EXPRESSIONS OF INTEREST

The ITDP Loan World Bank 8816-ID

Assignment Title:
Construction Management Consultan Lombok Water Supply System

8th August 2021

The undersigned below:

Name : Agung Wihartanto

Position : Head of Infrastructure Division
Acting for/on behalf of : PT. Yodya Karya (Persero)
Address : Yodya Tower 9th floor, Jl. DI Panjaitan Kav. 8 Cipinang Cempedak
Jakarta Timur
Telephone/Fax : 021-8193951
E-mail : pms.infrastruktur@yodyakarya.com

Certify that:

1. By law having the authority to represent the firm/company based on Notarial Deed No. 10 dated
22 January 2020.
2. The firm/company is not being declared bankrupt or its business activities are not being terminated
or not undergoing criminal sanctions or under the supervision of the court.
3. I have never been convicted on the basis of a court decision for actions relating to my professional
conduct
4. The firm/company data is as follows:

A. Administration

1. Name of the Firm/Company : PT. Yodya Karya (Persero)

2. Status of the Firm/Company : Head Office
3. Address : Yodya Tower 9th floor, Jl. DI Panjaitan Kav. 8 Cipinang
Cempedak, Jakarta Timur
Telephone : 021-8193951
Fax : 021-8193519
E-mail : pms.infrastruktur@yodyakarya.com

B. Business Permit

Business Permit : 9120202641873

Validity of Business Permit : -
Issued by : Pemerintah Republik Indonesia c.q. Lembaga Pengelola dan
Penyelenggara OSS
Business Permit : 1 - 3172 - 01 - 008 - 1 - 09 - 002100
Validity of Business Permit : 16 January 2023
Issued by : LPJK
Business Permit : 1 - 3172 - 02 - 008 - 1 - 09 - 002100
Validity of Business Permit : 16 January 2023
Issued by : LPJK
Business Permit : 1 - 3172 - 03 - 008 - 1 - 09 - 002100
Validity of Business Permit : 16 January 2023
Issued by : LPJK
Business Permit : 2 - 3172 - 13 - 008 - 1 - 09 - 002100
Validity of Business Permit : 16 January 2023
Issued by : LPJK
Business Permit : 2 - 3172 - 14 - 008 - 1 - 09 - 002100
Validity of Business Permit : 16 January 2023
 Issued by : LPJK
Business Permit : 2 - 3172 - 15 - 008 - 1 - 09 - 002100
Validity of Business Permit : 16 January 2023
Issued by : LPJK
Business Permit : 3 - 3172 - 05 - 008 - 1 - 09 - 002100
Validity of Business Permit : 16 January 2023
Issued by : LPJK
Business Permit : 4 - 3172 - 04 - 008 - 1 - 09 - 002100
Validity of Business Permit : 16 January 2023
Issued by : LPJK

C. Legal Standing of Firm/Company

1 Certificate of Incorporation (CoI)

Certificate Number : 62
Date : 15 March 1972
Issued by : Djojo Muljadi, SH.
2 Latest Amendment of CoI
Certificate Number : 01
Date : 08 Februari 2022
Issued by : Arminawan, SH

D. Firm/Company Management

1. Commissioner

No. Name ID Number Position in the Firm/Company

1 Dewi Chomistriana 3174066801710001 President Commissioner
2 Sidik Pramono 3671132009750006 Independent Commissioner
3 Didi Apriadi 3174052204690004 Independent Commissioner

2. Board of Directors

No Name ID Number Position in the Firm/Company

.
1 Colbert Thomas 3674052302600002 President Director
Pangaribuan
2 Delta Hatmantari 3374116811660006 Director
S.
3 Agung Wihartanto 7371112309750005 Head of Infrastructure Division

E. Financial Information

1. Share Ownership Structure

No Name ID Number Address Percentage

1 Departemen - Jl. Lapangan 100%
Keuangan RI. Banteng No. 2-4
Cq. Kantor Jakarta Pusat
Kementrian
Negara BUMN

2. Tax Information

1 Tax Payer ID No : 1.001.616.0-093.000

2 Receipt of Latest Tax Repayment : 51160406418221020111
Receipt No/Date : 20 April 2022
3 VAT for May : 75160606028220281413
Receipt No/Date : 18 June 2022
 VAT for April : 51160506036220313412
Receipt No/Date : 31 May 2022
VAT for March : 65150406088220276213
Receipt No/Date : 27 April 2022

F. Firm’s Financial Capacity in Last 3 Years

Attached

G. Firm’s Personnel Data

Attached

H. Firm’s/Company’s Experience Data for the Last 10 Years

Attached

Herewith I make this statement in truth and full of responsibility. If in the future,
data/documents that I submitted is not true and there is forgery, then I am willing to be imposed as
administrative sanction which is included in the blacklist in the Government for a period of 2 (two)
years, and civil and criminal sanctions in accordance with the applicable regulations.

Jakarta, 8th August 2022

PT. Yodya Karya (Persero)

Agung Wihartanto
Head of Infrastructure Division