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 DENGAN ANGKA

1   180,990,300

2   345,718,100

3 Err:509

4 Err:509

5 Err:509

6   -

7   -

8   -

9   -

10   -

11   -

12   -

13   -

14   -15   -

16   -

17   -

18   -

19   -

20   -

21   -22   -

23   -

24   -

25

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 DENGAN ANGKA

Err:509

Err:509Err:509

  -

Err:509

Err:509

Err:509

Err:509

Err:509

Err:509

Err:509

Err:509

Err:509

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Err:509

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 TERBILANG

SERATUS DELAPAN PULUH JUTA SEMBILAN RATUS SEMBILAN PULUH RIB   9

 TIGA RATUS EMPAT PULUH LIMA JUTA TUJUH RATUS DELAPAN BELAS RIB   9

Err:509   Err:509 Err:509

Err:509 Err:509

Err:509   Err:509 Err:509

 RUPIAH   1

 RUPIAH   1 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

 RUPIAH   1

RUPIAH 1

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 TERBILANG

Err:509   Err:509 Err:509

Err:509   Err:509Err:509   Err:509

 RUPIAH   1

Err:509   Err:509

Err:509   Err:509 Err:509

Err:509   Err:509 Err:509

Err:509   Err:509 Err:509

Err:509   Err:509 Err:509

Err:509   Err:509 Err:509

Err:509   Err:509 Err:509

Err:509   Err:509 Err:509

Err:509 Err:509 Err:509

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Err:509   Err:509 Err:509

1

SATU

SEBELAS

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180 SERATUS DELAPAN 990 SEMBILA SEMBILA

345 TIGA RAT EMPAT PULIMA 718 TUJUH RADELAPAN

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

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Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

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Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

2 3 4 5 6 7 8 9

DUA TIGA EMPAT LIMA ENAM TUJUH DELAPAN SEMBILAN

DUA BELATIGA BEL EMPAT BELIMA BEL ENAM BE TUJUH BEDELAPAN SEMBILAN BELAS

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 RUPIAH

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 RUPIAH

 RUPIAH

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 RUPIAH

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300 TIGA RAT SERATUS SERATUS SEMBILA

100 SERATUS TIGA RAT TIGA RAT TUJUH RA

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

0

00

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

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Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

0

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

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Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

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0

20

0

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22

0

23

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0

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SEMBILA TIGA RAT TIGA RAT  

TUJUH RASERATUS SERATUS

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

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Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509  

Err:509 Err:509 Err:509

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Err:509 Err:509 Err:509  

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PT. MULTI STRUCTURE

  r u c u r e e r e c o n

SERVICE O

 Nomor : 032/MS/RSU-IDI/V/2015

 Dii!i : BUILDING

 Pro"e# : RSUD $r% &u'ir M()*u$

 No*or N%P%+%PPT. MULTI STRUCTURE

No% 0,%-0,%.,,.%-%0/%000

+i!*( ./ Lt% 0 J1% Let2en$% S% P(r*(n

3(% . S1i4i% P(1*er()

P)one : 0,5-///.006 7(8 : 0,5-//5.

 J(#(rt( B(r(t D3IJA3ARTA

No URAIAN PEKERAAN SAT

1 P!". #$r! A%&rm

P!r&%&'& U'&m&  , M7A ; onention(1 < -0 &one c=> '(tter" ? c)(r@e Unit

  MD7 Unit

  5 ROR He(t Detector Bu()

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  / A1(r* Be11 Bu()

  . M(nu(1 Pu!) Button Bu()

  In$ic(tor L(*4 Bu()

  9 In!t(1(!i 7ire A1(r* Titi#

  ,0 M(teri(1 B(ntu Lot

  ,,  Te!tin@ ? o**i!ionin@ Lot

3 P!"!r&& I*'&%&*$

!, R&&' I& VIP K!%&* 1

, Ter*in(1 Bo8 ; TB 7A < unit

3('e1 $(ri MD7 #e :

(% TB% T B ;Ge$un@ R(>(t In(4 IP ? 3e1(! ,< ;NA 5 8 ; 8 , *C

  - S*o#e Detector Bu()

  7i8e$ Detector Bu()

  5 ROR He(t Detector Bu()  / A1(r* Be11 Bu()

  . M(nu(1 Pu!) Button Bu()

  In$ic(tor L(*4 Bu()

  9 In!t(1(!i 7ire A1(r* Titi#

  ,0 M(teri(1 B(ntu Lot  ,,  Te!tin@ ? o**i!ionin@ Lot

5 P!"!r&& I*'&%&*$

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!, CSSD

  ,  Ter*in(1 Bo8 ; TB 7A < unit

  3('e1 $(ri MD7 #e :

