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liaya &dmin Rp 2.0SO

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' *astikan Nornr:r ?*langgan / Norninal telah sesuai

*aek3
FhtKSEKUTTF
PT EKSEKUTIF
Regional Office
li.
Sarono )tvro 1122, Parjang liwo, Tenggilis 14ejoyo
Surabaya
Tel. | +62 31 99851199

TNVOTCE / RECETPT
r....=-
I Io: No.
MORULA ryF PUSURA TEGALSART - SURABAYA (SS) rNv/EFS-FSl22-0061
PT, MEDIKA SEJAHTERA BERSAMA
Jl. Tegalsari No. 59
Surabaya

We hereby invoice you for the following service (s)

SPECIFICATION AMOUNT
Comprising

OUR REF
1 MAIN CONTRACT PC 22-0001 16.453.833,00
MANPOWER COST - SECURITY SERVICES MORULA PUSURA
FOR PERIOD: 01 - 31 MAY 2022 TEGALSARI -
SURABAYA (SS)
2 MANAGEMENT FEE 1.234.037,00
FOR PERIOD: 01 - 3l MAY 2422

SUB TOTAL 17,687.87OIOO

VAT 11olo L35.744,04
INCOME TAX 2olo (24.681,00)

TOTAL AMOUNT DUE Rp 17.798.933,OO

Seventeen Million Seven Hundred Ninety Eight Thausand Nine Hundred Tttirty Three

We look forward to receiving your payment in respect of the above amount at yourearliest convenrence.
Any claims regarding this invoice wili not be considered if made more than seven days after date of invoice receipt.

Please pay by cheque in PT EKSEKUTIF Surabaya, 27 MaV 2422

or by bank transfer to : Yours faithfully,
PT EKSEKUTIF
BANK BCA KCP. KRAKSAAN . PROBOLINGGO
Account : PT EKSEKUTIF MUDA INDONESIA
No. :2O15544455
BANK MANDIRI KCP. KRAKSAAN - PROBOLINGGO
Account ; PT EKSEKUTIF MUDA INDOHESIA
No. ; 143 OO17 13448 5
Director
 Faktur Pajak
Kode dan Nomor Seri Faktur Pajak : 010.003-22.47097650

Pengusaha Kena Pajak

Nama : PT EKSEKUTIF
A|amat: DUSUN SEKOLAHAN RT 006 RW OO5, KAB.PROBOLINGGO
NPWP : 31 .540.588.6-625.000

Pembeli Barang Kena Pajak I Penerima Jasa Kena Pajak

NAma : MEDIKA SEJAHTERA BERSAMA
Alamat : JL. TEGALSARI Blok - No.- RT:000 RW:000 KeI.TEGALSARI Kec.TEGALSARI Kota/Kab.SURABAYA JAWA
TIMUR 60262
NPWP : 02.256.786.1-607.000
Harga juaiiPenggantianlUang
No. Nama Barang Kena Pajak / Jasa Kena Pajak
Mukaffermin
Jasa Manajemen - Security Seruices
1 1.234.037,00
Rp 1.234.037 x 1
Harga Jual i Penggantian 1.234.037,00
Dikurangi Potongan Harga 0,00
Dikirrangi Uang Muka U,UU

Dasar Pengenaan Pajak 1.234.037,00

TotalPPN 135.744,00

Total PPnBM {Pajak Penjualan Barang Mewah) 0,00

Sesuai dengan ketentuan yang berlaku, Direktorat Jenderal Pajak mengalur bahwa Faktur Pajak ini telah ditandatangani secara elektronik sehingga
tidak diperlukan tanda tanqan basah pada Faktur Pajak ini.

