MS Amlin Marine N.V.

Nomor Polis / Policy number : 50009827/2022

Nama Kapal / Name of ship : Bintang Samudra 8
Nomor atau Huruf Pengenal / Distinctive : YBCY2
numbers or letters
Pelabuhan Pendaftaran / Port of : SAMARINDA
Registry
Tonase Kotor / Gross Tonnage : 758
Nama pemilik / nama tertanggung / : Astan Kasgianto Effendi
Registered owner / name insured
Alamat pemilik / alamat tertanggung / : Jl. Danau Limboto Blok B5 No.12, Sektor VIII, BSD City
Address of the principal place of business RT002/RW008, Lengkong Gudang, Serpong, Kota Tangerang
of the registered owner / address of the
insured 15321
SELATAN, BANTEN, INDONESIA
Dengan ini menerangkan bahwa kapal yang namanya tersebut di atas telah memiliki polis asuransi atau jaminan
keuangan lainnya yang memenuhi persyaratan Pasal 18 Peraturan Menteri Perhubungan Nomor PM 71 tahun 2013
tentang Salvage dan/atau Pekerjaan Bawah Air. / This is to certify there is inforce in respect of the above-named
ship a policy of insurance or other financial security satisfying the requirements of Article 18 of the Ministry of
Transportation Regulation Numbers PM 71 year 2013

Jenis jaminan / Type of security : Shipowners’ P&I insurance

Masa berlaku / Duration of the security : From : 02-10-2022
Until : 02-10-2023
Nama dan alamat Perusahaan asuransi dan/atau pemberi jaminan / Name and address of the insurer(s) and/or
guarantor(s)
Nama / Name : MS Amlin Marine N.V. as authorized underwriting agent.

Alamat / Address : Koning Albert II-laan 37

1030 Brussels - Belgium
Telepon / Fax / Phone / Fax : +31 10 2425000
Email / Website : www.msamlin.com/pandi
(Keabsahan polis jaminan ini dapat dicek 24 jam melalui telepon/email/website perusahaan) / The validity of this
security policy may be checked 24 hours through phone/email/website
Perwakilan/orang yang ditunjuk perusahaan dan/atau pemberi jaminan untuk dapat dihubungi sewaktu-waktu (24
jam) / Designated Person by the company and/or other financial security company that may be contacted anytime
(24 hours)
Nama / Name : Duty Officer
Telepon / Phone : +31 10 2425000
Nomor HP / Mobile phone : +31 653902778 (Netherlands) +65 65936008 (Singapore)
Email / E-mail : pandiclaims@msamlin.com
Alamat / Address : Beursplein 37, 3011 AA
Rotterdam, The Netherlands
Dikeluarkan Di / Issued at : Rotterdam
Pada Tangggal / Date of : 01-09-2022
TTD dan Cap Perusahaan / (Signed and official stamp of the company)
Nama pimpinan / Direktur Utama Perusahaan / Name of the CEO : Tom Oostra

MS Amlin Marine N.V. (‘MSAM’) is part of the MSI group. MSAM is registered in Belgium and its registered office is Koning Albert II-laan 37,
1030, Brussels, Belgium. MSAM is licensed and regulated by the Financial Services Markets Authority, Belgium (FSMA), registration no.
0670.726.393.