Claim Approval Slip CAS No

Date
: CAS – 001/TJE/X/2023
: 04 October 2023
Unit Model GD755-5R Reference No EMR Techcare U.385761 001 = No Form Registration
Unit Serial Number 10499 Customer Name PT.PPA JKT = Branch/ Site Selling Location/ BBO/ MSO/ TRO
Delivery Date 3/10/2022 Customer Business VI = Month of create CAS
SMR (Hours Meter) / KM 5000 Location LAHAT 2015 = Years of create CAS
SUBJECT Swing Circle Shaft Broken
DESCRIPTION
Problem :
Indikasi Problem Swing Circle Shaft Broken MNG = Mining Sector
CON = Construction Sector
FOR = Forestry Sector
Sesuai EMR

Analisa :
Poor Durability Of Shaft Circle
CWR 065

Detail cost :
Labour Rp -
Transportasi & Consumable 0
Parts/VENDOR Rp -

Total Rp -
PPN 11% 0
Grand Total Rp -

Total Cost (Rp) Budget Remaining

Rp0 Rp0

Customer Responsibilities Cost (Rp) UT Responsibilities Cost (Rp)

Rp0 Rp0 BRANCH MANAGER/ANTHONIUS CHANDRA SITE MANAGER/ARIF WICAKSONO
Date : Date :
Reason Of Goodwill
UNIT NOT WARRANTY

SUHARDI/TSO SOD DIV HEAD ISTIQO PROJO/SALES DEPT HEAD SADAR SUTRISNO/ CSSD DEPT HEAD
Date : Date : Date :

s
No Part Number Description Qty Satuan Amount
1 FOC230-70-6500 Shaft 1 -
2 -

Total -

No Cost Jumlah Mekanik Cost Per hours Total Hrs Total Cost Man Hours
1 Labour ut 0 -
2 Transport & Consumable 0 -
Total -

Total Cost -