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PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

I PEMBANGUNAN/RAWAT INAP

1  PEKERJAAN PERSIAPAN
1  Pengukuran & bouwplank m1          72.31 Rp                2,411,538.50                         0.02             100.00              0.02 0 ‐
2  Pasang Papan Nama Proyek ls            1.00 Rp                   371,000.00                         0.00             100.00              0.00 0 ‐
3  Direksi Keet & Gudang/Bedeng m²          40.00 Rp             23,680,000.00                         0.17             100.00              0.17 0 ‐
4  Pembersihan Lapangan m²     1,259.51 Rp             15,114,120.00                         0.11             100.00              0.11 0 ‐
5  Pembongkaran Bangunan Existing m²        800.00 Rp             16,000,000.00                         0.12             100.00              0.12 0 ‐
6  Buang puing eks. Bongkaran rit          50.00 Rp             10,000,000.00                         0.07             100.00              0.07 0 ‐
7  Pagar Proyek m1        144.62 Rp             33,551,840.00                         0.24             100.00              0.24 0 ‐
8  Pengadaan listrik Kerja bln            8.00 Rp             16,000,000.00                         0.12             100.00              0.12 0 ‐
9  Pengadaan Air Kerja ls            1.00 Rp             10,000,000.00                         0.07             100.00              0.07 0 ‐
10  Photo Proyek, Laporan harian, mingguan, bulanan set            4.00 Rp                6,000,000.00                         0.04                59.00              0.03                   41.00 Masih berjalan sampai pekerjaan selesai
11  As Built Drawing set            4.00 Rp                8,000,000.00                         0.06                68.00              0.04                   32.00 Masih berjalan sampai pekerjaan selesai
12  Keamanan Proyek bln            9.00 Rp             27,000,000.00                         0.19                99.00              0.19                     1.00 ‐
13  Mobilisasi & Demobilisasi / barang dan tenaga ls            1.00 Rp             35,000,000.00                         0.25                99.00              0.25                     1.00 ‐
14 Alat batu (peracah scaffolding, instalasi MEP) ls            1.00 Rp             38,500,000.00                         0.28                98.00              0.27                     2.00 ‐
                   ‐                ‐
Jumlah Pekerjaan Persiapan Rp           241,628,498.50                     ‐                  ‐
                   ‐                ‐
2  PEKERJAAN STRUKTUR                     ‐                  ‐
A  PONDASI BOR dan TELAPAK                     ‐                  ‐
1  Tiang Pancang Bor Pile Ø 30 cm m1     1,005.00 Rp           291,450,000.00                         1.30             100.00              1.30 0 ‐
2  Galian Tanah Pondasi Batu belah / Pile Cap m³        347.62 Rp             28,334,506.20                         0.20             100.00              0.20 0 ‐
3  Beton Pondasi P1  m³            0.50 Rp                2,452,968.00                         0.02             100.00              0.02 0 ‐
4  Beton Pondasi P2 m³          33.39 Rp           162,509,130.00                         1.17             100.00              1.17 0 ‐
5  Beton Pondasi P3 m³          47.74 Rp           232,350,580.00                         1.67             100.00              1.67 0 ‐
6  Sloof 30/45 m³          74.12 Rp           360,717,705.00                         2.10             100.00              2.10 0 ‐
7  Sloof 30/60            6.40 Rp             31,143,933.00                         0.22             100.00              0.22 0 ‐
8  Beton Pondasi PT  tangga m³            2.82 Rp             13,724,940.00                         0.10             100.00              0.10 0 ‐
9  Pondasi Batu belah m³          40.71 Rp             25,458,307.88                         0.18             100.00              0.18 0 ‐
10  Sloof 20/30 m³          21.81 Rp           106,167,521.25                         0.77             100.00              0.77 0 ‐
11  Lantai Kerja 4 Cm Pondasi m²        116.62 Rp             14,070,203.00                         0.10             100.00              0.10 0 ‐
12  Pasir Urug Dibawah Pondasi m³          11.66 Rp                2,351,059.20                         0.02             100.00              0.02 0 ‐
13  Urug Tanah Leveling lantai 120 cm dr tanah asli m³        761.75 Rp           114,338,675.00                         0.82             100.00              0.82 0 ‐
Rp        1,385,069,528.53                     ‐                  ‐
B  LANTAI SATU dan LANTAI DUA                    ‐                ‐
1  Beton Kolom K1 30/50 m³          60.63 Rp           351,350,850.00                         1.53             100.00              1.53 0 ‐
2  Beton Kolom K2 30/30 m³          28.64 Rp           165,957,210.00                         1.20             100.00              1.20 0 ‐
3  Beton Plat Lantai t = 10 Cm lt.1 m³        104.98 Rp           511,759,218.75                         2.59             100.00              2.59 0 ‐
4  Pasir Urug 10 Cm dibawah lantai m³        104.98 Rp             21,163,212.00                         0.15             100.00              0.15 0 ‐
5  Lantai Kerja 4 Cm dibawah lantai m³          41.99 Rp                5,066,153.83                         0.04             100.00              0.04 0 ‐
6  Beton Tangga  m³          10.14 Rp             58,132,620.00                         0.42             100.00              0.42 0 ‐
7  Beton Ramp m³          17.33 Rp             99,341,424.00                         0.72             100.00              0.72 0 ‐
8  Beton Balok 25/50 m³          66.13 Rp           400,915,875.00                         2.38             100.00              2.38 0 ‐
9  Beton Balok 25/40 m³          22.14 Rp           134,234,820.00                         0.97             100.00              0.97 0 ‐
10  Beton Balok 30/60  m³            4.01 Rp             24,336,882.00                         0.18             100.00              0.18 0 ‐
11  Beton Plat Lantai lt.2 m³        115.21 Rp           698,496,742.73                         5.04             100.00              5.04 0 ‐
12 Water Profing Plat + Toilet m2        360.00 Rp             50,040,000.00                         0.36                67.00              0.24                  33.00 Sisa waterproofing
2
13 Screed 5 Cm m        193.70 Rp             12,590,500.00                         0.09                67.00              0.06                  33.00 Sisa screed
Rp        2,533,385,508.30                     ‐                  ‐
C LANTAI ATAP                     ‐                  ‐
1  Balok Atap 20/40 m³          41.17 Rp           249,620,985.60                         1.30                99.00              1.29                    1.00 ‐
2  Plat Atap m³          41.47 Rp           251,404,962.72                         1.81                98.00              1.78                    2.00 ‐
Rp           501,025,948.32                    ‐                ‐
                   ‐                ‐
Jumlah Pekerjaan Struktur Rp        4,419,480,985.15                     ‐                  ‐
3  PEKERJAAN ARSITEKTUR                     ‐                  ‐
 LANTAI SATU                    ‐                ‐
1  Pekerjaan Dinding                    ‐                ‐
 a. Pasangan Bata Ringan m²     1,821.46 Rp           276,879,526.56                         1.50                99.00              1.48                     1.00 ‐
 b. Plester / Aci m²     3,642.91 Rp           240,432,192.00                         1.73                99.00              1.72                     1.00 ‐
 c. Pasang Wall Protektor Panel Kayu Merbau m1          69.93 Rp                6,993,000.00                         0.05                60.00              0.03                   40.00 Belum sama sekali
 d. Plint Keramik Lantai m1        498.58 Rp             32,407,700.00                         0.23                52.00              0.12                   48.00 Sisa bobot material sudah on site tinggal pasang
 e. Keramik Km Mandi/WC  m2        376.46 Rp             77,174,300.00                         0.56                82.00              0.46                   18.00 Tinggal perapihan
 f. Kolom/Balok Praktis m1        255.00 Rp             34,680,000.00                         0.25             100.00              0.25                       ‐ ‐
 g. Riling Tangga Stainless steel m1          44.80 Rp             44,800,000.00                         0.32                60.00              0.19                   40.00 sisa bobot tinggal pasang stainless steel
Rp           713,366,718.56                    ‐                ‐
                   ‐                ‐
2  Pekerjaan Lantai                    ‐                ‐
 a. Pas. Keramik HT 60/60 seluruh ruangan m²        865.04 Rp           275,946,165.00                         1.49                98.00              1.46                     2.00 ‐
 b. Pas. Keramik KM/Toilet m²          87.33 Rp             17,901,625.00                         0.13                99.00              0.13                     1.00 ‐
 c. Pas. Keramik Tangga 30/30 m²          44.00 Rp                9,020,000.00                         0.07                87.00              0.06                   13.00 sisa perapihan
Rp           302,867,790.00                    ‐                ‐
3  Pekerjaan Plafond                    ‐                ‐
 a. Pas. Plafond Gypsum   m²        909.04 Rp           139,991,390.00                         1.01                91.00              0.92                     9.00 Sisa finishing
 b. Pas. Plafond Km Mandi Kalciboard m²          87.33 Rp             14,583,275.00                         0.11                80.00              0.08                   20.00 Sisa bobot tinggal pasang, material sudah on site
 c. Pas. List Plafond m1     1,700.00 Rp             44,166,000.00                         0.32                81.00              0.26                   19.00 Sisa bobot tinggal pasang, material sudah on site
Rp           198,740,665.00                    ‐                ‐
4  Pekerjaan Kusen Aluminium, Pintu/Jendela Lengkap                    ‐                ‐
 a. Pintu Type PJ1 (583x290) Pintu Utama Double Kaca unit            1.00 Rp             26,955,000.00                         0.19                80.00              0.16                   20.00 Kusen sudah terpasang
 b. Pintu Type PJ2 (235x265) Pintu Double Kaca unit            2.00 Rp             12,880,000.00                         0.09                80.00              0.07                   20.00 Kusen sudah terpasang
 c. Pintu Type PJ3 (470x265) Pintu Double Kaca unit            1.00 Rp             12,940,000.00                         0.09                80.00              0.07                   20.00 Kusen sudah terpasang
 d. Pintu Type PJ4 (132x220) Pintu Single Triplek/HPL unit            2.00 Rp                5,280,000.00                         0.04                80.00              0.03                   20.00 Kusen sudah terpasang
 e. Pintu Type PJ5 (216x265) Pintu single Triplek/HPL unit            1.00 Rp                5,232,000.00                         0.04                80.00              0.03                   20.00 Kusen sudah terpasang
 f. Pintu Type P1 (2x74x265)Double Kaca unit            2.00 Rp                9,576,000.00                         0.07                80.00              0.06                   20.00 Kusen sudah terpasang
 g. Pintu Type P2  (1x128x220) Single Doubel Triplek/HPL unit          12.00 Rp             33,600,000.00                         0.24                80.00              0.19                   20.00 Kusen sudah terpasang
 d. Pintu Type P3 (1x91x220) Pintu single / HPL  unit          11.00 Rp             15,400,000.00                         0.11                80.00              0.09                   20.00 Kusen sudah terpasang
 e. Pintu Type P4 (1x88x220) Single Doble Triplek/HPL unit          14.00 Rp             21,000,000.00                         0.15                80.00              0.12                   20.00 Kusen sudah terpasang
 f. Pintu Type P5 (1x78x220) Single Double Triplek/HPL unit            6.00 Rp                8,400,000.00                         0.06                80.00              0.05                   20.00 Kusen sudah terpasang
 g. Pintu Type P6 (1x88x220) Pintu Besi Geser unit            1.00 Rp                4,632,000.00                         0.03                80.00              0.03                   20.00 Kusen sudah terpasang
 h. Pintu Type P7 (2x74x220) Pintu Besi unit            7.00 Rp             47,600,000.00                         0.34                80.00              0.27                   20.00 Kusen sudah terpasang
 i. Pintu Type P8 (1x88x220) Pintu Besi unit            1.00 Rp                4,632,000.00                         0.03                79.00              0.03                   21.00 Kusen sudah terpasang
 j. Pintu Type P9 (2x74x220) Pintu Geser Double Triplek/HPL unit            1.00 Rp                3,900,000.00                         0.03                79.00              0.02                   21.00 Kusen sudah terpasang
 k.Jendela Type JA1 (175x370) unit            6.00 Rp             19,200,000.00                         0.14                79.00              0.11                   21.00 Kusen sudah terpasang
 l.Jendela Type JA2 ( 175x281) unit            1.00 Rp                3,000,000.00                         0.02                79.00              0.02                   21.00 Kusen sudah terpasang
 m.Jendela Type JA3 ( 175x70 ) unit            1.00 Rp                1,065,600.00                         0.01                79.00              0.01                   21.00 Kusen sudah terpasang
 n.Jendela Type JA4 ( 75x115 ) unit            1.00 Rp                1,512,000.00                         0.01                79.00              0.01                   21.00 Kusen sudah terpasang
 o.Jendela Type JA5 ( 585x175 ) unit            1.00 Rp                6,000,000.00                         0.04                79.00              0.03                   21.00 Kusen sudah terpasang

01 AFRL‐ 07 AFRL 2019 FIX (76)  1 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

 p.Jendela Type J1 ( 237x184 ) unit          13.00 Rp             34,450,000.00                         0.25                79.00              0.20                   21.00 Kusen sudah terpasang
 q.Jendela Type J6 ( 88x455 ) unit            2.00 Rp                4,400,000.00                         0.03                78.00              0.02                   22.00 Kusen sudah terpasang
 r.Jendela Type J8 ( 240x589 ) unit            1.00 Rp                8,240,000.00                         0.06                78.00              0.05                   22.00 Kusen sudah terpasang
 s.Jendela Type J9 ( 122x589 ) unit            1.00 Rp                4,000,000.00                         0.03                70.00              0.02                   30.00 Kusen sudah terpasang
 t.Bouvenlay Type BV1 ( 220x49 ) unit            1.00 Rp                   880,000.00                         0.01                70.00              0.00                   30.00 Kusen sudah terpasang
 u.Bouvenlay Type BV2 ( 183x49 ) unit            6.00 Rp                4,539,000.00                         0.03                70.00              0.02                   30.00 Kusen sudah terpasang
 v.Bouvenlay Type BV3 ( 123x49 ) unit            3.00 Rp                1,530,000.00                         0.01                62.00              0.01                   38.00 Kusen sudah terpasang
 x.Bouvenlay Type BV4 ( 64x49 ) unit            4.00 Rp                1,088,000.00                         0.01                54.00              0.00                   46.00 Kusen sudah terpasang
 l. Aluminium Composite Panel ( ACP ) m2        150.00 Rp           107,400,000.00                         0.77                52.00              0.40 Sisa bobot tinggal pasang, material sudah on site
Rp           409,331,600.00                    ‐                ‐
5  Pekerjaan Cat                    ‐                ‐
 a. Cat Dinding luar m²     1,200.00 Rp             40,800,000.00                         0.29                52.00              0.15                   48.00 Material on site
 b. Cat Dinding Dalam m²     1,300.00 Rp             37,986,000.00                         0.27                54.00              0.15                   46.00 Material on site
 c. Cat Plafond m²        909.04 Rp             26,562,002.70                         0.19                52.00              0.10                   48.00 Material on site
 d. Melamic Daun Pintu m²        400.00 Rp             51,400,000.00                         0.37                54.00              0.20                   46.00 Material on site
Rp           156,748,002.70                    ‐                ‐
6 Pekerjaan Wall paper                    ‐                ‐
a. Wall paper terpasang m²        400.00 Rp             31,200,000.00                         0.22                50.00              0.11                   50.00 ‐
Rp             31,200,000.00                ‐
7  Pekerjaan Sanitary                ‐
 a. Closed duduk CW 420 J unit          20.00 Rp             57,380,000.00                         0.41                83.00              0.34                   17.00 Terpasang
 b. Wastafel LW 660  unit          15.00 Rp             24,675,000.00                         0.18                82.00              0.15                   18.00 Terpasang
 c. Urinoir U 57 M unit            2.00 Rp                3,834,000.00                         0.03                82.00              0.02                   18.00 Terpasang
 d. Floor Drain TX 1 BN  bh          20.00 Rp                5,820,000.00                         0.04                82.00              0.03                   18.00 Terpasang
 e. Shower Set TS 309 RYRZ bh          10.00 Rp             16,280,000.00                         0.12                82.00              0.10                   18.00 Terpasang
 f. Shower Spray 403 bh          20.00 Rp                7,245,000.00                         0.05                82.00              0.04                   18.00 Terpasang
 g. Skat Urinoir A 100 bh            2.00 Rp                1,509,750.00                         0.01                82.00              0.01                   18.00 Terpasang
 h. Paper Holder TS 116 R (SR) bh            1.00 Rp                   403,500.00                         0.00                82.00              0.00                   18.00 Terpasang
 i. Soap Holder S 156 N (SR) bh            1.00 Rp                     97,500.00                         0.00                82.00              0.00                   18.00 Terpasang
 j. Grab Bar TX 3A2 (SR) bh            1.00 Rp                   634,725.00                         0.00                82.00              0.00                   18.00 Terpasang
 k. Towel Holder TX 726 AES (SR) bh            1.00 Rp                   745,200.00                         0.01                71.00              0.00                   29.00 Material on site
 l. Cubical Toilet set            4.00 Rp             14,000,000.00                         0.10                71.00              0.07                   29.00 Material on site
 m. Kran Dinding TX 23 B 13 bh          20.00 Rp                3,102,000.00                         0.02                57.00              0.01                   43.00 Material on site
  Rp           135,726,675.00                    ‐                ‐
                   ‐                ‐
 LANTAI DUA                    ‐                ‐
1  Pekerjaan Dinding                    ‐                ‐
 a. Pasangan Bata Ringan m²        862.98 Rp           131,180,981.76                         0.95                96.00              0.91                     4.00 ‐
 b. Plester / Aci m²     1,725.95 Rp           113,912,832.00                         0.82                90.00              0.74                   10.00 ‐
 c. Pasang Wall Protektor Panel Kayu Merbau m²        125.00 Rp             12,500,000.00                         0.09                75.00              0.07                   25.00 ‐
 d. Plint Keramik Lantai m²        152.25 Rp                9,896,250.00                         0.07                92.00              0.07                     8.00 ‐
 e. Keramik Km Mandi/WC  m1        325.00 Rp             66,625,000.00                         0.48                87.00              0.42                   13.00 Tinggal perapihan
 f. Kolom/Balok Praktis m²        285.60 Rp             38,841,600.00                         0.28             100.00              0.28                       ‐ ‐
 g. Riling Tangga Stainless steel m²          22.40 Rp             22,400,000.00                         0.16                57.00              0.09                   43.00 sisa bobot tinggal pasang stainless steel
  Rp           395,356,663.76                    ‐                ‐
                   ‐                ‐
2  Pekerjaan Lantai                    ‐                ‐
 a. Pas. Keramik HT 60/60 seluruh ruangan m²        865.00 Rp           275,935,000.00                         1.49                95.00              1.41                     5.00 ‐
 b. Pas. Keramik KM/Toilet m²          87.30 Rp             17,896,500.00                         0.13                52.00              0.07                   48.00 Material on site
 c. Pas. Keramik Tangga 30/30 m²          44.00 Rp                9,020,000.00                         0.07                90.00              0.06                   10.00 ‐
  Rp           302,851,500.00                    ‐                ‐
3  Pekerjaan Plafond                    ‐                ‐
 a. Pas. Plafond Gypsum   m²        909.04 Rp           139,991,390.00                         1.01                90.00              0.91                   10.00 ‐
 b. Pas. Plafond Km Mandi Kalciboard m²          87.33 Rp             14,583,275.00                         0.11                52.00              0.05                   48.00 Material on site
 c. Pas. List Plafond m1     1,500.00 Rp             38,970,000.00                         0.28                52.00              0.15                   48.00 Material on site
  Rp           193,544,665.00                    ‐                ‐
4  Pekerjaan Kusen Aluminium, Pintu/Jendela Lengkap                    ‐                ‐
 a. Pintu Type PJ2 (235x265) Pintu Double Kaca unit            1.00 Rp                6,440,000.00                         0.05                76.00              0.04                   24.00 Kusen sudah terpasang
 b. Pintu Type P2  (1x128x220) Single Doubel Triplek/HPL unit          24.00 Rp             67,200,000.00                         0.48                76.00              0.37                   24.00 Kusen sudah terpasang
 c. Pintu Type P3 (1x91x220) Pintu single / HPL  unit          23.00 Rp             32,200,000.00                         0.23                76.00              0.18                   24.00 Kusen sudah terpasang
 e. Pintu Type P4 (1x88x220) Single Doble Triplek/HPL unit            5.00 Rp                7,500,000.00                         0.05                76.00              0.04                   24.00 Kusen sudah terpasang
 f. Pintu Type P5 (1x78x220) Single Double Triplek/HPL unit            2.00 Rp                2,800,000.00                         0.02                76.00              0.02                   24.00 Kusen sudah terpasang
 g.Jendela Type JA1 (175x370) unit            5.00 Rp             16,000,000.00                         0.12                76.00              0.09                   24.00 Kusen sudah terpasang
 h.Jendela Type JA2 ( 175x281) unit            2.00 Rp                6,000,000.00                         0.04                76.00              0.03                   24.00 Kusen sudah terpasang
 i.Jendela Type JA3 ( 175x70 ) unit            1.00 Rp                1,065,600.00                         0.01                76.00              0.01                   24.00 Kusen sudah terpasang
 j.Jendela Type JA5 ( 585x175 ) unit            1.00 Rp                6,000,000.00                         0.04                76.00              0.03                   24.00 Kusen sudah terpasang
 k.Jendela Type J1 ( 237x184 ) unit          14.00 Rp             37,100,000.00                         0.27                76.00              0.20                   24.00 Kusen sudah terpasang
 l.Jendela Type J2 ( 64x265 ) unit          26.00 Rp             26,000,000.00                         0.19                76.00              0.14                   24.00 Kusen sudah terpasang
 m.Jendela Type J4 ( 310x184 ) unit            1.00 Rp                4,360,500.00                         0.03                76.00              0.02                   24.00 Kusen sudah terpasang
 n.Jendela Type J5 ( 178x184 ) unit            1.00 Rp                2,500,000.00                         0.02                74.00              0.01                   26.00 Kusen sudah terpasang
 o.Jendela Type J6 ( 88x455 ) unit            1.00 Rp                2,200,000.00                         0.02                74.00              0.01                   26.00 Kusen sudah terpasang
 p.Jendela Type J7 ( 88x316 ) unit            1.00 Rp                2,100,000.00                         0.02                74.00              0.01                   26.00 Kusen sudah terpasang
 q.Jendela Type J8 ( 240x589 ) unit            1.00 Rp                8,240,000.00                         0.06                74.00              0.04                   26.00 Kusen sudah terpasang
 r.Jendela Type J9 ( 122x589 ) unit            1.00 Rp                8,700,000.00                         0.06                75.00              0.05                   25.00 Kusen sudah terpasang
 s.Bouvenlay Type BV1 ( 220x49 ) unit            1.00 Rp                   880,000.00                         0.01                65.00              0.00                   35.00 Kusen sudah terpasang
  Rp           237,286,100.00                    ‐                ‐
5  Pekerjaan Cat                    ‐                ‐
 a. Cat Dinding luar m²        663.00 Rp             22,542,000.00                         0.16                48.00              0.08                   52.00 Material on site
 b. Cat Dinding Dalam m²     1,063.00 Rp             31,060,860.00                         0.22                48.00              0.11                   52.00 Material on site
 c. Cat Plafond m²        909.04 Rp             26,562,002.70                         0.19                48.00              0.09                   52.00 Material on site
 d. Melamic Daun Pintu m²        200.00 Rp             25,700,000.00                         0.19                48.00              0.09                   52.00 Material on site
  Rp           105,864,862.70                    ‐                ‐
6 Pekerjaan Wall paper                    ‐                ‐
a. Wall paper terpasang m²        400.00 Rp             31,200,000.00                         0.22                49.00              0.11                   51.00 ‐
                   ‐                ‐
7 Pekerjaan Atap                    ‐                ‐
a. Rangka atap m²     1,400.00 Rp           219,800,000.00                         1.49                96.00              1.43                     4.00 ‐
b. Penutup atap m²     1,400.00 Rp           229,600,000.00                         1.56                94.00              1.46                     6.00 ‐
c. Bubungan m1        160.00 Rp             22,240,000.00                         0.16                94.00              0.15                     6.00 ‐
d. Lisplank m1        130.00 Rp             13,130,000.00                         0.09                67.00              0.06                   33.00 ‐
  Rp           484,770,000.00                    ‐                ‐
8  Pekerjaan Sanitary                    ‐                ‐
 a. Closed duduk CW 420 J unit          27.00 Rp             77,463,000.00                         0.56                64.00              0.36                   36.00 Material on site
 b. Wastafel LW 660  unit          25.00 Rp             41,125,000.00                         0.30                64.00              0.19                   36.00 Material on site
 c. Urinoir U 57 M unit            2.00 Rp                3,834,000.00                         0.03                64.00              0.02                   36.00 Material on site
 d. Floor Drain TX 1 BN  bh          27.00 Rp                7,857,000.00                         0.06                64.00              0.04                   36.00 Material on site
 e. Shower Set TS 309 RYRZ bh          25.00 Rp             40,700,000.00                         0.29                64.00              0.19                   36.00 Material on site

