DIHARAPKAN UNTUK TIDAK MERUBAH UKURAN & BENTUK TULISAN SERTA KOL

PT. A
L
P
NO BLA
TGL E

JAMINAN PENAWARAN (SBA)

NO. NO. REG NO. BOND NAMA TERTANGGUNG

1
2
3
4
5
6
7
8

JAMINAN PELAKSANAAN (SBB)

NO. NO. REG NO. BOND NAMA TERTANGGUNG

1 2117751 18.91.01.170001.08.19 CV. FUN MAYA

2 2117752 18.91.01.170002.07.19 CV. AKU CINTA PAPUA
3 2117759 18.91.01.170004.08.19 CV. NUR WALAL JAYA
 4 2117758 18.91.01.170003.08.19 CV. NUR WALAL JAYA
5 2117761 18.91.01.170003.09.19 CV. SINAR WAIFAP
6 2117757 18.91.01.170005.08.19 CV. BERKAH JAYA BARU

JAMINAN UANG MUKA (SBC)

NO. NO. REG NO. BOND NAMA TERTANGGUNG

1 2117753 18.92.01.170001.08.19 CV. AKU CINTA PAPUA

2 2117755 18.92.01.170002.08.19 CV. NUR WALAL JAYA
3 2117760 18.92.01.170003.08.19 CV. NUR WALAL JAYA
4 2117765 18.92.01.170005.08.19 CV. SINAR WAIFAP
5 2117762 18.92.01.170004.08.19 CV. BERKAH JAYA BARY
6 2117763 18.92.01.170005.08.19 CV. FUN MAYA
7 2117764 18.92.01.170006.08.19 CV. WARIS NURFIRAWA

JAMINAN PEMELIHARAAN (SBD)

NO. NO. REG NO. BOND NAMA TERTANGGUNG

POLIS RUSAK / GANTI BLANKO

NO.
No. REGISTRASI KODE POLIS
BLANKO
1 2117760 20,000
2 2117756 20,000
 40,000

KETERANGAN :
JUMLAH BLANKO
SERVICE CHARGES
BIAYA ADD
BLANKO RUSAK
KOMISI
PEJAK KOMISI 5%
NETT ASURANSI (+PAJAK 5%)

Waisai, …… Agustus 2019

WAHYU MOUKO
TULISAN SERTA KOLOM YANG TELAH DI BUAT

PT. ASURANSI UMUM VIDEI

LAPORAN PRODUKSI
PEMASARAN WAISAI
NO BLANKO : 2117751 - 2117765 (15)
TGL EMAIL 4 SEPTEMBER 2019

PERIODE
JMLH. SERVICE
NILAI BOND
AWAL AKHIR HARI CHARGES

PERIODE
JMLH. SERVICE
NILAI BOND
AWAL AKHIR HARI CHARGES

14,150,000 23 Juli 2019 19 Desember 2019 150 130,000

48,270,000 18 Juli 2019 16 Okober 2019 90 144,810
24,736,266 02 Agustus 2019 30 Oktiober 2019 90 130,000
 24,910,000 29 Juli 2019 26 Oktober 2019 90 130,000
6,000,000 02 Agustus 2019 30 Oktiober 2019 90 130,000
29,050,000 06 Agustus 2019 05 Desember 2019 150 145,250

810,060

PERIODE
JMLH. SERVICE
NILAI BOND
AWAL AKHIR HARI CHARGES

289,620,000 19 Juli 2019 16 Oktober 2019 90 868,860

149,460,000 30 Juli 2019 28 November 2019 90 448,380
148,417,599 02 Agustus 2019 30 Oktober 2019 90 445,253
59,835,000 02 Agustus 2019 30 Oktober 2019 90 179,505
174,300,000 08 Agustus 2019 05 Desember 2019 120 697,200
70,750,000 22 Juli 2019 19 Desember 2019 150 353,750
85,800,000 09 Agustus 2019 05 Januari 2020 150 429,000

