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OSES

No Deskripsi Jasa / Material UOM


Point to Point
1 Point to Point Microwave Radio with Licensed Frequency 10 Mbps
2 Point to Point Microwave Radio with Licensed Frequency 50 Mbps
3 Point to Point Microwave Radio with Licensed Frequency 60 Mbps
4 Point to Point Microwave Radio unlicensed 10 Mbps
Point to Multipoint
5 PTMP Base radio Aggregate 250 Mbps
6 PTMP Subcriber Radio 10 Mbps
7 PTMP Subcriber Radio 513 Kbps

ONWJ

No Deskripsi Jasa / Material UOM


Point to Point
1 Point to Point Microwave Radio with Licensed Frequency 10 Mbps
2 Point to Point Microwave Radio with Licensed Frequency 150 Mbps
3 Point to Point Microwave Radio with Licensed Frequency 50 Mbps
4 Point to Point Microwave Radio unlicensed 10 Mbps
Jumlah Deliver Deliver
Plan as Planned Tdk Sesuai Plan

15 9 5
7 5 2
7 2 2
2 0 4

18 18 0
58 33 10
9 0 0

Jumlah Jumlah Jumlah


OTC Terdeliver Alokasi

12 14 0
5 9 0
9 3 1
4 4 0
OSES
2021
WO DESKRIPSI MAR APR MEI JUN JUL AGUST SEPT OKT NOV DES JAN
#1 Monthly Cost 22 Apr - 31 Des 2021
#2 OTC 20 Mar - 22 Apr 2021
#6 Monthly Cost

ONWJ
WO DESKRIPSI 2021 2022
OKT NOV DES JAN FEB MAR APR MEI JUN JUL AGUST
#3 OTC 11 Oct - 12 Nov 2021
#4 Monthly Cost 13 Nov - 31 Dec 2021
#8 OTC 11 Oct 2021 - 30 Juni 2022
#9 Monthly Cost 13 Nov - 31 Dec 2021
#14 Monthly Cost 01 Jan - 31 Des 2022
#15 OTC (FO) 01 Mar - 08 Apr 2022

TEJ
WO DESKRIPSI 2022
JAN FEB MAR APR MEI JUN JUL AGUST SEPT OKT NOV
#5 OTC 15 Feb - 15 Mar 2022

NSO
WO DESKRIPSI 2022
JAN FEB MAR APR MEI JUN JUL AGUST SEPT OKT NOV
#10 OTC
#11 Monthly Cost

RATEM
WO DESKRIPSI 2022
JAN FEB MAR APR MEI JUN JUL AGUST SEPT OKT NOV
#12 OTC 15 Feb - 31 Mei 2022

OK
WO DESKRIPSI 2022
JAN FEB MAR APR MEI JUN JUL AGUST SEPT OKT NOV
#13 OTC 15 Feb - 31 Mei 2022

2021
WO DESKRIPSI MAR APR MEI JUN JUL AGUST SEPT OKT NOV DES JAN
#16 OTC
#17 Monthly Cost
2022
FEB MAR APR MEI JUN JUL AGUST SEPT OKT NOV DES

01 Jan - 31 Des 2022

SEPT OKT NOV DES

es 2022

Note
DES
Revisi Tanggal WO

DES

Note
DES
Done 18 Mei 2022

Note
DES
Done 23 Mei 2022

2022
FEB MAR APR MEI JUN JUL AGUST SEPT OKT NOV DES
30 Jun-31 Okt 2022
1 Jul - 31 des 2022
OSES
WO DESKRIPSI PERIODE NILAI
#1 Monthly Co22 Apr - 21 Nov 2021 21,545,173,200
#2 OTC 20 Mar - 22 Apr 2021 1,607,760,000
#6 Monthly Co01 Jan - 31 Des 2022 8,746,292,667

ONWJ
WO DESKRIPSI PERIODE NILAI
#3 OTC 11 Oct - 12 Nov 2021 415,800,000
#4 Monthly Co13 Nov - 31 Dec 2021 690,585,600
#8 OTC 11 Oct 2021 - 30 Juni 2022 83,160,000
#9 Monthly Co13 Nov - 31 Dec 2021 133,566,400
#14 Monthly Co01 Jan - 31 Des 2022 5,121,940,000
#15 OTC (FO) 01 Mar - 08 Apr 2022 251,550,000

TEJ
WO DESKRIPSI PERIODE NILAI
#5 OTC 15 Feb - 15 Mar 2022 180,600,000

NSO
WO DESKRIPSI PERIODE NILAI
#10 OTC 264,880,000
#11 Monthly Cost 440,503,000

RATEM
WO DESKRIPSI PERIODE NILAI
#12 OTC (FO) 15 Feb - 31 Mei 2022 50,310,000

OK
WO DESKRIPSI PERIODE NILAI
#13 OTC (FO) 15 Feb - 31 Mei 2022 476,010,000

JAMER
WO DESKRIPSI PERIODE NILAI
#16 OTC 30 Jun-31 Okt 2022 -
#17 Monthly Co1 Jul - 31 des 2022 -
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/01 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (MC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : 7015 (OSES) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/01
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 22-Apr-21
Promised Work Completion *Please Tick One (Mandatory)
Date : 31-Dec-21

Cost Information Charge of Account


Division Of Interest
Work Order Value : 21,545,173,200 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : -
6001003100 N/A 7015 N/A 7015QR0DA1 IDR 21,545,173,200
Total WO Value to Date : 21,545,173,200
Contract Price : 93,915,805,000
Remaining Contract Value : 72,370,631,800
Contract Utilization
Percentage : 22.94%

*Instructed by: Approval As Per FAL

Name : Rommy P. Kurdi Name : Dhani Chandra Tirtalaga Name : P. V. Atihuta Name :
Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Rommy P. Kurdi Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/01
A Periode 22 sd. 30 April 2021 (9 Days)

Durasi Harga Satuan Unit


Jumlah Total Harga (Rp)
No Deskripsi Jasa / Material UOM (Days) per Bulan (Rp)

a b c d = a x b/30 x c
Point to Point
1 Point to Point Microwave Radio with Licensed Frequency 10 Mbps 9 9 8,600,000 23,220,000
2 Point to Point Microwave Radio with Licensed Frequency 150 Mbps 11 9 28,700,000 94,710,000
3 Point to Point Microwave Radio with Licensed Frequency 60 Mbps 14 9 16,600,000 69,720,000
Point to Multipoint
4 Point to Multipoint Base station Radio with Aggregate Bandwith 250 Mbps 72 9 15,782,000 340,891,200
5 Point to Multipoint Link Subscriber Radio (Hazardous Area Classification) 512 Kbps 139 9 6,000,000 250,200,000
Sub Total A 778,741,200

B Periode 1 Mei sd. 31 Desember 2021 (8 Months)

Jumlah Durasi Harga Satuan Unit Total Harga (Rp)


No Deskripsi Jasa / Material UOM (Bulan) per Bulan (Rp)

a b c d=axbxc
Point to Point
1 Point to Point Microwave Radio with Licensed Frequency 10 Mbps 9 8 8,600,000 619,200,000
2 Point to Point Microwave Radio with Licensed Frequency 150 Mbps 11 8 28,700,000 2,525,600,000
3 Point to Point Microwave Radio with Licensed Frequency 60 Mbps 14 8 16,600,000 1,859,200,000
Point to Multipoint
4 Point to Multipoint Base station Radio with Aggregate Bandwith 250 Mbps 72 8 15,782,000 9,090,432,000
5 Point to Multipoint Link Subscriber Radio (Hazardous Area Classification) 512 Kbps 139 8 6,000,000 6,672,000,000
Sub Total B 20,766,432,000

Description TOTAL (Rp)


Sub Total A 778,741,200
Sub Total B 20,766,432,000
TOTAL HARGA 21,545,173,200
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/02 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : 7015 (OSES) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/02
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 20-Mar-21
Promised Work Completion *Please Tick One (Mandatory)
Date : 21-Apr-21

Cost Information Charge of Account


Division Of Interest
Work Order Value : 1,607,760,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 21,545,173,200
6001003100 N/A 7015 N/A 7015QR0DA1 IDR 1,607,760,000
Total WO Value to Date : 23,152,933,200
Contract Price : 93,915,805,000
Remaining Contract Value : 70,762,871,800
Contract Utilization
Percentage : 24.65%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/02
A Periode 20 Maret sd. 21 April 2021 ( Installation Periode)
Durasi
Jumlah (OTC) Harga (OTC) Total Harga (Rp)
No Deskripsi Jasa / Material UOM
a b c d=axbxc
Point to Point
1 Point to Point Microwave Radio with Licensed Frequency 10 Mbps 15 1 13,860,000 207,900,000 14 194,040,000
2 Point to Point Microwave Radio with Licensed Frequency 50 Mbps 7 1 13,860,000 97,020,000 5 69,300,000
3 Point to Point Microwave Radio with Licensed Frequency 60 Mbps 7 1 13,860,000 97,020,000 5 69,300,000
4 Point to Point Microwave Radio unlicensed 10 Mbps 2 1 13,860,000 27,720,000 2 27,720,000
Point to Multipoint -
5 PTMP Base radio Aggregate 250 Mbps 18 1 13,860,000 249,480,000 18 249,480,000
6 PTMP Subcriber Radio 10 Mbps 58 1 13,860,000 803,880,000 44 609,840,000
7 PTMP Subcriber Radio 513 Kbps 9 1 13,860,000 124,740,000
Sub Total B 1,607,760,000 1,219,680,000

