Professional Documents
Culture Documents
QUOTATION SLIP
QS/0000066/BAE02/08/23
THE INSURED Mr. Jeffrey Halim including any subsidiary and/or related company
of the unnamed of this existing at the commencement of this
insurance or formed, purchased or otherwise acquired during the
currency of the Policy for their respective rights and interest.
It is also agreed and declared that the named Insured includes the
interest of any joint venture where Mr. Jeffrey Halim accepted
obligation to insure.
COVERAGE All Risks of physical loss or damage to the Insured property from any
cause not excluded in the Policy. It is hereby noted and agreed that
items excluded are amended to include all items which particularly
expressed in the Schedule under "INTEREST INSURED"
ADDITIONAL COVERAGES : The following items are included with First Loss Limit IDR 250.000.000
Construction/Erection/Alteration/RepairRp. 2.500.000.000,- in
● Works exclude ALOP/BI/CPME the aggregate
IDR 100.000.000
● Cash In Safe Rp. 250.000.000,- any
one occurrence /
location
DEDUCTIBLES: any one 1 Fire, Lightning, Explosion, Aircraft Damage, Smoke, Impact by
occurrence/location Vehicle - NIL.
2 Riot, Strike, Malicious Damage and Civil Commotion (RSMD
4.1B/2007) - 5% of Loss minimum Rp. 5.000.000,- anyone
occurrence
3 Earthquake, Volcanic Eruption & Tsunami (within 72 hours) -
2,5% of Total Sum Insured anyone occurrence
4 Flood, Windstorm, Typhoon, Water Damage, Landslide, Landslip,
and subsidence - 10% of loss anyone occurence
5 All other causes - Rp. 1.000.000,- anyone occurrence
Tanggal:
Bandung, 08-September-2023
Date/Signed :
Company :
Sign :
Comments :
All Other Contents Clause (Rp. 50.000.000,- per item and Rp. 500.000.000,- in aggregate)
It is noted and agreed that this Policy extends to include
a. Money and stamps not otherwise specifically insured for an amount not exceeding in the aggregate as
stated in the policy schedule
b. Documents, manuscripts and business books but only for the value of the materials as stationery,
together with the cost of clerical labour expended in writing up, and not for the value to the insured of the
information contained therein and for an amount not exceeding in the aggregate as stated in the policy
schedule
c. Computer system records but only for the value of the materials together with the cost of clerical labour
and computer time expended in reproducing such records (excluding any expenses in connection with the
production of information to be recorded therein) and not for the value to the insured of the information
contained therein for an amount not exceeding in the aggregate as stated in the policy schedule
d. Patterns, moulds, models, plans and designs, for an amount not exceeding in the aggregate as stated in
the policy schedule
e. Employees pedal cycles, clothing, tools and other personal effects for an amount not exceeding as stated
in the policy schedule in respect of any one employee.
or repair of Property Insured consequent upon its destruction or damage but not for preparing any claim, it
being understood that the amount payable under the item shall not exceed in total its sum insured.
The Company's Liability shall not exceed of Total Sum Insured stated in the Schedule of the Policy.
Automobile Clause
The housing of automobiles is allowed, and it is warranted that no inflammable spirit intended for fuel in
connection therewith be at any time in the portion of the building under the control of the insured, other
than contained in the reservoirs of such automobiles or in approved underground storage systems or in
sealed metal containers.
Awning, Blinds and Signs Clause (Sub-limit Rp. 250.000.000,- any one occurrence)
Awnings, blinds, signs or other outdoor fixtures or fittings of any description are covered by this Policy
provided that the Insurer's liability under this extension shall be on first loss basis, not in the aggregate to
exceed Rp. 250.000.000,- any one occurrence.
The conditions and warranties of this policy shall apply individually to each of the risks insured and not
collectively to them. Thus a breach in any condition or warranty shall void the section only in respect of all
the risks to which that breach applied and does not affect the section in respect of the other risks.
Claim Mitigation and Preventive Measure Clause (limit Rp. 2.500.000.000,- anyone occurrence and
Rp. 5.000.000.000,- in aggregate)
It is hereby agreed that in the event of actual damage (or imminent damage) to the insured property, the
Insurer will pay the reasonably costs necessary in preventing, minimizing or reducing damage to the insured
property including the cost to rent the temporary premises to minimise loss.
The Insured will prove the costs were necessarily incurred immediately and urgently in an emergency.
