CENTRATAMA v20240306

Final Acceptance Certificate (SAR)

Project Name Scope of Work Centratama Tower ID Centratama Name PO # PO Date

1 IOH B2S 2024 Falcon 2 B2S ID-JT-14468 KARANGTALUN_BOBOTSARI CMIPO24-002337 29-Apr-24

This is to certify that the works has been completed as per the specified requirements, free from defects and that the required complete and correct documentation has
been submitted.

PT. LIMA INTI SINERGI

Submitted By Okta Noor Patria

Direktur

Centratama Group

Approved By: Farid Ridwan

SAQ Manager

Approved By: Cesar Jeremiah Lonardy

Senior Project Manager

Acceptance Certificate Checklist

Filename Status Doc Type Copy Type Remarks

Checklist Indicate
No. Syntax (use Not Available Hard Copy
(Site Acquisition for B2S) Available (A) Copy (CP) Original (O) Soft Copy (SC) reason/justifications if not
Cent site id) (NA) (HC) available
0 Checklist (This Document)
1 SAR is Approved by Centratama site id_SAR X X X

Item 1
No. Centratama Site ID and Site Name Remarks
(OK/Not OK)
1 ID-JT-14468 / KARANGTALUN_BOBOTSARI OK
2

Approval
Documents in the checklist were reviewed by: Reason of Non Approval
(Approved or NOT approved)

Centratama Documentation
Approved
Controller: Mamat Rohimat

Eng-Imp-0623-01 FAC-SAR 1 of 1
fitri.handayani@limaintisinergi.com

From: Mamat Rohimat <mamat.rohimat@centratamagroup.com>

Sent: 07 May 2024 11:07
To: fitri.handayani@limaintisinergi.com
Cc: dimas.windika@limaintisinergi.com; iqbal.kurniawan@limaintisinergi.com; robi.tumewu@limaintisinergi.com;
fakhrul.fadhilah@limaintisinergi.com; Farid Ridwan
Subject: RE: FAC-SAR_LINI_06052024
Attachments: FAC-SAR_ ID-JT-14468 KARANGTALUN_BOBOTSARI.xlsx

Mba @fitri.handayani@limain sinergi.com

Terlampir FAC SAR Approved…

Warm Regards..,

Mamat Rohimat

CENT Group
TCC Batavia Tower One, 16th Floor
Jl. K.H. Mas Mansyur Kav. 126 Karet Tengsin
Jakarta Pusat 10250

From: fitri.handayani@limaintisinergi.com <fitri.handayani@limaintisinergi.com>

Sent: Monday, 06 May 2024 16:27
To: Mamat Rohimat <mamat.rohimat@centratamagroup.com>
Cc: dimas.windika@limaintisinergi.com; iqbal.kurniawan@limaintisinergi.com; robi.tumewu@limaintisinergi.com; fakhrul.fadhilah@limaintisinergi.com
Subject: FAC-SAR_LINI_06052024
1
 Caution: This is an external email and may be has a suspicious subject or content. Please take care when clicking links or opening attachments. When in doubt, contact
your IT Department

Dear Pak Mamat,

Berikut ini kami lampirkan so copy FAC-SAR untuk 1 site, dengan detail site name dibawah ini :

Site Amount Submit Date

Operator SOW Site Name PO Number Amount PO
ID Term1 100% Submit

ID-JT-
IOH Survey KARANGTALUN_BOBOTSARI CMIPO24-002337 Rp 5.000.000 Rp 5.000.000 06-May-24
14468

Mohon bantuan review approval dokumen agar kami bisa lanjutkan ke proses selanjutnya

Best n Regards

PT.LIMA INTI SINERGI

Operasional Office
Fitri Handayani Jl. Grand Galaxy City Rukan Rose Garden V No.112, RT.02/RW.17, Jaka
se a, Bekasi Selatan, Jawa Barat 17148, Indonesia
0852-1150-8247 | +62 811-1051-2508
fitri.handayani@limain sinergi.com | limain sinergi.com