WORK TIME COMPLETION REPORT ( CME )

Type of Works : PH 2C
Site ID / Site Name : NBTM_0079 / SUNGAI PANAS - BTS
Contract No. : 041/Procurement/SMART-Perissos/VI/17 , dated on 15-Jun-17
PO No. : 5200028037 , dated on 28-Aug-17
Representation Letter date :
On this day, , date , month , year the work at
project location mentioned above has been successfully completed.

The result as follows:

Duration of execution of work based on the amended KOM : calendar days
- Work is started on PO issued :
- Work should be finished on PO issued :
- Work has been finished on (PAC date) :
The actual duration of execution of work : calendar days

Job Acceleration / Delay (A) : calendar days *)

The reason of delay in the execution of work are :

1. Discontinuance / Postpone by PT. SMART Telecom : calendar days
2. Force Majeur : calendar days

Total ( B ) : calendar days

Job Acceleration / Delay (A) : calendar days

Penalty Calculation (Filled by SCM)

PO Value :
1. Late Completion (0,5% from PO Value X E) max 5%

Prepared by, Approved by, Approved by,

Contractor
PT. Perissos Andalan Abadi PT. Smart Telecom PT. Smart Telecom

Name : Ariansyah Name : …………………… Name : ……………………

Title : Project Manager Title : RPL Title : SCM Dept.
Date : ……….. Date : ……………..…… Date : ……………..……