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United Nations Population Fund

7th Floor Menara Thamrin


Jl. M.H. Thamrin Kav.3, Jakarta 10250
E-mail: indonesia.office@unfpa.org
Website: indonesia.unfpa.org

Date: 4 February 2019

REQUEST FOR QUOTATION


RFQ Nº UNFPA/IDN/RFQ/19/004

Dear Sir/Madam,

UNFPA hereby solicits a quotation for the following service:

Packaging and Shipping


*Details list please see annex IV

This Request for Quotation is open to all legally-constituted companies that can provide the requested
services and have legal capacity to perform in the country, or through an authorized representative.

I. About UNFPA
UNFPA, the United Nations Population Fund (UNFPA), is an international development agency that works to
deliver a world where every pregnancy is wanted, every child birth is safe and every young person’s potential
is fulfilled.

UNFPA is the lead UN agency that expands the possibilities for women and young people to lead healthy
sexual and reproductive lives. To read more about UNFPA, please go to: UNFPA about us

Objective:
The objective of the RFQ is to identify a supplier who can provide UNFPA with the above mentioned product.
The selected vendor is expected to provide such product, based on specific Purchase Orders submitted to
the vendor.

II. Questions
Questions or requests for further clarifications should be submitted in writing to the contact person below:

Name of contact person at UNFPA: Ms. Maya Dewi


Tel Nº: +62 21 29802300
Fax Nº: +62 21 31927902
Email address of contact person: mayadewi@unfpa.org

The deadline for submission of questions is Monday, February 11th 2018 at 17:00 Jakarta Time1. Questions
will be answered in writing and shared will parties as soon as possible after this deadline.

III. Content of quotations


Quotations should be submitted in a single e-mail whenever possible, depending on file size. Quotations must
contain price quotation, to be submitted strictly in accordance with Price Quotation Form, and comply with
the requirements outlined in the specifications described in Annex IV. The quotation must be signed by the
company’s relevant authority and submitted in PDF format.

IV. Instructions for submission

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http://www.timeanddate.com/worldclock/city.html?n=69
1 of 7
United Nations Population Fund
7th Floor Menara Thamrin
Jl. M.H. Thamrin Kav.3, Jakarta 10250
E-mail: indonesia.office@unfpa.org
Website: indonesia.unfpa.org

Quotations should be prepared based on the guidelines set forth in Section III above, along with a properly
filled out and signed price quotation form, are to be sent by e-mail to indonesia.office@unfpa.org no later
than: Monday, February 18th 2018 at 23:59 Jakarta Time2.

Please note the following guidelines for electronic submissions:


 The following reference must be included in the email subject line: RFQ Nº UNFPA/IDN/RFQ/19/004 –
Packaging & Shipping. Quotations that do not contain the correct email subject line may be overlooked
by the procurement officer and therefore not considered.
 The total e-mail size may not exceed 20 MB (including e-mail body, encoded attachments and headers).
Where they are in large electronic files, it is recommended that these be sent separately before the
deadline.

V. Overview of Evaluation Process


Quotations will be evaluated based on the compliance with the technical specifications ( Annex III) and the
total cost of the goods (price quote).

VI. Award Criteria


UNFPA shall award a Purchase Order to the lowest priced bidder whose bid has been determined to be
substantially compliant with the bidding documents.

VII. Right to Vary Requirements at Time of Award


UNFPA reserves the right at the time of award of contract to increase or decrease by up to 20% the volume
of goods specified in this RFQ without any change in unit prices or other terms and conditions.

VIII. Payment Terms


UNFPA payment terms are net 30 days upon receipt of shipping documents, invoice and other
documentation required by the contract.

IX. Fraud and Corruption


UNFPA is committed to preventing, identifying, and addressing all acts of fraud against UNFPA, as well as
against third parties involved in UNFPA activities. UNFPA’s policy regarding fraud and corruption is available
here: Fraud Policy. Submission of a proposal implies that the Bidder is aware of this policy.
Suppliers, their subsidiaries, agents, intermediaries and principals must cooperate with the UNFPA Office of
Audit and Investigations Services as well as with any other oversight entity authorized by the Executive
Director and with the UNFPA Ethics Advisor as and when required. Such cooperation shall include, but not
be limited to, the following: access to all employees, representatives agents and assignees of the vendor; as
well as production of all documents requested, including financial records. Failure to fully cooperate with
investigations will be considered sufficient grounds to allow UNFPA to repudiate and terminate the
Agreement, and to debar and remove the supplier from UNFPA's list of registered suppliers.
A confidential Anti-Fraud Hotline is available to any Bidder to report suspicious fraudulent activities at UNFPA
Investigation Hotline.