Cost of Clearing Drains (within radius 500 meters of the origin damage point within Insured's
premises - limit Rp. 2.500.000.000,- any one loss)
Subject to the liability of the Insurer(s) not being increased beyond the Limit(s) of Liability already stated
herein, the Insurer(s) will also indemnify the Insured for costs of clearance of drains including expenses
necessarily incurred in clearing and/or repairing drains, gutters, sewers and the like, at or in the vicinity of
Property Insured, consequent upon damage recoverable hereunder
Cost of Temporary Protection Clause (sub-limit Rp. 250.000.000,- per anyone loss)
To the extent not already insured this policy hereby extends to cover the cost of temporary protection
reasonably necessary for the safety and protection of the premises pending repairs/replacement of damage.
Limited to the amount provided in the Sub-limit in the Schedule.
(including the insured's legal liability for the cost of removal of debris, demolition, and temporary repairs in
regard to adjoining premises, roadways or waterways as well as on the site), consequent upon the destruction
of or damage to any property insured by this Policy occasioned by any peril thereby insured against. Provided
always that :
a. Such cost is not recoverable under any other insurance;
b. The indemnity afforded by this insurance shall not apply to or include liability assumed by the Insured
under agreement entered into after the commencing date of this insurance, unless such liability would have
attached to the Insured in the absence of such agreement.
Designation Clause
For the purpose of determining, where necessary, the definition of any property insured hereby the Insurer
agrees to accept the designation under which such property has been entered in the Insured's books.
Directors, Employees, and Guests Personal Effects Extension (limit Rp. 50.000.000,- any one loss
and Rp. 500.000.000,- in the aggregate)
The indemnity granted by this Policy extends to include clothing and/or personal effects of the directors,
employees and guests of the insured for an amount limit Rp. 50.000.000,- any one loss.
Duties Clause
The Insurer will also reimburse the Insured for customs and excise duties, import taxes, VAT/GST, freight,
insurance and similar charges in respect of the procurement / manufacturing of goods, materials and
services for replacement, restoration or re-commissioning. The application of the clause is subject to the
compliance with the tax regulation in Indonesia.
Electrical Short Circuit (Sub limit Rp. 500.000.000,- any one occurrence and in the aggregate)
It is hereby noted and agreed that this insurance shall cover physical damage to any one unit of electrical
or electronic equipment, except electrical or electronic equipment used for household purposes, stated in
the Schedule, caused by short circuit on such electrical or electronic equipment.
This extended cover shall not be applicable if the risk has been covered under more specific insurance
In the event of loss or damage to the property insured or any part thereof the cost of any repair, replacement
or rectification admitted under this policy shall include the additional costs not exceeding 25% of loss any
one occurrence of overtime weekend and shift working, bonus payments, plant hire charges, express
delivery, including airfreight and the like necessarily and reasonably incurred in expediting such repair,
replacement or rectification but excluding any such costs solely to expedite the completion of any
construction, erection or installation of property not loss or damage at a faster rate than would have been
obtained had no such loss or damage occur.
Fire Brigade Charges Clause (Limit Rp. 250.000.000,- any one occurrence)
It is hereby understood and agreed that the charges raised by any local authority for the provision of Fire
Fighting Appliances called for the purpose of protecting the premises shall be recoverable hereunder.
Interpretation Clause
In the event of any conflict of interpretation between the various clauses and conditions contained in this
policy, the broadest and least restrictive wording to the benefit of the insured shall always prevail.
Notwithstanding the above, this insurance shall not be affected by the failure of the insured to comply with
laws, statues or jurisdiction which would otherwise have been a bar to any claim in respect of loss,
destruction or damage.
Lock and Keys Clause (Limit Rp. 100.000.000,- any one occurrence)
It is hereby agreed that this insurance extends to include the cost of replacing locks and keys and/or
combinations if, as a result of theft or any attempt thereat, keys and/or combination are stolen, or if there
are any reasonable grounds to believe that they have been duplicated, also the cost of opening locked safes
or strong rooms as a result of theft of keys and/or combinations.
Minor alterations, additions and repairs to building plant fixtures and fittings, and machinery (exclusive of
any Sprinkler Installations) and minor works in progress are allowed and this shall not prejudice the
insurance by this Policy.
New Location Clause (Rp. 5.000.000.000,- subject to first class construction and within 60 days
declaration)
It is hereby declared and agreed that the Company will hold cover any new locations acquired by the Insured
during the period of Insurance subject to not exceeding of Rp. 5.000.000.000,- any one location within the
policy period
The Insured shall declare to the Company not later than 60 days from date of acquire and additional
premium shall be charged accordingly.
