Rab Fix Bandongan

DAFTAR HARGA MATERIAL
SATUAN STANDART HARGA KABUPATEN

NO BAHAN MATERIAL (INDEX 2019)
1 Semen @ 50 Kg Zak 53,000

2 Pasir beton m3 240,000
3 Split 2/3 pecah tangan m3 280,000
4 Batu bata Bh 750
5 Batako Bh 3,500
6 Bata ringan tb 7,5 cm m3 -
7 Genteng Bh 1,250
8 Seng 0,2 x 3 m Lbr -
9 Kayu 6/12 - 3 m Btg -
10 Kayu 6/12 - 4 m Btg 100,000
11 Kayu 8/12 - 4 m Btg 150,000
12 Kayu Usuk 5/7 - 4/6 3 m Btg 27,000
13 Usuk bambu m 5,500
14 Reng Bambu m 1,500
15 Kayu Papan 2/20 2m Lbr -
17 Besi Ø 8 mm Btg 37,500
18 Besi Ø 10 mm Btg 68,000
19 Besi Ø 12 mm Btg 90,000
20 Begel jadi Kg 18,000
21 Bendrat Kg 20,000
22 Kusen lokal Bh -
23 Kusen Pintu 80cm x 200cm lokal Bh 200,000
24 Kusen jendela lokal Bh 150,000
25 Daun pintu lokal Bh 350,000
26 Daun jendela lokal Bh 200,000
27 Kusen dan daun pintu Kamar mandi fiber Set 210,000
28 Seng 2,4 x 0,8 x 0,002 m Lbr 67,000
29 Seng 3 x 0,8 x 0,002 m Lbr 78,000
30 Bubungan lancip genteng Bh 5,000
31 Paku usuk Kg 15,000
32 Paku reng Kg 15,000
33 Paku seng Kg 18,000
34 Benang Rol -
35 Closet JONGKOK Bh 155,000
36 Stop Kran (PVC) 3/4" Bh 25,000
37 Pipa Diameter 3/4" Btg 27,500
38 Pipa Diameter 3" Btg 85,000
39 Pipa diameter 1/2" Btg 21,000
40 Pipa diameter 4 " Btg 130,000
41 Knie PVC 1/2" Bh 10,000
42 Knie PVC 3" Bh 15,000
43 Knie PVC 4" Bh 25,000
44 Knie PVC 3/4" Bh 15,000
45 Galvalum atap / Genteng m -
46 Saklar Bh
47 Kabel Eterna 50 m Rol
48 Pipa listrik Btg
49 Engsel Pintu 4" Psg 35,000
50 Engsel Jendela 3" Psg 21,000
51 Roster Bh 5,000
52 Stop Kontak Broco Bh -
53 Fitting Bh -
54 Semen Bata Ringan 40 kg Sak -
55 Batu pecah M3 215,000
56 Kayu reng - 2 m Btg
57 Batu kapur/gamping Zak 8,000
58 Ember Bh
ART HARGA KABUPATEN
(INDEX 2019)
63,000
280000 240,000
300,000
800
` 3,500
750,000
2,500
22,000 35,000
20,000
37,500
68,000
90,000
20,000
220,000
67,000
78,000
7,500
15,000
15,000
28,000
10,700
215,000
29,000
27,500
85,000
21,000
130,000
10,000
15,000
25,000
15,000
270,000
8,000
35,000
21,000
6000 5,000
27,000
10,260
215,000
15,500
RENCANA ANGGARAN BIAYA (RAB) BSPS
Nomor BNBA :
Nomor KTP :
Nama Penerima Bantuan : MUH SHOLEH
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
HARGA TOTAL HARGA SWADAYA
NO URAIAN PEKERJAAN VOLUME SATUAN (Rp) (Rp) BSPS
Dana Tunai
I Pekerjaan Persiapan
Bongkar Rumah Lama 1.00 ls - - - -
II Pekerjaan Pondasi
1 Galian Tanah Pondasi 7.20 M³ - - - -

2 Urugan Pasir 3.00 M³ 240,000 720,000 - 720,000
3 Pasangan Pondasi 4.68 M³ - -
-Semen @ 50 kg 8.00 Zak 53,000 424,000 424,000 -

-Pasir pasang 2.80 M³ 240,000 672,000 672,000 -
-Batu Kali 6.00 M³ 215,000 1,290,000 - 1,290,000
4 Urugan kembali 2.52 M³ - - - -
III Pekerjaan Sloof
1 Pekerjaan bekisting M² - - - -
2 Cor Beton Sloof, Ukuran 20 x 15 cm - - -
-Besi beton Φ 10 mm SNI 11.00 Btg 68,000 748,000 748,000
-Semen @ 50 kg 5.00 Zak 53,000 265,000 265,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.80 M³ 280,000 224,000 224,000 -
IV Pekerjaan Kolom
1 Pekerjaan bekisting M² 20,000 - - -
2 Cor Beton Kolom, Ukuran 15 x 15 cm min. T=3m 10.00 Bh
-Besi beton Φ 10 mm SNI 10.00 Btg 68,000 680,000 680,000 -

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok - M²
-Pasir Pasang 4.80 M³ 240,000 1,152,000 1,152,000 -

-Semen @ 50 kg 15.00 Zak 53,000 795,000 795,000
-Batu Bata 6,720.00 Bh 750 5,040,000 - 5,040,000
-Batako - Bh 3,500 - - -
2 Pekerjaan Plester
-Pasir Pasang 5.00 M³ 240,000 1,200,000 1,200,000 -
-Semen @ 50 kg 26.00 Zak 53,000 1,378,000 1,378,000 -
3 Papan
-Papan, Ukuran……… - Lbr - - - -
-Kayu, Ukuran………. - Btg - - - -
VI Pekerjaan Pintu dan Jendela
-Kusen Pintu, Ukuran 0,80 X 2,00 M 2.00 Unit 200,000 400,000 400,000 -
-Kusen Jendela - Unit 150,000 - - -
-Kusen Ventilasi, Ukuran…… - Unit - - - -
-Daun Pintu Kayu, Ukuran 2.00 Unit 350,000 700,000 700,000 -
-Daun Jendela Kayu, Ukuran - Unit 200,000 - - -
-Handle Pintu dan Kunci Pintu - Set - - - -
-Handle Jendela dan Kunci Jendela - Set - - - -
-Engsel Pintu - Set 35,000 - - -
-Engsel Jendela - Set 21,000 - - -
VII Ring Balok
1 Pekerjaan bekisting - M² - - - -
2 Pekerjaan Cor Beton
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
VIII Pekerjaan Struktur Atap
-Kayu rangka kuda-kuda, Ukuran 8/12 x 4m 2.00 Btg 150,000 300,000 300,000 -
-Kayu gapit, Ukuran ……. - Btg - - - -
-Kayu usuk, Ukuran 4/6 x 2m - Btg 22,000 - - -
-Kayu Usuk, Ukuran 5/7 x 2m - Btg 27,000 - - -
-Kayu Reng , Ukuran 2/3 x 2m - Btg 1,500 - -
IX Pekerjaan Penutup Atap
1 Penutup Atap 75.60
-Seng gelombang (0,2 cm x 80 cm x 300 cm), atau - Lbr 78,000 - - -
-Genteng 3,000.00 Bh 1,250 3,750,000 3,750,000 -
-Bahan penutup atap lainnya yang diijinkan - Lbr - - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
-Genteng bubungan - Bh 5,000 - - -
-Bahan penutup atap lainnya yang diijinkan Lbr - - -
3 Listplang papan, Ukuran……. M³ - - -
X Pekerjaan Lantai
1 Lantai Rabat Campuran minimal 1:5, T= 5 cm 3.15 M3
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²
-Papan, Ukuran……….. - Lbr - - - -

-Kayu, Ukuran……….. - Btg - - - -
XI MCK
-Septic Tank - Unit - - - -
-Closet Jongkok - Unit 155,000 - - -
-Pipa Air Bersih, Ukuran…… - Btg 27,500 - - -
-Pipa Air Kotor, Ukuran…… - Btg 85,000 - - -
-Kran - Bh 25,000 - - -
-Pintu Kamar Mandi 1.00 Set 210,000 210,000 210,000 -
XII Lain-lain/ Instalasi Listrik
Gamping 30.00 Zak 8,000 240,000 240,000 -
Paku 13.87 Kg 15,000 208,100 208,100 -
Bendrat 10.00 Kg 20,000 200,000 200,000 -
Loster 30.00 Bh 5,000 150,000 150,000 -
Papan Bekisting - Lbr - - - -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
Pembantu Tukang 60.00 Oh 60,000 3,600,000 3,600,000
JUMLAH 31,603,600 18,130,600 13,473,000
........................................ ....
Difasilitasi, Ketua KPB Diajukan Oleh,
Tenaga Fasilitator Lapangan Penerima Bantuan
(.........................................) ( ....................................) ( ....................................)
Disahkan oleh, Diverifikasi Oleh,

Tim Teknis Kabupaten Magelang Koordinator Fasilitator
( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17
PANJANG LEBAR KELL VOL M2

SUMBER DANA dimensi 9 7 32 63 genteng
SWADAYA pekerjaan
Memakai Bahan
Bangunan Lama atap kuda-kuda
penutup atap 75.6 1,890.00
SWADAYA pondasi Galian Tanah 7.2
Urugan Pasir 2.835
SWADAYA Pas. Batu belah 4.68
12 beton sloof 0.96
17 10 kolom 0.675
12 balk 15x15 0.72
17 dinding bata 96
58 batako
SWADAYA Plesteran dinding 192
lantai 5cm 3.15
SWADAYA kayu gording 4 m 35
usuk 2 m 32
reng 2m 157.5
kusen pintu 80*200 cm 1
jendela 1
daun pintu 80*200 cm 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1890
dimensi 9 7 32 63 genteng
pekerjaan
atap kuda-kuda 0 -
pondasi Galian Tanah 7.2 -
Urugan Pasir 2.835 -
Pas. Batu belah 4.68 -
beton sloof 0.96 -
10 kolom 0.675 -
balk 15x15 0.72 -
dinding bata 96 -
batako -
Plesteran dinding 192 -
lantai 5cm 3.15 -
kayu gording 4 m 35 -
usuk 2 m 32 -
reng 2m 157.5 -
kusen pintu 80*200 cm 1 -
jendela 1 -
daun pintu 80*200 cm 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 3000
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
Urugan Pasir 240,000 3.00 M³
-Semen @ 50 kg 53,000 61.00 Zak
-Pasir pasang 240,000 14.20 M³
-Batu Kali 215,000 6.00 M³
-Besi beton Φ 10 mm SNI 68,000 32.00 Btg
-Batu pecah 280,000 2.20 M³
-Batu Bata 750 6,720.00 Bh
-Batako 3,500 - Bh
-Kusen Pintu, Ukuran 0,80 X 2,00 M 200,000 2.00 Unit
-Kusen Jendela 150,000 - Unit
-Kusen Ventilasi, Ukuran…… - - Unit
-Daun Pintu Kayu, Ukuran 350,000 2.00 Unit
-Daun Jendela Kayu, Ukuran 200,000 - Unit
-Handle Pintu dan Kunci Pintu - - Set
-Handle Jendela dan Kunci Jendela - - Set
-Engsel Pintu 35,000 - Set
-Engsel Jendela 21,000 - Set
-Kayu rangka kuda-kuda, Ukuran 8/12 x 4m 150,000 2.00 Btg
-Kayu gapit, Ukuran ……. - - Btg
-Kayu usuk, Ukuran 4/6 x 2m 22,000 - Btg
-Kayu Usuk, Ukuran 5/7 x 2m 27,000 - Btg
-Kayu Reng , Ukuran 2/3 x 2m 1,500 - Btg
-Seng gelombang (0,2 cm x 80 cm x 300 cm 78,000 - Lbr
-Genteng 1,250 3,000.00 Bh
-Seng - - Lbr
-Genteng bubungan 5,000 - Bh
-Closet Jongkok 155,000 - Unit
-Pipa Air Bersih, Ukuran…… 27,500 - Btg
-Pipa Air Kotor, Ukuran…… 85,000 - Btg
-Kran 25,000 - Bh
-Pintu Kamar Mandi 210,000 1.00 Set
Gamping 8,000 30.00 Zak
Paku 15,000 13.87 Kg
Bendrat 20,000 10.00 Kg
Loster 5,000 30.00 Bh
Papan Bekisting - - Lbr
15,630,600
(630,600) -840.8
-42.04
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
Koordinator Fasilitator
23,803,600 15,630,600
15,630,600
( ....................................)
(630,600)
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
batu semen pasir spit bes 10 besi 8 bata batako
3.00
6.00 8.00 2.80
5.00 0.60 0.80 11.00 12.00
3.00 0.40 0.60 10.00 10.00
3.00 0.50 0.60 11.00 11.00
15.00 4.80 6,720.00
- - -
19.00 5.00
1.00 0.10 0.20
6 54 17.2 2.2 32 33 6720 0
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 3.00 - - - - -
6.00 8.00 2.80 - - - - -
- 5.00 0.60 0.80 11.00 12.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.50 0.60 11.00 11.00 - -
- 15.00 4.80 - - - 6,720.00 -
- - - - - - - -
- 26.00 5.00 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
6 61 17.2 2.2 32 33 6720 0
REKAP VOL
BIAYA BSPS DANA BSPS
- -
3,233,000.00 61.00
3,408,000.00 14.20
- -
1,428,000.00 21.00
787,500.00 21.00
616,000.00 2.20
- -
- -
400,000.00 2.00
- -
- #DIV/0!
700,000.00 2.00
- -
- #DIV/0!
- #DIV/0!
- -
- -
300,000.00 2.00
- #DIV/0!
- -
- -
- -
- -
3,750,000.00 3,000.00
- #DIV/0!
- -
- -
- -
- -
- -
210,000.00 1.00
240,000.00 30.00
208,100.00 13.87
200,000.00 10.00
150,000.00 30.00
- #DIV/0!
15,630,600.00
DA
Nomor BNBA
Nama Penerima Bantuan
Nomor KTP
Alamat
Desa/Kelurahan
kayu kusen daun Kecamatan
Gording usuk reng pintu jendela pintu jendela pintu KM Kabupaten/Kota
Nomor Rekening Penerim
A. Jumlah Dana yang ditr