X. Zero Tolerance
UNFPA has adopted a zero-tolerance policy on gifts and hospitality. Suppliers are therefore requested not to
send gifts or offer hospitality to UNFPA personnel. Further details on this policy are available here: Zero
Tolerance Policy.

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http://www.timeanddate.com/worldclock/city.html?n=69
2 of 7
United Nations Population Fund
7th Floor Menara Thamrin
Jl. M.H. Thamrin Kav.3, Jakarta 10250
E-mail: indonesia.office@unfpa.org
Website: indonesia.unfpa.org

XI. RFQ Protest


Bidder(s) perceiving that they have been unjustly or unfairly treated in connection with a solicitation,
evaluation, or award of a contract may submit a complaint to the UNFPA Representative, Dr. Annette Sachs
Robertson at indonesia.office@unfpa.org. Should the supplier be unsatisfied with the reply provided by the
UNFPA Representative, the supplier may contact the Chief, Procurement Services Branch at
procurement@unfpa.org.

XII. Disclaimer
Should any of the links in this RFQ document be unavailable or inaccessible for any reason, bidders can
contact the Procurement Officer in charge of the procurement to request for them to share a PDF version of
such document(s).

3 of 7
United Nations Population Fund
7th Floor Menara Thamrin
Jl. M.H. Thamrin Kav.3, Jakarta 10250
E-mail: indonesia.office@unfpa.org
Website: indonesia.unfpa.org

PRICE QUOTATION FORM


Name of Bidder:
Date of the quotation: Click here to enter a date.
Request for quotation Nº: UNFPA/IDN/RFQ/19/004
Currency of quotation : IDR
Delivery charges based on the following
N/A
2010 Incoterm:
Validity of quotation:
(The quotation must be valid for a period of
at least 3 months after the submission
deadline)

 Quoted rates must be exclusive of all taxes, since UNFPA is exempt from taxes.
 The format provided shall be used as a model in preparing the Price Quotation. The format includes specific
expenditures, which may or may not be required or applicable but are indicated to serve as examples.
 In case of discrepancy between unit price and total price, the lower price shall prevail and the higher price shall be
corrected. If the Bidder does not accept the correction of errors, its Proposal will be rejected.

Item Destination UOM Lead Mode of Unit Price (IDR)


(KG/M3) Time Transportation / UOM
*Name of City/District and Province *please Specify
1. KG Land/Sea
M3
KG Air
M3
2. KG Land/Sea
M3
KG Air
M3
*please adjust the column as required

Description Price
Unit
Packaging and handling All-in 1 package

Vendor’s Comments:

I hereby certify that the company mentioned above, which I am duly authorized to sign for, has reviewed RFQ Nº
UNFPA/IDN/RFQ/19/001 including all annexes, amendments to the RFQ document (if applicable) and the responses
provided by UNFPA on clarification questions from the prospective service providers. Further, the company accepts the
General Conditions of Contract for UNFPA and we will abide by this quotation until it expires.

Click here to enter a


date.

Name and title Date and place

4 of 7
United Nations Population Fund
7th Floor Menara Thamrin
Jl. M.H. Thamrin Kav.3, Jakarta 10250
E-mail: indonesia.office@unfpa.org
Website: indonesia.unfpa.org

ANNEX I:
General Conditions of Contracts:
De Minimis Contracts

This Request for Quotation is subject to UNFPA’s General Conditions of Contract: De Minimis Contracts,
which are available in: English, Spanish and French

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United Nations Population Fund
7th Floor Menara Thamrin
Jl. M.H. Thamrin Kav.3, Jakarta 10250
E-mail: indonesia.office@unfpa.org
Website: indonesia.unfpa.org

ANNEX II:
BIDDER IDENTIFICATION FORM
UNFPA/IDN/RFQ/19/004

1. Organizational Information
Company/Institution Name

Address, City, Country

Telephone/FAX

Website

Date of establishment

Legal Representative: Name/Surname/Position


Legal structure: natural person/Co. Ltd,
NGO/institution/other (specify)
Organizational Type: Manufacturer, Wholesaler,
Trader, Service provider, etc.
Areas of expertise of the organization
Current Licenses, if any, and permits (with dates,
numbers and expiration dates)
Years supplying to UN organizations