01 AFRL‐ 07 AFRL 2019 FIX (76)  2 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

 f. Shower Spray 403 bh          27.00 Rp                9,780,750.00                         0.07                64.00              0.05                   36.00 Material on site
 g. Skat Urinoir A 100 bh            2.00 Rp                1,509,750.00                         0.01                64.00              0.01                   36.00 Material on site
 h. Paper Holder TS 116 R (SR) bh            1.00 Rp                   403,500.00                         0.00                64.00              0.00                   36.00 Material on site
 i. Soap Holder S 156 N (SR) bh            1.00 Rp                     97,500.00                         0.00                68.00              0.00                   32.00 Material on site
 j. Grab Bar TX 3A2 (SR) bh            1.00 Rp                   634,725.00                         0.00                64.00              0.00                   36.00 Material on site
 k. Towel Holder TX 726 AES (SR) bh            1.00 Rp                   745,200.00                         0.01                64.00              0.00                   36.00 Material on site
 l. Kran Dinding TX 23 B 13 bh          20.00 Rp                3,102,000.00                         0.02                40.00              0.01                   60.00 Material on site
  Rp           187,252,425.00                    ‐                ‐
Jumlah Pekerjaan Arsitektur Rp        3,886,107,667.72                     ‐                  ‐
                   ‐                ‐
4  PEKERJAAN HALAMAN                    ‐                ‐
 a. Saluran Terbuka keliling bangunan 30x50 cm m1        110.00 Rp             46,200,000.00                         0.33                51.00              0.17                   49.00 Belum sama sekali
 b. Bak Kontrol 60x60x60 bh          20.00 Rp             11,000,000.00                         0.08                51.00              0.04                   49.00 Belum sama sekali
 c. Pengaspalan Perkerasan Halaman Area Parkir/Halaman m2        900.00 Rp           111,600,000.00                         0.80                51.00              0.41                   49.00 Belum sama sekali
 d. Taman m2        300.00 Rp             27,000,000.00                         0.19                51.00              0.10                   49.00 Belum sama sekali
 e. Talud batu keling keliling Bangunan m3        148.00 Rp             67,340,000.00                         0.49                    ‐                ‐
Jumlah Pekerjaan Halaman Rp           263,140,000.00                    ‐                ‐
                   ‐                ‐
5  PEKERJAAN RENOVASI                    ‐                ‐
 PEKERJAAN GROUND TANK                    ‐                ‐
1  Galian Tanah m3        209.88 Rp             17,107,318.80                         0.12             100.00              0.12                       ‐ ‐
2  Urug Kembali m3          41.98 Rp                   855,365.94                         0.01                91.00              0.01                     9.00 ‐
3  Pek. Beton m3          55.65 Rp           319,029,984.00                         1.30                92.00              1.20                     8.00 ‐
4  Pasir Urug Di bawah Lantai m3            7.00 Rp                1,050,099.60                         0.01                92.00              0.01                     8.00 ‐
5  Lantai Kerja m3            2.80 Rp                   337,626.96                         0.00                91.00              0.00                     9.00 ‐
Jumlah Pekerjaan Ground Tank Rp           338,380,395.30                     ‐                  ‐
6  PEKERJAAN PLUMBING AIR BERSIH, AIR KOTOR DAN AIR HUJAN                    ‐                ‐
RUANG RAWAT INAP                    ‐                ‐
                   ‐                ‐
A. PEKERJAAN PERALATAN UTAMA POMPA AIR BERSIH                    ‐                ‐
1 Pompa Transfer Air Bersih set            1.00 Rp             25,784,447.50                         0.19                49.00              0.09                   51.00 Pompa sudah dipesan (panjar)
 Cap.      : 200 liter / menit                    ‐                ‐
 Head      : 30 meter                    ‐                ‐
 Power    : 2,2 Kw/3 ph/380V/50 Hz                    ‐                ‐
 Type      : Vertical Multy Stage Inline Pump                    ‐                ‐
 Rot.       : 2900 rpm                    ‐                ‐
Lengkap dengan panel automatic kontrol, etc                    ‐                ‐
Paralel Alternate Automatically                    ‐                ‐
Accessories Pompa :                    ‐                ‐
• Header diameter 100 mm (4") GIP MED m            2.00 Rp                1,326,096.00                         0.01                50.00              0.00                   50.00 Material on site
• Butterfly Valve diameter 50 mm (2") bh            5.00 Rp                4,498,213.50                         0.03                50.00              0.02                   50.00 Material on site
• Strainer diameter 50 mm (2") bh            2.00 Rp                3,062,017.97                         0.02                50.00              0.01                   50.00 Material on site
• Check Valve diameter 50 mm (2") bh            2.00 Rp                3,806,071.68                         0.03                50.00              0.01                   50.00 Material on site
• Flexible Joint diameter 50 mm (2") bh            2.00 Rp                2,131,402.80                         0.02                50.00              0.01                   50.00 Material on site
• Water Level Control & Pengkabelan bh            1.00 Rp                1,961,112.50                         0.01                46.00              0.01                   54.00 Material on site
• Pressure Gauge 0 ‐ 10 bar bh            2.00 Rp                1,396,782.90                         0.01                46.00              0.00                   54.00 Material on site
• Pressure Switch bh            1.00 Rp                2,065,000.00                         0.01                46.00              0.01                   54.00 Material on site
               18.00                ‐
2 Pengadaan & Pemasangan Pompa Siram Taman/ Cuci ‐ Lengkap deng set            1.00 Rp             10,000,000.00                         0.07                24.00              0.02                   76.00 Pompa sudah dipesan (panjar)
Type  : Submersible drain pump                    ‐                ‐
Kap. : 50 Liter/menit         Head. 8 meter                    ‐                ‐
lengkap dengan automatic lavel control                    ‐                ‐
JUMLAH PEKERJAAN PERALATAN UTAMA POMPA AIR BERSIH: Rp             56,031,144.85                    ‐                ‐
                    ‐                  ‐
B. INSTALASI PIPA AIR BERSIH                    ‐                ‐
                   ‐                ‐
‐ Pemipaan dari Pompa Transfer ke Elevated Tank                    ‐                ‐
Pipa PPR‐PN.10 :                    ‐                ‐
• diameter 2 1/2" m          32.00 Rp                9,941,174.40                         0.07                84.00              0.06                   16.00 Instalasi sudah terpasang
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp                1,491,176.16                         0.01                84.00              0.01                   16.00 Instalasi sudah terpasang
                   ‐                ‐
Accessories :                    ‐                ‐
• Floating Valve diameter 2 1/2" bh            1.00 Rp                1,116,042.70                         0.01                84.00              0.01                   16.00 Instalasi sudah terpasang
                   ‐                ‐
‐ Luar Gedung dan service area                    ‐                ‐
Pipa PPR‐PN.10                    ‐                ‐
• diameter 11/2" m          24.00 Rp                3,304,648.80                         0.02                97.00              0.02                     3.00 Instalasi sudah terpasang
• diameter 1" m          32.00 Rp                2,059,682.40                         0.01                97.00              0.01                     3.00 Instalasi sudah terpasang
• diameter 3/4" m          43.00 Rp                1,697,025.64                         0.01                97.00              0.01                     3.00 Instalasi sudah terpasang
• diameter 1/2" m          60.00 Rp                1,884,372.75                         0.01                97.00              0.01                     3.00 Instalasi sudah terpasang
• diameter 2" m          10.00 Rp                2,185,965.75                         0.02                97.00              0.02                     3.00 Instalasi sudah terpasang
• diameter 21/2" m          28.00 Rp                8,698,527.60                         0.06                97.00              0.06                     3.00 Instalasi sudah terpasang
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp                2,974,533.44                         0.02                97.00              0.02                     3.00 Instalasi sudah terpasang
                   ‐                ‐
Accessories :                    ‐                ‐
• Butterfly Valve diameter 1" bh            2.00 Rp                1,311,722.40                         0.01                57.00              0.01                   43.00 Material on site
• Butterfly Valve diameter 3/4" bh            1.00 Rp                   392,186.20                         0.00                57.00              0.00                   43.00 Material on site
• Kran Siram 1/2" bh          12.00 Rp                   840,000.00                         0.01                58.00              0.00                   42.00 Material on site
• Bak Control 50 x 50 x 50 Pas. Bata Tutup Beton bh            2.00 Rp                2,500,000.00                         0.02                58.00              0.01                   42.00 Material on site
• Galian Tanah + Urug m          60.00 Rp                2,880,000.00                         0.02                58.00              0.01                   42.00 Material on site
                   ‐                ‐
‐ Lantai Satu                    ‐                ‐
Pipa PPR‐PN.10                    ‐                ‐
• diameter 11/2" m          30.00 Rp                4,130,811.00                         0.03                99.00              0.03                     1.00 Instalasi sudah terpasang
• diameter 1" m          48.00 Rp                3,089,523.60                         0.02                99.00              0.02                     1.00 Instalasi sudah terpasang
• diameter 3/4" m        160.00 Rp                6,314,514.00                         0.05                99.00              0.05                     1.00 Instalasi sudah terpasang
• diameter 1/2" m        180.00 Rp                5,653,118.25                         0.04                99.00              0.04                     1.00 Instalasi sudah terpasang
• diameter 2 " m            4.00 Rp                   874,386.30                         0.01                99.00              0.01                     1.00 Instalasi sudah terpasang
• diameter 21/2" m            5.00 Rp                1,553,308.50                         0.01                98.00              0.01                     2.00 Instalasi sudah terpasang
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp                3,242,349.25                         0.02             100.00              0.02                       ‐ Instalasi sudah terpasang
                   ‐                ‐
Accessories :                    ‐                ‐
• Butterfly Valve diameter 2 1/2" bh            1.00 Rp                1,189,685.20                         0.01                41.00              0.00                   59.00 Material on site
• Butterfly Valve diameter 2" bh            1.00 Rp                   899,642.70                         0.01                48.00              0.00                   52.00 Material on site
• Butterfly Valve diameter 1 1/2" bh            3.00 Rp                2,502,753.90                         0.02                48.00              0.01                   52.00 Material on site
• Butterfly Valve diameter 3/4" bh            4.00 Rp                1,568,744.80                         0.01                41.00              0.00                   59.00 Material on site

