RENCANA PENGADAAN

UPTD PUSKESMAS LAKAWALI

No Uraian Rincian Satuan Harga Jumlah Jenis Pengadaan

TRIWULAN I Rp 32,643,550
1 AC Split 1 PK 1 Unit Rp6,651,150 Rp 6,651,150 Non Ecatalog
2 Mesin Cuci 1 Unit Rp4,492,400 Rp 4,492,400 Non Ecatalog
3 Instalasi Jaringan Internet 1 Paket Rp6,000,000 Rp 6,000,000 Non Ecatalog
4 Sampiran Roda 2 Unit Rp 900,000 Rp 1,800,000 Non Ecatalog
5 Stetoscope Dewasa 3 Unit Rp1,500,000 Rp 4,500,000 Non Ecatalog
6 Tabung Oksigen Besar 2 Unit Rp3,000,000 Rp 6,000,000 Non Ecatalog
7 Longspinboard 1 Unit Rp1,700,000 Rp 1,700,000 Non Ecatalog
8 Regulator Oksigen 3 Unit Rp 500,000 Rp 1,500,000 Non Ecatalog
TRIWULAN II Rp 25,811,000
Lemari Es 1 Unit Rp3,811,000 Rp 3,811,000 Non Ecatalog
Tangga Aluminium 1 Unit Rp1,000,000 Rp 1,000,000 Non Ecatalog
Meja Kerja 4 Unit Rp1,500,000 Rp 6,000,000 Non Ecatalog
Kursi Kerja 6 Unit Rp1,000,000 Rp 6,000,000 Non Ecatalog
TRIWULAN III Rp 57,170,200
1 Bed Side Cabinet 6 Unit Rp1,500,000 Rp 9,000,000 Ecatalog
2 Doopler 1 Unit Rp1,000,000 Rp 1,000,000 Ecatalog
3 Nebulizer 2 Unit Rp3,500,000 Rp 7,000,000 Ecatalog
5 Tensimeter 4 Unit Rp1,600,000 Rp 6,400,000 Ecatalog
6 Tensimenter Roda Berdiri 1 Unit Rp3,000,000 Rp 3,000,000 Ecatalog
7 Timbangan Dewasa 4 Unit Rp 890,000 Rp 3,560,000 Ecatalog
8 Set Tang Cabut Gigi 2 Unit Rp1,800,000 Rp 3,600,000 Ecatalog
9 Laptop 2 Unit Rp8,500,000 Rp 17,000,000 Ecatalog
10 Printer 2 Unit Rp3,305,100 Rp 6,610,200 Ecatalog
TRIWULAN IV Rp 14,000,000
1 AC Split 2 PK 2 Unit Rp7,000,000 Rp 14,000,000 Non Ecatalog

JUMLAH Rp120,624,750

JKN Rp 111,624,750
APBD Rp 9,000,000
 Sumber
Keterangan
Anggaran

JKN 2021
JKN 2021 Emergency
JKN 2021 Emergency
JKN 2021 Emergency
JKN 2021 Emergency
JKN 2021 Emergency
JKN 2021 Emergency
JKN 2021 Emergency

JKN 2021
JKN 2021
JKN 2021
JKN 2021

APBD
JKN 2021
JKN 2021
JKN 2021
JKN 2021
JKN 2021
JKN 2021
JKN 2021
JKN 2021

JKN 2021
 RENCANA PENGADAAN KOMPUTER UNIT
UPTD PUSKESMAS LAKAWALI

No Uraian Rincian Satuan Harga Jumlah Jenis Pengadaan

TRIWULAN I Rp 6,000,000
3 Instalasi Jaringan Internet 1 Paket Rp6,000,000 Rp 6,000,000 Non Ecatalog
TRIWULAN III Rp 23,610,200
9 Laptop 2 Unit Rp8,500,000 Rp 17,000,000 Ecatalog
10 Printer 2 Unit Rp3,305,100 Rp 6,610,200 Ecatalog

JUMLAH Rp 29,610,200

JKN Rp 29,610,200
APBD Rp -
 Sumber
Keterangan
Anggaran

JKN 2021 Kebutuhan Mendesak

JKN 2021
JKN 2021
 RENCANA PENGADAAN BELANJA MODAL ALAT KANTOR DAN RUMAH TANGGA
UPTD PUSKESMAS LAKAWALI

No Uraian Rincian Satuan Harga Jumlah Jenis Pengadaan

TRIWULAN I Rp 11,143,550
1 AC Split 1 PK 1 Unit Rp6,651,150 Rp 6,651,150 Non Ecatalog
2 Mesin Cuci 1 Unit Rp4,492,400 Rp 4,492,400 Non Ecatalog
TRIWULAN II Rp 16,811,000
Lemari Es 1 Unit Rp3,811,000 Rp 3,811,000 Non Ecatalog
Tangga Aluminium 1 Unit Rp1,000,000 Rp 1,000,000 Non Ecatalog
Meja Kerja 4 Unit Rp1,500,000 Rp 6,000,000 Non Ecatalog
Kursi Kerja 6 Unit Rp1,000,000 Rp 6,000,000 Non Ecatalog
TRIWULAN IV Rp 14,000,000
1 AC Split 2 PK 2 Unit Rp7,000,000 Rp 14,000,000 Non Ecatalog

