5000801080 - Employee Welfare:Life Insurance
[Wo | Period |01897.3704-727002701.837.370A-T27 001 [01.837 3704-79501 01 837 370.4-726,001] 01 897.370.4-784001 01.837.370 11001
Ann | GS7aTe AE 7S] oo oU oa BORE
Dé fun | ___sestrezs[__a4e0esss[—1ea702e2,——=C SB HST| __—_—2a,teseer| mager
PS |Agustis | sas17e25| —saaa0gese | ojo Taaro202| o—o—oOasoser| —=Cétw TB SGT | oo 25GT
3 (September) — 58917625) __44e0e.958| —‘taaroze2| _—-as0ese7| ——ma,teseer| 112.867
TT] 705,494,334 [ __645,068,202[ _227,191,796| _21,047,488| ____348,202273| 1352004
5000801080 - Employee Welfare:Life Insurance
[No | Period |01.837370.4-71400101.3373704-728001701-837.370A-72800270137.3704735001701897.370A-725.001|—— Total
[tfanvan | oo 2200 ASA] oo oo o—- Io oo jon ee
2 [rebruan | o——— sas| o—— ass eg2n| —L— OS 30310535 maret —o— ter) — satapoa| Serma ———— Ai A TO | 183, 490,008 adem agser|———seosasr|—asmasee| SSS | 3maste| Gesanoare
3m ——rae7p—sp2s|o——Gogppe3| ———Gsaaste| 170,875,187
Delum ——Ggae7| — 65752) — Aes2ses| — | Asmsis| 1TaST516T ja ae7p— spa |o—Gosn3| ——Gsaaste| 170,875,167
Ts jusus |o—— gnaerp—osgg25| —Go32se3| — | saasne| Insert
[9 |Sepiember| — To7ae7| ops ——4egps3| | Aamaste| 17957567
Sofomoser | __terter| — oemes| 4622p SSS «| SSC BMT | 179,875,007
[72 Desember, __—tarte7[—e.s27e25| _tea2a503| == sange 179,675,167
461,982] 76394581] 213,128450| 196,904934| 21,715,346 | 2,274,018,366 bahwa dalam Uji Bukti Pemohon memperlihatkan General Ledger Akun 5000801080EmployeeWelfare:LifeInsuranceInvoice 235912820EB008832 sebesar Rp2.442.134.500,00
G/LAccount |G/L Account: Long Text Document (Posting — (Hard — (Hard Currency(Group © Group (Text
Number Date Currency (Value Currency |Currency
Key Key Value
FO ge sesi ONS ATION |__| RATER CE itl ere PO aaa | «ASD | RENTS CTCL
Koran amoretetikiewae pemutaran | Lessa | imsfron SuSE Gue
2442134500
Invoice No. 235912820EB008832
Berdasarkan Invoice No 235912820EB008832 dengan total tagihan sebesar Rp2.442.134.500,00 fC pn PT, Kalibesar Raya Utama aan Komp. Mega Grnsir Cempaka Mas Biak If Na. 1-6 Jl. Letjen. Supraptc lakarta 10640 - 'ndanesia
: Phone : 152-211 1288 - 3707 Hunting) * Fax: (62-21) 4288 - 3738. 4288 - 3709 * www hbru.ca.id
——ins: werg Nomor tz Usaha: SLUKNIK.017/1983
Insurance Brosers ember of APPARINDO
INVOICE ORIGINAL
No.: 235912820EB008832
Name 1 BUKIT MARMUR MANDIRI (ITAMA. PY
Address 1 The Hney Lady Larvaf OG CBD Plat tl. Phat Setatan Raya No. iif Penjaringan, Penjaringan, Jakarta Utara. DKI lakatia
Type of Cover 2 TERM LIFE INSURANCE
Period of Insurance OL lanuary 2021 - 31 December 2021
Effective Date 1 OL Tanuary 2021
Lotal Sum Insured PIDR 2.00
Perincian / Details
Cover Nete Number | DEAD LASU O26 KERUA 222 Premium IDR na, "
Stamp Dur. Cost IDR 5.00 bee “ IDR 1"
Please submat ihe abowes premuura to : PT. KALIBESAR RAYA UTAMA, Total Due Ts Us IDR 212 144,500.00
Bencficlary Name 1 KBRU QQ BUKIT MAKMUR MANDIRI UTAMA PT
Jakarta. 23 Deserzber 2020
AC No.: Bank Sinar Mas - 895220021536
Signed ‘or and on berall of
PT. KALIHESAR RAYA UTAMA.
Please Inforntus if you have tansfered to our accuunl, to thts e.mail address La ” .
eo tectianS hbru.coid ri