Years supplying to UNFPA

Production Capacity
Subsidiaries (indicate names of subsidiaries and
addresses, if relevant to the Bid)
Commercial Representatives in the country:
Name/Address/Phone (for international companies
only)

2. Expertise of Staff
Total number of staff
Number of staff involved in similar contracts

3. Contact details of persons that UNFPA may contact for requests for clarification during Bid
evaluation
Name/Surname

Telephone Number (direct)

Email address (direct)

6 of 7
United Nations Population Fund
7th Floor Menara Thamrin
Jl. M.H. Thamrin Kav.3, Jakarta 10250
E-mail: indonesia.office@unfpa.org
Website: indonesia.unfpa.org

ANNEX III:
BIDDER’S PREVIOUS EXPERIENCE
UNFPA/IDN/RFQ/19/004
Contact Date of Contract
Order person, service Amount
Satisfactory
No. & Description3 Client phone
completion
Date number, From To (Currency)
email address

Indicate the description of products, services or works provided to their clients.


To be attached: Evidence (client’s letter or certificate) in support of satisfactory completion of above
orders.

Signature and stamp of the Bidder:


Name and title:
Name of Company:
Telephone:
Email:
Date:

3
Please indicate relevant contracts to the one requested in the RFQ.
7 of 7
United Nations Population Fund
7th Floor Menara Thamrin
Jl. M.H. Thamrin Kav.3, Jakarta 10250
E-mail: indonesia.office@unfpa.org
Website: indonesia.unfpa.org
ANNEX IV
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

Yayasan Bina Muda Gemilang


1
Jl.Raya Kresek Perum Villa Balaraja Blok C9 No.24 Rt.05 Rw.04
Desa, Kec Balaraja, Kab Tangerang, Banten, 15610 Bpk. Bambang Sumantri 0813-8581-1707 2000 11600 300 10 58 1,5

2
Fatayat NU Jawa Timur
Jl. Masjid Al Akbar Timur No.9, Surabaya, Jawa Timur Ibu Hikmah Bafaqih 0821-4182-1296 0 7000 0 0 35 0

Yayasan KAPETA
3
Jl. Pluto Dalam I, No 8, Villa Cinere Mas, Kelurahan Pisangan, Kec
Ciputat Timur, Tangerang Selatan, Banten, 15419 Bpk. Indhi Sadrha 0815-1960-8074 0 9000 400 0 45 2

4
Jakarta 0 0 4000 0 0 20

Kelompok Kerja Bina Sehat (KKBS)


5
Jl. Ikan Wiji Nongko RT 01/07, Lingkungan Setendo, Kel Tukang
Kayu, Kab Banyuwangi, Jawa Timur, 68416 Bpk. Moch Hairon 0852-3255-0855 0 5400 1000 0 27 5

LKKNU Kalimantan Selatan


6
Jl. A. Yani KM. 12,5 Gedung Dakwah NU Kal-Sel, Kec Gambut, Kab
Banjat, Kalimantan Selatan Bpk. Samsul Rani 0816-212-258 0 2200 0 0 11 0
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

7
PKBI Jawa Timur
Jl. Indragiri No 24, Kec Wonokromo, Surabaya, Jawa Timur, 60241 Ibu Zahrotul Ulya 0838-3999-9090 0 8600 500 0 43 2,5

8
PKBI Kalimantan Timur
Jl. Letjend Suprapto. No 1, Samarinda, Klaimantan Timur, 75123 Bpk. Moeran Gautama 0812-5301-865 5000 12600 500 25 63 2,5

PKBI Daerah RIAU


9
JL. Adisucipto NO. 283 (Asrama Transito) Kel. Sidomulya Timur,
Kec. Marpoyan Damai, Kota Pekanbaru, Riau, 28125 Ibu. Kuntum khaira 0812-6736-9900 5800 4400 0 29 22 0

10
Yayasan PONTIANAK PLUS
Jl. Gusti Hamzah, Gg Nursalim No 5B, Pontianak, Kalimantan Barat Bpk. Syarizal Alkadrie 0821-5209-5458 0 5000 500 0 25 2,5