(% TB% T B ;Ge$un@ SSD < NA 8 ; 8 ,65**

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  . M(nu(1 Pu!) Button Bu()

  In$ic(tor L(*4 Bu()

  9 In!t(1(!i 7ire A1(r* Titi#

  ,0 M(teri(1 B(ntu Lot

  ,,  Te!tin@ ? o**i!ionin@ Lot

; PEKERAAN #IRE E

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  RDER (SO)

 3e4($( t)6

CV. PROTECTINDO

U4 ANDI PRANOTO

 Te14 0;12 6431 23407(8

3ur! R4

VOLUMEARA TOTAL

KETERANANSATUAN ( R. )

,%00   ,-6-06000%0 ,-6-06000%0

,%00   ,60,6500%0 ,60,6500%0

%00   .0600%0 0600%0

00 0 500 0 , /0 000 0

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%00   06500%0 ,6/06000%0

%00   06500%0 ,6/06000%0

%00   59600%0 .5600%0

,-%00   06500%0 -6,-6500%0

,%00   ,6-506000%0 ,6-506000%0

,%00   /.56000%0 /.56000%0

,%00   .6500%0 .6500%0

,%00   .6000%0 96,/6000%0

-%00   -/6,00%0 ,/6/06-00%0

0%00   -6.00%0

%00   .0600%0 ,0600%0%00   06500%0 056000%0

%00   06500%0 056000%0

%00   59600%0 ,,600%0

5,%00   06500%0 ,06-.6500%0

,%00  ,60,6500%0 ,60,6500%0

,%00   .06000%0 .06000%0

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,%00   .6500%0 .6500%0

,5%00   56000%0 65-6000%0

,-%00   -/6,00%0 560,96-00%0

0%00   -6.00%0

,%00   .0600%0 .0600%0

,%00   06500%0 06500%0

,%00   06500%0 06500%0

,%00   59600%0 59600%0

,.%00   06500%0 -66500%0

,%00   9,,650%0 9,,650%0

,%00   556000%0 556000%0

,%00   .6500%0 .6500%0

,.%00   56000%0 96/,6000%0

%00  -/6,00%0 96//600%0

0%00   -6.00%0

,%00   .0600%0 .0600%0

,%00   06500%0 06500%0

, 00 0 500 0 0 500 0

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,%00   06500%0 06500%0

,%00   59600%0 59600%0

,-%00   06500%0 6/-6500%0

,%00   /.56000%0 /.56000%0

,%00   --.6500%0 --.6500%0

/0%00   006000%0 60006000%0

,%00   /6506000%0 /6506000%0

TOTAL 345>91;>050.0

DI+ULATKAN 345>91;>100.0

 BU SERATUS RUPIAH 

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PT. MULTI STRUCTURE

S t r u c t u r e O f P e r f e c t i o n

 BERITA ACARA PEMERIKSAAN

1. MANGKU. PS :

2. ANDI PRANOTO :

Kedua belah pihak telah mengadakan pemeriksaan pekerjaan berdasarkan pada :

1 SO Nomor : 032/MS/RS!"#"/$/201%2 &anggal Kontrak : 1% Mei 201%

3 'khir Kontrak : 20 September 201%

.ada hari ini) Senin tanggal #ua .uluh &ujuh bulan 4uli tahun #ua Ribu 5ima belas) kami an

diba-ah ini :

Selaku Site Manager .roek .emb, RS dr, 6ubir'eh &imur dalam hal ini bertindak untuk dan ata

STRUCTURE ang berkedudukan di 4l, 5et, 4end,

4akarta 11(10) selanjutna disebut sebagai PIHA

Selaku SubKontraktor ang bertindak untuk dan ang berkedudukan di 4ln, &gk, #ihaji 5r, K

5amdingin Keamatan Kuta 'lam , 'eh) selanj

K#'

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 ANDI PRANOTO MAN

SubKontraktor Site

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bertanda tangan

Mahmud!"di) Kab,nama PT. MULTI

S, .arman Ka7, *8)

PERTAMA

  atas namana sendiriuhik udiman #esa

utna disebut ."'K

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  KU. PS

anager

PT. MULTI STRUCTURE

 t r u c t u r e e r e c t o n

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 ____________________________________________________________ PT. MULTI STRUCTURE Proyek Pemb. RSUD-Aceh Timur 

