QUOTATION SLIP

1098/PB/XI/2017
TYPE OF INSURANCE : Industrial All Risks Insurance excluding Earthquake

POLICY WORDING : Munich Re Wording

THE INSURED : PT BANK ICBC INDONESIA QQ PT MEGADAYA TANGGUH and

its subsidiaries and/or affiliated companies and/or
any other company owned, operated, managed or controlled by the
Insured for their respective rights and interests.

RISK LOCATION : PLTU MW Amurang, Sulawesi Utara

PERIOD OF INSURED : TBA

(Both dates inclusive at 12.00 noon local time where insured
properties are located.)

OCCUPANCY : Conventional power station, buildings with boiler houses and steam
houses /281 II

INTERESTS/SUM : BUILDING AND MACHINE = USD 85,000,000

INSURED

DEDUCTIBLES : Fire, Lightning, Explosion Aircraft Damage & Smoke :

(each and every loss or 5% of Claim or 0.10% of Total Sum Insured which ever is greater
damage) Riot, Strike, Malicious Damage ,Civil Commotion :
10% of Claim, Min. USD 2,500 each and every claim
Typhoon, Strikes, Flood and Water Damage :
10% of Claim
All Other losses or Damage :
10 % of Claim Min USD 500 any one accident

PREMIUM RATE : FLEXAS : 0.3011%

RSMDCC : 0.0015%
TSFWD : 0.0045%
Others : 0.0010%
Total : 0.3486%

PREMIUM : USD 85,000,000 x 0.3486% = USD 296,310 (Excl. Policy

CALCULATION Cost+Stamp)

SHARE : PT ASURANSI DAYIN MITRA TBK = 25%

ADDITIONAL CLAUSES : 1) All Other Contents Clause (Limit USD. 1,000.00 per item max. USD
5,000)
2) Alteration Clause (30 days)
3) Architects, Surveyors & Consulting Engineers Clause 5% of loss
4) Average Relief Clause (85%)
5) Automatic Reinstatement Value Clause (subject to additional premium)
6) Bankers Clause - PT Bank ICBC Indonesia
7) Capital Addition Clause (limit 10% of Sum Insured)
8) Claim Settlement Clause (Max 30 day Since Approval From The
Insured)
9) Co- Insurance Clause
10) Cover of extra charges for overtime, night work, work on public holidays
and express freight (MR 006) Limit maximum USD. 5,000 or 10% of
loss
11) Currency Clause
12) Cancellation Clause
13) Designation Clause
14) Exclude transmission and distribution line
15) Expediting Expenses Clause (5% of claim, max USD 10,000)
16) Extra Contractual Obligation Exclusion Clause
17) Electronic Date Recognition Clause (EDRC) A
18) Earthquake Exclusion Clause
19) Fire Brigade Charges Clause (USD 10,000)
20) Fire Extinguishing Cost Clause (USD 10,000)
21) General Interest Clause
22) Impact by own Vehicle Clause
23) Internal Removal Clause
24) Indonesian Jurisdiction Clause
25) Industries, Seepage, Pollution and Contamination exclusion Clause
26) Loss Notification Clause ( 14 day )
27) Misdescription Clause
28) Minor Alterations and Repairs Clause
29) NMA 2920 Terrorism Exclusion Clause
30) NMA 2912 IT Hazard Clarification Clause
31) NMA 2915 Cyber Risk Exclusion Clause
32) Nominated of Loss Adjuster ( PT. McLaren Indonesia and PT. Radita
Hutama Indonesia ) subject to mutually agreed by insurer and the
insured
33) Outbuildings Clause
34) Payment on Account Clause (25%)
35) Professional Fees Limit USD 10,000
36) Prorate Return of Premium Clause (maximum 85%) subject to nil claim
37) Public Authorities Clause
38) Removal of Debris (Limit 10% of loss)
39) Reinstatement Value Clause (Subject to Additional Premium)
40) Riot, Strike and Malicious Damage + Civil Commotion Endorsement
(4.1B/2007)
41) Services Clause
42) Waiver of Subrogation Clause (against subsidiary only)
 43) Vehicle Load Clause
44) Workmens Clause
45) Transmission & Distribution Line Exclusion Clause
46) Electronic Date Recognition Clause A
47) IT Hazard Clarification Clause
48) IT Clarification Agreement
49) Transmission and Distribution Lines Exclusion Clause
50) Dispute Clause
51) Termination of Insurance
52) Waiver Clause againts subsidiaries only