PPTI Balikpapan
11
Jl. Adil Makmur RT 23, No 01, Kelurahan Baru Ulu, Balikpapan
Barat, Kalimantan Timur, 76133 0542-850310 0 5600 0 0 28 0

Yayasan SADAR HATI


12
Jl. Kuntabhaswara II, No 27, Polehan, Blimbing, Malang, Jawa
Timur, 65121 Bpk. M. Theo Zaenuri 0813-3074-0741 0 0 2800 0 0 14

Yayasan REDLINE
13
Jl. Hasyim Ashari, Gg Mawar 37A, Banjarmelati, Mojorotoo, Kota
Kediri, Jawa Timur, 64114 Bpk. Hanjar Makhmucik 0822-5767-7477 0 6000 0 0 30 0
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

Yayasan VESTA INDONESIA


14
Jl. Sukun, NO:21, Pondok Karangbendo, Kecamatan Banguntapan,
Kab Bantul, DIY, 55198 bpk. Supriyanto 0857-2935-0699 1600 6000 400 8 30 2

Yayasan Embun Pelangi


15
Perumahan Anggrek Permai Blok K no.22, Baloi Indah, Lubuk Baja
, Batam , Kepri, 29432 Bpk. Hasiholan Kristanto Lumban Tobing
0821-6173-6446 0 4800 0 0 24 0

Yayasan Pelangi Maluku


16
Jl. Dr. Kayadoe-Kudamati, Depan RSU Dr M Haulussy Ambon,
Maluku, 97117 Ibu Rosano C Pentury 0813-4327-0400 3600 3400 0 18 17 0

17
Yayasan BAHTERA
Jl. Cijerah, Gg. Al Hidayah No 40, Bandung , Jawa Barat, 40213 Bpk. A Tamami Zain 0812-2339-928 0 12000 500 0 60 2,5

Yayasan Gaya Patriot Bekasi (GPB)


18
Jl, Guntur 2, blok DD No.1 Komplek Keuangan, Kelurahan
Kayuringin, Bekasi Selatan, Jawa Barat, 17144 Bpk. Bayu Tri Indriatmoko 0815-8621-5793 0 7600 400 0 38 2

Yayasan GRAPIKS
19
Komplek Bina Karya 1, C56, RT 03/13, Cimekar Cileunyi, Bandung,
Jawa Barat, 40393 Bpk. Kartono 0812-1473-7876 0 8400 2800 0 42 14

Komunitas Aksi Kemanusiaan Indonesia (KAKI)


20
Jl. Curug Agung Raya, RT. 003/06 NO. 14, Kelurahan Tanah Baru,
Kec. Beji Depok, Jawa Barat, 16426 Bpk. R. Tommy Soemantri 0856- 2417- 0066 2600 7000 500 13 35 2,5
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

Lembaga Kajian Strategis (LEKAS)


21
Jl. Sukasari III Ujung, No 19, RT 001/RW 001, Kel Tajur, Kec. Bogor
Timur, Kota Bogor, Jawa Barat, 16142 Bpk. Muksin Zaenal Abidin, S.Ag 0878-7025-8674 5600 10200 8900 28 51 44,5

22
Yayasan LENSA SUKABUMI
Jl. Yulius Usman No. 04, Sukabumi, Jawa Barat Bpk. Mahbub Alpariji 0857-2061-6292 0 10600 1100 0 53 5,5

PKBI Cab Garut


23
Jl. Patriot No 49, RT 04/06, Kel. Sukagalih, Kec Tarogong Kidul
Garut, Jawa Barat, 44151 Bpk. Denden Supresiana 0811 -2112-230 0 13000 1000 0 65 5

PKBI Cab Subang


24
Perum Puri Panji Kencana No.20, Cigadung, Kec. Subang,
Kabupaten Subang, Jawa Barat 4121 0 10000 1100 0 50 5,5

25
Yayasan SRIKANDI PASUNDAN
Jl. Sarimanah Blok 10 no 99, Sarijadi, Bandung, Jawa Barat, 40151 Riri Wirayadi 0821-2033-1973 0 15000 0 0 75 0