Description TOTAL (Rp)


Sub Total A 1,607,760,000
TOTAL HARGA 1,607,760,000
14

Jumlah
No Deskripsi Jasa / Material Site Location UOM Remark
a
Point to Point Microwave Radio w/ Licensed Frequency
1 Point to Point Microwave Radio w/ Licensed Frequency Arkadia KRISNA 60 Mbps 1
2 Point to Point Microwave Radio w/ Licensed Frequency KRISNA ZELDA 60 Mbps 1 2 Link tidak dihitung
3 Point to Point Microwave Radio w/ Licensed Frequency ZELDA PABELOKAN60 Mbps 1 karena merupakan hop
4 Point to Point Microwave Radio w/ Licensed Frequency PABELOKANBATUPAYUNG60 Mbps 1 pgascom
5 Point to Point Microwave Radio w/ Licensed Frequency BATUPAYUNG ARKADIA 60 Mbps 1
5
6 Point to Point Microwave Radio w/ Licensed Frequency KRISNA BANUWATI 50 Mbps 1
7 Point to Point Microwave Radio w/ Licensed Frequency BANUWATI WIDURI 50 Mbps 1
8 Point to Point Microwave Radio w/ Licensed Frequency WIDURI KARMILA 50 Mbps 1 2 unit tidak bisa deliver
9 Point to Point Microwave Radio w/ Licensed Frequency KARMILA ZELDA 50 Mbps 1 licensed
10 Point to Point Microwave Radio w/ Licensed Frequency CINTA PABELOKAN50 Mbps 1
5
11 Point to Point Microwave Radio w/ Licensed Frequency SELATAN A CINTA 10 Mbps 1
12 Point to Point Microwave Radio w/ Licensed Frequency WANDA PABELOKAN10 Mbps 1
13 Point to Point Microwave Radio w/ Licensed Frequency SUNDARI BANUWATI 10 Mbps 1
14 Point to Point Microwave Radio w/ Licensed Frequency WIDURI WIDURI D 10 Mbps 1
15 Point to Point Microwave Radio w/ Licensed Frequency WIDURI D INTAN B 10 Mbps 1
16 Point to Point Microwave Radio w/ Licensed Frequency INTAN B WIDURI 10 Mbps 1
17 Point to Point Microwave Radio w/ Licensed Frequency NEIA WIDURI 10 Mbps 1
18 Point to Point Microwave Radio w/ Licensed Frequency ARKADIA KALIJAPAT 10 Mbps 1
19 Point to Point Microwave Radio w/ Licensed Frequency ARKADIA GMS 10 Mbps 1
20 Point to Point Microwave Radio w/ Licensed Frequency LISA WIDURI 10 Mbps 1
21 Point to Point Microwave Radio with Licensed Frequency Krisna B Krisna A 10 Mbps 1
22 Point to Point Microwave Radio with Licensed Frequency Krisna A Krisna E 10 Mbps 1
Link Baru
23 Point to Point Microwave Radio with Licensed Frequency Krisna E Krisna D 10 Mbps 1
24 Point to Point Microwave Radio with Licensed Frequency Krisna D Krisna 10 Mbps 1
14
Point to Point Microwave Radio w/ UnLicensed Frequency
1 Point to Point Microwave Radio w/ UnLicensed Frequency PABELOKAN C144 10 Mbps 1
2 Point to Point Microwave Radio w/ UnLicensed Frequency C114 CINTA 10 Mbps 1
3 Point to Point Microwave Radio w/ UnLicensed Frequency PTX KRISNA 10 Mbps 1
4 Point to Point Microwave Radio w/ UnLicensed Frequency FSO FEDERAL WIDURI 10 Mbps 1
4 hysy-widuri ,lisa-widuri awalnya unlicensed
5 Point to Point Microwave Radio w/ UnLicensed Frequency PTX ZELDA 50 Mbps 1
6 Point to Point Microwave Radio w/ UnLicensed Frequency TJ LESUNG WIDURI 50 Mbps 1
2
Point to Multipoint Base station Radio with Aggregate Bandwith
1 Point to Multipoint Base station Radio with Aggregate Bandwith PABELOKAN SUB SBU 250 Mbps 1
2 Point to Multipoint Base station Radio with Aggregate Bandwith PABELOKAN SUB SBU 250 Mbps 1
3 Point to Multipoint Base station Radio with Aggregate Bandwith CINTA SUB SBU 250 Mbps 1
4 Point to Multipoint Base station Radio with Aggregate Bandwith CINTA SUB SBU 250 Mbps 1
5 Point to Multipoint Base station Radio with Aggregate Bandwith WANDA SUB SBU 250 Mbps 1
6 Point to Multipoint Base station Radio with Aggregate Bandwith CINTA SUB SBU 250 Mbps 1
7 Point to Multipoint Base station Radio with Aggregate Bandwith KRISNA SUB CBU 250 Mbps 1
8 Point to Multipoint Base station Radio with Aggregate Bandwith KRISNA SUB CBU 250 Mbps 1
9 Point to Multipoint Base station Radio with Aggregate Bandwith KRISNA SUB CBU 250 Mbps 1
10 Point to Multipoint Base station Radio with Aggregate Bandwith ZELDA SUB CBU 250 Mbps 1
11 Point to Multipoint Base station Radio with Aggregate Bandwith ZELDA SUB CBU 250 Mbps 1
12 Point to Multipoint Base station Radio with Aggregate Bandwith ZELDA SUB CBU 250 Mbps 1
13 Point to Multipoint Base station Radio with Aggregate Bandwith BANUWATI SUB CBU 250 Mbps 1
14 Point to Multipoint Base station Radio with Aggregate Bandwith KARMILA SUB CBU 250 Mbps 1
15 Point to Multipoint Base station Radio with Aggregate Bandwith SUNDARI SUB CBU 250 Mbps 1
16 Point to Multipoint Base station Radio with Aggregate Bandwith WIDURI SUB NBU 250 Mbps 1
17 Point to Multipoint Base station Radio with Aggregate Bandwith WIDURI SUB NBU 250 Mbps 1
18 Point to Multipoint Base station Radio with Aggregate Bandwith WIDURI SUB NBU 250 Mbps 1
19 Point to Multipoint Base station Radio with Aggregate Bandwith WIDURI SUB NBU 250 Mbps 1
19
Point to Multipoint Link Subscriber Radio
1 Point to Multipoint Link Subscriber Radio CINTA-A - 10 Mbps 1
2 Point to Multipoint Link Subscriber Radio CINTA-B - 10 Mbps 1
3 Point to Multipoint Link Subscriber Radio CINTA-D - 10 Mbps 1
4 Point to Multipoint Link Subscriber Radio CINTA-E - 10 Mbps 1
5 Point to Multipoint Link Subscriber Radio CINTA-F - 10 Mbps 1
6 Point to Multipoint Link Subscriber Radio CINTA-G - 10 Mbps 1
7 Point to Multipoint Link Subscriber Radio CINTA-H - 10 Mbps 1
8 Point to Multipoint Link Subscriber Radio GITA-A - 10 Mbps 1
9 Point to Multipoint Link Subscriber Radio KITTY-A - 10 Mbps 1
10 Point to Multipoint Link Subscriber Radio LITA A - 10 Mbps 1
11 Point to Multipoint Link Subscriber Radio N. WANDA-A (GUARDIAN 1)
- 10 Mbps 1
12 Point to Multipoint Link Subscriber Radio N. WANDA-B (GUARDIAN)- 10 Mbps 1
13 Point to Multipoint Link Subscriber Radio RAMA-A - 10 Mbps 1
14 Point to Multipoint Link Subscriber Radio RAMA-B - 10 Mbps 1
15 Point to Multipoint Link Subscriber Radio RAMA-C - 10 Mbps 1
16 Point to Multipoint Link Subscriber Radio RAMA-D - 10 Mbps 1
17 Point to Multipoint Link Subscriber Radio RAMA-E - 10 Mbps 1
18 Point to Multipoint Link Subscriber Radio RAMA-F - 10 Mbps 1
19 Point to Multipoint Link Subscriber Radio RAMA-G - 10 Mbps 1
20 Point to Multipoint Link Subscriber Radio RAMA-H - 10 Mbps 1
21 Point to Multipoint Link Subscriber Radio RAMA-I - 10 Mbps 1
22 Point to Multipoint Link Subscriber Radio RAMA-P - 10 Mbps 1
23 Point to Multipoint Link Subscriber Radio S WANDA A - 10 Mbps 1
24 Point to Multipoint Link Subscriber Radio SURATMI - 10 Mbps 1
25 Point to Multipoint Link Subscriber Radio E RAMA A - 10 Mbps 1
26 Point to Multipoint Link Subscriber Radio FARIDA A - 10 Mbps 1
27 Point to Multipoint Link Subscriber Radio YANI-A - 10 Mbps 1
28 Point to Multipoint Link Subscriber Radio ASTI A - 10 Mbps 1
29 Point to Multipoint Link Subscriber Radio MILA - 10 Mbps 1
30 Point to Multipoint Link Subscriber Radio ZELDA F - 10 Mbps 1
31 Point to Multipoint Link Subscriber Radio ZELDA B - 10 Mbps 1
32 Point to Multipoint Link Subscriber Radio ZELDA C - 10 Mbps 1
33 Point to Multipoint Link Subscriber Radio ZELDA D - 10 Mbps 1
34 Point to Multipoint Link Subscriber Radio ZELDA E - 10 Mbps 1
35 Point to Multipoint Link Subscriber Radio TITI A - 10 Mbps 1
36 Point to Multipoint Link Subscriber Radio BANUWATIK - 10 Mbps 1
37 Point to Multipoint Link Subscriber Radio COSL 221 BARGE - 10 Mbps 1
38 Point to Multipoint Link Subscriber Radio BAYU CAKRAWALA - 10 Mbps 1
39 Point to Multipoint Link Subscriber Radio COSL 225 BARGE - 10 Mbps 1
40 Point to Multipoint Link Subscriber Radio COSL 223 BARGE - 10 Mbps 1
41 Point to Multipoint Link Subscriber Radio AWB STAR ONYX - 10 Mbps 1
42 Point to Multipoint Link Subscriber Radio FALCON FORCE - 10 Mbps 1
43 Point to Multipoint Link Subscriber Radio DSV OPS AVOIR - 10 Mbps 1
44 Point to Multipoint Link Subscriber Radio PETROLEUM WINNER - 10 Mbps 1
44
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/03 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : 7015 CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/03
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 11-Oct-21
Promised Work Completion *Please Tick One (Mandatory)
Date : 12-Nov-21

