QUOTATION SLIP

Reff No. 23.05.01121/QS/MH/PTBJ

Type of Insurance : Marine Hull;

Form : MAR 91

Quotation Valid Until : June 12, 2023

General Information of The Insured

The Insured : PT Pelayaran Teluk Bajau Lestari

Trading Area : Indonesia waters only

Period of Insurance : TBA

Terms & Conditions of Cover on To cover loss of or damage to subject matter insured and/or Insured\\'s Liability(s) as
described in the terms and conditions mentioned bellow

Interest Insured : Hull and Machinery including but not limited to Crane, Materials, Machinery, Outfit, Equipment of
every description, and spares and everything connected therewith :

Vessel Name: K-VIII

Type: Barge
YOB: 2005
GT: 3137
Class: BKI
Port: Jakarta

Value of Vessel : IDR 14,068,000,000.00

Coverages : Institute Time Clauses Total Loss Only 1/10/83 – Cl. 289 (Excluding Salvage, Salvage Charges,
and Sue & Labour) amended to delete clause 1.2

Conditions : - The cost of temporary repairs and the excess cost of overtime incurred in connection with repairs
to damage caused by an insured peril shall be deemed as part of the reasonable cost of repairs;
- Ranging damage sustained during cargo operations at each port shall be deemed as damage
caused by a single accident or occurrence;
- It is noted and agreed that any claim under this policy shall be settled at no longer than 30 (Thirty)
days after the date of final adjustment report has been agreed by both the Lead Underwriter and the
Assured. This clause is in place in compliance with ;
- The Insured Vessels shall be considered fully insured for the purpose of claims under the policy in

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 respect of General Average, Salvage, Salvage Charges, and Sue and Labour;
- The measure of indemnity in respect of claims for unrepaired damage shall be estimated cost of
repair at the time of this insurance terminates;
- For the purpose of any claims under this policy, it is agreed that the Total Sum Insured of the
subject matter insured shall be deemed and/or considered to be her actual sound values at time
accident;
- When vessel missing for 6 (six) consecutive months from the date of sailing from the last port
shall be presumed to be an “Actual Total Loss”;
- All claims for loss, damage or expense resulting from any one occurrence or series of occurrence
out of any event, shall be deemed as damage casued by a single accident and adjusted as one
claim.;

Deductibles/Excess : - IDR. 200,000,000.00 anyone accident/occurrence for all claims with additional deductible 20% of
claim payable in respect of any loss/damage derived from the vessel being stranded/grounded
and/or capsized whatsoever caused;

Clauses : 1. Banker’s Clause. if required;

2. Additional Notice of Claim Clause (30 days);
3. Adjuster Clause;
It is hereby noted and agreed that Assured or the Broker have the liberty to appoint one of the
following adjusters in respect of any claim on the policy :
1. PT. MCO Prima Indonesia
2. PT. Radita Hutama Internusa / Charles Taylor Adjusting
3. PT. Global Internusa Adjusting
4. As per above, Subject to subject to JWC Hull War, Piracy, Terrorism and Related Perils Listed
Areas dated 29th April 2021 (or as maybe updated) with Indonesia deleted from the Listed Areas at
nil additional premium;
5. Cancelling Return Only (No Lay Up Return);
6. Claimant's other than Shipowner Proof of Insurable Interest Clause (For use on Marine Hull &
Machinery Insurance); It is hereby agreed that every claimants of the policy benefit on this
insurance who is named as the Assured herein but not declared as the Shipowner in the Certificate
of Nationality/ Registry Certificate issued by the flag state of the insured vessels, they have a duty
to prove by legal documents or contracts when submitting a claim to Insurer that they stand in legal
& equitable relations with the Subject Matter of Insured covered hereunder with acknowledgment
from the registered Shipowner.
7. Communicable Disease Exclusion clause;
1. Notwithstanding any provision to the contrary within this insurance agreement, this insurance
agreement excludes any loss, damage, liability, claim, cost or expense of whatsoever nature,
directly or indirectly caused by, contributed to by, resulting from, arising out of, or in connection
with a Communicable Disease or the fear or threat (whether actual or perceived) of a
Communicable Disease regardless of any other cause or event contributing concurrently or in any
other sequence thereto.
2. As used herein, a Communicable Disease means any disease which can be transmitted by means
of any substance or agent from any organism to another organism where :
- the substance or agent includes, but is not limited to, a virus, bacterium, parasite or other
organism or any variation thereof, whether deemed living or not, and
- the method of transmission, whether direct or indirect, includes but is not limited to, airborne
transmission, bodily fluid transmission, transmission from or to any surface or object, solid, liquid
or gas or between organisms, and - the disease, substance or agent can cause or threaten damage to
human health or human welfare or can cause or threaten damage to, deterioration of, loss of value
of, marketability of or loss of use of property
8. Dispute Clause;
9. Exclude cover loss of hire;
10. Exclude cover P&I risk;

