REQUEST FOR PAYMENT

REQUEST FOR CASH ADVANCE

REIMBURSEMENT

Date: 30-Apr-19

Pay to Payment Type :

Position Cash
Acc. No. Bank Transfer

Purpose

Project :

Date Particulars Type Amount Charge to

Total Rp -

Prepared by, Reviewed by, Reviewed by, Approved by

Lutfi Octa Rudhi Bualangi Retno Sih Wulandari Andri Gunawan

Logistic Officer Project Coordinator Finance Officer Branch Manager

Peyment Allocation :
Petty Cash Cash
Bank
Bank Account _____________
Cheque Number _____________
 T E R (Travel Expense Report)
TER No.

Tick the appropriate box

Employee Name : Lutfi Octa Training/Workshop Coordination Meeting E & M Emergency

Department : Program Department Office Setup Local Meeting v Other
Date Prepared : NBOT Meeting E & M Regular IDR Currency
Purpose : Material Proyek Mojokerto
Detail : Material Proyek Mojokerto
For Coding Purpose
Repairs &
Bank
Maintenan
No. Date Doc Description Gr Trans Fuel Meals Phone Supplies CIP Charges Charging to
ce
573001 573101 573301 567001 551001 140101 556501 562001
1
2
3
4
5
6
7
8
9
10

Grand Total 0 0 0 0 0 0 0 0
Total T E R 0 Prepared by Reviewed by Approved by
Advance
Refund (Reimburshe) 0

Lutfi Octa Retnosih Wulandari Andri Gunawan

 PURCHASE ORDER
Kraton WaterPark Jln.Baypass Krian Sidoarjo
Kepada :
Bpk Djuned Order No. :
Attn:Bpk Djuned Date : : 15-Nov-2019
Credit Delivery Date: : 18-Nov-2019

Alamat pengiriman
Kraton Waterpark Krian Sidoarjo

Invty
No Description of Goods / Nama Material QTY Uom Unit Price (Rp) Amount (Rp)
Code

PURCHASE ORDER
Kraton WaterPark Jln.Baypass Krian Sidoarjo
Kepada :
Bpk Djuned Order No. :
Attn:Bpk Djuned Date : : 15-Nov-2019
Credit
Delivery Date: : 18-Nov-2019

Alamat pengiriman
Kraton Waterpark Krian Sidoarjo

Invty
No Description of Goods / Nama Material QTY Uom Unit Price (Rp) Amount (Rp)
Code
1 Tawas Powder 6 Sak 203500 1,221,000
2 H2O2 4 Jerigen 528000 2,112,000
Kaporit 1 Jerigen 610500 610,500
4 HCL 2.5 Jerigen 110000 275,000
5 Sodium Hypo 1 Jerigen 250000 250,000
6 Soda As 0.5 Sak 400000 200,000
7
8 -
9 -
10 -
11 -
12 -
13 -
14 -
15 -
16 -
Remarks
Chemical Maintenance Pool
Total 4,668,500

Prepared by, Approved by, Acknowledge By

1
 PURCHASE ORDER
Kraton WaterPark Jln.Baypass Krian Sidoarjo
Kepada :
Bpk Djuned Order No. :
Attn:Bpk Djuned Date : : 15-Nov-2019
Credit Delivery Date: : 18-Nov-2019

Alamat pengiriman
Kraton Waterpark Krian Sidoarjo

Invty
No Description of Goods / Nama Material QTY Uom Unit Price (Rp) Amount (Rp)
Code
Lutfi Octa Tavib Ganggawati
Finance Manager Bpk Djuned
Date : Date :
Payment terms:
Transfer Credit
Catatan : Jadwal pengiriman barang sesuai koordinasi dengan staf Kolam
031 99893834

2
 PURCHASE ORDER
Kraton WaterPark Jln.Baypass Krian Sidoarjo
Kepada :
Bpk Imam Order
:
No.
Attn:Bpk Imam Date : : 15-Nov-2019
Credit Delivery
: 17-Nov-2019
Date:

Alamat pengiriman
Kraton Waterpark Krian Sidoarjo

Invty Description of Goods / Nama Amount

No QTY Uom Unit Price (Rp)
Code Material (Rp)
1 Tawas Powder 12 Sak 225000 2,700,000
2 H2O2 3 Jerigen 475000 1,425,000
4 HCL 12 Jerigen 100000 1,200,000
6
7 -
8 -
9 -
10 -
11 -
12 -
13 -
14 -
15 -
Remarks
Chemical Maintenance Pool
Total 5,325,000