Cost Information Charge of Account


Division Of Interest
Work Order Value : 415,800,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 23,152,933,200
6001003100 N/A 7015 N/A 7015QR0DA1 IDR 415,800,000
Total WO Value to Date : 23,568,733,200
Contract Price : 93,915,805,000
Remaining Contract Value : 70,347,071,800
Contract Utilization
Percentage : 25.10%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/03
A Periode 11 October sd. 12 November 2021 ( Installation Periode)
Durasi
Jumlah (OTC) Harga (OTC) Total Harga (Rp)
No Deskripsi Jasa / Material UOM
a b c d=axbxc
Point to Point
1 Point to Point Microwave Radio with Licensed Frequency 10 Mbps 12 1 13,860,000 166,320,000 12 166,320,000
2 Point to Point Microwave Radio with Licensed Frequency 150 Mbps 5 1 13,860,000 69,300,000 5 69,300,000
3 Point to Point Microwave Radio with Licensed Frequency 50 Mbps 9 1 13,860,000 124,740,000 3 41,580,000
4 Point to Point Microwave Radio unlicensed 10 Mbps 4 1 13,860,000 55,440,000 4 55,440,000
Sub Total B 415,800,000 332,640,000

Description TOTAL (Rp)


Sub Total A 415,800,000
TOTAL HARGA 415,800,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/03 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (MC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : 7015 CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/03
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 13-Nov-21
Promised Work Completion *Please Tick One (Mandatory)
Date : 31-Dec-21

Cost Information Charge of Account


Division Of Interest
Work Order Value : 690,585,600 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 23,568,733,200
6001003100 N/A 7015 N/A 7015QR0DA1 IDR 690,585,600
Total WO Value to Date : 24,259,318,800
Contract Price : 93,915,805,000
Remaining Contract Value : 69,656,486,200
Contract Utilization
Percentage : 25.83%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/04
A Periode 13 sd. 30 November 2021 (18 Days)

Durasi Harga Satuan Unit


Jumlah Total Harga (Rp)
No Deskripsi Jasa / Material UOM (Days) per Bulan (Rp)

a b c d = a x b/30 x c
Point to Point
1 Point to Point Microwave Radio with Licensed Frequency 10 Mbps 12 18 8,600,000 61,920,000 12 61,920,000
2 Point to Point Microwave Radio with Licensed Frequency 150 Mbps 5 18 28,700,000 86,100,000 5 86,100,000
3 Point to Point Microwave Radio with Licensed Frequency 50 Mbps 9 18 16,600,000 89,640,000 3 29,880,000
4 Point to Point Microwave Radio unlicensed 10 Mbps 4 18 8,879,000 21,309,600 4 21,309,600
Sub Total A 258,969,600 199,209,600

B Periode 1 sd. 31 Desember 2021 (1 Months)

Durasi Harga Satuan Unit


Jumlah Total Harga (Rp)
No Deskripsi Jasa / Material UOM (Bulan) per Bulan (Rp)

a b c d=axbxc
Point to Point
1 Point to Point Microwave Radio with Licensed Frequency 10 Mbps 12 1 8,600,000 103,200,000 12 103,200,000
2 Point to Point Microwave Radio with Licensed Frequency 150 Mbps 5 1 28,700,000 143,500,000 5 143,500,000
3 Point to Point Microwave Radio with Licensed Frequency 50 Mbps 9 1 16,600,000 149,400,000 3 49,800,000
4 Point to Point Microwave Radio unlicensed 10 Mbps 4 1 8,879,000 35,516,000 4 35,516,000
Sub Total B 431,616,000 332,016,000

Description TOTAL (Rp)


Sub Total A 258,969,600
Sub Total B 431,616,000
TOTAL HARGA 690,585,600
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/05 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE Tuban East Java (7013) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/05

Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974


Shipping Agreement
Date Method
Work Commencement Date : 15-Feb-22
Promised Work Completion *Please Tick One (Mandatory)
Date : 15-Mar-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 180,600,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 24,259,318,800
6001003100 N/A 7013 N/A 7013QR0DA1 IDR 180,600,000
Total WO Value to Date : 24,439,918,800
Contract Price : 93,915,805,000
Remaining Contract Value : 69,475,886,200
Contract Utilization
Percentage : 26.02%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/5

A Periode 15 Februari - 15 Maret 2022


Durasi Harga Satuan
Jumlah (Bulan) Instalasi (OTC) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM
a b c d=axbxc
Fiber Optic
1 Fiber Optic PAD B TOWER MUDI Meter 280 1 645,000 180,600,000
Sub Total B 180,600,000

Description TOTAL (Rp)


Sub Total A 180,600,000
TOTAL HARGA 180,600,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/6 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (MC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE OSES (7015) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/6
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 1-Jan-22
Promised Work Completion *Please Tick One (Mandatory)
Date : 31-Dec-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 8,746,292,667 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 24,439,918,800
6001003100 N/A 7015 N/A 7015QR0DA1 IDR 8,746,292,667
Total WO Value to Date : 33,186,211,467
Contract Price : 93,915,805,000
Remaining Contract Value : 60,729,593,533
Contract Utilization
Percentage : 35.34%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/6