26
kota cirebon 0 13400 1700 0 67 8,5
Yayasan Caritas PSE
Jalan W.R. Supratman, Pasar IV, Lingkungan V, Kelurahan Lubuk
27
Pakam I-II, Kec Lubuk Pakam, Kab Deli Serdang, Sumatera Utara,
20511 Bpk. Mangatur Markus Manurung 0812-6492-106 0 3000 500 0 15 2,5
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

28
Yayasan Galatea
Jalan Danau Marsabut No. 79 A Medan, Sumatera Utara, 20111 Bpk. Badurani Lubis 0812-6511-276 0 8000 500 0 40 2,5

29
Kota Kendari 0 4800 0 0 24 0

LKKNU Gorontalo
30
Jl. Bypass, kel Pauwo, Kec Kabila Kab Bone Bolaango, Gorontalo,
96583 Bpk. Yunus Asssagaf 0812-4482-818 0 5000 0 0 25 0

NAD Support Group


31
Jl. Residen Danu Broto lr. Taman Mulia No 27, Desa Geuceu Kayee
Jato, Kec Banda Raya Aceh, Kota Banda Aceh, NAD, 23239 Bpk. Muhammad Gunawan Purba 0813-9796-6955 0 3000 0 0 15 0

32
Kota Jayapura 0 3000 0 0 15 0

PKBI Daerah Sulawesi Utara


33
Jl. Ahmad Yani 14, Lr GPDI sario Tumpaan, Manado, Sulawesi
Utara, 95114 Bpk. Asep Rahman 0815-2708-3919 0 15000 800 0 75 4

Yayasan AKBAR SUMBAR


34
Jl Jati V No. 14D Kelurahan Jati Baru, Kec. Padang Timur, Kota
Padang, Sumatera Barat, 25129 Bpk. Toni Gusti 0812-6609-5461 0 7000 0 0 35 0
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

Yayasan Gaya Celebes (YGC)


35
Jl. Inspeksi Kanal No 50, Landak baru, Kel Bonto Lebang, Makassar,
Sulawesi Selatan, 90133 Bpk. Aziz La Sabbe 0813-4354-4131 0 8000 1200 0 40 6

36
Yayasan GAYA DEWATA (YGD)
Jl. Sakura IV, No.8, Denpasar, Bali, 80233 Bpk. Christian Supriyadinata '0812-3681-0000 0 11200 800 0 56 4

Yayasan INSET NTB


37
Jl. Kesra Raya, No 62, Perumnas Tanjung Karang, mataram, NTB,
83115 Bpk. Himawan Afrian 0818-0366-0666 0 5000 500 0 25 2,5

Yayasan Mitra Husada


38
Komp. Bumi Permata Sudiang, Blok E1, No 12
Makassar, Sulawesi Selatan, 90242 Bpk. Zainuddin '0852-9920-7202 9600 6000 400 48 30 2

Yayasan INTERMEDIKA PRANA


39
Wisma Griya Kemayoran R-20, Jl Industri Raya No 9-10, jakarta,
10720 Bpk. Ardhian Harrymukti P 0812-9404-1979 0 8000 0 0 40 0
Yayasan PESONA JAKARTA
Jl. Kebon Baru II/L, No 7, RT 004/011, Kel Kebon Baru, Kec. Tebet,
40
Jakarta Selatan, 12830
Bpk. Juna Riston Damanik 0813-1137-9909 0 13800 0 0 69 0

Yayasan SRIKANDI SEJATI


41
Jl. Moncokerto I no.3 Rt01/13 Utan Kayu Jakarta Timur, DKI
Jakarta, 13120 Ibu Lenny Eko Sugiharto 0812-8040-8213 0 4000 0 0 20 0
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

Yayasan FKPB Batang


42
Jl. Rata Banyuputih - Limpung KM 1, Dk. Lokojoyo, RT 008/003, Ds
Banyuputih, Kec Banyuputih, kab batang, Jawa tengah, 51271 Bpk. Nur Khasan 08122-8822-9111 5800 13400 0 29 67 0

Yayasan KALANDARA
43
Jl. Duku No 57, lamper Kidul
Kec. Seamrang Selatan, Kota Semarang< Jawa Tengah, 50249 Bpk. Yacobus Kristono 0812-2811-166 0 10600 0 0 53 0
Lingkungan Hidup (LPPSLH)
Jl. Jatisari No.28 Kelurahan Sumampir Kec.Purwokerto Utara Kab.
44
Banyumas, Jawa tengah, 53125
Bpk. Bangkit Ari Sasongko 0815-4887-3580 3000 10000 400 15 50 2

