QUOTATION SLIP

NO. 112083/QS/PAR/D99.318-KBRU/12/2020
Type of Cover : - PROPERTY ALL RISKS Insurance
- Extended with Riots, Strikes, Malicious Damage + Civil Commotion 4.1B
Endorsement / AAUI 2007
Wording / Form : - Munich-Re Standard Wording (Amended)
- Extended with RSMD + CC 4.1B Endorsement / AAUI 2007
The Insured : PT. NISSINDO JAYA PERKASA and/or associated and/or subsidiary and/or affiliated
companies including those acquired or incorporated during the period of insurance for
their respective rights and interests
Risk Location : Komplek Roma Sumatra Blok B No. 03 & 04, Batam
Class of Construction : FIRST CLASS

Period of Insurance : 2021-03-25 - 2022-03-25

(Both dates inclusive at 12.00 o'clock at noon standard local time).
Occupation : 2934-Shops, non chain store and/or sales activities and/or operation activities and/or
others related to the insured business.
Interest Insured : All Real and Personal Property of every kind and nature or description in or about the
premises including material on the ground and all structural appurtenances, foundation,
fixtures, fittings attached and belonging thereto and external walls, gates, fences,
machinery and plant (including supporting and protective structures), soft furnishing,
fixtures, fittings of every description, stock of every description related to the Insured's
trade of business including raw material, work in progress and finished goods, the
property where the insured may be held liable or shall have assumed liability, the
property brought into the premises and integral part thereof

Sum Insured : Total Sum Insured = SGD 360,000.00

- Building : SGD 100,000.00
- Stock : SGD 250,000.00
- Content : SGD 10,000.00
Deductibles : Any one loss or series of losses arising out of any one event :
- Fire, Lightning, Explosion, Impact of Falling Aircraft and Smoke: NIL
- Riots, Strikes, Malicious Damage, Civil Commotion, Preventive Acts related to Civil
Commotion, Looting during Civil Commotion :
5% of Claim, Minimum IDR 5,000,000.00
- Typhoon, Storm, Flood, Water Damage, Landslide, Landslip & Subsidence: 10% of
claim
- Others :IDR 1,000,000.00

- Impact of Vehicle : NIL

Additional Clauses : - 30 days Cancellation Clause
- Additional and Deletion Clause
- All Other Contents Clause (Limit IDR 50,000,000.00 in aggregate)
- Alteration Clause (60 Days)

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PT. NISSINDO JAYA PERKASA
 - Appraisement Clause (5% of Total Sum Insured)
- Automatic Increase Clause (Limit 10% of Total Sum Insured)
- Average Relief Clause (85%)
- Banker's Clause
Noted and agreed that the property insured by this policy has been mortgaged with :
Name of Bank : if any
And that in consequence thereof, it has been agreed with the said mortgaged and the
insured, that in case of loss, if any, payable under this policy less than 15% of Total
Sum Insured hereunder shall be payable to the insured(s) and claim more than or
equal to 15% of Total Sum Insured shall be payable to the said bank, unless the bank
shall give it's written consent that any such claim shall be released to the insured.
This clause to be null and void no receipt of advice from the said mortgaged that
they are no longer interested in the property insured under this policy.

- Brand and Label Clause

- Breach of Warranty Clause
- Broad Pair and Set Clause
- Burst Pipe Endorsement
- Capital Additions Clause (10% of Total Sum Insured)
- Civil Authorities Clause
- Claim Preparation Clause (Sub Limit IDR 100,000,000.00)
- Claim Settlement Clause (30 Days)
- Computer Records Clause (Limit IDR 100,000,000.00)
- Cost of Re – Erection Clause
- Cost of Re-writing Records and Claim Preparation Clause
- Customer Goods Clause
- Damage to Fixed Glass Clause
- Debris Removal Clause (10% of Total Sum Insured)
- Defunct Spare Clause
- Designation Clause
- Dispute Clause
- Electrical Short Circuit (limit 10% of Total Sum Insured IDR Maximum IDR
1,000,000,000.00 in aggregate, applicable to items other than Machineries)
- EDRC “A”
- Employees Personal Effects Clause
- Error and Omission Clause
- Escalation Clause (15%)
- Expediting Expenses Clause (10% of claim)
- Fire Brigades Charges Clause (Limit IDR 100,000,000.00)
- Fire Extinguishing Cost Clause (Limit IDR 50,000,000.00)
- General Interest Clause
- Impact by Own Vehicle