A Periode Monthly 2022

Durasi Harga Satuan Unit


Jumlah Durasi (Bulan) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM Periode (Days) per Bulan (Rp)

a b c d e = a x ( b/- +c ) x d
1 Point to Point Microwave Radio w/ Licensed Frequency CINTA CIPALA 10 Mbps 1 Jan s.d 25 Feb 2022 1 25 1 8,600,000 16,278,571
2 Point to Point Microwave Radio w/ Licensed Frequency CIPALA BEJ 10 Mbps 1 Jan s.d 25 Feb 2022 1 25 1 8,600,000 16,278,571
3 Point to Point Microwave Radio with Licensed Frequency Krisna B Krisna A 10 Mbps 1 Jul s.d 31 Des 2022 1 6 8,600,000 51,600,000
4 Point to Point Microwave Radio with Licensed Frequency Krisna A Krisna E 10 Mbps 1 Jul s.d 31 Des 2022 1 6 8,600,000 51,600,000
5 Point to Point Microwave Radio with Licensed Frequency Krisna E Krisna D 10 Mbps 1 Jul s.d 31 Des 2022 1 6 8,600,000 51,600,000
6 Point to Point Microwave Radio with Licensed Frequency Krisna D Krisna B 10 Mbps 1 Jul s.d 31 Des 2022 1 6 8,600,000 51,600,000
7 Point to Point Microwave Radio w/ Licensed Frequency SELATAN A CINTA 10 Mbps 25 Apr s.d 31 Des 2022 1 6 8 8,600,000 70,520,000
8 Point to Point Microwave Radio w/ Licensed Frequency WANDA PABELOKAN 10 Mbps 7 Apr s.d 31 Des 2022 1 24 8 8,600,000 75,680,000
9 Point to Point Microwave Radio w/ Licensed Frequency SUNDARI BANUWATI 10 Mbps 24 Apr s.d 31 Des 2022 1 7 8 8,600,000 70,806,667
10 Point to Point Microwave Radio w/ Licensed Frequency WIDURI P WIDURI D 10 Mbps 1 Mei s.d 31 Des 2022 1 8 8,600,000 68,800,000
11 Point to Point Microwave Radio w/ Licensed Frequency WIDURI D INTAN B 10 Mbps 1 Mei s.d 31 Des 2022 1 8 8,600,000 68,800,000
12 Point to Point Microwave Radio w/ Licensed Frequency INTAN B WIDURI P 10 Mbps 1 Mei s.d 31 Des 2022 1 8 8,600,000 68,800,000
13 Point to Point Microwave Radio w/ Licensed Frequency NEIA WIDURI 10 Mbps 1 Mei s.d 31 Des 2022 1 8 8,600,000 68,800,000
14 Point to Point Microwave Radio w/ Licensed Frequency PABELOKAN ARKADIA 60 Mbps 26 Feb s.d 31 Des 2022 1 3 10 16,600,000 167,778,571
15 Point to Point Microwave Radio w/ Licensed Frequency Arkadia KRISNA 60 Mbps 3 Feb s.d 31 Des 2022 1 26 10 16,600,000 181,414,286
16 Point to Point Microwave Radio w/ Licensed Frequency KRISNA ZELDA 60 Mbps 1 Jan s.d 31 Des 2022 1 12 16,600,000 199,200,000
17 Point to Point Microwave Radio w/ Licensed Frequency ZELDA PABELOKAN 60 Mbps 1 Jan s.d 31 Des 2022 1 12 16,600,000 199,200,000
18 Point to Point Microwave Radio w/ Licensed Frequency KRISNA BANUWATI 50 Mbps 1 Jan s.d 31 Des 2022 1 12 16,600,000 199,200,000
19 Point to Point Microwave Radio w/ Licensed Frequency BANUWATI WIDURI 50 Mbps 1 Jan s.d 31 Des 2022 1 12 16,600,000 199,200,000
20 Point to Point Microwave Radio w/ Licensed Frequency WIDURI P KARMILA 50 Mbps 1 Jan s.d 31 Des 2022 1 12 16,600,000 199,200,000
21 Point to Point Microwave Radio w/ Licensed Frequency KARMILA ZELDA 50 Mbps 1 Jan s.d 31 Des 2022 1 12 16,600,000 199,200,000
22 Point to Point Microwave Radio w/ Licensed Frequency CINTA PABELOKAN 50 Mbps 1 Jan s.d 31 Des 2022 1 12 16,600,000 199,200,000
23 Point to Point Microwave Radio w/ Licensed Frequency CINTA KRISNA 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
24 Point to Point Microwave Radio w/ Licensed Frequency ARKADIA KALIJAPAT 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
25 Point to Point Microwave Radio w/ Licensed Frequency ARKADIA GMS 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
26 Point to Point Microwave Radio w/ Licensed Frequency LISA WIDURI P 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
Point to Point Microwave Radio w/ UnLicensed Frequency
27 Point to Point Microwave Radio w/ UnLicensed Frequency PABELOKAN C114 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,879,000 106,548,000
28 Point to Point Microwave Radio w/ UnLicensed Frequency C114 CINTA 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,879,000 106,548,000
29 Point to Point Microwave Radio w/ UnLicensed Frequency PTX KRISNA 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,879,000 106,548,000
30 Point to Point Microwave Radio w/ UnLicensed Frequency FSO FEDERAL WIDURI P 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,879,000 106,548,000
31 Point to Point Microwave Radio w/ UnLicensed Frequency PTX ZELDA 50 Mbps 1 Jan s.d 31 Des 2022 1 12 8,959,000 107,508,000
32 Point to Point Microwave Radio w/ UnLicensed Frequency TJ LESUNG WIDURI 50 Mbps 1 Jan s.d 31 Des 2022 1 12 8,959,000 107,508,000
Point to Multipoint Base station Radio with Aggregate Bandwith
33 Point to Multipoint Base station Radio with Aggregate Bandwith PABELOKAN SUB SBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
34 Point to Multipoint Base station Radio with Aggregate Bandwith PABELOKAN SUB SBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
35 Point to Multipoint Base station Radio with Aggregate Bandwith CINTA SUB SBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
36 Point to Multipoint Base station Radio with Aggregate Bandwith CINTA SUB SBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
37 Point to Multipoint Base station Radio with Aggregate Bandwith CINTA SUB SBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
38 Point to Multipoint Base station Radio with Aggregate Bandwith WANDA SUB CBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
39 Point to Multipoint Base station Radio with Aggregate Bandwith KRISNA SUB CBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
40 Point to Multipoint Base station Radio with Aggregate Bandwith KRISNA SUB CBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
41 Point to Multipoint Base station Radio with Aggregate Bandwith ZELDA SUB CBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
42 Point to Multipoint Base station Radio with Aggregate Bandwith ZELDA SUB CBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
43 Point to Multipoint Base station Radio with Aggregate Bandwith ZELDA SUB CBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
44 Point to Multipoint Base station Radio with Aggregate Bandwith BANUWATI SUB CBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
45 Point to Multipoint Base station Radio with Aggregate Bandwith KARMILA SUB CBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
46 Point to Multipoint Base station Radio with Aggregate Bandwith WIDURI SUB NBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
47 Point to Multipoint Base station Radio with Aggregate Bandwith WIDURI SUB NBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
48 Point to Multipoint Base station Radio with Aggregate Bandwith WIDURI SUB NBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
49 Point to Multipoint Base station Radio with Aggregate Bandwith WIDURI SUB NBU 250 Mbps 1 Jan s.d 31 Des 2022 1 12 15,782,000 189,384,000
Point to Multipoint Link Subscriber Radio
50 Point to Multipoint Link Subscriber Radio CINTA-A - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
51 Point to Multipoint Link Subscriber Radio CINTA-B - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
52 Point to Multipoint Link Subscriber Radio CINTA-D - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
53 Point to Multipoint Link Subscriber Radio CINTA-E - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
54 Point to Multipoint Link Subscriber Radio CINTA-F - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
55 Point to Multipoint Link Subscriber Radio CINTA-G - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
56 Point to Multipoint Link Subscriber Radio CINTA-H - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
57 Point to Multipoint Link Subscriber Radio GITA-A - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
58 Point to Multipoint Link Subscriber Radio KITTY-A - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
59 Point to Multipoint Link Subscriber Radio LITA A - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
60 Point to Multipoint Link Subscriber Radio N. WANDA-A (GUARDIAN 1) - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
61 Point to Multipoint Link Subscriber Radio N. WANDA-B (GUARDIAN) - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
62 Point to Multipoint Link Subscriber Radio RAMA-A - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
63 Point to Multipoint Link Subscriber Radio RAMA-B - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
64 Point to Multipoint Link Subscriber Radio RAMA-C - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
65 Point to Multipoint Link Subscriber Radio RAMA-D - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
66 Point to Multipoint Link Subscriber Radio RAMA-E - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
67 Point to Multipoint Link Subscriber Radio RAMA-F - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
68 Point to Multipoint Link Subscriber Radio RAMA-G - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
69 Point to Multipoint Link Subscriber Radio RAMA-H - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
70 Point to Multipoint Link Subscriber Radio RAMA-I - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
71 Point to Multipoint Link Subscriber Radio RAMA-P - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
72 Point to Multipoint Link Subscriber Radio S WANDA A - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
73 Point to Multipoint Link Subscriber Radio SURATMI - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
74 Point to Multipoint Link Subscriber Radio E RAMA A - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
75 Point to Multipoint Link Subscriber Radio YANI-A - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
76 Point to Multipoint Link Subscriber Radio ASTI A - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
77 Point to Multipoint Link Subscriber Radio MILA - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
78 Point to Multipoint Link Subscriber Radio ZELDA F - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
79 Point to Multipoint Link Subscriber Radio BANUWATIK - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
80 Point to Multipoint Link Subscriber Radio COSL 221 BARGE - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
81 Point to Multipoint Link Subscriber Radio COSL 225 BARGE - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000 37
82 Point to Multipoint Link Subscriber Radio COSL 223 BARGE - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
83 Point to Multipoint Link Subscriber Radio AWB STAR ONYX - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
84 Point to Multipoint Link Subscriber Radio FALCON FORCE - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
85 Point to Multipoint Link Subscriber Radio DSV OPS AVOIR - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
86 Point to Multipoint Link Subscriber Radio PETROLEUM WINNER - 10 Mbps 1 Jan s.d 31 Des 2022 1 12 4,500,000 54,000,000
Sub Total B 8,746,292,667