01 AFRL‐ 07 AFRL 2019 FIX (76)  3 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

                   ‐                ‐
‐ Lantai Dua                    ‐                ‐
Pipa PPR‐PN.10                    ‐                ‐
• diameter 11/2" m          35.00 Rp                4,819,279.50                         0.03                82.00              0.03                   18.00 Instalasi sudah terpasang
• diameter 1" m          25.00 Rp                1,609,126.88                         0.01                82.00              0.01                   18.00 Instalasi sudah terpasang
• diameter 3/4" m        140.00 Rp                5,525,199.75                         0.04                82.00              0.03                   18.00 Instalasi sudah terpasang
• diameter 1/2" m        198.00 Rp                6,218,430.08                         0.04                82.00              0.04                   18.00 Instalasi sudah terpasang
• diameter 3" m            6.00 Rp                2,589,325.20                         0.02                82.00              0.02                   18.00 Instalasi sudah terpasang
• diameter 21/2" m          35.00 Rp             10,873,159.50                         0.08                82.00              0.06                   18.00 Instalasi sudah terpasang
• diameter 2" m            5.00 Rp                1,092,982.88                         0.01                82.00              0.01                   18.00 Instalasi sudah terpasang
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp                2,725,805.43                         0.02                78.00              0.02                   22.00 Instalasi sudah terpasang
                   ‐                ‐
Accessories :                    ‐                ‐
• Butterfly Valve diameter 3" bh            1.00 Rp                1,242,420.20                         0.01                68.00              0.01                   32.00 Material on site
• Butterfly Valve diameter 1" bh          11.00 Rp                7,214,473.20                         0.05                68.00              0.04                   32.00 Material on site
• Butterfly Valve diameter  3/4" bh            2.00 Rp                   784,372.40                         0.01                68.00              0.00                   32.00 Material on site
• Butterfly Valve diameter 1 1/2" bh            1.00 Rp                   834,251.30                         0.01                68.00              0.00                   32.00 Material on site
                   ‐                ‐
‐ Pipa Tegak (Riser)                    ‐                ‐
Pipa PPR‐PN.10                    ‐                ‐
• diameter 4" m          10.00 Rp                6,464,742.00                         0.05                97.00              0.05                     3.00 Instalasi sudah terpasang
• diameter 21/2" m          10.00 Rp                3,106,617.00                         0.02             100.00              0.02                       ‐ Instalasi sudah terpasang
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp                1,435,703.85                         0.01                97.00              0.01                     3.00 Instalasi sudah terpasang
                   ‐                ‐
Accessories :                    ‐                ‐
• Butterfly Valve diameter 50 mm (2') bh            3.00 Rp                2,698,928.10                         0.02                55.00              0.01                   45.00 Material on site
• Butterfly Valve diameter 40 mm (1 1/2') bh            1.00 Rp                   834,251.30                         0.01                55.00              0.00                   45.00 Material on site
                   ‐                ‐
‐ Lantai Atap                    ‐                ‐
Pipa PPR‐PN.10                    ‐                ‐
• diameter 4" m            4.00 Rp                2,585,896.80                         0.02                80.00              0.01                   20.00 Instalasi sudah terpasang
• diameter 21/2" m            8.00 Rp                2,485,293.60                         0.02                86.00              0.02                   14.00 Instalasi sudah terpasang
• diameter 2" m          23.00 Rp                5,027,721.23                         0.04                78.00              0.03                   22.00 Instalasi sudah terpasang
• diameter 1‐1/2" m          20.00 Rp                2,753,874.00                         0.02                78.00              0.02                   22.00 Instalasi sudah terpasang
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp                1,927,917.84                         0.01                78.00              0.01                   22.00 Instalasi sudah terpasang
                   ‐                ‐
Accessories :                    ‐                ‐
• Butterfly Valve diameter  4" bh            2.00 Rp                3,434,070.40                         0.02                72.00              0.02                   28.00 Instalasi sudah terpasang
• Butterfly Valve diameter 2 1/2" bh            3.00 Rp                3,569,055.60                         0.03                72.00              0.02                   28.00 Instalasi sudah terpasang
• Butterfly Valve diameter  1 1/2" bh            2.00 Rp                1,668,502.60                         0.01                72.00              0.01                   28.00 Instalasi sudah terpasang
• Check Valve diameter  1 1/2" bh            2.00 Rp                2,735,664.75                         0.02                78.00              0.02                   22.00 Instalasi sudah terpasang
                   ‐                ‐
Roof Tank Fibre Panel, Kap. 5 m3 lengkap dengan dudukan bh            1.00 Rp             13,217,393.75                         0.10                72.00              0.07                   28.00 ‐
Header diameter 8" panjang 3 m bh            1.00 Rp                7,915,626.18                         0.06                72.00              0.04                   28.00 ‐
                   ‐                ‐
Booster Pump Packaged (1paket 2 pompa) set            1.00 Rp             99,178,135.00                         0.71                90.00              0.64                   10.00 ‐
 Cap.      : 2 x 150 liter / menit                    ‐                ‐
 Head      : 20 meter                    ‐                ‐
 Power    : 2,1 Kw/3 ph/380V/50 Hz                    ‐                ‐
 Type      : Vertical multy stage inline Pump                    ‐                ‐
Lengkap dengan panel automatic kontrol, Inverter                    ‐                ‐
Paralel Alternate Automatically                    ‐                ‐
Pressure Tank, etc                    ‐                ‐
                   ‐                ‐
JUMLAH INSTALASI PIPA AIR BERSIH: Rp           280,864,116.04                    ‐                ‐
                   ‐                ‐
C.  PEKERJAAN INSTALASI AIR KOTOR & BEKAS                    ‐                ‐
                   ‐                ‐
‐ Lantai Satu dan Luar Gedung                    ‐                ‐
a Pipa Air Kotor dan Air bekas                    ‐                ‐
Pipa PVC.AW :                    ‐                ‐
• diameter 8" m          52.00 Rp             20,957,336.40                         0.15             100.00              0.15                       ‐ Terpasang
• diameter 6" m          72.00 Rp             18,282,596.40                         0.13             100.00              0.13                       ‐ Terpasang
• diameter 4" m        146.00 Rp             17,874,254.40                         0.13             100.00              0.13                       ‐ Terpasang
• diameter 3" m          28.00 Rp                2,378,592.30                         0.02             100.00              0.02                       ‐ Terpasang
• diameter 2" m        127.00 Rp                5,792,966.89                         0.04             100.00              0.04                       ‐ Terpasang
• diameter 11/2" (Pipa Vent) m          76.00 Rp                2,989,400.63                         0.02             100.00              0.02                       ‐ Terpasang
                   ‐                ‐
Accessories :                    ‐                ‐
• Floor Drain Ɵ 2" SS bh          26.00 Rp                7,454,621.20                         0.05                70.00              0.04                   30.00 Material on site
• Floor Clean Out ø 100mm (4") bh            3.00 Rp                   539,261.10                         0.00                70.00              0.00                   30.00 Material on site
• Floor Clean Out ø 50mm (2") SS bh            5.00 Rp                   506,987.25                         0.00                70.00              0.00                   30.00 Material on site
• Bio septictank Ɵ 900 mm T. 1150 mm bh            1.00 Rp             12,289,825.00                         0.09                69.00              0.06                   31.00 Material on site
• Holding Tank 4 m3 Unit            1.00 Rp                6,000,000.00                         0.04                26.00              0.01                   74.00 Material on site
• Sewage Pump Kap. 200 l/menit, Head 7 m Unit            1.00 Rp             10,000,000.00                         0.07                70.00              0.05                   30.00 Material on site
• Bak Kontrol + Tutup Beton 60x60x60 Bh          12.00 Rp                6,000,000.00                         0.04                70.00              0.03                   30.00 Material on site
• Grease Trap Kap. 2 m3 Unit            1.00 Rp             12,000,000.00                         0.09                70.00              0.06                   30.00 Material on site
                   ‐                ‐
‐ Pipa Tegak (Riser)                    ‐                ‐
a Pipa Air Kotor, Air Bekas dan Vent                    ‐                ‐
Pipa PVC.AW :                    ‐                ‐
• diameter 6" m            8.00 Rp                2,031,399.60                         0.01                99.00              0.01                     1.00 Terpasang
• diameter 4" m            8.00 Rp                   979,411.20                         0.01                99.00              0.01                     1.00 Terpasang
• diameter 3" m          12.00 Rp                1,019,396.70                         0.01                99.00              0.01                     1.00 Terpasang
• diameter 2" (Pipa Vent) m          16.00 Rp                   729,822.60                         0.01                99.00              0.01                     1.00 Terpasang
• diameter 1 1/2" (Pipa Vent) m          56.00 Rp                2,202,716.25                         0.02                99.00              0.02                     1.00 Terpasang
                   ‐                ‐
‐ Lantai Dua                    ‐                ‐
a Pipa Air Kotor, Air Bekas dan Vent                    ‐                ‐
Pipa PVC.AW :                    ‐                ‐
• diameter 6" m          65.00 Rp             16,505,121.75                         0.12                94.00              0.11                     6.00 Terpasang
• diameter 4" m          65.00 Rp                7,957,716.00                         0.06                94.00              0.05                     6.00 Terpasang
• diameter 3" m          26.00 Rp                2,208,692.85                         0.02                94.00              0.01                     6.00 Terpasang
• diameter 2" m          84.00 Rp                3,831,568.65                         0.03                94.00              0.03                     6.00 Terpasang
• diameter 1 1/2" m          76.00 Rp                2,989,400.63                         0.02                93.00              0.02                     7.00 Terpasang
Accessories :                65.00                ‐
• Floor Drain (Ɵ 2") bh          10.00 Rp                2,867,162.00                         0.02                71.00              0.01                   29.00 Material on site

01 AFRL‐ 07 AFRL 2019 FIX (76)  4 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

• Floor Clean Out ø 100mm (4") bh            1.00 Rp                   179,753.70                         0.00                71.00              0.00                   29.00 Material on site
• Floor Clean Out ø 50mm (2") bh            6.00 Rp                   608,384.70                         0.00                71.00              0.00                   29.00 Material on site
Rp                                ‐                    ‐                ‐
JUMLAH PEKERJAAN INSTALASI AIR KOTOR & BEKAS: Rp           167,176,388.19                    ‐                ‐
                   ‐                ‐
D. PEKERJAAN INSTALASI AIR HUJAN                     ‐                ‐
                   ‐                ‐
Pipa PVC.AW :                    ‐                ‐
• diameter 10" (pipa datar) m            4.00 Rp                1,681,951.80                         0.01                87.00              0.01                   13.00 Terpasang
• diameter 6" (pipa datar) m          38.00 Rp                9,649,148.10                         0.07                87.00              0.06                   13.00 Terpasang
• diameter 4" (pipa datar) m        220.00 Rp             26,933,808.00                         0.19                87.00              0.17                   13.00 Terpasang
• diameter 3" (pipa tegak) m        410.00 Rp             34,829,387.25                         0.25                87.00              0.22                   13.00 Terpasang
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp                3,654,714.76                         0.03                87.00              0.02                   13.00 Terpasang
Accessories :                35.00                ‐
• Roof Drain Cast Iron diameter 3" bh          30.00 Rp                6,000,000.00                         0.04                60.00              0.03                   40.00 Material on site
• Sumur Resapan bh            2.00 Rp             11,077,200.00                         0.08                37.00              0.03                   63.00 Belum sama sekali
• Bak kontrol 60x60x60+TUTUP bh            6.00 Rp                3,000,000.00                         0.02                37.00              0.01                   63.00 Belum sama sekali
Rp                                ‐                           ‐                37.00                ‐
JUMLAH PEKERJAAN INSTALASI AIR HUJAN : Rp             96,826,209.91                    ‐                ‐
                   ‐                ‐
E. PEKERJAAN INSTALASI PIPA AIR PANAS                    ‐                ‐
                   ‐                ‐
1 Peralatan Utama                    ‐                ‐
a Solar Water Heater Kapasitas 300 Liter unit            2.00 Rp             67,000,000.00                         0.48                56.00              0.27                   44.00 Pompa sudah dipesan (panjar)
b Pompa Sirkulasi air panas kapasitas 100 ltr/mnt Head 20mtr unit            1.00 Rp             12,000,000.00                         0.09                60.00              0.05                   40.00 Pompa sudah dipesan (panjar)
c Instalasi pemipaan air panas Lt.1 pipa PPR PN‐20                50.00                ‐
• diameter 21/2" m            8.00 Rp                2,940,924.00                         0.02                94.00              0.02                     6.00 Terpasang
• diameter 2" m            4.00 Rp                1,160,278.26                         0.01                94.00              0.01                     6.00 Terpasang
• diameter 11/2" m          44.00 Rp                8,727,599.50                         0.06                94.00              0.06                     6.00 Terpasang
• diameter 1" m          34.00 Rp                3,264,226.85                         0.02                94.00              0.02                     6.00 Terpasang
• diameter 3/4" m          46.00 Rp                3,087,112.47                         0.02                94.00              0.02                     6.00 Terpasang
• diameter 1/2" m          64.00 Rp                3,446,737.80                         0.02                94.00              0.02                     6.00 Terpasang
• Fitting pipa (Elbow,Tee, Rebucer,dll) lot            1.00 Rp                1,131,343.94                         0.01                94.00              0.01                     6.00 Terpasang
• Butterfly Valve diameter 2 1/2" bh            1.00 Rp                1,189,685.20                         0.01                81.00              0.01                   19.00 Terpasang
• Butterfly Valve diameter  3/4" bh            9.00 Rp                3,529,675.80                         0.03                81.00              0.02                   19.00 Terpasang
                   ‐                ‐
d Instalasi pipa air panas Lt.2                    ‐                ‐
Pipa PPR PN‐20                    ‐                ‐
• diameter 2" m          20.00 Rp                5,801,391.29                         0.04                76.00              0.03                   24.00 Material on site
• diameter 11/2" m          10.00 Rp                1,983,545.34                         0.01                76.00              0.01                   24.00 Material on site
• diameter 1" m          24.00 Rp                2,304,160.13                         0.02                76.00              0.01                   24.00 Material on site
• diameter 3/4" m          36.00 Rp                2,416,001.07                         0.02                76.00              0.01                   24.00 Material on site
• diameter 1/2" m        126.00 Rp                6,785,765.04                         0.05                76.00              0.04                   24.00 Material on site
• Fitting pipa (Elbow,Tee, Rebucen,dll) lot            1.00 Rp                   964,543.14                         0.01                76.00              0.01                   24.00 Material on site
• Butterfly Valve diameter 2" bh            1.00 Rp                   899,642.70                         0.01                63.00              0.00                   37.00 Material on site
• Butterfly Valve diameter  3/4" bh          14.00 Rp                5,490,606.80                         0.04                63.00              0.02                   37.00 Material on site
                   ‐                ‐
e Pipa Tegak (riser) air panas                    ‐                ‐
pipa PPR PN‐20                    ‐                ‐
•diameter 21/2" m          16.00 Rp                5,881,848.00                         0.04                78.00              0.03                   22.00 Instalasi sudah terpasang
•Fitting pipa lot            1.00 Rp                   294,092.40                         0.00                73.00              0.00                   27.00 Instalasi sudah terpasang
•Butterfly valve Ø2 1/2" bh            2.00 Rp                2,379,370.40                         0.02                73.00              0.01                   27.00 Instalasi sudah terpasang
                   ‐                ‐
f pipa air panas di lt. atap                    ‐                ‐
pipa PPR PN‐20 + Isolasi Thermaflex density 80‐120kg/m3                    ‐                ‐
•diameter 6" bh            3.00 Rp                4,557,346.15                         0.03                68.00              0.02                   32.00 Material on site
•Butterfly valve Ø 2" bh          10.00 Rp                8,996,427.00                         0.06                60.00              0.04                   40.00 Material on site
•Butterfly valve Ø 2 1/2" bh          10.00 Rp             11,896,852.00                         0.09                60.00              0.05                   40.00 Material on site
•Check valve Ø 2" bh            2.00 Rp                3,806,071.68                         0.03                60.00              0.02                   40.00 Material on site
•Strainer Ø 2" bh            2.00 Rp                3,062,017.97                         0.02                60.00              0.01                   40.00 Material on site
•Flexible joint Ø 2" bh            4.00 Rp                4,262,805.59                         0.03                59.00              0.02                   41.00 Material on site
•Automatic air vent Ø 3/4" bh            3.00 Rp                1,125,000.00                         0.01                59.00              0.00                   41.00 Material on site
                   ‐                ‐
JUMLAH PEKERJAAN INSTALASI PIPA AIR PANAS: Rp           180,385,070.54                    ‐                ‐
                   ‐                ‐
F. PEKERJAAN INSTALASI PEMIPAAN GAS LPG                     ‐                ‐
Pipa Tembaga Class L                    ‐                ‐
• diameter  1/2" m          17.00 Rp                1,399,256.40                         0.01                61.00              0.01                   39.00 Material on site
diameter 3/4" m            2.00 Rp                   272,078.40                         0.00                61.00              0.00                   39.00 Material on site
diameter 1" m            8.00 Rp                1,464,423.60                         0.01                61.00              0.01                   39.00 Material on site
diameter 3" (Header GSP) m            2.00 Rp                2,800,000.00                         0.02                61.00              0.01                   39.00 Material on site
• Ball Valve Ø 1/2" bh            4.00 Rp                   520,000.00                         0.00                61.00              0.00                   39.00 Material on site
• Double Neple  1/2" x 1/2" bh            4.00 Rp                   200,000.00                         0.00                61.00              0.00                   39.00 Material on site
• Pressure Regulator Ø 1" bh            1.00 Rp                2,450,000.00                         0.02                61.00              0.01                   39.00 Material on site
• Pressure Gaunge bh            1.00 Rp                   330,000.00                         0.00                61.00              0.00                   39.00 Material on site
• Regulator bh            4.00 Rp               1,080,000.00                         0.01                53.00              0.00                   47.00 Material on site
JUMLAH PEKERJAAN INSTALASI PEMIPAAN GAS LPG : Rp             10,515,758.40                    ‐                ‐
                   ‐                ‐
G. Testing Commisioning and Balancing Lot            1.00 Rp                3,678,837.72                         0.03                42.00              0.01                   58.00 ‐
                   ‐                ‐
JUMALH PEKERJAAN AIR BERSIH, AIR KOTOR DAN AIR HUJAN Rp           795,477,525.63                     ‐                  ‐
                   ‐                ‐
7 PEKERJAAN TATA UDARA DAN VENTILASI                    ‐                ‐
RUANG RAWAT INAP/PEMBANGUNAN                    ‐                ‐
                   ‐                ‐
A. PEKERJAAN TATA UDARA                    ‐                ‐
1 LANTAI SATU                    ‐                ‐
a. Pengadaan dan Pemasangan Unit AC Split Duct                    ‐                ‐
Flexible Conection (Canvas) dan peralatana bantu                    ‐                ‐
Kapasitas : 24.000 BTU/h unit            1.00 Rp             22,025,045.00                         0.16                51.00              0.08                   49.00 Material on site
                   ‐                ‐
b. Pengadaan dan Pemasangan Split Unit lengkap Pemipaan                    ‐                ‐
•Kapasitas :  31.000 BTU/h Split Wall‐Ceiling unit            2.00 Rp             19,328,320.00                         0.14                60.00              0.08                   40.00 Material on site
•Kapasitas :  12000 ‐ 12500 BTU/h Split Wall  unit          11.00 Rp             53,122,801.05                         0.38                60.00              0.23                   40.00 Material on site
•Kapasitas :  18500 BTU/h Split Wall  unit            2.00 Rp             11,891,690.00                         0.09                60.00              0.05                   40.00 Material on site
•Kapasitas :  7000 BTU/h Split Wall  unit            3.00 Rp             11,141,553.15                         0.08                60.00              0.05                   40.00 Material on site
•Kapasitas :  5000 BTU/h Split Wall  unit            1.00 Rp                3,483,717.50                         0.03                60.00              0.02                   40.00 Material on site

