|
PT. BANGGAI SENTRAL SULAWESI
General Contractor and Suppliers
Jl. Urip Sumoharjo No. 53 Luwuk, Kabupaten Banggai, Propinsi Sulawesi Tengah
|
|
RINCIAN PEKERJAAN
| Rincian Pekerjaan | : | 029/BSS-JOB/WS/VIII/2026 |
Ditujukan Kepada | : | JOB Pertamina - Medco E&P Tomori Sulawesi |
| Nomor Kontrak | : | 7201250141 |
Nomor Purchase Order | : | 0 |
| Nama Kontrak | : | Penyediaan General Services Untuk Mendukung Kegiaatan Pengemboran, Kerja Ulang Dan Perawatan Sumur di Blok Senoro - Toili, Sulawesi Tengah |
Lingkup Pekerjaan | : | Pengadaan Diesel Fuel & Lube Oil include Tranportir fee untuk Support Pekerjaan Well Services di Senoro Periode Agustus 2026 |
| Nomor Tender | : | S25048TPD |
Tanggal Purchase Order | : | 07 Aug 2026 |
| Tanggal Proforma | : | 31 Aug 2026 |
Mata Uang | : | IDR |
| No. |
Kategori |
Uraian Pekerjaan |
Qty |
Satuan |
Tgl Mulai |
Tgl Selesai |
Harga Satuan (IDR) |
Total Harga (IDR) |
Keterangan |
| 1 |
PENGADAAN MATERIAL |
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
250.00 |
Ltr |
08 Aug 2026 |
08 Aug 2026 |
25,000 |
6,250,000 |
Pengadaan Diesel Fuel include Tranportir fee, untuk Crane 70 Ton |
| 2 |
PENGADAAN MATERIAL |
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
200.00 |
Ltr |
23 Aug 2026 |
23 Aug 2026 |
25,000 |
5,000,000 |
Pengadaan Diesel Fuel include Tranportir fee, untuk Crane 100 Ton |
| 3 |
PENGADAAN MATERIAL |
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
50.00 |
Ltr |
08 Aug 2026 |
08 Aug 2026 |
25,000 |
1,250,000 |
Pengadaan Diesel Fuel include Tranportir fee, untuk Genset 80 KVa |
| 4 |
PENGADAAN MATERIAL |
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
50.00 |
Ltr |
08 Aug 2026 |
08 Aug 2026 |
25,000 |
1,250,000 |
Pengadaan Diesel Fuel include Tranportir fee, untuk Genset 80 KVa |
| 5 |
PENGADAAN MATERIAL |
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
50.00 |
AU |
08 Aug 2026 |
08 Aug 2026 |
25,000 |
1,250,000 |
Pengadaan Diesel Fuel include Tranportir fee, untuk Lighting Tower 05 |
| 6 |
PENGADAAN MATERIAL |
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
50.00 |
Ltr |
08 Aug 2026 |
08 Aug 2026 |
25,000 |
1,250,000 |
Pengadaan Diesel Fuel include Tranportir fee, untuk Lighting Tower 06 |
| 7 |
PENGADAAN MATERIAL |
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
115.00 |
Ltr |
08 Aug 2026 |
23 Aug 2026 |
25,000 |
2,875,000 |
Pengadaan Diesel Fuel include Tranportir fee, untuk Vacuum Truck 5000 L |
| TOTAL TAGIHAN : |
19,125,000 |
|
Terbilang : Sembilan Belas Juta Seratus Dua Puluh Lima Ribu Rupiah
DIBUAT OLEH
Yanuar Wiranata / Ireine Langi
Supervisor
|
DIPERIKSA
Onesimus Suriadi
Manager General Services
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|
|
PT. BANGGAI SENTRAL SULAWESI
General Contractor and Suppliers
Jl. Urip Sumoharjo No. 53 Luwuk, Kabupaten Banggai, Propinsi Sulawesi Tengah
|
|
PROFORMA INVOICE
TO:
JOB Pertamina - Medco E&P Tomori Sulawesi
Bidakara Office Tower I 4Th Floor, Jl. Gatot Subroto Kav. 71 - 73, Jakarta 12870, Indonesia
Attn.: Accounts Payable - Finance Department
|
| Proforma Invoice No. | : | 029/BSS-JOB/WS/VIII/2026 |
| Tanggal Performa Invoice | : | 31 Aug 2026 |
| Nomor Kontrak | : | 7201250141 |
| Jangka Waktu Kontrak | : | 2 tahun (17 Desember 2025 sd 03 Desember 2027) |
| Nomor Purchase Order | : | 0 |
|
| Item |
Description |
Qty |
Satuan |
Unit Price (IDR) |
TOTAL (IDR) |
| 1 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Crane 70 Ton |
250.00 |
Ltr |
25,000 |
6,250,000 |
