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20                                     PPWG
                                                                                                                             nUSA DUA
                                            ACCSQ                                                                            bali
                       The          Th                                                                                       13-17 may
                                            ASEAN CONSULTATIVE COMMITTEE FOR STANDARDS AND QUALITY                                                                           nadfc
                                            Pharmaceutical Product Working Group                                             2013
Sekretariat Gabungan Perusahaan Farmasi Indonesia, Jl Angkasa No 20 A Kemayoran Jakarta 10620
Phone: +62 21 420 3040, Fax : +62 21 420 3047, 420 3048, Email : sekretariatgpfi@yahoo.com                                                    Official website : www.20thaccsq-ppwg.com




        Hotel Reservation Form
            Full Name                                                                                                  Passport No./
            (Mr / Mrs / Ms /Dr )                                                                                         ID Card No.

            Share With                                                                                                 Passport No./
                                                                                                                         ID Card No.

            Address
            Phone No.                                                                                                         Fax.No
            Email



        FLIGHT INFORMATION
                                   Departure date                                                                           Arrival date
         Flight No.:               Date :                         Time:                              Flight No.:          Date :                    Time:




        ROOM RESERVATION DETAILS
         Check-in Date:                                                                              Check-out Date:




        HOTEL ACCOMODATION
        A great range of accommodation has been secured at special price for participants attending this meeting. As the 20th ACCSQ-
        PPWG Meeting falls in a reasonably busy time for Bali, we strongly recommend participants book their accommodation as early
        as possible. These special hotel rates are applicable for reservation made before 30 April, 2013. Any reservation made after 30
        April 2013 will be subject to room and price availability. The room rate is quoted per room per night, including breakfast for 2
        persons and 21% tax and service charge.


                                                                           Please tick your choice:
                             HOTEL NAME                                                        ROOM TYPE                                   PRICE (IDR /US$)
           	 ourtyard Marriot Hotel (**** /4 stars)
            C                                                                     	 Deluxe Garden room 	                          Rp	     1,400,000 	      (US$ 143)
                                                                                  	 Deluxe Pool view room	                        Rp.	    1,600,000	       (USD 164)
                                                                                  	 Premium Deluxe room	                          Rp. 	   1,700,000	       (USD 175)
                                                                                  	 Deluxe Pool Terrace 	                         Rp.	    2,050,000	       (USD 210)

           	 ovotel Nusa Dua (**** /4 stars)
            N                                                                    	 Deluxe room      	                             Rp 	 1,200,000 	 (US$ 123)
                                                                                 	 One bedroom Suite 	                            Rp 	 1,750,000 	 (US$ 184)
                                                                                 	 Two bedroom Suite	                             Rp 	 2,500,000 	 (US$ 258)

           	 elia Bali Nusa Dua (***** /5 stars)
            M                                                                    	 Deluxe room	                                   Rp 	 1,450,000 	 (US$ 148)
                                                                                 	 Duplex Suite	                                  Rp 	 1,800,000 	 (US$ 188)
                                                                                 	 Lagoon Access Suite	                           Rp 	 3,200,000 	 (US$ 228)

                                                                                  	 Deluxe room	                                  Rp 	    1,650,000 	      (US$ 168)
           Nusa Dua Beach Hotel (***** /5 stars)                                 	 Premier room	                                 Rp 	    1,850,000 	      (US$ 188)
                                                                                  	 Palace Club room	                             Rp	     2,600,000 	      (US$ 268)
                                                                                  	 Palace Club suite	                            Rp 	    3,750,000 	      (US$ 288)
20                                     PPWG
                                                                                                             nUSA DUA
                                         ACCSQ                                                               bali
                      The          Th                                                                        13-17 may
                                         ASEAN CONSULTATIVE COMMITTEE FOR STANDARDS AND QUALITY                                                            nadfc
                                         Pharmaceutical Product Working Group                                2013
Sekretariat Gabungan Perusahaan Farmasi Indonesia, Jl Angkasa No 20 A Kemayoran Jakarta 10620
Phone: +62 21 420 3040, Fax : +62 21 420 3047, 420 3048, Email : sekretariatgpfi@yahoo.com                                  Official website : www.20thaccsq-ppwg.com




        RESERVATION PAYMENT Method
        The hotel requires security of payment to guarantee your hotel room. Payment can be made either by credit card (subject to 6%
        administration fee) or through bank transfer (subject to local bank administration fee of USD 30.00 per remittance).
        Bank Name 	             :	 Bank Mandiri, Branch Kuta, Bali
        Swift Code	             :	 BMRIIDJA
        Bank Address	           : Jl. Raya Kuta 456 Kuta - Bali
        Beneficiary	            :	 PT. MELALI BALI
        USD account no.	        :	 145 - 000 527 72 03
        IDR account no. 	       :	 145 - 000 531 75 61

          Hotel Reservation Contact:
          PT MELALI BALI Jl. Dewi Sri, Complex The Lotus No.10 Kuta 80361 – Bali, Indonesia, Ph. +62 (361) 766156, Fax. +62 (361) 763435
          info@melali-bali.com, www.melali-bali.com. Reservation Coordinator : Mrs. Maria Yovieta, Ph. +62852 3421 8484, maria.yovieta@melali-bali.com




        Terms and conditions
        1)	 Every reservation will be handled confidentially.
        2)	 Reservation can only be accepted with full pre-payment (advance payment) to the organizer.
        3)	 In case of cancellation the following terms applied:
             •	 Cancellation made up to 30 days prior to check in date will be free from cancellation fee
             •	 Cancellation made between 30 days to 10 days prior to check in date will be charged equivalent to one (1) night
                 of the room charge for each room cancelled.
             •	 Cancellation made between 9 days to 4 days prior to check in date will be charged equivalent to two (2) night of
                 the room charge for each room cancelled.
             •	 Cancellation made less than 4 days prior to check in date and in the case of no show will be charged equivalent
                 to 100% of the total night reserved.



