PURCHASE ORDER

PO# : 20XII0003
PO Date : 10-Dec-20

To : PT. FORTUNA SEMBADA MAKMUR MEDIKA
Kompleks Agung Sedayu Blok K No. 28
Jl. Auto Ringroad Lingkar Luar Barat
Cengkareng - Jakarta Barat 11730
Attn : Devia
Phone: (021) 2295 6888
Ship To : PT. KREASI SATU ALGORITMA
Epiwalk - Komplek Rasuna Epicentrum
Jl. HR Rasuna Said Lt.5 Blok B547-548
Jakarta 12960
Attn : Bambang Trianto H
Phone : (021) 2994 1392

FOB Shipped Via Payment Term

- DP 30%
- Pelunasan dengan 2 tahap
pembayaran Giro

Item No. Description Qty Unit Price Total

1 ORICARE V7600 Emergency 30 Rp 330,800,000 Rp 9,924,000,000
Transport Ventilator

2 Ventilator AEON VG70 6 Rp 485,000,000 Rp 2,910,000,000

Remarks : Sub Total Rp 12,834,000,000

Harga sudah termasuk PPN
Tax Rp -
Freight Rp -
Total Rp 12,834,000,000

Authorization

Authorized By Hirfansyah Anwar

Date 10-December-2020
 PURCHASE ORDER
PO# : 21/I/0003
PO Date : 28-Jan-21

To : PT. CATRA WIDJAJA USAHA Ship To : PT. MARNAH TIGA MANDIRI

Jl. Bendungan Jago Raya No.K40D Gedung Ganecca Lantai 4
RT012/RW002, Kel. Serdang, Kec. Kemayoran Jl. Pasar Minggu No.234, Kel. Duren Tiga
Kota Jakarta Pusat Kec. Pancoran Jakarta Selatan 12760
Attn : Suhendri Attn : Bambang Trianto H
Phone: (021) 4249 9508 Phone -

FOB Shipped Via Payment Term

Item No. Description Qty Unit Unit Price Total

1 PANBIO COVID-19 Ag Rapid Test 520 Box Rp 3,200,000 Rp 1,664,000,000
(Device) per Box isi 25 Pcs

Remarks : Sub Total Rp 1,664,000,000

Harga sudah termasuk PPN
Tax Rp -
Freight Rp -
Total Rp 1,664,000,000

Authorization

Authorized By
Date 28-January-2021
 PURCHASE ORDER
PO# : 21/I/0001
PO Date : 4-Feb-21

To : PT. INDO MEDIKA LESTARI From : PT. AAYU WARAS SENTOSA

Jl. Milenium 16, Blok J7 No.5 Ruko Two Much
Kawasan Industri Milenium Jl. Raya Tengah No. 18A, Gedong
Cikupa Tangerang Indonesia Kec. Pasarrebo, Jakarta Timur 13760
Attn : Yoyok Setiawan Attn : Bambang Trianto H
Phone : (021) 2969 8047 Phone -

FOB Shipped Via Payment Term

Item No. Description Qty Unit Ket

1 ANHUI Rapid Test Antigen 2,000 BOX Pemesanan Kemenhub
(Device) per Box isi 25 Pcs
Alamat Pengiriman :

Jl. Medan Merdeka Barat No.8,

RT.2/RW.3, Gambir, Kecamatan
Gambir, Kota Jakarta Pusat,
Daerah Khusus Ibukota Jakarta
10110

Authorization

Authorized By Dewi Lestari

Date 04-February-2021