1. No flood prone area.

2. No claim up to binding date.
3. Adequate APAR in good condtion.

SUBJECT TO :

Signed for and on behalf of

PT. ASURANSI DAYIN MITRA TBK
Marketing Department PT. Lombok Saka

Jimmy Subroto / Gisela Rita

 QUOTATION SLIP
1099/PB/XI/2017

TYPE OF INSURANCE : Machinery Breakdown

INSURED : PT BANK ICBC INDONESIA QQ PT MEGADAYA TANGGUH and/or

all their respective subsidiary companies and those acquired or
incorporated during the period of Insurance, and all their
respective interest, rights and liabilities and to the extent that
they are not more specifically insured.

RISK LOCATION : PLTU MW Amurang, Sulawesi Utara

PERIOD : This Contract shall apply to losses occurring during the period
From : .. ...... 2017
To : .. ...... 2018
Both dates inclusive at 12:00 noon Local Standard Time.

OCCUPATION : Operators and owners of Gas Power Plant , Distributors of

Electricity and activities related to and associated therewith

INTEREST INSURED : Section 1 Material Damage

All Real and Personal Property of every kind and description,
including turbines, machinery and equipment, inventory,
improvements and betterment and property of others in the
care custody or control of the Insured or for which the Insured
has assumed legal responsibility

Gas turbine generator dual fuel

Merk: ........

Tipe: ........

Serial no.: ........

SUM INSURED : USD 30,000,000

LOSS LIMIT : 70%

DEDUCTIBLE : 10.00% of claim with a minimum USD 2,500

(each and every loss)
ADDITIONAL : 1. Appraisement Clause (5%)
CLAUSES/ENDORSE 2. Automatic Reinstatement Clause. (with additional premium)
ENTS 3. Average Relief Clause (85%)
4. Banker Clause DBS Bank Ltd
5. Cover for Loss or Damage due to Strike, Riot and Civil
Commotion(S.R.C.C.) 41.B/2007/AAUI
6. Cover of Extra Charges for Overtime, Night Work, Work on Public Holidays,
Express Freight (Sub Limit 10.00% of Loss, max USD. 10,000)
7. Cover of Extra Charges for Airfreight (10.00% of Loss, max USD. 10,000)
8. Cover for Lubricating Oil or Refrigerant (10.00% of Loss, Max USD
10,000.00).
9. Cover for Conveyor Belts and Chains (M.Re Endorsement 321).
10. Cover for Wires and Non Electric Cables (M.Re Endorsement 322).
11. MR 345 Inspection & Overhaul of Boilers
12. MR 391 Special Agreement Regarding Maintenance Work on Electronic
Component The Insured Machinery
13. Cover for Floodlight Bulbs (M.Re Endorsement 323) Limit USD. 50,000.00
14. Cancellation Clause
15. Explosion in Internal Combustion engines and Hydrogen cooled generators
(M.Re Endorsement 314).
16. Internal Fire/Chemical Explosion and Lightning (M.Re Endorsement 313).
17. Removal of Debris Clause. (10.00% of Loss , Max USD 10,000.00)
18. Claims preparation costs (10% of loss).
19. Payment on Account Clause.( 25%)
20. Professional Fees Clause Limit USD. 10,000
21. Time Adjustment Clause (72 Hours) for Earthquake and Volcanic Eruption
Only.
22. Notification Clause.
23. Nominated of Loss Adjuster ( PT. McLaren Indonesia and PT. Radita
Hutama Indonesia )
24. Non Cancellation Clause
25. IT Clarification Agreement
26. Transmission & Distribution Line Exclusion Clause
27. Electronic Date Recognition Clause A
28. IT Hazard Clarification Clause
29. Dispute Clause
30. Waiver Clause
31. Termination of insurance
32. Currency Clause

RATE OF PREMIUM 0.1500%

PREMIUM : USD 30,000,000 x 0.1500% x 70% = USD 31,500 (Excl. Policy Cost+Stamp)
CALCULATIONS
- No Claim up to binding date
SUBJECTIVITY : - No Cover for Manufactures risk & Guarantee cover
- Skilled & Experienced technical
- TSI as NRV
- Loss Record Nil ( 3 tahun terakhir )