGE TRIM
Corrected
Ship's Ullage/ Trim Ullage Volume Temp. Observed Temp. Density QTTY in
Tank Sounding Corrn. Corrected Volume METRIC
TONS
No. (M) (mm) (M) (K/L) Factor (M3) °C

TOTAL QUANTITY BIFORE DISCHARGE 2,306.783

REMARK :

R1 : BL to SFAL R2 : SFAL to SFBD BL to SFBD

BL 2,299.989 M/TONS SFAL 2,324.912 M/TONS BL 2,299.989 M/TONS
SFAL 2,324.912 M/TONS SFBD 2,306.783 M/TONS SFBD 2,306.783 M/TONS
DIFF 24.923 M/TONS DIFF -18.129 M/TONS DIFF 6.794 M/TONS
PCT 1.084 % PCT -0.780 % PCT 0.295 %

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya
 Surveyor Chief Officer/Master Consignee Representative

ULLAGE / SOUNDING REPORT

(BEFORE DISCHARGE)

NAME OF VESSEL : BG. Kahuripan 502 / TB. Surya Perkasa 502

COMMODITY : Crude Palm Oil in Bulk
QUANTITY (B/L) : 2,699.953 MT
LOADING PORT : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah INITIAL DRAUGHT
DISCHARGING PORT : Jetty B Pelindo , Port of Dumai, Indonesia FWD
SHIPPER : PT. Mulia Agro Permai AFT
CONSIGNEE : PT. KreasiJaya Adhikarya TRIM
APPLICANT : PT. KreasiJaya Adhikarya FINAL DRAUGHT
DATE / PLACE : 0 FWD
AFT
SHIP'S ULLAGE REPORT BEFORE DISCHARGE TRIM
Ship's Ullage/ Trim Corrected Temp.
Ullage Volume Observed Temp. Density QTTY in
Tank Sounding Corrn. Corrected Volume METRIC
TONS
No. (M) (mm) (M) (K/L) Factor (M3) °C

TOTAL QUANTITY BIFORE DISCHARGE 2,707.928

REMARK :

R1 : BL to SFAL R2 : SFAL to SFBD BL to SFBD

BL 2,699.953 M/TONS SFAL 2,729.209 M/TONS BL 2,699.953 M/TONS
SFAL 2,729.209 M/TONS SFBD 2,707.928 M/TONS SFBD 2,707.928 M/TONS
DIFF 29.256 M/TONS DIFF -21.281 M/TONS DIFF 7.975 M/TONS
PCT 1.084 % PCT -0.780 % PCT 0.295 %

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya
Surveyor Chief Officer/Master Consignee Representative
 DISCHARGING SUMMARY

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 4,999.942 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi & PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

PARAMETER FIGURES UNIT

B/L to Before Disch. Quantity
Bill of Lading Quantity 4,999.942 Metric Tons
Before Disch. Quantity / SFBD Metric Tons
Difference Metric Tons
Percentage %

B/L to Received Quantity

B/L Quantity 4,999.942 Metric Tons
Received Quantity / PT.KJA Metric Tons
Difference Metric Tons
Percentage %

Remarks :
1. Bill (s) Lading quantity determined by Ship’s Tank Calibration Table.
2. Vessel's Loaded quantity determined by Ship’s Tank Calibration Table.
3. Bill Of Lading Quantities were based measurement of ship’s/shore tank/weight bridge*
4. Received Quantities were based measurement of ship’s tank before discharge

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 DISCHARGING SUMMARY

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 2,299.989 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

PARAMETER FIGURES UNIT

B/L to Before Disch. Quantity
Bill of Lading Quantity 2,299.989 Metric Tons
Before Disch. Quantity / SFBD Metric Tons
Difference Metric Tons
Percentage %

B/L to Received Quantity

B/L Quantity 2,299.989 Metric Tons
Received Quantity / PT.KJA Metric Tons
Difference Metric Tons
Percentage %

Remarks :
1. Bill (s) Lading quantity determined by Ship’s Tank Calibration Table.
2. Vessel's Loaded quantity determined by Ship’s Tank Calibration Table.
3. Bill Of Lading Quantities were based measurement of ship’s/shore tank/weight bridge*
4. Received Quantities were based measurement of ship’s tank before discharge

