Contract ADVANCE PAYMENT Amandement No. 1 Previous Comulative Total Claim Total Comulative Balance Discription
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1 GOVERNMENT OF REPUBLIC OF INDONESIA MINISTRY OF PUBLIC WORK Contract No. : KU.08.08/Kontrak/Pamsimas/174/VIII/2013 Regional Oversight Management Services (ROMS) - 5 Contract Date : August,27,2013 Community Based Water Supply Project (PAMSIMAS 2) Amendment No. : No. 01, November 25, 2013 Advance Payment / Invoice No. : 04 Period Of Month Invoice : 8 (April 2014) Contract ADVANCE PAYMENT Amandement No. 1 Previous Comulative Total Claim Total Comulative Balance No. Discription Amount Amount Amount [IDR] Amount Amount Amount Amount (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (1) (2) (3) (4) (5) (6)=(4)+(5) (7) = (3)-(6) A REMUNERATION 19,723,500, ,000,000 19,723,500,000 2,202,440, ,250,000 2,744,690,000 16,149,370,000 1 Regional Team 1,764,000,000 49,000,000 1,764,000, ,100,000 49,000, ,100,000 1,441,900,000 2 Provincial Team 3,307,500,000 63,000,000 3,307,500, ,800,000 83,500, ,300,000 2,775,200,000 3 District Team 14,652,000, ,000,000 14,652,000,000 1,480,540, ,750,000 1,890,290,000 12,761,710,000 B REIMBURSABLE COST 19,584,375,000 3,653,787,500 20,253,855,000 2,787,244,219 89,212,500 2,876,456,719 15,602,940,281 1 Duty Travel 757,440, ,440,000 10,450,000 2,450,000 12,900, ,540,000 Management Fee 5 % of [ ] 37,872,000-37,872, , , ,000 37,227,000 2 Mobilization and De-mobilization 295,940, ,190, ,940,000 42,946,399-42,946, ,993,601 Management Fee 5 % of [ ] 14,797,000 9,759,500 14,797,000 2,147,320-2,147,320 12,649,680 3 Office Space 1,484,400,000 1,379,400,000 1,484,400, ,400,000 11,800, ,200, ,200,000 4 Utilities Expenses 752,400,000 29,700, ,400, ,000,000 24,800, ,800, ,600,000 5 Office Equipment 371,600, ,600, ,600, ,600, ,600,000-6 Vehicle Rental 6,924,000, ,000,000 6,924,000, ,500,000 45,000, ,500,000 5,950,500,000 7 Communication 589,800,000 27,150, ,800, ,800,000 Management Fee 5 % of [ ] 29,490,000 1,357,500 29,490, ,490,000 8 Training 8,106,560,000 1,282,300,000 8,106,560,000 10,400,000 4,800,000 15,200,000 8,091,360,000 Total Management Fee Training Activity 175,226,000 57,615, ,226, , , , ,466,000 9 Reporting 44,850,000 8,715,000 44,850,000 2,500,000-2,500,000 42,350, Sanitasi Total Berbasis Masyarakat (STBM) Training - 637,600, ,960, ,960,000 51,640,000 Management Fee of [10] - 31,880,000 29,298,000-29,298,000 2,582,000 C TOTAL CONTRACT [A + B] 39,307,875,000 3,930,787,500 39,977,355,000 4,374,426, ,462,500 5,005,888,719 32,982,826,281 D ADVANCE PAYMENT 4,009,403,250 4,009,403,250 - E ADVANCE PAYMENT [80% of IBRD Portion] 3,207,522,600 3,207,522,600 - F ADVANCE PAYMENT [20% of APBN-RM Portion] 801,880, ,880,650 - G IBRD PORTION (80%) X TOTAL CONTRACT 31,446,300,000 3,144,630,000 31,446,300,000 3,499,540, ,170,000 4,004,710,975 26,386,261,025 H REPAYMENT OF ADVANCE PAYMENT [1/12 of IBRD Portion] - 1,310,262,500-1,310,262,500 I TOTAL CLAIM THIS INVOICE IBRD PORTION [G - H] 31,446,300,000 3,144,630,000 31,446,300,000 2,189,278, ,170,000 2,694,448,475 25,607,221,525 J APBN-RM PORTION (20%) X TOTAL CONTRACT 7,861,575, ,157,500 7,861,575, ,885, ,292,500 1,001,177,744 6,860,397,256 K REPAYMENT OF ADVANCE PAYMENT [1/12 of APBN-RM Portion] - 327,565, ,565,625 Amount Eligible for TF Funding - 669,480, ,222,000 L PPN (10%) FOR APBN-RM PORTION 10% x (J - K ) 