Lampiran Addendum 1

Perjanjian Penggunaan Jasa Perawatan Kebersihan

Antara PT.Aqua Golden Mississippi Tbk Dan PT.ISS Facility Services

PERINCIAN PENAGIHAN CLEANING SERVICE AQUA GOLDEN MISISIPI proposal 15 Mei 2010 s/d 14 Mei 2011

Komponen Plant Bekasi Total

Quantity Requirement / month
No. Item Description *Subject to changed upon User's request TOTAL
BIAYA TENAGA KERJA 14,562,399 14,562,399 Plant Bekasi

BIAYA MACHINERY 170,833 170,833 1 CHIEF SUPERVISOR -

BIAYA EQUIPMENT + GARDENING 1,041,201 1,041,201 2 SUPERVISOR 1

BIAYA CHEMICAL 805,500 805,500 3 LEADER -

SUB TOTAL 16,579,933 16,579,933 4 CLEANER DAN LDR 9

JASA PERUSAHAAN 10% 1,657,993 1,657,993 5 GARDENER -

TOTAL SETELAH JASA PERUSAHAAN 18,237,926 18,237,926 10 10

PPN 10% 1,823,793 1,823,793 Note : Jumlah Tenaga kerja untuk Cleaning Service & Laundry
SETELAH PPN 10% 20,061,719 20,061,719
PPh Pasal 23 : 2% 364,759 364,759
TOTAL 19,696,960 19,696,960

PERINCIAN PENAGIHAN ROMPI & SAFETY SHOES AQUA GOLDEN MISISIPI proposal 15 Mei 2010 s/d 14 Mei 2011

Komponen Plant Bekasi Total

Quantity Requirement / month
No. Item Description *Subject to changed upon User's request TOTAL
BIAYA ROMPI 35,000 35,000 Plant Bekasi

BIAYA SAFETY SHOES 125,000 125,000 1 ROMPI 6 6

SUBTOTAL 160,000 160,000 2 SAFETY SHOES 6 6
PPN 10% 16,000 16,000 12 12

SETELAH PPN 10% 176,000 176,000

PPh Pasal 23 : 2% 3,200 3,200

TOTAL 172,800 172,800

Page 2 of 15
 Lampiran Addendum 1
Perjanjian Penggunaan Jasa Perawatan Kebersihan
Antara PT.Tirta Investama Dan PT.ISS Facility Services

PERINCIAN PENAGIHAN CLEANING SERVICE PT. TIRTA INVESTAMA Untuk proposal 15 Mei 2010 s/d 14 Mei 2011

Depo Depo Rawa Depo Pulo Depo Depo Depo Depo Nusa
Komponen Depo Meruya Depo Ciputat Depo Karawang Depo Bandung Depo Solo Depo Rungkut Depo Manado Total Depo
Kembangan Domba Kambing Semarang Yogyakarta Denpasar Dua

MP 4 2 4 1 3 2 2 2 3 1 2 3 2 2 33

BIAYA TENAGA KERJA 5,301,814 2,650,907 5,301,814 1,325,454 3,976,361 2,650,907 2,650,907 2,238,881 2,685,470 897,822 2,450,945 3,913,920 2,609,280 2,159,700 40,814,183

BIAYA MACHINERY 41,667 - - - - - - - - - - - - - 41,667

BIAYA EQUIPMENT + GARDENING 578,845 425,886 554,595 523,136 425,845 425,845 429,595 450,428 1,674,060 429,386 492,720 427,261 588,000 1,047,650 8,473,251

BIAYA CHEMICAL 244,000 244,000 244,000 244,000 244,000 244,000 244,000 244,000 244,000 244,000 244,000 244,000 244,000 244,000 3,415,999

SUB TOTAL 6,166,326 3,320,793 6,100,409 2,092,589 4,646,206 3,320,752 3,324,502 2,933,309 4,603,530 1,571,207 3,187,665 4,585,181 3,441,280 3,451,350 52,745,099

JASA PERUSAHAAN 10% 616,633 332,079 610,041 209,259 464,621 332,075 332,450 293,331 460,353 157,121 318,766 458,518 344,128 345,135 5,274,510