01 AFRL‐ 07 AFRL 2019 FIX (76)  5 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

•Kapasitas 32.000 BTU/h ‐ Type Cassette unit            2.00 Rp             41,237,240.00                         0.30                69.00              0.21                   31.00 Material on site
               34.00                ‐
c. Support/ Bracket C/W wooden ls            1.00 Rp                8,111,518.34                         0.06                69.00              0.04                   31.00 Material on site
                   ‐                ‐
d ‐ R. Isolasi                    ‐                ‐
Duct PU                    ‐                ‐
•Ducting 8" x 8 " m            4.00 Rp                1,339,048.07                         0.01                89.00              0.01                   11.00 Terpasang
•Ducting 10" x 10 " m            5.00 Rp                2,092,262.61                         0.02                89.00              0.01                   11.00 Terpasang
•Ducting 14" x 14 " m            8.00 Rp                4,686,668.25                         0.03                85.00              0.03                   15.00 Terpasang
•Ducting 14" x 7 " m            6.50 Rp                2,855,938.46                         0.02                85.00              0.02                   15.00 Terpasang
•Ducting 4" x 5 " m            7.00 Rp                1,318,125.45                         0.01                85.00              0.01                   15.00 Terpasang
                   ‐                ‐
e. Support/ Bracket C/W wooden ls            1.00 Rp                   614,602.14                         0.00                42.00              0.00                   58.00 Material on site
                   ‐                ‐
f. Grill, Diffuser & Louvre                    ‐                ‐
•Supply Air Diffuser Line Air 40" x 4" bh          29.00 Rp             16,530,000.00                         0.12                57.00              0.07                   43.00 Material on site
•Return Air Grill Line Air 40" x 5" bh          28.00 Rp             15,148,000.00                         0.11                57.00              0.06                   43.00 Material on site
•Fresh Air Grille 5" x 10" bh            2.00 Rp                   340,000.00                         0.00                57.00              0.00                   43.00 Material on site
•Volume Dumper 40" x 12" bh            2.00 Rp                1,440,000.00                         0.01                57.00              0.01                   43.00 Material on site
•Drain Pan 60" x 40 " bh            2.00 Rp                2,800,000.00                         0.02                57.00              0.01                   43.00 Material on site
•Plenum Diffuser Grill bh          57.00 Rp             14,820,000.00                         0.11                57.00              0.06                   43.00 Material on site
                   ‐                ‐
•diff sad 10"x10" bh            2.00 Rp                   500,000.00                         0.00                60.00              0.00                   40.00 Material on site
•Grille/ EG  15"x15" bh            1.00 Rp                   350,000.00                         0.00                60.00              0.00                   40.00 Material on site
•FAG 5"x6" bh            2.00 Rp                   260,000.00                         0.00                60.00              0.00                   40.00 Material on site
•Grille 15"x15" bh            1.00 Rp                   350,000.00                         0.00                60.00              0.00                   40.00 Material on site
•Grille 15"x8" bh            3.00 Rp                   450,000.00                         0.00                60.00              0.00                   40.00 Material on site
•HEPA Filter 500 CFM bh            1.00 Rp                5,000,000.00                         0.04                60.00              0.02                   40.00 Material on site
•HEPA Filter 952 CFM bh            1.00 Rp                5,250,000.00                         0.04                60.00              0.02                   40.00 Material on site
                   ‐                ‐
2 Lantai Dua                    ‐                ‐
a. Pengadaan dan Pemasangan Split Duct unit            1.00 Rp             48,153,745.00                         0.35                60.00              0.21                   40.00 Material on site
Flexible Conection (Canvas) dan peralatana bantu                    ‐                ‐
Kapasitas : 100.000 BTU/h                    ‐                ‐
                   ‐                ‐
b. Pengadaan dan pemasangan spilt unit lengkap dengan pipa refrigerant dan draint                    ‐                ‐
•Kapasitas 18400 ‐ 19.200 BTU/h R. Perawat unit            1.00 Rp                5,945,845.00                         0.04                52.00              0.02                   48.00 Material on site
Tipe Wall                    ‐                ‐
•Kapasitas 24.000 BTU/h unit            2.00 Rp             17,471,172.40                         0.13                51.00              0.06                   49.00 Material on site
Tipe Wall kls 3                    ‐                ‐
•Kapasitas 12.500 ‐ 14.000 BTU/h unit          20.00 Rp             96,586,911.00                         0.70                48.00              0.33                   52.00 Material on site
Tipe Wall kls 2, kls 1, VVIP                    ‐                ‐
•Kapasitas 7.000 BTUH/h unit            1.00 Rp                3,713,851.05                         0.03                48.00              0.01                   52.00 Material on site
Tipe wall R. Diskusi                    ‐                ‐
•Kapasitas 5.000 BTUH/h unit            1.00 Rp                3,483,717.50                         0.03                48.00              0.01                   52.00 Material on site
                   ‐                ‐
c. Support/ Bracket C/W wooden unit            1.00 Rp                8,593,576.22                         0.06                48.00              0.03                   52.00 Material on site
                   ‐                ‐
d. Ducting Supply + Return                    ‐                ‐
PU Density 53 kg/m3                    ‐                ‐
Koridoor ‐ lobby                    ‐                ‐
•Ducting 8" x 10" m          12.00 Rp                4,519,287.24                         0.03                75.00              0.02                   25.00 Terpasang
•Ducting 18" x 8" m          16.00 Rp                8,703,812.46                         0.06                75.00              0.05                   25.00 Terpasang
•Ducting 20" x 8" m          12.00 Rp                7,030,002.37                         0.05                75.00              0.04                   25.00 Terpasang
•Ducting 27" x 10" m          28.00 Rp             21,675,840.65                         0.16                75.00              0.12                   25.00 Terpasang
•Ducting 30" x 10" m            9.00 Rp                7,532,145.40                         0.05                75.00              0.04                   25.00 Terpasang
•Volume Dumper 30" x 10" bh            1.00 Rp                   550,000.00                         0.00                75.00              0.00                   25.00 Terpasang
•Flexible Duct Ɵ 8" m          16.00 Rp                1,120,000.00                         0.01                72.00              0.01                   28.00 Terpasang
                   ‐                ‐
e. Diffuser, Grille                    ‐                ‐
•Supply Air Diffuser Line Air 40" x 4" bh          13.00 Rp                7,410,000.00                         0.05                62.00              0.03                   38.00 Material on site
•Return Air Grill 40" x 6" bh          12.00 Rp                7,080,000.00                         0.05                62.00              0.03                   38.00 Material on site
•Fresh Air grile 22" x 9" bh            2.00 Rp                   740,000.00                         0.01                62.00              0.00                   38.00 Material on site
               ‐
f. Pipa Refrigerant split Duct koridor, lobby, pipa tembaga class L + Isolasi insuflex density 80‐120Kg/m3                ‐
•Pipa Ɵ 5/8" m          12.00 Rp                1,682,440.87                         0.01                73.00              0.01                   27.00 Terpasang
•Pipa Ɵ 1 1/8" m          12.00 Rp                   674,704.87                         0.00                73.00              0.00                   27.00 Terpasang
•Fitting lot            1.00 Rp                   353,571.86                         0.00                73.00              0.00                   27.00 Terpasang
•Pipa drain PVC AW+Isolasi Ɵ1" m          10.00 Rp                   436,599.81                         0.00                77.00              0.00                   23.00 Terpasang
                   ‐                ‐
JUMLAH PEKERJAAN TATA UDARA  Rp           499,943,753.72                    ‐                ‐
                   ‐                ‐
B. PEKERJAAN  EXHAUST FAN                    ‐                ‐
                   ‐                ‐
1 Lantai Satu                     ‐                ‐
a. Pengadaan dan Pemasangan Exhaust Fan lengkap                     ‐                ‐
Flexible Conection (Canvas) dan peralatana bantu                    ‐                ‐
•Wall Exhaust Axial Fan Type, kap :  400 CFM R. Pompa, 2 panel unit            1.00 Rp                3,222,665.00                         0.02                73.00              0.02                   27.00 Material on site
•Wall Exhaust Axial Fan Type, kap :  350 CFM M. GAS unit            1.00 Rp                3,104,080.90                         0.02                73.00              0.02                   27.00 Material on site
•Wall Exhaust Axial Fan Type, kap :  600 CFM R.Panel unit            1.00 Rp                3,725,140.00                         0.03                73.00              0.02                   27.00 Material on site
•Duct Fan Type Kap 50 CFM. Toilet unit          11.00 Rp             11,704,356.40                         0.08                73.00              0.06                   27.00 Material on site
•Cabinet Fan Type Kap 200 CFM Toilet unit            1.00 Rp                5,132,070.00                         0.04                70.00              0.03                   30.00 Material on site
•Cabinet Fan kitchen 2600 CFM unit            1.00 Rp             16,688,995.00                         0.12                70.00              0.08                   30.00 Material on site
•Cabinet Fan laundry kap: 2800 CFM unit            1.00 Rp             18,196,420.00                         0.13                70.00              0.09                   30.00 Material on site
•Cabinet Fan kap: 700CFM koridor unit            1.00 Rp             13,875,135.00                         0.10                70.00              0.07                   30.00 Material on site
                   ‐                ‐
b. Exhaust toilet rawat inap, R. Perawat Toilet publik                    ‐                ‐
Duct PU Desity 53/kg/m3                    ‐                ‐
•4"x4" m            8.00 Rp                1,339,048.07                         0.01                74.00              0.01                   26.00 Terpasang
•6"x6" m          20.00 Rp                5,021,430.27                         0.04                74.00              0.03                   26.00 Terpasang
•6"x8" m          10.00 Rp                2,929,167.66                         0.02                74.00              0.02                   26.00 Terpasang
•8"x10" m          10.00 Rp                3,766,072.70                         0.03                74.00              0.02                   26.00 Terpasang
•6"x4" m            5.00 Rp                1,046,131.31                         0.01                81.00              0.01                   19.00 Terpasang
•Flexible Duct Ø 4" m          35.00 Rp                2,929,167.66                         0.02                81.00              0.02                   19.00 Terpasang
                   ‐                ‐
c. Exhaust Grille                    ‐                ‐
•Exhoust Grille ukuran : 7" x 5" bh            1.00 Rp                   150,000.00                         0.00                86.00              0.00                   14.00 Terpasang

01 AFRL‐ 07 AFRL 2019 FIX (76)  6 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

•Exhoust Grille ukuran : 9" x 11" bh            1.00 Rp                   250,000.00                         0.00                81.00              0.00                   19.00 Terpasang
                   ‐                ‐
d. Exhaust Duct, Fresh air duct kitchen laundry                    ‐                ‐
Ducting Bahan BJLS Finis cat, tebal 1 mm                    ‐                ‐
‐ 16"x10" m            2.00 Rp                1,173,347.56                         0.01                79.00              0.01                   21.00 Terpasang
‐ 18"x10" m            4.00 Rp                2,527,210.12                         0.02                79.00              0.01                   21.00 Terpasang
‐ 20"x10" m            4.00 Rp                2,707,725.13                         0.02                79.00              0.02                   21.00 Terpasang
‐ 22"x10" m            4.00 Rp                2,888,240.14                         0.02                79.00              0.02                   21.00 Terpasang
‐ 25"x10" m            5.50 Rp                4,343,642.40                         0.03                79.00              0.02                   21.00 Terpasang
‐ 35"x10" m            2.50 Rp                2,538,492.31                         0.02                79.00              0.01                   21.00 Terpasang
‐ 32"x10" m            1.50 Rp                1,421,555.70                         0.01                87.00              0.01                   13.00 Terpasang
‐ 12"x15" m            5.50 Rp                3,350,809.85                         0.02                86.00              0.02                   14.00 Terpasang
               28.00                ‐
e. Grille                28.00                ‐
‐ EG 15"x10" bh            8.00 Rp                2,480,000.00                         0.02                51.00              0.01                   49.00 Material on site
‐ EG 12"x6" bh            4.00 Rp                   840,000.00                         0.01                51.00              0.00                   49.00 Material on site
               20.00                ‐
f. Hood Bahan SS                20.00                ‐
75"x50"x20" bh            2.00 Rp                7,400,000.00                         0.05                55.00              0.03                   45.00 Material on site
                   ‐                ‐
2 Lantai Dua                    ‐                ‐
a. Pengadaan dan Pemasangan Exhaust Fan lengkap                     ‐                ‐
Flexible Conection (Canvas) dan peralatana bantu                    ‐                ‐
•Duct Fan Kap 50 cfm ceiling duct unit          21.00 Rp             22,344,680.40                         0.16                64.00              0.10                   36.00 Material on site
•Cabinet Fan Kap 650 cfm unit            1.00 Rp             12,166,720.00                         0.09                64.00              0.06                   36.00 Material on site
               ‐
b. Ducting Exhoust                ‐
Termasuk bracket, penggantung, support, peralatan bantu dll.                ‐
•6" x 8" m          22.00 Rp                6,444,168.84                         0.05                83.00              0.04                   17.00 Terpasang
•20" x 6" m            4.00 Rp                2,175,953.12                         0.02                83.00              0.01                   17.00 Terpasang
•22" x 6" m            3.00 Rp                1,757,500.59                         0.01                83.00              0.01                   17.00 Terpasang
•25" x 6" m            4.00 Rp                2,594,405.64                         0.02                83.00              0.02                   17.00 Terpasang
               41.00                ‐
c. Grill & Louvre                41.00                ‐
•Exhaust Grille, Ukuran : 8" x 6" bh            9.00 Rp                1,440,000.00                         0.01                76.00              0.01                   24.00 Terpasang
•20" x 6" bh            2.00 Rp                   620,000.00                         0.00                83.00              0.00                   17.00 Terpasang
•25" x 6" bh            1.00 Rp                   370,000.00                         0.00                83.00              0.00                   17.00 Terpasang
               41.00                ‐
3 Lantai Atap                41.00                ‐
a. Pengadaan dan Pemasangan Exhaust Fan                41.00                ‐
Kapasitas 100 CFM Tipe Cabinet Hight static press lengkap dengan ka unit            6.00 Rp                9,688,470.00                         0.07                66.00              0.05                   34.00 Material on site
b. Flexible Duct                 41.00                ‐
•Ø 6" m          40.00 Rp                2,000,000.00                         0.01                66.00              0.01                   34.00 Material on site
•Ø 8" m          18.00 Rp                1,260,000.00                         0.01                68.00              0.01                   32.00 Material on site
c. EG Ø10" bh            6.00 Rp                   660,000.00                         0.00                68.00              0.00                   32.00 Material on site
d. Acessories, alat bantu lot            1.00 Rp                1,294,847.00                         0.01                68.00              0.01                   32.00 Material on site
               43.00                ‐
JUMLAH PEKERJAAN EXHAUST FAN Rp           189,567,648.76                43.00                ‐
               43.00                ‐
C. Testing Commisioning and Balancing Lot            1.00 Rp                3,447,557.01                         0.02                43.00              0.01                   57.00 ‐
                          ‐                28.00                ‐
TOTAL PEKERJAAN TATA UDARA DAN VENTILASI RAWAT INAP Rp           692,958,959.50                     ‐                  ‐
                   ‐                ‐
8 PEKERJAAN INSTALASI FIRE HYDRANT                      ‐                  ‐
RUANG RAWAT INAP                    ‐                ‐
A. PEKERJAAN PERALATAN UTAMA POMPA HYDRANT                    ‐                ‐
                   ‐                ‐
1) Peralatan utama                    ‐                ‐
bDiesel Fire Pump (DFP)‐NFPA‐ 20 std unit            1.00 Rp           279,167,460.00                         1.01                52.00              0.53                   48.00 Pompa sudah dipesan (panjar)
• Tipe : Sentrafugal & Suction Pump                    ‐                ‐
• Capacity : 500 USGpm                    ‐                ‐
• Total Head : 70 m                    ‐                ‐
• Clarke diesel engine 61 kw, 3000 Rpm                    ‐                ‐
• Heat Exchanger Cooling System                    ‐                ‐
• Flexible Exhaust Connector & Industrial Type Steel Sharf                    ‐                ‐
• Engine Jacket Water Heater of Factory Installed                    ‐                ‐
• Fuel Oil Tank                    ‐                ‐
• Fire Pump Controller NFPA‐ 20 std                    ‐                ‐
• Accessories                    ‐                ‐
                   ‐                ‐
c Jockey  Pump (JP) ‐ NFPA‐ 20 std unit            1.00 Rp             33,284,260.00                         0.24                49.00              0.12                   51.00 Pompa sudah dipesan (panjar)
• Kapasitas : 25 USGPM                    ‐                ‐
• Head : 80 meter                    ‐                ‐
• Type : Vertical multi stage Inline pump                    ‐                ‐
• Elec. Power : 2,2 kw/2900 Rpm/380 V / 3 Ph / 50 Hz                    ‐                ‐
• Jockey Pump Controller ‐ NFPA‐ 20 std                    ‐                ‐
• Accessories                    ‐                ‐
                   ‐                ‐
dPressure Controle Tank Lengkap unit            1.00 Rp             20,000,000.00                         0.14                49.00              0.07                   51.00 Pompa sudah dipesan (panjar)
• Kapasitas : 500 Lt                           ‐                    ‐                ‐
• Accessories :                           ‐                    ‐                ‐
• Pressure Gauge 0 s/d 25 bar                           ‐                    ‐                ‐
• Safety Valve ø1"                           ‐                    ‐                ‐
• Pressure Switch                           ‐                    ‐                ‐
• Gate Valve ø 2"                           ‐                    ‐                ‐
• Ball Valve ø 1" (screw)                           ‐                    ‐                ‐
• Etc, Lihat gambar perencanaan                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
eKabel Kontrol                           ‐                    ‐                ‐
• Jockey Pump FRC 4 x 1 x 4 mm m            8.00 Rp                2,504,940.00                         0.02                49.00              0.01                   51.00 Pompa sudah dipesan (panjar)
Dari Panel Kontrol Pompa Hydrant                           ‐                    ‐                ‐
• Kabel Kontrol dari Flow Switch tiap lantai ke MFCA                            ‐                    ‐                ‐
di ruang kontrol Lt. 1                           ‐                    ‐                ‐
FRC 2x1x2,5 mm m          60.00 Rp                8,490,861.00                         0.06                56.00              0.03                   44.00 Material on site
• Kabel Kontrol dari Panel‐panel pompa Hydrant                            ‐                41.00                ‐
ke MCFA di ruang kontrol Lt. 1                           ‐                41.00                ‐