786,157,500 78,615, ,157,500 54,731,962 12,629,250 67,361,212 M TOTAL CLAIM THIS INVOICE GOI PORTION [J - K + L] 8,647,732, ,773,250 8,647,732, ,051, ,921, ,973,331 7,041,985,919 GRAND TOTAL CLAIM THIS INVOICE [I + M+TF Funding] 40,094,032,500 4,009,403,250 40,763,512,500 2,791,330, ,091,750 3,435,421,806 32,703,429,444 Approved by: Prepared by : Pejabat Pembuat Komitmen PT. Tata Guna Patri Wilayah II in JV with: Satuan Kerja Pembinaan Pamsimas AHT Group Consultants Diah Suryaningtyas, SIP, MM NIP Ir. Satria Ernata President Director of PT. Tata Guna Patria
2 GOVERNMENT OF REPUBLIC OF INDONESIA MINISTRY OF PUBLIC WORK Contract No. : KU.08.08/Kontrak/Pamsimas/174/VIII/2013 Regional Oversight Management Services (ROMS) - 5 Contract Date : August,27,2013 Community Based Water Supply Project (PAMSIMAS 2) Amendment No. 1 : No. 01, November 25, 2013 Advance Payment / Invoice No. : 04 B. REIMBURSABLE (AT COST) Period of Invoice : 8 (April 2014) Contract Total Previous Comulative Payment Claim This Invoice 4 Total Comulative Balance No. Description Unit Unit Cost Amount Amount Amount Amount Amount Volume Volume Volume Volume Volume (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) 1 DUTY TRAVEL 757,440,000 6, ,450, ,450, ,900,000 6, ,412, Spot Checking Provincial Team - Province to District Village (10%) - - Bali - - Inland Transport r-trip ,000 2,880, ,880,000 Accomodation r-trip ,000 5,760, ,760,000 OSA (Fixed) r-trip ,000 8,640, ,640,000 Nusa Tenggara Barat Inland Transport r-trip ,000 17,280, ,280,000 Accomodation r-trip ,000 34,560, ,560,000 OSA (Fixed) r-trip ,000 51,840, ,840,000 Nusa Tenggara Timur Inland Transport r-trip ,600, ,880, ,880,000 Accomodation r-trip ,000 54,720, ,720,000 OSA (Fixed) r-trip ,000 82,080, ,080, District Team - District to Village (50%) District Coordinator Bali r-trip ,000 6,000, , , , ,300,000 District Coordinator NTB r-trip ,000 36,000, ,400, , ,850, ,150,000 District Coordinator NTT r-trip , ,000, , ,000 2, ,700,000 Financial management Ass. Bali r-trip ,000 4,800, ,800,000 Financial management Ass. NTB r-trip ,000 28,800, ,550, , ,950, ,850,000 Financial management Ass. NTT r-trip ,000 91,200, ,100, ,100,000 1, ,100,000 Management Fee 5% of [ ] 37,872, ,500 37,872,000 2 MOBILIZATION AND DEMOBILIZATION 295,940, ,554, ,554, ,182, Regional Team - Jakarta Province to Province to Jakarta Project Manager Jakarta-Mataram-Jakarta r-trip ,020,000 3,020,000-1,530, ,530, ,490, Data Management Jakarta-Mataram-Jakarta r-trip ,020,000 3,020, , , ,770, LG Specialist Jakarta-Mataram-Jakarta r-trip ,020,000 3,020, ,020, Trainer Coordinator Jakarta-Mataram-Jakarta r-trip ,020,000 3,020, ,020, Local Transport r-trip , , , Provincecial Team - Jakarta to Province to Jakarta Provincial Coordinator/LG Jakarta-Mataram-Jakarta r-trip ,020,000 3,020,000-1,391, ,391, ,628,600 Jakarta-Denpasar-Jakarta r-trip ,050,000 3,050, , , ,800, Financial Management Specialist Jakarta-Mataram-Jakarta r-trip ,020,000 3,020,000-1,664, ,664, ,355,500 Jakarta-Denpasar-Jakarta r-trip ,050,000 3,050,000-1,799, ,799, ,251, Quality Assurance Specialist Jakarta-Mataram-Jakarta r-trip ,020,000 3,020, ,020,000 Jakarta-Denpasar-Jakarta r-trip ,050,000 3,050, , , ,800, Local Transport r-trip ,000 1,800, ,800, District Team - Jakarta to Province to Jakarta District Coordinator Jakarta-Mataram-Jakarta ,750,000 28,500,000-7,243, ,243, ,256,400 Jakarta-Denpasar-Jakarta ,750,000 4,750,000-1,391, ,391, ,358,600 Jakata-Kupang-Jakarta ,050,000 57,950,000-23,145, ,145, ,804, Financial Management Assistant Jakarta-Mataram-Jakarta ,750,000 28,500, ,500,000 Jakarta-Denpasar-Jakarta ,750,000 4,750, ,750,000 Jakata-Kupang-Jakarta ,050,000 57,950,000-2,399, ,399, ,550, Local Transport (Province to Old District) ,000 5,600, , , ,360,000 Local Transport (Province to New District) ,600,000 60,800, ,800,000
