POLICY SCHEDULE

MARINE CARGO IMPORT INSURANCE 20-2242997

POLICY NO. : Reg. No. : 2003022003183

THE INSURED : PT. MULTI SARANA COMPUTER
CORRESPONDENCE ADDRESS : PERTOKOAN MANYAR MEGAH INDAH BLOK G24-25, JL. NGAGEL JAYA
SELATAN (EX KEBUN BIBIT) SURABAYA – INDONESIA
-, -

TYPE OF COVER (RATE) : Institute Cargo Clause "C" (0.10000 %)

TOTAL SUM INSURED : USD  23,080.00
INTEREST : - 355 CARTON OF UPS IF 1200VA, UPS IF 1500VA, UPS IF 2000VA, GAMING
CHAIR GK-0910, FREE SPARE PART FOR UPS : BATTERY, 1200VA UPS
MAIN BOARD, 1200VA UPS COLOR BOX,
DEDUCTIBLE : - Institute Cargo Clauses "C" : 5 % of SI

ATTACHMENT / EXTENSIONS : - Institute Cargo Clause "C" - 1/1/82, Institute Classification Clause 01/08/97

- Institute Chemical, Biological, Bio-Chemical, Electromagnetic Weapon and

Cyber Attack Exclusion Clause 1/11/02
- Political Risk, Financial Guarantee and Credit Exclusion Clause 1995
- Extra Contractual Obligations Clause 1/9/80 ; Paramount War Clause 5/10/77

- Termination of Transit Clause (Terrorism)

- Institute Extended Radioactive Contamination Exclusion Clause 1/11/02
VOYAGE : From : SHEKOU, CHINA
Transhipment : -
To : SURABAYA, INDONESIA
B/L NO. : 025A651244
INVOICE NO. : 20201001SH
CONSIGNEE NAME : PT. MULTI SARANA COMPUTER
CONSIGNEE ADDRESS : PERTOKOAN MANYAR MEGAH INDAH BLOK G24-25 JL. NGAGEL JAYA
SELATAN (EX KEBUN BIBIT) SURABAYA - INDONESIA
DATE OF SAILING : 29 October, 2020
GRT : 17119
YEAR OF BUILT : 2017
VESSEL NAME : INFINITY S009
NOTE : - Excluding Scratching, Denting, Bending, Rust, Oxidation and Discoloration, etc.
- Excluding electrical, Mechanical, Derangement
- Subject To No Claim As Per Date November 05, 2020
- WPC : 30 Days

PREMIUM CALCULATION :
- Institute Cargo Clause "C" USD 23,080.00 x 0.1% USD  23.08
TOTAL PREMIUM USD  23.08
Policy Cost USD  1.70
Stamp Duty USD  0.61
TOTAL USD  25.39

KF Surabaya , 29 October 2020

MSI0006 Agent PT. ASURANSI INTRA ASIA
AGENT / SV

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