PT EBSO NIAGA INTERNASIONAL INVOICE

Provide the Perfections Date: 19 Agustus 2021

Invoice No: 400082021
For: 0
Bill To: PT TIGA DARMA ABADI

PT EBSO NIAGA INTERNASIONAL Finance Department

Pulogadung Trade Center Kav. 8 B No.28 Jl. Sersan Muslim RT.07
Kel. Paal Merah, Kec. Paal Merah,
Raya Bekasi KM.21, Rawa Terate, Cakung, Jakarta Timur 13920
Kota Jambi
Jambi
Phone : +622146832910 Phone : +6281298661616
Fax : +622146836818 0
sales@ebsoniaga.com
www.ebosoniaga.com

ID Description Quantity Unit Unit Price Discount AMOUNT

Regulator Tabung O2 + Nasal
RO2NC 81 Unit 900,000.00 72,900,000.00
Canula

Say In Words : Delapan puluh juta seratus sembilan puluh ribu rupiah SUBTOTAL 72,900,000.00

TAX RATE 10.00%

Please transfer to : SALES TAX 7,290,000.00
PT EBSO NIAGA INTERNASIONAL OTHER -
BANK BNI Cabang Pulogadung TOTAL 80,190,000.00
ACCOUNT NO. 7117 7117 52
NPWP 90.614.325.0-447.000

Jakarta, 19 Agustus 2021

Diterima oleh,

Mario Hadi