| 2 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Crane 100 Ton |
200.00 |
Ltr |
25,000 |
5,000,000 |
| 3 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Genset 80 KVa |
50.00 |
Ltr |
25,000 |
1,250,000 |
| 4 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Genset 80 KVa |
50.00 |
Ltr |
25,000 |
1,250,000 |
| 5 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Lighting Tower 05 |
50.00 |
AU |
25,000 |
1,250,000 |
| 6 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Lighting Tower 06 |
50.00 |
Ltr |
25,000 |
1,250,000 |
| 7 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Vacuum Truck 5000 L |
115.00 |
Ltr |
25,000 |
2,875,000 |
| GRAND TOTAL: |
19,125,000 |
Terbilang: Sembilan Belas Juta Seratus Dua Puluh Lima Ribu Rupiah
PAYMENT INSTRUCTION:
Please remit to our bank:
Bank Name: BANK RAKYAT INDONESIA (PERSERO) Tbk.
Branch: Cabang Luwuk
Account No: 0167 0167 8888 303
Account Name: PT. BANGGAI SENTRAL SULAWESI
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PT Banggai Sentral Sulawesi
Onesimus Suriadi
Manager General Services
|
|
BERITA ACARA SERAH TERIMA BARANG (BASTB)
PENYERAHAN BARANG / MATERIAL
|
|
Pada hari ini, tanggal 8 Agustus 2026, yang bertanda tangan di bawah ini:
| 01. PIHAK PERTAMA | |
| Nama Perusahaan | : JOB Pertamina - Medco E&P Tomori Sulawesi |
| Alamat | : Bidakara Office Tower I 4Th Floor, Jl. Gatot Subroto Kav. 71 - 73, Jakarta 12870, Indonesia |
| Diwakili oleh | : Aldito Fauzi Roe / Aryanto Yoga |
| Jabatan | : Contract Engineer |
| 02. PIHAK KEDUA | |
| Nama Perusahaan | : PT Banggai Sentral Sulawesi |
| Alamat | : Jl. Urip Sumorharjo No. 53, Luwuk, Kabupaten Banggai, Provinsi Sulawesi Tengah (94715), Indonesia |
| Diwakili oleh | : Ir. Ferry Tatimu |
| Jabatan | : Direktur |
DASAR PENYERAHAN BARANG / MATERIAL
| Nomor Kontrak | : 7201250141 |
| Tanggal Kontrak | : 17 Dec 2025 |
| Nomor Purchase Order | : 0 |
| Tanggal Purchase Order | : 07 Aug 2026 |
| Lingkup Pengadaan | : Pengadaan Diesel Fuel & Lube Oil include Tranportir fee untuk Support Pekerjaan Well Services di Senoro Periode Agustus 2026 |
Dengan ini PIHAK KEDUA menyerahkan dan PIHAK PERTAMA menyatakan telah menerima pengadaan barang/material dengan baik, lengkap, dan sesuai spesifikasi terhitung sampai dengan tanggal 8 Agustus 2026:
| NO |
SPESIFIKASI BARANG / MATERIAL |
QTY |
SATUAN |
KONDISI / KETERANGAN |
| 1 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
250.00 |
Ltr |
Pengadaan Diesel Fuel include Tranportir fee, untuk Crane 70 Ton |
| 2 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
200.00 |
Ltr |
Pengadaan Diesel Fuel include Tranportir fee, untuk Crane 100 Ton |
| 3 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
50.00 |
Ltr |
Pengadaan Diesel Fuel include Tranportir fee, untuk Genset 80 KVa |
| 4 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
50.00 |
Ltr |
Pengadaan Diesel Fuel include Tranportir fee, untuk Genset 80 KVa |
| 5 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
50.00 |
AU |
Pengadaan Diesel Fuel include Tranportir fee, untuk Lighting Tower 05 |
| 6 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
50.00 |
Ltr |
Pengadaan Diesel Fuel include Tranportir fee, untuk Lighting Tower 06 |
| 7 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee, |
115.00 |
Ltr |
Pengadaan Diesel Fuel include Tranportir fee, untuk Vacuum Truck 5000 L |
Demikian Berita Acara Serah Terima ini dibuat dengan sebenarnya dan ditandatangani oleh kedua belah pihak untuk dipergunakan sebagaimana mestinya.
