asuransi<>Asei CREDIT NOTE No. RI.AU.07.04,162.00.CN To PT JAYA PROTEKSI SAKTI REINSURANCE Reference Reinsurer Document | Reinsurer Balance Due To You Scheme Of Payment Bank Detail Remarks V| Treaty Facultative Due Date Payment | | Installment I & Amount Installment II & Amount Installment IIT & Amount Installment IV & Amount Installment V & Amount Installment VI & Amount : Facultative Reinsurance Slip PT Pelayaran Nelly Dwi Putri : PT Jaya Proteksi Sakti Reinsurance) * IDR 61,256,250.00 y | Installment Full of Payment : BANK Danamon Ruko Cabang Ruko Atrium Senen USD A/C No. 660056229 (USD) IDRA/CNo, 660056179 (IDR) + Slip Fakultatif PT Pelayaran Nelly Dwi Putri vessel Nelly 86 19 April 2020 (IDR 10,209,375.00) + 19 May 2020 (IDR 10,209,375.00) + 19 Juni 2020 (IDR 10,209,375.00) + 19 Juli 2020 (IDR 10,209,375.00) + 19 Agustus 2020 (IDR 10,209,375.00) * 19 September 2020 (IDR 10,209,375.00) PT. Asuransi Asei Indonesia Gedung Menara Kain indonesia 21 JLHER Rasuna Said Blok X5, Kav. 23 Jakarta 12950 Jakarta, °% April 2019 PT Asuransi-Asei Indonesiaasuransi<>Asei FACULTATIVE REINSURANCE SLIP RISK CEDED 2 "TYPE OF COVER © MARINE HULL CESSION NO + F.HO1.012.20.000005.01 POLICY NO. + M.HO1.012.20,000001.01 PERIOD OF INSURANCE + 4March-2020 to 4-March-2021 THE INSURED 1 PT. PELAYARAN NELLY DWI PUTRI ADDRESS 2 OBJECT INFORMATION : Vessel Name + Nelly 86 ‘Type of Vessel : PROPELLED BARGE Vessel Construction ‘STEEL or 13276 Vessel Tonnage + 2000 GRT AND OVER Vessel Year of Built 2018 Vessel Age + Older than 15 years but not older then 20 years Vessel Class : CLASS Class Society + Biro Klasifikasi Indonesia (BK) Flag INDONESIAN IMO No. DEDUCTIBLE .5% of Sum Insured/any one accident or occurrence except in respect of actual TOTAL SUM INSURED SHARE ASEL Total Loss or Constructive Total Loss whereby deductible is NIL. Rp. 18,000,000,000.00 100.00% ae __THE REINSURER Sas FE NAME + PT Jaya Proteksindo Sakti Reinsurance ADDRESS : Komp Kramat Center Blok A No 4 JI Kramat Raya 7-9 Senen, Jakarta Pusati0450 PERIOD OF REINS. + -March-2020 to 4-March-2021, ‘SHARE REINS. 1 75.00% of TSI ‘SUM REINSURED + Rp. 13,500,000,000.00 RATE + 0580% R/L COMMISION 2 17.50% Be _____ PREMIUM CALCULATION _ eae PREMIUM Rp. 18,000,000,000.00 x 75.00% x 0.550% Rp. 74,250,000.00 R/LCOMMISION —_Rp. 74,250,000.00 x 17.50% Rp. 12,993,750.00 Due To You Rp. 61,256,250.00 FOR AND ON BEHALF OF THE COMPANY _ ‘Asei Indonesia PT. Asuransi Asei Indonesia Gedung Menara Kain Indonesia it 1 JLHR Rasuna Said Blok XS, Kav. 23 Sakarta 12950 t +622 3535,