No.
1
2
3
4
5
6
7
8
9.00 9
36.00 10
162.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
9 36 162 1 1 1 1 1
kayu kusen daun TOTAL HARGA PEMBELIAN

Gording usuk reng pintu jendela pintu jendela pintu KM Terbilang : Enam Juta Dua Ra
- - - - - - - - Disanggupi oleh :
- - - - - - - - Nama Toko/Penyedia Baha
- - - - - - - - Alamat Toko/Penyedia Bah
- - - - - - - - Nomor Rekening Bank Tok
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - B. Jumlah dana yang dita
2.00 - - - - - - - No
- - - - - - - 1
- - - - - - - TOTAL TARIK TUNAI (B)
- - - 2.00 - - - - Terbilang : Tujuh Juta Lima R
- - - - - - - -
- - - - - 2.00 - - C. Total dana yang ditarik (
- - - - - - - - Dana Yang Ditarik (Rp.)
- - - - - - - 1.00 Terbilang : Tujuh Juta Lima R
2 0 0 2 0 2 0 1
disahkan oleh:
Tim Teknis Kabupaten Ma
( .....................................
NIP.................................
*) coret yang tidak perlu
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
TOTAL HARGA PEMBELIAN

Terbilang : Enam Juta Dua Ra
Disanggupi oleh :
Nama Toko/Penyedia Baha
Alamat Toko/Penyedia Bah
Nomor Rekening Bank Tok
B. Jumlah dana yang dita

No
1
TOTAL TARIK TUNAI (B)
Terbilang : Tujuh Juta Lima R
C. Total dana yang ditarik (

Dana Yang Ditarik (Rp.)
disahkan oleh:
( .....................................
NIP.................................

DAFTAR RENCANA PEMANFAATAN BANTUAN (DRPB) TAHAP 1
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0
Nomor Rekening Penerima Bantuan :
A. Jumlah Dana yang ditransfer ke Toko/Penyedia Bahan Bangunan (Tahap I/II *)

Jumlah Harga per Unit
Jenis Bahan Bangunan
(unit) (Rp)
Batu belah 6.00 m3 215,000
Semen 61.00 zak 53,000
Pasir 17.20 m3 240,000
Batu Pecah 2.20 m3 280,000
Besi Ø 10 32.00 btg 68,000
Besi Ø 8 33.00 btg 37,500
Kusen Pintu Ukuran 0,80 x 2,00 m - Bh 200,000
Kusen Jendela - Bh 150,000
Batu Bata 6,720.00 bh 750
Gamping 30.00 zak 8,000
Paku 13.87 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Papan Bekisting - Lbr 20,000
Genteng 3,000.00 Bh 1,250
Genteng bubungan - Bh 5,000

Terbilang : Enam Juta Dua Ratus Lima Puluh Ribu Rupiah
Disanggupi oleh :
Nama Toko/Penyedia Bahan Bangunan :
Alamat Toko/Penyedia Bahan Bangunan :
Nomor Rekening Bank Toko/ Penyedi BB :
Toko/Penyedia Bahan Bangunan

(..................................................)
B. Jumlah dana yang ditarik tunai untuk upah kerja (Tahap I / II *)

Uraian Jumlah harga (Rp)
Upah Kerja PKRS 1,250,000
TOTAL TARIK TUNAI (B) 1,250,000
Terbilang : Tujuh Juta Lima Ratus Ribu Rupiah
C. Total dana yang ditarik ( A + B )

........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
disahkan oleh: Diverifikasi oleh: Difasilitasi Oleh :

Tim Teknis Kabupaten Magelang Koordinator Fasilitator Tenaga Fasilitator Lapangan
( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0
Nomor Rekening Penerima Bantuan : 0

(unit) (Rp)
Batu belah 0 m3 215,000
Semen 45.00 zak 53,000
Pasir 6 m3 240,000
Batu Pecah 0 m3 280,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Kusen Pintu Ukuran 0,80 x 2,00 m 0 Bh 200,000
Kusen Jendela 0 Bh 150,000
Batu Bata 700 bh 750
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000
Kayu usuk 10 Btg 19,000

Disanggupi oleh :
Nama Toko/Penyedia Bahan Bangunan : 0
Alamat Toko/Penyedia Bahan Bangunan : 0
Nomor Rekening Bank Toko/ Penyedi BB : 0
(..................................................)

Upah Kerja PKRS/PBRS *) 1,250,000

........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,290,000
3,233,000
4,128,000
616,000
2,176,000
1,237,500
-
-
5,040,000
240,000
208,100
-
-
-
3,750,000
-
21,918,600 15,630,600
(6,288,000)
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
23,168,600
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
enaga Fasilitator Lapangan
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,385,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,369,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,619,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 371,000 -

-Pasir pasang 2.40 M³ 240,000 576,000 576,000 -
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 2.00 Zak 53,000 106,000 106,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
V Dinding Permanen
1 Tembok 84.00 M²
-Pasir Pasang 6.10 M³ 240,000 1,464,000 1,464,000 -

-Semen @ 50 kg 19.00 Zak 53,000 1,007,000 1,007,000
-Batu Bata - Bh 750 - - -
-Batako 1,100.00 Bh 3,500 3,850,000 3,850,000 -
2 Pekerjaan Plester
-Pasir Pasang 4.40 M³ 240,000 1,056,000 - 1,056,000
-Semen @ 50 kg 17.00 Zak 53,000 901,000 - 901,000
3 Papan
-Kusen Jendela 2.00 Unit 150,000 300,000 300,000 -
-Daun Jendela Kayu, Ukuran 2.00 Unit 200,000 400,000 400,000 -
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
-Kayu usuk, Ukuran 4/6 x 3 m - Btg 27,000 - - -
-Usuk bambu 200.00 m 5,500 1,100,000 1,100,000 -
-Reng bambu 320.00 m 1,500 480,000 480,000 -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 - 53,000

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
-Pintu Kamar Mandi - Set 210,000 - - -
Gamping - Zak 8,000 - - -
Paku 8.53 Kg 15,000 128,000 128,000 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 26,365,000 17,500,000 8,865,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.16
12 beton sloof 0.84
17 8 kolom 0.54
12 balk 15x15 0.63
17 dinding bata
58 batako 84
lantai 5cm 2.4
usuk 3 m 28
reng 3 m 120
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1440
pekerjaan
atap kuda-kuda 0 -
penutup atap 57.6 -
Urugan Pasir 2.16 -
beton sloof 0.84 -
8 kolom 0.54 -
balk 15x15 0.63 -
dinding bata 0 -
batako 84 -
lantai 5cm 2.4 -
usuk 3 m 28 -
reng 3 m 120 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 53.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 1.90 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,100.00 Bh
-Kusen Jendela 150,000 2.00 Unit
-Daun Jendela Kayu, Ukuran 200,000 2.00 Unit
-Kayu usuk, Ukuran 4/6 x 3 m 27,000 - Btg
-Usuk bambu 4m 5,500 200.00 m
-Reng bambu 4m 1,500 320.00 m
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
-Pintu Kamar Mandi 210,000 - Set
Gamping 8,000 - Zak
Paku 15,000 8.53 Kg
Bendrat 20,000 5.00 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
18,565,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 7.00 2.40
4.00 0.50 0.70 10.00 10.00
2.00 0.40 0.50 8.00 8.00
3.00 0.40 0.50 10.00 10.00
- - -
19.00 6.10 1,050.00
17.00 4.40
1.00 0.10 0.20
5 53 16.3 1.9 28 28 0 1050
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 7.00 2.40 - - - - -
- 4.00 0.50 0.70 10.00 10.00 - -
- 2.00 0.40 0.50 8.00 8.00 - -
- 3.00 0.40 0.50 10.00 10.00 - -
- - - - - - - -
- 19.00 6.10 - - - - 1,100.00
- 17.00 4.40 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 53 16.3 1.9 28 28 0 1100
REKAP VOL
- -
1,855,000.00 35.00
2,376,000.00 9.90
- -
1,904,000.00 28.00
975,000.00 26.00
532,000.00 1.90
- -
3,850,000.00 1,100.00
200,000.00 1.00
300,000.00 2.00
- #DIV/0!
350,000.00 1.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
400,000.00 4.00
- #DIV/0!
- -
1,100,000.00 200.00
480,000.00 320.00
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
128,000.00 8.53
100,000.00 5.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
10.00 9
32.00 10
124.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
10 32 124 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
4.00 - - - - - - - No
- 200.00 - - - - - - 1
- - 320.00 - - - - - TOTAL TARIK TUNAI (B)
- - - - 2.00 - - -
- - - - - - 2.00 - Dana Yang Ditarik (Rp.)
- - - - - - - Terbilang : Tujuh Juta Lima R
4 200 320 1 2 1 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 53.00 zak 53,000
Pasir 16.30 m3 240,000
Batu Pecah 1.90 m3 280,000
Besi Ø 10 28.00 btg 68,000
Besi Ø 8 28.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 8.53 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 37.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
2,809,000
3,912,000
532,000
1,904,000
1,050,000
-
-
-
-
128,000
-
-
-
-
-
11,410,000 15,000,000
3,590,000
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
12,660,000
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
1,961,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
5,945,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,195,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 371,000 -

-Pasir pasang 2.40 M³ 240,000 576,000 576,000 -
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 2.00 Zak 53,000 106,000 106,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
V Dinding Permanen
1 Tembok 84.00 M²
-Pasir Pasang 6.10 M³ 240,000 1,464,000 1,464,000 -

-Semen @ 50 kg 19.00 Zak 53,000 1,007,000 1,007,000
-Batako 1,100.00 Bh 3,500 3,850,000 3,850,000 -
2 Pekerjaan Plester
-Pasir Pasang 4.40 M³ 240,000 1,056,000 1,056,000 -
-Semen @ 50 kg 17.00 Zak 53,000 901,000 901,000 -
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
-Kayu rangka kuda-kuda, Ukuran 8/12 x 4m - Btg 150,000 - - -
-Kayu Usuk, Ukuran 5/7 x 3 m - Btg 27,000 - - -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 - 53,000

-Pasir pasang 0.10 M³ 240,000 24,000 - 24,000
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 11.67 Kg 15,000 175,000 175,000 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 24,432,000 17,500,000 6,932,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.16
12 beton sloof 0.84
17 8 kolom 0.54
12 balk 15x15 0.63
17 dinding bata
58 batako 84
lantai 5cm 2.4
usuk 3 m 28
reng 3 m 120
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1440
pekerjaan
atap kuda-kuda 0 -
penutup atap 57.6 -
Urugan Pasir 2.16 -
beton sloof 0.84 -
8 kolom 0.54 -
balk 15x15 0.63 -
dinding bata 0 -
batako 84 -
lantai 5cm 2.4 -
usuk 3 m 28 -
reng 3 m 120 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 53.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 1.90 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,100.00 Bh
-Kayu rangka kuda-kuda, Ukuran 8/12 x 4m 150,000 - Btg
-Kayu Usuk, Ukuran 5/7 x 3 m 27,000 - Btg
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 11.67 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
16,632,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 7.00 2.40
4.00 0.50 0.70 10.00 10.00
2.00 0.40 0.50 8.00 8.00
3.00 0.40 0.50 10.00 10.00
- - -
19.00 6.10 1,050.00
17.00 4.40
1.00 0.10 0.20
5 53 16.3 1.9 28 28 0 1050
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 7.00 2.40 - - - - -
- 4.00 0.50 0.70 10.00 10.00 - -
- 2.00 0.40 0.50 8.00 8.00 - -
- 3.00 0.40 0.50 10.00 10.00 - -
- - - - - - - -
- 19.00 6.10 - - - - 1,100.00
- 17.00 4.40 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 53 16.3 1.9 28 28 0 1100
REKAP VOL
- -
2,756,000.00 52.00
3,408,000.00 14.20
- -
1,904,000.00 28.00
975,000.00 26.00
532,000.00 1.90
- -
3,850,000.00 1,100.00
200,000.00 1.00
300,000.00 2.00
- #DIV/0!
350,000.00 1.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
175,000.00 11.67
100,000.00 5.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
10.00 9
32.00 10
124.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
10 32 124 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - No
- - - - - - - - 1
- - - - 2.00 - - -
0 0 0 1 2 1 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 53.00 zak 53,000
Pasir 16.30 m3 240,000
Batu Pecah 1.90 m3 280,000
Besi Ø 10 28.00 btg 68,000
Besi Ø 8 28.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 11.67 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 37.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
2,809,000
3,912,000
532,000
1,904,000
1,050,000
-
-
-
-
175,000
-
-
-
-
-
11,457,000 15,000,000
3,543,000
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
12,707,000
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
1,961,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
5,945,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,195,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 1.00 M³ 240,000 240,000 - 240,000
-Semen @ 50 kg 6.00 Zak 53,000 318,000 - 318,000

