CERTIFICATE

FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\01N

DATE OF ISSUANCE:

20 July 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date July 20, 1999, ref.No. 002/LP-I/VII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

b. Total approved VO
Update contract value
SUBSEQUENT CHARGE ORDER

NUMBER

0.00%

2,600,000,000.00

100.00%

before PPN 10%

APPROVED

V.O.

100.00%

before PPN 10%

(DATED)

c. Last Month Progress

0.00

0.00%

d. This Month Progress

259,778,583.71

9.99%

e. Achieved progress (d - c)

259,778,583.71

9.99%

f. Deduct advanced payment

-51,955,716.74

(-e% x DP.)

g. Retention 5%
Total recommended to be paid

-12,988,929.19

(-5% x e.)

194,833,937.78

(e+f+g)

By word:
Thirty four million nine hundred ninety seven thousand and fifty rupiah
TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO
Update contract value

SUBSEQUENT CHARGE ORDER

2,600,000,000.00

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

259,778,583.71

V.O.

(DATED)

d. This Month Progress

488,455,432.91

e. Achieved progress (d - c)

228,676,849.20

f. Deduct advanced payment

-45,735,369.84

g. Retention 5%

-11,433,842.46

Total recommended to be paid

171,507,636.90

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

100.00%
0.00%
100.00%

9.99%
18.79%
8.80%
(-e% x DP.)

Teruskan

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO
Update contract value

SUBSEQUENT CHARGE ORDER

2,600,000,000.00

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

488,455,432.91

V.O.

(DATED)

d. This Month Progress

849,921,363.77

e. Achieved progress (d - c)

361,465,930.86

f. Deduct advanced payment

-72,293,186.17

g. Retention 5%

-18,073,296.54

Total recommended to be paid

271,099,448.15

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

100.00%
0.00%
100.00%

18.79%
32.69%
13.90%
(-e% x DP.)

Teruskan

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO
Update contract value

SUBSEQUENT CHARGE ORDER

2,600,000,000.00

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

849,921,363.77

V.O.

(DATED)

d. This Month Progress

1,180,282,726.50

e. Achieved progress (d - c)

330,361,362.73

f. Deduct advanced payment

-66,072,272.55

g. Retention 5%

-16,518,068.14

Total recommended to be paid

247,771,022.05

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

100.00%
0.00%
100.00%

32.69%
45.40%
12.71%
(-e% x DP.)

Teruskan

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO
Update contract value

SUBSEQUENT CHARGE ORDER

2,600,000,000.00

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

1,180,282,726.50

V.O.

(DATED)

d. This Month Progress

1,246,205,440.15

e. Achieved progress (d - c)

65,922,713.65

f. Deduct advanced payment

-13,184,542.73

g. Retention 5%

-3,296,135.68

Total recommended to be paid

49,442,035.24

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

100.00%
0.00%
100.00%

45.40%
47.93%
2.54%
(-e% x DP.)

Teruskan

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO

441,841,777.50

Update contract value

SUBSEQUENT CHARGE ORDER

3,041,841,777.50

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

1,246,205,440.15

V.O.

(DATED)

d. This Month Progress

1,482,470,326.12

e. Achieved progress (d - c)

236,264,885.97

f. Deduct advanced payment

-40,389,260.75

g. Retention 5%

-11,813,244.30

Total recommended to be paid

184,062,380.92

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

85.47%
14.53%
100.00%

40.97%
48.74%
7.77%
(-e% x DP.)

Teruskan

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO

441,841,777.50

Update contract value

SUBSEQUENT CHARGE ORDER

3,041,841,777.50

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

1,482,470,326.12

V.O.

(DATED)

d. This Month Progress

1,587,388,579.69

e. Achieved progress (d - c)

104,918,253.57

f. Deduct advanced payment

-17,935,677.08

g. Retention 5%

-5,245,912.68

Total recommended to be paid

81,736,663.81

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

85.47%
14.53%
100.00%

48.74%
52.19%
3.45%
(-e% x DP.)

