Item qty satuan harga

map coklat 312 1 pak 75,000

map merah 1 pak 85,000
amplop putih 1 kotak 30,000
stabilo kuning 1 pcs 10,000
tinta hp laserjet 85a 1 kotak 925,000
flashdisk 8gb 1 pcs 100,000
port usb 1 pcs 70,000
stapler kangoro kecil 1 pcs 20,000
kertas a4 1 rim 50,000
keranjang file 1 pcs 27,000
baterai a3 1 pasang 13,000
lakban bening 1 rol 18,000
baterai a2 1 pasang 15,000
buku batik besar 1 pcs 20,000
buku batik sedang 1 pcs 15,000
buku batik kecil 1 pcs 8,000
isi staples no.10 1 kotak 3,000
spidol permanent 1 kotak 95,000
cater 1 pcs 20,000
gunting besar 1 pcs 15,000
puspin 1 kotak 8,000
post-it 1 pcs 16,000
rak meja 3 susun 1 pcs 135,000
pulpen v-5 1 kotak 55,000
spidol boardmarker 1 kotak 95,000
spidol putih 1 kotak 215,000
lakban hitam rol 18,000
lakban kertas 1 rol 20,000
lakban coklat 1 rol 18,000
double tip 1 rol 20,000
buku saku 1 pcs 10,000
isi cater 1 kotak 8,000
penggaris besi 1 pcs 20,000
map biola 1 lembar 5,000
trigonal clip 1 kotak 15,000
Map Bening Plastik 1 pak 85,000
Binder Clip No.105 1 kotak 8,000
Binder Clip No.107 1 kotak 10,000
Kertas Laminating 1 pak 185,000
Binder Clip 155 1 kotak 15,000
Binder Clip 200 1 kotak 20,000
 FRM-HGA-025.Rev 00

GENERAL REQUEST

NO. PROJECT MGM

DATE Friday, July 15, 2022 DEPARTMENT PLANT

ETA SUPPLY

ACCOUNT CODE AMOUNT BEGINNING BALANCE ENDING BALANCE

BUDGET / NON
BUDGET * Rp 4,520,000 Rp 4,520,000

NO DESCRIPTION QTY SATUAN UNIT PRICE TOTAL PRICE

1 DAIA ( CUCI TANGAN MEKANIK ) 8 PCS Rp 20,000 Rp 160,000
2 TRASHBAG 20 PCS Rp 50,000 Rp 1,000,000
3 SAPU IJUK 5 PCS Rp 50,000 Rp 250,000
4 SAPU LIDI 5 PCS Rp 50,000 Rp 250,000
5 ENGKRAK 2 PCS Rp 50,000 Rp 100,000
6 GULA 5 PCS Rp 20,000 Rp 100,000
7 KOPI 5 PCS Rp 25,000 Rp 125,000
8 TEH 2 PCS Rp 10,000 Rp 20,000
9 SABUN SUNLIGHT 2 PCS Rp 25,000 Rp 50,000
10 TERPAL 6x8 m 2 PCS Rp 150,000 Rp 300,000
11 SPONS 3 PCS Rp 5,000 Rp 15,000
12 KARPET TIKAR 1 ROLL Rp 100,000 Rp 100,000
13 KABEL 1 ROLL Rp 150,000 Rp 150,000
14 STOP KONTAK 4 PCS Rp 15,000 Rp 60,000
15 STEKER 4 PCS Rp 15,000 Rp 60,000
16 SENTER KEPALA 10 PCS Rp 50,000 Rp 500,000
17 KIPAS ANGIN TEMPEL TEMBOK 2 PCS Rp 300,000 Rp 600,000
18 SPEAKER AKTIF 1 PCS Rp 500,000 Rp 500,000
19 MICROPHONE ZOOM 1 PCS Rp 100,000 Rp 100,000
20 PEL LANTAI 2 PCS Rp 40,000 Rp 80,000

TOTAL Rp 4,520,000

REASON OF DISAGREED

SUPPORT WOKSHOP DAN OFFICE PLANT AGUSTUS 2022

PIC BUDGET
Authorized Person / Special Approval Requested by,
Agreed/Disagreed,

Sugiyarto RIAWAN SANTOSO SAEPUDIN

PROJECT MANAGER SECT. HEAD HCGS DEPT. HEAD PLANT

* Coret Salah Satu

 FRM-HGA-025.Rev 00

GENERAL REQUEST

NO. GR/PROD/MGM/6/4 PROJECT MGM

DATE Friday , Oktober 07, 2022 DEPARTMENT PRODUKSI

ETA VENDOR

ACCOUNT CODE AMOUNT BEGINNING BALANCE ENDING BALANCE

BUDGET / NON
BUDGET * Rp 8,800,000 Rp 8,800,000

NO DESCRIPTION QTY SATUAN UNIT PRICE TOTAL PRICE

1 BAUT HPPE 15 CM UKURAN 30 200 PCS 44,000 Rp 8,800,000
2 Rp -
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
TOTAL Rp 8,800,000