01 AFRL‐ 07 AFRL 2019 FIX (76)  7 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

FRC 2x1x2,5 mm m          50.00 Rp                7,075,717.50                         0.05                56.00              0.03                   44.00 Material on site
                          ‐                    ‐                ‐
‐ Piping & Accessories (Pump Room)                           ‐                    ‐                ‐
Pipe GIP Schedule 40                           ‐                    ‐                ‐
• diameter 10" (Header) m            3.00 Rp                7,359,489.00                         0.05                66.00              0.04                   34.00 Material on site
• diameter 6" m          16.00 Rp             19,710,208.00                         0.14                66.00              0.09                   34.00 Material on site
• diameter 3" m            8.00 Rp                3,760,104.00                         0.03                66.00              0.02                   34.00 Material on site
• diameter 2 1/2" m            4.00 Rp                1,576,352.00                         0.01                66.00              0.01                   34.00 Material on site
• diameter 2" m            4.00 Rp                1,120,136.00                         0.01                66.00              0.01                   34.00 Material on site
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp                5,028,943.35                         0.04                66.00              0.02                   34.00 Material on site
• Support & Hanger ls            1.00 Rp                1,676,314.45                         0.01                45.00              0.01                   55.00 Material on site
                          ‐                    ‐                ‐
Accessories Hydrant                           ‐                    ‐                ‐
Butterfly Valve 16 Bar                           ‐                    ‐                ‐
• diameter 6" bh            4.00 Rp             13,196,340.80                         0.10                51.00              0.05                   49.00 Material on site
• diameter 3" bh            2.00 Rp                2,801,250.40                         0.02                51.00              0.01                   49.00 Material on site
• diameter 21/2" bh            1.00 Rp                1,295,155.20                         0.01                51.00              0.00                   49.00 Material on site
• diameter 2" bh            2.00 Rp                1,972,256.20                         0.01                51.00              0.01                   49.00 Material on site
Strainer 16 Bar                           ‐                36.00                ‐
• diameter 6" bh            1.00 Rp                7,126,202.31                         0.05                51.00              0.03                   49.00 Material on site
• diameter 3" bh            1.00 Rp                2,624,052.76                         0.02                51.00              0.01                   49.00 Material on site
Fleksible Joint 16 Bar                           ‐                36.00                ‐
• diameter 6" bh            2.00 Rp                7,974,683.52                         0.06                51.00              0.03                   49.00 Material on site
• diameter 3" bh            2.00 Rp                3,389,691.68                         0.02                51.00              0.01                   49.00 Material on site
• diameter 2 1/2" bh            1.00 Rp                1,359,816.65                         0.01                51.00              0.00                   49.00 Material on site
• diameter 2" bh            1.00 Rp                1,065,701.40                         0.01                51.00              0.00                   49.00 Material on site
Check Valve 16 Bar                           ‐                36.00                ‐
• diameter 6" bh            1.00 Rp                9,067,239.73                         0.07                51.00              0.03                   49.00 Material on site
• diameter 3" bh            1.00 Rp                3,659,711.71                         0.03                51.00              0.01                   49.00 Material on site
•Pressure Gauge 0 s/d 25 bh            4.00 Rp                4,047,265.80                         0.03                51.00              0.01                   49.00 Material on site
•Pressure Switch bh            2.00 Rp                4,200,000.00                         0.03                51.00              0.02                   49.00 Material on site
•Main kontrol valve diameter 4" bh            1.00 Rp             23,800,000.00                         0.17                51.00              0.09                   49.00 Material on site
Rp           478,334,153.45                    ‐                ‐
B. INSTALASI PIPA HYDRANT                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
Accessories Hydrant :                           ‐                    ‐                ‐
• Hydrant Box Type Indoor bh            1.00 Rp                4,029,750.00                         0.03                51.00              0.01                   49.00 Material on site
ukuran :  125 x 75 x 18 cm, red color                           ‐                    ‐                ‐
 ‐ 1 pc Hose Nozzle Ø 40 mm                           ‐                    ‐                ‐
 ‐ 1 pcc Hydrant valve Ø 40 mm                           ‐                    ‐                ‐
 ‐ 1 pc Hydrant valve Ø 65 mm                           ‐                    ‐                ‐
 ‐ 1 pc Hose rack 600 mm COMB                           ‐                    ‐                ‐
 ‐ 1 roll fire hose with Machino Coupling Ø 40 mm x 30 m                           ‐                    ‐                ‐
Butterfly Valve 16 Bar                           ‐                    ‐                ‐
• diameter 3" bh            1.00 Rp                1,400,625.20                         0.01                58.00              0.01                   42.00 Material on site
• diameter 2 1/2" bh            1.00 Rp                1,295,155.20                         0.01                58.00              0.01                   42.00 Material on site
•Pressure Gauge 0 ‐16 bar include ball valve bh            1.00 Rp                1,011,816.45                         0.01                58.00              0.00                   42.00 Material on site
•Fire Extinguiser kap.3 kg bh            3.00 Rp                1,462,650.00                         0.01                58.00              0.01                   42.00 Material on site
                          ‐                    ‐                ‐
‐ Instalasi Hydrant Pillar Luar Gedung                           ‐                    ‐                ‐
Pipe GIP Schedule 40                           ‐                    ‐                ‐
• diameter 6" m        120.00 Rp           147,826,560.00                         1.07                58.00              0.62                   42.00 Material on site
• diameter 4" m          26.00 Rp             16,959,488.00                         0.12                58.00              0.07                   42.00 Material on site
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp             24,717,907.20                         0.18                58.00              0.10                   42.00 Material on site
• Galian dan Urugan Kembali m        120.00 Rp                5,760,000.00                         0.04                58.00              0.02                   42.00 Material on site
• Hydrant Box Type Outdoor bh            3.00 Rp             10,746,000.00                         0.08                58.00              0.04                   42.00 Material on site
ukuran :  95 x 66 x 20 cm, red color                           ‐                    ‐                ‐
 ‐ 1 pc Hose Nozzle Ø 40 mm                           ‐                    ‐                ‐
 ‐ 1 roll fire hose with Machino Coupling Ø 65 mm x 30 m                           ‐                    ‐                ‐
• Hydrant Pillar Cast Iron bh            3.00 Rp                9,701,250.00                         0.07                53.00              0.04                   47.00 Material on site
type : H‐14A, two way                           ‐                28.00                ‐
Seammese Connection Cast Iron Two Way bh            1.00 Rp                3,383,000.00                         0.02                53.00              0.01                   47.00 Material on site
Butterfly Valve 16 Bar                           ‐                28.00                ‐
• diameter 6" bh            1.00 Rp                3,299,085.20                         0.02                53.00              0.01                   47.00 Material on site
• diameter 4" bh            5.00 Rp                9,639,876.00                         0.07                53.00              0.04                   47.00 Material on site
Check Valve 16 Bar                           ‐                28.00                ‐
• diameter 4" bh            5.00 Rp             24,338,095.26                         0.18                53.00              0.09                   47.00 Material on site
                          ‐                    ‐                ‐
                          ‐                    ‐                ‐
‐ Instalasi Indoor Hydrant Box Lantai Dua                           ‐                    ‐                ‐
Pipe GIP Schedule 40                           ‐                    ‐                ‐
• diameter 2 1/2" m          20.00 Rp                7,881,760.00                         0.06                58.00              0.03                   42.00 Material on site
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp                1,182,264.00                         0.01                58.00              0.00                   42.00 Material on site
• Support & Hanger ls            1.00 Rp                   394,088.00                         0.00                58.00              0.00                   42.00 Material on site
                          ‐                33.00                ‐
Accessories Hydrant : bh            2.00 Rp                8,059,500.00                         0.06                58.00              0.03                   42.00 Material on site
• Hydrant Box Type Indoor                           ‐                    ‐                ‐
ukuran :  125 x 75 x 18 cm, red color                           ‐                    ‐                ‐
 ‐ 1 pc Hose Nozzle Ø 40 mm                           ‐                    ‐                ‐
 ‐ 1 pcc Hydrant valve Ø 40 mm                           ‐                    ‐                ‐
 ‐ 1 pc Hydrant valve Ø 65 mm                           ‐                    ‐                ‐
 ‐ 1 pc Hose rack 600 mm COMB                           ‐                    ‐                ‐
 ‐ 1 roll fire hose with Machino Coupling Ø 40 mm x 30 m                           ‐                    ‐                ‐
Butterfly Valve 16 Bar                           ‐                    ‐                ‐
• diameter 2 1/2" bh            1.00 Rp                1,295,155.20                         0.01                58.00              0.01                   42.00 Material on site
•Pressure Gauge 0 ‐16 bar include ball valve bh            1.00 Rp                1,011,816.45                         0.01                58.00              0.00                   42.00 Material on site
•Fire Extinguiser kap.3 kg bh            3.00 Rp                1,462,650.00                         0.01                58.00              0.01                   42.00 Material on site
                          ‐                    ‐                ‐
                          ‐                    ‐                ‐
‐ Instalasi  Hydrant  Riser                           ‐                    ‐                ‐
Pipe GIP Schedule 40                           ‐                    ‐                ‐
• diameter 4" m            9.00 Rp                5,870,592.00                         0.04                58.00              0.02                   42.00 Material on site
• Fitting pipa ( Elbow, Tee, Tee reducer, dll ) ls            1.00 Rp                   880,588.80                         0.01                58.00              0.00                   42.00 Material on site
• Support & Hanger ls            1.00 Rp                   293,529.60                         0.00                58.00              0.00                   42.00 Material on site
                          ‐                    ‐                ‐
Accessories Hydrant :                           ‐                    ‐                ‐
Butterfly Valve 16 Bar                           ‐                    ‐                ‐

01 AFRL‐ 07 AFRL 2019 FIX (76)  8 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

• diameter 4" bh            1.00 Rp                1,927,975.20                         0.01                58.00              0.01                   42.00 Material on site
•Pressure Gauge 0 ‐16 bar include ball valve bh            1.00 Rp                1,011,816.45                         0.01                58.00              0.00                   42.00 Material on site
•Automatic Air Vent bh            1.00 Rp                   350,000.00                         0.00                58.00              0.00                   42.00 Material on site
                          ‐                    ‐                ‐
Rp           297,192,994.21                     ‐                  ‐
C. Testing Commisioning and Balancing Lot            1.00 Rp                3,877,635.74                         0.03                43.00              0.01                   57.00 ‐
                          ‐                    ‐                ‐
TOTAL PEKERJAAN HYDRANT R. RAWAT INAP Rp           779,404,783.41                     ‐                  ‐
                          ‐                    ‐                ‐
9 PEKERJAAN SISTEM GAS MEDIS                           ‐                    ‐                ‐
RUANG SENTRAL MEDICAL GAS                           ‐                    ‐                ‐
PEMBANGUNAN/ RUANG RAWAT INAP                           ‐                    ‐                ‐
1 PERALATAN UTAMA                           ‐                    ‐                ‐
Pengadaan dan Pemasangan Peralatan dibawah ini lengkap dengan steel braket, support, klem, dan accessories                           ‐                    ‐                ‐
1 Sentral Oxygen (O2)  Unit            1.00 Rp           205,000,000.00                         1.48                46.00              0.68                   54.00 Instalasi sudah terpasang
Type : Digital Automatc Change Over Gas Manifoid                           ‐                    ‐                ‐
Kapasitas : Double Row @10 tabung (tanpa Tabung)                           ‐                    ‐                ‐
Max Flow 140 Nm3/Hr : 6700 BTUH                           ‐                    ‐                ‐
Output Pressure : 0 ‐ 5 Kg/cm2                           ‐                    ‐                ‐
‐ Double Stage Pressure Regulator (Total 3 Regulators)                           ‐                    ‐                ‐
‐ Digital Pressure Gauge for Operating Pressure                           ‐                    ‐                ‐
Header from High Pressure Copper                           ‐                    ‐                ‐
‐ Non Return Valve : 20 pcs                           ‐                    ‐                ‐
‐ Pig Tails: 20 pcs                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
2 Sentral Nitrous Oxide (N20) Unit            1.00 Rp           237,000,000.00                         1.71                50.00              0.85                   50.00 Instalasi sudah terpasang
Type : Digital Automatc Change Over Gas Manifoid                           ‐                    ‐                ‐
Kapasitas  3/14/2017 Double Row @1 tabung (tanpa Tabung)                           ‐                    ‐                ‐
Max Flow 140 Nm3/Hr : 6700 BTUH                           ‐                    ‐                ‐
Output Pressure : 0 ‐ 5 Kg/cm2                           ‐                    ‐                ‐
‐ Double Stage Pressure Regulator (Total 3 Regulators)                           ‐                    ‐                ‐
‐ Digital Pressure Gauge for Operating Pressure                           ‐                    ‐                ‐
Header from High Pressure Copper                           ‐                    ‐                ‐
‐ Non Return Valve : 2 pcs                           ‐                    ‐                ‐
‐ Pig Tails: 2 pcs                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
3 Medical Vacuum Unit            1.00 Rp           228,000,000.00                         1.64                50.00              0.82                   50.00 Instalasi sudah terpasang
Duplex System‐as per NFPA‐99 : Cassette                           ‐                    ‐                ‐
Type of Vacuum pump : oil rotary vane : 24000 BTUH                           ‐                    ‐                ‐
consist of 2 vacuum pumps                           ‐                    ‐                ‐
Motor : 2x1,5 Kw                           ‐                    ‐                ‐
Tank Capacity: 500 ltr                           ‐                    ‐                ‐
consist of :                           ‐                    ‐                ‐
‐ Control Panel                           ‐                    ‐                ‐
‐ Wistandart accessories                           ‐                    ‐                ‐
4 Bacterial Filter Unit            1.00 Rp           128,000,000.00                         0.92                50.00              0.46                   50.00 Instalasi sudah terpasang
5 Master Alarm for 3 Gases (O,N,V) Unit            1.00 Rp             34,000,000.00                         0.25                50.00              0.12                   50.00 Instalasi sudah terpasang
Digital Type                           ‐                    ‐                ‐
Type wall mounted for concealed piping                           ‐                    ‐                ‐
Pressure indicated digital                           ‐                    ‐                ‐
Digital Sensor instalation of box inside                           ‐                    ‐                ‐
Rp           832,000,000.00                    ‐                ‐
                          ‐                    ‐                ‐
2 PEKERJAAN ACCESSORIES                           ‐                    ‐                ‐
1 Flowmeter with Humidifier set          44.00 Rp             88,000,000.00                         0.63                50.00              0.32                   50.00 Instalasi sudah terpasang
‐ standar : 3.5kgf/cm2                           ‐                    ‐                ‐
‐ Flow Ra : 0‐15 LPM                           ‐                    ‐                ‐
‐ Buble M: 80% ± 10%/LPM ‐ 70%± 10%15/LPM                           ‐                    ‐                ‐
‐ Jet Mod: 80% ± 10%/LPM ‐ 80%± 10%15/LPM                           ‐                    ‐                ‐
‐ Safety V: 0.14kg/cm2                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
2 Wall Suction Unit set            3.00 Rp             15,000,000.00                         0.11                50.00              0.05                   50.00 Instalasi sudah terpasang
‐ Regulator Vacum Range : 0‐700 mmHg                           ‐                    ‐                ‐
‐ Full Line/Off/Regulated Vacuum ‐ one touch change selector                           ‐                    ‐                ‐
‐ Unbreakebale Policarbonate Collection Bottle (1200 cc)                           ‐                    ‐                ‐
with overflow protector                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
3 Movable Suction Unit set            2.00 Rp             23,000,000.00                         0.17                50.00              0.08                   50.00 Instalasi sudah terpasang
Type : Movable Kick Suction                           ‐                    ‐                ‐
Consist O‐ Suction Gauge : 0 ‐ 700 mmHg                           ‐                    ‐                ‐
‐ 8.000 cc Collection Bottle                           ‐                    ‐                ‐
‐ On/Off valve & Stand By inlet cock valve                           ‐                    ‐                ‐
‐ Over ‐ Flow protector                           ‐                    ‐                ‐
‐ Movable kick type bottle guide w/caster                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
Rp           126,000,000.00                    ‐                ‐
                          ‐                    ‐                ‐
3 INSTALASI GAS MEDIS                           ‐                    ‐                ‐
A. Pekerjaan Lantai Satu                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
1 Area Alarm for 3 Gases (O,A,V)                           ‐                    ‐                ‐
Digital Type  Unit            1.00 Rp             24,000,000.00                         0.17                83.00              0.14                   17.00 Terpasang
Type wall mounted for concealed piping                           ‐                    ‐                ‐
Pressure indicated digital                           ‐                    ‐                ‐
Digital Sensor instalation of box inside                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
2 Zone valve for 3 Gases (O,N,V)                           ‐                    ‐                ‐
Wall mounted for concealed piping Type  Unit            1.00 Rp             14,000,000.00                         0.10                60.00              0.06                   40.00 Instalasi sudah terpasang
Gauge :  ‐ Oxygen : 15Kg/cm2                           ‐                    ‐                ‐
‐ N20 : 15 Kg/cm2                           ‐                    ‐                ‐
‐ Vacuum : 760 mmHg                           ‐                    ‐                ‐
Valves max. 20 Kg/cm2 (Ball valve)                           ‐                    ‐                ‐
Finishing cover : powder coated paint finish                           ‐                    ‐                ‐
Emergency breakable panel from Acrylic                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
3 Area Alarm for 3 Gases (O,N,V) Unit            1.00 Rp             35,000,000.00                         0.25                78.00              0.20                   22.00 Instalasi sudah terpasang

01 AFRL‐ 07 AFRL 2019 FIX (76)  9 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

Digital Type (SME‐AD23‐1100)                           ‐                    ‐                ‐


Type wall mounted for concealed piping                           ‐                    ‐                ‐
Pressure indicated digital                           ‐                    ‐                ‐
Digital Sensor instalation of box inside                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
4 Zone valve for 3 Gases (O,N,V)                           ‐                    ‐                ‐
Wall mounted for concealed piping  Unit            1.00 Rp             15,000,000.00                         0.11                78.00              0.08                   22.00 Instalasi sudah terpasang
Gauge :  ‐ Oxygen : 15Kg/cm2                           ‐                    ‐                ‐
‐ Nitrous Oxide : 15 Kg/cm2                           ‐                    ‐                ‐
‐ Vacuum : 760 mmHg                           ‐                    ‐                ‐
Valves max. 20 Kg/cm2 (Ball valve)                           ‐                    ‐                ‐
Finishing cover : powder coated paint finish                           ‐                    ‐                ‐
Emergency breakable panel from Acrylic                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
5 Wall Point Outlet for Oxygen (O2)                           ‐                    ‐                ‐
Quick connect type, pin index (JIS/KS) ‐ Push Type                           ‐                    ‐                ‐
Optional : Ohmeda Type, Diss Type ea          10.00 Rp             16,000,000.00                         0.12                84.00              0.10                   16.00 Instalasi sudah terpasang
Double check by color code for different gas and pin index‐                           ‐                    ‐                ‐
system between check and inlet parts                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
6 Wall Point Outlet for Nitrous (N)                           ‐                    ‐                ‐
Quick connect type, pin index (JIS/KS) ‐ Push Type                           ‐                    ‐                ‐
Optional : Ohmeda Type, Diss Type ea            3.00 Rp                4,800,000.00                         0.03                42.00              0.01                   58.00 Material on site
Double check by color code for different gas and pin index‐                           ‐                    ‐                ‐
system between check and inlet parts                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
7 Wall Point Outlet for Vacuum/Suction (V)  ea            3.00                         0.03                42.00              0.01                   58.00 Material on site
Quick connect type, pin index (JIS/KS) ‐ Push Type                           ‐                    ‐                ‐
Optional : Ohmeda Type, Diss Type                           ‐                    ‐                ‐
Double check by color code for different gas and pin index‐                           ‐                    ‐                ‐
system between check and inlet parts                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
8 Anaesthetic Gas Scavenging System (AGSS) set            2.00 Rp             42,000,000.00                         0.30                38.00              0.12                   62.00 Material on site
Excess N20 gas automatic purging system for O.T                           ‐                    ‐                ‐
Sucks away excess anesthetic gas through ventury                           ‐                    ‐                ‐
system from compressed air to free atmosphere                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
9 Bed Head ea          15.00                           ‐                    ‐                ‐
Bedhead terbuat dari bahan almunium dan di cat menggunakan powder coating                           ‐                    ‐                ‐
‐ Panjang 120cm                           ‐                    ‐                ‐
Lebar 20cm                           ‐                    ‐                ‐
Tebal  8cm                           ‐                    ‐                ‐
Saklar 1set                           ‐                    ‐                ‐
Power Receptacle 220v 2set                           ‐                    ‐                ‐
Lampu TL 8 watt 1set                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
# Ball Valve                           ‐                    ‐                ‐
‐ Dia. 3/4" ea            8.00 Rp                2,400,000.00                         0.02                70.00              0.01                   30.00 Material on site
‐ Dia 1" ea            4.00 Rp                2,000,000.00                         0.01                70.00              0.01                   30.00 Material on site
‐ Dia. 1,1/4" ea            2.00 Rp                1,200,000.00                         0.01                70.00              0.01                   30.00 Material on site
                          ‐                    ‐                ‐
# Pekerjaan pipa menggunakan pipa tembaga seamiess                           ‐                    ‐                ‐
ASTM B‐819 Tipe L, Support pipa dibuat maksimal setiap 2 mtr.                           ‐                    ‐                ‐
pipa pada support dilindungi oleh bahan karet/plastik                           ‐                    ‐                ‐
‐ Dia. 3/8" m        120.00 Rp                6,000,000.00                         0.04                95.00              0.04                     5.00 Terpasang
‐ Dia. 1/2" m          30.00 Rp                2,310,000.00                         0.02                95.00              0.02                     5.00 Terpasang
‐ Dia. 5/8" m          55.00 Rp                5,500,000.00                         0.04                95.00              0.04                     5.00 Terpasang
‐ Dia.3/4" m          98.00 Rp             12,740,000.00                         0.09                95.00              0.09                     5.00 Terpasang
‐ Dia. 7/8" m          36.00 Rp                5,598,000.00                         0.04                96.00              0.04                     4.00 Terpasang
‐ Dia. 1.1/8" m          50.00 Rp             11,250,000.00                         0.08                96.00              0.08                     4.00 Terpasang
‐ Dia.1.3/8" m          50.00 Rp             14,575,000.00                         0.11                96.00              0.10                     4.00 Terpasang
Fitting & Accessoriees lot            1.00 Rp             17,391,900.00                         0.13                96.00              0.12                     4.00 Terpasang
Rp           236,564,900.00                    ‐                ‐
                          ‐                    ‐                ‐
B. Pekerjaan di Lantai Dua                           ‐                    ‐                ‐
1 Area Alarm for (O) Unit            1.00 Rp                9,800,000.00                         0.07                76.00              0.05                   24.00 Instalasi sudah terpasang
Digital Type                            ‐                    ‐                ‐
Type wall mounted for concealed piping                           ‐                    ‐                ‐
Pressure indication of box inside                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
2 Zone Valve for  (O) Unit            1.00 Rp                5,800,000.00                         0.04                76.00              0.03                   24.00 Instalasi sudah terpasang
Wall mounted for concealed piping Type (SME‐AE11‐2025)                           ‐                    ‐                ‐
Gauge : ‐ Oxygen : 15 Kg/cm2                           ‐                    ‐                ‐
‐ Vacuum : 760 mmHg                           ‐                    ‐                ‐
Finishing cover : powder coated paint finish                           ‐                    ‐                ‐
Emergency breakable panel from Acrylic                           ‐                    ‐                ‐
                          ‐                    ‐                ‐
3 Bed Head  ea                           ‐                    ‐                ‐
Bedhead terbuat dari bahan almunium dan di cat menggunakan powder coating                           ‐                    ‐                ‐
‐ Panjang 120cm                           ‐                    ‐                ‐
Lebar 20cm                           ‐                    ‐                ‐
Tebal  8cm                           ‐                    ‐                ‐
Saklar 1set                           ‐                    ‐                ‐
Power Receptacle 220v 2set                           ‐                    ‐                ‐
Lampu TL 8 watt 1set                           ‐                    ‐                ‐
4 Ball Valve                           ‐                    ‐                ‐
‐ Dia. 3/4" ea            1.00 Rp                   300,000.00                         0.00                57.00              0.00                   43.00 Material on site
‐ Dia 1" ea            1.00 Rp                   500,000.00                         0.00                57.00              0.00                   43.00 Material on site
                          ‐                    ‐                ‐
5 Pekerjaan pipa menggunakan pipa tembaga seamiess                           ‐                    ‐                ‐
ASTM B‐819 Tipe L, Support pipa dibuat maksimal setiap 2 mtr.                           ‐                    ‐                ‐
pipa pada support dilindungi oleh bahan karet/plastik                           ‐                    ‐                ‐
‐ Dia. 1/2" m        212.00 Rp             16,324,000.00                         0.12                97.00              0.11                     3.00 Terpasang
‐ Dia.3/4" m          58.00 Rp                7,540,000.00                         0.05                97.00              0.05                     3.00 Terpasang
‐ Dia. 7/8" m          78.00 Rp             12,129,000.00                         0.09                97.00              0.08                     3.00 Terpasang
Fitting & Accessories lot            1.00 Rp             10,797,900.00                         0.08                97.00              0.08                     3.00 Terpasang
                   ‐                ‐