JUMLAH Rp 41,954,550

JKN Rp 41,954,550
APBD Rp -
UMAH TANGGA

Sumber
Keterangan
Anggaran

JKN 2021
JKN 2021 Kebutuhan Mendesak

JKN 2021
JKN 2021
JKN 2021
JKN 2021

JKN 2021
 RENCANA PENGADAAN
UPTD PUSKESMAS LAKAWALI

No Uraian Rincian Satuan Harga Jumlah Jenis Pengadaan

TRIWULAN I Rp 15,500,000
1 Sampiran Roda 2 Unit Rp 900,000 Rp 1,800,000 Non Ecatalog
2 Stetoscope Dewasa 3 Unit Rp1,500,000 Rp 4,500,000 Non Ecatalog
3 Tabung Oksigen Besar 2 Unit Rp3,000,000 Rp 6,000,000 Non Ecatalog
4 Longspinboard 1 Unit Rp1,700,000 Rp 1,700,000 Non Ecatalog
5 Regulator Oksigen 3 Unit Rp 500,000 Rp 1,500,000 Non Ecatalog
TRIWULAN III Rp 33,560,000
1 Bed Side Cabinet 6 Unit Rp1,500,000 Rp 9,000,000 Ecatalog
2 Doopler 1 Unit Rp1,000,000 Rp 1,000,000 Ecatalog
3 Nebulizer 2 Unit Rp3,500,000 Rp 7,000,000 Ecatalog
4 Tensimeter 4 Unit Rp1,600,000 Rp 6,400,000 Ecatalog
5 Tensimenter Roda Berdiri 1 Unit Rp3,000,000 Rp 3,000,000 Ecatalog
6 Timbangan Dewasa 4 Unit Rp 890,000 Rp 3,560,000 Ecatalog
7 Set Tang Cabut Gigi 2 Unit Rp1,800,000 Rp 3,600,000 Ecatalog

JUMLAH Rp 49,060,000

JKN Rp 40,060,000
APBD Rp 9,000,000
 Sumber
Keterangan
Anggaran

JKN 2021 Emergency

JKN 2021 Emergency
JKN 2021 Emergency
JKN 2021 Emergency
JKN 2021 Emergency

APBD
JKN 2021
JKN 2021
JKN 2021
JKN 2021
JKN 2021
JKN 2021
 Non Ecatalog
UPTD Puskesmas Lakawali
No Nama Barang Qty Nama LKPP Harga Jumlah PPN 10% HPS Total
1 AC Split 1 PK 1 Unit Non Ecatalog Rp 6,651,150 Rp 6,651,150 10.0% Rp 665,115 Rp 5,986,035 Rp 5,986,035
2 Mesin Cuci 1 Unit Non Ecatalog Rp 4,492,400 Rp 4,492,400 10.0% Rp 449,240 Rp 4,043,160 Rp 4,043,160
3 Instalasi Jaringan Internet 1 Unit Non Ecatalog Rp 6,000,000 Rp 6,000,000 10.0% Rp 600,000 Rp 5,400,000 Rp 5,400,000

Jumlah Rp 17,143,550 Rp 1,714,355 Rp 15,429,195

PPN 10%
Total Rp 15,429,195

PPK,

Mahfud Burhami, S.Kep.,Ns

NIP. 19870419 201404 1 001
 Non Ecatalog
UPTD Puskesmas Lakawali
No Nama Barang Qty Nama LKPP Harga Jumlah PPN 10% HPS Total
1 Sampiran Roda 2 Unit Non Ecatalog Rp 900,000 Rp 1,800,000 10.0% Rp 90,000 Rp 810,000 Rp 1,620,000
2 Stetoscope Dewasa 3 Unit Non Ecatalog Rp 1,500,000 Rp 4,500,000 10.0% Rp 150,000 Rp 1,350,000 Rp 4,050,000
3 Tabung Oksigen Besar 2 Unit Non Ecatalog Rp 3,000,000 Rp 6,000,000 10.0% Rp 300,000 Rp 2,700,000 Rp 5,400,000
4 Longspinboard 1 Unit Non Ecatalog Rp 1,700,000 Rp 1,700,000 10.0% Rp 170,000 Rp 1,530,000 Rp 1,530,000