-Pasir pasang 2.10 M³ 240,000 504,000 - 504,000
-Batu Kali 4.00 M³ 215,000 860,000 - 860,000
III Pekerjaan Sloof
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu Pecah 0.60 M³ 280,000 168,000 168,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 2.00 Zak 53,000 106,000 106,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
V Dinding Permanen
1 Tembok 72.00 M²
-Pasir Pasang 5.20 M³ 240,000 1,248,000 1,248,000 -

-Semen @ 50 kg 16.00 Zak 53,000 848,000 848,000
-Batako 1,150.00 Bh 3,500 4,025,000 4,025,000 -
2 Pekerjaan Plester
-Pasir Pasang 3.80 M³ 240,000 912,000 912,000 -
-Semen @ 50 kg 14.00 Zak 53,000 742,000 583,000 159,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 2.00 Zak 53,000 106,000 106,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
-Kayu rangka kuda-kuda, Ukuran 6/12 x 4m 10.00 Btg 100,000 1,000,000 1,000,000 -
-Usuk bambu 100.00 Btg 5,500 550,000 550,000 -
-Reng bambu 360.00 Btg 1,500 540,000 540,000 -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 - 24,000
-Batu pecah 0.10 M³ 280,000 28,000 28,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 6.67 Kg 15,000 100,000 100,000 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 20.00 Bh 5,000 100,000 100,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 24,905,000 17,500,000 7,405,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
penutup atap 38.4 960.00
Urugan Pasir 1.44
12 beton sloof 0.72
17 8 kolom 0.54
12 balk 15x15 0.54
17 dinding bata
58 batako 72
lantai 5cm 1.6
usuk 3 m 24
reng 3 m 80
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 960
pekerjaan
atap kuda-kuda 0 -
penutup atap 38.4 -
Urugan Pasir 1.44 -
beton sloof 0.72 -
8 kolom 0.54 -
balk 15x15 0.54 -
dinding bata 0 -
batako 72 -
lantai 5cm 1.6 -
usuk 3 m 24 -
reng 3 m 80 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 44.00 Zak
-Batu Kali 215,000 4.00 M³
-Batu pecah 280,000 1.70 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,150.00 Bh
-Usuk bambu 4m 5,500 100.00 Btg
-Reng bambu 4m 1,500 360.00 Btg
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 6.67 Kg
Loster 5,000 20.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
17,105,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
1.00
4.00 6.00 2.10
3.00 0.50 0.60 8.00 9.00
2.00 0.40 0.50 8.00 8.00
2.00 0.40 0.50 8.00 8.00
- - -
16.00 5.20 900.00
14.00 3.80
1.00 0.10 0.10
4 44 13.5 1.7 24 25 0 900
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 1.00 - - - - -
4.00 6.00 2.10 - - - - -
- 3.00 0.50 0.60 8.00 9.00 - -
- 2.00 0.40 0.50 8.00 8.00 - -
- 2.00 0.40 0.50 8.00 8.00 - -
- - - - - - - -
- 16.00 5.20 - - - - 1,150.00
- 14.00 3.80 - - - - -
- 1.00 0.10 0.10 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
4 44 13.5 1.7 24 25 0 1150
REKAP VOL
- -
1,855,000.00 35.00
2,472,000.00 10.30
- -
1,632,000.00 24.00
900,000.00 24.00
476,000.00 1.70
- -
4,025,000.00 1,150.00
200,000.00 1.00
300,000.00 2.00
- #DIV/0!
350,000.00 1.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
1,000,000.00 10.00
- #DIV/0!
- -
550,000.00 100.00
540,000.00 360.00
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
100,000.00 6.67
100,000.00 5.00
100,000.00 20.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
10.00 9
28.00 10
84.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
10 28 84 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
10.00 - - - - - - - No
- 100.00 - - - - - - 1
- - - - 2.00 - - -
10 100 360 1 2 1 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 4.00 m3 215,000
Semen 44.00 zak 53,000
Pasir 13.50 m3 240,000
Batu Pecah 1.70 m3 280,000
Besi Ø 10 24.00 btg 68,000
Besi Ø 8 25.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 6.67 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 28.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
860,000
2,332,000
3,240,000
476,000
1,632,000
937,500
-
-
-
-
100,000
-
-
-
-
-
9,577,500 15,000,000
5,422,500
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
10,827,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
1,484,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
5,468,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
6,718,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 3.00 M³ 240,000 720,000 - 720,000
-Semen @ 50 kg 9.00 Zak 53,000 477,000 - 477,000

-Pasir pasang 3.00 M³ 240,000 720,000 - 720,000
-Batu Kali 6.00 M³ 215,000 1,290,000 - 1,290,000
III Pekerjaan Sloof
-Semen @ 50 kg 5.00 Zak 53,000 265,000 265,000 -
-Pasir pasang 0.70 M³ 240,000 168,000 168,000 -
-Batu Pecah 0.80 M³ 280,000 224,000 224,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 2.00 Zak 53,000 106,000 106,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
V Dinding Permanen
1 Tembok 102.00 M²
-Pasir Pasang 7.40 M³ 240,000 1,776,000 1,776,000 -

-Semen @ 50 kg 23.00 Zak 53,000 1,219,000 1,219,000
-Batako 1,100.00 Bh 3,500 3,850,000 3,850,000 -
2 Pekerjaan Plester
-Pasir Pasang 5.40 M³ 240,000 1,296,000 - 1,296,000
-Semen @ 50 kg 21.00 Zak 53,000 1,113,000 - 1,113,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Usuk Bambu 240.00 m 5,500 1,320,000 1,320,000 -
-Reng Bambu 360.00 m 1,500 540,000 540,000 -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 4.97 Kg 15,000 74,500 74,500 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 28,416,000 17,500,000 10,916,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 3.24
12 beton sloof 1.02
17 8 kolom 0.54
12 balk 15x15 0.765
17 dinding bata
58 batako 102
lantai 5cm 3.6
usuk 3 m 34
reng 3 m 180
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 2160
pekerjaan
atap kuda-kuda 0 -
penutup atap 86.4 -
Urugan Pasir 3.24 -
beton sloof 1.02 -
10 kolom 0.54 -
balk 15x15 0.765 -
dinding bata 0 -
batako 102 -
lantai 5cm 3.6 -
usuk 3 m 34 -
reng 3 m 180 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 65.00 Zak
-Batu Kali 215,000 6.00 M³
-Batu pecah 280,000 2.10 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,100.00 Bh
-Usuk Bambu 4m 5,500 240.00 m
-Reng Bambu 4m 1,500 360.00 m
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 4.97 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
20,616,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
3.00
6.00 9.00 3.00
5.00 0.70 0.80 12.00 12.00
2.00 0.40 0.50 8.00 8.00
4.00 0.50 0.60 12.00 11.00
- - -
23.00 7.40 1,275.00
21.00 5.40
1.00 0.10 0.20
6 65 20.5 2.1 32 31 0 1275
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 3.00 - - - - -
6.00 9.00 3.00 - - - - -
- 5.00 0.70 0.80 12.00 12.00 - -
- 2.00 0.40 0.50 8.00 8.00 - -
- 4.00 0.50 0.60 12.00 11.00 - -
- - - - - - - -
- 23.00 7.40 - - - - 1,100.00
- 21.00 5.40 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
6 65 20.5 2.1 32 31 0 1100
REKAP VOL
- -
1,855,000.00 35.00
2,184,000.00 9.10
- -
2,176,000.00 32.00
1,012,500.00 27.00
588,000.00 2.10
- -
3,850,000.00 1,100.00
200,000.00 1.00
300,000.00 2.00
- #DIV/0!
350,000.00 1.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
1,320,000.00 240.00
540,000.00 360.00
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
74,500.00 4.97
100,000.00 5.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
12.00 9
38.00 10
184.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
12 38 184 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - No
- 240.00 - - - - - - 1
- - - - 2.00 - - -
0 240 360 1 2 1 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 6.00 m3 215,000
Semen 65.00 zak 53,000
Pasir 20.50 m3 240,000
Batu Pecah 2.10 m3 280,000
Besi Ø 10 32.00 btg 68,000
Besi Ø 8 31.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 4.97 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 49.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,290,000
3,445,000
4,920,000
588,000
2,176,000
1,162,500
-
-
-
-
74,500
-
-
-
-
-
13,656,000 15,000,000
1,344,000
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
14,906,000
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,597,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,581,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,831,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 8.00 Zak 53,000 424,000 - 424,000

-Pasir pasang 2.80 M³ 240,000 672,000 - 672,000
-Batu Kali 6.00 M³ 215,000 1,290,000 - 1,290,000
III Pekerjaan Sloof
-Semen @ 50 kg 5.00 Zak 53,000 265,000 265,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.80 M³ 280,000 224,000 224,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.20 M³ 240,000 48,000 48,000 -
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -
-Batu pecah 0.30 M³ 280,000 84,000 84,000 -
V Dinding Permanen
1 Tembok 96.00 M²
-Pasir Pasang 7.00 M³ 240,000 1,680,000 1,680,000 -

-Semen @ 50 kg 12.00 Zak 53,000 636,000 636,000
-Batako 750.00 Bh 3,500 2,625,000 2,625,000 -
2 Pekerjaan Plester
-Pasir Pasang 5.00 M³ 240,000 1,200,000 - 1,200,000
-Semen @ 50 kg 19.00 Zak 53,000 1,007,000 424,000 583,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Usuk bambu 120.00 Btg 5,500 660,000 660,000 -
-Reng Bambu 280.00 Btg 1,500 420,000 420,000 -
-Genteng 1,500.00 Bh 1,250 1,875,000 1,875,000 -
2 Bubungan Atap Bh
-Seng Lbr - - -
-Genteng bubungan 30.00 Bh 5,000 150,000 150,000 -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Closet Jongkok 1.00 Unit 155,000 155,000 155,000 -
-Kran - Bh 25,000 - - -
-Pintu Kamar Mandi 1.00 Set 210,000 210,000 210,000 -
Paku 8.10 Kg 15,000 121,500 121,500 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 6.00 Bh 5,000 30,000 30,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 27,449,000 17,500,000 9,949,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.16
12 beton sloof 0.96
17 5 kolom 0.3375
12 balk 15x15 0.72
17 dinding bata
58 batako 96
lantai 5cm 2.4
usuk 2 m 32
reng 2m 120
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1440
pekerjaan
atap kuda-kuda 0 -
Urugan Pasir 2.16 -
beton sloof 0.96 -
5 kolom 0.3375 -
balk 15x15 0.72 -
dinding bata 0 -
batako 96 -
lantai 5cm 2.4 -
usuk 2 m 32 -
reng 2m 120 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 1500
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 49.00 Zak
-Batu Kali 215,000 6.00 M³
-Batu pecah 280,000 1.90 M³
-Batu Bata 750 - Bh
-Batako 3,500 750.00 Bh
-Usuk bambu 4m 5,500 120.00 Btg
-Reng Bambu 4m 1,500 280.00 Btg
-Genteng 1,250 1,500.00 Bh
-Seng - - Lbr
-Genteng bubungan 5,000 30.00 Bh
-Closet Jongkok 155,000 1.00 Unit
-Kran 25,000 - Bh
-Pintu Kamar Mandi 210,000 1.00 Set
Gamping 8,000 - Zak
Paku 15,000 8.10 Kg
Loster 5,000 6.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
19,649,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
6.00 8.00 2.80
5.00 0.60 0.80 11.00 12.00
1.00 0.20 0.30 5.00 5.00
3.00 0.50 0.60 11.00 11.00
- - -
22.00 7.00 1,200.00
19.00 5.00
1.00 0.10 0.20
6 59 18.2 1.9 27 28 0 1200
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
6.00 8.00 2.80 - - - - -
- 5.00 0.60 0.80 5.00 4.00 - -
- 1.00 0.20 0.30 5.00 5.00 - -
- 3.00 0.50 0.60 11.00 11.00 - -
- - - - - - - -
- 12.00 7.00 - - - - 750.00
- 19.00 5.00 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
6 49 18.2 1.9 21 20 0 750
REKAP VOL
- -
1,590,000.00 30.00
2,016,000.00 8.40
- -
1,428,000.00 21.00
787,500.00 21.00
532,000.00 1.90
- -
2,625,000.00 750.00
400,000.00 2.00
300,000.00 2.00
- #DIV/0!
700,000.00 2.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
500,000.00 5.00
- #DIV/0!
- -
660,000.00 120.00
420,000.00 280.00
- -
1,875,000.00 1,500.00
- #DIV/0!
150,000.00 30.00
155,000.00 1.00
- -
- -
- -
210,000.00 1.00
- -
121,500.00 8.10
100,000.00 5.00
30,000.00 6.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
5.00 9
36.00 10
124.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
5 36 124 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5.00 - - - - - - - No
- 120.00 - - - - - - 1
- - - - 2.00 - - -
- - - - - - - 1.00 Terbilang : Tujuh Juta Lima R
5 120 280 2 2 2 2 1
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 6.00 m3 215,000
Semen 49.00 zak 53,000
Pasir 18.20 m3 240,000
Batu Pecah 1.90 m3 280,000
Besi Ø 10 21.00 btg 68,000
Besi Ø 8 20.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 8.10 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng 1,500.00 Bh 1,250
Genteng bubungan 30.00 Bh 5,000