01 AFRL‐ 07 AFRL 2019 FIX (76)  10 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

Rp             63,190,900.00                    ‐                ‐


TOTAL PEKERJAAN GAS MEDIS Rp        1,257,755,800.00                     ‐                  ‐
                   ‐                ‐
10 PEKERJAAN ELEKTRIKAL                     ‐                ‐
LANTAI 1                    ‐                ‐
A INSTALASI PENERANGAN DAN DAYA                     ‐                ‐
1 Down Light (1x18) W Unit        111.00 Rp             27,069,819.75                         0.20                93.00              0.18                     7.00 Instalasi sudah terpasang
2 TL 5 (2x28) W Ballast Electronic (Recesscel Mounted) Unit          34.00 Rp             15,431,478.00                         0.11                93.00              0.10                     7.00 Instalasi sudah terpasang
3 Lampu Taman + Tiang 2m Unit          10.00 Rp             19,111,407.00                         0.14                93.00              0.13                     7.00 Instalasi sudah terpasang
4 EXIT Lamp LED 10 W Unit            2.00 Rp                2,802,373.21                         0.02                93.00              0.02                     7.00 Instalasi sudah terpasang
5 EMERGENCY Lamp 10 W Unit            2.00 Rp                2,802,373.21                         0.02                93.00              0.02                     7.00 Instalasi sudah terpasang
6 Saklar Tunggal Unit          41.00 Rp                3,016,698.00                         0.02                93.00              0.02                     7.00 Instalasi sudah terpasang
7 Saklar Double Unit          22.00 Rp                1,756,623.00                         0.01                93.00              0.01                     7.00 Instalasi sudah terpasang
8 Stop Kontak 1 Phase Unit          71.00 Rp                5,965,810.50                         0.04                93.00              0.04                     7.00 Instalasi sudah terpasang
9 Great Switch 6 Unit            3.00 Rp                   750,438.00                         0.01                93.00              0.01                     7.00 Instalasi sudah terpasang
10 Titik Instalasi Lampu Titik        169.00 Rp             38,742,531.75                         0.28                93.00              0.26                     7.00 Instalasi sudah terpasang
11 Titik Instalasi Stop Kontak 1 Phase Titik          71.00 Rp             22,989,489.38                         0.17                93.00              0.15                     7.00 Instalasi sudah terpasang
12 TL 5 (1x28)w Surface Mounted (Ball Electronic) Titik            6.00 Rp                2,579,026.50                         0.02                93.00              0.02                     7.00 Instalasi sudah terpasang
13 Lampu jalan LED 100w  bh          12.00 Rp             21,794,652.00                         0.16                92.00              0.14                     8.00 Instalasi sudah terpasang
14 Titik Instalasi Lampu Jalan Titik          12.00 Rp                9,320,337.00                         0.07                92.00              0.06                     8.00 Instalasi sudah terpasang
15 memasang tiang tipe parabola bh          12.00 Rp             31,197,402.00                         0.22                92.00              0.21                     8.00 Instalasi sudah terpasang
16 pondasi PJU bh          12.00 Rp             11,138,202.00                         0.08                80.00              0.06                   20.00 ‐
                          ‐                    ‐                ‐
B INSTALASI KABEL                           ‐                    ‐                ‐
1 Dari P. Genset + AMF ke Panel PEMBAGI                           ‐                    ‐                ‐
NYY 4x70 mm² + BC 35 mm² m'          20.00 Rp                8,700,080.00                         0.06                52.00              0.03                   48.00 Material on site
2 Dari Panel Genset ke Panel PEMBAGI                           ‐                    ‐                ‐
NYY 4x50mm² + BC 25mm² m'          20.00 Rp                6,470,285.00                         0.05                52.00              0.02                   48.00 Material on site
3 Dari Panel PEMBAGI ke P.D.U.1                           ‐                    ‐                ‐
NYY 4x70mm²+ BC 35mm² m'          10.00 Rp                4,350,040.00                         0.03                52.00              0.02                   48.00 Material on site
4 Dari P. PEMBAGI ke P.D.U.2                           ‐                    ‐                ‐
NYY 4x50mm²+ BC 25mm² m'          10.00 Rp                3,235,142.50                         0.02                57.00              0.01                   43.00 Material on site
5 Kwh‐meter 1 ke P.D.U.1                           ‐                    ‐                ‐
NYY 4x70 mm²+ BC 35mm² m'          20.00 Rp                8,700,080.00                          0.06                 57.00                0.04                   43.00 Material on site
6 Dari Kwh meter 2 ke P.D.U.2                            ‐                     ‐                  ‐
NYY 4x70 mm²+ BC 35mm² m'          20.00 Rp                8,700,080.00                         0.06                52.00              0.03                   48.00 Material on site
7 Dari P.D.U.1 ke P.P dan Daya Lt.1                           ‐                    ‐                ‐
NYY 4x35mm² + BC 25mm² m'          15.00 Rp                3,852,903.75                         0.03                52.00              0.01                   48.00 Material on site
8 Dari P.D.U.1 ke Panel AC.1                           ‐                    ‐                ‐
NYY 4x35mm² + BC 25mm² m'          15.00 Rp                3,852,903.75                         0.03                32.00              0.01                   68.00 Material on site
9 Dari P.D.U.1 ke P.D Pompa                            ‐                    ‐                ‐
NYY 4x6 mm² m'          15.00 Rp                1,044,600.00                         0.01                62.00              0.00                   38.00 Material on site
10 Dari P.D.U.1 ke P Hydrant (Jocky Pump)                           ‐                    ‐                ‐
NYY 4x6mm² m'          15.00 Rp                1,044,600.00                          0.01                 62.00                0.00                   38.00 Material on site
11 Dari P.D.U.1 ke P.P Luar                           ‐                    ‐                ‐
NYY 4x4mm² m'          30.00 Rp                1,728,761.25                          0.01                 62.00                0.01                   38.00 Material on site
12 P.D.Pompa ke P.Control Pompa Transfer                           ‐                    ‐                ‐
NYY 4x2,5 mm² m'          10.00 Rp                   482,226.25                          0.00                 62.00                0.00                   38.00 Material on site
13 P.D.Pompa ke P.Daya Atap                           ‐                    ‐                ‐
NYY 4x4mm² m'          30.00 Rp                1,728,761.25                          0.01                 62.00                0.01                   38.00 Material on site
14 P.Daya atap ke P.Control Booster Pump                           ‐                    ‐                ‐
NYY 4x2,5 mm² m'          15.00 Rp                   723,339.38                         0.01                62.00              0.00                   38.00 Material on site
15 P.Daya atap ke P.Control Water heater                           ‐                    ‐                ‐
NYY 3x2,5mm² m'          15.00 Rp                   644,983.13                         0.00                62.00              0.00                   38.00 Material on site
                          ‐                    ‐                ‐
C KABEL TRAY ELEKTRIKAL                            ‐                    ‐                ‐
1 400X100 mm m'        102.00 Rp             31,481,968.50                         0.23                86.00              0.20                   14.00 Terpasang
4 Tee Tray 400 mm Buah            2.00 Rp                   832,512.00                         0.01                86.00              0.01                   14.00 Terpasang
5 Elbow Tray 400 mm Buah            3.00 Rp                   556,098.75                         0.00                86.00              0.00                   14.00 Terpasang
                          ‐                    ‐                ‐
D INSTALASI PANEL                           ‐                    ‐                ‐
1 PP & Daya Lt.1 bh            1.00 Rp             15,993,971.00                         0.12                78.00              0.09                   22.00 Terpasang
2 P.D.U.1 bh            1.00 Rp             48,556,000.00                         0.35                78.00              0.27                   22.00 Terpasang
3 P.D.U.2 bh            1.00 Rp             31,641,000.00                         0.23                78.00              0.18                   22.00 Terpasang
4 Panel Pembagi bh            1.00 Rp             17,412,500.00                         0.13                78.00              0.10                   22.00 Terpasang
5 P. AC. 1 Lt. 1 bh            1.00 Rp             13,701,471.00                         0.10                78.00              0.08                   22.00 Terpasang
6 P. Distribusi Pompa bh            1.00 Rp                5,487,146.00                         0.04                78.00              0.03                   22.00 Terpasang
7 P. Hydrant (Jocky ‐ pump) bh            1.00 Rp                5,469,229.00                         0.04                71.00              0.03                   29.00 Terpasang
8 P.P Luar bh            1.00 Rp                4,506,646.00                         0.03                71.00              0.02                   29.00 Terpasang
9 P. Genset + AMF bh            1.00 Rp             29,700,750.00                         0.21                71.00              0.15                   29.00 Terpasang
                          ‐                    ‐                ‐
Rp           477,066,739.79                    ‐                ‐
LANTAI 2                           ‐                    ‐                ‐
A INSTALASI PENERANGAN DAN DAYA                            ‐                    ‐                ‐
1 Down Light (1x18) W Unit        122.00 Rp             29,752,414.50                         0.21                86.00              0.18                   14.00 Instalasi sudah terpasang
2 TL 5 (2x28) W Ballast Electronic (Recesscel Mounted) Unit          56.00 Rp             25,416,552.00                         0.18                76.00              0.14                   24.00 Instalasi sudah terpasang
3 EXIT Lamp 10 W Unit            3.00 Rp                4,203,559.81                         0.03                76.00              0.02                   24.00 Instalasi sudah terpasang
4 EMERGENCY Lamp 10 W Unit            4.00 Rp                5,604,746.41                         0.04                76.00              0.03                   24.00 Instalasi sudah terpasang
5 Great Switch 6 Gang Unit            6.00 Rp                1,500,876.00                         0.01                76.00              0.01                   24.00 Instalasi sudah terpasang
6 Saklar Tunggal Unit          89.00 Rp                6,548,442.00                         0.05                76.00              0.04                   24.00 Instalasi sudah terpasang
7 Saklar Double Unit            4.00 Rp                   319,386.00                         0.00                79.00              0.00                   21.00 Instalasi sudah terpasang
8 Stop Kontak 1 Phase Unit          61.00 Rp                5,125,555.50                         0.04                79.00              0.03                   21.00 Instalasi sudah terpasang
9 Titik Instalasi Lampu Titik        185.00 Rp             42,410,463.75                         0.31                79.00              0.24                   21.00 Instalasi sudah terpasang
10 Titik Instalasi Stop Kontak Titik          61.00 Rp             19,751,533.13                         0.14                80.00              0.11                   20.00 Instalasi sudah terpasang
                          ‐                    ‐                ‐
B INSTALASI KABEL                           ‐                    ‐                ‐
1 Dari P.D.U. 2 ke P.P & Daya Lt.2                           ‐                    ‐                ‐
NYY 4x70 mm² + BC 35 mm² m'          25.00 Rp             10,875,100.00                         0.08                60.00              0.05                   40.00 Material on site
2 Dari P.D.U.2 ke P. AC.2 Lt.2                           ‐                ‐
NYY 4x35mm²+BC25mm² m'          25.00 Rp                6,421,506.25                         0.05                60.00              0.03                   40.00 Material on site
                          ‐                ‐
C KABEL TRAY ELEKTRIKAL                            ‐                ‐
1 400X100 mm m'          90.00 Rp             27,778,207.50                         0.20                81.00              0.16                   19.00 Terpasang
4 Tee Tray 400 mm bh            1.00 Rp                   416,256.00                         0.00                81.00              0.00                   19.00 Terpasang
5 Elbow Tray 400mm bh            1.00 Rp                   185,366.25                         0.00                81.00              0.00                   19.00 Terpasang
                   ‐                ‐