Prepared by, Approved by, Acknowledge By

Lutfi Octa Tavib Ganggawati

Finance Manager Bpk Imam
Date : Date :
Payment terms:
Transfer Credit
Catatan : Jadwal pengiriman barang sesuai koordinasi dengan staf Kolam
031 99893834
 PURCHASE ORDER
Kraton WaterPark Jln.Baypass Krian Sidoarjo
Kepada :
Order
Bpk Djuned :
No.
Attn:Bpk Djuned Date : : 15-Nov-2019
Credit Delivery
: 18-Nov-2019
Date:

Alamat pengiriman
Kraton Waterpark Krian Sidoarjo

Invty Description of Goods / Nama

No QTY Uom Unit Price (Rp) Amount (Rp)
Code Material
1 Tawas Powder 6 Sak 203500 1,221,000
2 H2O2 4 Jerigen 528000 2,112,000
Kaporit 1 Jerigen 610500 610,500
4 HCL 2 Jerigen 110000 220,000
5 Sodium Hypo 1 Jerigen 250000 250,000
6 -
7
8 -
9 -
10 -
11 -
12 -
13 -
14 -
15 -
16 -
Remarks
Chemical Maintenance Pool
Total 4,413,500

Prepared by, Approved by, Acknowledge By

Lutfi Octa Tavib Ganggawati

Finance Manager Bpk Djuned
Date : Date :
Payment terms:
Transfer Credit
Catatan : Jadwal pengiriman barang sesuai koordinasi dengan staf Kolam
031 99893834
 DOWN PAYMENT REQUEST TO SUPPLIER

HABITAT FOR HUMANITY INDONESIA

Rungkut Asri 9 no 11
SURABAYA

1. Name of Supplier : UD. Kastim

2. Bank Name : none
3. Bank Account Name: none
4. Bank Account Numb: none
5. Project : Tegalsari
5. Donor Project : ID00800
6. Date Fund Needed :

Quant
NO DESCRIPTION TIMES PRICE TOTAL
ity
1 Bata 3000 1 600.00 ###
2 Kerikil 18 1 65,000.00 ###
3 Pasir 30 1 37,000.00 ###
-
-
-
-
-
-
-
-
-
-
-
TOTAL ###

Logistic Officer Project Coordinator Branch Manager

Lutfi Octa Rudhi Virgarius Bualangi Andri Gunawan

 Laporan Keuangan Project Gresik

GRESIK HOUSE UPGRADING PROJECT

Habitat For Humanity Surabaya
Surabaya Branch
Perum Rungkut Asri IX/11 Surabaya, Jawa Timur

No House : 3
Site : Manyar Komplek

Home Partner : Dewi Juariah

Start : 31-Oct-2014
Finish :
Project Location : Manyarsidorukun, Manyar, Gresik.
PAYMENT
No PARTICULARS Date AMOUNT TO
TRANSFER CASH
1 Order Pertama 13-Oct-14 Rp 700,000.00 Yulia
2 Pasir, Paku, Kawat, Benang 31-Oct-14 Rp 222,000.00 WB
3 Bata Rise 300 Buah 3-Nov-14 Rp 390,000.00 AP
4 Paku 3'' 31-Oct-14 Rp 15,000.00 Anugrah
5 Order Kedua 22-Oct-14 Rp 2,490,000.00 Yulia
6 Bata Rise 300 Buah & Pasir 7-Nov-14 Rp 1,110,000.00 RT
7 Order Ketiga 5-Nov-14 Rp 1,575,000.00 Yulia
8 Fibersement Eter 180x80 7-Nov-14 Rp 1,404,000.00 555
9 Kayu Glugu 6/12 13-Nov-14 Rp 50,000.00 Suhar
10 Kayu MC 5/7 13-Nov-14 Rp 649,998.00 Suhar
11 Paku Payung & Karet 20-Nov-14 Rp 41,500.00 Sriwijaya
12 Paku 1/2'',3'',4'' 20-Nov-14 Rp 50,000.00 Sriwijaya
13 Engsel Pintu & Jendela 27-Nov-14 Rp 12,500.00 AU
14 Order Keempat 3-Dec-14 Rp 1,000,000.00 Yulia
15 Pasir & Semen 17-Dec-14 Rp 408,000.00 RT
16 Pasang Instalasi dari Tetangga 17-Dec-14 Rp 150,000.00 DEWI
17
18
19
20
21
Total Pengeluaran Saat Ini Rp 10,267,998.00
Dana Yang Ada Rp 22,500,000.00
Kontrak Tukang Rp 4,000,000.00
Dana Material Rp 18,500,000.00
Sisa Dana Rp 8,232,002.00
Prepared By Reviewed By Approved By
Friand Alif Arba' A. Wulan/Wiro Andri Gunawan
Const. Spv Finance Branch Manager
ya, Jawa Timur
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