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 33.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,290,000
2,597,000
4,368,000
532,000
1,428,000
750,000
-
-
-
-
121,500
-
-
-
1,875,000
150,000
13,111,500 15,000,000
1,888,500
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
14,361,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
1,749,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
5,733,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
6,983,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 3.00 M³ 240,000 720,000 - 720,000
-Semen @ 50 kg 8.00 Zak 53,000 424,000 - 424,000

-Pasir pasang 2.80 M³ 240,000 672,000 - 672,000
-Batu Kali 6.00 M³ 215,000 1,290,000 - 1,290,000
III Pekerjaan Sloof
-Semen @ 50 kg 5.00 Zak 53,000 265,000 265,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.80 M³ 280,000 224,000 224,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok 96.00 M²
-Pasir Pasang 4.80 M³ 240,000 1,152,000 1,152,000 -

-Semen @ 50 kg 15.00 Zak 53,000 795,000 795,000
-Batu Bata 2,000.00 Bh 750 1,500,000 1,500,000 -
-Batako - Bh 3,500 - - -
2 Pekerjaan Plester
-Pasir Pasang 5.00 M³ 240,000 1,200,000 - 1,200,000
-Semen @ 50 kg 19.00 Zak 53,000 1,007,000 1,007,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Usuk Bambu - m - - - -
-Reng bambu - m 1,500 - -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Gamping 20.00 Zak 8,000 160,000 160,000 -
Paku - Kg 15,000 - - -
Bendrat 4.00 Kg 20,000 80,000 80,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 22,951,500 12,338,500 10,613,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.835
12 beton sloof 0.96
17 10 kolom 0.675
12 balk 15x15 0.72
17 dinding bata 96
58 batako
lantai 5cm 3.15
usuk 2 m 32
reng 2m 157.5
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1890
pekerjaan
atap kuda-kuda 0 -
penutup atap 75.6 -
Urugan Pasir 2.835 -
beton sloof 0.96 -
6 kolom 0.675 -
balk 15x15 0.72 -
dinding bata 96 -
batako 0 -
lantai 5cm 3.15 -
usuk 2 m 32 -
reng 2m 157.5 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 54.00 Zak
-Batu Kali 215,000 6.00 M³
-Batu pecah 280,000 2.20 M³
-Batu Bata 750 2,000.00 Bh
-Batako 3,500 - Bh
-Usuk Bambu - - m
-Reng bambu 1,500 - m
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Paku 15,000 - Kg
Loster 5,000 10.00 Bh
9,838,500
5,161,500 6882
344.1
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
15,151,500 9,838,500
9,838,500
( ....................................)
5,161,500
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
3.00
6.00 8.00 2.80
5.00 0.60 0.80 11.00 12.00
3.00 0.40 0.60 10.00 10.00
3.00 0.50 0.60 11.00 11.00
15.00 4.80 6,720.00
- - -
19.00 5.00
1.00 0.10 0.20
6 54 17.2 2.2 32 33 6720 0
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 3.00 - - - - -
6.00 8.00 2.80 - - - - -
- 5.00 0.60 0.80 5.00 6.00 - -
- 3.00 0.40 0.60 5.00 5.00 - -
- 3.00 0.50 0.60 11.00 11.00 - -
- 15.00 4.80 - - - 2,000.00 -
- - - - - - -
- 19.00 5.00 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
6 54 17.2 2.2 21 22 2000 0
REKAP VOL
- -
1,431,000.00 27.00
1,536,000.00 6.40
- -
1,428,000.00 21.00
787,500.00 21.00
616,000.00 2.20
1,500,000.00 2,000.00
- -
200,000.00 1.00
300,000.00 2.00
- #DIV/0!
350,000.00 1.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
1,000,000.00 10.00
- #DIV/0!
- -
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
160,000.00 20.00
- -
80,000.00 4.00
50,000.00 10.00
- #DIV/0!
9,838,500.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
12.00 9
36.00 10
162.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
12 36 162 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
10.00 - - - - - - - No
- - - - - - - 1
- - - - 2.00 - - -
10 0 0 1 2 1 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 6.00 m3 215,000
Semen 54.00 zak 53,000
Pasir 17.20 m3 240,000
Batu Pecah 2.20 m3 280,000
Besi Ø 10 21.00 btg 68,000
Besi Ø 8 22.00 btg 37,500
Paku - Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 38.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,290,000
2,862,000
4,128,000
616,000
1,428,000
825,000
-
-
1,500,000
160,000
-
-
-
-
-
-
12,809,000 9,838,500
(2,970,500)
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
14,059,000
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,014,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
5,998,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,248,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 8.00 Zak 53,000 424,000 - 424,000

-Pasir pasang 2.80 M³ 240,000 672,000 - 672,000
-Batu Kali 6.00 M³ 215,000 1,290,000 - 1,290,000
III Pekerjaan Sloof
-Besi beton Φ 8 mm SNI 10.00 Btg 37,500 375,000 - 375,000
-Semen @ 50 kg 5.00 Zak 53,000 265,000 265,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.80 M³ 280,000 224,000 224,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok 96.00 M²
-Pasir Pasang 7.00 M³ 240,000 1,680,000 1,680,000 -

-Semen @ 50 kg 22.00 Zak 53,000 1,166,000 1,166,000
-Batako 1,350.00 Bh 3,500 4,725,000 4,725,000 -
2 Pekerjaan Plester
-Pasir Pasang 5.00 M³ 240,000 1,200,000 - 1,200,000
-Semen @ 50 kg 19.00 Zak 53,000 1,007,000 53,000 954,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Usuk bambu - Btg - - - -
Reng bambu - Btg 1,500 - -
-Genteng 1,800.00 Bh 1,250 2,250,000 2,250,000 -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 2.80 Kg 15,000 42,000 42,000 -
Bendrat 2.00 Kg 20,000 40,000 40,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 28,982,500 17,500,000 11,482,500
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
penutup atap 72 1,800.00
Urugan Pasir 2.7
12 beton sloof 0.96
17 10 kolom 0.675
12 balk 15x15 0.72
17 dinding bata
58 batako 96
lantai 5cm 3
usuk 2 m 32
reng 2m 150
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1800
pekerjaan
atap kuda-kuda 0 -
Urugan Pasir 2.7 -
beton sloof 0.96 -
10 kolom 0.675 -
balk 15x15 0.72 -
dinding bata 0 -
batako 96 -
lantai 5cm 3 -
usuk 2 m 32 -
reng 2m 150 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 1800
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 61.00 Zak
-Batu Kali 215,000 6.00 M³
-Batu pecah 280,000 2.20 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,350.00 Bh
-Usuk bambu - - Btg
Reng bambu 1,500 - Btg
-Genteng 1,250 1,800.00 Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 2.80 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
21,182,500 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
6.00 8.00 2.80
5.00 0.60 0.80 10.00 12.00
3.00 0.40 0.60 10.00 10.00
3.00 0.50 0.60 11.00 11.00
- - -
22.00 7.00 1,200.00
19.00 5.00
1.00 0.10 0.20
6 61 18.4 2.2 31 33 0 1200
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
6.00 8.00 2.80 - - - - -
- 5.00 0.60 0.80 10.00 12.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.50 0.60 11.00 11.00 - -
- - - - - - - -
- 22.00 7.00 - - - - 1,350.00
- 19.00 5.00 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
6 61 18.4 2.2 31 33 0 1350
REKAP VOL
- -
1,855,000.00 35.00
2,064,000.00 8.60
- -
2,108,000.00 31.00
- -
616,000.00 2.20
- -
4,725,000.00 1,350.00
200,000.00 1.00
300,000.00 2.00
- #DIV/0!
350,000.00 1.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
- #DIV/0!
- -
- -
2,250,000.00 1,800.00
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
42,000.00 2.80
40,000.00 2.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
13.00 9
36.00 10
154.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
13 36 154 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - No
- - - - - - - 1
- - - - 2.00 - - -
0 0 0 1 2 1 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 6.00 m3 215,000
Semen 61.00 zak 53,000
Pasir 18.40 m3 240,000
Batu Pecah 2.20 m3 280,000
Besi Ø 10 31.00 btg 68,000
Besi Ø 8 33.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 2.80 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng 1,800.00 Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 45.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,290,000
3,233,000
4,416,000
616,000
2,108,000
1,237,500
-
-
-
-
42,000
-
-
-
2,250,000
-
15,192,500 15,000,000
(192,500)
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
16,442,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,385,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,369,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,619,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 3.00 M³ 240,000 720,000 - 720,000
-Semen @ 50 kg 9.00 Zak 53,000 477,000 - 477,000

-Pasir pasang 3.00 M³ 240,000 720,000 - 720,000
-Batu Kali 6.00 M³ 215,000 1,290,000 - 1,290,000
III Pekerjaan Sloof
-Semen @ 50 kg 5.00 Zak 53,000 265,000 265,000 -
-Pasir pasang 0.70 M³ 240,000 168,000 168,000 -
-Batu Pecah 0.80 M³ 280,000 224,000 224,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Batu pecah 0.70 M³ 280,000 196,000 196,000 -
V Dinding Permanen
1 Tembok 102.00 M²
-Pasir Pasang 7.40 M³ 240,000 1,776,000 1,776,000 -

-Semen @ 50 kg 23.00 Zak 53,000 1,219,000 1,219,000
-Batako 1,450.00 Bh 3,500 5,075,000 5,075,000 -
2 Pekerjaan Plester
-Pasir Pasang 5.40 M³ 240,000 1,296,000 - 1,296,000
-Semen @ 50 kg 21.00 Zak 53,000 1,113,000 689,000 424,000
3 Papan
-Kusen Pintu, Ukuran 0,80 X 2,00 M - Unit 200,000 - - -
-Daun Pintu Kayu, Ukuran - Unit 350,000 - - -
VII Ring Balok
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Kayu Usuk, Ukuran 5/7 x 3m - Btg - - - -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 4.83 Kg 15,000 72,500 72,500 -
Bendrat 7.00 Kg 20,000 140,000 140,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 27,727,000 17,500,000 10,227,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 3.24
12 beton sloof 1.02
17 12 kolom 0.81
12 balk 15x15 0.765
17 dinding bata
58 batako 102
lantai 5cm 3.6
usuk 2 m 34
reng 2m 180
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 2160
pekerjaan
atap kuda-kuda 0 -
penutup atap 86.4 -
Urugan Pasir 3.24 -
beton sloof 1.02 -
12 kolom 0.81 -
balk 15x15 0.765 -
dinding bata 0 -
batako 102 -
lantai 5cm 3.6 -
usuk 2 m 34 -
reng 2m 180 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 67.00 Zak
-Batu Kali 215,000 6.00 M³
-Batu pecah 280,000 2.30 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,450.00 Bh
-Kusen Pintu, Ukuran 0,80 X 2,00 M 200,000 - Unit
-Daun Pintu Kayu, Ukuran 350,000 - Unit
-Kayu Usuk, Ukuran 5/7 x 3m - - Btg
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 4.83 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
19,927,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
3.00
6.00 9.00 3.00
5.00 0.70 0.80 12.00 12.00
4.00 0.50 0.70 12.00 12.00
4.00 0.50 0.60 12.00 11.00
- - -
23.00 7.40 1,275.00
21.00 5.40
1.00 0.10 0.20
6 67 20.6 2.3 36 35 0 1275
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 3.00 - - - - -
6.00 9.00 3.00 - - - - -
- 5.00 0.70 0.80 12.00 12.00 - -
- 4.00 0.50 0.70 12.00 12.00 - -
- 4.00 0.50 0.60 12.00 11.00 - -
- - - - - - - -
- 23.00 7.40 - - - - 1,450.00
- 21.00 5.40 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
6 67 20.6 2.3 36 35 0 1450
REKAP VOL
- -
2,650,000.00 50.00
2,208,000.00 9.20
- -
2,448,000.00 36.00
1,312,500.00 35.00
644,000.00 2.30
- -
5,075,000.00 1,450.00
- -
- -
- #DIV/0!
- -
- -
- #DIV/0!
- #DIV/0!
- -
- -
400,000.00 4.00
- #DIV/0!
- -
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
72,500.00 4.83
140,000.00 7.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
12.00 9
38.00 10
184.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
12 38 184 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
4.00 - - - - - - - No
- - - - - - - 1
- - - - - - - - Terbilang : Tujuh Juta Lima R
- - - - - - - -
- - - - - - - - C. Total dana yang ditarik (
4 0 0 0 0 0 0 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 6.00 m3 215,000
Semen 67.00 zak 53,000
Pasir 20.60 m3 240,000
Batu Pecah 2.30 m3 280,000
Besi Ø 10 36.00 btg 68,000
Besi Ø 8 35.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 4.83 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 51.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,290,000
3,551,000
4,944,000
644,000
2,448,000
1,312,500
-
-
-
-
72,500
-
-
-
-
-
14,262,000 15,000,000
738,000
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
15,512,000
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,703,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,687,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,937,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 1.00 M³ 240,000 240,000 - 240,000
-Semen @ 50 kg 6.00 Zak 53,000 318,000 - 318,000

