PEMENANG Consultant

Jl. Raya Darmo Permai III Plaza Segi 8 Blok C-819 Surabaya
Telp (62-31) 7328374, 7343170, 7325844 Fax (62-31) 7328374, 7343169
Email : pemenang_fire@yahoo.com
__________________________________________________________________________________________
To: Surabaya, April 12th 2019
PT. ETIQA
Attn: Mr. Heru

QUOTATION SLIP
Type of insurance PAR + RSMD 4.1B/2007 + CC Exclude EQ/VET
Wordings As per Munich Re Standard amended with RSMD 4.1B/2007 + CC
Insurance Period __________2019 to _________2020 (one year)
The Insured AUTOCARE
Address Jl. Ngagel Jaya Utara 148, Surabaya
Risk Location Jl. Ngagel Jaya Utara 148, Surabaya
Occupation TBA
Interest/ Sum Insured Building (Including Foundation) IDR 2,200,000,000.00
Third Party’s Vehicle IDR 2,000,000,000.00
Stock IDR 1,000,000,000.00
Contents IDR 100,000,000.00 +
Total IDR 5,300,000,000.00
st
Class 1 First Class
FLEXAS Rp5,300,000,000.00 X - = #VALUE!
RSMD CC Rp5,300,000,000.00 X 0.001% = 53,000.00
TSFWD Rp5,300,000,000.00 X 0.045% = 2,385,000.00
Others Rp5,300,000,000.00 X 0.001% = 53,000.00
Rate / Premium Calculation TOTAL = #VALUE!

Outgo 15%

A. BUILDING
The Building on the described premises including:
a. Landlord’s fixtures and fittings,
b. Fire and security protection installation,
c. Telephone, gas, water and electric instruments, meters, pipings, cabling (including underground cable)
and the like and accessories there of including similar property in adjoining yards or roadways or
underground (to the building or buildings or contents insured by the respective items of this
specification) all the property of the insured or of supplier or others for which the Insured is
responsible ( all to be within the Insured’s premises),
d. Plumbing, ventilation, flag poles, awnings, signs, doors and windows, display, cabinets and similar
structure of whatsoever description.
e. Site improvements scaled areas, landscaping, car parks, paths, dyke, ditch and the like which partly
or wholly serves to supply the described premises,
f. Walls, gates and fences around and pertaining to described premises,
g. Decoration and other exterior fixtures and fittings.
h. All of spare components/ parts store within the premises.
PEMENANG Consultant
Jl. Raya Darmo Permai III Plaza Segi 8 Blok C-819 Surabaya
Telp (62-31) 7328374, 7343170, 7325844 Fax (62-31) 7328374, 7343169
Email : pemenang_fire@yahoo.com
__________________________________________________________________________________________

B. STOCKS
Stocks of material, including raw material, good in process, finished products, packaging materials, other stocks
related to the insured business contained within the premises and belonging to the Insured or business contained
within the premises and belonging to the insured or held by them in trust or on commission or on consignment or
on display and for which the insured are responsible.

C. CONTENTS
Office equipments, decoration and other interior fixtures and fittings, computers and other equipments including
but not limited to furniture, filling cabinets, electronic and non electronic typewriter, telephone, telex, and facsimile
machinery, and all other s accessories attached thereto as the property of the insured or held by them in trust for
which the insured as legally responsible.

DEDUCTIBLE: 1. Flexas : NIL

2. RSMD : 5% of claim, min IDR 5,000,000.00
3. Civil Commotion : 5% of claim, min IDR 5,000,000.00
4. TSFWD + LLS : 10% of recoverable claim amount
5. Impact of Vehicle & All Other Losses : IDR 1,000,000.00
6. Burglary (with forcible entry) : IDR 1,000,000.00

EXTENSION CLAUSES :
1. All Others Contents Clause (IDR 100,000,000.00 in aggregate)
2. Average Relief Clause (85%)
3. Alterations Clause (60 Days)
4. Appraisement Clause (10% of SI)
5. Architects, Surveyors, Consulting Engineers Fees Clause (Limit 10% of SI)
6. Awning, Blind and Sign Clause (Limit 10% of SI)
7. Automatic Reinstatement of Sum Insured Clause (Subject to Additional Premium)
8. Breach of Warranty Clause
9. Burst Pipes Endorsement
10. Capital Addition Clause (10% of SI)
11. Cancellation Notice Clause (30 Days, 3 Days for RSMD 4.1B 2007 + CC)
12. Civil Authorities Clause
13. Cost of Re- writing Records & Claims Preparation (Limit 10% of loss)
14. Cost of Temporary Protection Clause (limit IDR 50,000,000.00) each & every loss
15. Customer's Goods Clause
16. Designation Clause
17. Deterioration of Undamaged Stocks Clause
18. Dispute Clause
19. Duties Clause
20. Earthquake Exclusion Clause
21. Electrical Short Circuit Clause
22. Errors and Omissions Clause
23. Escalation Clause (20% of TSI)
24. Fire Brigade Charges Clause (reasonable cost)
25. Fire Extinguishing Cost Clause (reasonable cost)
26. Flood, Windstorm, Typhoon, Water Damage Endorsement 4.3 A
27. General Interest Clause
28. Interpretation Clause
29. Impact by Own Vehicle Clause
30. Internal Removal Clause
31. Landslide and Subsidence Clause
32. Loss Notification Clause (30 Days)
33. Loss of Damaged Goods Clause
34. Mold and Fungi Endorsement Clause
PEMENANG Consultant
Jl. Raya Darmo Permai III Plaza Segi 8 Blok C-819 Surabaya
Telp (62-31) 7328374, 7343170, 7325844 Fax (62-31) 7328374, 7343169
Email : pemenang_fire@yahoo.com
__________________________________________________________________________________________
35. Minor Alterations and Repairs Clause
36. Misdescription Clause
37. Non Invalidation Clause
38. Notification Clause
39. Nominated Adjusters Clause: 1. SDP Crawford
2. Cunningham Lindsey
40. Outbuilding Clause
41. Payment on Account Clause (25% of claim)
42. Premises Clause
43. Premium Payment Warranty (60 Days)
44. Prevention of Access Clause
45. Preventive Measure Clause
46. Public Authorities Clause
47. Pro rata Return Premium Clause (Subject to no claim)
48. Riot, Strike & Malicious Damage Endt (RSMD 4.1B/2007 + CC)
49. Reinstatement Value Clause
50. Removal Permit Clause
51. Removal of Debris Clause ((10% of TSI & including in TSI)
52. Services Clause
53. Structural Alteration Clause
54. Sue and Labor Clause
55. Temporary Removal Clause
56. Vehicle Load clause
57. Waiver Clause
58. Workmen Clause

Regards,

RUSLY