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 DISCHARGING SUMMARY

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 2,699.953 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

PARAMETER FIGURES UNIT

B/L to Before Disch. Quantity
Bill of Lading Quantity 2,699.953 Metric Tons
Before Disch. Quantity / SFBD Metric Tons
Difference Metric Tons
Percentage %

B/L to Received Quantity

B/L Quantity 2,699.953 Metric Tons
Received Quantity / PT.KJA Metric Tons
Difference Metric Tons
Percentage %

Remarks :
1. Bill (s) Lading quantity determined by Ship’s Tank Calibration Table.
2. Vessel's Loaded quantity determined by Ship’s Tank Calibration Table.
3. Bill Of Lading Quantities were based measurement of ship’s/shore tank/weight bridge*
4. Received Quantities were based measurement of ship’s tank before discharge

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 DRY TANKS INSPECTIONS
(AFTER DISCHARGING)

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 4,999.942 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi & PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

Dear Sir,

We, the undersigned, have been appointed as surveyors by our principal, for discharging inspection of CPO, have to
inform you that we already inspected ship’s / barge tanks (manhole), ballast tanks, cargo pumps, pipelines, hoses on
November (?), 2020 at hours up to hours.

BASED ON OUR VISUAL INSPECTION THE SHIP’S TANKS, CARGO PUMPS, PIPELINES AND HOSES WERE
ACCESSIBLE FOUND EMPTY AND ALL CARGOES ON BOARD HAS BEEN DELIVERED TO CONSIGNEE IN
GOOD ORDER AND CONDITION.

This certificate reflects our above findings at time and place of intervention only and does not refer to any
other matters. It is issued without prejudice. Please acknowledge receipt by signing and returning the
original.

Remarks :

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 DRY TANKS INSPECTIONS
(AFTER DISCHARGING)

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 2,299.989 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

Dear Sir,

We, the undersigned, have been appointed as surveyors by our principal, for discharging inspection of ???, have to
inform you that we already inspected ship’s / barge tanks (manhole), ballast tanks, cargo pumps, pipelines, hoses
on , 2020 at hours up to hours.

BASED ON OUR VISUAL INSPECTION THE SHIP’S TANKS, CARGO PUMPS, PIPELINES AND HOSES WERE
ACCESSIBLE FOUND EMPTY AND ALL CARGOES ON BOARD HAS BEEN DELIVERED TO CONSIGNEE IN
GOOD ORDER AND CONDITION.

This certificate reflects our above findings at time and place of intervention only and does not refer to any
other matters. It is issued without prejudice. Please acknowledge receipt by signing and returning the
original.

Remarks :

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 DRY TANKS INSPECTIONS
(AFTER DISCHARGING)

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 2,699.953 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

Dear Sir,

We, the undersigned, have been appointed as surveyors by our principal, for discharging inspection of ???, have to
inform you that we already inspected ship’s / barge tanks (manhole), ballast tanks, cargo pumps, pipelines, hoses
on , 2020 at hours up to hours.

BASED ON OUR VISUAL INSPECTION THE SHIP’S TANKS, CARGO PUMPS, PIPELINES AND HOSES WERE
ACCESSIBLE FOUND EMPTY AND ALL CARGOES ON BOARD HAS BEEN DELIVERED TO CONSIGNEE IN
GOOD ORDER AND CONDITION.

This certificate reflects our above findings at time and place of intervention only and does not refer to any
other matters. It is issued without prejudice. Please acknowledge receipt by signing and returning the
original.