TOTAL SETELAH JASA PERUSAHAAN 6,782,959 3,652,872 6,710,450 2,301,848 5,110,826 3,652,827 3,656,952 3,226,640 5,063,883 1,728,328 3,506,431 5,043,699 3,785,408 3,796,485 58,019,609

PPN 10% 678,296 365,287 671,045 230,185 511,083 365,283 365,695 322,664 506,388 172,833 350,643 504,370 378,541 379,648 5,801,961

SETELAH PPN 10% 7,461,255 4,018,159 7,381,495 2,532,033 5,621,909 4,018,110 4,022,647 3,549,304 5,570,271 1,901,161 3,857,074 5,548,069 4,163,949 4,176,133 63,821,570

PPh Pasal 23 : 2% (135,659) (73,057) (134,209) (46,037) (102,217) (73,057) (73,139) (64,533) (101,278) (34,567) (70,129) (100,874) (75,708) (75,930) (1,160,392)

TOTAL 7,325,595 3,945,102 7,247,286 2,485,996 5,519,692 3,945,053 3,949,508 3,484,771 5,468,994 1,866,594 3,786,946 5,447,195 4,088,241 4,100,203 62,661,177

Plant
Komponen Plant Subang Plant Pandaan Plant Mambal Plant Manado Total Plant Total Seluruh
Winongan

MP 26 59 29 23 19 156 189

BIAYA TENAGA KERJA 30,159,144 72,450,265 35,622,149 31,456,687 21,392,585 191,080,828 231,895,011

BIAYA MACHINERY 562,500 708,333 604,167 708,333 562,500 3,145,833 3,187,500

BIAYA EQUIPMENT + GARDENING 4,726,984 3,476,605 4,264,578 2,327,451 1,191,130 15,986,747 24,459,998

BIAYA CHEMICAL 954,950 954,950 954,950 954,950 954,950 4,774,750 8,190,749

SUB TOTAL 36,403,577 77,590,153 41,445,843 35,447,421 24,101,165 214,988,159 267,733,257

JASA PERUSAHAAN 10% 3,640,358 7,759,015 4,144,584 3,544,742 2,410,116 21,498,816 26,773,326

TOTAL SETELAH JASA PERUSAHAAN 40,043,935 85,349,168 45,590,427 38,992,163 26,511,281 236,486,974 294,506,583

PPN 10% 4,004,394 8,534,917 4,559,043 3,899,216 2,651,128 23,648,697 29,450,658

SETELAH PPN 10% 44,048,329 93,884,085 50,149,470 42,891,379 29,162,409 260,135,672 323,957,241

PPh Pasal 23 : 2% (800,879) (1,706,983) (911,809) (779,843) (530,226) (4,729,739) (5,890,132)

TOTAL 43,247,450 92,177,101 49,237,661 42,111,536 28,632,183 255,405,932 318,067,110

Page 5 of 59
 Lampiran Addendum 1
Perjanjian Penggunaan Jasa Perawatan Kebersihan
Antara PT.Tirta Investama Dan PT.ISS Facility Services

MANPOWER SUMMARY CLEANING SERVICE

Depo Depo Rawa Depo Pulo Depo Depo Depo Depo Nusa
No. Item Description Kembangan
Depo Meruya Depo Ciputat
Domba Kambing
Depo Karawang Depo Bandung
Semarang Yogyakarta
Depo Solo Depo Rungkut
Denpasar Dua
Depo Manado Total Depo

1 CHIEF SUPERVISOR - - - - - - - - - - - - - - -

2 SUPERVISOR - - - - - - - - - - - - - - -

3 LEADER - - - - - - - - - - - - - - -

4 CLEANER 4 2 4 1 3 2 2 2 3 1 2 3 2 2 33

5 GARDENER - - - - - - - - - - - - - - -

4 2 4 1 3 2 2 2 3 1 2 3 2 2 33

Plant
No. Item Description Plant Subang Plant Pandaan
Winongan
Plant Mambal Plant Manado Total Plant Total Seluruh

