PT, ASURANS/ UNUM BUMPUTERA MUDA 1987 seamen tetas BUMIDA tonitutera Bua nn neler hans (Fax, 7680406 ~ Ent: bata it SCHEDULE issued by + PT. Asurans! Bumiputera Mutha 2967 ‘Branch Office = Batam Address 2 Kamplek Mahkota Raya Blok 0 No. 5 Batam Centre: Telp (0778) 7483477; Fax 7an3465 1 POLICY NUMBER "192Ton0es 9040004 - 0 2 TYPEOF INSURANCE | LARIITY RIGURANCE POLICY INCLUDING EWVIRONMENTAL 3. INSURED PT. GREEN GLOBAL SARAMA 4 ADDRESS. Kompiak Fluko Plamo Garden fiok (No. 5 Bal Pormsts Batarn oua Kip eu, nanos. 5S. SCOPE OF COVERAGE gpetion - Comprehensive General Lsbility ‘Section t — aviomobile Liatalty Irctusing Sudden and Accidental Pollulion ~ 72 Hours [Envirenmmerial Lintility) 5 Rus LOCATON. © GEDUNG MPLUTOLI KASML 83 KABIL KOTA BATAM = ‘Transport route: ms attach 7 PERIOD OF INSURANCE 13 Apd.2019- 13 Amr 200 8 TPE OF POULUTANT evga, ute ven sg es grt ap al ae of, used woo. sludge of, IPA, comiaminated rags. toots rrecn oe omnes oe Poort tems % DETAILS OF WORK swrage & 83 waste tansponsiion (23 wast i 10. LIMST OF LABILITY. ~ Baadly injury and Property Oomage Each Occurence Limit (Rp 5.000.000 000.4 any one acodent Agregms ima each policy yaer Fp 6 000.000 090.- Inctusing Sudden anc Accidental Poiuton Each Occurence Limi -Rp 5.000.600.2004 ary ane asciaen ‘Agragame imi each pokey yoer: Fp 6 000,000 100. if, DEQUCTIBLE + TOA of claim min Rp 50.C0n000- each and every lone (Property Damage & Body imury) = Rlamecianon Gos for Suction & Aceiderta! Palliion 10% of lain min Rp 60.008.900,-eacth & every clam 12, CLAUSES > Cla made Basis of Indemnity ~ Extra Contractual ebiigatons Exclusion Clause Policy te, 102709082 9080004 - 0 PT. GREEN GLOBAL SAAN 2