JOB Pertamina - Medco E&P Tomori Sulawesi
PIHAK PERTAMA
Aldito Fauzi Roe / Aryanto Yoga
Contract Engineer
|
PT Banggai Sentral Sulawesi
PIHAK KEDUA
Ir. Ferry Tatimu
Direktur
|
Dokumen No: FM-GS-04 Rev:03
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Penyediaan General Services Untuk Mendukung Kegiaatan Pengemboran, Kerja Ulang Dan Perawatan Sumur di Blok Senoro - Toili, Sulawesi Tengah
Contract No. 7201250141
|
|
WORK COMPLETION CERTIFICATE
CERTIFICATE NO : 7201250141-BSS-WCC-2026-006C
On the date of 8 August 2026 we on behalf of PT Banggai Sentral Sulawesi have completed the following job:
| WORK ORDER NUMBER |
: |
0 |
| WORK ORDER TITLE |
: |
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee untuk Support Pekerjaan Well Services di Senoro Periode Agustus 2026 |
| CTR NUMBER |
: |
017/BSS-JOB/FLD/II/2026 |
| DESCRIPTION |
: |
100% - Penyelesaian Pekerjaan
Rp 19,125,000
|
| AMOUNT TOTAL |
: |
Sembilan Belas Juta Seratus Dua Puluh Lima Ribu Rupiah |
The work has been properly completed as per requirement, witnessed and accepted by JOB Pertamina - Medco E&P Tomori Sulawesi.
Luwuk, 8 August 2026
PT Banggai Sentral Sulawesi
Prepared by,
Onesimus Suriadi
Manager General Services
|
JOB Pertamina - Medco E&P Tomori Sulawesi
Approved by,
Aldito Fauzi Roe / Aryanto Yoga
Contract Engineer
|
|
|
PT. BANGGAI SENTRAL SULAWESI
General Contractor and Suppliers
Jl. Urip Sumoharjo No. 53 Luwuk, Kabupaten Banggai, Propinsi Sulawesi Tengah
|
|
BERITA ACARA PEKERJAAN / OPNAME
| JOB TITLE / WO / PO | : Pengadaan Diesel Fuel & Lube Oil include Tranportir fee untuk Support Pekerjaan Well Services di Senoro Periode Agustus 2026 |
| CTR / WO / PO No. | : 0 |
| DATE | : 8 Agustus 2026 |
| PROFORMA INVOICE No. | : 029/BSS-JOB/WS/VIII/2026 |
| NO |
ITEM - DESCRIPTION |
UOM |
BASE ON CTR / PO |
PREVIOUS OPNAME (IDR) |
AKTUAL OPNAME (BULAN INI) (IDR) |
CUMMULATIVE OPNAME (IDR) |
| VOLUME |
UNIT PRICE |
TOTAL PRICE |
VOLUME |
TOTAL PRICE |
VOLUME |
TOTAL PRICE |
VOLUME |
TOTAL PRICE |
| 1.1 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Crane 70 Ton |
Ltr |
250.00 |
25,000 |
6,250,000 |
0.00 |
0 |
250.00 |
6,250,000 |
250.00 |
6,250,000 |
| 1.2 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Crane 100 Ton |
Ltr |
200.00 |
25,000 |
5,000,000 |
0.00 |
0 |
200.00 |
5,000,000 |
200.00 |
5,000,000 |
| 1.3 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Genset 80 KVa |
Ltr |
50.00 |
25,000 |
1,250,000 |
0.00 |
0 |
50.00 |
1,250,000 |
50.00 |
1,250,000 |
| 1.4 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Genset 80 KVa |
Ltr |
50.00 |
25,000 |
1,250,000 |
0.00 |
0 |
50.00 |
1,250,000 |
50.00 |
1,250,000 |
| 1.5 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Lighting Tower 05 |
AU |
50.00 |
25,000 |
1,250,000 |
0.00 |
0 |