1 CHIEF SUPERVISOR - - - - - - -

2 SUPERVISOR 1 1 1 1 1 5 5

3 LEADER 1 3 1 1 1 7 7

4 CLEANER 22 48 24 20 16 130 163

5 GARDENER 2 7 3 1 1 14 14

26 59 29 23 19 156 189

Catatan : ada tambahan MP di winongan 6 Tenaker

Page 5 of 59
 Lampiran Addendum 1
Perjanjian Penggunaan Jasa Perawatan Kebersihan
Antara PT.Tirta Investama Dan PT.ISS Facility Services

PERINCIAN PENAGIHAN ROMPI & SAFETY SHOES PT. TIRTA INVESTAMA Untuk proposal 15 Mei 2010 s/d 14 Mei 2011

Depo Depo Rawa Depo Pulo Depo Depo Depo Depo Nusa
Komponen Depo Meruya Depo Ciputat Depo Karawang Depo Bandung Depo Solo Depo Rungkut Depo Manado Total Depo
Kembangan Domba Kambing Semarang Yogyakarta Denpasar Dua

BIAYA ROMPI 23,333 11,667 23,333 5,833 17,500 11,667 11,667 11,667 17,500 5,833 17,500 17,500 11,667 11,667 198,333

BIAYA SAFETY SHOES 23,333 11,667 23,333 5,833 17,500 11,667 11,667 11,667 17,500 5,833 29,167 17,500 11,667 11,667 210,000

SUB TOTAL 46,667 23,333 46,667 11,667 35,000 23,333 23,333 23,333 35,000 11,667 46,667 35,000 23,333 23,333 408,333

PPN 10% 4,667 2,333 4,667 1,167 3,500 2,333 2,333 2,333 3,500 1,167 4,667 3,500 2,333 2,333 40,833

SETELAH PPN 10% 51,333 25,667 51,333 12,833 38,500 25,667 25,667 25,667 38,500 12,833 51,333 38,500 25,667 25,667 449,167

PPh Pasal 23 : 2% (933) (467) (933) (233) (700) (467) (467) (467) (700) (233) (933) (700) (467) (467) (8,167)

TOTAL 50,400 25,200 50,400 12,600 37,800 25,200 25,200 25,200 37,800 12,600 50,400 37,800 25,200 25,200 441,000

Plant
Komponen Plant Subang Plant Pandaan Plant Mambal Plant Manado Total Plant Total Seluruh
Winongan

BIAYA ROMPI 99,167 297,500 93,333 70,000 134,167 694,167 892,500

BIAYA SAFETY SHOES 187,500 770,833 375,000 270,833 270,833 1,875,000 2,085,000

SUB TOTAL 286,667 1,068,333 468,333 340,833 405,000 2,569,167 2,977,500

PPN 10% 28,667 106,833 46,833 34,083 40,500 256,917 297,750

SETELAH PPN 10% 315,333 1,175,167 515,167 374,917 445,500 2,826,083 3,275,250

PPh Pasal 23 : 2% (5,733) (21,367) (9,367) (6,817) (8,100) (51,383) (59,550)

TOTAL 309,600 1,153,800 505,800 368,100 437,400 2,774,700 3,215,700

ROMPI & SAFETY SHOES SUMMARY CLEANING SERVICE

Depo Depo Rawa Depo Pulo Depo Depo Depo Depo Nusa
No. Item Description Kembangan
Depo Meruya Depo Ciputat
Domba Kambing
Depo Karawang Depo Bandung
Semarang Yogyakarta
Depo Solo Depo Rungkut
Denpasar Dua
Depo Manado Total Depo

1 ROMPI (Pcs) 4 2 4 1 3 2 2 2 3 1 3 3 2 2 34

2 SAFETY SHOES (Psg) 4 2 4 1 3 2 2 2 3 1 5 3 2 2 36

8 4 8 2 6 4 4 4 6 2 8 6 4 4 70

Plant
No. Item Description Plant Subang Plant Pandaan
Winongan
Plant Mambal Plant Manado Total Plant Total Seluruh