01 AFRL‐ 07 AFRL 2019 FIX (76)  11 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

D INSTALASI PANEL                    ‐                ‐


1 PP & Daya Lt.2 m            1.00                         0.09                53.00              0.05                   47.00 Instalasi sudah terpasang
2 P. AC Lt. 2 m            1.00 Rp             14,111,971.00                         0.10                53.00              0.05                   47.00 Instalasi sudah terpasang
                   ‐                ‐
E PEKERJAAN PENANGKAL PETIR DAN GROUNDING                    ‐                ‐
Pengadaan dan Pemasangan Instalasi Penangkal Petir                     ‐                ‐
Type Electrostatic Fild Sistem, Instalasi Wiring Grounding                     ‐                ‐
Cabel NYY 70 mm , Bak Kontrol, Grounding 2 Ohm, Test Coms,                      ‐                ‐
Lengkap dengan Accessories Terpasang sesuai  Gambar dan                     ‐                ‐
Data Spesifikasi Teknis                    ‐                ‐
                   ‐                ‐
1 Air terminal type Electrostatis Sistem Bh            1.00 Rp                9,372,000.00                         0.07                62.00              0.04                   38.00 Material on site
2 Kabel BC 70  mm2 m          51.00 Rp                5,125,245.00                         0.04                56.00              0.02                   44.00 Material on site
3 Material Bantu lot            1.00 Rp                   724,862.25                         0.01                56.00              0.00                   44.00 Material on site
Grounding Sistem c/w :                           ‐                    ‐                ‐
4 Box control 400 x400x400 Bh            2.00 Rp                2,000,000.00                         0.01                56.00              0.01                   44.00 Material on site
5 Copper rod da. 5/8 Bh            1.00 Rp                2,300,000.00                         0.02                56.00              0.01                   44.00 Material on site
                          ‐                    ‐                ‐
F GROUNDING PANEL (Tegangan Rendah)                           ‐                    ‐                ‐
1 Titik Terminal Grounding titik            1.00 Rp                3,000,000.00                         0.02                56.00              0.01                   44.00 Material on site
2 Titik elektroda pentanahan grounding rod dia 20 mm ditanam titik            1.00 Rp                4,000,000.00                         0.03                56.00              0.02                   44.00 Material on site
 sedalam 6 m. Bak kontrol 400x400x400 mm lengkap dgn External                           ‐                    ‐                ‐
3  Grounding Bar CU, ukuran 300x50x5 mm dia lubang 13,5 mm x 3 buah  Bh            1.00 Rp                6,000,000.00                         0.04                56.00              0.02                   44.00 Material on site
                   ‐                ‐
G PENAMBAHAN DAYA PLN ± 35KW                    ‐                ‐
                   ‐                ‐
Rp           245,640,514.35                    ‐                ‐
                   ‐                ‐
3 Testing Commisioning and Balancing Lot            1.00 Rp                3,613,536.27                         0.03                56.00              0.01                   44.00 ‐
                   ‐                ‐
TOTAL PEKERJAAN ELEKTRIKAL Rp           726,320,790.40                     ‐                  ‐
                   ‐                ‐
11 PEKERJAAN ELEKTRONIKA                    ‐                ‐
PEMBANGUNAN/RUANG RAWAT INAP                    ‐                ‐
                   ‐                ‐
LANTAI 1                    ‐                ‐
PEKERJAAN ELEKTRONIK                    ‐                ‐
Pengadaan dan Pemasangan Instalasi Telepon                    ‐                ‐
Instalasi  MATV,Instalasi Fire Alarm, Instalasi Sound System & Nurse Call                    ‐                ‐
Lengkap dengan Accessories                    ‐                ‐
Sesuai Gambar dan Data Spesifikasi Teknis                    ‐                ‐
                   ‐                ‐
A TELEPON                    ‐                ‐
1 PABX /2/100‐105 Extention, lengkap dengan Pesawat, Rectifier Unit            1.00 Rp                7,500,000.00                         0.05                92.00              0.05                     8.00 Instalasi sudah terpasang
Battere, etc                           ‐                35.00                ‐
2 Biaya Conecting dan setting ke peralatan utama PABX existing Unit            1.00 Rp                4,000,000.00                         0.03                88.00              0.03                   12.00 Instalasi sudah terpasang
3 TBT ‐ 1 (20 Pairs)   Unit            1.00 Rp                   627,817.88                         0.00                88.00              0.00                   12.00 Instalasi sudah terpasang
4 Outlet  Telepon  Bh          27.00 Rp                2,522,562.75                         0.02                92.00              0.02                     8.00 Instalasi sudah terpasang
5 Titik Instalasi Telepon Ttk          27.00 Rp             14,623,902.00                         0.11                97.00              0.10                     3.00 Instalasi sudah terpasang
6 Telpon IP Bh          27.00 Rp             27,000,000.00                         0.19                92.00              0.18                     8.00 Instalasi sudah terpasang
                   ‐                ‐
B INSTALASI KABEL                    ‐                ‐
Dari  MDF ke TBT                     ‐                ‐
20 (UTP Cat. 6. 4 pair) M'          15.00 Rp                2,792,596.50                         0.02                84.00              0.02                   16.00 Instalasi sudah terpasang
                   ‐                ‐
C MATV                    ‐                ‐
1 Outlet TV Unit          18.00 Rp                1,530,000.00                         0.01                70.00              0.01                   30.00 Instalasi sudah terpasang
2 Splitter 4 way Unit            4.00 Rp                   260,000.00                         0.00                70.00              0.00                   30.00 Instalasi sudah terpasang
3 Coupler 3 way Bh            2.00 Rp                   140,000.00                         0.00                70.00              0.00                   30.00 Instalasi sudah terpasang
4 Master Antena Control TV & Amplifier ttk            1.00 Rp                3,500,000.00                         0.03                71.00              0.02                   29.00 Instalasi sudah terpasang
5 Instalasi titik coaxial TV RG.6 ttk          18.00 Rp                7,943,940.00                         0.06                71.00              0.04                   29.00 Instalasi sudah terpasang
                   ‐                ‐
D FIRE ALARM                    ‐                ‐
1 MCFA ( Master Control Fire Alarm )  Unit            1.00 Rp             22,657,385.00                         0.16                69.00              0.11                   31.00 Sudah Dipesan
Semi Adressible, 1 loop                    ‐                ‐
Temprtr/  Range :  0  ‐ 49° Celcius                    ‐                ‐
Power  Supply :  AC 220 V, 50 Hz                     ‐                ‐
   Rectifier                    ‐                ‐
   Batteray Nicad  ( 24 V )                    ‐                ‐
   ( min  sistem load )                    ‐                ‐
Accessories :  Lengkap Key Switch, Push Buto ( Indicator                     ‐                ‐
   Lamp, Analog signaling,                     ‐                ‐
   Main Frocessor Alarm Circuit, Realy Digital, Alrm                    ‐                ‐
   Printer,  etc )                    ‐                ‐
2 Booster Power Supply c/w Box Unit            1.00 Rp             11,480,158.50                         0.08                56.00              0.05                   44.00 Sudah Dipesan
3 Monitor Module For Detector Unit            1.00 Rp                1,309,517.25                         0.01                56.00              0.01                   44.00 Sudah Dipesan
4 Single input monitor module ‐ manual breakglass Unit            1.00 Rp                   850,000.00                         0.01                56.00              0.00                   44.00 Sudah Dipesan
5 Single input riser module ‐ Alarm Bell + Strobe Light Unit            1.00 Rp                1,000,000.00                         0.01                56.00              0.00                   44.00 Sudah Dipesan
6 Control Relay Module, Sound system, PABX Unit            1.00 Rp                1,700,000.00                         0.01                56.00              0.01                   44.00 Sudah Dipesan
7 Dual input module ‐ flow switch dan temperatur switch Unit            1.00 Rp                2,000,000.00                         0.01                56.00              0.01                   44.00 Sudah Dipesan
8 Annunciator , Remote graphical LCD Unit            1.00 Rp                9,075,635.00                         0.07                56.00              0.04                   44.00 Sudah Dipesan
9 TBF Bh            1.00 Rp                   510,283.50                         0.00                56.00              0.00                   44.00 Sudah Dipesan
10 Heat Detector, 135 oF (57 oC) Rate ‐ of‐ Rise and fixed Temp c/w Base Bh          11.00 Rp                1,303,524.75                         0.01                56.00              0.01                   44.00 Sudah Dipesan
11 Foto Electric Smoke Detec for c/w base Bh          41.00 Rp             11,497,978.50                         0.08                56.00              0.05                   44.00 Sudah Dipesan
12 End of Line Resistor (EOL) Bh            1.00 Rp                   108,054.75                         0.00                56.00              0.00                   44.00 Sudah Dipesan
13 Alarm Bell Bh            1.00 Rp                   254,319.75                         0.00                56.00              0.00                   44.00 Sudah Dipesan
14 Push Button (Manual Break Glass) Bh            1.00 Rp                   160,292.25                         0.00                56.00              0.00                   44.00 Sudah Dipesan
15 Indicator Lamp Bh            1.00 Rp                     99,696.75                         0.00                56.00              0.00                   44.00 Sudah Dipesan
16 Instalation  Fire  Alarm ttk          57.00 Rp             14,793,979.50                         0.11                92.00              0.10                     8.00 Instalasi sudah terpasang
INSTALASI KABEL                    ‐                ‐
Dari MCFA ke TBF                    ‐                ‐
17 NYA  3 x 2 x 2,5 mm2  M'          15.00 Rp                   943,823.25                         0.01                64.00              0.00                   36.00 Material on site
Dari MCFA ke Anunciator                           ‐                    ‐                ‐
18 FRC 3 x 2,5 mm2 M'          60.00 Rp                7,160,283.00                         0.05                64.00              0.03                   36.00 Material on site
Dari MCFA ke R. Satpam                           ‐                    ‐                ‐
19 FRC STP AWG 18 IP M'          60.00 Rp                2,140,231.50                         0.02                64.00              0.01                   36.00 Material on site

01 AFRL‐ 07 AFRL 2019 FIX (76)  12 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

20 APAR Dry Chemical Powder Kap. 3 kg bh            5.00 Rp                3,250,000.00                         0.02                64.00              0.01                   36.00 Material on site
                   ‐                ‐
E SOUND SYSTEM                    ‐                ‐
Central Sound System ( Paging & Background Music)                    ‐                ‐
1 Power Amplifier 240 Watt bh            2.00 Rp                7,811,442.00                         0.06                55.00              0.03                   45.00 Sudah Dipesan
2 Monitor Panel bh            1.00 Rp                4,480,333.50                         0.03                55.00              0.02                   45.00 Sudah Dipesan
3 Paging Microphone bh            1.00 Rp                5,470,756.50                         0.04                55.00              0.02                   45.00 Sudah Dipesan
4 Chime Module bh            1.00 Rp                2,652,021.00                         0.02                55.00              0.01                   45.00 Sudah Dipesan
5 CD/MMC/USB with FM Turner bh            1.00 Rp                1,607,271.00                         0.01                55.00              0.01                   45.00 Sudah Dipesan
6 Digital Mixer Pre Amplifier bh            1.00 Rp                4,678,836.00                         0.03                55.00              0.02                   45.00 Sudah Dipesan
7 Audio Rack  bh            1.00 Rp                4,010,196.00                         0.03                55.00              0.02                   45.00 Sudah Dipesan
8 MDF bh            1.00 Rp                   641,922.00                         0.00                55.00              0.00                   45.00 Sudah Dipesan
9 Accessories Ls            1.00 Rp                1,300,146.00                         0.01                55.00              0.01                   45.00 Sudah Dipesan
10 TBS  Bh            1.00 Rp                   405,808.50                         0.00                55.00              0.00                   45.00 Sudah Dipesan
11 Ceiling Speaker 3 Watt Bh          39.00 Rp                6,414,378.75                         0.05                55.00              0.03                   45.00 Sudah Dipesan
12 Volume Control Bh            6.00 Rp                   968,022.00                         0.01                55.00              0.00                   45.00 Sudah Dipesan
13 Instalasi titik speaker Ttk          45.00 Rp             13,343,744.25                         0.10                88.00              0.08                   12.00 Instalasi sudah terpasang
Dari Selector Switch ke TBS                     ‐                ‐
14 NYMHY 3 X 2.5 mm2 M'          15.00 Rp                   922,667.06                         0.01                56.00              0.00                   44.00 Material on site
                   ‐                ‐
F PEKERJAAN INSTALASI NURSE CALL LT. SATU                    ‐                ‐
1 12 chanel unit sentral Nurse Call Unit            1.00 Rp                9,600,000.00                         0.07                68.00              0.05                   32.00 Instalasi sudah terpasang
2 Push Button 1 Bed Side Call Button Unit          10.00 Rp                4,000,000.00                         0.03                74.00              0.02                   26.00 Instalasi sudah terpasang
3 Toilet Button/ Emergency switch toilet Unit          10.00 Rp                3,000,000.00                         0.02                74.00              0.02                   26.00 Instalasi sudah terpasang
4 Unit koridor lamp/ corridor lamp Unit          10.00 Rp                5,000,000.00                         0.04                74.00              0.03                   26.00 Instalasi sudah terpasang
5 Titik Instalasi  Ttk          10.00 Rp                1,300,000.00                         0.01                72.00              0.01                   28.00 Instalasi sudah terpasang
6 UPS‐1,4 kw (1400 w) Bh            1.00 Rp                2,425,000.00                         0.02                72.00              0.01                   28.00 Instalasi sudah terpasang
                   ‐                ‐
G GROUNDING PERALATAN ELEKTRONIK                    ‐                ‐
1 Titik Terminal Grounding titik            1.00 Rp                3,000,000.00                         0.02                53.00              0.01                   47.00 Material on site
2 Titik elektroda pentanahan grounding rod dia 20 mm ditanam titik            1.00 Rp                4,000,000.00                         0.03                53.00              0.02                   47.00 Material on site
 sedalam 6 m. Bak kontrol 400x400x400 mm lengkap dgn External                    ‐                ‐
3  Grounding Bar CU, ukuran 300x50x5 mm dia lubang 13,5 mm x 3 buah  Bh            1.00 Rp                6,000,000.00                         0.04                53.00              0.02                   47.00 Material on site
                   ‐                ‐
H KABEL TRAY ELEKTRONIK m          90.00 Rp             19,409,760.00                         0.14                95.00              0.13                     5.00 Terpasang
1 200x100 mm bh            2.00 Rp                   285,063.00                         0.00                95.00              0.00                     5.00 Terpasang
2 Tee Tray 200 mm bh            2.00 Rp                   247,287.55                         0.00                95.00              0.00                     5.00 Terpasang
3 Elbow Tray 200 mm                    ‐                ‐
                   ‐                ‐
Rp           277,710,637.49                    ‐                ‐
LANTAI 2                    ‐                ‐
PEKERJAAN ELEKTRONIK                    ‐                ‐
Pengadaan dan Pemasangan Instalasi Telepon                    ‐                ‐
Instalasi  MATV,Instalasi Fire Alarm, Instalasi Sound System & Nurse Call                    ‐                ‐
Lengkap dengan Accessories                    ‐                ‐
Sesuai Gambar dan Data Spesifikasi Teknis                    ‐                ‐
                   ‐                ‐
A TELEPON                    ‐                ‐
1 TBT ‐ 1 (20 Pairs)   Unit            1.00 Rp                   627,817.88                         0.00                66.00              0.00                   34.00 Instalasi sudah terpasang
2 Outlet  Telepon  Bh          21.00 Rp                1,961,993.25                         0.01                56.00              0.01                   44.00 Instalasi sudah terpasang
3 Titik Instalasi Telepon titik          21.00 Rp             11,374,146.00                         0.08                77.00              0.06                   23.00 Instalasi sudah terpasang
4 Telepon IP Bh          21.00 Rp             21,000,000.00                         0.15                66.00              0.10                   34.00 Instalasi sudah terpasang
                   ‐                ‐
B INSTALASI KABEL                    ‐                ‐
Dari  MDF ke TBT ‐LANTAI 2                    ‐                ‐
20 (UTP Cat. 6. 4 pair) M'          25.00 Rp                4,654,327.50                         0.03                67.00              0.02                   33.00 Instalasi sudah terpasang
                   ‐                ‐
C MATV                    ‐                ‐
1 Outlet TV Bh          25.00 Rp                2,125,000.00                         0.02                55.00              0.01                   45.00 Instalasi sudah terpasang
2 Spliter 4 way Bh            7.00 Rp                   455,000.00                         0.00                63.00              0.00                   37.00 Instalasi sudah terpasang
3 Coupler 3 way Bh          74.00 Rp                5,180,000.00                         0.04                55.00              0.02                   45.00 Instalasi sudah terpasang
4 Master Antena TV & Amplifier Ttk            1.00 Rp                3,500,000.00                         0.03                55.00              0.01                   45.00 Instalasi sudah terpasang
5 Instalasi TV RG. 6 Ttk          25.00 Rp             11,033,250.00                         0.08                65.00              0.05                   35.00 Instalasi sudah terpasang
                   ‐                ‐
D FIRE ALARM                    ‐                ‐
1 TBF Bh            1.00 Rp                   510,283.50                         0.00                60.00              0.00                   40.00 Instalasi sudah terpasang
2 Heat Detector, 135 oF (57 oC) Rate ‐ of‐ Rise and fixed Temp c/w Base Bh          35.00 Rp                4,147,578.75                         0.03                58.00              0.02                   42.00 Instalasi sudah terpasang
3 Foto Electric Smoke Detec for c/w base Bh            2.00 Rp                   560,877.00                         0.00                52.00              0.00                   48.00 Instalasi sudah terpasang
4 End of Line Resistor (EOL) Bh            1.00 Rp                   108,054.75                         0.00                52.00              0.00                   48.00 Instalasi sudah terpasang
5 Alarm Bell Bh            1.00 Rp                   254,319.75                         0.00                58.00              0.00                   42.00 Instalasi sudah terpasang
6 Push Button (Manual Break Glass) Bh            1.00 Rp                   160,292.25                         0.00                52.00              0.00                   48.00 Instalasi sudah terpasang
7 Indicator Lamp Bh            1.00 Rp                     99,696.75                         0.00                68.00              0.00                   32.00 Instalasi sudah terpasang
8 Instalation  Fire  Alarm Bh          42.00 Rp             10,900,827.00                         0.08                61.00              0.05                   39.00 Instalasi sudah terpasang
9 Instalasi  Kabel                    ‐                ‐
Dari MCFA ke TBF                    ‐                ‐
NYA  3 x 2 x 2,5 mm2  M'          25.00                         0.01                65.00              0.01                   35.00 Instalasi sudah terpasang
10 APAR Dry Chemical Powder Kap. 3 kg bh            5.00 Rp                3,250,000.00                         0.02                57.00              0.01                   43.00 Instalasi sudah terpasang
                   ‐                ‐
E SOUND SYSTEM                    ‐                ‐
1 TBS  Bh            1.00 Rp                   405,808.50                         0.00                57.00              0.00                   43.00 Instalasi sudah terpasang
2 Ceiling Speaker 3 Watt Bh          34.00 Rp                5,592,022.50                         0.04                57.00              0.02                   43.00 Instalasi sudah terpasang
3 Volume Control Bh            2.00 Rp                   322,674.00                         0.00                57.00              0.00                   43.00 Instalasi sudah terpasang
4 Instalasi titik speaker Ttk          36.00 Rp             10,674,995.40                         0.08                57.00              0.04                   43.00 Instalasi sudah terpasang
Dari Selector Switch ke TBS                     ‐                ‐
5 NYMHY 3 X 2.5 mm2 M'          25.00 Rp                1,537,778.44                         0.01                57.00              0.01                   43.00 Instalasi sudah terpasang
                   ‐                ‐
F PEKERJAAN INSTALASI NURSE CALL LT. DUA                    ‐                ‐
1 12 chanel unit sentral Nurse Call Unit            2.00                         0.14                75.00              0.10                   25.00 Instalasi sudah terpasang
2 Push Button 1 Bed Side Call Button Unit          22.00 Rp                8,800,000.00                         0.06                75.00              0.05                   25.00 Instalasi sudah terpasang
3 Toilet Button/ Emergency switch toilet Unit          28.00 Rp                8,400,000.00                         0.06                75.00              0.05                   25.00 Instalasi sudah terpasang
4 Unit koridor lamp/ corridor lamp Unit          22.00 Rp             11,000,000.00                         0.08                75.00              0.06                   25.00 Instalasi sudah terpasang
5 Titik Instalasi  Ttk          22.00 Rp                2,860,000.00                         0.02                75.00              0.02                   25.00 Instalasi sudah terpasang
6 UPS‐1,4 kw (1400 w) Bh            1.00 Rp                2,425,000.00                         0.02                75.00              0.01                   25.00 Instalasi sudah terpasang
               19.00                ‐
G KABEL TRAY ELEKTRONIK                19.00                ‐
1 200x100 mm m          63.00 Rp             13,586,832.00                         0.10                78.00              0.08                   22.00 Terpasang
2 Tee Tray 200 mm bh            1.00 Rp                   142,531.50                         0.00                77.00              0.00                   23.00 Terpasang