REASON OF DISAGREED REASON OF REQUEST

PRODUKSI

BUDGET : OYS / OTP / RIBS / FDB / RPM / AP / ATMP

PIC BUDGET
Authorized Person / Special Approval Requested by,
Agreed/Disagreed,

SUGIYARTO RIAWAN SANTOSO SAEPUDIN

PROJECT MANAGER SECT. HEAD GEA DEPT. HEAD PRODUKSI

* Coret Salah Satu

 FRM-HGA-025.Rev 00

GENERAL REQUEST

NO. PROJECT MGM

DATE Wednesday, July 13, 2022 DEPARTMENT OFFICE PLANT

ETA SUPPLY

ACCOUNT CODE AMOUNT BEGINNING BALANCE ENDING BALANCE

BUDGET / NON
BUDGET * Rp 1,220,500 Rp 1,220,500

NO DESCRIPTION QTY SATUAN UNIT PRICE TOTAL PRICE

1 FORM JOB HAND OVER (1PLY) 4 BUKU Rp 21,000 Rp 84,000
2 FORM ABSENSI P5M BARU 4 BUKU Rp 27,000 Rp 108,000
3 P2H LV (3 PLY) 8 BUKU Rp 30,000 Rp 240,000
4 P2H CRANE TRUCK (3 PLY) 4 BUKU Rp 30,000 Rp 120,000
5 FORM CUTI (3 PLY) 5 BUKU Rp 16,000 Rp 80,000
6 FORM SKL (2 PLY) 5 BUKU Rp 10,500 Rp 52,500
7 FORM IZIN MENINGGALKAN JOBSITE 8 BUKU Rp 14,500 Rp 116,000
8 FORM MAR 40 BUKU Rp 10,500 Rp 420,000
TOTAL Rp 1,220,500

REASON OF DISAGREED REASON OF REQUEST

SUPPORT ADMINISTRASI PLANT BULAN AGUSTUS 2022

PIC BUDGET
Authorized Person / Special Approval Requested by,
Agreed/Disagreed,

Sugiyarto Riawan Santoso Trio Septiawan

PROJECT MANAGER SECT. HEAD HCGS DEPT. HEAD PLANT

* Coret Salah Satu

 Jobsite MGM
Department Plant
Form Budget Bulanan Periode 01-30 JUNI 2022

Job Site MGM

Department Plant
Periode 01-31 JULY 2022

01-31 JULY 2022

No Supplier Keterangan
Week 1 Week 2 Week 3 Week 4 Week 5 Total
JUMLAH SATUAN HARGA/SATUAN 1 s.d 7 8 s.d 14 15 s.d 21 22 s.d 31