Description TOTAL (Rp)


Sub Total A (Monthly) 8,746,292,667
TOTAL HARGA 8,746,292,667
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/8 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE ONWJ (7001) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/8
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 11-Oct-21
Promised Work Completion *Please Tick One (Mandatory)
Date : 30-Jun-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 83,160,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 33,186,211,467
6001003100 N/A 7001 N/A 7001QR0DA1 IDR 83,160,000
Total WO Value to Date : 33,269,371,467
Contract Price : 93,915,805,000
Remaining Contract Value : 60,646,433,533
Contract Utilization
Percentage : 35.42%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/8

A Periode 11 October 2021 sd. 23 Feb 2022 ( Installation Periode)


Harga Satuan Instalasi
Jumlah Durasi (Bulan) (OTC) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM
a b c d=axbxc
Point to Point Microwave Radio w/ UnLicensed Frequency
1 Point to Point Microwave Radio w/ UnLicensed Frequency BCS Arco Arjuna 50 Mbps 1 1 13,860,000 13,860,000
Sub Total B 13,860,000

B Periode 11 October 2021 sd. 30 Juni 2022 ( Installation Periode)

Jumlah Durasi (Bulan) Harga Satuan Instalasi Total Harga (Rp)


No Deskripsi Jasa / Material Site Location UOM (OTC)
a b c d=axbxc
Point to Point Microwave Radio w/ Licensed Frequency
1 Point to Point Microwave Radio w/ Licensed Frequency ECHO FOXTROT 150 Mbps 1 1 13,860,000 13,860,000
2 Point to Point Microwave Radio w/ Licensed Frequency FOXTROT Balongan 150 Mbps 1 1 13,860,000 13,860,000
3 Point to Point Microwave Radio w/ Licensed Frequency Balongan Arkadia 150 Mbps 1 1 13,860,000 13,860,000
4 Point to Point Microwave Radio w/ Licensed Frequency Balongan GGA 10 Mbps 1 1 13,860,000 13,860,000
5 Point to Point Microwave Radio w/ Licensed Frequency KLA KL-GAS 10 Mbps 1 1 13,860,000 13,860,000
Sub Total B 69,300,000

Description TOTAL (Rp)


Sub Total A (OTC) 13,860,000
Sub Total B (OTC) 69,300,000
TOTAL HARGA 83,160,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/9 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (MC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE ONWJ (7001) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/9
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 13-Nov-21
Promised Work Completion *Please Tick One (Mandatory)
Date : 31-Dec-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 133,566,400 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 33,269,371,467
6001003100 N/A 7001 N/A 7001QR0DA1 IDR 133,566,400
Total WO Value to Date : 33,402,937,867
Contract Price : 93,915,805,000
Remaining Contract Value : 60,512,867,133
Contract Utilization
Percentage : 35.57%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/9
A Periode 13 sd. 30 November 2021 (18 Days)

Durasi Harga Satuan Unit


Jumlah Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM (Days) per Bulan (Rp)

a b c d = a x b/30 x c
Point to Point
1 Point to Point Microwave Radio with Licensed Frequency Balongan GGA 10 Mbps 1 18 8,600,000 5,160,000
2 Point to Point Microwave Radio with Licensed Frequency KLA KL-GAS 10 Mbps 1 18 8,600,000 5,160,000
3 Point to Point Microwave Radio with Licensed Frequency ECHO FOXTROT 150 Mbps 1 18 28,700,000 17,220,000
4 Point to Point Microwave Radio with Licensed Frequency FOXTROT Arkadia 150 Mbps 1 18 28,700,000 17,220,000
5 Point to Point Microwave Radio with Unlicensed Frequency BCS Arco Arjuna 10 Mbps 1 18 8,879,000 5,327,400
Sub Total A 50,087,400

B Periode 1 sd. 31 Desember 2021 (1 Months)

Durasi Harga Satuan Unit


Jumlah (Bulan) per Bulan (Rp) Total Harga (Rp)
No Deskripsi Jasa / Material UOM
a b c d=axbxc
Point to Point
1 Point to Point Microwave Radio with Licensed Frequency Balongan GGA 10 Mbps 1 1 8,600,000 8,600,000
2 Point to Point Microwave Radio with Licensed Frequency KLA KL-GAS 10 Mbps 1 1 8,600,000 8,600,000
3 Point to Point Microwave Radio with Licensed Frequency ECHO FOXTROT 150 Mbps 1 1 28,700,000 28,700,000
4 Point to Point Microwave Radio with Licensed Frequency FOXTROT Arkadia 150 Mbps 1 1 28,700,000 28,700,000
5 Point to Point Microwave Radio with Unlicensed Frequency BCS Arco Arjuna 10 Mbps 1 1 8,879,000 8,879,000
Sub Total B 83,479,000

Description TOTAL (Rp)


Sub Total A 50,087,400
Sub Total B 83,479,000
TOTAL HARGA 133,566,400
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/10 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE NSO (7007) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/10
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 15-Mar-22
Promised Work Completion *Please Tick One (Mandatory)
Date : 31-May-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 264,880,000 GL Account AFE No. Company Cost Center Currency Amount
(DOI)
Value of Previous WO(s) : 33,402,937,867
6001003100 N/A 7007 N/A 7007QR0DA2 IDR 264,880,000
Total WO Value to Date : 33,667,817,867
Contract Price : 93,915,805,000
Remaining Contract Value : 60,247,987,133
Contract Utilization
Percentage : 35.85%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/10

A Periode 15 Maret-31 Mei 2022


Durasi Harga Satuan
Jumlah (Bulan) Instalasi (OTC) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM
a b c d=axbxc
Point to Point Microwave Radio
1 Point to Point Microwave Radio w/ Licensed Frequency PAG TVRI 10 Mbps 1 1 13,860,000 13,860,000
2 Point to Point Microwave Radio w/ UnLicensed Frequency PAG AHE 10 Mbps 1 1 13,860,000 13,860,000
Sub Total A 27,720,000

B Periode 15 Maret-31 Mei 2022

Jumlah Durasi Harga Satuan Total Harga (Rp)


No Deskripsi Jasa / Material Site Location UOM (Bulan) Instalasi (OTC)
a b c d=axbxc
Point to Multipoint Base station Radio with Aggregate Bandwith
1 Point to Multipoint Base station Radio with Aggregate Bandwith BS TOWER SRU,MCR 10 Mbps 1 1 13,860,000 13,860,000
2 Point to Multipoint Base station Radio with Aggregate Bandwith BS TOWER OSO,Warehouse 10 Mbps 1 1 13,860,000 13,860,000
Sub Total A 27,720,000

C Periode 15 Maret-31 Mei 2022


Durasi Harga Satuan
Jumlah Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM (Bulan) Instalasi (OTC)
a b c d=axbxc
Point to Multipoint Link Subscriber Radio
1 Point to Multipoint Link Subscriber Radio OSO BS TOWER 10 Mbps 1 1 13,860,000 13,860,000
2 Point to Multipoint Link Subscriber Radio MCR BS TOWER 10 Mbps 1 1 13,860,000 13,860,000
3 Point to Multipoint Link Subscriber Radio SRU BS TOWER 10 Mbps 1 1 13,860,000 13,860,000
4 Point to Multipoint Link Subscriber Radio Warehouse BS TOWER 10 Mbps 1 1 13,860,000 13,860,000
Sub Total B 55,440,000

D Periode 15 Maret-31 Mei 2022


Durasi Harga Satuan
Jumlah (Bulan) Instalasi (OTC) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM
a b c d=axbxc
Tower
1 Pole 10 meter Monopole AHE Office Meter 1 1 38,500,000 38,500,000
2 Pole 10 meter Monopole MCR Office Meter 1 1 38,500,000 38,500,000
3 Pole 10 meter Monopole OSO Office Meter 1 1 38,500,000 38,500,000
4 Pole 10 meter Monopole SRU Office Meter 1 1 38,500,000 38,500,000
Sub Total E 154,000,000

Description TOTAL (Rp)


