08-PARC-00004-000-02-2023

SCHEDULE DRAFT
Register No :
Co-Insurance
POLICY NO. : 08-PARC-00004-000-02-2023 Reference No : 20301042300001
NAME OF THE INSURED : PT. BNI (PERSERO) TBK SENTRA BISNIS KOMERSIAL (SBK) SURABAYA
QQ PT. MAULANA KARYA PERSADA
ADDRESS : GEDUNG BNI GRAHA PANGERAN LT. 3
JL. JEND. A. YANI NO. 286
KOTA SURABAYA Postal Code : 60234
INCEPTION : 23rd December 2023 EXPIRATION : 23rd December 2024
(12.00 o'clock at noon local time at the location of the insured
object)
Unit No : 0001
SECTION I : MATERIAL DAMAGE
Location of Risk : TANJUNG BUNUT, TAYAN HILIR, SANGGAU,
WEST KALIMANTAN
Postal Code : 78564
Code No./Occupation : 2742 / EDIBLE OILS PLANTS AND OTHER PLANTS PRODUCING EDIBLE PALM OIL
(CPO, PKO, CCO) COOKING OIL AND MARGARINE FROM VEGETABLE OIL
OR OTHER EDIBLE OILS OR DESICCATED COCONUT
Construction : 1ST CLASS
Insured Interest : Sum Insured
(IDR)

- CRUDE PALM OIL IDR 44,637,573,362.00 51,095,100,000.00

- KERNEL IDR 6,457,526,638.00

Total Sum Insured : IDR 51,095,100,000.00
(says : RUPIAH : Fifty-One Billion Ninety-Five Million One Hundred Thousand only )
Limit of Liability :
Deductible : - Typhoon, Storm, Flood, Water Damage : 10% of Claim a.o.a
- Riots, Strike, Malicious Damage (RSMD) : 15% of Claim minimum
IDR 25,000,0000.00 for anyone accident
- Others : IDR 2,500,000.00 for a.o.a
- Fire, Lightning, Explosion, Impact of Falling Aircraft, and Smoke :
0.5% of TSI or 15% of Approved Claim (Whichever is Higher)
- Civil Commotion : 10% of Claim minimum IDR 25,000,000.00 for anyone
accident
Clauses, Endorsements, Special Conditions and Warranties
SECTION I
1. FEBC BANKER'S CLAUSE PT. BANK NEGARA INDONESIA (PERSERO) TBK
2. FEDP6 DEFERRED PREMIUM CLAUSE (4 TIMES WITHIN 4 MONTHS)
3. 4,1B RIOTS, STRIKES, MALICIOUS DAMAGE AND CIVIL COMMOTIONS ENDORSEMENT (IAR/PAR)
4. FEAR ALTERATIONS CLAUSE (PAR)
5. FEAIRP APPRAISEMENT CLAUSE (5% OF TSI)
6. FEAE ARCHITECTS, SURVEYORS AND CONSULTING ENGINEERS EXPENSES CLAUSE
7. FEAVRP AVERAGE RELIEF CLAUSE (85%)
8. FEAW AWNINGS BLINDS SIGNS OR OTHER OUTDOOR FITTINGS OF EVERY DESCRIPTION CLAUSE
9. FECA CAPITAL ADDITIONS CLAUSE (PAR)
10. FECC CIVIL AUTHORITIES CLAUSE (PAR)
11. FECOIN CO-INSURANCE CLAUSE
 08-PARC-00004-000-02-2023

(Attaching to and forming part of Policy No. 08-PARC-00004-000-02-2023 End.

