FORMULIR PERHITUNGAN TINGKAT KOMPONEN DALAM NEGERI DOMESTIC CONTENT CALCULATION FORM

FORMULIR No. : SC-02 Nama Peserta/Bidder Name : Deskripsi/Description Total Nilai Penawaran/ Total Quoted Price: Butir/Item Nilai per Item /Item Value a A. BARANG/GOODS I. MATERIAL TERPAKAI Used Materials II. PERALATAN Equipment Sub Total (A) B. JASA/SERVICES III. PERSONIL/KONSULTAN Personnel/Consultant IV. ALAT KERJA/PERALATAN Tools/Equipment V. KONSTRUKSI/FABRIKASI Construction/Fabrication VI. JASA UMUM DLL. Other Services Sub Total (B) C. JUMLAH (T O T A L)= Sub Jumlah A+ B b : Nilai per Item/Jumlah Nilai Penawaran x 100% e : Nilai KDN Penawaran/Jumlah Nilai Penawaran x 100% % Komponen Dalam Negeri (KDN)/ Domestic Content (DC) % b Komponen Dalam Negeri Penawaran/ Quoted Domestic Content Nilai/Value c d=axc % e

Catatan/Note:
Personil/Konsultan : Personnel/Consultant Alat Kerja/Peralatan : Tools/Equipment Konstruksi/Fabrikasi : Construction/Fabrication Jasa Umum dll. : Other Services etc. Material Terpakai : Material Used Peralatan Equipment Rekayasa, survey perencanaan, pengawasan, manajemen, tenaga kerja, dll. Engineering, research design, supervision, management, personnel etc. Sewa rig, sewa kendaraan, sewa kapal, sewa pompa, dll. Rental of rig, vehicle, barge, pump, etc. Konstruksi sipil, mesin, listrik, dll. Civil, mechanical, electrical construction, etc. Pengurusan, asuransi, sewa rumah, dll. Management handling, insurance, house rent, etc. Pipa, Semen, Chemical, dll. Pipe, Cement, Chemical, etc : Pompa Kompresor, Generator dll Pump, Compressor, Generator, etc

Tanda Tangan Signature Materai Duty Stamp Nama & Jabatan Penandatangan

: : : _____________________________

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