Notification Clause
It is hereby noted and agreed that the present situation, manner of connection, construction, nature and
interior of the buildings and also the trade carried on therein, is known to Insurers.
Outbuilding Clause
The insurance by each item under buildings is understood to include walls, gates and fences, small outside
buildings, extensions, annexes, exterior staircase, fuel installations, steel or iron framework and tanks in
the said premises and the insurance by each item under contents extends to contents of each outbuilding,
provided their values are included in the sum insured.
Premises Clause
Extends to cover property whilst on platform, alleys, yards, buildings and in the open within the compound
provided that the insured have done all that are necessary to prevent a loss from happening which should
be precedent to liability to the company.
Reinstatement Value Clause (This particular Clause attached and applied to Earthquake Policy only
- Maximum 24 months Reinstatement Period from the date of Loss)
It is hereby declared and agreed that in the event of the property insured being destroyed or damaged the
basis upon which the amount payable under the Policy is to be calculated shall be the cost of replacing or
reinstating on the same site property of the same kind or type but not superior to or more extensive than
the insured property when new, subject to the following Special Provisions and subject also to the terms and
conditions of the Policy except insofar as the same may be varied hereby.
Special Provisions
i ) The work of replacement or reinstatement (which may be carried out upon another site and in any
manner suitable to the requirements of the Insured subject to the liability or Insurer not being thereby
increased) must be commenced and carried out with reasonable dispatch and in any case must be completed
within 24 months after the destruction or damage or within such further time as the Insurer may (during
the said 24 months) in writing allow otherwise no payment beyond the amount which would have been
payable under the Policy if this memorandum had not been incorporated therein shall be made.
ii) Until expenditure has been incurred by the Insured in replacing or reinstating the property destroyed or
damaged the Insurer shall not be liable for any payment in excess of the amount which would have been
payable under the Policy if this memorandum had not been incorporated therein.
iii) If at the time of replacement or reinstatement the sum representing the cost which would have been
incurred in replacement or reinstatement if the whole of the property covered had been destroyed exceeds
the sum insured thereon at the breaking out of any fire or at the commencement of any destruction of or
damage to such property by any other peril insured against by this Policy then the Insured shall be
considered as being his own insurer for the excess and shall bear a ratable proportion of the loss accordingly.
Each item of the Policy (if more than one) to which this memorandum applies shall be separately subject to
the foregoing provision.
iv) No payment beyond the amount which would have been payable under the Policy if this memorandum
had not been incorporated therein shall be made if at the time of any destruction or damage to any
property insured hereunder such property shall be covered by any other insurance effected by or on
behalf of the Insured which is not upon the identical basis of reinstatement set forth herein.
v) This memorandum shall be without force or effect if
(a) The Insured fails to intimate to the Insurer within 24 months from the date of destruction or damage or
such further time as the Insurer may in writing allow his intention to replace or reinstate the property
destroyed or damaged.
(b) The insured is unable or unwilling to replace or reinstate the property destroyed or damaged on the same
or another site.
Recoveries Clause
Notwithstanding anything contained in this Policy to the contrary, if the Insured shall sustain any loss
covered by this Policy which exceeds the Sum(s) Insured, the Insured shall be entitled to all recoveries by
whomsoever made on account of such loss until fully reimbursed, and any remainder shall be applied to the
reimbursement of the Insurer.
Services Clause
The insurance by this Policy relating to machinery and equipment extends to include telephone, gas, water
and electric instruments, meters, piping, cabling and the like and accessories thereof including similar
property in adjoining yards or roadways or underground all the property of the Insured or of suppliers or
others for which the Insured are responsible provided their values are included in the sum insured.
Workmen's Clause
Workmen are allowed in and about any of the described premises or the purposes of making new erections
or alterations, repair, decoration, plant installation, general maintenance and the like without prejudice to
the terms and conditions of the policy.
Currency Clause
It is hereby understood and agreed that in case a claimable loss hereunder, if any, if denominated in currency
other than the currency stated in the Policy Schedule, then the conversion rate shall be the middle rate for
bank notes published by the Bank Indonesia on the Date of Agreement between the Insurer and Insured as
to the amount of loss.
Dispute Clause
1. In the event of any dispute arising between the Insurer and the Insured as consequence of the
interpretation of liability or amount of indemnity of this Policy, the dispute shall be settled amicably by
the complaint handling and resolution unit of the Insurers within 60 (sixty) calendar days from the dispute
arose. The dispute arises since the Insured has expressed disagreement in writing on the subject matter of
the dispute.