01 AFRL‐ 07 AFRL 2019 FIX (76)  13 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

3 Elbow Tray 200 mm bh            1.00 Rp                   123,643.78                         0.00                77.00              0.00                   23.00 Terpasang
                   ‐                ‐
Rp           168,547,789.24                    ‐                ‐
                   ‐                ‐
Testing Commisioning and Balancing Lot            1.00 Rp                2,231,292.13                         0.02                51.00              0.01                   49.00 ‐
                   ‐                ‐
TOTAL PEKERJAAN ELEKTRONIKA Rp           448,489,718.86                     ‐                  ‐
SUB TOTAL  ‐   I  (PEMBANGUNAN  RAWAT INAP) Rp     13,849,145,064.47                     ‐                  ‐
                   ‐                ‐
II  PEKERJAAN RELOKASI                    ‐                ‐
                   ‐                ‐
1  Relokasi Peralatan Rumah Sakit ls            1.00 Rp             20,000,000.00                         0.14                50.00              0.07                   50.00 ‐
SUB TOTAL  ‐   II  (RELOKASI) Rp             20,000,000.00                     ‐                  ‐
III PEKERJAAN HERITAGE                    ‐                ‐
1  Bangunan Heritage Existing                    ‐                ‐
1  Pekerjaan Bongkaran ls            1.00 Rp                3,000,000.00                         0.02             100.00              0.02                       ‐ ‐
2  Pondasi Batu Belah m3            4.86 Rp                3,038,958.00                         0.02                99.00              0.02                     1.00 ‐
3  Sloof Beton m3            1.08 Rp                5,256,360.00                         0.04                99.00              0.04                     1.00 ‐
4  Pekerjaan Urug Lantai m3        222.16 Rp             33,346,816.40                         0.24             100.00              0.24                       ‐ ‐
5  Pekerjaan Pas Dinding m2        163.13 Rp             24,797,391.30                         0.18                90.00              0.16                   10.00 ‐
6  Pekerjaan Plester / Aci m2        326.26 Rp             21,533,160.00                         0.16                98.00              0.15                     2.00 ‐
7  Pekerjaan Pas Lantai HT 60x60 m2        299.20 Rp             95,444,800.00                         0.69                98.00              0.67                     2.00 ‐
8  Pekerjaan Dinding Keramik m2          42.00 Rp                8,610,000.00                         0.06                98.00              0.06                     2.00 ‐
9  Pekerjaan Pas Plafond m2        417.43 Rp             64,283,450.00                         0.46                98.00              0.45                     2.00 ‐
10  Pekerjaan Pas List m1        355.92 Rp                9,246,801.60                         0.07                98.00              0.07                     2.00 ‐
11  Pekerjaan Pintu Dobel bh            6.00 Rp             38,640,000.00                         0.28                98.00              0.27                     2.00 ‐
12  Pekerjaan Pintu Single bh            9.00 Rp             23,760,000.00                         0.17                98.00              0.17                     2.00 ‐
13  Pekerjaan Jendela bh          12.00 Rp             36,000,000.00                         0.26                98.00              0.25                     2.00 ‐
14  Pekerjaan Closed unit            3.00 Rp                8,607,000.00                         0.06                97.00              0.06                     3.00 ‐
15  Pekerjaan Wastafel unit            3.00 Rp                4,935,000.00                         0.04                97.00              0.03                     3.00 ‐
16  Pekerjaan Shower Set bh            3.00 Rp                4,884,000.00                         0.04                97.00              0.03                     3.00 ‐
17  Pekerjaan Floor Drain bh            3.00 Rp                   873,000.00                         0.01                97.00              0.01                     3.00 ‐
18  Pekerjaan Kran Dinding bh            3.00 Rp                   465,300.00                         0.00                97.00              0.00                     3.00 ‐
19  Pekerjaan Penutup Atap  m2        418.88 Rp             68,696,320.00                         0.50                98.00              0.49                     2.00 ‐
20  Pekerjaan Rangka Atap Baja Ringan m2        418.88 Rp             65,764,160.00                         0.47                98.00              0.46                     2.00 ‐
21  Pekerjaan Bubungan m1          62.40 Rp                8,673,600.00                         0.06                98.00              0.06                     2.00 ‐
22  Pekerjaan Lisplank m1        151.80 Rp             15,331,800.00                         0.11                98.00              0.11                     2.00 ‐
23  Pekerjaan Cat Dinding Exterior m2        163.13 Rp                5,546,420.00                         0.04                65.00              0.03                   35.00 Sisa perapihan
24  Pekerjaan Cat Dinding Dalam m2        163.13 Rp                4,766,658.60                         0.03                65.00              0.02                   35.00 Sisa perapihan
25  Pekerjaan Cat Plafond m2        417.43 Rp             12,197,158.50                         0.09                63.00              0.06                   37.00 Sisa perapihan
Jumlah Bangunan Heritage Existing Rp           567,698,154.40                     ‐                  ‐
2  PEKERJAAN TATA UDARA R. HERITAGE                    ‐                ‐
A Pengadaan dan Pemasangan Unit AC lengkap dengan pemipaan dan pengkabelan                    ‐                ‐
a. Split Wall Kap, 12.000 ‐12500 BTU/h unit            5.00 Rp             24,157,550.00                         0.17                86.00              0.15                   14.00 Terpasang
b. Split Wall Kap, 18.500 BTU/h unit            2.00 Rp             11,907,240.00                         0.09                72.00              0.06                   28.00 Terpasang
               58.00                ‐
B. Testing Commisioning and Balancing Lot            1.00 Rp                   180,323.95                         0.00                58.00              0.00                   42.00 ‐
                   ‐                ‐
Jumlah Pek.  Tata Udara R.Heritage Rp             36,245,113.95                     ‐                  ‐
                   ‐                ‐
3 PEKERJAAN ELEKTRIKAL R. HERITAGE                    ‐                ‐
A INSTALASI PENERANGAN DAN DAYA                     ‐                ‐
1 Down Light (1x18) W Unit          31.00 Rp                7,591,776.00                         0.05                98.00              0.05                     2.00 Instalasi sudah terpasang
2 TL 5 (2x28) W Ballast Electronic (Recesscel Mounted) Unit          16.00 Rp                7,295,136.00                         0.05                98.00              0.05                     2.00 Instalasi sudah terpasang
3 Saklar Tunggal Unit            7.00 Rp                   516,222.00                         0.00                98.00              0.00                     2.00 Instalasi sudah terpasang
4 Saklar Double Unit            6.00 Rp                   480,276.00                         0.00                98.00              0.00                     2.00 Instalasi sudah terpasang
5 Stop Kontak 1 Phase Unit          18.00 Rp                1,516,428.00                         0.01                98.00              0.01                     2.00 Instalasi sudah terpasang
6 Great Switch 6 Unit            2.00 Rp                   500,292.00                         0.00                98.00              0.00                     2.00 Instalasi sudah terpasang
7 Titik Instalasi Lampu Titik          47.00 Rp             10,819,212.00                         0.08                98.00              0.08                     2.00 Instalasi sudah terpasang
8 Titik Instalasi Stop Kontak 1 Phase Titik          18.00 Rp                5,853,978.00                         0.04                98.00              0.04                     2.00 Instalasi sudah terpasang
9 TL 5 (1x28)w Surface Mounted (Ball Electronic) Titik            6.00 Rp                2,590,776.00                         0.02                98.00              0.02                     2.00 Instalasi sudah terpasang
                   ‐                ‐
B Testing Commisioning and Balancing Lot            1.00 Rp                   185,820.48                         0.00                52.00              0.00                   48.00 ‐
Jumlah Pek. Elektrikal Rp             37,349,916.48                    ‐                ‐
                   ‐                ‐
SUB TOTAL  ‐   III  (PEKERJAAN HERITAGE) Rp           641,293,184.83                     ‐                  ‐
                   ‐                ‐
IV PEKERJAAN RUANG ICU                    ‐                ‐
                   ‐                ‐
1 Bangunan Existing Tahap I ( R. ICU )                    ‐                ‐
1  Pekerjaan Bongkaran ls            1.00 Rp                3,000,000.00                         0.02                74.00              0.02                   26.00 Existing
2  Pondasi Batu Belah m3          11.61 Rp                7,259,733.00                         0.05                55.00              0.03                   45.00 Existing
3  Sloof Beton m3            2.58 Rp             12,556,860.00                         0.09                55.00              0.05                   45.00 Existing
4  Pekerjaan Pas Dinding m2        129.00 Rp             19,609,290.00                         0.14                55.00              0.08                   45.00 Existing
5  Pekerjaan Pas Lantai HT 60x60 ( Perbaikan ) m2          81.51 Rp             26,000,493.75                         0.19                55.00              0.10                   45.00 Existing
6  Pekerjaan Dinding Keramik m2        105.00 Rp             21,525,000.00                         0.16                55.00              0.09                   45.00 Existing
7  Pekerjaan Pas Plafond ( Perbaikan ) m2          81.51 Rp             12,551,962.50                         0.09                55.00              0.05                   45.00 Existing
8  Pekerjaan Plester / Aci m2        258.00 Rp             17,028,000.00                         0.12                55.00              0.07                   45.00 Existing
9  Pekerjaan Dinding Partisi m2          30.00 Rp                4,560,300.00                         0.03                55.00              0.02                   45.00 Existing
10  Pekerjaan Cat Dinding Exterior m2        129.00 Rp                4,386,000.00                         0.03                55.00              0.02                   45.00 Existing
11  Pekerjaan Cat Dinding Dalam m2        258.00 Rp                7,538,760.00                         0.05                55.00              0.03                   45.00 Existing
12  Pekerjaan Cat Plafond m2        271.69 Rp                7,938,708.75                         0.06                55.00              0.03                   45.00 Existing
13  Pekerjaan Pintu Dobel bh            4.00 Rp             25,760,000.00                         0.19                55.00              0.10                   45.00 Existing
14  Pekerjaan Pintu Single bh            8.00 Rp             21,120,000.00                         0.15                55.00              0.08                   45.00 Existing
15  Pekerjaan Closed unit            5.00 Rp             14,345,000.00                         0.10                55.00              0.06                   45.00 Existing
16  Pekerjaan Wastafel unit            5.00 Rp                8,225,000.00                         0.06                55.00              0.03                   45.00 Existing
17  Pekerjaan Shower Set bh            5.00 Rp                8,140,000.00                         0.06                55.00              0.03                   45.00 Existing
18  Pekerjaan Floor Drain bh            5.00 Rp                1,455,000.00                         0.01                55.00              0.01                   45.00 Existing
19  Pekerjaan Kran Dinding bh            5.00 Rp                   775,500.00                         0.01                55.00              0.00                   45.00 Existing
                   ‐                ‐
Jumlah Existing Tahap I Rp           223,775,608.00                    ‐                ‐
                   ‐                ‐
2 PEKERJAAN TATA UDARA & VENTILASI R. ICU                    ‐                ‐
A. PEKERJAAN VENTILASI R. ICU                    ‐                ‐
a. Pengadaan dan Pemasangan Peralatan Fan                    ‐                ‐

01 AFRL‐ 07 AFRL 2019 FIX (76)  14 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

Exhaust air fan, cabinet fan                    ‐                ‐


Kapasitas : 1100 CFM unit            1.00 Rp             14,169,420.00                         0.10                49.00              0.05                   51.00 Existing
                   ‐                ‐
b. Fresh air fan Hight Static‐Cabinet fan                    ‐                ‐
Kapasitas :  2300 CFM unit            1.00 Rp             16,681,795.00                         0.12                49.00              0.06                   51.00 Existing
                   ‐                ‐
c. Exhaust fan type ceiling duct                    ‐                ‐
Kapasitas 216 CFM unit            1.00 Rp                5,426,355.00                         0.04                59.00              0.02                   41.00 Existing
                   ‐                ‐
d. Ducting Exhaust dan fresh air                    ‐                ‐
BKoridor + Loby                    ‐                ‐
•4"x4" m            3.00 Rp                   502,143.03                         0.00                65.00              0.00                   35.00 Existing
•6"x6" m            4.00 Rp                1,004,286.05                         0.01                59.00              0.00                   41.00 Existing
•28"x8" m            6.00 Rp                4,519,287.24                         0.03                59.00              0.02                   41.00 Existing
•28"x10" m            3.00 Rp                2,385,179.38                         0.02                59.00              0.01                   41.00 Existing
•30"x8" m            6.00 Rp                4,770,358.75                         0.03                59.00              0.02                   41.00 Existing
•14"x8" m            6.00 Rp                2,761,786.65                         0.02                59.00              0.01                   41.00 Existing
•20"x8" m            2.00 Rp                1,171,667.06                         0.01                59.00              0.00                   41.00 Existing
               33.00                ‐
e. Exhaust Grille dan Fresh Grille                33.00                ‐
•4"x5" bh            3.00 Rp                   300,000.00                         0.00                57.00              0.00                   43.00 Existing
•8"x8" bh            4.00 Rp                   760,000.00                         0.01                57.00              0.00                   43.00 Existing
•28"x8" bh            3.00 Rp                1,290,000.00                         0.01                57.00              0.01                   43.00 Existing
•22"x10" bh            1.00 Rp                   380,000.00                         0.00                57.00              0.00                   43.00 Existing
•32"x12" bh            1.00 Rp                   520,000.00                         0.00                57.00              0.00                   43.00 Existing
•10"x14" bh            1.00 Rp                   280,000.00                         0.00                57.00              0.00                   43.00 Existing
•10"x12" bh            1.00 Rp                   260,000.00                         0.00                57.00              0.00                   43.00 Existing
               42.00                ‐
f. HEPA Filter Kapasitas 2300 CFM bh            1.00 Rp                8,500,000.00                         0.06                57.00              0.03                   43.00 Existing
               42.00                ‐
g. Acessories dan alat bantu lot            1.00 Rp                2,712,000.00                         0.02                57.00              0.01                   43.00 Existing
                   ‐                ‐
B. PEKERJAAN TATA UDARA  R. ICU                    ‐                ‐
1 Pengadaan dan Pemasangan Unit AC lengkap dengan pemipaan dan pengkabelan                    ‐                ‐
aSplit duct H.Press Kap, 44.300 BTU/h unit            1.00 Rp             29,542,170.00                         0.21                57.00              0.12                   43.00 Existing
bSplit duct  Kap, 59.900 BTU/h unit            1.00 Rp             35,069,395.00                         0.24                57.00              0.14                   43.00 Existing
c Ducting suplly, Return Bahan PU Density 54Kg/m3                42.00                ‐                   58.00 Existing
‐ 8"x8" m          16.00 Rp                5,356,192.28                         0.04                58.00              0.02                   42.00 Existing
‐ 8"x10" m          12.00 Rp                4,519,287.24                         0.03                59.00              0.02                   41.00 Existing
‐ 10"x10" m          10.00 Rp                4,184,525.22                         0.03                59.00              0.02                   41.00 Existing
‐ 12"x10" m            2.00 Rp                   987,547.95                         0.01                59.00              0.00                   41.00 Existing
‐ 14"x8" m            3.00 Rp                1,481,321.93                         0.01                59.00              0.01                   41.00 Existing
‐ 15"x10" m            3.00 Rp                1,569,196.96                         0.01                59.00              0.01                   41.00 Existing
‐ 18"x10" m            3.00 Rp                1,757,500.59                         0.01                59.00              0.01                   41.00 Existing
‐ 25"x8" m            2.00 Rp                1,380,893.32                         0.01                59.00              0.01                   41.00 Existing
25"x10" m            8.00 Rp                5,858,335.31                         0.04                59.00              0.02                   41.00 Existing
               ‐
dDiffuser 12"x12" bh            4.00 Rp                1,240,000.00                         0.01                63.00              0.01                   37.00 Existing
          10"x10" bh            8.00 Rp                2,160,000.00                         0.02                59.00              0.01                   41.00 Existing
                   ‐                ‐
eGrille Return                    ‐                ‐
‐ 10"x12" bh            5.00 Rp                1,550,000.00                         0.01                56.00              0.01                   44.00 Existing
14"x9" bh            2.00 Rp                   420,000.00                         0.00                56.00              0.00                   44.00 Existing
               ‐
f HEPA Filter Kap 1250 CFM bh            1.00 Rp                6,000,000.00                         0.04                56.00              0.02                   44.00 Existing
               ‐
gAcessories dan alat bantu lot            1.00 Rp             30,922,909.74                         0.21                56.00              0.12                   44.00 Existing
                   ‐                ‐
C. Testing Commisioning and Balancing Lot            1.00 Rp                1,011,967.77                         0.01                56.00              0.00                   44.00 Existing
                   ‐                ‐
Jumlah Pek.  Tata Udara & Ventilasi Rp           203,405,521.49                     ‐                  ‐
                   ‐                ‐
3 PEKERJAAN INSTALASI GAS MEDIS R. ICU                    ‐                ‐
                   ‐                ‐
1 Wall Point Outlet for Oxygen (O2)                    ‐                ‐
Quick connect type, pin index (JIS/KS) ‐ Push Type                    ‐                ‐
Optional : Ohmeda Type, Diss Type ea            4.00 Rp                6,400,000.00                         0.05                57.00              0.03                   43.00 Existing
Double check by color code for different gas and pin index‐                    ‐                ‐
system between check and inlet parts                    ‐                ‐
                   ‐                ‐
2 Wall Point Outlet for Nitrous (N)                    ‐                ‐
Quick connect type, pin index (JIS/KS) ‐ Push Type                    ‐                ‐
Optional : Ohmeda Type, Diss Type ea            4.00 Rp                6,400,000.00                         0.05                65.00              0.03                   35.00 Existing
Double check by color code for different gas and pin index‐                    ‐                ‐
system between check and inlet parts                    ‐                ‐
                   ‐                ‐
3 Wall Point Outlet for Vacuum/Suction (V)  ea            4.00 Rp                6,400,000.00                         0.05                64.00              0.03                   36.00 Existing
Quick connect type, pin index (JIS/KS) ‐ Push Type                    ‐                ‐
Optional : Ohmeda Type, Diss Type                    ‐                ‐
Double check by color code for different gas and pin index‐                    ‐                ‐
system between check and inlet parts                    ‐                ‐
                   ‐                ‐
4 Pekerjaan pipa menggunakan pipa tembaga seamiess                    ‐                ‐
ASTM B‐819 Tipe L, Support pipa dibuat maksimal setiap 2 mtr.                    ‐                ‐
pipa pada support dilindungi oleh bahan karet/plastik                    ‐                ‐
‐ DDia. 1/2" m          50.00 Rp                4,115,460.00                         0.03                57.00              0.02                   43.00 Existing
‐ DDia. 5/8" m          25.00 Rp                2,729,355.00                         0.02                57.00              0.01                   43.00 Existing
                   ‐                ‐
Jumlah Pek. Instalasi Gas Medik Rp             26,044,815.00                    ‐                ‐
                   ‐                ‐
4 PEKERJAAN ELEKTRIKAL R. ICU                    ‐                ‐
A INSTALASI PENERANGAN DAN DAYA                     ‐                ‐
1 Down Light (1x18) W Unit          40.00 Rp                9,754,890.00                         0.07                60.00              0.04                   40.00 Existing
2 TL 5 (2x28) W Ballast Electronic (Recesscel Mounted) Unit          14.00 Rp                6,354,138.00                         0.05                59.00              0.03                   41.00 Existing
3 Saklar Tunggal Unit          10.00 Rp                   735,780.00                         0.01                59.00              0.00                   41.00 Existing
4 Saklar Double Unit            4.00 Rp                   319,386.00                         0.00                59.00              0.00                   41.00 Existing
5 Stop Kontak 1 Phase Unit          15.00 Rp                1,260,382.50                         0.01                59.00              0.01                   41.00 Existing

01 AFRL‐ 07 AFRL 2019 FIX (76)  15 of 16
PEMERIKSAAN PEKERJAAN

JUMLAH SAMPAI 07 AFRIL
  URAIAN PEKERJAAN SAT VOL HARGA BOBOT  KOMULATIF   KOMULATIF  SISA BOBOT %
( RP ) PERSENTASE %  BOBOT 

6 Great Switch 6 Unit            2.00 Rp                   500,292.00                         0.00                59.00              0.00                   41.00 Existing
7 Titik Instalasi Lampu Titik          54.00 Rp             12,379,270.50                         0.09                59.00              0.05                   41.00 Existing
8 Titik Instalasi Stop Kontak 1 Phase Titik          15.00 Rp                4,856,934.38                         0.04                59.00              0.02                   41.00 Existing
                   ‐                ‐
B Testing Commisioning and Balancing Lot            1.00 Rp                   180,805.37                         0.00                    ‐                ‐                 100.00 ‐

JUMLAH TOTAL PERSENTASE
Jumlah Pek. Elektrikal Rp             36,341,878.74

01 AFRL‐ 07 AFRL 2019 FIX (76)  16 of 16

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