50.00 |
1,250,000 |
50.00 |
1,250,000 |
| 1.6 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Lighting Tower 06 |
Ltr |
50.00 |
25,000 |
1,250,000 |
0.00 |
0 |
50.00 |
1,250,000 |
50.00 |
1,250,000 |
| 1.7 |
PENGADAAN MATERIAL
Pengadaan Diesel Fuel & Lube Oil include Tranportir fee,
Pengadaan Diesel Fuel include Tranportir fee, untuk Vacuum Truck 5000 L |
Ltr |
115.00 |
25,000 |
2,875,000 |
0.00 |
0 |
115.00 |
2,875,000 |
115.00 |
2,875,000 |
| TOTAL : |
250.00 | - | 19,125,000 |
0.00 | 0 |
250.00 | 19,125,000 |
250.00 | 19,125,000 |
Total Akumulasi Penyerapan (Cumulative Opname): Rp 19,125,000
Sisa Nilai Anggaran PO (Deviasi): Rp 0
Luwuk, 8 Agustus 2026
PT Banggai Sentral Sulawesi
Prepared by,
Onesimus Suriadi
Manager General Services
|
JOB Pertamina - Medco E&P Tomori Sulawesi
Approved by,
Aldito Fauzi Roe / Aryanto Yoga
Contract Engineer
|
|
|
PT. BANGGAI SENTRAL SULAWESI
General Contractor and Suppliers
Jl. Urip Sumoharjo No. 53 Luwuk, Kabupaten Banggai, Propinsi Sulawesi Tengah
|
|
TABEL PERHITUNGAN TINGKAT KOMPONEN DALAM NEGERI - JASA
SELF - ASSESSMENT (PERMEN ESDM NO. 15 TAHUN 2013)
| Nama Penyedia Jasa | : | PT Banggai Sentral Sulawesi |
Nomor Kontrak | : | 7201250141 |
| Judul Kontrak | : | Penyediaan General Services Untuk Mendukung Kegiaatan Pengemboran, Kerja Ulang Dan Perawatan Sumur di Blok Senoro - Toili, Sulawesi Tengah |
Nomor PO | : | 0 |
| Mata Uang | : | IDR |
Tanggal | : | 11 September 2026 |
A. KOMPONEN BIAYA
(COST COMPONENT) |
MATA UANG |
KDN (A) |
KLN (B) |
TOTAL (C = A + B) |
% NILAI TKDN
(D = A / C) |
NILAI TKDN
(E = C X D) |
I. Biaya Bahan (Material) Terpakai
(material used cost) |
Rp |
Rp 0 |
Rp 0 |
Rp 0 |
0.00% |
Rp 0 |
|
US$ |
0.00 |
0.00 |
0.00 |
0.00% |
0.00 |
II. Biaya Tenaga Kerja & Konsultan
(personnel & consultant cost) |
Rp |
Rp 0 |
Rp 0 |
Rp 0 |
0.00% |
Rp 0 |
|
US$ |
0.00 |
0.00 |
0.00 |
0.00% |
0.00 |
III. Biaya Alat Kerja / Fasilitas Kerja
(equipment & work facility cost) |
Rp |
Rp 0 |
Rp 0 |
Rp 0 |
0.00% |
Rp 0 |
|
US$ |
0.00 |
0.00 |
0.00 |
0.00% |
0.00 |
IV. Biaya Jasa Umum
(other services cost) |
Rp |
Rp 18,168,750 |
Rp 0 |
Rp 18,168,750 |
100.00% |
Rp 18,168,750 |
|
US$ |
0.00 |
0.00 |
0.00 |
0.00% |
0.00 |
V. JUMLAH BIAYA (Σ I s/d IV)
(Total Cost) |
Rp |
Rp 18,168,750 |
Rp 0 |
Rp 18,168,750 |
100.00% |
Rp 18,168,750 |
|
US$ |
0.00 |
0.00 |
0.00 |
0.00% |
0.00 |
B. KOMPONEN BUKAN BIAYA
(Non-cost Component) |
Rp |
|
Rp 956,250 |
|
|
US$ |
|
0.00 |
|
| C. JUMLAH NILAI TOTAL (A + B) |
Rp |
|
Rp 19,125,000 |
|
|
US$ |
|
0.00 |
|
| CAPAIAN PERSENTASE TKDN AKHIR (%): |
95.00 % |
Catatan:
• Isi hanya pada kolom yang berwarna kuning pastel.
• Formulasi perhitungan mengacu pada Permen ESDM No. 15 Tahun 2013.
|
Luwuk, 11 September 2026
PT Banggai Sentral Sulawesi
Ir. Ferry Tatimu
Direktur
|