3,421,948

PERIODE
JMLH. SERVICE
NILAI BOND
AWAL AKHIR HARI CHARGES

-
 15
4,232,008
260,000
40,000
846,402
42,320
3,727,926
 TOTAL NETT ASURANSI
SERVICE PAJAK
BIAYA ADM KOMISI 10%
CHARGES KOMISI 5% ( + PAJAK 5%)
(SC)

- - - - -

TOTAL NETT ASURANSI

SERVICE PAJAK
BIAYA ADM KOMISI 20%
CHARGES KOMISI 5% ( + PAJAK 5%)
(SC)
20,000 150,000 26,000 1,300 125,300
20,000 164,810 28,962 1,448 137,296
20,000 150,000 26,000 1,300 125,300
 20,000 150,000 26,000 1,300 125,300
20,000 150,000 26,000 1,300 125,300
20,000 165,250 29,050 1,453 137,653

120,000 930,060 162,012 8,101 776,149

TOTAL NETT ASURANSI

SERVICE PAJAK
BIAYA ADM KOMISI 20%
CHARGES KOMISI 5% ( + PAJAK 5%)
(SC)
20,000 888,860 173,772 8,689 723,777
20,000 468,380 89,676 4,484 383,188
20,000 465,253 89,051 4,453 380,655
20,000 199,505 35,901 1,795 165,399
20,000 717,200 139,440 6,972 584,732
20,000 373,750 70,750 3,538 306,538
20,000 449,000 85,800 4,290 367,490

140,000 3,561,948 684,390 34,219 2,911,778

TOTAL NETT ASURANSI

SERVICE PAJAK
BIAYA ADM KOMISI 20%
CHARGES KOMISI 5% ( + PAJAK 5%)
(SC)

- - - - -
 PT. ASURANSI UMUM VIDEI
LAPORAN PRODUKSI
PEMASARAN SORONG
NO BLANKO : 2075303 - 2075350
TGL EMAIL 27 JUNI 2019

JAMINAN PENAWARAN (SBA)

PERIODE
JMLH. SERVICE
NO. NO. REG NO. BOND NAMA TERTANGGUNG NILAI BOND
AWAL AKHIR HARI CHARGES

1 2075318 18.90.01.050009.01.19 PT. KARYA UTAMA PERSADA 375,940,680 14 January 2019 27 April 2019 104 1,086,051
2 2075319 18.90.01.050010.01.19 PT. SORONG RAYA KONSTRUKSI 48,125,000 11 March 2019 8 June 2019 90 120,313
3 2075320 18.90.01.050011.01.19 CV. RINTIS BUANA RAYA 48,125,000 11 March 2019 8 June 2019 90 120,313
4 2075321 18.90.01.050012.01.19 CV. PUTRA PAPUA MEMBANGUN 48,125,000 11 March 2019 8 June 2019 90 120,313
5 2075322 18.90.01.050013.01.19 PT. SORONG RAYA KONSTRUKSI 31,789,150 11 March 2019 8 June 2019 90 79,473
6 2075323 18.90.01.050014.01.19 CV. RINTIS BUANA RAYA 31,789,150 11 March 2019 8 June 2019 90 79,473
7 2075324 18.90.01.050015.01.19 CV. PUTRA PAPUA MEMBANGUN 31,789,150 11 March 2019 8 June 2019 90 79,473
8 2075325 18.90.01.050016.01.19 CV. RINTIS BUANA RAYA 20,000,000 11 March 2019 8 June 2019 90 50,000
9 2075326 18.90.01.050017.01.19 PT. SORONG RAYA KONSTRUKSI 23,625,000 11 March 2019 8 June 2019 90 59,063
10 2075327 18.90.01.050018.01.19 PT. SORONG RAYA KONSTRUKSI 23,625,000 11 March 2019 8 June 2019 90 59,063
11 2075328 18.90.02.050019.01.19 CV. GASAM ENDO STAR 15,000,000 13 March 2019 10 June 2019 90 37,500
12 2075329 18.90.01.050020.01.19 CV. TIMERI MANDIRI 36,000,000 13 March 2019 10 June 2019 90 90,000
13 2075330 18.90.01.050021.01.19 CV. GUNUNG HOREB 18,000,000 13 March 2019 10 June 2019 90 45,000
14 2075331 18.90.01.050022.01.19 CV. ALFA MANDIRI 75,200,000 13 March 2019 10 June 2019 90 188,000
15 2075334 18.90.01.050023.01.19 CV. KARYA PAPUA 28,350,000 13 March 2019 10 June 2019 90 70,875
16 2075332 18.90.01.050024.01.19 CV. KARYA PAPUA 24,592,500 13 March 2019 10 June 2019 90 61,481
17 2075333 18.90.02.050025.01.19 CV. KARYA PAPUA 60,000,000 13 March 2019 10 June 2019 90 150,000
18 2075335 18.90.01.050026.01.19 CV. RAHA ASIAF MANDIRI 28,500,000 13 March 2019 10 June 2019 90 71,250
19 2075343 18.90.01.050027.01.20 CV. INTI PRATAMA 36,000,000 8 May 2019 6 June 2019 30 90,000
 2,657,641

