Page 1
AMENDMENT NO. 4 TO THE CONTRACT
(Dated April 21, 2015)
FOR
NON-CONSULTING SERVICES TIME BASED
REGIONAL OVERSIGHT MANAGEMENT SERVICES (ROMS) – 6
IBRD Loan 8259-ID
BETWEEN
Directorate of Water Supply Development
Directorate General of Human Settlements
Ministry of Public Works and Public Housing
AND
PT. Kogas Driyap Konsultan
in Joint Venture With :
PT. Perentjana Djaja
Contract Number : KU.08.08/Kontrak/Pamsimas/175/VIII/2013
Dated : August 27, 2013
Page 2
SUMMARY OF CONTRACT
1. Loan No. : Loan IBRD8259 ID (Third Water Supply and
Sanitation for Low Income Communities-WSLIC3/
PAMSIMAS II)
2. Name of Service Providers : PT. KogasDriyapKonsultan
In Joint Venture with :
PT. PerentjanaDjaja
3. Contract No. and Date : : KU.08.08/Kontrak/Pamsimas/175/VIII/2013
Date: August 27, 2013
Amendment No. 1 : Dated : Nov 25, 2013
Amendment No. 2 : Dated : May 30, 2014
Amendment No. 3 : Dated : November 27, 2014
Amendment No. 4 : Dated : April 21, 2015
4. Domicile/Address of : Jl. Jatipadang Raya No. 41 Pasar Minggu,
Service Providers Jakarta Selatan, 12540
5. Value of Contract :
Original Contract : IDR 37,303,950,000 (Include VAT 10% APBN Portion)
Amendment No. 1 : IDR 36,505,201,500 (Include VAT 10% APBN Portion)
Amendment No. 2 : IDR 40,065,450,060 (Include VAT 10% APBN Portion)
Amendment No. 3 : IDR 44,553,693,599 (Include VAT 10% APBN Portion)
Amendment No. 4 : IDR 44,553,693,599 (Include VAT 10% APBN Portion)
6. Brief Description of Services : Provision of advisory services for the Provincial
Project Management Unit and District Project
Management Unit in the daily operation,
management and implementation of Community-
Based Water Supply Project (PAMSIMAS II) in the
Provinces of Gorontalo, Central Sulawesi, North
Sulawesi, Maluku and North Maluku.
7. Percentage Eligible for :
IBRD Financing
Original Contract : 80 % Net of VAT
Amendment No. 1 : 80 % Net of VAT
Amendment No. 2 : 80 % Net of VAT
Amendment No. 3 : 80 % Net of VAT
Amendment No. 4 : 80 % Net of VAT
Page 3
8. Percentage Eligible for :
APBN-RM Financing
Original Contract : 20 % Net of VAT
Amendment No. 1 : 20 % Net of VAT
Amendment No. 2 : 20 % Net of VAT
Amendment No. 3 : 20 % Net of VAT
Amendment No. 4 : 20 % Net of VAT
9. Percentage Eligible for :
APBN-RM Financing
(Non Sharing)
Original Contract : Nil
Amendment No. 1 : Nil
Amendment No. 2 : 100 % Net of VAT
Amendment No. 3 : 100 % Net of VAT
Amendment No. 4 : 100 % Net of VAT
10. Amount Eligible for :
IBRD Financing
