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PT.

BIROTIKA SEMESTA
Building F, Mulia Business Park
Jl. M.T. Haryono Kav 58-60
Jakarta 12780, Indonesia *9557629513*
Toll Free: 0-800-1333-333
NPWP 01.310.774.3-062.000
INBOUND CHARGES INVOICE
PT SINERGY ERA CEMERLANG
Account Number : DUTYIDUPG
PROYEK PLTS GORONTALO DESA MOLOWAHU
KECAMATAN TIBAWA KABUPATEN GORONTAL Invoice Number : D04791545
PROVINSI GORONTALO HWB Number : 9557629513
96111
Date : 07/01/2019
Attn: BANGUN MARDIYANTO
Contact Number: 62 813 2508 9646 Payment Due Date : 07/01/2019

Please Reimburse the Total Charges Shown Below To: PT. BIROTIKA SEMESTA

Shipment Details
Origin: SHA Pieces: 3 Contents: PLASTIC CONNECTOR
Destination: UPG Weight: 19.30 Assessed Value: Arrival Date: 03/01/2019

Billing Details
IMPORT EXPORT DUTIES 1,107,000
BANK CHARGES 45,000
DOCUMENT CHARGES 20,000
DUTY HANDLING CHARGES (ADVANCE PAYMENTS) 100,000
VAT FOR OTHER CHARGES 12,000

Payment Terms
Cash on delivery unless
stated otherwise on the invoice
THIS IS A COMPUTER GENERATED INVOICE. NO SIGNATURE IS REQUIRED.
Please Pay This Amount: IDR 1,284,000

Remittance Advice

Company Signature / Stamp: Account Number : DUTYIDUPG


We enclose cash for IDR 1,284,000
Invoice Number : D04791545
We enclose cheque No. ________________ for IDR 1,284,000
HWB Number : 9557629513
Please debit our Credit / Charge Card No. ____________________________
Date : 07/01/2019
Cardholder name: _______________________________
Total Amount IDR : 1,284,000
Expiry date: ____________________________________

Not all payment options are available to all countries

* 1 2 8 4 0 0 0 * * D U T Y I D U P G * * D 0 4 7 9 1 5 4 5 *

1. Detach this payment advice and return it together with your payment
2. Cheque should be crossed and made payable to PT. BIROTIKA SEMESTA

Customer Endorsement
SSPCP PIB/PIBT Nota 2A

We acknowledge receipt of the above documentation Account Number : DUTYIDUPG

PT SINERGY ERA CEMERLANG Invoice Number : D04791545

Company Signature / Stamp: HWB Number : 9557629513

Printed Name / Title: Date : 07/01/2019

Total Amount IDR : 1,284,000

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