JAMINAN PELAKSANAAN (SBB)

PERIODE
JMLH. SERVICE
NO. NO. REG NO. BOND NAMA TERTANGGUNG NILAI BOND
AWAL AKHIR HARI CHARGES

1 2075305 18.91.01.0500018.12.18 CV. TAKASIMA JAYA 97,077,800 30 November 2018 31 December 2018 32 291,233
2 2075336 18.91.01.0500019.03.19 CV. PUTRI DAI SULY 75,000,000 3 April 2019 1 August 2019 120 300,000
3 2075338 18.91.02.0500020.03.19 CV. LAMBANAN 29,887,000 5 March 2019 31 August 2019 180 179,322
4 2075341 18.91.02.0500021.04.19 CV. SEPADAN TEGUH ABADI - CV. MAND 236,384,550 15 April 2019 11 October 2019 180 1,418,307
5 2075342 18.91.02.0500022.04.19 CV. PUTRA PAPUA MEMBANGUN 47,297,400 25 April 2019 21 October 2019 180 283,784
6 2075345 18.91.01.0500023.05.19 CV. TOMMY JAYA 47,325,709 2 May 2019 14 October 2019 180 283,954
7 2075348 18.91.02.0500024.05.19 CV.PANCA PRIMA PAPUA 24,893,000 13 May 2019 25 June 2019 44 130,000

2,886,600

JAMINAN UANG MUKA (SBC)

PERIODE
JMLH. SERVICE
NO. NO. REG NO. BOND NAMA TERTANGGUNG NILAI BOND
AWAL AKHIR HARI CHARGES

1 2075304 18.92.02.050011.12.18 CV. PRIMA PAPUA CONSTRUKSI 132,412,800 12 November 2018 27 December 2018 46 397,238
2 2075337 18.92.01.0500012.03.19 CV. PUTRI DAI SULY 450,000,000 3 April 2019 1 August 2019 120 1,800,000
3 2075344 18.92.02.0500013.05.19 CV. YOBES PAPUA 49,050,000 22 March 2019 22 June 2019 90 147,150

2,344,388
JAMINAN PEMELIHARAAN (SBD)
PERIODE
JMLH. SERVICE
NO. NO. REG NO. BOND NAMA TERTANGGUNG NILAI BOND
AWAL AKHIR HARI CHARGES