OPNAME PRESTASIOPNAME 3E : 0,

 N(*( = No% Pro"e# : 0-=MS=RSUIDI==0,5

 Lo#(!i Pro"e# : J1n% Me$(n B(n$( Ace) I$i 3('u4(ten Ace) Ti*ur No% SO : 0-=MS=RSUIDI==0,5

N(*( Pe#er2((n : PEKERAAN #IRE ALARM

 Lo#(!i Pe#er2((n : Ge$un@ RSU Dr% &u'ir M()*u$ I$i Ace) Ti*ur

No URAIAN PEKERAAN

SESUAI SPK 

VOLUME ARA UMLA

SAT UMLA SATUAN ( R. )

1 P!". #$r! A%&rm

P!r&%&'& U'&m&

,M7A ; onention(1 < -0 &one c=> '(tter" ? c)(r  Unit ,%00 KKK   ,-6-06000%00

MD7  Unit ,%00 ,60,6500%00 ,60,6500%00

-P(ne1 Annunci(tor  Unit ,%00 /606000%00 /606000%00

Groun$in@ S"!te*  L! ,%00 6056000%00 6056000%00

5M(teri(1 B(ntu  L! ,%00 /.56000%00 /.56000%00

2 P!"!r&& I*'&%&*$

+&,& U'&m&  , Ter*in(1 Bo8 ; TB 7A <  Unit 5%00 .6500%00 6-/6500%00

3('e1 $(ri MD7 #e :

(% TB% T A, ;NA / 8 ; 8 <  *C %00 ,6000%00 ,6.6000%00

'% TB% T A ;NA 8 ; 8 ,65**

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 ____________________________________________________________ PT. MULTI STRUCTURE Proyek Pemb. RSUD-Aceh Timur 

@ 4

- S*o#e Detector  Bu() ,5%00 -/6,00%00 .,66500%00

7i8e$ Detector  Bu() -6.00%00

5 ROR He(t Detector  Bu() %00 .0600%00 0600%00

/ A1(r* Be11  Bu() %00 06500%00 ,6/06000%00

. M(nu(1 Pu!) Button  Bu() %00 06500%00 ,6/06000%00

In$ic(tor L(*4  Bu() %00 59600%00 .5600%00

9 In!t(1(!i 7ire A1(r*  Titi# ,-%00 06500%00 -6,-6500%00

,0 M(teri(1 B(ntu  Lot ,%00 ,6-506000%00 ,6-506000%00

,, Te!tin@ ? o**i!ionin@  Lot ,%00 /.56000%00 /.56000%00

3 P!"!r&& I*'&%&*$

!, R&&' I& VIP K!%&* 1

,Ter*in(1 Bo8 ; TB 7A <  unit ,%00 .6500%00 .6500%00

3('e1 $(ri MD7 #e :(% TB% T B ;Ge$un@ R(>(t In(4 IP ? 3e1(! ,< ;N  *C ,%00 .6000%00 96,/6000%00

-S*o#e Detector  Bu() -%00 -/6,00%00 ,/6/06-00%00

7i8e$ Detector  Bu() -6.00%00

5ROR He(t Detector  Bu() %00 .0600%00 ,0600%00

/A1(r* Be11  Bu() %00 06500%00 056000%00

.M(nu(1 Pu!) Button  Bu() %00 06500%00 056000%00

In$ic(tor L(*4  Bu() %00 59600%00 ,,600%00

9In!t(1(!i 7ire A1(r*  Titi# 5,%00 06500%00 ,06-.6500%00,0M(teri(1 B(ntu  Lot ,%00 ,60,6500%00 ,60,6500%00

,,Te!tin@ ? o**i!ionin@  Lot ,%00 .06000%00 .06000%00

4 P!"!r&& I*'&%&*$

!, R&&' I& K!%&* 3 (1 2)

,Ter*in(1 Bo8 ; TB 7A <  unit %00 .6500%00 956000%00

3('e1 $(ri MD7 #e :

(% TB% T B ;Ge$un@ R(>(t In(4 3e1(! - H,?H< ;N  *C -,/%00 56000%00 ,.60/6000%00

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 ____________________________________________________________ PT. MULTI STRUCTURE Proyek Pemb. RSUD-Aceh Timur 