Sub Total A (OTC) 27,720,000
Sub Total B (OTC) 27,720,000
Sub Total C (OTC) 55,440,000
Sub Total D (OTC) 154,000,000
TOTAL HARGA 264,880,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/11 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (Monthly)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE NSO (7007) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/11
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 1-Jun-22
Promised Work Completion *Please Tick One (Mandatory)
Date : 31-Dec-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 440,503,000 GL Account AFE No. Company Cost Center Currency Amount
(DOI)
Value of Previous WO(s) : 33,667,817,867
6001003100 N/A 7007 N/A 7007QR0DA2 IDR 440,503,000
Total WO Value to Date : 34,108,320,867
Contract Price : 93,915,805,000
Remaining Contract Value : 59,807,484,133
Contract Utilization
Percentage : 36.32%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/11

A Periode Juni - Desember 22

Durasi Harga Satuan Unit


Jumlah Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM (Bulan) per Bulan (Rp)

a b c d=axbxc
Point to Point Microwave Radio
1 Point to Point Microwave Radio w/ Licensed Frequency PAG TVRI 10 Mbps 1 7 8,600,000 60,200,000
2 Point to Point Microwave Radio w/ UnLicensed Frequency PAG AHE 10 Mbps 1 7 8,879,000 62,153,000
Sub Total A 122,353,000

B Periode Juni - Desember 22

Jumlah Durasi Harga Satuan Unit Total Harga (Rp)


No Deskripsi Jasa / Material Site Location UOM (Bulan) per Bulan (Rp)

a b c d=axbxc
Point to Multipoint Base station Radio with Aggregate Bandwith
1 Point to Multipoint Base station Radio with Aggregate Bandwith BS TOWER SRU,MCR 10 Mbps 1 7 13,725,000 96,075,000
2 Point to Multipoint Base station Radio with Aggregate Bandwith BS TOWER OSO,Warehouse 10 Mbps 1 7 13,725,000 96,075,000
Sub Total C 192,150,000

C Periode Juni - Desember 22

Jumlah Durasi Harga Satuan Unit Total Harga (Rp)


No Deskripsi Jasa / Material Site Location UOM (Bulan) per Bulan (Rp)

a b c d=axbxc
Point to Multipoint Link Subscriber Radio
1 Point to Multipoint Link Subscriber Radio OSO BS TOWER 10 Mbps 1 7 4,500,000 31,500,000
2 Point to Multipoint Link Subscriber Radio MCR BS TOWER 10 Mbps 1 7 4,500,000 31,500,000
3 Point to Multipoint Link Subscriber Radio SRU BS TOWER 10 Mbps 1 7 4,500,000 31,500,000
4 Point to Multipoint Link Subscriber Radio Warehouse BS TOWER 10 Mbps 1 7 4,500,000 31,500,000
Sub Total D 126,000,000

Description TOTAL (Rp)


Sub Total A (Monthly) 122,353,000
Sub Total B (Monthly) 192,150,000
Sub Total C (Monthly) 126,000,000
TOTAL HARGA 440,503,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/12 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE RAJA TEMPIRAI (7017) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/12

Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974


Shipping Agreement
Date Method
Work Commencement Date : 15-Feb-22
Promised Work Completion *Please Tick One (Mandatory)
Date : 31-May-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 50,310,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 34,108,320,867
6001003100 N/A 7017 N/A 7017QR0DA1 IDR 50,310,000
Total WO Value to Date : 34,158,630,867
Contract Price : 93,915,805,000
Remaining Contract Value : 59,757,174,133
Contract Utilization
Percentage : 36.37%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/12

A Periode 15 Februari - 31 Mei 2022

Jumlah Durasi Harga Satuan Total Harga (Rp)


No Deskripsi Jasa / Material Site Location UOM (Bulan) Instalasi (OTC)
a b c d=axbxc
Fiber Optic
1 Fiber Optic OFFICE 1 OFFICE 2 Meter 78 1 645,000 50,310,000
Sub Total B 50,310,000

Description TOTAL (Rp)


Sub Total A 50,310,000
TOTAL HARGA 50,310,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/13 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE OGAN KOMERING (7014) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/13

Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974


Shipping Agreement
Date Method
Work Commencement Date : 15-Feb-22
Promised Work Completion *Please Tick One (Mandatory)
Date : 31-May-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 476,010,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 34,158,630,867
6001003100 N/A 7014 N/A 7014QR0DA1 IDR 476,010,000
Total WO Value to Date : 34,634,640,867
Contract Price : 93,915,805,000
Remaining Contract Value : 59,281,164,133
Contract Utilization
Percentage : 36.88%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/13

A Periode 15 Februari - 31 Mei 2022


Durasi Harga Satuan
Jumlah (Bulan) Instalasi (OTC) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM
a b c d=axbxc
Fiber Optic
1 Fiber Optic PRODUCTION FIELD OFFICE HVS PUMP Meter 104 1 645,000 67,080,000
2 Fiber Optic HVS PUMP MCC Meter 241 1 645,000 155,445,000
3 Fiber Optic MCC TOWER SHELTER Meter 224 1 645,000 144,480,000
4 Fiber Optic TOWER SHELTER WAREHOUSE OFFICE Meter 94 1 645,000 60,630,000
5 Fiber Optic WAREHOUSE OFFICE HSSE OFFICE LT.1 Meter 75 1 645,000 48,375,000
Sub Total B 476,010,000

Description TOTAL (Rp)


Sub Total A 476,010,000
TOTAL HARGA 476,010,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/14 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (MC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE ONWJ (7001) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/14
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 1-Jan-22
Promised Work Completion *Please Tick One (Mandatory)
Date : 31-Dec-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 5,121,940,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 34,634,640,867
6001003100 N/A 7001 N/A 7001QR0DA1 IDR 5,121,940,000
Total WO Value to Date : 39,756,580,867
Contract Price : 93,915,805,000
Remaining Contract Value : 54,159,224,133
Contract Utilization
Percentage : 42.33%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/14

B Periode Monthly
Harga Satuan Unit per
Jumlah Durasi (Days) Durasi (Bulan) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM Periode Bulan (Rp)
a b c d e = a x ( b/- +c ) x d
Point to Point Microwave Radio w/ Licensed Frequency
1 Point to Point Microwave Radio w/ Licensed Frequency FOXTROT Arkadia 150 Mbps 1 Jan s.d 28 Feb 2022 1 2 28,700,000 57,400,000
2 Point to Point Microwave Radio w/ Licensed Frequency FOXTROT Balongan 150 Mbps 1 Mar s.d 31 Des 2022 1 10 28,700,000 287,000,000
3 Point to Point Microwave Radio w/ Licensed Frequency Balongan Arkadia 150 Mbps 1 Mar s.d 31 Des 2022 1 10 28,700,000 287,000,000
4 Point to Point Microwave Radio w/ Licensed Frequency Zulu Q Pabelokan 50 Mbps 14 Feb s.d 31 Des 2022 1 15 10 16,600,000 174,892,857
5 Point to Point Microwave Radio w/ Licensed Frequency Pabelokan Arkadia 50 Mbps 14 Feb s.d 31 Des 2022 1 15 10 16,600,000 174,892,857
6 Point to Point Microwave Radio w/ Licensed Frequency BCS NGL 50 Mbps 1 Jan s.d 31 Des 2022 1 12 16,600,000 199,200,000
7 Point to Point Microwave Radio w/ Licensed Frequency Arkadia PAPA 150 Mbps 1 Jan s.d 31 Des 2022 1 12 28,700,000 344,400,000
8 Point to Point Microwave Radio w/ Licensed Frequency PAPA MM 150 Mbps 1 Jan s.d 31 Des 2022 1 12 28,700,000 344,400,000
9 Point to Point Microwave Radio w/ Licensed Frequency MM LIMA 150 Mbps 1 Jan s.d 31 Des 2022 1 12 28,700,000 344,400,000
10 Point to Point Microwave Radio w/ Licensed Frequency LIMA BCS 150 Mbps 1 Jan s.d 31 Des 2022 1 12 28,700,000 344,400,000
11 Point to Point Microwave Radio w/ Licensed Frequency BCS ECHO 150 Mbps 1 Jan s.d 31 Des 2022 1 12 28,700,000 344,400,000
12 Point to Point Microwave Radio w/ Licensed Frequency ECHO FOXTROT 150 Mbps 1 Jan s.d 31 Des 2022 1 12 28,700,000 344,400,000
13 Point to Point Microwave Radio w/ Licensed Frequency MM MB2 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
14 Point to Point Microwave Radio w/ Licensed Frequency LIMA KLA 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
15 Point to Point Microwave Radio w/ Licensed Frequency KLA KL-GAS 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
16 Point to Point Microwave Radio w/ Licensed Frequency BCS UNIORM 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
17 Point to Point Microwave Radio w/ Licensed Frequency PAPA APNA 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
18 Point to Point Microwave Radio w/ Licensed Frequency APNA APNB 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
19 Point to Point Microwave Radio w/ Licensed Frequency APNB APND 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
20 Point to Point Microwave Radio w/ Licensed Frequency APND PAPA 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
21 Point to Point Microwave Radio w/ Licensed Frequency PAPA APNE A 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
22 Point to Point Microwave Radio w/ Licensed Frequency APNE A APNE B 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
23 Point to Point Microwave Radio w/ Licensed Frequency APNE B APNF 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
24 Point to Point Microwave Radio w/ Licensed Frequency APNF APNB 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
25 Point to Point Microwave Radio w/ Licensed Frequency Balongan GGA 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,600,000 103,200,000
Point to Point Microwave Radio w/ Unlicensed Frequency
26 Point to Point Microwave Radio w/ UnLicensed Frequency BCS Arco Arjuna 10 Mbps 1 Jan s.d 23 Feb 2022 1 23 1 8,879,000 16,172,464
27 Point to Point Microwave Radio w/ UnLicensed Frequency BCS Arco Arjuna 50 Mbps 24 Feb s.d 31 Des 2022 1 5 10 8,959,000 91,189,821
28 Point to Point Microwave Radio w/ UnLicensed Frequency ZULU J ZULU Q 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,879,000 106,548,000
29 Point to Point Microwave Radio w/ UnLicensed Frequency MM MMC 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,879,000 106,548,000
30 Point to Point Microwave Radio w/ UnLicensed Frequency BCS B2C 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,879,000 106,548,000
31 Point to Point Microwave Radio w/ UnLicensed Frequency FSER FPRO 10 Mbps 1 Jan s.d 31 Des 2022 1 12 8,879,000 106,548,000
Sub Total B 5,121,940,000