1 2075306 18.93.01.050005.12.18 CV. TAKASIMA JAYA 97,077,800 11 December 2018 11 March 2019 90 291,233
2 2075307 18.93.01.050007.12.18 CV. WE WEWORU MULAWANA 18,600,000 19 November 2018 17 May 2019 180 130,000
3 2075303 18.93.01.050008.12.18 CV. BERKAH 62,800,000 23 November 2018 21 May 2018 180 376,800
4 2075308 18.93.01.050009.12.18 CV. PUTRA PAPUA MEMBANGUN 70,090,000 5 December 2018 3 April 2019 120 280,360
5 2075309 18.93.01.050010.12.18 CV. PAPUA MANDIRI 22,450,000 19 November 2018 17 May 2019 180 134,700
6 2075310 18.93.01.050011.12.18 CV. AMOT ISO 12,400,000 6 December 2018 5 March 2019 90 130,000
7 2075311 18.93.01.050012.12.18 CV. AMOT ISO 7,400,000 6 December 2018 5 March 2019 90 130,000
8 2075312 18.93.01.050013.12.18 CV. AMOT ISO 24,950,000 7 December 2018 6 March 2019 90 130,000
9 2075313 18.93.01.050014.12.18 CV. JANUAR JAYA KARYA 17,750,000 4 December 2018 3 March 2018 90 130,000
10 2075314 18.93.01.050015.12.18 CV. IRHAM 10,000,000 4 December 2018 3 March 2018 90 130,000
11 2075315 18.93.01.050016.12.18 CV. IRHAM 43,450,000 4 December 2018 3 March 2018 90 130,350
12 2075316 18.93.01.050017.12.18 CV. RAIS MANDIRI 7,500,000 4 December 2018 3 March 2018 90 130,000
13 2075339 18.93.01.050018.03.19 CV. SURYA MAKMUR RAYA 41,687,450 14 January 2019 12 June 2019 150 208,437
14 2075340 18.93.01.050019.04.19 CV. MAHARANI INDAH 44,100,000 14 December 2018 11 June 2019 180 264,600
15 2075349 18.93.02.050020.05.19 CV. YABES PAPUA 8,175,000 16 May 2019 13 August 2019 90 130,000
16 2075350 18.93.01.050021.05.19 CV. WE WEWORU MULAWANA 19,000,000 5 April 2018 9 May 2018 35 130,000

2,856,480

POLIS RUSAK / GANTI BLANKO

NO.
No. REGISTRASI KODE POLIS
BLANKO
1 2075317 20,000
2 2075346 20,000
3 2075347 20,000
4 2075301 20,000
5 2075302 20,000
 100,000

KETERANGAN :
JUMLAH BLANKO 50
SERVICE CHARGES 10,745,109
BIAYA ADD 900,000
BLANKO RUSAK 100,000
KOMISI 1,883,258
PEJAK KOMISI 5% 94,163
NETT ASURANSI (+PAJAK 5%) 9,956,014

SORONG, 27 Juni 2019

RAHADIAN DWIPUTRA
 TOTAL
SERVICE
BIAYA ADM KOMISI 10%
CHARGES
(SC)
20,000 1,106,051 108,605
20,000 140,313 12,031
20,000 140,313 12,031
20,000 140,313 12,031
20,000 99,473 7,947
20,000 99,473 7,947
20,000 99,473 7,947
20,000 70,000 5,000
20,000 79,063 5,906
20,000 79,063 5,906
20,000 57,500 3,750
20,000 110,000 9,000
20,000 65,000 4,500
20,000 208,000 18,800
20,000 90,875 7,088
20,000 81,481 6,148
20,000 170,000 15,000
20,000 91,250 7,125
20,000 110,000 9,000
 380,000 3,037,641 265,764

TOTAL
SERVICE
BIAYA ADM KOMISI 20%
CHARGES
(SC)
20,000 311,233 58,247
20,000 320,000 60,000
20,000 199,322 35,864
20,000 1,438,307 283,661
20,000 303,784 56,757
20,000 303,954 56,791
20,000 150,000 26,000

140,000 3,026,600 577,320

TOTAL
SERVICE
BIAYA ADM KOMISI 20%
CHARGES
(SC)
20,000 417,238 79,448
20,000 1,820,000 360,000
20,000 167,150 29,430

60,000 2,404,388 468,878

 TOTAL
SERVICE
BIAYA ADM KOMISI 20%
CHARGES
(SC)
20,000 311,233 58,247
20,000 150,000 26,000
20,000 396,800 75,360
20,000 300,360 56,072
20,000 154,700 26,940
20,000 150,000 26,000
20,000 150,000 26,000
20,000 150,000 26,000
20,000 150,000 26,000
20,000 150,000 26,000
20,000 150,350 26,070
20,000 150,000 26,000
20,000 228,437 41,687
20,000 284,600 52,920
20,000 150,000 26,000
20,000 150,000 26,000

320,000 3,176,480 571,296