-S*o#e Detector  Bu() 5%00 -/6,00%00 060..600%00

7i8e$ Detector  Bu() -6.00%00

5ROR He(t Detector  Bu() %00 .0600%00 0600%00

/A1(r* Be11  Bu() ,%00 06500%00 06500%00

.M(nu(1 Pu!) Button  Bu() ,%00 06500%00 06500%00

In$ic(tor L(*4  Bu() ,%00 59600%00 59600%00

9In!t(1(!i 7ire A1(r*  Titi# 59%00 06500%00 ,,69.6500%00

,0M(teri(1 B(ntu  Lot ,%00 ,60,6500%00 ,60,6500%00

,,Te!tin@ ? o**i!ionin@  Lot ,%00 --.6500%00 --.6500%00

5 P!"!r&& I*'&%&*$

!, CSSD

,Ter*in(1 Bo8 ; TB 7A <  unit ,%00 .6500%00 .6500%00

3('e1 $(ri MD7 #e :(% TB% T B ;Ge$un@ SSD < NA 8 ; 8 ,65**

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 ____________________________________________________________ PT. MULTI STRUCTURE Proyek Pemb. RSUD-Aceh Timur 

-S*o#e Detector  Bu() %00 -/6,00%00 96//600%00

7i8e$ Detector  Bu() -6.00%00

5ROR He(t Detector  Bu() ,%00 .0600%00 .0600%00

/A1(r* Be11  Bu() %00 06500%00 056000%00

.M(nu(1 Pu!) Button  Bu() %00 06500%00 056000%00

In$ic(tor L(*4  Bu() %00 59600%00 ,,600%00

9 In!t(1(!i 7ire A1(r*  Titi# -,%00 06500%00 /6..6500%00

,0M(teri(1 B(ntu  Lot ,%00 /.56000%00 /.56000%00

,,Te!tin@ ? o**i!ionin@  Lot ,%00 --.6500%00 --.6500%00

9 P!"!r&& I*'&%&*$

!, !&&7

,Ter*in(1 Bo8 ; TB 7A <  unit ,%00 .6500%00 .6500%00

3('e1 $(ri MD7 #e :(% TB% T B ;Ge$un@ Jen(F()< ;NA 8 ; 8 ,65**  *C ,99%00 56000%00 ,06./6000%00

-S*o#e Detector  Bu() %00 -/6,00%00 -60600%00

7i8e$ Detector  Bu() -6.00%00

5ROR He(t Detector  Bu() %00 .0600%00 ,0600%00

/A1(r* Be11  Bu() ,%00 06500%00 06500%00

.M(nu(1 Pu!) Button  Bu() ,%00 06500%00 06500%00

In$ic(tor L(*4  Bu() ,%00 59600%00 59600%00

9In!t(1(!i 7ire A1(r*  Titi# ,-%00 06500%00 6/-6500%00,0M(TB% T ;Ge$un@ UGD ? 3e'i$(n(n< ;NA - 8 ;  Lot ,%00 /.56000%00 /.56000%00

,,Te!tin@ ? o**i!ionin@  Lot ,%00 --.6500%00 --.6500%00

; PEKERAAN #IRE E

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 ____________________________________________________________ PT. MULTI STRUCTURE Proyek Pemb. RSUD-Aceh Timur 

 3e4($( "(n@ 'er!(n@#ut(n $i#en(#(n reten!i !e'e!(r

L(in1(in

Su' Tot(1

3e4($( "(n@ 'er!(n@#ut(n te1() $i'("(r !e'e!(r

3e4($( "(n@ 'er!(n@#ut(n $(4(t $i'("(r#(n !e'e!(r

T!r=$%&, :  SERATUS DEA!A" !UU# JUTA SE$%&A" RATUS SE$%&A" !U

(t(t(n ;E< : (n@ Meneri*( Tu@(!

Pe*'("(r(n #e , R4% ,069906-00%00

Pe*'("(r(n #e R4%

Pe*'("(r(n #e - R4%

Pe*'("(r(n #e R4%

Pe*'("(r(n #e 5 R4%Pe*'("(r(n #e / R4%

 Ju*1() R4% ,069906-00%00  ANDI PRANOTO

Su'3ontr(#tor

Di!tri'u!i :