3 Management Fee 5 % of [ ] 14,797, ,797,000 3 OFFICE SPACE 2,300,400, ,400,000-11,800, ,200,000 1,609,200, Regional Team & Prov. Team Provincial Team Kupang ,000,000 99,000, ,000, ,000, ,000, Regional Team & Prov. Team Kupang ,100,000 69,300, ,200, ,200, ,100, Provincial Team in Mataram ,100,000 75,600, ,200, ,200, ,400, Office Running Cost ,000, ,000,000-23,000,000 4,000,000-27,000, ,000, District Team District Team in Mataram ,700, ,600, ,800, ,800,000 (51.00) 193,800,000 District Team in Bali ,700,000 56,100, ,400, ,400, ,700,000 District Team in Kupang Old ,700, ,800, ,000, ,000,000 (84.00) 346,800,000 District Team in Kupang New ,700, ,000, ,200, ,200,000 (63.00) 397,800, Office Running Cost old district , ,000,000-16,200,000 3,000,000-19,200, ,800,000 Office Running Cost new district , ,000,000-23,400,000 4,800,000-28,200, ,800,000 4 UTILITIES EXPENSES 752,400,000-24,800, ,600, Regional and Province Office Supply and Consumable old district ,200,000 86,400, ,000,000 2,000, ,400,000 Office Supply and Consumable new district - - 2,000,000 2,000,000 - (2,000,000) 4.2 District Office Supply and Consumable old district , ,000, ,000,000 8,000, ,000,000 Office Supply and Consumable new district , ,000, ,800,000 12,800, ,200,000 5 OFFICE EQUIPMENT 371,600, ,600, ,600, Notebook Computer (Regional+Provincial+District) ,000, ,000, ,000, ,000, Portable Computer for Supporting Regional ,500,000 7,000, ,000, ,000, Portable Computer + Printer for Supporting District ,000, ,000, ,000, ,000, Printer Laserjet ,500,000 7,500, ,500, ,500, Printer Colour A ,000,000 9,000, ,000, ,000, scanner ,500,000 4,500, ,500, ,500, Facsimile ,000,000 3,000, ,000, ,000, Digital Camera ,000,000 3,000, ,000, ,000, GSM Modem + SIM CARD ,000 1,500, ,500, ,500, Router, LAN Peripheral ,000 2,100, ,100, ,100, GPS ,500,000 9,000, ,000, ,000, VEHICLE RENTAL 6,924,000, ,500, ,000, ,500,000 5,950,500, Car including O&M and Driver (Regional Team) ,000, ,000, ,000, ,000, ,000, ,000, Car including O&M and Driver (Provincial Team) ,000, ,000, ,000, ,000, ,000, ,000, Car including O&M (District Team) old district ,500,000 2,340,000, ,500, ,000, ,500, ,878,500,000 Car including O&M (District Team) new district ,500,000 3,432,000, ,000, ,000, ,120,000,000 7 COMMUNICATION 145,800, ,800, Regional and Province Telephone and Postage ,000, ,000, ,000, Internet Connection fo Office ,000 37,800, ,800, District Telephone and Internet Connection old district , ,000, ,000,000 - Telephone and Internet Connection new district , ,000, ,000,000 Management Fee 5 % of [ ] 29,490, ,490,000 8 TRAINING 4,800, Pelatihan FM Ass. Dan Data Entry Operator Peserta a Paket Full Board days ,000 39,000, ,000,000 b Transportation Participant time ,000 10,400, ,400, Pelatih (air transport economy class) a Acomodation days ,000 3,600, ,600,000 b Training Material + Kit paket ,000 2,600, ,600,000 Management Fee 5 % of [8.1.1a+8.1.2a] 2,130, ,130,000