PKBI Cab Kota Semarang


45
Jl. Nangka III, No 3, Kel. Lamper Kidul, kec. Semarang Selatan, jawa
Tengah, 50249 Bpk. Dwi Yoga Yulianto 0811-2711-1 57 0 10000 400 0 50 2

46
Fatayat NU Jawa Tengah
Jl. Dr. Cipto, 180, Semarang, jawa tengah, 50125 Ibu. Khizanaturrohmah 0812-2533-0777 0 11000 800 0 55 4

Solidaritas Perempuan untuk Kemanusiaan dan HAM (SPEK-HAM)


47
Jl. Srikoyo No 14, RT 01/04, Karangasem, Laweyan, Surakarta,
Jawa Tengah, 57145 Ibu. Rahayu Purwaningsih 0856-4215-9760 0 9000 800 0 45 4

Yayasan PESONA BENGKULU


48
JL. Gunung Bungkuk RT. 03 RW. 02 NO. 33. KEL Tanah Patah, Kec.
Ratu Agung, Kota Bengkulu, Bengkulu, 38224 Bpk. Yayan Triyansyah Putra 0821-8261-6665 3600 6000 0 18 30 0
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

Yayasan INTAN MAHARANI


49
Jl. Mayor Salim Batubara, Lr. Pendopo no. 164G Sekip Ujung -
Palembang, Sumatera Selatan, 30127 Bpk. Syahri 0813-6741-3340 0 12000 1200 0 60 6

YKMNU Jawa Tengah


50
Gedung Pendidikan Muslimat NU Jateng, Jl Prof Hamka Ngaliyan,
Semarang, Jawa Tengah, 50185 dr.Siti Masfufah 0815-6581-770 0 10000 0 0 50 0

Yayasan MITRA ALAM


51
Jl. Batara Bromo E-3, Perum Gentan Wyakta, gentan, baki,
Sukoharjo, Jawa Tengah, 57194 Bpk. Ligik Triyogo 0813-2952-5252 3000 9400 800 15 47 4

PKBI Sumatera Utara


52
Jl. Multatuli 34-X Kota Medan, Sumatera Utara 20151
Telp. 061 - 451 4595 / 061 - 414 3302 Ibu Ummi Lestari Koordinator
081260047856
IU 7600 38
Jl. Narumonda Bawah No. 15 Simpang Jalan Gunung Sinabung,
Kel. Karo, Kec. Siantar Selatan, Pematang Siantar, Sumatera Utara,
53
21122
Pak Hardiman Koordinator
081396100842
IU 6600 33

PKBI Sumatera Barat


54
Jl. Sutan Syahrir No. 50 Padang 25214
Telp. (0751) 39630 Eva Herawati Damanik / Lova
Koordinator
081363857174
IU 3600 18

PKBI Jambi
55
Jl. Dara Jingga No. 49, Jambi 36143
Telp. (0741) 7554579 Helina Erika Siregar / Elin Koordinator
081268972308
IU 3000 15
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

PKBI Sumatera Selatan


Jl. Kol H. Burlian / Mahkamah Militer KM 6 Palembang - Sumatra
56
Selatan
Telp. (0711) 421692 M. Zulkarnaen Koordinator
08127826080
IU 9000 45
PKBI Lampung
Jl. Abdi Negara No. 1 Gulak Galik, Teluk Betung, Bandar Lampung,
57
Lampung 35214
Telp. (0721) 487483 / 488395 Rachmad Cahya Aji / Aji Koordinator
08127970657
IU 3000 15

PKBI Kepulauan Riau


58
Jl. RH Fisabilillah No. 56i Sei Jang, Tanjung Pinang, Kepulauan Riau
Telp. 0771-8081195 Rosdawati Laode Koordinator
081364705304
IU 7000 35

Yayasan Wijaya Kusuma


59
Jl. Masjid Al Hikmah RT/RW 004/002 Kel. Jerambah Gantung, Kec.
Gabeg, Kota Pangkal Pinang, Kepulauan Bangka Belitung, 33119 Yorian Gunanda Koordinator
081379959557
IU 1400 7