Original Contract : IDR 29,258,000,000 (Net of VAT)
Amendment No. 1 : IDR 28,355,120,000 (Net of VAT)
Amendment No. 2 : IDR 28,355,120,000 (Net of VAT)
Amendment No. 3 : IDR 31,605,703,168 (Net of VAT)
Amendment No. 4 : IDR 31,605,703,168 (Net of VAT)
11. Amount Eligible for :
APBN-RM Financing
Original Contract : IDR 7,314,500,000 (Net of VAT)
IDR 731,450,040 (VAT 10%)
Amendment No. 1 : IDR 7,088,780,000 (Net of VAT)
IDR 708,878,600 (VAT 10%)
Amendment No. 2 : IDR 7,088,780,000 (Net of VAT)
IDR 708,878,600 (VAT 10%)
Amendment No. 3 : IDR 7,901,425,792 (Net of VAT)
IDR 790,142,579 (VAT 10%)
Amendment No. 4 : IDR 7,901,425,792 (Net of VAT)
IDR 790,142,579 (VAT 10%)
12. Amount Eligible for :
TF Financing
Original Contract : Nil
Amendment No. 1 : IDR 352,423,500 (Net of VAT)
Page 5
Table of Contents
Section I
FORM OF CONTRACT
Section II
GENERAL CONDITIONS OF CONTRACT ( No Change )
Section III
SPECIAL CONDITIONS OF CONTRACT ( Amended )
APPENDIX A
DESCRIPTION OF SERVICES ( No Change )
APPENDIX B
PERSONNEL AND STAFFING SCHEDULE ( No Change )
APPENDIX C
SUMMARY OF COST ESTIMATE ( No Change )
APPENDIX D
REMUNERATION AND REIMBURSABLE COST ESTIMATE ( No Change )
APPENDIX E
ADVANCE PAYMENT GUARANTEE ( No. Change )
APPENDIX F
PERFORMANCE BANK GUARANTEE ( No Change )
Page 6
Section I
FORM OF CONTRACT
Page 7
AMENDMENT No. 4 TO THE CONTRACT
Dated April 21, 2015
REGIONAL OVERSIGHT MANAGEMENT SERVICES (ROMS) 6
IBRD Loan 8259-ID
Contract Number : KU.08.08/Kontrak/Pamsimas/175/VIII/2013
Dated : August 27, 2013
This Contract Amendment No. 4 (hereinafter called “Amendment No. 4”) is made on
Tuesday, 21 of the month of April 2015 between, on the one hand, Directorate of Water
Supply Development, Directorate General of Human Settlements, Ministry of Public Works
and Public Housing, Government of Indonesia, (hereinafter called the “Employer”) and, on
the other hand, a Joint Venture PT. Kogas Driyap Konsultan consisting of the following
entities, each member of which will be jointly and severally liable to the Employer for all the
Service Provider’s obligations under this Contract, namely, PT. Perentjana Djaja
(hereinafter called the “Service Provider”).
WHEREAS
(a) decree of Minister of Public Works and Public Housing, number 137/KPTS/M/2015
dated March 17, 2015;
(b) the Employer had officially requested the Service Provider to submit the draft contract
Amendment No. 4, with letter No. UM.01.01/Pamsimas/IV/......, dated April 20, 2015;
(c) the Service Provider submit the Contract Amendment No. 4.
