The USAID Jalin Project

LETTER OF ENGAGEMENT
SURAT KONFIRMASI PERSETUJUAN
No.: LoE/22/Jalin/VI/2020

Date: 26June 2020

To: Dr. Djatmiko

We are writing to advise you that USAID Jalin Bersama ini kami menginformasikan USAID Jalin
has agreed to pay fees and cover costs telah menyetujui untuk membayar honor dan
associated with your involvement in biaya-biaya terkait dengan keterlibatan
“Strenghtening Health Facilities on
Andadalam kegiatan “Penguatan Pelayanan
Delivering MNH Service in Grobogan
District”, on 26 June 2020 Kesehatan Ibu dan Bayi pada Fasilitas
Kesehatan di Kabupaten Grobogan” pada
tanggal 26 Juni 2020

Purpose Tujuan
To undertake the tasks of Resource Person on Untuk melakukan tugas sebagai Narasumber pada
June 26, 2020. tanggal 26 Juni 2020

Scope of the Services Lingkup Layanan

Deliver the presentation on the topics related to Menyampaikan paparan tentang topik yang sesuai
the activity. dengan tema kegiatan.

Fees Honor
Based on your role, USAID Jalin shall provide Sesuai dengan kapasitas Anda, USAID Jalin
a fee of IDR 900.000/day for maximum memberikan honor sebesar Rp 900.000/hari
involvement of 1 day. All sums payable is untuk durasi keterlibatan maksimum 1 hari.
subject to any applicable taxes under Republic Seluruh jumlah yang diterima akan dipotong
of Indonesia tax regulations. pajak-pajak sesuai peraturan perpajakan
Republik Indonesia.

Outputs Hasil-hasil
The audiens understand about the presentation Peserta paham dengan presentasi yang telah
delivered disampaikan

Fee will be transferred to your bank account Honor akan dibayarkan melalui transfer ke
after your working finished. Please provide rekening bank Anda setelah pekerjaan berakhir.
bank account to USAID Jalin Mohon untuk menginformasikan rekening bank
Anda kepada USAID Jalin

Please sign and return a copy of this letter as an Mohon untuk menandatangani dan
acknowledgement of your acceptance of these mengembalikan salinan surat ini sebagai
terms and conditions. konfirmasi persetujuan atas syarat-syarat dan
ketentuan diatas.

World Trade Center 5, 16th Floor

Jl. Jend. Sudirman Kav. 29, Jakarta Selatan 12920
Phone: +62 21- 526-1068 Fax: +62 21- 526-1069
 USAID Jalin

Yours sincerely/Hormat Kami, Accepted by/Diterima oleh,

Hartanto Hardjono dr. Djatmiko

Regional Manager Resource Person

World Trade Center 5, 16th Floor

Jl. Jend. Sudirman Kav. 29, Jakarta Selatan 12920
Phone: +62 21- 299 27823 Fax: +62 21- 29930999
 USAID Jalin

INVOICE

To: From:
Flagship MNH Activity (Jalin)
Attn. Ageng Wahyudi dr. Djatmiko
Jl. Pandean Lamper I No.9
Semarang Selatan, Jawa Tengah

Unit Unit Rate Sub Total

Date(s) Description
Qty IDR IDR
26 June 2020 Honorarium Resource person 1 900.000 900.000
26 June 2020 WHT art 21 (2,5%) 1 -22.500 -22.500

Total 877.500

WHT is 2.5% if NPWP and ID Card are available

WHT is 3% if NPWP and ID Card are not available

Please Pay: CASH ELECTRONIC TRANSFER

Account Name : Djatmiko .dr

Account No : 3017030891

Bank Name : Bank Jateng

Required Approvals Signature Date

26Juni
dr. Djatmiko 2020
(Resource Person)

Hartanto Hardjono
(Regional Manager of Usaid Jalin-Central Java)

* Any outputs must be provided to and approved by USAID JalinCOP/DCOP/RM/PM/Technical

Leadbefore invoice can be paid. Signature of USAID JalinCOP/DCOP/RM/PM/Technical Leadis
proof of acceptance and authorization for payment.

World Trade Center 5, 16th Floor

Jl. Jend. Sudirman Kav. 29, Jakarta Selatan 12920
Phone: +62 21- 299 27823 Fax: +62 21- 29930999
 USAID Jalin

* Tagihan akan dibayarkan setelah hasil yang harus diberikan kepada USAID Jalin telah disetujui
oleh USAID JalinCOP/DCOP/RM/PM/Technical Lead. Tanda tangan USAID
JalinCOP/DCOP/RM/PM/Technical Leadadalah bukti penerimaan dan otorisasi pembayaran.

World Trade Center 5, 16th Floor

Jl. Jend. Sudirman Kav. 29, Jakarta Selatan 12920
Phone: +62 21- 299 27823 Fax: +62 21- 29930999