Jumlah Rp 14,000,000 Rp 12,600,000

PPN 10%
Total Rp 12,600,000

PPK,

Mahfud Burhami, S.Kep.,Ns

NIP. 19870419 201404 1 001
Rp 180,000
Rp 450,000
Rp 600,000
Rp 170,000

Rp 1,400,000
Non Ecatalog
UPTD Puskesmas Lakawali
No Nama Barang Qty Nama LKPP Harga Jumlah PPN 10% HPS Total
1 Lemari Es 1 Unit Non Ecatalog Rp 3,811,000 Rp 3,811,000 10.0% Rp 381,100 Rp 3,429,900 Rp 3,429,900
2 Tangga Aluminium 1 Unit Non Ecatalog Rp 1,000,000 Rp 1,000,000 10.0% Rp 100,000 Rp 900,000 Rp 900,000
3 Meja Kerja 4 Unit Non Ecatalog Rp 1,500,000 Rp 6,000,000 10.0% Rp 150,000 Rp 1,350,000 Rp 5,400,000
4 Kursi Kerja 6 Unit Non Ecatalog Rp 1,000,000 Rp 6,000,000 10.0% Rp 100,000 Rp 900,000 Rp 5,400,000

Jumlah Rp 16,811,000 Rp 731,100 Rp 15,129,900

PPN 10%
Total Rp 15,129,900

PPK,

Mahfud Burhami, S.Kep.,Ns

NIP. 19870419 201404 1 001
Rp 381,100
Rp 100,000
Rp 600,000
Rp 600,000

Rp 1,681,100
Ecatalog
UPTD Puskesmas Lakawali
No Nama Barang Qty Nama LKPP Harga Jumlah PPN 10% HPS Total
1 Bed Side Cabinet 6 Unit Ecatalog Rp 1,500,000 Rp 9,000,000 10.0% Rp 150,000 Rp 1,350,000 Rp 8,100,000
2 Doopler 1 Unit Ecatalog Rp 1,000,000 Rp 1,000,000 10.0% Rp 100,000 Rp 900,000 Rp 900,000
3 Nebulizer 2 Unit Ecatalog Rp 3,500,000 Rp 7,000,000 10.0% Rp 350,000 Rp 3,150,000 Rp 6,300,000
4 Regulator Oksigen 3 Unit Ecatalog Rp 500,000 Rp 1,500,000 10.0% Rp 50,000 Rp 450,000 Rp 1,350,000
5 Tensimeter 4 Unit Ecatalog Rp 1,600,000 Rp 6,400,000 10.0% Rp 160,000 Rp 1,440,000 Rp 5,760,000
6 Tensimenter Roda Berdiri 1 Unit Ecatalog Rp 3,000,000 Rp 3,000,000 10.0% Rp 300,000 Rp 2,700,000 Rp 2,700,000
7 Timbangan Dewasa 4 Unit Ecatalog Rp 890,000 Rp 3,560,000 10.0% Rp 89,000 Rp 801,000 Rp 3,204,000
8 Set Tang Cabut Gigi 2 Unit Ecatalog Rp 1,800,000 Rp 3,600,000 10.0% Rp 180,000 Rp 1,620,000 Rp 3,240,000

Jumlah Rp 35,060,000 Rp 31,554,000

PPN 10%
Total Rp 31,554,000

PPK,

Mahfud Burhami, S.Kep.,Ns

NIP. 19870419 201404 1 001
Rp 900,000
Rp 100,000
Rp 700,000
Rp 150,000
Rp 640,000
Rp 300,000
Rp 356,000
Rp 360,000

Rp 3,506,000
Ecatalog
UPTD Puskesmas Lakawali
No Nama Barang Qty Nama LKPP Harga Jumlah PPN 10% HPS Total
1 Laptop 2 Unit Ecatalog Rp 8,500,000 Rp 17,000,000 10.0% Rp 850,000 Rp 7,650,000 Rp 15,300,000
2 Printer 2 Unit Ecatalog Rp 3,305,100 Rp 6,610,200 10.0% Rp 330,510 Rp 2,974,590 Rp 5,949,180

Jumlah Rp 23,610,200 Rp 21,249,180

PPN 10%
Total Rp 21,249,180

PPK,

Mahfud Burhami, S.Kep.,Ns

NIP. 19870419 201404 1 001
Rp 1,700,000
Rp 661,020

Rp 2,361,020
Non Ecatalog
UPTD Puskesmas Lakawali
No Nama Barang Qty Nama LKPP Harga Jumlah PPN 10% HPS Total
1 AC Split 2 PK 2 Unit Non Ecatalog Rp 7,000,000 Rp 14,000,000 10.0% Rp 700,000 Rp 6,300,000 Rp 12,600,000

Jumlah Rp 14,000,000 Rp 12,600,000

PPN 10%
Total Rp 12,600,000

PPK,

Mahfud Burhami, S.Kep.,Ns

NIP. 19870419 201404 1 001
Rp 1,400,000

Rp 1,400,000