Subcontractor Materials Reconcilation Form

Subcontractor：PT. AGUNA SATYA MULYA Witel: SAMARINDA Date: 3-July-2023

Mitratel 2022 Samarinda 6 Sites Project Witel Samarinda
MRF No.：

Num PO Num Site Name Site ID

1 ID-TA-AGUNA-0575-OS 19TRG004-22TRG0070 REG06-0751
2 ID-TA-AGUNA-0581-OS 22TRG0092-22TRG0110 REG06-0757
3 ID-TA-AGUNA-0582-OS 22TRG0110-22TRG0112 REG06-0758
4 ID-TA-AGUNA-0583-OS 22TRG0112-22TRG0113 REG06-0759
5 ID-TA-AGUNA-0584-OS 22TRG0113-22TRG0074 REG06-0760
6 ID-TA-AGUNA-0585-OS 22TRG0074-19TRG013 REG06-0761

Here only mention 1. positive no.

1. Materials taken mateirals quantity Materials lend to means materials lost
Description from FH warehouse Materials Quantity already returned to FH other subcon, must Materials still in by subcon
Explanation of GAP
2. Materiasl taken in as built BOQ warehouse, if materials have BA of subcon wareshoue 2. negative
from other subcon not yet return, mention materials handover no.means maetials
in actual stock overlap

Materials Quantity Materials Quantity Materials Returned Materials lend to

Code Description Unit Actual Stock GAP Remark
in MRF in as built BOQ Quantity other subcon

1 FNA300001-24-GJ V/FOSC-H4-B-S1-3601-L-41-GJ PCS 0 7 0 0 7 pcs using TA Material

6 FNA-TA-16 ODC-C-48 PCS 0 4 0 0 4 pcs using TA Material
7 FNA-TA-21 ODP-PL-8 PCS 0 2 0 0 2 pcs using TA Material
8 FNA-TA-04 Telephone Pole 7 Meter PCS 0 5 0 0 5 pcs using TA Material
23 GYTC8A-24 AC-OF-SM-24D Meter 0 31,159 0 0 31,159 m using TA Material

Note:
1. This Inventory Report already checked by FiberHome Project Manager and Subcontractor Project Manager
2. If any materials not in this list but subcon picked up from FiberHome, materials information can add to here by insert more columns.
3. Subcontractor shall keep the remaining materials from each project in good condition and security.

Subcontractor Project Manager Fiberhome Project Manager

Name: Name: Zheng Huining