SCHEDULE

CONTRACTORS PLANT AND MACHINERY POLICY

POLICY SCHEDULE NUMBER : 008.1050.302.2024.000001.00 NEW

NAME OF INSURED : Marnie

ADDRESS OF INSURED : Jln. Yos Sudarso No. 6, Kel. Bumi Waras, Kec. Bumi Waras,
Bandar Lampung.

PERIOD OF INSURANCE : 12 (Twelve) Months

From May 20, 2024 To May 20, 2025
(Both dates inclusive at 12 o’clock (noon) local time and any subsequent
period for which the Company shall have agreed to renew this polis)

LOCATION : Pengerasan Jalan di Rawa Jitu kab. Tulang Bawang Mesuji

TOTAL SUM INSURED : IDR 500,000,000.00

SPECIFICATION OF EQUIPMENTS

BRAND,MODEL AND TYPE : SDLG EXCAVATOR E680F

SERIAL NUMBER : VLGE608FJM0606931
MACHINE NUMBER : 86323A
MANUFACTURING YEAR / COLOR : 2021 /
USANCE : KOMERSIL
COVERAGE : Contractor Plant And Machinery, as per Munich Re Standard

EXTENSION :
DEDUCTIBLE
Others : 10.00 % dari Claim Paid Minimum amount USD 1,500.00
RINCIAN PERLENGKAPAN NON STANDAR : -
CLAUSES AND WARRANTY :
- ACT OF GOD EXTENSION CLAUSE
- AVERAGE RELIEF CLAUSE (85%)
- DISPUTE CLAUSE - AAUI 2021 (Indonesia)
- ELECTRONIC DATE RECOGNITION EXCLUSION (EDRE) CLAUSE
- ENDORSEMENT 001 - COVER FOR LOSS OR DAMAGE DUE TO STRIKE, RIOT AND CIVIL COMMOTION (SRCC)
- INFECTIOUS DISEASE EXCLUSION CLAUSE (LSW 1191)
- LOSS NOTIFICATION CLAUSE (14 DAYS)
- NOMINATED LOSS ADJUSTERS
- SANCTION LIMITATION AND EXCLUSION CLAUSE
- TERRORISM EXCLUSION ENDORSEMENT NMA 2920
- WAIVER CLAUSE
- WARRANTY PAYMENT CLAUSE

- DEDUCTIBLE :
- Partial Loss ; 10% of claim, minimum USD.1,500.00 a.o.a for Others
- Total Loss Only ; 20% Of Claim Paid

PT. ASURANSI WAHANA TATA CABANG BANDAR LAMPUNG 008.1050.302.2024.000001.00

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 Cover on Project Site Only
Operated by Skilled and Authorized Person (Wajib memiliki SIMPER / Sertifikat Pelatihan)
Standard Maintenance and Good Operation
Exclude Off Shore construction and/or activities
Exclude Underground Activities and Tunnel
Exclude Rescue Activities
Exclude Whilst in Transit
Exclude Third Party Liability / Public Liability
Not operated on barge / pontoon & the like
Not operated on slope more than 45 degrees
Exclude Logging, Plantation, Land Clearing and Oil & Gas Project
RATE : 0.85% pa

PRORATE FACTOR : 1 YEAR

PREMIUM : IDR 4,250,000.00

ADMINISTRATION COST : IDR 54,000.00

STAMP DUTY : IDR 10,000.00

TOTAL : IDR 4,314,000.00

IN AMOUNT : Four Million Three Hundred Fourteen Thousand Rupiah

In witness whereof the Undersigned being duly authorized by the Insurer

and on behalf of the Insurer has hereunto set his hand
Bandarlampung , This May day of 24, 2024

AUTHORIZED SIGNATURE

PT. ASURANSI WAHANA TATA CABANG BANDAR LAMPUNG 008.1050.302.2024.000001.00

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 PT. ASURANSI WAHANA TATA CABANG BANDAR LAMPUNG 008.1050.302.2024.000001.00
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THESE CLAUSES ARE FORMING PART AND ATTACHED TO POLICY SCHEDULE NO :
008.1050.302.2024.000001.00

