Fitter Fuel Claim (Per-Job)

Name Andriadi Authorized by Simon Purchase Rp -

Destination(s) Kayuagung,Pekanbaru Date Submitted Rp 15,000

Customer Nam PT.Telaga Hikmah , PT.Petronesia Benimel total(s) 14

Location(s) Kayuagung,Pekanbaru Price Package(include Vat)

Departure Notes Rp 210,000

Return Per Job Fitment/Repair/De Re/Cancellatio Rp 210,000

Allowance Rp15,000

Date Description address Ground total Job Per Job Telecommun Miscellaneo Self Drive Mileage Expense Total Billable
of Expense Transportati Reimbusemen ication / us (KM) Reimbursem Currency Expense
on (Gas, t Internet ent
Rental Car,
12-Dec-22 Repair PT.Telaga Hikmah motor cycle 1
Rp15,000 Rp - Rp 15,000
13-Dec-22 Repair PT.Telaga Hikmah motor cycle 2
Rp15,000 Rp - Rp 30,000
23-Dec-22 Fitment PT.Petronesia Benimel motor cycle 1
Rp15,000 Rp - Rp 15,000
24-Dec-22 Fitment PT.Petronesia Benimel motor cycle 3
Rp15,000 Rp - Rp 45,000
26-Dec-22 Fitment PT.Petronesia Benimel motor cycle 2
Rp15,000 Rp - Rp 30,000
28-Dec-22 Repair PT.Petronesia Benimel motor cycle 1
Rp15,000 Rp - Rp 15,000
29-Dec-22 Fitment PT.Petronesia Benimel motor cycle 1
Rp15,000 Rp - Rp 15,000
31-Dec-22 Repair PT.Petronesia Benimel motor cycle 3
Rp15,000 Rp - Rp 45,000

Rp - Rp -

Rp - Rp -

Rp - Rp -

Rp - Rp -

Rp - Rp -

Total Rp - Rp 210,000

Reimbursement Received Date: Approval By: Simon Purchase Date:

Reimbursement Ref:

Expense Account:
CARTRACK ASIA PTE LTD

CARTRACK S.E.A. PTE LTD