Description TOTAL (Rp)


Sub Total A (Monthly) 5,121,940,000
TOTAL HARGA 5,121,940,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/15 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE ONWJ (7001) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/15
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 1-Mar-22
Promised Work Completion *Please Tick One (Mandatory)
Date : 8-Apr-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 251,550,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 39,756,580,867
6001003100 N/A 7001 N/A 7001QR0DA1 IDR 251,550,000
Total WO Value to Date : 40,008,130,867
Contract Price : 93,915,805,000
Remaining Contract Value : 53,907,674,133
Contract Utilization
Percentage : 42.60%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/15

A Periode 01-08 April 2022 ( Installation Periode)


Harga Satuan Instalasi
Jumlah Durasi (Bulan) (OTC) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM
a b c d=axbxc
Fiber Optic
1 Fiber Optic MK -ORF PJB-MK Meter 390 1 645,000 251,550,000
Sub Total B 251,550,000

Description TOTAL (Rp)


Sub Total A (OTC) 251,550,000
TOTAL HARGA 251,550,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/16 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE Jambi Merang CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/16
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 15-Feb-22
Promised Work Completion *Please Tick One (Mandatory)
Date : 15-Mar-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 305,690,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 40,008,130,867
6001003100 N/A - N/A 7013QR0DA1 IDR 305,690,000
Total WO Value to Date : 40,313,820,867
Contract Price : 93,915,805,000
Remaining Contract Value : 53,601,984,133
Contract Utilization
Percentage : 42.93%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/16

A Periode 15 Februari - 15 Maret 2022


Durasi Harga Satuan
Jumlah (Bulan) Instalasi (OTC) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM
a b c d=axbxc
Point to Point Microwave Radio with Licensed Frequency
1 Point to Point Microwave Radio with Licensed Frequency SKN Office PG Office 10 Mbps 1 1 13,860,000 13,860,000
Sub Total B 13,860,000

B Periode 15 Februari - 15 Maret 2022

Jumlah Durasi Harga Satuan Total Harga (Rp)


No Deskripsi Jasa / Material Site Location UOM (Bulan) Instalasi (OTC)
a b c d=axbxc
Point to Multipoint Base station Radio with Aggregate Bandwith -
1 Point to Multipoint Base station Radio with Aggregate Bandwith SKN Office Subscriber 250 Mbps 1 1 13,860,000 13,860,000
2 Point to Multipoint Base station Radio with Aggregate Bandwith SKN Office Subscriber 250 Mbps 1 1 13,860,000 13,860,000
3 Point to Multipoint Base station Radio with Aggregate Bandwith SKN Office Subscriber 250 Mbps 1 1 13,860,000 13,860,000
Sub Total B 41,580,000

C Periode 15 Februari - 15 Maret 2022


Durasi Harga Satuan
Jumlah (Bulan) Instalasi (OTC) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM
a b c d=axbxc
Point to Multipoint Link Subscriber Radio -
1 Point to Multipoint Link Subscriber Radio Mess VIP SKN Office 10 Mbps 1 1 13,860,000 13,860,000
2 Point to Multipoint Link Subscriber Radio Training Center SKN Office 10 Mbps 1 1 13,860,000 13,860,000
3 Point to Multipoint Link Subscriber Radio Project Office SKN Office 10 Mbps 1 1 13,860,000 13,860,000
4 Point to Multipoint Link Subscriber Radio AKOM-B SKN Office 10 Mbps 1 1 13,860,000 13,860,000
5 Point to Multipoint Link Subscriber Radio Field SKN Office 10 Mbps 1 1 13,860,000 13,860,000
6 Point to Multipoint Link Subscriber Radio Pipeyard SKN Office 10 Mbps 1 1 13,860,000 13,860,000
7 Point to Multipoint Link Subscriber Radio Clinic SKN Office 10 Mbps 1 1 13,860,000 13,860,000
8 Point to Multipoint Link Subscriber Radio RAM Building & Warehouse SKN Office 10 Mbps 1 1 13,860,000 13,860,000
Sub Total B 110,880,000

D Periode 15 Februari - 15 Maret 2022

Jumlah Durasi Harga Satuan Total Harga (Rp)


No Deskripsi Jasa / Material Site Location UOM (Bulan) Instalasi (OTC)
a b c d=axbxc
Tower -
1 Triangle PG (Maint) PG Office Tower PAG 25 Meter 1 1 53,900,000 53,900,000
2 SST SKN (Maint) SKN Office Tower PAG 52 Meter 1 1 85,470,000 85,470,000
Sub Total B 139,370,000

Description TOTAL (Rp)


Sub Total A 13,860,000
Sub Total B 41,580,000
Sub Total C 110,880,000
Sub Total D 139,370,000
TOTAL HARGA 305,690,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/17 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE Jambi Merang CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/17
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 16 Maret 2022
Promised Work Completion *Please Tick One (Mandatory)
Date : 31 Desember 2022

Cost Information Charge of Account


Division Of Interest
Work Order Value : 874,970,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 40,313,820,867
6001003100 N/A - N/A 7013QR0DA1 IDR 874,970,000
Total WO Value to Date : 41,188,790,867
Contract Price : 93,915,805,000
Remaining Contract Value : 52,727,014,133
Contract Utilization
Percentage : 43.86%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/17

A Periode 16-31 Maret 2022


Harga Satuan
Jumlah Durasi (Days) Perbulan (MC) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM
a b c d = a x b/31 x c
Point to Point Microwave Radio with Licensed Frequency
1 Point to Point Microwave Radio with Licensed Frequency SKN Office PG Office 10 Mbps 1 16 8,600,000 4,438,710
Point to Multipoint Base station Radio with Aggregate Bandwith -
1 Point to Multipoint Base station Radio with Aggregate Bandwith SKN Office Subscriber 250 Mbps 1 16 15,782,000 8,145,548
2 Point to Multipoint Base station Radio with Aggregate Bandwith SKN Office Subscriber 250 Mbps 1 16 15,782,000 8,145,548
3 Point to Multipoint Base station Radio with Aggregate Bandwith SKN Office Subscriber 250 Mbps 1 16 15,782,000 8,145,548
Point to Multipoint Link Subscriber Radio -
1 Point to Multipoint Link Subscriber Radio Mess VIP SKN Office 10 Mbps 1 16 4,500,000 2,322,581
2 Point to Multipoint Link Subscriber Radio Training Center SKN Office 10 Mbps 1 16 4,500,000 2,322,581
3 Point to Multipoint Link Subscriber Radio Project Office SKN Office 10 Mbps 1 16 4,500,000 2,322,581
4 Point to Multipoint Link Subscriber Radio AKOM-B SKN Office 10 Mbps 1 16 4,500,000 2,322,581
5 Point to Multipoint Link Subscriber Radio Field SKN Office 10 Mbps 1 16 4,500,000 2,322,581
6 Point to Multipoint Link Subscriber Radio Pipeyard SKN Office 10 Mbps 1 16 4,500,000 2,322,581
7 Point to Multipoint Link Subscriber Radio Clinic SKN Office 10 Mbps 1 16 4,500,000 2,322,581
8 Point to Multipoint Link Subscriber Radio RAM Building & SKN Office 10 Mbps 1 16 4,500,000 2,322,581
Sub Total B 47,456,000