ACT OF GOD EXTENSION CLAUSE

It is hereby declared and agreed that the insurance by this Policy is extended to covers loss of or damage to the
Insured equipment directly caused by Earthquake, Volcanic Eruption, Tsunami, Wind storm, Tempest, Flood of any
nature.
AVERAGE RELIEF CLAUSE (85%)

If at the time of reinstatement the sum representing 85 (Eighty Five) percent of the cost which would have been
incurred in reinstating the whole of the property covered by any item subject to this memorandum exceeds its sum
insured at the commencement of any DAMAGE, then the Insured shall be considered as being his own insurer for
the difference between the sum insured and the sum representing the total cost of reinstatement of the whole of
the property at that time and shall bear a rate able proportion of the loss accordingly.

DISPUTE CLAUSE - AAUI 2021 (Indonesia)

KLAUSUL PERSELISIHAN

1. Dalam hal timbul perselisihan antara Penanggung dan Tertanggung sebagai akibat dari penafsiran atas tanggung
jawab atau besarnya ganti rugi dari Polis ini, maka perselisihan tersebut akan diselesaikan melalui forum
perdamaian atau musyawarah oleh unit internal Penanggung yang menangani Pelayanan dan Penyelesaian
Pengaduan bagi Konsumen. Perselisihan timbul sejak Tertanggung menyatakan secara tertulis ketidaksepakatan
atas hal yang diperselisihkan. Penyelesaian perselisihan melalui perdamaian atau musyawarah dilakukan dalam
waktu paling lama 60 (enam puluh) hari kalender sejak timbulnya perselisihan.

2. Apabila penyelesaian perselisihan melalui perdamaian atau musyawarah sebagaimana diatur pada ayat 1 tidak
mencapai kesepakatan, maka ketidaksepakatan tersebut harus dinyatakan secara tertulis oleh Penanggung dan
Tertanggung. Selanjutnya Tertanggung dapat memilih penyelesaian sengketa di luar pengadilan atau melalui
pengadilan dengan memilih salah satu klausul penyelesaian sengketa sebagaimana diatur di bawah ini.

A. LEMBAGA ALTERNATIF PENYELESAIAN SENGKETA SEKTOR JASA KEUANGAN

Dengan ini dinyatakan dan disepakati bahwa Tertanggung dan Penanggung akan melakukan penyelesaian sengketa
melalui
Lembaga Alternatif Penyelesaian Sengketa Sektor Jasa Keuangan dibawah Ototritas Jasa Keuangan

B. PENGADILAN
Dengan ini dinyatakan dan disepakati bahwa Tertanggung dan Penanggung akan melakukan penyelesaian sengketa
melalui Pengadilan Negeri di wilayah Republik Indonesia

ELECTRONIC DATE RECOGNITION EXCLUSION (EDRE) CLAUSE

This Policy does not cover any loss, damage, cost, claim or expense, whether preventive, remedial or otherwise,
directly or indirectly arising out of or relating to:

1. the calculation, comparison, differentiation, sequencing or processing of data involving the date change to the
year 2000, or any other date change, including leap year calculations by any computer system, hardware
programme or software and/or any microchip, integrated circuit or similar device in computer equipment or non
computer equipment whether the property of the insured or not; or

2. any change, alteration or modification involving the date change to the year 2000, or any other date change,
including leap year calculations to any such computer system, hardware programme or software and/or any
microchip, integrated circuit or similar device in computer equipment or non computer equipment whether the
property of the insured or not.

This clause applies regardless of any other cause or event that contributes concurrently or in any sequence to the
loss, damage, cost, claim or expense.

PT. ASURANSI WAHANA TATA CABANG BANDAR LAMPUNG 008.1050.302.2024.000001.00

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NMA 2802 (17/12/1997)
From approved by Lyod's Underwriters' Non Marine Association Limited.

