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QUOTATION

CUSTOMER INFO BILL TO Barcode


PT TOP TEKNO INDO (HEJOTEKNO) PT TOP TEKNO INDO (HEJOTEKNO)
PALANGKARAYA PALANGKARAYA
Quotation No. MIP.QT22020419
CP. Ibu Bebi Ph. 08111330124 CP. Ibu Bebi Ph. 08111330124 Date February 17, 2022
Email. hejotekno@gmail.com Email. hejotekno@gmail.com Valid Up to. February 24, 2022

Dear Valued Customer,


With reference to your request, we are pleased to offer you the following service(s) calculation details:
Sampling Qty
No. Description Regulation Testing Parameter1 Testing Methods Price Total
Duration (Points)
A. Laboratory Analysis
1 Air Emissions Stationary PerMenLHK 6/2021 Sulfur Dioxide (SO2) IKM-UE-7.2.2-MI (Gas Analyzer) 5 Titik 19.250.000 96.250.000
Source Nitrogen Dioxide (NO2) IKM-UE-7.2.1-MI (Gas Analyzer)
TBT Incinerator Hydrogen Fluoride (HF)* Spectrophotometry
5 Skenario : Carbon Monoxide (CO) IKM-UE-7.2.3-MI (Gas Analyzer)
Blank Sample @ 1 Run Hydrogen Chloride (HCl) SNI 19-7117.8 - 2005
Beban 80% @ 2 Run Hydrocarbon (CH4)* Direct Reading
Beban 100% @ 2 Run Opacity SNI 19-7117.11 - 2005
Particulate EPA Method 1-5 - 1993
Arsenic (As) EPA Method 29 - 1993
Cadmium (Cd) EPA Method 29 - 1993
Chromium (Cr) EPA Method 29 - 1993
Lead (Pb) EPA Method 29 - 1993
Mercury (Hg) EPA Method 29 - 1993
Thalium (Tl) EPA Method 29 - 1993
Oxygen (O2) IKM-UE-7.2.9-MI (Gas Analyzer)
Efisiensi Pembakaran (EP)*
Carbon Dioxide (CO2)*
Kecepatan Gas*
Waktu Tinggal Gas*

B. Sampling
1 Engineer fee Isokinetik 4 5.500.000 22.000.000
2 Fee Instrument 4 825.000 3.300.000
3 Transportation medialab - Airport 2 600.000 1.200.000
4 Transportation Airways (3 engineer) JKT-Palangkaraya 3 2.500.000 7.500.000
5 Transportation Airways (3 engineer) Palangkaraya-JKT 3 2.500.000 7.500.000
6 Cargo Tools (PP) JKT -Palangkaraya 192 275.000 52.800.000
7 Cargo Chemicals (PP) JKT-Palangkaraya 5 300.000 1.500.000
8 Mob Demob 1 Ls 5.500.000 5.500.000
9 Accommodation (Hotel and Meals/days) 1 Ls 6.600.000 6.600.000

C. Reporting Costs
1 Tenaga Ahli (Lumpsum) 1 Ls 14.000.000 14.000.000
2 Pembuatan /Penyusunan Laporan dan Buku TBT (Lumpsum) 1 Ls 7.000.000 7.000.000
Test PCR (2 x 2 engineer)
PAYMENT INFORMATION Sub Total2 225.150.000
Bank Mandiri KCP Bekasi Jatiasih
A/n.: PT MEDIALAB INDONESIA VAT -
A/c No. 156-00-0457633-8 TOTAL (IDR) 225.150.000

Form-7.1.1-MI; Rev.4; January 1, 2020 1 of 2


QUOTATION
SAMPLING LOCATION DOCUMENT DELIVERY ADDRESS RECIPIENT EMAIL ADDRESS
RSUD KOTA PALANGKA RAYA PT TOP TEKNO INDO (HEJOTEKNO) 1) hejotekno@gmail.com
Jl. Mahir Mahar KM.18,5 Kel. Kalampangan Kec. Sebagau PALANGKARAYA 2)
3)
CP. Ibu Bebi Ph. 08111330124 CP. Ibu Bebi Ph. 08111330124 4)

Term & Conditions


1 Non accredited parameter is marked by *
2 Minimum order Rp. 300.000,00
3 Please send your Purchase Order (PO) or Surat Perintah Kerja (SPK) to our fax or email. Or you may sign this quotation as approval document and return to us
4 Sampling schedule will be informed after PO/SPK/Approved Quotation received
5 Supporting Facility such as Board Desk, Stair, and Electricity on site shall be provided by Customer
6 Customers must provide safe site conditions to ensure the safety of sampling process. If unsafe conditions are found, the sampling process will be stopped until the
conditions meet the requirements of
7 Unexpected condition (bad weather, natural disasters, unsafe site condition) that resulted delayed sampling process will be charged to customer
8 The result will be send 14 working days (Normal Service) after samples received at the Laboratory Facilities of PT Medialab Indonesia
9 Term of payment is 30 days after invoce received

Prepared by, Verified by, Acknowledged by, Customer Approval,3


Adm. Marketing Marketing Rep. Technical Advisor

Lia Anjarwati Fany Kusuma H. Dian K


February 17, 2022 Date:

Form-7.1.1-MI; Rev.4; January 1, 2020 2 of 2

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