B Periode April- Desember 2022


Harga Satuan
Jumlah Durasi (Bulan) Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM Perbulan (MC)
a b c d=axbxc
Point to Point Microwave Radio with Licensed Frequency
1 Point to Point Microwave Radio with Licensed Frequency SKN Office PG Office 10 Mbps 1 9 8,600,000 77,400,000
Point to Multipoint Base station Radio with Aggregate Bandwith -
1 Point to Multipoint Base station Radio with Aggregate Bandwith SKN Office Subscriber 250 Mbps 1 9 15,782,000 142,038,000
2 Point to Multipoint Base station Radio with Aggregate Bandwith SKN Office Subscriber 250 Mbps 1 9 15,782,000 142,038,000
3 Point to Multipoint Base station Radio with Aggregate Bandwith SKN Office Subscriber 250 Mbps 1 9 15,782,000 142,038,000
Point to Multipoint Link Subscriber Radio -
1 Point to Multipoint Link Subscriber Radio Mess VIP SKN Office 10 Mbps 1 9 4,500,000 40,500,000
2 Point to Multipoint Link Subscriber Radio Training Center SKN Office 10 Mbps 1 9 4,500,000 40,500,000
3 Point to Multipoint Link Subscriber Radio Project Office SKN Office 10 Mbps 1 9 4,500,000 40,500,000
4 Point to Multipoint Link Subscriber Radio AKOM-B SKN Office 10 Mbps 1 9 4,500,000 40,500,000
5 Point to Multipoint Link Subscriber Radio Field SKN Office 10 Mbps 1 9 4,500,000 40,500,000
6 Point to Multipoint Link Subscriber Radio Pipeyard SKN Office 10 Mbps 1 9 4,500,000 40,500,000
7 Point to Multipoint Link Subscriber Radio Clinic SKN Office 10 Mbps 1 9 4,500,000 40,500,000
8 Point to Multipoint Link Subscriber Radio RAM Building & SKN Office 10 Mbps 1 9 4,500,000 40,500,000
Sub Total B 827,514,000
91,946,000
Description TOTAL (Rp)
Sub Total A 47,456,000
Sub Total A 827,514,000
TOTAL HARGA 874,970,000 3,499,880,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/18 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (OTC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE Tuban East Java (7013) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/18
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 15-Feb-22
Promised Work Completion *Please Tick One (Mandatory)
Date : 15-Mar-22

Cost Information Charge of Account


Division Of Interest
Work Order Value : 118,580,000 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 41,188,790,867
6001003100 N/A 7013 N/A 7013QR0DA1 IDR 118,580,000
Total WO Value to Date : 41,307,370,867
Contract Price : 93,915,805,000
Remaining Contract Value : 52,608,434,133
Contract Utilization
Percentage : 43.98%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/18

A Periode 15 Februari - 15 Maret 2022

Jumlah Durasi Harga Satuan Total Harga (Rp)


No Deskripsi Jasa / Material Site Location UOM (Bulan) Instalasi (OTC)
a b c d=axbxc
Point to Point Microwave Radio with Licensed Frequency
1 Point to Point Microwave Radio with Licensed Frequency Mudi Office PAD A 10 Mbps 1 1 13,860,000 13,860,000
2 Point to Point Microwave Radio with Licensed Frequency Mudi Office PAD C 10 Mbps 1 1 13,860,000 13,860,000
3 Point to Point Microwave Radio with Licensed Frequency Mudi Office NGANDONG 10 Mbps 1 1 13,860,000 13,860,000
Sub Total B 41,580,000

B Periode 15 Februari - 15 Maret 2022


Durasi Harga Satuan
Jumlah Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM (Bulan) Instalasi (OTC)
a b c d=axbxc
Tower
1 Pole 15 meter PAD A Mudi Office Meter 1 1 38,500,000 38,500,000
2 Pole 15 meter PAD C Mudi Office Meter 1 1 38,500,000 38,500,000
Sub Total E 77,000,000

Description TOTAL (Rp)


Sub Total B (OTC) 41,580,000
Sub Total C (OTC) 77,000,000
TOTAL HARGA 118,580,000
WORK ORDER

WO Information Contract Information


WO No. : ICT&DM/4710003974/WO/19 Contract No. : 4710003974
Project Title
: Layanan Telekomunikasi Site - GS Contract Title : Layanan Telekomunikasi Site - GS
Work Order Title Contract Commencement Date : 29-Jan-21
Layanan Telekomunikasi Site - GS (MC)
Contract End Date : 28-Jan-26
Contractor : PT. PGAS TELEKOMUNIKASI NUSANTARA Contract Type : Service Contract

Company Information Reference (If Any)


Company Name : PHE Tuban East Java (7013) CEWE/CTR/SR/FRW/DWO No. : N/A

We hereby instruct you through this WO to perform the following service (s) :
Detail attached :
Lampiran 1 - Rincian WO ICT&DM/4710003974/WO/19
Lampiran 2 - HOA & Lampiran C Kontrak No. 4710003974

Shipping Agreement
Date Method
Work Commencement Date : 16 Maret 2022
Promised Work Completion *Please Tick One (Mandatory)
Date : 31 Desember 2022

Cost Information Charge of Account


Division Of Interest
Work Order Value : 245,516,129 GL Account AFE No. Company (DOI) Cost Center Currency Amount
Value of Previous WO(s) : 41,307,370,867
6001003100 N/A 7013 N/A 7013QR0DA1 IDR 245,516,129
Total WO Value to Date : 41,552,886,996
Contract Price : 93,915,805,000
Remaining Contract Value : 52,362,918,004
Contract Utilization
Percentage : 44.24%

*Instructed by: Approval As Per FAL

Name : Name : Name : P. V. Atihuta Name :


Signature: Signature: Signature: Signature:

Title : Network Support Assistant Mgr Title : Pjs. ICT Operation Manager Title : VP Information Technology Title :
Department : Information Technology Department : Information Technology Department : Information Technology Department :
: :
Division/ Division/ Division/ Division/
Section/ : Section/ : Section/ Section/
Team Team Team Team
Date : Date : Date : Date :

Work Acceptance Please Tick One (Mandatory).


Contractor Representative
Contract User Acceptor/Contract User On Time / within schedule
(If Work accepted earlier than or same as The Work
Name : Name : Completion Date)
Signature: Signature:
Remark/Comments **:
Actual Work Completion Date: …
Justification:

Title : Title : Information Technology


Date : Date :
Delay …. day(s) /
Actual Work Completion Date: …
(If Work is accepted after The Work Completion Date); Penalty
is applicable in accordance with the Contract.

Notes:
* Filled in the event the departement / division of user is different from the owner of the contract. If the name of Instructor as same as the contract holder, please put signature in contract holder's column.

**Mandatory to add remarks if the Work Acceptance is signed not on the actual date of Work completion.
An original of this Work Order signed by Company representative should be attached to the Contractor’s invoice. For Partial payment, a copy of Work Order is attached to the Contractor’s invoice, and the original Work Order should be attached to Contractor’s final
invoice.
Lampiran 1 - ICT&DM/4710003974/WO/19

A Periode 16-31 Maret 2022

Durasi Harga Satuan Unit


Jumlah Total Harga (Rp)
No Deskripsi Jasa / Material Site Location UOM (Days) per Bulan (Rp)

a b c d=axbxc
Point to Point Microwave Radio with Licensed Frequency
1 Point to Point Microwave Radio with Licensed Frequency Mudi Office PAD A 10 Mbps 1 16 8,600,000 4,438,710
2 Point to Point Microwave Radio with Licensed Frequency Mudi Office PAD C 10 Mbps 1 16 8,600,000 4,438,710
3 Point to Point Microwave Radio with Licensed Frequency Mudi Office NGANDONG 10 Mbps 1 16 8,600,000 4,438,710
Sub Total D 13,316,129
25,800,000
B Periode Apr - Desember 22

Jumlah Durasi Harga Satuan Unit Total Harga (Rp)


No Deskripsi Jasa / Material Site Location UOM (Bulan) per Bulan (Rp)

a b c d=axbxc
Point to Point Microwave Radio with Licensed Frequency
1 Point to Point Microwave Radio with Licensed Frequency Mudi Office PAD A 10 Mbps 1 9 8,600,000 77,400,000
2 Point to Point Microwave Radio with Licensed Frequency Mudi Office PAD C 10 Mbps 1 9 8,600,000 77,400,000
3 Point to Point Microwave Radio with Licensed Frequency Mudi Office NGANDONG 10 Mbps 1 9 8,600,000 77,400,000
Sub Total D 232,200,000

Description TOTAL (Rp)


Sub Total A (Monthly) 13,316,129
Sub Total B (Monthly) 232,200,000
TOTAL HARGA 245,516,129 982,064,516

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