-Pasir pasang 2.30 M³ 240,000 552,000 - 552,000
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu Pecah 0.60 M³ 280,000 168,000 168,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 2.00 Zak 53,000 106,000 106,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
V Dinding Permanen
1 Tembok 78.00 M²
-Pasir Pasang 5.70 M³ 240,000 1,368,000 1,368,000 -

-Semen @ 50 kg 17.00 Zak 53,000 901,000 901,000
-Batako 500.00 Bh 3,500 1,750,000 1,750,000 -
2 Pekerjaan Plester
-Pasir Pasang 4.10 M³ 240,000 984,000 984,000 -
-Semen @ 50 kg 16.00 Zak 53,000 848,000 848,000 -
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
-Kayu Usuk, Ukuran 5/7 x 3m - Btg - - - -
-Genteng 1,400.00 Bh 1,250 1,750,000 1,750,000 -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.10 M³ 280,000 28,000 28,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Gamping 35.00 Zak 8,000 280,000 280,000 -
Paku 8.10 Kg 15,000 121,500 121,500 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 24,985,000 17,500,000 7,485,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 1.8
12 beton sloof 0.78
17 8 kolom 0.54
12 balk 15x15 0.585
17 dinding bata
58 batako 78
lantai 5cm 2
usuk 2 m 26
reng 2m 100
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1200
pekerjaan
atap kuda-kuda 0 -
Urugan Pasir 1.8 -
beton sloof 0.78 -
8 kolom 0.54 -
balk 15x15 0.585 -
dinding bata 0 -
batako 78 -
lantai 5cm 2 -
usuk 2 m 26 -
reng 2m 100 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 1400
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 49.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 1.70 M³
-Batu Bata 750 - Bh
-Batako 3,500 500.00 Bh
-Kayu Usuk, Ukuran 5/7 x 3m - - Btg
-Genteng 1,250 1,400.00 Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Paku 15,000 8.10 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
17,185,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
1.00
5.00 6.00 2.30
4.00 0.50 0.60 9.00 10.00
2.00 0.40 0.50 8.00 8.00
3.00 0.40 0.50 9.00 9.00
- - -
17.00 5.70 975.00
16.00 4.10
1.00 0.10 0.10
5 49 14.5 1.7 26 27 0 975
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 1.00 - - - - -
5.00 6.00 2.30 - - - - -
- 4.00 0.50 0.60 9.00 10.00 - -
- 2.00 0.40 0.50 8.00 8.00 - -
- 3.00 0.40 0.50 9.00 9.00 - -
- - - - - - - -
- 17.00 5.70 - - - - 500.00
- 16.00 4.10 - - - - -
- 1.00 0.10 0.10 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 49 14.5 1.7 26 27 0 500
REKAP VOL
- -
2,279,000.00 43.00
2,688,000.00 11.20
- -
1,768,000.00 26.00
937,500.00 25.00
476,000.00 1.70
- -
1,750,000.00 500.00
400,000.00 2.00
300,000.00 2.00
- #DIV/0!
700,000.00 2.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
1,000,000.00 10.00
- #DIV/0!
- -
- #DIV/0!
- -
- -
1,750,000.00 1,400.00
- #DIV/0!
- -
- -
- -
- -
- -
- -
280,000.00 35.00
121,500.00 8.10
100,000.00 5.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
10.00 9
30.00 10
104.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
10 30 104 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
10.00 - - - - - - - No
- - - - - - - 1
- - - - 2.00 - - -
10 0 0 2 2 2 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 49.00 zak 53,000
Pasir 14.50 m3 240,000
Batu Pecah 1.70 m3 280,000
Besi Ø 10 26.00 btg 68,000
Besi Ø 8 27.00 btg 37,500
Batu Bata - bh 750
Paku 8.10 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng 1,400.00 Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 33.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
2,597,000
3,480,000
476,000
1,768,000
1,012,500
-
-
-
280,000
121,500
-
-
-
1,750,000
-
12,560,000 15,000,000
2,440,000
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
13,810,000
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
1,749,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
5,733,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
6,983,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 - 371,000

-Pasir pasang 2.60 M³ 240,000 624,000 - 624,000
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok - M²
-Pasir Pasang 4.50 M³ 240,000 1,080,000 1,080,000 -

-Semen @ 50 kg 14.00 Zak 53,000 742,000 742,000
-Batu Bata 5,000.00 Bh 750 3,750,000 3,750,000 -
-Batako - Bh 3,500 - - -
2 Pekerjaan Plester
-Pasir Pasang 4.70 M³ 240,000 1,128,000 240,000 888,000
-Semen @ 50 kg 25.00 Zak 53,000 1,325,000 530,000 795,000
3 Papan
-Daun Jendela Kayu, Ukuran 10.00 Unit 200,000 2,000,000 2,000,000 -
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Genteng 1,000.00 Bh 1,250 1,250,000 1,250,000 -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 5.80 Kg 15,000 87,000 87,000 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 27,408,000 17,500,000 9,908,000
........................................ ....
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.43
12 beton sloof 0.9
17 10 kolom 0.675
12 balk 15x15 0.675
17 dinding bata 90
58 batako
lantai 5cm 2.7
usuk 2 m 30
reng 2m 135
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1620
pekerjaan
atap kuda-kuda 0 -
Urugan Pasir 2.43 -
beton sloof 0.9 -
10 kolom 0.675 -
balk 15x15 0.675 -
dinding bata 90 -
batako -
lantai 5cm 2.7 -
usuk 2 m 30 -
reng 2m 135 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 1000
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 57.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 2.10 M³
-Batu Bata 750 5,000.00 Bh
-Batako 3,500 - Bh
-Genteng 1,250 1,000.00 Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 5.80 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
19,608,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 7.00 2.60
4.00 0.60 0.70 10.00 11.00
3.00 0.40 0.60 10.00 10.00
3.00 0.40 0.60 10.00 10.00
14.00 4.50 6,300.00
- - -
18.00 4.70
1.00 0.10 0.20
5 50 15.3 2.1 30 31 6300 0
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 7.00 2.60 - - - - -
- 4.00 0.60 0.70 10.00 11.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 14.00 4.50 - - - 5,000.00 -
- - - - - - - -
- 25.00 4.70 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 57 15.3 2.1 30 31 5000 0
REKAP VOL
- -
1,855,000.00 35.00
1,680,000.00 7.00
- -
2,040,000.00 30.00
750,000.00 20.00
588,000.00 2.10
3,750,000.00 5,000.00
- -
200,000.00 1.00
- -
- #DIV/0!
350,000.00 1.00
2,000,000.00 10.00
- #DIV/0!
- #DIV/0!
- -
- -
300,000.00 2.00
- #DIV/0!
- -
- -
- -
- -
1,250,000.00 1,000.00
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
87,000.00 5.80
100,000.00 5.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
12.00 9
34.00 10
140.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
12 34 140 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
2.00 - - - - - - - No
- - - - - - - 1
- - - - - - - -
2 0 0 1 0 1 10 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 57.00 zak 53,000
Pasir 15.30 m3 240,000
Batu Pecah 2.10 m3 280,000
Besi Ø 10 30.00 btg 68,000
Besi Ø 8 31.00 btg 37,500
Gamping - zak 8,000
Paku 5.80 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng 1,000.00 Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 41.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
3,021,000
3,672,000
588,000
2,040,000
1,162,500
-
-
3,750,000
-
87,000
-
-
-
1,250,000
-
16,645,500 15,000,000
(1,645,500)
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
17,895,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,173,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,157,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,407,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 371,000 -

-Pasir pasang 2.60 M³ 240,000 624,000 624,000 -
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok - M²
-Pasir Pasang 4.50 M³ 240,000 1,080,000 1,080,000 -

-Semen @ 50 kg 14.00 Zak 53,000 742,000 742,000
-Batu Bata 5,000.00 Bh 750 3,750,000 3,750,000 -
-Batako - Bh 3,500 - - -
2 Pekerjaan Plester
-Pasir Pasang 4.70 M³ 240,000 1,128,000 1,128,000 -
-Semen @ 50 kg 25.00 Zak 53,000 1,325,000 - 1,325,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Gamping 30.00 Zak 8,000 240,000 240,000 -
Paku 5.93 Kg 15,000 89,000 89,000 -
Bendrat 4.00 Kg 20,000 80,000 80,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 25,680,000 17,500,000 8,180,000
........................................ ....
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.43
12 beton sloof 0.9
17 10 kolom 0.675
12 balk 15x15 0.675
17 dinding bata 90
58 batako
lantai 5cm 2.7
usuk 2 m 30
reng 2m 135
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1620
pekerjaan
atap kuda-kuda 0 -
penutup atap 64.8 -
Urugan Pasir 2.43 -
beton sloof 0.9 -
10 kolom 0.675 -
balk 15x15 0.675 -
dinding bata 90 -
batako -
lantai 5cm 2.7 -
usuk 2 m 30 -
reng 2m 135 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 57.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 2.10 M³
-Batu Bata 750 5,000.00 Bh
-Batako 3,500 - Bh
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Paku 15,000 5.93 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
17,880,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 7.00 2.60
4.00 0.60 0.70 10.00 11.00
3.00 0.40 0.60 10.00 10.00
3.00 0.40 0.60 10.00 10.00
14.00 4.50 6,300.00
- - -
18.00 4.70
1.00 0.10 0.20
5 50 15.3 2.1 30 31 6300 0
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 7.00 2.60 - - - - -
- 4.00 0.60 0.70 10.00 11.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 14.00 4.50 - - - 5,000.00 -
- - - - - - - -
- 25.00 4.70 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 57 15.3 2.1 30 31 5000 0
REKAP VOL
- -
1,696,000.00 32.00
3,192,000.00 13.30
- -
2,040,000.00 30.00
1,125,000.00 30.00
588,000.00 2.10
3,750,000.00 5,000.00
- -
400,000.00 2.00
450,000.00 3.00
- #DIV/0!
700,000.00 2.00
600,000.00 3.00
- #DIV/0!
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
240,000.00 30.00
89,000.00 5.93
80,000.00 4.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
12.00 9
34.00 10
140.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
12 34 140 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - No
- - - - - - - 1
- - - - 3.00 - - -
0 0 0 2 3 2 3 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 57.00 zak 53,000
Pasir 15.30 m3 240,000
Batu Pecah 2.10 m3 280,000
Besi Ø 10 30.00 btg 68,000
Besi Ø 8 31.00 btg 37,500
Paku 5.93 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 41.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
3,021,000
3,672,000
588,000
2,040,000
1,162,500
-
-
3,750,000
240,000
89,000
-
-
-
-
-
15,637,500 15,000,000
(637,500)
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
16,887,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,173,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,157,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,407,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 6.00 Zak 53,000 318,000 159,000 159,000

-Pasir pasang 2.30 M³ 240,000 552,000 552,000 -
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu Pecah 0.60 M³ 280,000 168,000 168,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 2.00 Zak 53,000 106,000 106,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
V Dinding Permanen
1 Tembok 78.00 M²
-Pasir Pasang 5.70 M³ 240,000 1,368,000 1,368,000 -