,De4t% 3eu(n@(n

M(n$or

-Ar!i4 Pro"e#

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  ERA 

OPNAME VOLUME PEKERAAN UMLA SISA

 MINU MINU S/D MINU OPNAME S/D VOLUME KETERANAN

LALU INI INI MINU INI SPK

,%00

,%00

,%00

,%00

,%00

5%00 5%00 6-/6500%00

%00 %00 ,6.6000%00

-%00 -%00 ,6-/6000%00

./%00 ./%00 -606000%00

  5/%00 5/%00 6506000%00

/%00 /%00 606000%00

,5 00

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,5%00

%00

%00

%00

%00

,-%00 ,-%00 -6,-6500%00

,%00 ,%00 ,6-506000%00

,%00

,%00 ,%00 .6500%00

,%00 ,%00 96,/6000%00

-%00 -%00 ,/6/06-00%00

%00

%00

%00

%00

5,%00 5,%00 ,06-.6500%00 ,%00 ,%00 ,60,6500%00

,%00

%00 %00 956000%00

  -,/%00 -,/%00 ,.60/6000%00

5 00

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5%00

%00

,%00

,%00

,%00

59%00 59%00 ,,69.6500%00

,%00 ,%00 ,60,6500%00

,%00

,%00 ,%00 .6500%00

,5%00 ,5%00 65-6000%00

,-%00 ,-%00 560,96-00%00

,%00

,%00

,%00

,%00

,.%00 ,.%00 -66500%00 ,%00 ,%00 9,,650%00

,%00

,%00 ,%00 .6500%00

 

,.%00 ,.%00 96/,6000%00

00 00 9 // 00 00

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%00 %00 96//600%00

,%00

%00

%00

%00

-,%00 -,%00 /6..6500%00

,%00 ,%00 /.56000%00

,%00

,%00 ,%00 .6500%00

,99%00 ,99%00 ,06./6000%00

%00 %00 -60600%00

%00

,%00

,%00

,%00

,-%00 ,-%00 6/-6500%00 ,%00 ,%00 /.56000%00

,%00 ,%00 --.6500%00

/0%00

,%00

 TOTAL ; A < @@@ 55; B < 5 525 ;05 00

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 ; B < 5   >525>;05.00; <

; D < ; A < ; B < @@@ ; E <

;7 < ; D < ; E < @@@  U# R&%U T&'A RATUS RU!&A#

Di4eri#!( Men"etu2ui J(#(rt( 6 . Ju1i 0,5

 Di'u(t O1e) :

ANKU. PS ER#AN S?AMSUL +ARI PATRIA RIDA. N

Site M(n(@er Pro2ect M(n(@er Site Oce En@ineer

L(*4ir(n : G(*'(r Lo#(!i=Per)itun

o1u*e "(n@ $i#er2(#(n

PT. MULTI STRUCTURE

S t t O f P f t i

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S t r u c t u r e O f P e r f e c t i o n

 BERITA ACARA PEMBAYARAN

SAMSU :

ANDI PRANOTO :

KM'4'N .KR4''

NO, R'"'N S/# .R"O# 5'5 .R"O# "N"9Rp, 9Rp,

1, .restasi .ekerjaan ! 1;0)%18)100,00

.ada hari ini) Senin tanggal #ua .uluh &ujuh bulan 4uli tahun #ua Ribu 5ima belas) k

diba-ah ini :

Selaku Keuangan .roek .emb, RS dr, 6ubir

&imur dalam hal ini bertindak untuk dan atas nama

 ang berkedudukan di 4l, 5et, 4end, S, .arman

selanjutna disebut sebagai ."'K .R&'M'

Selaku SubKontraktor ang bertindak untuk dan

berkedudukan di 4ln, &gk, #ihaji 5r, Keuhik

Keamatan Kuta 'lam , 'eh) selanjutna disebut

erdasarkan erita 'ara .emeriksaan 9terlampir dan sesuai Surat .erjanjian dan S

Mei 201%) maka ."'K K#' berhak menerima pembaaran dengan rinian sebagai be

P

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 ANDI PRANOTO SA

SubKontraktor Keu

#isetujui Oleh)

PT. MULTI STRUCTURE

.roek .embangunan RS dr, 6"R M'M# 'eh &imur

ER#AN SYAMSUL BAHRI

.roje1t Manager

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S/# .R"O# "N"9Rp,

1;0)%18)100,00

mi ang bertanda tangan

ahmud ! "di) Kab, 'eh

.&, M5&" S&R=&R

Ka7, *8) 4akarta 11(10)

tas namana sendiri ang

udiman #esa 5amdingin

."'K K#'

r7ie Order0) tanggal 1%

rikut:

SU

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  SU

ngan

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Sudah Terima Dari   :   T. MULTI STRUCTURE

Terbilang   :

Untuk Pembayaran   :  Mandor Borong

Lokasi   :  032/MS/RSU!D!/"/20#$

 %omor &ontrak    :  032/MS/RSU!D!/"/20#$

Tagihan   :  !

'umlah   :  R() #*0+,,0+300)00

!di -.eh Timur 0# -gustus 20#$

Lokasi   : !, RSU Dr. B=$r M&7m - I$ A!7 T$   ang Menerima

 ANDI PRANOTO

SubKontraktor

SERATUS DELAPAN PULUH JUTA SEMBILAN RATUS SEMBILAN PULUH RIBU

TIGA RATUS RUPIAH

K > " & ' N S "

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