ENDORSEMENT 001 - COVER FOR LOSS OR DAMAGE DUE TO STRIKE, RIOT AND CIVIL COMMOTION
(SRCC)
It is agreed and understood that otherwise subject to the terms, exclusions, provisions and
conditions contained in the Policy or endorsed thereon, and subject to the Insured having
paid the agreed extra premium, this Policy shall be extended to cover loss or damage due to
strike, riot and civil commotion which for the purpose of this Endorsement shall mean (subject
always to the Special Conditions hereinafter contained) loss of or damage to the property
insured directly caused by

1. the act of any person taking part together with others in any disturbance of the public
peace (whether in connection with a strike or lock-out or not) not being an occurrence
mentioned in Condition 2 of the Special Conditions hereof,

2. the action of any lawfully constituted authority in suppressing or attempting to suppress

any such disturbance or in minimizing the consequences of any such disturbance,

3. the willful act of any striker or locked-out worker performed in furtherance of a strike or
in resistance to a lock-out,

4. the action of any lawfully constituted authority in preventing or attempting to prevent

any such act or in minimizing the consequences of any such act.

Provided that it is hereby further expressly agreed and declared that

1. all the terms, exclusions, provisions and conditions of the Policy shall apply in all respects
to the insurance granted by this extension save in so far as the same are expressly
varied by the following Special Conditions and any reference to loss or damage in the
wording of the Policy shall be deemed to include the perils hereby insured against,

2. the following Special Conditions shall apply only to the insurance granted by this
extension, and the wording of the Policy shall apply in all respects to the insurance
granted by the Policy as if this Endorsement had not been made thereon.

Special Conditions

1. This insurance shall not cover

a. loss or damage resulting from total or partial cessation of work or the retarding,
interruption or cessation of any process or operation

b. loss or damage occasioned by permanent or temporary dispossession resulting

from confiscation, commandeering or requisition by any lawfully constituted authority,

c. loss or damage occasioned by permanent or temporary dispossession of any building

resulting from the unlawful occupation by any person of such building,

d. consequential loss or liability of any kind or description, any payments over and
above the indemnity for the material damage as provided herein.

Provided nevertheless that the Insurers are not relieved under b or c above of any

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 liability to the Insured in respect of physical damage to the property insured
occurring before dispossession or during temporary dispossession.

2. This insurance does not cover any loss or damage occasioned by or through or in
consequence, directly or indirectly, of any of the following occurrences, namely

a. war, invasion, act of foreign enemy, hostilities or warlike operations (whether

war be declared or not), civil war,

b. mutiny, civil commotion assuming the proportion of or amounting to a popular

rising, military rising, insurrection, rebellion, revolution, military or usurped power,

c. any act of any person acting on behalf of or in connection with any organization
with activities directed toward the overthrow by force of the government de jure
or de facto or to the influencing of it by terrorism or violence.

In any action, suit or other proceeding, where the Insurers allege that by reason of
the provisions of this condition any loss or damage is not covered by this insurance,
the burden of proving that such loss or damage is covered shall be upon the Insured.

3. This insurance may at any time be terminated by the Insurers on notice to that effect
being given by registered post to the Insured's last known address, in which case the
Insurers shall be liable to repay a rateable proportion of the premium for the unexpired
term from the date of termination.

4. The limit of indemnity any one occurrence as stated below shall be understood to limit
the indemnity for all loss or damage covered by this Endorsement during a consecutive
period of 168 hours.

The aggregate liability of the Insurers during the period of cover of this Policy shall be
limited by twice the limit of indemnity any one occurrence.

Limit of indemnity : any one occurrence

Deductible: any one occurrence

Extra premium
INFECTIOUS DISEASE EXCLUSION CLAUSE (LSW 1191)
This insurance excludes any loss directly or indirectly arising out of, contributed to by, or resulting from any
communicable disease which leads to:
(i) the imposition of quarantine or restriction in movement of people or animals by any national or international
body or
agency; and/or
(ii) any travel advisory or warning being issued by a national or international body or agency and in respect of (i) or
(ii)
any fear or threat thereof (whether actual or perceived). If the Underwriters allege that by reason of this
exclusion, any
loss is not covered by this insurance the burden of proving the contrary shall be upon the Assured.