-Semen @ 50 kg 17.00 Zak 53,000 901,000 901,000
-Batako 1,400.00 Bh 3,500 4,900,000 4,900,000 -
2 Pekerjaan Plester
-Pasir Pasang 4.10 M³ 240,000 984,000 984,000 -
-Semen @ 50 kg 16.00 Zak 53,000 848,000 - 848,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
-Usuk bambu - Btg 5,500 - - -
-Reng bambu - Btg 1,500 - -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.10 M³ 280,000 28,000 28,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 9.23 Kg 15,000 138,500 138,500 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 25,362,000 17,500,000 7,862,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 1.89
12 beton sloof 0.78
17 8 kolom 0.54
12 balk 15x15 0.585
17 dinding bata
58 batako 78
lantai 5cm 2.1
usuk 3 m 26
reng 3 m 105
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1260
pekerjaan
atap kuda-kuda 0 -
penutup atap 50.4 -
Urugan Pasir 1.89 -
beton sloof 0.78 -
8 kolom 0.54 -
balk 15x15 0.585 -
dinding bata 0 -
batako 78 -
lantai 5cm 2.1 -
usuk 3 m 26 -
reng 3 m 105 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 49.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 1.70 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,400.00 Bh
-Usuk bambu 5,500 - Btg
-Reng bambu 1,500 - Btg
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 9.23 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
17,562,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 6.00 2.30
4.00 0.50 0.60 9.00 10.00
2.00 0.40 0.50 8.00 8.00
3.00 0.40 0.50 9.00 9.00
- - -
17.00 5.70 975.00
16.00 4.10
1.00 0.10 0.10
5 49 15.5 1.7 26 27 0 975
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 6.00 2.30 - - - - -
- 4.00 0.50 0.60 9.00 10.00 - -
- 2.00 0.40 0.50 8.00 8.00 - -
- 3.00 0.40 0.50 9.00 9.00 - -
- - - - - - - -
- 17.00 5.70 - - - - 1,400.00
- 16.00 4.10 - - - - -
- 1.00 0.10 0.10 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 49 15.5 1.7 26 27 0 1400
REKAP VOL
- -
1,590,000.00 30.00
3,240,000.00 13.50
- -
1,768,000.00 26.00
937,500.00 25.00
476,000.00 1.70
- -
4,900,000.00 1,400.00
400,000.00 2.00
300,000.00 2.00
- #DIV/0!
700,000.00 2.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
138,500.00 9.23
100,000.00 5.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
9.00 9
30.00 10
110.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
9 30 110 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - No
- - - - - - - - 1
- - - - 2.00 - - -
0 0 0 2 2 2 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 49.00 zak 53,000
Pasir 15.50 m3 240,000
Batu Pecah 1.70 m3 280,000
Besi Ø 10 26.00 btg 68,000
Besi Ø 8 27.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 9.23 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 33.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
2,597,000
3,720,000
476,000
1,768,000
1,012,500
-
-
-
-
138,500
-
-
-
-
-
10,787,000 15,000,000
4,213,000
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
12,037,000
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
1,749,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
5,733,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
6,983,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 - 371,000

-Pasir pasang 2.60 M³ 240,000 624,000 - 624,000
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok 90.00 M²
-Pasir Pasang 6.50 M³ 240,000 1,560,000 1,560,000 -

-Semen @ 50 kg 20.00 Zak 53,000 1,060,000 1,060,000
-Batako 1,250.00 Bh 3,500 4,375,000 4,375,000 -
2 Pekerjaan Plester
-Pasir Pasang 4.70 M³ 240,000 1,128,000 1,128,000 -
-Semen @ 50 kg 18.00 Zak 53,000 954,000 795,000 159,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Usuk bambu - m 5,500 - - -
-Reng bambu - m 1,500 - - -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 5.00 Kg 15,000 75,000 75,000 -
Bendrat 8.05 Kg 20,000 161,000 161,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 25,509,000 17,500,000 8,009,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.43
12 beton sloof 0.9
17 10 kolom 0.675
12 balk 15x15 0.675
17 dinding bata
58 batako 90
lantai 5cm 2.7
usuk 3 m 30
reng 3 m 135
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1620
pekerjaan
atap kuda-kuda 0 -
penutup atap 64.8 -
Urugan Pasir 2.43 -
beton sloof 0.9 -
10 kolom 0.675 -
balk 15x15 0.675 -
dinding bata 0 -
batako 90 -
lantai 5cm 2.7 -
usuk 3 m 30 -
reng 3 m 135 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 56.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 2.10 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,250.00 Bh
-Usuk bambu 4m 5,500 - m
-Reng bambu 4m 1,500 - m
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 5.00 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019 0
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
17,709,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 7.00 2.60
4.00 0.60 0.70 10.00 11.00
3.00 0.40 0.60 10.00 10.00
3.00 0.40 0.60 10.00 10.00
- - -
20.00 6.50 1,125.00
18.00 4.70
1.00 0.10 0.20
5 56 17.3 2.1 30 31 0 1125
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 7.00 2.60 - - - - -
- 4.00 0.60 0.70 10.00 11.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- - - - - - - -
- 20.00 6.50 - - - - 1,250.00
- 18.00 4.70 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 56 17.3 2.1 30 31 0 1250
REKAP VOL
- -
2,438,000.00 46.00
3,048,000.00 12.70
- -
2,040,000.00 30.00
1,125,000.00 30.00
588,000.00 2.10
- -
4,375,000.00 1,250.00
400,000.00 2.00
- -
- #DIV/0!
700,000.00 2.00
- -
- #DIV/0!
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
75,000.00 5.00
161,000.00 8.05
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
8.00 9
34.00 10
140.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
8 34 140 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - No
- - - - - - - - 1
- - - - - - - - TOTAL TARIK TUNAI (B)
- - - - - - - -
0 0 0 2 0 2 0 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 56.00 zak 53,000
Pasir 17.30 m3 240,000
Batu Pecah 2.10 m3 280,000
Besi Ø 10 30.00 btg 68,000
Besi Ø 8 31.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 5.00 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 40.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
2,968,000
4,152,000
588,000
2,040,000
1,162,500
-
-
-
-
75,000
-
-
-
-
-
12,060,500 15,000,000
2,939,500
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
13,310,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,120,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,104,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,354,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 - 371,000

-Pasir pasang 2.60 M³ 240,000 624,000 - 624,000
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok 90.00 M²
-Pasir Pasang 6.50 M³ 240,000 1,560,000 1,560,000 -

-Semen @ 50 kg 20.00 Zak 53,000 1,060,000 477,000 583,000
-Batako 1,000.00 Bh 3,500 3,500,000 3,500,000 -
2 Pekerjaan Plester
-Pasir Pasang 4.70 M³ 240,000 1,128,000 - 1,128,000
-Semen @ 50 kg 18.00 Zak 53,000 954,000 - 954,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Kayu usuk, Ukuran 4/6 x 3 m 10.00 Btg 27,000 270,000 270,000 -
-Usuk bambu - m 5,500 - - -
-Reng bambu - m 1,500 - - -
-Genteng 1,500.00 Bh 1,250 1,875,000 1,875,000 -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 6.13 Kg 15,000 92,000 92,000 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 6.00 Bh 5,000 30,000 30,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 28,015,000 17,500,000 10,515,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.43
12 beton sloof 0.9
17 10 kolom 0.675
12 balk 15x15 0.675
17 dinding bata
58 batako 90
lantai 5cm 2.7
usuk 3 m 30
reng 3 m 135
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1620
pekerjaan
atap kuda-kuda 0 -
Urugan Pasir 2.43 -
beton sloof 0.9 -
10 kolom 0.675 -
balk 15x15 0.675 -
dinding bata 0 -
batako 90 -
lantai 5cm 2.7 -
usuk 3 m 30 -
reng 3 m 135 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 1500
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 56.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 2.10 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,000.00 Bh
-Kayu usuk, Ukuran 4/6 x 3 m 27,000 10.00 Btg
-Genteng 1,250 1,500.00 Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 6.13 Kg
15,000,000
- 0
0
........................................ .....2019 0
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
20,215,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 7.00 2.60
4.00 0.60 0.70 10.00 11.00
3.00 0.40 0.60 10.00 10.00
3.00 0.40 0.60 10.00 10.00
- - -
20.00 6.50 1,125.00
18.00 4.70
1.00 0.10 0.20
5 56 17.3 2.1 30 31 0 1125
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 7.00 2.60 - - - - -
- 4.00 0.60 0.70 10.00 11.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- - - - - - - -
- 20.00 6.50 - - - - 1,000.00
- 18.00 4.70 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 56 17.3 2.1 30 31 0 1000
REKAP VOL
- -
1,060,000.00 20.00
1,920,000.00 8.00
- -
2,040,000.00 30.00
1,125,000.00 30.00
588,000.00 2.10
- -
3,500,000.00 1,000.00
400,000.00 2.00
300,000.00 2.00
- #DIV/0!
700,000.00 2.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
600,000.00 6.00
- #DIV/0!
270,000.00 10.00
- -
- -
- -
1,875,000.00 1,500.00
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
92,000.00 6.13
100,000.00 5.00
30,000.00 6.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
12.00 9
34.00 10
140.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
12 34 140 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
6.00 - - - - - - - No
- - - - - - - - 1
- - - - 2.00 - - -
6 0 0 2 2 2 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 56.00 zak 53,000
Pasir 17.30 m3 240,000
Batu Pecah 2.10 m3 280,000
Besi Ø 10 30.00 btg 68,000
Besi Ø 8 31.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 6.13 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng 1,500.00 Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 40.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
2,968,000
4,152,000
588,000
2,040,000
1,162,500
-
-
-
-
92,000
-
-
-
1,875,000
-
13,952,500 15,000,000
1,047,500
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
15,202,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,120,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,104,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,354,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 - 371,000

-Pasir pasang 2.60 M³ 240,000 624,000 - 624,000
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok 90.00 M²
-Pasir Pasang 6.50 M³ 240,000 1,560,000 1,560,000 -

-Semen @ 50 kg 20.00 Zak 53,000 1,060,000 1,060,000 -
-Batako 1,600.00 Bh 3,500 5,600,000 5,600,000 -
2 Pekerjaan Plester
-Pasir Pasang 4.70 M³ 240,000 1,128,000 1,128,000 -
-Semen @ 50 kg 18.00 Zak 53,000 954,000 583,000 371,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Usuk bambu - m 5,500 - - -
-Reng bambu - m 1,500 - - -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 8.20 Kg 15,000 123,000 123,000 -
Bendrat 10.00 Kg 20,000 200,000 200,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 25,721,000 17,500,000 8,221,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.43
12 beton sloof 0.9
17 10 kolom 0.675
12 balk 15x15 0.675
17 dinding bata
58 batako 90
lantai 5cm 2.7
usuk 3 m 30
reng 3 m 135
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1620
pekerjaan
atap kuda-kuda 0 -
penutup atap 64.8 -
Urugan Pasir 2.43 -
beton sloof 0.9 -
10 kolom 0.675 -
balk 15x15 0.675 -
dinding bata 0 -
batako 90 -
lantai 5cm 2.7 -
usuk 3 m 30 -
reng 3 m 135 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 56.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 2.10 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,600.00 Bh
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 8.20 Kg
Bendrat 20,000 10.00 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019 0
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
17,921,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 7.00 2.60
4.00 0.60 0.70 10.00 11.00
3.00 0.40 0.60 10.00 10.00
3.00 0.40 0.60 10.00 10.00
- - -
20.00 6.50 1,125.00
18.00 4.70
1.00 0.10 0.20
5 56 17.3 2.1 30 31 0 1125
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 7.00 2.60 - - - - -
- 4.00 0.60 0.70 10.00 11.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- - - - - - - -
- 20.00 6.50 - - - - 1,600.00
- 18.00 4.70 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 56 17.3 2.1 30 31 0 1600
REKAP VOL
- -
2,226,000.00 42.00
3,048,000.00 12.70
- -
2,040,000.00 30.00
1,125,000.00 30.00
588,000.00 2.10
- -
5,600,000.00 1,600.00
- -
- -
- #DIV/0!
- -
- -
- #DIV/0!
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
123,000.00 8.20
200,000.00 10.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
12.00 9
34.00 10
140.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
12 34 140 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - No
- - - - - - - - 1
- - - - - - - -
0 0 0 0 0 0 0 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 56.00 zak 53,000
Pasir 17.30 m3 240,000
Batu Pecah 2.10 m3 280,000
Besi Ø 10 30.00 btg 68,000
Besi Ø 8 31.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 8.20 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 40.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
2,968,000
4,152,000
588,000
2,040,000
1,162,500
-
-
-
-
123,000
-
-
-
-
-
12,108,500 15,000,000
2,891,500
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
13,358,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,120,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,104,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,354,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 - 371,000

-Pasir pasang 2.60 M³ 240,000 624,000 - 624,000
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok 90.00 M²
-Pasir Pasang 6.50 M³ 240,000 1,560,000 1,560,000 -

-Semen @ 50 kg 20.00 Zak 53,000 1,060,000 1,060,000 -
-Batako 1,250.00 Bh 3,500 4,375,000 4,375,000 -
2 Pekerjaan Plester
-Pasir Pasang 4.70 M³ 240,000 1,128,000 480,000 648,000
-Semen @ 50 kg 18.00 Zak 53,000 954,000 106,000 848,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Kayu usuk, Ukuran 4/6 x 3 m 10.00 Btg 27,000 270,000 270,000 -
-Usuk bambu - m 5,500 - - -
-Reng bambu - m 1,500 - - -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 - 53,000