1 ROMPI (Pcs) 17 51 16 12 23 119 153

2 SAFETY SHOES (Psg) 9 37 18 13 13 90 126

26 88 34 25 36 209 279

Page 5 of 59
 Lampiran Addendum 1
Perjanjian Penggunaan Jasa Perawatan Kebersihan
Antara PT.Tirta Investama Dan PT.ISS Facility Services

PERINCIAN PENAGIHAN LAUNDRY PT. TIRTA INVESTAMA Untuk proposal 15 Mei 2010 s/d 14 Mei 2011

Plant
Komponen Plant Subang Plant Pandaan Plant Manado Total
Winongan

BIAYA TENAGA KERJA 1,121,341 4,779,381 2,389,691 3,239,550 11,529,962

SUB TOTAL 1,121,341 4,779,381 2,389,691 3,239,550 11,529,962

JASA PERUSAHAAN 10% 112,134 477,938 238,969 323,955 1,152,996

TOTAL SETELAH JASA PERUSAHAAN 1,233,475 5,257,319 2,628,660 3,563,505 12,682,959

PPN 10% 123,347 525,732 262,866 356,350 1,268,296

SETELAH PPN 10% 1,356,822 5,783,051 2,891,526 3,919,855 13,951,254

PPh Pasal 23 : 2% (24,669) (105,146) (52,573) (71,270) (253,659)

TOTAL 1,332,153 5,677,905 2,838,953 3,848,585 13,697,595

MANPOWER SUMMARY LAUNDRY

Plant
No. Item Description Plant Subang Plant Pandaan
Winongan
Plant Manado Total

1 LAUNDRY 1 4 2 3 10

1 4 2 3 10

Page 5 of 59
 Lampiran Addendum 1
Perjanjian Penggunaan Jasa Perawatan Kebersihan
Antara PT.Tirta Investama Dan PT.ISS Facility Services

PERINCIAN PENAGIHAN TENAGA REPACKING PT. TIRTA INVESTAMA Untuk proposal 15 Mei 2010 s/d 14 Mei 2011
Komponen Depo Rungkut Total
BIAYA TENAGA KERJA 3,047,014 3,047,014

BIAYA EQUIPMENT 231,667 231,667

Quantity Requirement
No. Item Description *Subject to changed upon User's request TOTAL
SUB TOTAL 3,278,681 3,278,681 Depo Rungkut
JASA PERUSAHAAN 10% 327,868 327,868 1 Repacking 2 2
TOTAL SETELAH JASA PERUSAHAAN 3,606,549 3,606,549
PPN 10% 360,655 360,655
SETELAH PPN 10% 3,967,204 3,967,204
PPh Pasal 23 : 2% (72,131) (72,131)
TOTAL 3,895,073 3,895,073

PERINCIAN PENAGIHAN TENAGA TEKNISI PT. TIRTA INVESTAMA Untuk proposal 15 Mei 2010 s/d 14 Mei 2011
Komponen Depo Rungkut Total
BIAYA TENAGA KERJA 2,119,576 2,119,576

BIAYA EQUIPMENT 197,917 197,917

Quantity Requirement
No. Item Description *Subject to changed upon User's request TOTAL
SUB TOTAL 2,317,493 2,317,493 Depo Rungkut
JASA PERUSAHAAN 10% 231,749 231,749 1 Teknisi 1 1
TOTAL SETELAH JASA PERUSAHAAN 2,549,242 2,549,242
PPN 10% 254,924 254,924
SETELAH PPN 10% 2,804,167 2,804,167
PPh Pasal 23 : 2% (50,985) (50,985)
TOTAL 2,753,182 2,753,182

Page 6 of 59
 Lampiran Addendum 1
Perjanjian Penggunaan Jasa Perawatan Kebersihan
Antara PT.Tirta Investama Dan PT.ISS Facility Services

PROPOSAL PERPANJANGAN KONTRAK PERJANJIAN PERIODE 15 MEI 2010 S/D 14 MEI 2011
TOTAL REKAPITULASI TENAGA KERJA & BIAYA
AQUA DANONE SELURUH INDONESIA