OPSI Banten
60
Jl. Lingkar Selatan - Perumahan Citraland Puri Blok D6 No. 9
Ciracas, Kota Serang, Banten RR. Ratu Reza Umami Koordinator
081906226000
IU 7400 37

Yayasan Gema Indonesia


61
Jl. Kemang Selatan XA No. 19 RT 003 RW 02 Kel. Bangka Kec.
Mampang Prapatan Jakarta Selatan Fauzi Dhonie / Oji Koordinator
081314102511
IU 13200 66

PKBI Cab Jakarta Timur


62
Jl. Raya Kelapa Dua Wetan RT/RW 06/01 No. 1 Kel. Ciracas, Kec.
Ciracas, Jakarta Timur Junnedi Galingging Koordinator
081296161415
IU 7000 35
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

Yayasan Hidup Positif


63
Jl. Raya PKP Gg. Darusalam No. 48 RT/RW 01/12 Kel. Kelapa Dua
Wetan, Kec. Ciracas, Jakarta Timur 13730 Novi Mudjiati Koordinator
08128104056
IU 5000 25

PKBI Cab Jakarta Utara


64
Jl. Matahari No. 12 RT/RW 005/014 Kel. Rawa Badak Utara, Kec.
Koja, Jakarta Utara Muhammad Suhendra / Hendra
Koordinator
085100747463
IU 7400 37

Yayasan Grapiks Bekasi


65
Perumahan Villa Bekasi Indah 1 No. 41 Blok B6, RT.012/RW.012,
Desa Mangun Jaya, Kec. Tambun Selatan, Kab. Bekasi SANTIANA KOORDINATOR
08990500835
IU 8000 40

66
PKBI Cab Kota Bandung
Jl. Pasir Kaliki No. 26 Bandung 40181 GANJAR SUTISNA KOORDINATOR
081322891933
IU 7000 35

PKBI Cab Cirebon


67
Perumahan Pondok Mutiara, Blok C6 N0. 03, Kel. Gegunung, Kec.
Sumber, Cirebon LANLAN MUHRIA KOORDINATOR
085223716840
IU 5000 25
Yayasan Resik Subang
Jl. Raya Pantura Sukamandi (Klinik Pramagistra), Dsn Wesel,
68
RT.39/RW.18, Desa Sukamandi Jaya, Kec. Ciasem, Kab. Subang
41256 HASANUDIN KOORDINATOR
08122179302
IU 4000 20

69
SOKOGURU Foundation
Jl. Sembungan Utara No. 264 Ungaran, Kab. Semarang SUTARDI KOORDINATOR
081325061442
IU 7000 35
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

Yayasan Tekad
70
Jl. Arum Blok B7, RT.02/RW.10, Kel. Randugunting, Kec. Tegal
Selatan, Kota Tegal ANANG KOORDINATOR
08156533181
IU 6000 30

71
PKBI Kalimantan Barat
Jl. Letjend No. 17A Pontianak, Kalimantan Timur. 78121 Ishak Koordinator
0896-4804-4498
IU 4600 23

72
PKBI Kalimantan Selatan
Jl. Brigjend. Hasan Basri No. 24A, Banjarmasin, 70125. Hapniah Koordinator
0811-5180-582
IU 3600 18

73
PKBI Kalimantan Tengah
Jl. Putri Junjung Buih I No. 2, Palangkaraya, Kalimantan Tengah Alin Koordinator
0812-4955-2551/
IU 0815-2841-1711
1400 7

PKBI Kota Tarakan


74
Jl. Jenderal Sudirman Belakang Gedung Gadis I RT.03 Kelurahan
Pamusian, Kecamatan Tarakan Tengah, 77134 Amrin Koordinator
0812-5553-277
IU 2000 10

SuaR Indonesia
75
Jalan Dandang Gendis Perum pondok Doko Indah Blok A Nomer 1,
doko kecamatan Gampeng Kabupaten Kediri Bayu Koordinator
0823-3503-2881/
IU 0811-3674-114
9000 45

76
Yayasan Paramitra
Jl. Ir. Sukarno No.369 Kota Batu Iwan Koordinator
0812-3358-712
IU 4000 20
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

Laskar Jember
77
Perum Taman Muktisari Blok Anggrek No. 12 A- Kelurahan Tegal
Besar Kecamatan Kaliwates Jember Jawa Timur Khamid Direktur 0852-0497-3822 8000 40