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 5.07 Kg 15,000 76,000 76,000 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 6.00 Bh 5,000 30,000 30,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 26,899,000 17,500,000 9,399,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.43
12 beton sloof 0.9
17 10 kolom 0.675
12 balk 15x15 0.675
17 dinding bata
58 batako 90
lantai 5cm 2.7
usuk 3 m 30
reng 3 m 135
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1620
pekerjaan
atap kuda-kuda 0 -
penutup atap 64.8 -
Urugan Pasir 2.43 -
beton sloof 0.9 -
10 kolom 0.675 -
balk 15x15 0.675 -
dinding bata 0 -
batako 90 -
lantai 5cm 2.7 -
usuk 3 m 30 -
reng 3 m 135 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 56.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 2.10 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,250.00 Bh
-Kayu usuk, Ukuran 4/6 x 3 m 27,000 10.00 Btg
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 5.07 Kg
15,000,000
- 0
0
........................................ .....2019 0
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
19,099,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 7.00 2.60
4.00 0.60 0.70 10.00 11.00
3.00 0.40 0.60 10.00 10.00
3.00 0.40 0.60 10.00 10.00
- - -
20.00 6.50 1,125.00
18.00 4.70
1.00 0.10 0.20
5 56 17.3 2.1 30 31 0 1125
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 7.00 2.60 - - - - -
- 4.00 0.60 0.70 10.00 11.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- - - - - - - -
- 20.00 6.50 - - - - 1,250.00
- 18.00 4.70 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 56 17.3 2.1 30 31 0 1250
REKAP VOL
- -
1,696,000.00 32.00
2,400,000.00 10.00
- -
2,040,000.00 30.00
1,125,000.00 30.00
588,000.00 2.10
- -
4,375,000.00 1,250.00
400,000.00 2.00
300,000.00 2.00
- #DIV/0!
700,000.00 2.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
500,000.00 5.00
- #DIV/0!
270,000.00 10.00
- -
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
76,000.00 5.07
100,000.00 5.00
30,000.00 6.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
12.00 9
34.00 10
140.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
12 34 140 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5.00 - - - - - - - No
- - - - - - - - 1
- - - - 2.00 - - -
5 0 0 2 2 2 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 56.00 zak 53,000
Pasir 17.30 m3 240,000
Batu Pecah 2.10 m3 280,000
Besi Ø 10 30.00 btg 68,000
Besi Ø 8 31.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 5.07 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 40.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
2,968,000
4,152,000
588,000
2,040,000
1,162,500
-
-
-
-
76,000
-
-
-
-
-
12,061,500 15,000,000
2,938,500
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
13,311,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,120,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,104,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,354,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 371,000 -

-Pasir pasang 2.60 M³ 240,000 624,000 624,000 -
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok - M²
-Pasir Pasang 4.50 M³ 240,000 1,080,000 1,080,000 -

-Semen @ 50 kg 14.00 Zak 53,000 742,000 742,000
-Batu Bata 4,000.00 Bh 750 3,000,000 3,000,000 -
-Batako - Bh 3,500 - - -
2 Pekerjaan Plester
-Pasir Pasang 4.70 M³ 240,000 1,128,000 480,000 648,000
-Semen @ 50 kg 25.00 Zak 53,000 1,325,000 424,000 901,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Genteng 1,600.00 Bh 1,250 2,000,000 2,000,000 -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 3.20 Kg 15,000 48,000 48,000 -
Bendrat 3.00 Kg 20,000 60,000 60,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 26,279,000 17,500,000 8,779,000
........................................ ....
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.43
12 beton sloof 0.9
17 10 kolom 0.675
12 balk 15x15 0.675
17 dinding bata 90
58 batako
lantai 5cm 2.7
usuk 2 m 30
reng 2m 135
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1620
pekerjaan
atap kuda-kuda 0 -
Urugan Pasir 2.43 -
beton sloof 0.9 -
10 kolom 0.675 -
balk 15x15 0.675 -
dinding bata 90 -
batako -
lantai 5cm 2.7 -
usuk 2 m 30 -
reng 2m 135 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 1600
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 57.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 2.10 M³
-Batu Bata 750 4,000.00 Bh
-Batako 3,500 - Bh
-Genteng 1,250 1,600.00 Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 3.20 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
18,479,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 7.00 2.60
4.00 0.60 0.70 10.00 11.00
3.00 0.40 0.60 10.00 10.00
3.00 0.40 0.60 10.00 10.00
14.00 4.50 6,300.00
- - -
18.00 4.70
1.00 0.10 0.20
5 50 15.3 2.1 30 31 6300 0
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 7.00 2.60 - - - - -
- 4.00 0.60 0.70 10.00 11.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 14.00 4.50 - - - 4,000.00 -
- - - - - - - -
- 25.00 4.70 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 57 15.3 2.1 30 31 4000 0
REKAP VOL
- -
2,120,000.00 40.00
2,544,000.00 10.60
- -
2,040,000.00 30.00
750,000.00 20.00
588,000.00 2.10
3,000,000.00 4,000.00
- -
400,000.00 2.00
300,000.00 2.00
- #DIV/0!
700,000.00 2.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
2,000,000.00 1,600.00
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
48,000.00 3.20
60,000.00 3.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
8.00 9
34.00 10
140.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
8 34 140 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - No
- - - - - - - 1
- - - - 2.00 - - -
0 0 0 2 2 2 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 57.00 zak 53,000
Pasir 15.30 m3 240,000
Batu Pecah 2.10 m3 280,000
Besi Ø 10 30.00 btg 68,000
Besi Ø 8 31.00 btg 37,500
Gamping - zak 8,000
Paku 3.20 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng 1,600.00 Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 41.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
3,021,000
3,672,000
588,000
2,040,000
1,162,500
-
-
3,000,000
-
48,000
-
-
-
2,000,000
-
16,606,500 15,000,000
(1,606,500)
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
17,856,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,173,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,157,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,407,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 2.00 M³ 240,000 480,000 - 480,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 - 371,000

-Pasir pasang 2.40 M³ 240,000 576,000 - 576,000
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok 84.00 M²
-Pasir Pasang 6.10 M³ 240,000 1,464,000 1,464,000 -

-Semen @ 50 kg 19.00 Zak 53,000 1,007,000 1,007,000 -
-Batako 1,050.00 Bh 3,500 3,675,000 3,675,000 -
2 Pekerjaan Plester
-Pasir Pasang 4.40 M³ 240,000 1,056,000 1,056,000 -
-Semen @ 50 kg 17.00 Zak 53,000 901,000 265,000 636,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
-Usuk bambu 140.00 m 5,500 770,000 770,000 -
-Reng bambu 240.00 m 1,500 360,000 360,000 -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 3.27 Kg 15,000 49,000 49,000 -
Bendrat 3.00 Kg 20,000 60,000 60,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 25,938,000 17,500,000 8,438,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.16
12 beton sloof 0.84
17 10 kolom 0.675
12 balk 15x15 0.63
17 dinding bata
58 batako 84
lantai 5cm 2.4
usuk 3 m 28
reng 3 m 120
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1440
pekerjaan
atap kuda-kuda 0 -
penutup atap 57.6 -
Urugan Pasir 2.16 -
beton sloof 0.84 -
10 kolom 0.675 -
balk 15x15 0.63 -
dinding bata 0 -
batako 84 -
lantai 5cm 2.4 -
usuk 3 m 28 -
reng 3 m 120 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 54.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 2.00 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,050.00 Bh
-Usuk bambu 4m 5,500 140.00 m
-Reng bambu 4m 1,500 240.00 m
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 3.27 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019 0
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
18,138,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
2.00
5.00 7.00 2.40
4.00 0.50 0.70 10.00 10.00
3.00 0.40 0.60 10.00 10.00
3.00 0.40 0.50 10.00 10.00
- - -
19.00 6.10 1,050.00
17.00 4.40
1.00 0.10 0.20
5 54 16.3 2 30 30 0 1050
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 2.00 - - - - -
5.00 7.00 2.40 - - - - -
- 4.00 0.50 0.70 10.00 10.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.40 0.50 10.00 10.00 - -
- - - - - - - -
- 19.00 6.10 - - - - 1,050.00
- 17.00 4.40 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 54 16.3 2 30 30 0 1050
REKAP VOL
- -
1,855,000.00 35.00
2,856,000.00 11.90
- -
2,040,000.00 30.00
1,125,000.00 30.00
560,000.00 2.00
- -
3,675,000.00 1,050.00
- -
- -
- #DIV/0!
- -
- -
- #DIV/0!
- #DIV/0!
- -
- -
1,600,000.00 16.00
- #DIV/0!
- -
770,000.00 140.00
360,000.00 240.00
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
49,000.00 3.27
60,000.00 3.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
10.00 9
32.00 10
124.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
10 32 124 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
16.00 - - - - - - - No
- 140.00 - - - - - - 1
- - - - - - - -
16 140 240 0 0 0 0 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 54.00 zak 53,000
Pasir 16.30 m3 240,000
Batu Pecah 2.00 m3 280,000
Besi Ø 10 30.00 btg 68,000
Besi Ø 8 30.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 3.27 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 38.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
2,862,000
3,912,000
560,000
2,040,000
1,125,000
-
-
-
-
49,000
-
-
-
-
-
11,623,000 15,000,000
3,377,000
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
12,873,000
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,014,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
5,998,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,248,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 3.00 M³ 240,000 720,000 - 720,000
-Semen @ 50 kg 8.00 Zak 53,000 424,000 - 424,000

-Pasir pasang 2.80 M³ 240,000 672,000 - 672,000
-Batu Kali 6.00 M³ 215,000 1,290,000 - 1,290,000
III Pekerjaan Sloof
-Semen @ 50 kg 5.00 Zak 53,000 265,000 265,000 -
-Pasir pasang 0.60 M³ 240,000 144,000 144,000 -
-Batu Pecah 0.80 M³ 280,000 224,000 224,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
V Dinding Permanen
1 Tembok 96.00 M²
-Pasir Pasang 7.00 M³ 240,000 1,680,000 1,680,000 -

-Semen @ 50 kg 22.00 Zak 53,000 1,166,000 1,166,000 -
-Batako 1,300.00 Bh 3,500 4,550,000 4,550,000 -
2 Pekerjaan Plester
-Pasir Pasang 5.00 M³ 240,000 1,200,000 1,200,000 -
-Semen @ 50 kg 19.00 Zak 53,000 1,007,000 1,007,000 -
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu pecah 0.60 M³ 280,000 168,000 168,000 -
-Usuk bambu - m 5,500 - - -
-Reng bambu - m 1,500 - - -
-Genteng - Bh 1,250 - - -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.20 M³ 280,000 56,000 56,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 3.27 Kg 15,000 49,000 49,000 -
Bendrat 3.00 Kg 20,000 60,000 60,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 25,642,500 17,236,500 8,406,000
........................................ .....20
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 2.88
12 beton sloof 0.96
17 10 kolom 0.675
12 balk 15x15 0.72
17 dinding bata
58 batako 96
lantai 5cm 3.2
usuk 3 m 32
reng 3 m 160
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1920
pekerjaan
atap kuda-kuda 0 -
penutup atap 76.8 -
Urugan Pasir 2.88 -
beton sloof 0.96 -
10 kolom 0.675 -
balk 15x15 0.72 -
dinding bata 0 -
batako 96 -
lantai 5cm 3.2 -
usuk 3 m 32 -
reng 3 m 160 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 0
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 61.00 Zak
-Batu Kali 215,000 6.00 M³
-Batu pecah 280,000 2.20 M³
-Batu Bata 750 - Bh
-Batako 3,500 1,300.00 Bh
-Genteng 1,250 - Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 3.27 Kg
Loster 5,000 10.00 Bh
14,736,500
263,500 351.3333333333
17.5666666667
........................................ .....2019 13.175
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
17,842,500 14,736,500
14,736,500
( ....................................)
263,500
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
3.00
6.00 8.00 2.80
5.00 0.60 0.80 11.00 12.00
3.00 0.40 0.60 10.00 10.00
3.00 0.50 0.60 11.00 11.00
- - -
22.00 7.00 1,200.00
19.00 5.00
1.00 0.10 0.20
6 61 19.4 2.2 32 33 0 1200
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 3.00 - - - - -
6.00 8.00 2.80 - - - - -
- 5.00 0.60 0.80 11.00 12.00 - -
- 3.00 0.40 0.60 10.00 10.00 - -
- 3.00 0.50 0.60 11.00 11.00 - -
- - - - - - - -
- 22.00 7.00 - - - - 1,300.00
- 19.00 5.00 - - - - -
- 1.00 0.10 0.20 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
6 61 19.4 2.2 32 33 0 1300
REKAP VOL
- -
2,809,000.00 53.00
3,264,000.00 13.60
- -
2,176,000.00 32.00
1,162,500.00 31.00
616,000.00 2.20
- -
4,550,000.00 1,300.00
- -
- -
- #DIV/0!
- -
- -
- #DIV/0!
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
49,000.00 3.27
60,000.00 3.00
50,000.00 10.00
- #DIV/0!
14,736,500.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
10.00 9
36.00 10
164.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
10 36 164 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - No
- - - - - - - - 1
- - - - - - - -
0 0 0 0 0 0 0 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 6.00 m3 215,000
Semen 61.00 zak 53,000
Pasir 19.40 m3 240,000
Batu Pecah 2.20 m3 280,000
Besi Ø 10 32.00 btg 68,000
Besi Ø 8 33.00 btg 37,500
Batu Bata - bh 750
Gamping - zak 8,000
Paku 3.27 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng - Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 45.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,290,000
3,233,000
4,656,000
616,000
2,176,000
1,237,500
-
-
-
-
49,000
-
-
-
-
-
13,257,500 14,736,500
1,479,000
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
14,507,500
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,385,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
6,369,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,619,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Nomor BNBA :
Nomor KTP :
Alamat :
Desa/Kelurahan :
Kecamatan :
Kabupaten/Kota :
Jenis Kegiatan :
SUMBER DANA
Dana Tunai