KAB.PROBOLI NGGO, 27 Mei 2A22

Zulmi Noor Hasani

INVOICE : INV/EFS-FSI22-0061
PERIODE MEI2022

PEMEFRITAIIUAN: Faktur Pajak ini telah dilapcrkan ke Direklcrat Jeede€l Paiak dan leiah memseroleh persetujuan sesuai 4 Aa.i I
dengaB kelsntran peraluran perpajakan yang beriaku. PERINGATAN: PKP yang nrenerbitkafr Faktur Pajak ysng tidak sesusi
dengao keadaan yang sebenarnya dan/atau sesungguhnya sebagaimana dimaksud Pasal '13 ayat (Si UU PPN dikenai sanksi
sesuai dengan Pasal 14 ayat {4) ULi KUP
p, KSEKUTIF
{el,*nt $ervie# c*aiitv

BREAI(I)OtrIN COST OPERATIOITAJ,

IUORULA TUTF SURABAYA
PUSUSRA TEGAI,SARI
J1. Tegalsari No. 59
Surabaya

Security Sl,enrices, 3 {tiga) Manpornet

Periode I Apt,I2022 - 31 Maret 2O23

No, Detail Security

1 Basic Wages Rp 4,375,479
2 insentif Aliowance Rp
J Olfice Allowance Rp lCO,OOO
4 BPJS/Worker lnsurance : 6.54%.UMK Rp 286,156
5 BPJS/ Medical h'rsurance : 49t"Utu1K Rp 175.O 19
6 Feast Alloli,ance {THR) Rp 364.623
7 Uniform + ID card Rp 6J, JJJ
Sub Total Bp 5,384,6r. r"

Total Manpower 3

a Manpower Cost :
Security: 3 (tiga} Manpower Rp 16, 153,833
b Direct Product Cost
Consumable Oifice'I'ooi Rp
Externai Support Rp 300,ooo
Total Cost Rp 16,453,833
Management Fee 7,5,9,o Rp t.lJ+,tJJ /

VAT (PPN 11?o from Management Fee) Rp 735,741

Income Tax 2o/o {rom

Note t
Hargatersebut diatas sdahtem*k ditannbahkan PPN 1 1ao (PPN dan !\{anagement Fee) dan dikurangtkart
PPh 2oo (PPhdai Mamgement Fee)
Harga tdse'but diais sudah te*tasuk take ham.e paA rna*paluer dertg<trt perhihtngcLrL UMK liota
Surabagcsta?un 2022 sebesar Rp. 4.375.479
Untuk jam kerja difuar jam kerjo wajib atas pemirtmn pemakai jasa ftrcer) akctn ditagihkan terserudii ditamba'
 PT. Eksekutif
Order
fa-ge 1

Morula IVF Sur:abaya

lndonesia

Phone No.
Home Page https://www. m orula ivf.co.i d/
Email contact.center@m orulaivf.co.id
Buy-from Vendor No. PTE VAT Registration No.
0rder No. 1 700-P000022000140 Giro l.,lo.
Document Date April 8, 2022 Bank
Payment Terms Account No.
Shipment Method
Prepayment Payment Terms
Prices lncluding VAT No

Direcf Allow
uslPl Ut*" !E${a{E€. VAT
No- Qua*ity tiecure
Description Cost Discount 96 Discount lde;rt3fier Amount
BY_ By-Man Power 1 UNIT 37,543,621 Yes 37,s43,621.00
OUTSOURCI Outsourcing/Services
PPhI PPN 10% 1 KALI 288,1 25.00 No 288,1 25.00

Total IDR 37,&lI,746Jt

0

Ship-oAddrcss
Morula IVF Surabaya
&KSEKUTTF
PT EKSEKUTIF
Regional Office
JI. Sarono liwo 1122, Panjano liwo, Tenoqllis Meiovo
Surabaya
Tel. : +62 3t 99851199

INVOICE I RECEIPT
r_:-lo:
I No.
IIIORULA M PUSURA TEGALSARI - SURABAYA (CS) rNv/EFS-FS/22-0062
PT. MEDIKA SE]AHTERA BERSAMII
Jl. Tegalsari No. 59
Surabaya

We hereby invoice you for the following service (s) :

SPECIFICA.TION AMOUNT
Comprising :