78
Yayasan Orbit
Jl. Bratang Binangun 5c No. 19 Surabaya Jawa Timur. Faisol Koordinator
0856-4621-4751/
IU 0822-3298-9124
5400 27

79
Yayasan Bambu Nusantara
Jl. Nginden Intan Utara No.32 Surabaya Titik Koordinator
0812-3061-537
IU 2000 10

80
Yayasan Citra Usadha Indonesia
Jl. Sarigading Timur No. 1 Denpasar Bali Wayan Yudana Koordinator
0819-3655-0003
IU 5000 25

81
Yayasan Kerti Praja
Jalan Raya Sesetan No. 270 Denpasar, Bali Wayan Swastina Koordinator
0851-0117-8871
IU 9000 45

Yayasan Inset
82
Jalan Kesra Raya No. 62 Perumnas Tanjung Karang Permai,
Ampenan, Mataram Yudi Kusnagin Koordinator
0821-4448-8196
IU 1400 7

83
Yayasan Tanpa Batas
Jl. Percetakan Cendana no.01 Fonten Kupang Deni Sailana Koordinator
0813-3333-1476
IU 2400 12
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

LKKNU Sulawesi Utara


84
Jl Hasanudin 14 No.45 Kel Islam Kec. Tuminting Manado Sulawesi
Selatan Tomy Panaha Koordinator
0852-5625-6621
IU 5000 25

85
PKBI Sulawesi Tengah
Jl. Pue Bongo Lr. Lekatu No.7 Palu Yospina Koordinator
0821-8989-4280
IU 2000 10

Yayasan Alpen Sultra


86
BTN, Az Zharna Blok A/14 Jl. Badak, Kel. Wundumbatu, kec.
Poasia, Kota Kendari, Sulawesi Tenggara Hasmida Direktur 0812-4270-188 4000 20

Yasobat
87
Kampung Katemba RT 2 Distrik Fakfak Tengah, Kode Pos 98613,
Papua Barat Rhyan Daffa IU Koordinator
082248223545 1400 7

PTPS Manokwari
88
Jl. Swapen Perkebunan No.51 Manokwari Kode Pos 98312, Papua
Barat Saragih IU Koordinator
85244493862 1400 7

YAPARI Sorong
89
Yayasan Papua Lestari Jl. Moyo Permai Blok C No. 61 Klamana
Sorong Timur Kota Sorong 98417, Papua Barat Hilal Achmad IU Koordinator
085244339362 3000 15

90
Klasis GPIP Merauke
Jl. R.E. Martadinata 2 Merauke Kode Pos 99611, Papua Herry Erlely IU Koordinator
081344130402 2400 12
DAFTAR ALAMAT PENGIRIMAN DAN JUMLAH MEDIA KIE YANG AKAN DIKIRIM
PROGRAM HIV-AIDS
Note : berat 1.5 kg/200 pc leaflet (7.5gr/pc leaflet)
berat 7.36kg/200 pc booklet (36.8gr/pc booklet)
pc pack (isi 200 pc)
Media Kie Media KIE Media Media Kie Media KIE Media KIE
NO Alamat Pengiriman Penerima Jabatan Telp
FSW MSM/TG KIE PWID FSW MSM/TG PWID

Yukemdi Wamena
91
Kantor Yukemdi, Jalan JB Wenas no. 17 wesaput. Wamena
Kode Pos 99511, Jayawijaya-Papua Loisa Siburi IU Koordinator
081226930026 1000 5

92
Primari Nabire
Jl. Pipit Girimulyo, PO Box 138 Nabire 98814, Papua Krisna Tohariadi IU Koordinator
085254876446 3000 15
FPPA Mimika
Sekretariat FPPA Kab. Mimika, Jalan Poros Mapurujaya KM.7
93
Timika,
Papua Benny Tulenan IU Koordinator
081240001224 3000 15

Yakenpa
94
Perum. Doyo Baru Grand, Blok C Jalur 1 No.16.
Kabupaten Jayapura 99111, Papua Nani Pundu IU Koordinator
081344755908 2000 10

95 YHI Papua
Gang Bisoka IB No. 83 Kotataraja Dalam 99225, Jayapura-Papua Hiswita Pangau IU Koordinator
0811480645 5000 25
260.400 405.000 37.500 1.302 2.025 188

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