Remarks :

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 SHORE LINE SEALING

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 4,999.942 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi & PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

We, the undersigned, have been appointed as surveyors by our principal, have inspected all seals of
compartments Shore Tank and Valve before discharge, jointly with shipper/ buyer representative with
details as follows:

Shore Tank / Valve Seal Number Amount Remarks

TOTAL 0 PCS

Remarks :

Dumai, November 2020 Disaksikan Oleh, Diketahui Oleh

PT. COTECNA INSPECTION INDONESIA

__________________________ _________________ _____________

Surveyor Terminal Representative Chief Officer
 SHORE LINE SEALING

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 2,299.989 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

We, the undersigned, have been appointed as surveyors by our principal, have inspected all seals of
compartments Shore Tank and Valve before discharge, jointly with shipper/ buyer representative with
details as follows:

Shore Tank / Valve Seal Number Amount Remarks

TOTAL 0 PCS

Remarks :

Dumai, November 2020 Disaksikan Oleh, Diketahui Oleh

PT. COTECNA INSPECTION INDONESIA

__________________________ _________________ _____________

Surveyor Terminal Representative Chief Officer
 SHORE LINE SEALING

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 2,699.953 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

We, the undersigned, have been appointed as surveyors by our principal, have inspected all seals of
compartments Shore Tank and Valve before discharge, jointly with shipper/ buyer representative with
details as follows:

Shore Tank / Valve Seal Number Amount Remarks

TOTAL 0 PCS

Remarks :

Dumai, November 2020 Disaksikan Oleh, Diketahui Oleh

PT. COTECNA INSPECTION INDONESIA

__________________________ _________________ _____________

Surveyor Terminal Representative Chief Officer
 UNSEALING REPORT

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 4,999.942 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi & PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

We, the undersigned, have been appointed as surveyors by our principal, have inspected all seals of
compartments Ship's before discharge, jointly with shipper/ buyer representative with details as follows:

NO. DISCRIPTION AMOUND SEAL NO. CONDITION

1 MANHOLE 12 0015201 - 0015212 GOOD
2 PUMPROOM 16 0015257 - 0015272 GOOD
12 0015213 - 0015224 GOOD
3 SOUNDING/ULLAGE PIPE
7 0015289 - 0015295 GOOD
4 SUCTION VALVE 24 0015233 - 0015256 GOOD
5 MANIFOLD 8 0015225 - 0015232 GOOD
6 BUTTERWORTH
7 MEASUREMENT STES
8

TOTAL SEAL 79 PCS

Remarks :

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 SAMPLING REPORT

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Quantity Based on BL : 4,999.942 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi & PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

We, the undersigned, have been appointed as surveyors by our principal, have drawn Ship’s tanks
samples before discharge with detail as follows:

SAMPLE SOURCE
EACH SHIP'S TANK 3 SET / 36 Bottoles
COMPOSITE SHIP'S TANK 3 Bottiles Composite
Bottom Ships Tank 3 SET / 36 Bottoles

DISTRIBUTION

EACH SHIP’S COMPOSITE SEAL NO. COTECNA SEAL NO. OTHER

DISTRIBUTION SHORE TANK
TANK SHIP’S TANK (CII) SURVEYOR
TO VESSEL
TO CONSIGNEE 1 Set 1 Set 1 0015298
OUR REFERENCE 1 Set 1 Set 1
TOTAL

Remarks :

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 SAMPLING REPORT
Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502
Quantity Based on BL : 4,999.942 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

We, the undersigned, have been appointed as surveyors by our principal, have drawn Ship’s tanks
samples before discharge with detail as follows:

SAMPLE SOURCE
EACH SHIP'S TANK
COMPOSITE SHIP'S TANK

DISTRIBUTION

EACH SHIP’S COMPOSITE SEAL NO. COTECNA SEAL NO. OTHER

DISTRIBUTION SHORE TANK
TANK SHIP’S TANK (CII) SURVEYOR
TO VESSEL
TO CONSIGNEE
OUR REFERENCE
TOTAL

Remarks :

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 SAMPLING REPORT
Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502
Quantity Based on BL : 4,999.942 MT
Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

We, the undersigned, have been appointed as surveyors by our principal, have drawn Ship’s tanks
samples before discharge with detail as follows:

SAMPLE SOURCE
EACH SHIP'S TANK
COMPOSITE SHIP'S TANK

DISTRIBUTION

EACH SHIP’S COMPOSITE SEAL NO. COTECNA SEAL NO. OTHER

DISTRIBUTION SHORE TANK
TANK SHIP’S TANK (CII) SURVEYOR
TO VESSEL
TO CONSIGNEE
OUR REFERENCE
TOTAL

Remarks :

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 OFFICIAL REPORT OF SAMPLING BEFORE UNLOADING

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Description of Goods : Crude Palm Oil in Bulk
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S
Date :

State thet

Priour to unloading, we as surveyor take sampless for analysis purposes, sampling in each tank where the
cargo will be unloaded. Thus this official report was made.