Teruskan

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO

970,212,071.36

Update contract value

SUBSEQUENT CHARGE ORDER

3,570,212,071.36

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

1,587,388,579.69

V.O.

(DATED)

d. This Month Progress

1,896,520,724.90

e. Achieved progress (d - c)

309,132,145.21

f. Deduct advanced payment

-45,024,976.75

g. Retention 5%

-15,456,607.26

Total recommended to be paid

248,650,561.20

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

72.82%
27.18%
100.00%

44.46%
53.12%
8.66%
(-e% x DP.)

Teruskan

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO

1,494,109,071.36

Update contract value

SUBSEQUENT CHARGE ORDER

4,094,109,071.36

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

1,896,520,724.90

V.O.

(DATED)

d. This Month Progress

2,293,129,810.37

e. Achieved progress (d - c)

396,609,085.47

f. Deduct advanced payment

-50,374,018.10

g. Retention 5%

-19,830,454.27

Total recommended to be paid

326,404,613.10

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

63.51%
36.49%
100.00%

46.32%
56.01%
9.69%
(-e% x DP.)

Teruskan

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO

1,494,109,071.36

Update contract value

SUBSEQUENT CHARGE ORDER

4,094,109,071.36

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

2,293,129,810.37

V.O.

(DATED)

d. This Month Progress

3,276,793,162.47

e. Achieved progress (d - c)

983,663,352.10

f. Deduct advanced payment

-117,034,979.29

g. Retention 5%

-49,183,167.61

Total recommended to be paid

817,445,205.20

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

63.51%
36.49%
100.00%

56.01%
80.04%
24.03%
(-e% x DP.)

Oke

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO

1,494,109,071.36

Update contract value

SUBSEQUENT CHARGE ORDER

4,094,109,071.36

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

3,276,793,162.47

V.O.

(DATED)

d. This Month Progress

3,665,323,518.40

e. Achieved progress (d - c)

388,530,355.93

f. Deduct advanced payment

0.00

g. Retention 5%

-19,426,517.80

Total recommended to be paid

369,103,838.13

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

63.51%
36.49%
100.00%

80.04%
89.53%
9.49%
(-e% x DP.)

Oke

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO

1,494,109,071.36

Update contract value

SUBSEQUENT CHARGE ORDER

4,094,109,071.36

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

3,665,323,518.40

V.O.

(DATED)

d. This Month Progress

3,895,523,714.03

e. Achieved progress (d - c)

230,200,195.63

f. Deduct advanced payment

0.00

g. Retention 5%

-11,510,009.78

Total recommended to be paid

218,690,185.85

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

63.51%
36.49%
100.00%

89.53%
95.15%
5.62%
(-e% x DP.)

Oke

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Teruskan

CERTIFICATE
FOR PAYMENT
PROJECT:

LOSARI COFFEE PLANTATION RESORT AND SPA

CERTIFICATE NO.:

LS\02N

DATE OF ISSUANCE:

03 August 1999

PROJECT NO.:

10

CONTRACTOR:

BP. ANDY PRASETYO

CONTRACT FOR:

LOSARI COFFEE PLANTATION RESORT & SPA

(Name, Address) LOSARI KEBON KOPI, GRABAG

MAGELANG, JATENG
TO:
(Employer)

PT. LUPITA AMANDA

SETIA BUDI BUILDING I, 4 FL, BLOCK D-2
JL. H.R. RASUNA SAID, KUNINGAN
JAKARTA - INDONESIA

PROJECT PHASE I
CONTRACT DATE:

28 June 1999

In accordance with this Contract and the attached Application for payment date August 03, 1999, ref.No. 010/LP-I/VIII/1999, the Contractor is entitled
to payment in the amount stipulated below. The present status of the account for this Contract is as follows:
ADDITION RP.

DEDUCTION RP.

Change order approved in previous

a. Original Contract

months by Employer - TOTAL

2,600,000,000.00

before PPN 10%

b. Total approved VO

1,494,109,071.36

Update contract value

SUBSEQUENT CHARGE ORDER

4,094,109,071.36

before PPN 10%

NUMBER

APPROVED

c. Last Month Progress

3,895,523,714.03

V.O.