NOW THEREFORE the parties hereto hereby agree as follows:
The following documents attached hereto shall be deemed to form an integral part of this
Contract:
1. The General Conditions of Contract (including Attachment 1 “Bank Policy – Corrupt and
Fraudulent Practices); No Change
2. The Special Conditions of Contract ; Amended
3. Appendices:
(a) Appendix A : Description of Services; No Change
(b) Appendix B : Personnel, Staffing Schedule; No Change
(c) Appendix C : Summary Cost Estimates; No Change
(d) Appendix D : Remuneration and Reimbursable Cost Estimates; No Change
(e) Appendix E : Advance Payments Guarantee; No Change
(f) Appendix F : Performance Bank Guarantee; No Change
Page 9
Section II
GENERAL CONDITIONS OF CONTRACT (No Change)
Page 10
Section III
SPECIAL CONDITIONS OF CONTRACT (Amended)
Page 11
Special Conditions of Contract
Number of
GC Clause
Amendments of, and Supplements to, Clauses in the General
Conditions of Contract
1.1(e) The contract name is
Regional Oversight Management Services (ROMS) – 6
1.1(h) Currently written as :
The Employer is
Pejabat Pembuat Komitmen, Kegiatan Wilayah II,
Satuan Kerja Pembinaan Pamsimas
Direktorat Jenderal Cipta Karya
Kementerian Pekerjaan Umum
To be amended as :
The Employer is
Pejabat Pembuat Komitmen, Pembinaan Pelaksanaan Wilayah II,
Satuan Kerja Pengembangan Air Minum Berbasis Masyarakat
Direktorat Jenderal Cipta Karya
Kementerian Pekerjaan Umum dan Perumahan Rakyat
1.4 Currently written as :
The addresses are:
Employer: Pejabat Pembuat Komitmen, Kegiatan Wilayah II,
Satuan Kerja Pembinaan Pamsimas
Direktorat Jenderal Cipta Karya,
Kementerian Pekerjaan Umum
Attention: Diah Suryaningtyas,SIP,MM
Address: Jl. PAM Baru I No. 1
Pejompongan, Jakarta Pusat 10210
Telephone : 021 - 5742254
Service Provider: PT. Kogas Driyap Konsultan in Joint Venture with
PT. Perentjana Djaya
Attention: Yenni Siti Rostiani
Address: Jl. Jatipadang Raya No. 41 Pasar Minggu, Jakarta
Selatan 12540
Telephone : 021 - 7817707
Email: [email protected]
To be amended as :
The addresses are:
Employer: Pejabat Pembuat Komitmen, Pembinaan Pelaksanaan
Wilayah II, Satuan Kerja Pengembangan Air Minum
Berbasis Masyarakat
Direktorat Jenderal Cipta Karya,
Page 12
Number of
GC Clause
Amendments of, and Supplements to, Clauses in the General
Conditions of Contract
Kementerian Pekerjaan Umum dan Perumahan Rakyat
Attention: Diah Suryaningtyas,SIP,MM
Address: Jl. PAM Baru I No. 1
Pejompongan, Jakarta Pusat 10210
Telephone : 021 - 5742254
Service Provider: PT. Kogas Driyap Konsultan in Joint Venture with
PT. Perentjana Djaya
Attention: Yenni Siti Rostiani
Address: Jl. Jatipadang Raya No. 41 Pasar Minggu, Jakarta
Selatan 12540
Telephone : 021 - 7817707
Email: [email protected]
1.6 Currently written as :
The Authorized Representatives are:
For the Employer : Diah Suryaningtyas,SIP,MM
Pejabat Pembuat Komitmen, Kegiatan Wilayah
II, Satuan Kerja Pembinaan Pamsimas
Direktorat Jenderal Cipta Karya
Kementerian Pekerjaan Umum
For the Service Provider : Yenni Siti Rostiani
President Director PT. Kogas Driyap Konsultan
To be amended as :
The Authorized Representatives are:
For the Employer : Diah Suryaningtyas,SIP,MM
Pejabat Pembuat Komitmen, Pembinaan
Pelaksanaan Wilayah II, Satuan Kerja
Pengembangan Air Minum Berbasis
Masyarakat
Direktorat Jenderal Cipta Karya
Kementerian Pekerjaan Umum dan Perumahan
Rakyat
For the Service Provider : Yenni Siti Rostiani
President Director PT. Kogas Driyap Konsultan
Page 13
APPENDIX A
TERMS OF REFERENCE
(No Change)
Page 14
APPENDIX B
PERSONNEL AND STAFFING SCHEDULE
(No Change)
Page 15
APPENDIX C
SUMMARY OF COST ESTIMATE
(No Change)
Page 16
APPENDIX D
REMUNERATION AND REIMBURSABLE
COST ESTIMATE
(No Change)
Page 17
APPENDIX E
ADVANCE PAYMENT GUARENTEE
(No Change)
Page 18
APPENDIX F
PERFORMANCE BANK GUARANTEE
(No Change)