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PT. NISSINDO JAYA PERKASA
 - Industries, Seepage, Pollution & Contamination Clause NMA 1685
- Information Technology Hazards Clarification Clause NMA 2912
- Internal Removal Clause
- Interpretation Clause
- Landscape Clause
- Landslide, Landslip and Subsidence Clause
It is hereby noted and agreed that, this policy shall also cover the peril of subsidence,
landslip or landslide.
- Leased Property Clause (If Any)
- Lessor’s Interest Clause (If any)
- Loading and Unloading Clause
- Lock and Keys Clause
- Loss Notification Clause (30 days)
- Loss of Damaged Goods Clause
- Memorandum of Dispute Clause “C”
- Metered Gas Extension
- Minor Alteration and Repair Clause
- Misdescription Clause
- Nominated Loss Adjuster Clause:
Is is hereby noted and agreed that in the even of a claim, loss adjusters to be selected
from the following panel :

PT. PRIMA ADJUSTERINDO MANDIRI

PT. ATLAS ADJUSTING
PT. MCLARENS INDONESIA
- Non-Invalidation Clause
- Notification Clause
- Onsite Storage Clause
- Outbuildings Clause
- Payment on Account Clause
- Premises Clause
- Preventive Measure Clause
- Professional Fees Clause (Limit 10% of Total Sum Insured
- Property Damage Clarification Clause
- Pro-rata Return Premium Clause (Subject to no claim)
- Public Authorities Clause
- Removal Permit Clause
- Riot, Strikes, Malicious Damage plus Civil Commotion (RSMD CC) 4.1B
Endorsement / AAUI 2007
- Rent Clause
- Selling Price Clause
- Services Clause
- Sprinkle Leakage Clause

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PT. NISSINDO JAYA PERKASA
 - Structural alteration Clause
- Sue and Labour Clause
- Temporary Removal Clause
- Tenant Improvement Clause
- Tenants Privilege Granted Clause
- Terrorism Exclusion Clause NMA 2920
- Transmission & Distribution Lines Exclusion Clause
All Transmission and distribution, including wire, cables, poles, pylons, standard
towers and any equipment of any type of which may be attendant to such installation
of any description. This exclusion includes but not limited to transmission or
distribution of electrical power, telephone or telegraph signal and all communication
signals whether audio or visual.

This exclusion applies to both above and below ground equipment except that which
is within 1,000 meters of the insured's premises or as defined in the Assured's
original policy (ies).
This exclusion applies both to physical or damage to the equipment and all business
interruption, consequential loss and/or other contingent losses related to transmission
and distribution lines.

- Undamaged Stock Clause

- Vehicle Load Clause
- Waiver Clause (article 1266 & 1267 Indonesian Civil Code)
- Waiver of subrogation clause
- Workmen’s Clause
- Extra Contractual Obligation Exclusion Clause
- Earthquake Exclusion Clause
- Cyber Risks Exclusion Clause (NMA 2915)
- Communicable Disease Endorsement (LMA5393)

Subjectivity : - No loss record for the past 3 years and up to binding date

- Exclude silent risk

- Adequate fire Protection in valid condition
- No flooding experience for the past 5 years
- Comply with OJK regulation
- Quotation is valid until Thu Mar 25 2021 otherwise automatically cancelled
Important Notice : This is quotation only and no cover given, please sign if you want to proceed cover

Rate : FLEXAS : 0.152 %

TSFWD : 0.045 %
RSMDCC : 0.000001 %
OTHERS : 0.000001 %
Total Rate : 0.197002 %

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PT. NISSINDO JAYA PERKASA
 Premium Calculation : TSFWD
SGD 110,000.00 x 0.045% x 365 / 365 = SGD 49.50
Stock IDR 250,000.00 x 0.045% x 100.00% x 365 / 365 = IDR 112.50
RSMDCC
IDR 110,000.00 x 0.000001% x 365 / 365 = IDR .00
Stock IDR 250,000.00 x 0.000001% x 100.00% x 365 / 365 = IDR .00
OTHERS
IDR 110,000.00 x 0.000001% x 365 / 365 = IDR .00
Stock IDR 250,000.00 x 0.000001% x 100.00% x 365 / 365 = IDR .00
FLEXAS
IDR 110,000.00 x 0.152% x 365 / 365 = IDR 167.20
Stock IDR 250,000.00 x 0.152% x 100.00% x 365 / 365 = IDR 380.00
Total Premium = IDR 709.21

Policy Cost = IDR 50,000.00

Stamp Duty = IDR 10,000.00
Total = 60,709.21

Security : PT. ASURANSI SINAR MAS - 100 % (Leader)

Jakarta, April 09, 2021

Signed for and on behalf of
Confirmed By: PT. KALIBESAR RAYA UTAMA

Date : ......../......../........

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PT. NISSINDO JAYA PERKASA