2. If the dispute could not be settled amicably as provided in item 1 above, both the Insurer and the
Insured shall make statement of disagreement in writing. Then the Insured shall choose to settle the
dispute through out of the court or court settlement by selecting either one of the following dispute
settlement clauses as stated below.
B. COURT
It is hereby declared and agreed that the Insured and the Insurer shall settle the dispute through the Court
(Pengadilan Negeri) within the territory of the Republic of Indonesia.
Notwithstanding any provision to the contrary within the Policy or any endorsement thereto, it is understood
and agreed as follows:-
a) This Policy does not insure, loss, damage, destruction, distortion, erasure, corruption or alteration of
ELECTRONIC DATA from any cause whatsoever (including but not limited to COMPUTER VIRUS) or loss of
use, reduction in functionality, cost, expense of whatsoever nature resulting therefrom, regardless of any
other cause or event contributing concurrently or in any other sequence to the loss.
ELECTRONIC DATA means facts, concepts and information converted to a form useable for
communications, interpretation or processing by electronic and electromechanical data processing or
electronically controlled equipment and includes programmes, software, and other coded instructions for
the processing and manipulation of data or the direction and manipulation of such equipment.
COMPUTER VIRUS means a set of corrupting, harmful or otherwise unauthorised instructions or code
including a set of maliciously introduced unauthorised instructions or code, programmatic or otherwise,
that propagate themselves through a computer system or network of whatsoever nature. COMPUTER VIRUS
includes but is not limited to 'Trojan Horses', 'worms' and 'time or logic bombs'.
b) However, in the event that a peril listed below results from any of the matters described in paragraph a)
above, this Policy, subject to all its terms, conditions and exclusions will cover physical damage occurring
during the Policy period to property insured by this Policy directly caused by such listed peril.
Listed Perils
Fire
Explosion
Should electronic data processing media insured by this Policy suffer physical loss or damage insured by
this Policy, then the basis of valuation shall be the cost of the blank media plus the costs of copying the
ELECTRONIC DATA from back-up or from originals of a previous generation. These costs will not include
research and engineering nor any costs of recreating, gathering or assembling such ELECTRONIC DATA. If
the media is not repaired, replaced or restored the basis of valuation shall be the cost of the blank media.
However this Policy does not insure any amount pertaining to the value of such ELECTRONIC DATA to the
Assured or any other party, even if such ELECTRONIC DATA cannot be recreated, gathered or assembled.
N.M.A. 2915
1. In no case shall this insurance cover loss, damage, liability or expense directly or indirectly caused by or
contributed to by or arising from :
1.1 ionising, radiations from or contamination by radioactivity from any nuclear fuel or from any nuclear
waste or from the combustion of nuclear fuel.
1.2 the radioactive, toxic, explosive or other hazardous or contaminating properties of any nuclear
installations, reactor or other nuclear assembly or nuclear component thereof
1.3 any weapon of war employing atomic or nuclear fission and/or fusion or other like reaction or radioactive
force or matter.
The cost of removing, nullifying or cleaning-up seeping, polluting or contaminating substances unless the
seepage, pollution or contamination is caused by sudden, unintended and unexpected happening during
the period of this Contract.
a. Arbitration
It is hereby declared and agreed that the insured and the insurer shall settle the dispute through Arbitration
Ad Hoc as follows:
1. The Ad Hoc Arbitration consists of 3 (three) Arbitrators. The insured and the insurer shall each appoint
one Arbitrator within 30 (thirty) calendar days from the date of the receipt of the written notification, then
the two Arbitrators shall choose and appoint the third Arbitrator calendar days from the date of appointment
of the second Arbitrator, The third Arbitrator shall act as Umpire of the Arbitration Ad Hoc.
2. Should there be any failure as to the appointment of the third Arbitrator, the insured and or the insurer
could request the Chairman of the court (Ketua Pengadilan Negeri) where the defendant domiciles to appoint
the Umpire.
3. The examination of the dispute shall be settled within 180 (one hundred and eighty) calendar days from
the date of the formation of the Arbitration Ad Hoc. The period of examination of the case could be extended.
Upon the agreement of booth parties and if it is deemed necessary by the Arbitration Ad Hoc, the period of
the examination of the dispute could be extended.
4. The Arbitration award is final and enforceable at law and binding the insured and the insurer. Should
the insured and or theinsurer fail to comply with the arbitration award, then the award shall be executed
under the order of the Chairman of the competent court (Ketua Pengadilan Negeri yang berwenang) at the
request of the other party in dispute.