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 11. Exclude cover wreck removal;
12. Exclude simultaneous settlement clause;
13. Full Annual Premium if Loss Clause;
14. Institute Cyber Attack Exclusion Clause 10/11/03 - Cl. 380;
15. Institute Notice of Cancellation Automatic Termination of Cover and War and Nuclear
Exclusion Clause – Hulls etc (Clause 359) 1/11/95;
16. Institute Radioactive Contamination, Chemical, Biological, Bio Chemical, Electromagnetic
Weapons Exclusion Clause (10/11/2003) – Cl. 370;
17. Institute War and Strikes Clauses – Hulls – Time 1/10/83 (Cl.281) amended to include
Vandalism and sabotage risks.;
18. IT Hazard clarification clause;
19. Law & Jurisdiction; This insurance shall be governed by and construed in accordance with the
laws of England and the exclusive jurisdiction of the Indonesian Courts.
20. Navigation Limitations for hull War, Strikes, Terrorism and Related Perils Endorsement
(JW2005/001A);
21. Payment on Account (25%); – for estimated claim amount above IDR 1,000,000,000 only
22. Sanction Limitation and Exclusion Clause JH2010/009;
23. Seepage and Pollution Exclusion Clause 01/01/89;
24. Subject to Navigation Limitations for Hull War, Strikes, Terrorism and Related Perils
Endorsement (JW2005/001A);
25. Surveyor Clause;
It is hereby noted and agreed that Assured or the Broker have the liberty to appoint one of the
following independent surveyors to attend on the Underwriter’s behalf in respect of any claim on
the policy :
1. PT. Maritim Surveindo Internusa
2. PT. Asuka Bahari Nusantara
26. The Underwriters agree to waive rights of subrogation against any subsidiary, associated,
affiliated, or interrelated companies of the Assured and all parties specified in the Assured Clause
and this insurance shall not be prejudiced;

Notes : - Warranty :
- Warranted vessel BKI Classed and Class maintained at the time of accident
- Warranted the insured vessels are complied with any statutory/regulatory provision, with valid
and maintained flag state certificates at the time of loss
- Warranted sailing permit from departure port authority
- Warranted single tow operation only
- Warranted no overdraft of the vessel at the time of accident related to relevant load line of the
vessel
- Seaworthiness warranty
- Warranted no overload passenger and/or cargo during operation
- Premium Warranty : In full within 60 days of inception date
- Trading Area : Indonesia water
- Subjectivity :
- No cover unless formally advised and agreed by insurance
- Subject to no outstanding premium for existing policy
- Subject to clean loss record for existing policy
- Subject to no loss until bind cover
- Sight & Review of Gross Akta before bind
- Subject to vessel’s not in laid up condition.
- Period to be informed prior to inception
- No Claim up to binding date or inception date whichever latest (not back date)
- Period must be informed before on risk

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Placement Information and Proposed Insurer(s)

Security : This quotation is supported up to (100%) of sum insured based on written confirmation from PT
Asuransi Jasa Indonesia (Persero) (50%) As a Leader, PT Asuransi Mitra Pelindung Mustika (15%)
as a member, PT Asuransi Takaful Umum (10%) as a member, PT Asuransi Candiutama (10%) as
a member, PT Asuransi Umum Bumiputera Muda 1967 (5%) as a member, PT Asuransi Umum
Videi (5%) as a member, PT Asuransi Bhakti Bhayangkara (5%) as a member.

Proposed (Leader) : - PT Asuransi Jasa Indonesia (Persero) (50%) As a Leader

(Policy Issuer) - PT Asuransi Mitra Pelindung Mustika (15%) as a member
- PT Asuransi Takaful Umum (10%) as a member
- PT Asuransi Candiutama (10%) as a member
- PT Asuransi Umum Bumiputera Muda 1967 (5%) as a member
- PT Asuransi Umum Videi (5%) as a member
- PT Asuransi Bhakti Bhayangkara (5%) as a member

Note:
We have done our placement to search for the best terms and conditions offered at the best rate of
premium, Fresnel is not responsible for insurer\\'s financial or managerial default, we encourage the
insured to inform us if there is any concern regarding any particular insurer(s) we propose in this
quotation or if there is any specific preference towards a certain insurer(s) upon such
communication, we will act accordingly as per your instruction.

Premium Calculation and Payment

Rate & Premium : Detail Rate as below :-

Calculation
H&M = 1,350% per annum
WAR = 0,025% per annum

Detail Premium Calculation as below :-

H&M : IDR 14,068,000,000.00 x 1,350% = IDR 189,918,000.00 per annum

WAR : IDR 14,068,000,000.00 x 0.025% = IDR 3,517,000.00 per annum

Total Premium Calculation : IDR 193,435,000 per annum

Excluding administration, policy cost and stamp duty

Payment : Within 60 days of inception date.

Note:

1. No claim will be honored and no liability under this insurance will be admitted by underwriter
before receiving the full amount of the premium in their account, subject otherwise to prior
written agreement. Please allow a reasonable time frame for us to process payment of your
premium to the insurer(s) so that they can receive the premium in time prior to the date stated
above for each payment.
2. Should you decide to cancel this policy once instructed and prior to the expiry, you are
obligated to pay for the premium during that validity period of the cover.

Jakarta, 29 May 2023

Signed for and on behalf of,

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Created by Bayya Ziqra on 2023-05-30 11:40:27 doc. number: 01121/QS.Checked by M Husni Barkah, SE, APAI, CIIB, ANZIIF (Snr. Assoc), CIP.
PT. Fresnel Perdana Mandiri

M Husni Barkah, SE, APAI, CIIB, ANZIIF (Snr. Assoc), CIP

CIIB Reg. No. M20170457

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Created by Bayya Ziqra on 2023-05-30 11:40:27 doc. number: 01121/QS.Checked by M Husni Barkah, SE, APAI, CIIB, ANZIIF (Snr. Assoc), CIP.