S E A L N O.
SHIP'S TANK
COTECNA LAB CLIENT/BUYER RETAINS
1P - 6P 0016144
1S - 6S 0016145

Thank you for the attention, thus this official report was made and be used properly

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 OFFICIAL REPORT OF SEALING MEASURING

Date :
In the capacity of : PT. KreasiJaya Adhikarya
Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Description of Goods : Crude Palm Oil in Bulk
stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

State thet

We are as the surveyor of PT. Cotecna Inspection Indonesia, acts tocarry out the loading controls that
listed above

We here by inform you that at the completion of the measurement process and after calculation the
amount of cargo in the ship's tank after the completion of the loading process, we make a sealing against
the measuring instrument used as follows

SOUNDING TAPE SOUNDING TABLE THERMOMETER

Thus this report was made in truth to be used properly.

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

To the master / Chief Officer

NOTICE OF RESERVE
REMAIN ON BOARD (ROB) / UNPUMPABLE CARGO

Client : PT. Kreasi Jaya Adhikarya

Cargo : Crude Palm Oil
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S

Upon completion of discharging operation and during tank(s) inspection for emptiness we noted that
there is substantial amount still remained which estimated as follows :

Ship's / Barge Quantity Estimated Ship's / Barge Quantity Estimated

1P 1S

2P 2S

3P 3S

4P 4S

5P 5S

6P 6S

Based on the above, we lodged this NOTICE and reserve the right of our principal to revert to this matter
at a later date

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative

 VESSEL EXPERIENCE FACTOR

Name of Vessel : BG. Kahuripan 502 / TB. Surya Perkasa 502

Description of Goods : Crude Palm Oil in Bulk
Loading Port : Pelindo lll ,Bagendang , Sampit , Kalimantan Tengah
Discharging Port : Jetty B Pelindo , Port of Dumai, Indonesia
Shipper : PT. Karya Makmur Abadi & PT. Mulia Agro Permai
Notify Consignee : PT. KreasiJaya Adhikarya
Principal : PT. KreasiJaya Adhikarya
Stowage : 1P,1S,2P,2S,3P,3S,4P,4S,5P,5S,6P And 6S
Quantity Loading Port Quantity Discharge Port
No. Loading port Discharging Port Commodity Ship's (MT) Bill (MT) Difference Bill (MT) Different
Percent Percent
Figure Figure Mt/Kg Receive Mt/Kg

V.E.F : BL FIGURES/SHIPS FIGURES

REMARKS :

Acknowledged Receipt By,

Master / Chief Officer

BG. Kahuripan 502 / TB. Surya Perkasa 502
To :
Master/Chief Officer,
BG. Kahuripan 502 / TB. Surya Perkasa 502
Wharf. PELINDO III at BAGENDANG, SAMPIT

Date : NOVEMBER , 2020

Dear Sirs,

Re : MASTER’S RECEIPT FOR DOCUMENTS

Kindly acknowledge receipt of the following documents for ship’s : -

01. Loading Sequences

02. Certificate Fosfa Combined Master
03. Fosfa Heating Instruction
04. Master's Statement On The Last Three Cargoes
05. Notice Of Instructions
06. Time Sheet/Statement Of Fact
07. Notice Of Reserve
08. Certificate Of Owner/Master
09. Certificate Tank's Inspection
10. Certificate Of Dryness
11. Certificate Of Last Three Cargoes (Fosfa)
12. Certificate Of Compliance and Cleanliness
13. Vessel’s History Report/VEF
14. Master’s Receipt for Sample/Receipt of Samples
15. Sealed Certificate
16. Shore Tank Calculation
17. Statement of Cargo/Ship Tank's Calculation
18. Notice of Discrepancy
19. Notice Seal Terminal
20. Notice of Sampling

Your Faithfully Acknowledge by, Accepted by,

PT. Cotecna Inspection Indonesia BG. Kahuripan 502 PT. Kreasi Jaya Adhikarya

Surveyor Chief Officer/Master Consignee Representative