OUR REF
,t MAIN CONTRACT PC 22-4042 18.470.466,00
MANPOWER COST - CLEANING SERVICES MORULA PUSURA
FOR PERIOD: 01 - 31 MAY 2022 TEGALSARI .
SUR.ABAYA. (CS)
7 MANAGEMENT TEE 1.385.285,00
FOR PERIOD: 01 - 31 MAY 2022

SU8 TOTAL 19.855.751,OO

VAT l lolo 152.381,00
INCOME TAX Zo/a (27.706,0A)

TOTALAMOUHT DUE Rp 19.98O.426,0O

Nineteen Million Nine Hundred Eiqhty Thousand Four Hundred

We look forward to receiving your payment in respect of the above amount at your earliest convenience.
Any claims regarding this invoice will not be considered if made more than seven days after date of invoice receipt

Please pay by cheque in PT EKSEKUTIF Surabaya, 27 May 2022

or by bank transfer to : Yours faithfully,
PT EKSEKUTIF
BAIIK BCA KCP. KRAKSAAN - PROBOLINGGCI
Account : PT EKSEKUTIF MUDA INDONESIA
No. :2O15544*55
BANK MANDIRI KCP. KRAKSAAN . PROBOLINGGO T

ACCOufit : PT EKSEKUTIF MUDA INDONESIA

No. : 143 OO17 13448 5
Directar
 Faktur Pajak
Kode dan Nomor Seri Faktur Pajak : 010.003-22.47097651

Pengusaha Kena Pajak

Nama : PT EKSEKUTIF
Alamat: DUSUN SEKOLAHAN RT 006 RW 005 , KAB.PROBCLTNGGO
NPWP : 31.540.588.6-625.000

Pembeli Barang Kena Pajak I Penerima Jasa Kena Pajak

Nama : MEDIKA SEJAHTERA BERSAMA
Alamat : JL" TEGALSARI Blok - No.- RT:000 RW:000 KeI.TEGALSARI Kec.TEGALSARI Kota/Kab.SURABAYA JAWA
TlhtuR 60262
NPWP : A2.256.7 86.1 -607.000

No. Nama Barang Kena Pajak I Jasa Kena Pajak Harga JuaiiPenggantianiUang
Mukaffermin
1
Jasa Manajemen - Cleaning Services
Rp 1.385.285 x 1 1.385.295,00

Harga Jual i Penggantian 1.385.285,00

Dikurangi Potongan Harga 0,00
Dikr-r r airgi Uang i\,iuka L',UU

Dasar Pengenaan Pajak 1.385.285,CIO

Total PPN 152.381,00

Total PPnBM (Pajak Penjualan Barang Mewah) 0,00
Sesuai dengan ketenluan yang berlaku, Direktorat Jenderal Pa.jak mengalur bairwa Faktur Pajak ini telah ditandatangani secara elektronik sehingga
tidak diperiukan tanda tanqan basah pada Faktur Pajak ini.

KAB.PROBOLI NGGO, 27 Mei 2A22

Zulmi Noor Hasani

lNVOICE : INV/EFS-FSl22-0062
PERIODE MEI 2022

PEf',{S=RiTAHUAN: i:klur Paiak ini ielah dilapcrkan kD !lifeklcrat Jenderai Paltsk dan telah memosroleh }€rsetujuan sesuai
'l Anti I
dengan ketentuan peratur*n peroajakan y3ng beriaku. PERINGATAN: frKP yang nrenefbitkan Faktur Pajak yang tjdak sesLai
dengan keadaan yang sebenafnya dar/atau sesungguhiya sebagainrafra dimfiksud Psiai 13 ayal (S') l-lU PPN .!ikeIai sailks]
sesuai dengan Pasal 14 ay,?t t4) UU KUP
&n,.q,8.[.y-,:,#