06/03
LSW1191
LOSS NOTIFICATION CLAUSE (14 DAYS)
Notwithstanding anything contained herein to the contrary,
it is agreed that this insurance will not be prejudiced by any inadvertent delays,
errors or omission in notifying the Company of any circumstances or events

PT. ASURANSI WAHANA TATA CABANG BANDAR LAMPUNG 008.1050.302.2024.000001.00

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giving rise or likely to give rise to a claim under this Policy.
Provided the claim is intimated not later than 14 (fourteen) days from date of loss

NOMINATED LOSS ADJUSTERS

Its is hereby and agreed that in the event of a claim being made under this Policy for which loss adjuster are
appointed on behalf of Insurers they shall be either :

* PT. Radita Hutama Internusa

* PT. Dharma Nilaitama
* PT. Prima Adjusterindo Mandiri

SANCTION LIMITATION AND EXCLUSION CLAUSE

No insurer shall be deemed to provide cover and no insurer shall be liable to pay any claim or provide any benefit
hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would
expose that insurer to any sanction, prohibition or restriction under United Nations resolutions or the trade or
economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.
TERRORISM EXCLUSION ENDORSEMENT NMA 2920
Notwithstanding any provision to the contrary within this insurance or any endorsement thereto it is agreed that this
insurance excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting
from or in connection with any act of terrorism regardless of any other cause or event contributing concurrently or
in any other sequence to the loss.

For the purpose of this endorsement an act of terrorism means an act, including but not limited to the use of force
or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or
in connection with any organization(s) or government(s), committed for political, religious, ideological or similar
purposes including the intention to influence any government and/or to put the public, or any action of the public,
in fear.

This endorsement also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly caused by,
resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating
to any act of terrorism.

If the Insurer alleges that by reason of this exclusion any loss, damage, cost or expense is not covered by this
insurance the burden of proving the contrary shall be upon the Insured.

In the event any portion of this endorsement is found to be invalid or unenforceable, the remainder shall
remain in full force and effect.
WAIVER CLAUSE

It is hereby declared that in the event of the Insured or the Insurer terminates this insurance, then both parties
agree to waive articles 1266 and 1267 of the Indonesian Civil Code and such termination shall be made without
requiring any consent of the Court (Pengadilan Negeri) within the territory of the Republic of Indonesia.

_____
SK No. 12/AAUI/2012
WARRANTY PAYMENT CLAUSE

1. Notwithstanding the provisions of Article 257 of the Commercial Code (Kitab Undang-Undang Hukum Dagang)
and notwithstanding anything herein contained to the contrary, and subject only and without prejudice to
clause 2 hereinafter set out, it is hereby declared and agreed that it is a condition precedent to liability under
this Policy, any Renewal Certificate, Endorsement or Cover Note that any premium due must be paid and
actually received in full by the company:

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a. When the period of insurance is 30 days or more, within thirty (30) days from the inception date of
coverage under the Policy, Renewal Certificate, Endorsement or Cover Note.

b. When the period of insurance is LESS than thirty (30) days, within the period of insurance specified in the
Policy, Endorsement, Renewal Certificate or Cover Note.

2. In the event any of the above mentioned premium is not paid in full to and received by the company, as
described above in the manner and within the time stipulated above (the "premium warranty period"), the
cover under this policy, any Renewal Certificate, Endorsement of Cover Note shall be deemed to have
terminated from the expiry of the premium warranty period and the company shall be discharged from all
liability therefrom but without prejudice to any liability incurred before that date and the company will be
entitled to a pro-rata time on risk premium subject to a minimum of 25 % of the annual premium

PT. ASURANSI WAHANA TATA CABANG BANDAR LAMPUNG 008.1050.302.2024.000001.00

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