          Signature                                                                 Date          dd             mm                  yy

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20th ACCSQ-PPWG HOTEL RESERVATION FORM

  • 1. 20 PPWG nUSA DUA ACCSQ bali The Th 13-17 may ASEAN CONSULTATIVE COMMITTEE FOR STANDARDS AND QUALITY nadfc Pharmaceutical Product Working Group 2013 Sekretariat Gabungan Perusahaan Farmasi Indonesia, Jl Angkasa No 20 A Kemayoran Jakarta 10620 Phone: +62 21 420 3040, Fax : +62 21 420 3047, 420 3048, Email : sekretariatgpfi@yahoo.com Official website : www.20thaccsq-ppwg.com Hotel Reservation Form Full Name Passport No./ (Mr / Mrs / Ms /Dr ) ID Card No. Share With Passport No./ ID Card No. Address Phone No. Fax.No Email FLIGHT INFORMATION Departure date Arrival date Flight No.: Date : Time: Flight No.: Date : Time: ROOM RESERVATION DETAILS Check-in Date: Check-out Date: HOTEL ACCOMODATION A great range of accommodation has been secured at special price for participants attending this meeting. As the 20th ACCSQ- PPWG Meeting falls in a reasonably busy time for Bali, we strongly recommend participants book their accommodation as early as possible. These special hotel rates are applicable for reservation made before 30 April, 2013. Any reservation made after 30 April 2013 will be subject to room and price availability. The room rate is quoted per room per night, including breakfast for 2 persons and 21% tax and service charge. Please tick your choice: HOTEL NAME ROOM TYPE PRICE (IDR /US$)  ourtyard Marriot Hotel (**** /4 stars) C  Deluxe Garden room Rp 1,400,000 (US$ 143)  Deluxe Pool view room Rp. 1,600,000 (USD 164)  Premium Deluxe room Rp. 1,700,000 (USD 175)  Deluxe Pool Terrace Rp. 2,050,000 (USD 210)  ovotel Nusa Dua (**** /4 stars) N  Deluxe room Rp 1,200,000 (US$ 123)  One bedroom Suite Rp 1,750,000 (US$ 184)  Two bedroom Suite Rp 2,500,000 (US$ 258)  elia Bali Nusa Dua (***** /5 stars) M  Deluxe room Rp 1,450,000 (US$ 148)  Duplex Suite Rp 1,800,000 (US$ 188)  Lagoon Access Suite Rp 3,200,000 (US$ 228)  Deluxe room Rp 1,650,000 (US$ 168)  Nusa Dua Beach Hotel (***** /5 stars)  Premier room Rp 1,850,000 (US$ 188)  Palace Club room Rp 2,600,000 (US$ 268)  Palace Club suite Rp 3,750,000 (US$ 288)
  • 2. 20 PPWG nUSA DUA ACCSQ bali The Th 13-17 may ASEAN CONSULTATIVE COMMITTEE FOR STANDARDS AND QUALITY nadfc Pharmaceutical Product Working Group 2013 Sekretariat Gabungan Perusahaan Farmasi Indonesia, Jl Angkasa No 20 A Kemayoran Jakarta 10620 Phone: +62 21 420 3040, Fax : +62 21 420 3047, 420 3048, Email : sekretariatgpfi@yahoo.com Official website : www.20thaccsq-ppwg.com RESERVATION PAYMENT Method The hotel requires security of payment to guarantee your hotel room. Payment can be made either by credit card (subject to 6% administration fee) or through bank transfer (subject to local bank administration fee of USD 30.00 per remittance). Bank Name : Bank Mandiri, Branch Kuta, Bali Swift Code : BMRIIDJA Bank Address : Jl. Raya Kuta 456 Kuta - Bali Beneficiary : PT. MELALI BALI USD account no. : 145 - 000 527 72 03 IDR account no. : 145 - 000 531 75 61 Hotel Reservation Contact: PT MELALI BALI Jl. Dewi Sri, Complex The Lotus No.10 Kuta 80361 – Bali, Indonesia, Ph. +62 (361) 766156, Fax. +62 (361) 763435 info@melali-bali.com, www.melali-bali.com. Reservation Coordinator : Mrs. Maria Yovieta, Ph. +62852 3421 8484, maria.yovieta@melali-bali.com Terms and conditions 1) Every reservation will be handled confidentially. 2) Reservation can only be accepted with full pre-payment (advance payment) to the organizer. 3) In case of cancellation the following terms applied: • Cancellation made up to 30 days prior to check in date will be free from cancellation fee • Cancellation made between 30 days to 10 days prior to check in date will be charged equivalent to one (1) night of the room charge for each room cancelled. • Cancellation made between 9 days to 4 days prior to check in date will be charged equivalent to two (2) night of the room charge for each room cancelled. • Cancellation made less than 4 days prior to check in date and in the case of no show will be charged equivalent to 100% of the total night reserved. Signature Date dd mm yy