2 Urugan Pasir 1.00 M³ 240,000 240,000 - 240,000
-Semen @ 50 kg 7.00 Zak 53,000 371,000 - 371,000

-Pasir pasang 2.40 M³ 240,000 576,000 - 576,000
-Batu Kali 5.00 M³ 215,000 1,075,000 - 1,075,000
III Pekerjaan Sloof
-Semen @ 50 kg 4.00 Zak 53,000 212,000 212,000 -
-Pasir pasang 0.50 M³ 240,000 120,000 120,000 -
-Batu Pecah 0.70 M³ 280,000 196,000 196,000 -
IV Pekerjaan Kolom

-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Semen @ 50 kg 2.00 Zak 53,000 106,000 106,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
V Dinding Permanen
1 Tembok - M²
-Pasir Pasang 4.20 M³ 240,000 1,008,000 1,008,000 -

-Semen @ 50 kg 13.00 Zak 53,000 689,000 689,000
-Batu Bata 6,000.00 Bh 750 4,500,000 4,500,000 -
-Batako - Bh 3,500 - - -
2 Pekerjaan Plester
-Pasir Pasang 4.40 M³ 240,000 1,056,000 1,056,000 -
-Semen @ 50 kg 24.00 Zak 53,000 1,272,000 371,000 901,000
3 Papan
VII Ring Balok
-Semen @ 50 kg 3.00 Zak 53,000 159,000 159,000 -
-Pasir pasang 0.40 M³ 240,000 96,000 96,000 -
-Batu pecah 0.50 M³ 280,000 140,000 140,000 -
-Usuk bambu 240.00 Btg 5,500 1,320,000 1,320,000 -
-reng bambu - Btg 1,500 - -
-Genteng 500.00 Bh 1,250 625,000 625,000 -
2 Bubungan Atap Bh
-Seng Lbr - - -
X Pekerjaan Lantai
-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Pasir pasang 0.10 M³ 240,000 24,000 24,000 -
-Batu pecah 0.10 M³ 280,000 28,000 28,000 -
2 Lantai Papan M²

XI MCK
-Kran - Bh 25,000 - - -
Paku 5.47 Kg 15,000 82,000 82,000 -
Bendrat 5.00 Kg 20,000 100,000 100,000 -
Loster 10.00 Bh 5,000 50,000 50,000 -
XIII Upah Kerja
Tukang 60.00 Oh 70,000 4,200,000 2,500,000 1,700,000
JUMLAH 26,263,000 17,500,000 8,763,000
........................................ ....
(.........................................) ( ....................................) ( ....................................)

( ...............................................) ( ....................................)
NIP..........................................
FORMAT III-17

SWADAYA pekerjaan
Memakai Bahan
Urugan Pasir 1.8
12 beton sloof 0.84
17 8 kolom 0.54
12 balk 15x15 0.63
17 dinding bata 84
58 batako
lantai 5cm 2
usuk 2 m 28
reng 2m 100
jendela 1
jendela 1
pintu kmr 1
SWADAYA JUMLAH 1200
pekerjaan
atap kuda-kuda 0 -
penutup atap 48 500.00
Urugan Pasir 1.8 -
beton sloof 0.84 -
8 kolom 0.54 -
balk 15x15 0.63 -
dinding bata 84 -
batako -
lantai 5cm 2 -
usuk 2 m 28 -
reng 2m 100 -
jendela 1 -
jendela 1 -
pintu kmr 1 -
JUMLAH 500
SWADAYA
HARGA
MATERIAL VOL SATUAN
SATUAN
-Semen @ 50 kg 53,000 54.00 Zak
-Batu Kali 215,000 5.00 M³
-Batu pecah 280,000 1.80 M³
-Batu Bata 750 6,000.00 Bh
-Batako 3,500 - Bh
-Usuk bambu 5,500 240.00 Btg
-reng bambu 1,500 - Btg
-Genteng 1,250 500.00 Bh
-Seng - - Lbr
-Kran 25,000 - Bh
Gamping 8,000 - Zak
Paku 15,000 5.47 Kg
Loster 5,000 10.00 Bh
15,000,000
- 0
0
........................................ .....2019
Diajukan Oleh,
Penerima Bantuan
( ....................................)
Diverifikasi Oleh,
18,463,000 15,000,000
15,000,000
( ....................................)
-
4
20.25 1.0888888889 4.549 0.45
24.25 0.0108888889
1.00
5.00 7.00 2.40
4.00 0.50 0.70 10.00 10.00
2.00 0.40 0.50 8.00 8.00
3.00 0.40 0.50 10.00 10.00
13.00 4.20 5,880.00
- - -
17.00 4.40
1.00 0.10 0.10
5 47 13.4 1.8 28 28 5880 0
- - - - - - - -
- - - - - - - -
- - - - - - - -
- 1.00 - - - - -
5.00 7.00 2.40 - - - - -
- 4.00 0.50 0.70 10.00 10.00 - -
- 2.00 0.40 0.50 8.00 8.00 - -
- 3.00 0.40 0.50 10.00 10.00 - -
- 13.00 4.20 - - - 6,000.00 -
- - - - - - - -
- 24.00 4.40 - - - - -
- 1.00 0.10 0.10 - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
5 54 13.4 1.8 28 28 6000 0
REKAP VOL
- -
1,590,000.00 30.00
2,400,000.00 10.00
- -
1,904,000.00 28.00
675,000.00 18.00
504,000.00 1.80
4,500,000.00 6,000.00
- -
200,000.00 1.00
300,000.00 2.00
- #DIV/0!
350,000.00 1.00
400,000.00 2.00
- #DIV/0!
- #DIV/0!
- -
- -
- -
- #DIV/0!
- -
1,320,000.00 240.00
- -
- -
625,000.00 500.00
- #DIV/0!
- -
- -
- -
- -
- -
- -
- -
82,000.00 5.47
100,000.00 5.00
50,000.00 10.00
- #DIV/0!
15,000,000.00
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan

No.
1
2
3
4
5
6
7
8
13.00 9
32.00 10
104.00 11
1.00 12
1.00 13
1.00 14
1.00 15
1.00 16
13 32 104 1 1 1 1 1

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - - No
- 240.00 - - - - - - 1
- - - - 2.00 - - -
0 240 0 1 2 1 2 0
disahkan oleh:
( .....................................
NIP.................................
DA
Nomor BNBA
Nomor KTP
Alamat
Desa/Kelurahan
Kecamatan
Kabupaten/Kota

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

Disanggupi oleh :

No
1

disahkan oleh:
( .....................................
NIP.................................

Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Batu belah 5.00 m3 215,000
Semen 54.00 zak 53,000
Pasir 13.40 m3 240,000
Batu Pecah 1.80 m3 280,000
Besi Ø 10 28.00 btg 68,000
Besi Ø 8 28.00 btg 37,500
Gamping - zak 8,000
Paku 5.47 Kg 15,000
Bendrat - Kg 22,000
Loster - Bh 7,000
Genteng 500.00 Bh 1,250

Disanggupi oleh :

(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH

( ...............................................) ( ....................................) (.........................................)

NIP..........................................
Nomor BNBA : 0
Nomor KTP : 0
Alamat : 0
Desa/Kelurahan : 0
Kecamatan : 0
Kabupaten/Kota : 0

(unit) (Rp)
Semen 38.00 zak 53,000
Pasir 6 m3 240,000
Besi Ø 10 25 btg 68,000
Besi Ø 8 0 btg 37,500
Gamping 0 zak 8,000
Paku 0.0 Kg 15,000
Bendrat 0 Kg 22,000
Loster 0 Bh 7,000

Disanggupi oleh :
(..................................................)


........................................ .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
( ...............................................) ( ....................................) (.........................................)

NIP..........................................

Format IV - 2
HAP 1
Jumlah Harga
(Rp)
1,075,000
2,862,000
3,216,000
504,000
1,904,000
1,050,000
-
-
4,500,000
-
82,000
-
-
-
625,000
-
15,818,000 15,000,000
(818,000)
edia Bahan Bangunan

.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
17,068,000
........................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)
Format IV - 2
HAP 2
Jumlah Harga
(Rp)
-
2,014,000
1,440,000
-
1,700,000
-
-
-
525,000
-
129,000
-
-
190,000
5,998,000
edia Bahan Bangunan
.................................)
Jumlah harga (Rp)

1,250,000
1,250,000
7,248,000
..................................... .....2019
Diajukan Oleh :
Penerima Bantuan
MUH SHOLEH
Difasilitasi Oleh :
.......................................)

Rab Fix Bandongan

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DAFTAR HARGA MATERIAL

SATUAN STANDART HARGA KABUPATEN

1 Semen @ 50 Kg Zak 53,000

1 Galian Tanah Pondasi 7.20 M³ - - - -

3 Pasangan Pondasi 4.68 M³ - -

-Semen @ 50 kg 8.00 Zak 53,000 424,000 424,000 -

-Besi beton Φ 10 mm SNI 10.00 Btg 68,000 680,000 680,000 -

-Pasir Pasang 4.80 M³ 240,000 1,152,000 1,152,000 -

-Semen @ 50 kg 1.00 Zak 53,000 53,000 53,000 -

-Papan, Ukuran……….. - Lbr - - - -

JUMLAH 31,603,600 18,130,600 13,473,000

(.........................................) ( ....................................) ( ....................................)

Disahkan oleh, Diverifikasi Oleh,

PANJANG LEBAR KELL VOL M2

batu semen pasir spit bes 10 besi 8 bata batako

6 54 17.2 2.2 32 33 6720 0

batu semen pasir spit bes 10 besi 8 bata batako

A. Jumlah Dana yang ditr

kayu kusen daun TOTAL HARGA PEMBELIAN

*) coret yang tidak perlu

A. Jumlah Dana yang ditr

TOTAL HARGA PEMBELIAN

B. Jumlah dana yang dita

C. Total dana yang ditarik (

*) coret yang tidak perlu

A. Jumlah Dana yang ditransfer ke Toko/Penyedia Bahan Bangunan (Tahap I/II *)

TOTAL HARGA PEMBELIAN

Toko/Penyedia Bahan Bangunan

B. Jumlah dana yang ditarik tunai untuk upah kerja (Tahap I / II *)

C. Total dana yang ditarik ( A + B )

disahkan oleh: Diverifikasi oleh: Difasilitasi Oleh :

( ...............................................) ( ....................................) (.........................................)

*) coret yang tidak perlu

DAFTAR RENCANA PEMANFAATAN BANTUAN (DRPB) TAHAP 2

A. Jumlah Dana yang ditransfer ke Toko/Penyedia Bahan Bangunan (Tahap I/II *)

TOTAL HARGA PEMBELIAN

Toko/Penyedia Bahan Bangunan

B. Jumlah dana yang ditarik tunai untuk upah kerja (Tahap I / II *)

C. Total dana yang ditarik ( A + B )

( ...............................................) ( ....................................) (.........................................)

*) coret yang tidak perlu

edia Bahan Bangunan

Jumlah harga (Rp)

edia Bahan Bangunan

Jumlah harga (Rp)

1 Galian Tanah Pondasi 6.30 M³ - - - -

3 Pasangan Pondasi 4.10 M³ - -

-Semen @ 50 kg 7.00 Zak 53,000 371,000 371,000 -

-Besi beton Φ 10 mm SNI 8.00 Btg 68,000 544,000 544,000 -

-Pasir Pasang 6.10 M³ 240,000 1,464,000 1,464,000 -

-Semen @ 50 kg 1.00 Zak 53,000 53,000 - 53,000

-Papan, Ukuran……….. - Lbr - - - -

JUMLAH 26,365,000 17,500,000 8,865,000

(.........................................) ( ....................................) ( ....................................)

Disahkan oleh, Diverifikasi Oleh,

PANJANG LEBAR KELL VOL M2

batu semen pasir spit bes 10 besi 8 bata batako

5 53 16.3 1.9 28 28 0 1050

batu semen pasir spit bes 10 besi 8 bata batako

A. Jumlah Dana yang ditr

kayu kusen daun TOTAL HARGA PEMBELIAN

*) coret yang tidak perlu

A. Jumlah Dana yang ditr