5. Other matters which are not provided under this clause shall be subject to the provisions of laws on
arbitration, which currently be the Act of the Republic of Indonesia Nr. 30 year 1999 dated August 12, 1999
regarding Arbitration and Alternative Dispute Resolution).
b. Court
It is hereby declared and agreed that the insured and the insurer shall settle the dispute through the Court
(Pengadilan Negeri) within the territory of the Republic of Indonesia.
4. In case of the decision of adjudication of BMAI is declined by the insured, but the insured does not take
the case to arbitration or court within 180 (one hundred eighty) calendar days from the date of the
adjudication's decision made by BMAI in writing, then the rights of the insured to the indemnification will
be automatically forfeited.
Mis-description Clause
It is understood that this insurance shall not be prejudiced by any alteration or misdescription of occupancy
provided the Insured shall notify the Company immediately they become aware of the same and to pay
additional premium if required from the date of the inception of the increased hazard.
A. Any change of occupancy or increase of risk taking place in the property insured without the Insured's
knowledge, provided that they shall, immediately on the same coming to their knowledge, advise the Insurers
and pay any additional premium that may be required from the date of such increase of risk.
B. Workmen on the premises for the purpose of affecting repairs minor alterations or general maintenance
purposes and the like.
It is hereby declared and agreed that progress payment on account of any loss recoverable under this policy
will be made to the Insured at such stages as may be mutually agreed upon if desired by the Insured and
on production of an interim report by the loss adjuster (if appointed) provided that such payment are
deducted from the finally agreed claim settlement figures.
Plans & Documents Clause (limit 20% anyone claim amount per occurrence)
Notwithstanding anything herein contained to the contrary the Insurance hereby is extended to indemnity
the Insured against the necessarily incurred costs of re-writing or re-drawing of plans and drawing or other
contract documents lost destroyed or damage as a result or peril insured hereunder wherever or whenever
such loss destruction or damage shall occur.
Such indemnification shall however be limited to:
A maximum amount of 20% anyone claim amount per occurrence out of any event.
The cost of labour expended in such re-writing or re-drawing including all necessary overtime working or
research.
For the purpose of this endorsement an act of terrorism means an act, including but not limited to the use
of force or violence and/or the threat thereof, of any person or groups(s) of persons, whether acting alone or
on behalf of or in connection with any organization(s) or government(s), committed for political, religious,
ideological or similar purposes including the intention to influence any government and/or to put the public,
or any section of the public, in fear.
This endorsement also excludes loss, damage, cost or expense of whatsoever nature directly or indirectly
caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or
in any way relating to any act of terrorism.
If the Underwriters allege that by reason of this exclusion, any loss, damage, cost or expense is not covered
by this insurance the burden of proving the contrary shall be upon the Assured.
In the event any portion of this clause is found to be invalid or unenforceable, the remainder shall remain
in full force and effect.
Thirty (30) days cancellation notice clause (except 3 days for RSMD 4.1B/2007 and 5 days for
Earthquake Policy)
It is hereby declared and agreed that both the Insurer and the Insured are entitled to cancel this insurance
at any time without given reason therefore. Such cancellation shall however only become effective on the
expiration of 30 (thirty) days from midnight of the day on which notice of the cancellation is issued. If the
Insurer cancels the insurance he is obliged to return the pro-rata premium for the unexpired period of
insurance. If it is the Insured who cancels the insurance, premium will be calculated on the short term rate
for the completed period of Insurance.
72 Hours Time Adjustment Clause (for Earthquake, Tsunami & Volcanic Eruption & 4.3A
Endorsement)
Each occurrence of loss and or damahe caused by any insured perils shall contitute a single claim
hereunder, provided that if more than one event shall occur within a period of 72 hours as from the first
occurrence, such events shall be deemed to be a single event within the meaning hereof.
The Insurer shall not be liable for any loss although caused by any insured perils occuring before the effective
date and time of this policy, nor for any loss occurring after the expiry date and time of this policy
This agreement does not cover any liability assumed by the Insured for loss or damage directly or indirectly
occasioned by happening through or in consequence of war, invasion, acts of foreign enemies, hostilities or
war-like operations (whether war be declared or not), civil war, mutiny, civil commotion assuming the
proportions of or amounting to popular rising, military rising, insurrection, rebellion, revolution, military or
usurped power, martial law, confiscation or nationalization or requisition or destruction of or damage to
property by or under the order of any Government or public or local authority.
Display and Exhibition Clause (Limit Rp. 1.000.000.000,- maximum 30 days / event within
Indonesia territory)