4 8.2 Expert Group Meeting - Central Regional Team - Air Fare Province to akarta Provincial team - Air Fare Province to Jakarta Inland Transport - Regional and Provincial Team OSA (fixed) - Regional Team days ,000 21,600, ,600, OSA (fixed) - Provincial Team days ,000 48,600,000-5,400, ,800, ,200, ,400,000 Management Fee 5 % of [ ] 3,510, ,000 3,510, Expert Group Meeting - Regional - - a Fullboard Pacakage for District Team days , ,400, ,400,000 b Fullboard Pacakage for Provincial Team days ,000 27,000, ,000,000 c Fullboard Pacakage for Regional Team days ,000 17,280, ,280, Air Transpoet (Economy Class) a Regional Team Mataram-Denpasar r-trip ,300,000 31,200, ,200,000 b Regional Team Mataram-Kupang r-trip ,700, ,800, ,800,000 Management Fee 5 % of [8.3.1] 10,800, ,800, Inland Transport - - a District Team Denpasar r-trip ,000 3,600, ,600,000 District Team Mataram r-trip ,000 21,600, ,600,000 District Team Kupang r-trip ,600, ,200, ,200,000 b OSA (Fixed) days 1, , ,600, , ,600,000 Management Fee 5 % of [ ] 44,100, ,020, OJT Fasilitator Training Material + Kit days 2, , ,400, , ,400, Meals, Snack days 2, , ,600, , ,600, Pelatihan Penguatan BPSPAM Paket Fullboard Participant days 5, ,000 1,300,000, , ,300,000, Paket Fullday for DPMU + TKK days , ,600, ,600, Uang Saku Participant days 5, , ,000, , ,000, Uang Transport Participant time 1, , ,000, , ,000, Training Material + Kit unit ,000 14,560, ,560, Spanduk paket 1, , ,000, , ,000,000 Management Fee 5 % of [ ] 33,228, ,228, Pelatihan Kader AMPL Paket Fullboard Participant days 5, ,000 1,300,000, , ,300,000, Paket Fullday for DPMU + TKK days , ,600, ,600, Uang Saku Participant days 5, , ,000, , ,000, Uang Transport Participant time 1, , ,000, , ,000, Training Material + Kit unit ,000 14,560, ,560, Spanduk paket 1, , ,000, , ,000,000 Management Fee 5 % of [ ] 33,228, ,228, Workshop RAD AMPL paket ,000, ,000, ,000, ,000, ,000,000 Management Fee 5 % of [8.7] 39,000, ,000, Workshop Forum/Assosiasi BPSPAM in Province Paket Fullboard Participant days , ,200, ,200, Paket Fullday for DPMU + TKK days ,000 14,000, ,000, Uang Transport Participant time ,000 38,000, ,000, Training Material + Kit paket ,000 26,000, ,000, Spanduk unit ,000 14,560, ,560,000 Management Fee 5 % of [ ] 4,628, ,628, Pelatihan Pengelola Program Kabupaten (DPMU+TKK+Satker) in Province Paket Fullboard Participant days , ,960, ,960, Uang Transport Participant days ,000 46,800, ,800, Training Material + Kit paket ,000 23,400, ,400, Spanduk unit ,000 21,840, ,840,000 Management Fee 5 % of [ ] 4,602, ,602,000
5 8.10 Printing/Media - - Spanduk unit , ,000, ,000,000 Poster unit 23, , ,300, , ,300,000 Leaflet unit 42, , ,700, , ,700,000 Total Management Fee Training Activity [ ] 175,226, , ,226,000 9 REPORTING ,850, ,500, ,500, ,250, Inception Report exp ,000 2,500, ,500, ,500,000-83,900, Monthly Report exp ,000 13,500, ,500, Quarterly Report exp ,000 6,300, ,300, Special Report exp ,000 1,800, ,800, Annual Report exp ,000 4,500, ,500, Financial Management Report (FMR) exp ,000 1,500, ,500, Draft Final Report exp ,000 1,500, ,500, Final Report exp ,000 2,000, ,000, Training Program Report exp ,000 11,250, ,250,000 TOTAL B- REIMBURSABLE COST [IDR] ,592,430,000 2,034,004,999 84,050,000 1,721,654,999 6,136,441,602
Contract Amandement No. 2 Previous Comulative Total Claim Total Comulative Balance Discription
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