No.00)
12. LM5394 COMMUNICABLE DISEASE EXCLUSION
13. NM2915 CYBER RISK EXCLUSION
14. FEDO DESIGNATION CLAUSE (PAR)
15. FEDCS DISPUTE CLAUSE
16. IAR-EQ EARTHQUAKE EXCLUSION CLAUSE
17. EDRCB ELECTRONIC DATA ENDORSEMENT B
18. EDRC-A ELECTRONIC DATE RECOGNITION CLAUSE (EDRC A) - FIRE
19. 43IAR ENDORSEMENT FLOOD, WINDSTORM, TEMPEST AND WATER DAMAGE (CODE:4.3 A) AMENDED FOR
IAR/PAR
20. FEEX EXTRA-CONTRACTUAL OBLIGATION EXCLUSION CLAUSE
21. FEFBRP FIRE BRIGADES CHARGES CLAUSE (IDR 100.000.000,00 IN AGGREGATE)
22. FEFC1 FIRE EXTINGUISHING COSTS CLAUSE (IDR 100.000.000,00 IN AGGREGATE)
23. FEGI GENERAL INTEREST CLAUSE (PAR)
24. FEIO IMPACT BY OWN VEHICLES CLAUSE
25. NM1685 INDUSTRIES, SEEPAGE, POLLUTION AND CONTAMINATION CLAUSE (NMA 1685) (SUDDEN AND
ACCIDENTAL)
26. NM2912 INFORMATION TECHNOLOGY HAZARDS CLARIFICATION CLAUSE
27. FEII INTERNAL REMOVAL CLAUSE (PAR)
28. FELANS LANDSLIDE, LANDSLIP AND SUBSIDENCE
29. FELN LOSS NOTIFICATION CLAUSE (30 DAYS)
30. FEMA MINOR ALTERATION AND REPAIRS CLAUSE
31. FEMI4 MISDESCRIPTION CLAUSE
32. FENA3 NOMINATED ADJUSTERS CLAUSE AS PER TRIPA LIST
33. FENOR NON AUTOMATIC RENEWAL CLAUSE
34. FENIRP NON INVALIDATION CLAUSE
35. FENO1 NOTIFICATION CLAUSE
36. FENER NUCLEAR ENERGY RISK EXCLUSION CLAUSE (WORLDWIDE EXCLUDING USA AND CANADA)
37. FEOB OUTBUILDING CLAUSE (PAR)
38. PAYRP PAYMENT ON ACCOUNT CLAUSE (PAR) (10% OF CLAIM)
39. FEPRE POLITICAL RISK EXCLUSIONS ENDORSEMENT
40. FEPDC PROPERTY DAMAGE CLARIFICATION CLAUSE
41. FEPU PUBLIC AUTHORITIES CLAUSE (PAR)
42. FERV REINSTATEMENT VALUE CLAUSE (PAR)
43. 4.4-A REMOVAL OF DEBRIS CLAUSE (5% of Sum Insured inc. in TSI)
44. SLEC SANCTION LIMITATION AND EXCLUSION CLAUSE
45. FETAS TERRORISM AND SABOTAGE EXCLUSION CLAUSE
46. NM2920 TERRORISM EXCLUSION ENDORSEMENT
47. FETAE TOTAL ASBESTOS EXCLUSION CLAUSE
48. IARTRD TRANSMISSION AND DISTRIBUTION LINES EXCLUSION CLAUSE (500M)
49. FEWS1 WAIVER OF SUBROGATION CLAUSE
50. NM0464 WAR AND CIVIL WAR EXCLUSION CLAUSE (NMA 0464)
51. NM2918 WAR AND TERRORISM EXCLUSION ENDORSEMENT
52. FEWO WORKMENS CLAUSE
Additional Clause :
- Theft Endorsement (Forcible Entry)
- Klausula Administrasi Barang Dagangan / Stock
- Full Premium If Loss Clause
- Waiver Clause

Additional Terms and Conditions :

- Cyber Loss Limited Exclusion Clause

Subject to :
- STNC as at January 30, 2023
- Clean loss record for the past 3 years
 08-PARC-00004-000-02-2023

- Exclude machinery breakdown

- FEA adequate and in valid condition
- Good Housekeeping
- Good electrical maintenance and wiring system
- Good maintenance for machinery
- Never been affected by flood for the last 3 years and not located
in flood prone area
- No Smoking Regulation are applied strictly
- No Silent risk
- 24 hours security system
- Cyber Liability Risk Exluded
- Terrorism and Sabotage Covered Totally Excluded
SECTION II : NOT COVERED
Coinsurance :
. PT. ASURANSI TRIPAKARTA 50 %
. PT. ASURANSI MAXIMUS GRAHA PERSADA 10 %
. PT. ASURANSI RAKSA PRATIKARA CAB. SURABAYA 20 %
. PT. ASURANSI BINTANG TBK. 20 %
 08-PARC-00004-000-02-2023

ACCEPTANCE OF POLICY
We hereby confirm acceptance of the Policy below :

Policy No : 08-PARC-00004-000-02-2023

Name of Insured : PT. BNI (PERSERO) TBK SENTRA BISNIS KOMERSIAL (SBK) SURABAYA
QQ PT. MAULANA KARYA PERSADA
Insurance Period : 12 Months
Inception : 23 December 2023 Expiration : 23 December 2024

BNI-YAN / / BNI-YAN / 08-SBY1 / DANIK SURABAYA , 10 February 2023

Y.0 /

Authorized Signature
 PREMIUM CALCULATION DRAFT

( Attaching to and forming part of Policy No. 08-PARC-00004-000-02-2023 Endorsement No. 00 )

4.1B

STOK 51,095,100,000.00 X 0.000100 % X 366 / 366 = IDR 51,095.00

4.3

STOK 51,095,100,000.00 X 0.045000 % X 366 / 366 = IDR 22,992,795.00

=

STOK 51,095,100,000.00 X 0.081000 % X 366 / 366 = IDR 41,387,031.00

OTHS

OTHS 51,095,100,000.00 X 0.000100 % X 366 / 366 = IDR 51,095.00

IDR 64,482,016.00

IDR 64,482,016.00

Say : (RUPIAH : sixty four million four hundred eighty two thousand sixteen only)