1. FORMULIR PERHITUNGAN TINGKAT KOMPONEN DALAM NEGERI
DOMESTIC CONTENT CALCULATION FORM
FORMULIR No. : SC-02
Nama Peserta/Bidder Name :
Total Nilai Penawaran/ Total Quoted Price:
Deskripsi/Description
% Komponen Dalam Komponen Dalam
Butir/Item Negeri (KDN)/ Negeri Penawaran/
Domestic Content (DC) Quoted Domestic
Content
Nilai per Item
Nilai/Value %
/Item Value %
a b c d=axc e
A. BARANG/GOODS
I. MATERIAL TERPAKAI
Used Materials
II. PERALATAN
Equipment
Sub Total (A)
B. JASA/SERVICES
III. PERSONIL/KONSULTAN
Personnel/Consultant
IV. ALAT KERJA/PERALATAN
Tools/Equipment
V. KONSTRUKSI/FABRIKASI
Construction/Fabrication
VI. JASA UMUM DLL.
Other Services
Sub Total (B)
C. JUMLAH (T O T A L)=
Sub Jumlah A+ B
b : Nilai per Item/Jumlah Nilai Penawaran x 100%
e : Nilai KDN Penawaran/Jumlah Nilai Penawaran x 100%
Catatan/Note:
Personil/Konsultan : Rekayasa, survey perencanaan, pengawasan, manajemen, tenaga kerja, dll.
Personnel/Consultant Engineering, research design, supervision, management, personnel etc.
Alat Kerja/Peralatan : Sewa rig, sewa kendaraan, sewa kapal, sewa pompa, dll.
Tools/Equipment Rental of rig, vehicle, barge, pump, etc.
Konstruksi/Fabrikasi : Konstruksi sipil, mesin, listrik, dll.
Construction/Fabrication Civil, mechanical, electrical construction, etc.
Jasa Umum dll. : Pengurusan, asuransi, sewa rumah, dll.
Other Services etc. Management handling, insurance, house rent, etc.
Material Terpakai : Pipa, Semen, Chemical, dll.
Material Used Pipe, Cement, Chemical, etc
Peralatan : Pompa Kompresor, Generator dll
Equipment Pump, Compressor, Generator, etc
Tanda Tangan :
Signature
Materai :
Duty Stamp
Nama & Jabatan Penandatangan : _____________________________