__ INVOICE KUITANSI PT.KUBA PRIMA MINING SUCOFINDO Kode Pelanggan/ Account Number: 62711 No, Invoicelinvoice Number 38011808019 Tal. Invoicerinvoice Date (08-Sep-2016 J RAYA AN IL NO, OEEA KWAK, KECSULIC NPWP/Taxpayer ID Number 02,650.246.9-712,000 Keterangan// Deseription NoJTal. Oraer NoReff: PO/WO/SPK/ No, Setifkat / Report 240161G8BPA) Kegietan/ Intervention: ANALISA/ PENGUJIAN : 1 CONTOH BATUAN ‘Total Tagihan / Total Fee UUang Muka / Advance Payment ‘isa Pembayaran / Remaining Blaya Analsa / Analysis Fee Dasar Pengenaan Pajak (DP) / Net Amount PN VAT (10.00 % x OPP) ‘Total setelah PajakiTotal after VAT TERBILANG / SAY satu jute delapan tus tuuh puluh ma ribu ima ratus pian (CATATAN/ NOTES PT, SUCOFINCO NPVIPrTaxpayer ID 101,300.982.3-083,000 ‘Ajamat NEW [RAHA SUOFINDO 3 Raya Panga Kr 34 4 Anus TalGetungtNe # cba Beas 17529 Kantor Penerbivissued ‘Jumlah | Amount ‘CBT/50/0157 1/09/2016 / ANALISA BAHAN TAMBANG Tol seria 07/09/2016, RP 1.875.500 RP. 4.875.500 RP ° RP 1.706.000 RP. 4.705.000 RP. 170.500 RP. 775.600 ‘ADI SANTOSO BAGOES KEPALA SUB BAGIAN KEU. & AKT, +. Pembayaran melalui transfer dengan mencantumkan nomar invoice pada slip transfer! Payment through bank transfer, Please ensure the invcice number stated clearly in your transfer sip Diujukan ke /to PT, SUCOFINDO (Perserc), No, Mandir Vidual Account 6101 62711 (Rupiah), 88202 62711 (USD) 2. Bukti perotongan PPh 29 agar dkienkan ke alamat Kantor Penerbit Kindly send withholding tex evidence tothe related issuing office "TANDA TERIA / REMITTANCE Nama/Name ‘Tanggal / Date Tanda Tangan / SignatureCertificate No. 24416/GBBPAJ Date: September 7, 2016 oD ed SPS seers ae oe ae cage ees eet ee ges REPORT OF ANALYSIS ‘The sample was submitted by client with the following identification CLIENT ADDRESS TYPE OF SAMPLE DATE OF RECEIVED TEST REQUIRED KUBA PRIMA MINING, PT. JI. Raya Kujan KM. 1 No. 34 Kujan, Bulik, Lamandau. KALIMANTAN TENGAH. IRON ORE. 01/09/2016. Chemical Analysis. DESCRIPTION OF SAMPLE Form Boulder WeightiVolume : + 4.62 kg Packing Plastic bag. ‘SAMPLE IDENTIFICATION Code: KPM 0816. DATE OF ANALYSIS 01/09/2016 to 06/09/2016 YOUR REFERENCE - Result: { Parameter Unit 1 Results Method iron (Fe) Total % 56.91 PO /MIN-BT/ Of Iron Trioxide (Fe,0.) %, 81.37. PO /MIN-BT/ 01 ‘Aluminium Trioxide (AI,O,) % 2.03 PO/MIN-BT/ 01 Calcium Oxide (CaO) %, 0.06 PO/MIN-ET/OT | Magnesium Oxide (MgO) % 0.02 PO/MIN-BT/O4 Manganese Dioxide (MnO) % Less than 0.01 PO/MIN-BT/Ot Chromium Trioxide (CrOs) % Less than 0.01 POTMIN-BT 04 Sodium Oxide (Na;O) % 0.04 POTMIN-BT/Ot Potassium Oxide (K-O} % 01 POTMIN-BT 01 Silicon Dioxide (SiOz) % 6.30 POTMIN-BT 01 Titanium Dioxide (TiO) [% 0.14 POTMIN-BT/O1 [Loss On Ignition (LO! [aie 9.64 PO/MIN-BT/O1 Phosphorus (P) % 0.05 POTMIN-BT/ 01 Sulfur (S) % 0.01 PO/MIN-BT/01 Moisture Content (MC) AR 1.59 POTMIN-BT 01 Note : AR (As Received Basis) ‘The Confcatlepris ised ude Genel Ters an Condos, copy fh i aval Uno quest er maybe aoesed at nw sonidos (©BT5001571165010Certificate No. 24416/GBBPAJ Seppcse: Date: September 7, 2016 SE SUCOFINDO leaving Office: “Aten Tol Cbtung No.1, Chtang Bekasi 17820, Indonesia PPhonelFacs: #82 21 985211 7siaa221166 mall afakhrudin@sucofindo cod REPORT OF ANALYSIS The sample was submitted by client with the following identification, CLIENT 2 KUBA PRIMA MINING, PT. ADDRESS, 2 Ji, Raya Kujan KM. 41 No, 31 Kujan, Bulik, Lamandau. KALIMANTAN TENGAH. ‘TYPE OF SAMPLE IRON ORE. DATE OF RECEIVED 1/09/2016. TEST REQUIRED ‘Chemical Analysis. DESCRIPTION OF SAMPLE Form : WeightVolume : Packing SAMPLE IDENTIFICATION Code: KPM 0816. DATE OF ANALYSIS 01/09/2016 to-08/09/2016. YOUR REFERENCE + &) Resu Parameter Unit Reslilts I Method J Iron (Fe) Total Ee % 56.97 PO/MIN-BT/O1 | Iron Trioxide (Fe.O;) {| Ne 8137 PO/MIN-BT/01 ‘Aluminium Trioxide (AlO3) N LJ 203 PO/MIN-BT/01 Calcium Oxide (CaO) % 0.06 a PO/MIN-BT/01 Magnesium Oxide (MgO). % 0.02 PO/MIN-BT/O1 Manganese Dioxide (MinOz) % Less than 0.0% PO/MIN-BT/O1 ‘Chromium Trioxide (CrzO.) % Less than 0.01 PO/ MIN-BT / 01 ‘Sodium Oxide (Na;O) 0.01 PO/MIN-BT/O1 Potassium Oxide (K-0) O01 PO/MIN-BT/O1 | Silicon Dioxide (SiOz) x %. 6.30 PO/MIN-BT/O1 Titanium Dioxide (TiO2) % 0.14 | PO/MIN-BT /01 Loss On Ignition (LOI) %. 964 PO/MIN-BT/01 Phosphorus (P) % 0.05 PO/MIN-BT/Ot ‘Sulfur (S) % 0.01 PO/MIN-BT/ Ot Moisture Content (MC) bi %, AR 1.59 | PO/MIN-BT/ 01 Note = AR (As Received Basis). “his Crater sued under our General Tens 2d Condos, apy af hic valle un request of aye acess at wn sinc ©BT5001571165010