Kebutuhan : Operasional

1 BALLPOINT HITAM 2 BOX Rp 55,000 Rp 55,000 55,000.00 110,000.00

2 KERTAS A4 1 BOX Rp 200,000 Rp 200,000 200,000.00
3 CUTTER 1 PCS Rp 25,000 Rp 25,000 25,000.00
4 REFIIL CATER 1 PCS Rp 10,000 Rp 10,000 10,000.00
5 GUNTING BESAR 6 PCS Rp 15,000 Rp 15,000 15,000.00 15,000.00 90,000.00
6 POS-IT 2 PCS Rp 16,000 Rp 16,000 16,000.00 32,000.00
7 LAKBAN COKLAT 2 PCS Rp 20,000 Rp 20,000 20,000.00 40,000.00
8 LAKBAN KERTAS 2 PCS Rp 20,000 Rp 20,000 20,000.00 40,000.00
9 LAKBAN HITAM 2 PCS Rp 20,000 Rp 20,000 20,000.00 40,000.00
10 MAP COKLAT TALI 1 PAK Rp 75,000 Rp 75,000 75,000.00
11 DOUBLE TIP 2 PCS Rp 20,000 Rp 20,000 20,000.00 40,000.00
12 BUKU SAKU 10 PCS Rp 10,000 Rp 10,000 10,000.00 10,000.00 10,000.00 100,000.00
13 SPIDOL PERMANENT 4 BOX Rp 95,000 Rp 95,000 95,000.00 380,000.00
14 SPIDOL PUTIH 4 BOX Rp 215,000 Rp 215,000 215,000.00 860,000.00
15 STAPLES 2 PCS Rp 20,000 Rp 20,000 20,000.00 40,000.00
16 ISI STAPLES 1 BOX Rp 20,000 Rp 20,000 20,000.00
17 MAP MERAH 1 PAK Rp 85,000 Rp 85,000 85,000.00
18 BANTEX 20 PCS Rp 50,000 Rp 50,000 50,000.00 50,000.00 50,000.00 1,000,000.00
19 TRIGONAL CLIP 1 KOTAK Rp 15,000 Rp 15,000 15,000.00
20 BINDER CLIP 155 3 KOTAK Rp 15,000 Rp 15,000 45,000.00
21 BINDER CLIP 200 4 KOTAK Rp 20,000 Rp 20,000 20,000.00 50,000.00 80,000.00
22 SPIDOL BOARDMARKER 3 KOTAK Rp 95,000 Rp 95,000 95,000.00 50,000.00 285,000.00
23 DAIA ( CUCI TANGAN MEKANIK ) 8 PCS Rp 20,000 Rp 20,000 20,000.00 20,000.00 160,000.00
24 TRASHBAG 20 PCS Rp 50,000 Rp 50,000 50,000.00 50,000.00 50,000.00 1,000,000.00
25 SAPU IJUK 5 PCS Rp 50,000 Rp 50,000 50,000.00 50,000.00 50,000.00 250,000.00
26 SAPU LIDI 5 PCS Rp 50,000 Rp 50,000 50,000.00 50,000.00 50,000.00 250,000.00
27 ENGKRAK 2 PCS Rp 50,000 Rp 50,000 50,000.00 100,000.00
28 GULA 5 PCS Rp 20,000 Rp 20,000 20,000.00 100,000.00
29 KOPI 5 PCS Rp 25,000 Rp 25,000 25,000.00 125,000.00
30 TEH 2 PCS Rp 10,000 Rp 10,000 10,000.00 20,000.00
31 SABUN SUNLIGHT 2 PCS Rp 25,000 Rp 25,000 25,000.00 50,000.00
32 TERPAL 6x8 m 2 PCS Rp 150,000 Rp 150,000 150,000.00 300,000.00
33 SPONS 3 PCS Rp 5,000 Rp 5,000 5,000.00 15,000.00
34 KARPET TIKAR 1 ROLL Rp 100,000 Rp 10,000 100,000.00
35 KABEL 1 ROLL Rp 150,000 Rp 150,000 150,000.00
36 STOP KONTAK 4 PCS Rp 15,000 Rp 15,000 15,000.00 60,000.00
37 STEKER 4 PCS Rp 15,000 Rp 15,000 15,000.00 60,000.00
38 SENTER KEPALA 10 PCS Rp 50,000 Rp 50,000 50,000.00 50,000.00 50,000.00 500,000.00
39 KIPAS ANGIN TEMPEL TEMBOK 2 PCS Rp 300,000 Rp 300,000 300,000.00 600,000.00
40 SPEAKER AKTIF 1 PCS Rp 500,000 Rp 500,000 500,000.00
41 MICROPHONE ZOOM 1 PCS Rp 100,000 Rp 100,000 100,000.00
42 PEL LANTAI 2 PCS Rp 40,000 Rp 40,000 40,000.00 80,000.00
43 FORM JOB HAND OVER (1PLY) 4 BUKU Rp 21,000 Rp 21,000 21,000.00 84,000.00
44 FORM ABSENSI P5M BARU 4 BUKU Rp 27,000 Rp 27,000 27,000.00 108,000.00
45 P2H LV (3 PLY) 8 BUKU Rp 30,000 Rp 30,000 30,000.00 30,000.00 30,000.00 240,000.00
46 P2H CRANE TRUCK (3 PLY) 4 BUKU Rp 30,000 Rp 30,000 30,000.00 120,000.00
47 FORM CUTI (3 PLY) 5 BUKU Rp 16,000 Rp 16,000 16,000.00 80,000.00
48 FORM SKL (2 PLY) 5 BUKU Rp 10,500 Rp 10,500 10,500.00 52,500.00
49 FORM IZIN MENINGGALKAN JOBSITE 8 BUKU Rp 14,500 Rp 14,500 14,500.00 14,500.00 116,000.00
50 FORM MAR 40 BUKU Rp 10,500 Rp 10,500 10,500.00 10,500.00 10,500.00 420,000.00
Total 9,352,500.00
Kebutuhan : Investasi
34
35
36
37
37
37
38
39
40
41
42
43
44
45
46
Total 2,910,500.00 350,000.00 1,685,500.00 420,500.00 -
Total Budget 2,910,500.00 350,000.00 1,685,500.00 420,500.00 9,352,500.00