BREAKDOU'N COST OPERATIOITAI,

MORULA ryF TPUSURA TEGALSARII
Jl. Tegalsart I{o. 59
Surabaya

Cleanniag Services 3 {tiga} Maapover

Periode : 1 April ?,OZI - 31 Mryet 2(}23

l{o Detail Cleaner

1 Basic Wages Rp 4,375,479
2 Oflice Ailo-,valce Rp
3 incentive Allo,a'ance Rp 100,o00
4 BRIS/Worker Insurance : 6.24oto Rp 273,4?)O
5 BPJS/Medical Insurance : 49./o Rp 175,019
6 Other insuramce Rp
7 Feast Aliov,.ance {THR) Rp 364,623
8 Uniform + ID Card Rp 83,333
Total Take tlome Pay Rp 5,371,485
Total Manpower .)

a *Ianpower Cost:
Cleaner : 3 (Tigai Manpower Rp 16,114,454
b Direet Product Cost :
Machinery {Periodic) Rp
Chemical & Clearing Support Rp 535,120
Equipment and Tools Rent {Depr.) Rp 1,824,892
TotalCosta+b Rp 18,470,466
Management Fee 7.5a/o Rp 1,385,285
rii#fil,ffi68
VAT iPPN 119{; tiom Malagement Fee) 152,381.34
Income Tax 2a/" frorn 7A6
 Order
PT. Eksekutif Page 1

Moruia IVF Surabaya

lndonesia

Phone No.
Home Page https:/lwww.m orul aivf.co.id/
Email laivf.co.ld
co ntact.center@ m oru
Buy-from Vendor No. PTE VAT Registration No.
Order No. 1700 PO00022000140 Giro No.
Document Date April B, 2022 Bank
Payment Terms Account No.
Shipment Method
Prepayment Payment Terms
Prices lncluding VAT No

Direct Allow
Unit of Unit lnvoice
No. Description Quantity Measure Cost Discount % Discount ldentifier Amount

BY. By-Man Power 1 UNIT 37,543,621 Yes 37,543,621 .04

OUTSOURCI Outsourcing/Services .00
PPN PPN 1O% 1 KALI 288,125.00 No 288.1 25.00

Total IDR 37,831,746.0

0

Ship-to Address
Morula IVF Surabaya
 FAKTUR PENJUALAN
Hasil Sempurna Globa[
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 Pr. An gratn /"gon \\'A,o*

PT ANUGRAH ARGON MEDICA Nomor SO 49220074901

Jl. Rungkut industri lll No. 35 SURABAYA 031-99854435 Tanggal 21-lrAY-22 09:18
DELIVERY ORDER
Rayon

lzin Cabang PBF : 812u3048401210007 Tipe :,'^x,3'^?", **., llilillllilllilillillllllllfllllilllllllllillllillllilllilllilllil

lzin Cabang PAK : 81203048401210076 TOP 30 NET 4922067998
Tgl.Jatuh Tempo 20-JUN-22
No. P0
Customer PUSURA TEGALSARI, RSIA. (PT. MEDIKA SEJAHTERA BERSAMA)
Alamat JL. TEGALSARI NO. 59 TEGALSARI - TEGALSARI SURABAYA 60262, Telp : +62 000
Halaman tlt
Tr Cetak : 21-MAY-22 09'.31

OTY UOM BATCH ED RP/UNIT %DISC DPP NOTES

No NAMA BARANG
PSIDI CAPSULE 5OO MG @50 BOX FEB-25 275,000.00 0.001 275,000.0q
1

TETAGAM P. Prefilled Syringe 1mL l BOX P1 0038721 6A FEB.24 210,000.00 o ool 210,000"0q

t I

f'

penjualan 0ngkos Kirim 0.00

Dokumef ini Nilai tagihan yang sah adalah nilai yang

Potongan 0.00
DPP 485,000.00

PPN 53,350.00
t 538,350.00 G
Diperiksa,
Jam Terima
APJ PHARMA: apt. Oky Putra, S.Farm
Suhu Terima
SIK : 503.4461268lBl SIP N 436.7 .1 512022
Suhu Min/Max
 PT SEJAHTERA SURYA INTRIO

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Nat ona llea ih Care. Consumer Prccucl, & Raw l,4ateria
F {K.[t R. FEN.IL,.\T,AN
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No:0373835

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