PT. TIRTA INVESTAMA PT. TIRTA INVESTAMA

Laundry & Cleaning (Termasuk Machinery,Equipment,Gardening dan Chemical) REPACKING
Uraian Jumlah Biaya/Bulan Uraian Jumlah Biaya/Bulan
BIAYA TENAGA KERJA 199 243,424,973 BIAYA TENAGA KERJA 2 3,047,014
BIAYA MACHINERY 3,187,500 BIAYA EQUIPMENT 231,667
BIAYA EQUIPMENT + GARDENING 24,459,998 SUB TOTAL 3,278,681
BIAYA CHEMICAL 8,190,749 JASA PERUSAHAAN 10% 327,868
SUB TOTAL 279,263,220 TOTAL SETELAH JASA PERUSAHAAN 3,606,549
JASA PERUSAHAAN 10% 27,926,322 PPN 10% 360,655
TOTAL SETELAH JASA PERUSAHAAN 307,189,542 SETELAH PPN 10% 3,967,204
PPN 10% 30,718,954 PPh Pasal 23 : 2% (72,131)
SETELAH PPN 10% 337,908,496 TOTAL 3,895,073
PPh Pasal 23 : 2% (6,143,791)
TOTAL 331,764,705 PT. TIRTA INVESTAMA
TEKNISI
PT. TIRTA INVESTAMA Uraian Jumlah Biaya/Bulan
Safety (Rompi & Safety Shoes) BIAYA TENAGA KERJA 1 2,119,576
Uraian Jumlah Biaya/Bulan BIAYA EQUIPMENT 197,917
BIAYA ROMPI 153 892,500 SUB TOTAL 2,317,493
BIAYA SAFETY SHOES 126 2,085,000 JASA PERUSAHAAN 10% 231,749
SubTOTAL 2,977,500 TOTAL SETELAH JASA PERUSAHAAN 2,549,242
PPN 10% 297,750 PPN 10% 254,924
SETELAH PPN 10% 3,275,250 SETELAH PPN 10% 2,804,167
PPh Pasal 23 : 2% (59,550) PPh Pasal 23 : 2% (50,985)
TOTAL 3,215,700 TOTAL 2,753,182

TOTAL BIAYA ATAS PT.TIRTA INVESTAMA 341,628,659

Page 1 of 59
 Lampiran Addendum 1
Perjanjian Penggunaan Jasa Perawatan Kebersihan
Antara PT.Aqua Golden Mississippi Tbk Dan PT.ISS Facility Services

PROPOSAL PERPANJANGAN KONTRAK PERJANJIAN PERIODE 15 MEI 2010 S/D 14 MEI 2011
TOTAL REKAPITULASI TENAGA KERJA & BIAYA
AQUA DANONE SELURUH INDONESIA

PT. AQUA GOLDEN MISSISSIPPI Tbk

Laundry & Cleaning (Termasuk Machinery,Equipment,Gardening dan Chemical)
Uraian Jumlah Biaya/Bulan
BIAYA TENAGA KERJA 10 14,562,399
BIAYA MACHINERY 170,833
BIAYA EQUIPMENT + GARDENING 1,041,201
BIAYA CHEMICAL 805,500
SUB TOTAL 16,579,933
JASA PERUSAHAAN 10% 1,657,993
TOTAL SETELAH JASA PERUSAHAAN 18,237,926
PPN 10% 1,823,793
SETELAH PPN 10% 20,061,719
PPh Pasal 23 : 2% (364,759)
TOTAL 19,696,960

PT. AQUA GOLDEN MISSISSIPPI Tbk

Safety (Rompi & Safety Shoes)
Uraian Jumlah Biaya/Bulan
BIAYA ROMPI 6 35,000
BIAYA SAFETY SHOES 6 125,000
SubTOTAL 160,000
PPN 10% 16,000
SETELAH PPN 10% 176,000
PPh Pasal 23 : 2% (3,200)
TOTAL 172,800

TOTAL BIAYA ATAS PT.AQM 19,869,760

Page 1 of 15