(DATED)

d. This Month Progress

4,094,109,071.36

e. Achieved progress (d - c)

198,585,357.33

f. Deduct advanced payment

0.00

g. Retention 5%

-9,929,267.87

Total recommended to be paid

188,656,089.46

By word:
Seventy seven million three hundred sixty three
thousand and sixty hundred rupiah
0.00

TOTAL
SUPERVISOR:

CONTRACTOR:

PT. CARATWARSA HANGANDANA

EMPLOYER:
PT. LUPITA AMANDA

Signed:

Signed:

Signed:

Name:

Name:

Name:

Date:

Date:

Date:

This certificate is negotiable. It is payable only to the payee herein and its issuance, payment and acceptance are without prejudice to any rights of the Employer or Contractor
under their contract. If application for payment or other application form containing satisfactory evidence of payment for work previously completed DOES NOT ACCOMPANY
THIS CERTIFICATE, the Contractor shall first provide the equivalent certification by completing and executing the following:
The undersigned that the works covered by this Certificate for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid for
for which previous Certificate for Payment issued and payments received, and that the current payment shown herein is now due.

TIFICATE
PAYMENT

E PLANTATION RESORT & SPA

Contractor is entitled

63.51%
36.49%
100.00%

95.15%
100.00%
4.85%
(-e% x DP.)

Oke

(-5% x e.)
(e+f+g)

of the Employer or Contractor

d DOES NOT ACCOMPANY

amounts have been paid for

Oke

Certificate Payment ( Non PPN )

No.
%

1
2
3
4
5
6
7
8
9
10
11
12
13

9.99%
8.80%
13.90%
12.71%
2.54%
7.77%
3.45%
8.66%
9.69%
24.03%
9.49%
5.62%
4.85%

Total

Progress
Nilai (Rp)

Pot. Uang Muka Pot. Retensi

( Rp )
( Rp )

Total Pot.
Uang Muka s/d

12,988,929.19
11,433,842.46
18,073,296.54
16,518,068.14
3,296,135.68
11,813,244.30
5,245,912.68
15,456,607.26
19,830,454.27
49,183,167.61
19,426,517.80
11,510,009.78
9,929,267.87

194,833,937.78
171,507,636.90
271,099,448.15
247,771,022.05
49,442,035.24
184,062,380.92
81,736,663.81
248,650,561.20
326,404,613.10
817,445,205.20
369,103,838.13
218,690,185.85
188,656,089.46

121.48% 4,094,109,071.36 520,000,000.00 204,705,453.57

3,369,403,617.79

Uraian
Kontrak
VO
Total
Selisih

259,778,583.71 51,955,716.74
228,676,849.20 45,735,369.84
361,465,930.86 72,293,186.17
330,361,362.73 66,072,272.55
65,922,713.65 13,184,542.73
236,264,885.97 40,389,260.75
104,918,253.57 17,935,677.08
309,132,145.21 45,024,976.75
396,609,085.47 50,374,018.10
983,663,352.10 117,034,979.29
388,530,355.93
0.00
230,200,195.63
0.00
198,585,357.33
0.00

Total
( Rp )

Nilai (Rp.)

DP 20%

Retensi 5%

Yg harus dibayarkan

2,600,000,000.00 520,000,000.00 130,000,000.00

1,950,000,000.00

1,494,109,071.36

74,705,453.57

1,419,403,617.79

4,094,109,071.36 520,000,000.00 204,705,453.57

3,369,403,617.79

0.00

0.00

0.00

0.00

0.00

51,955,716.74
97,691,086.58
169,984,272.75
236,056,545.30
249,241,088.03
289,630,348.78
307,566,025.86
352,591,002.61
402,965,020.71
520,000,000.00
520,000,000.00
520,000,000.00
520,000,000.00

Total

194,833,937.78
366,341,574.68
637,441,022.83
885,212,044.88
934,654,080.11
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