Lawung Tuhup, 27 Mei 2022

Mengetahui, Validasi Budget, Menyetujui,

Trio Septiawan Riawan Santoso Sugiyarto

Plant Dept. Head Hcgs Sect. Head Project Manajer
 FRM-HGA-025.Rev 00

GENERAL REQUEST

NO. 01/RML-TCM/PLT-GR/II/2020 PROJECT MELAK

DATE Tuesday, January 21, 2020 DEPARTMENT OFFICE PLANT

ETA SUPPLY

ACCOUNT CODE AMOUNT BEGINNING BALANCE ENDING BALANCE

BUDGET / NON
BUDGET * Rp 340,000 Rp 340,000

NO DESCRIPTION QTY UNIT PRICE TOTAL PRICE

1 ENGSEL PINTU 6 Rp 30,000 Rp 180,000
2 FITTING LAMPU 2 Rp 10,000 Rp 20,000
3 LAMPU 2 Rp 50,000 Rp 100,000
4 STOP KONTAK COLOKAN 4 LUBANG + KABEL 1 Rp 40,000 Rp 40,000

TOTAL Rp 340,000

REASON OF DISAGREED REASON OF REQUEST

UNTUK SB

PIC BUDGET
Authorized Person / Special Approval Requested by,
Agreed/Disagreed,

Wasno Wijoyo Tude Merta SJ Daryono

PROJECT MANAGER GEA . SECT .HEAD DEPT . HEAD

* Coret Salah Satu

 FRM-HGA-025.Rev 00

GENERAL REQUEST

NO. 01/RML-TCM/PLT-GR/I/2020 PROJECT MELAK

DATE Thursday, January 30, 2020 DEPARTMENT OFFICE PLANT

ETA SUPPLY

ACCOUNT CODE AMOUNT BEGINNING BALANCE ENDING BALANCE

BUDGET / NON
BUDGET * Rp 1,130,000 Rp 1,130,000

NO DESCRIPTION QTY UNIT PRICE TOTAL PRICE

1 MCB 3 PHASE (63A) 1 Rp 400,000 Rp 400,000
2 CABLE GROUND KUNING GARIS HIJAU 3 (MTR) Rp 10,000 Rp 10,000
3 CAM STARTER 60A 1 Rp 150,000 Rp 150,000
4 MCB 1 PHASE (10A) 3 Rp 150,000 Rp 450,000
5 SCUN CABLE TUNGGAL 4 Rp 30,000 Rp 120,000

TOTAL Rp 1,130,000

REASON OF DISAGREED REASON OF REQUEST

UNTUK INSTALLASI GENSET GS023 ( SUPPORT OFFICE SB )

PIC BUDGET
Authorized Person / Special Approval Requested by,
Agreed/Disagreed,

Wasno Wijoyo Tude Merta SJ TRIO.S

PROJECT MANAGER GEA . SECT .HEAD PLANT SECT . HEAD

* Coret Salah Satu

 FRM-HGA-025.Rev 00

GENERAL REQUEST

NO. 01/RML-TCM/PLT-GR/II/2020 PROJECT MELAK

DATE Tuesday, February 4, 2020 DEPARTMENT OFFICE PLANT

ETA SUPPLY

ACCOUNT CODE AMOUNT BEGINNING BALANCE ENDING BALANCE

BUDGET / NON
BUDGET * Rp 800,000 Rp 800,000

NO DESCRIPTION QTY UNIT PRICE TOTAL PRICE

1 MCB 10A 2phase 2 Rp 200,000 Rp 400,000
2 MCB 63A 3phase 1 Rp 400,000 Rp 400,000

TOTAL Rp 800,000

REASON OF DISAGREED REASON OF REQUEST

UNTUK INSTALLASI GENSET GS023 ( SUPPORT OFFICE BK14 )

PIC BUDGET
Authorized Person / Special Approval Requested by,
Agreed/Disagreed,

Wasno Wijoyo Tude Merta SJ TRIO.S

PROJECT MANAGER GEA . SECT .HEAD PLANT SECT . HEAD

* Coret Salah Satu

 FRM-HGA-025.Rev 00

GENERAL REQUEST

NO. 02/RML-TCM/PLT-GR/II/2020 PROJECT MELAK

DATE Tuesday, February 4, 2020 DEPARTMENT OFFICE PLANT

ETA SUPPLY

ACCOUNT CODE AMOUNT BEGINNING BALANCE ENDING BALANCE

BUDGET / NON
BUDGET * Rp 170,000 Rp 170,000

NO DESCRIPTION QTY UNIT PRICE TOTAL PRICE

1 AQUA 600ML 1 Rp 85,000 Rp 85,000
2 THE KOTAK 1 Rp 85,000 Rp 85,000

TOTAL Rp 170,000

REASON OF DISAGREED REASON OF REQUEST

SHARING & OBSERVASI TEAM EDJS

PIC BUDGET
Authorized Person / Special Approval Requested by,
Agreed/Disagreed,

Wasno Wijoyo Tude Merta SJ TRIO.S

PROJECT MANAGER GEA . SECT .HEAD PLANT SECT . HEAD

* Coret Salah Satu