Lama

Jumlah
No Nama Barang / Ket Harga Satuan Merek Pelaksanaa Ruangan
Barang
n

1 Transfer Strecher 2 35,143,609.00 Poly Medical 90 HK

2 Ventilator 1 762,964,809.00 Draeger 120 HK

3 Termometer Digital 15 18,649,666.00 RGB 65 HK

4 Rak Buku 1 8,500,000.00 Lokal 18 HK

5 Mobil Ambulance 1 717,999,999.00 Hyundai 120 HK

6 Syringe Pump Instilar 1418 2 26,544,000.00 Dixion 50 HK

Regulator Flowmeter O2
7 5 770,000.00
Gentec
8 Botol Anchor 1,5 M3 3 1,540,000.00 5 HK
Trolly Tabung Oksigen Cap 6
9 2 1,320,000.00
M3

10 Tanah 100 447,775,000.00 120 hk

11 Laptop 1 12,440,054.00 13 hk

12 AC 1 PK 2 Rudis dr
18,000,000.00 14 hk
13 AC 2 PK 1 Kepeg

14 Defribrilator Monitor 2

15 Electrosurgical Generator 1 80,170,000.00 120 hk

16 Emergency Suction Pump 7 19,723,857.14

17 Spill Kit 10 43,394.00 Onemed 85 hk

18 Tensimeter Mobile 15 3,008,800.00 70 hk

19 Pen Light 12 1,833,333.33 Hope 45 hk

20 ECG 7 55,385,714.29 BTL 120 hk

21 Mayo Table 15 10,500,000.00

120 hk
22 Stetoskop 15 2,500,000.00
23 Minor Surgery Set 1 72,951,000.00

24 Partus Set 1 36,394,000.00

25 Curret Set 1 22,635,200.00 85 hk

26 Laparatomi Set 2 25,886,300.00

27 Neonatal Fototerapi 1 69,504,700.00

Transcutaneus Electrical
Nerve Simulation 4 Channel +
28 Sponge Cover Tens, Laser 1 500,200,000.00 85 hk rehab
Therapy, Megneto Therapy,
Short Wave Diaterny

29 Emergency Trolley 5 20,300,000.00 MT502 120 hk

30 Tempat Tidur 2 Crank 14 19,454,643 70 hk

31 Ventilator 1 1,850,708,598.00 Draeger 85 hk

Fisher &
32 T-Plece Resusitator 1 19,099,000.00 80 hk
Paykel

33 Steam Suhu Rendah 1 2,161,500,000.00 80 hk

34 Operating Lamp Mobile 1 209,431,814.00 120 hk

35 Oxymetri 7 16,490,356.29

36 USD 1 78,000,000.00 85 hk

37 USG 3D BREAST ABUS 1 2,809,000,000.00 GE 85 hk

38 Dental Xray Panoramic 1 1,488,161,931.00 85 hk

39 USG 5 Probe 1 1,583,939,334.00 GE 85 hk

40 Refleks Hammer 12 358,633.33 Solid 125 hk

41 X-Ray Mobile Digital 1 2,335,961,641.00 GE 85 hk

Echo Cardiography 952,000,000.00 Siemens 65 hk

42 CTG 1 98,880,000.00

80 hk

43 INFUS PUMP 8 14,337,500.00

44 Kursi Roda 13 2,992,153.85 90 hk

45 Monitor Central 1 35,604,000.00 radiologi radiologi

85 hk

46 Vidio Laringoskop 1 64,240,200.00 radiologi

47 Lampu Kepala 5 26,750,000.00 90 hk radiologi

ibs

Elitech
48 Nebulizer 8 22,225,000.00 140 HK
Indonesia

49 Infra Red 2 10,625,500.00 85 hk radiologi

50 Ligasure / Harmony Set 1 550,000,000.00 80 hk radiologi

51 Ventilator Bayi 2 809,000,000.00 90 hk

52 E Limbah B3/ Autoclave 1 4,290,000,000.00 150 hk

53 USG 2 PROBE 1 520,000,000.00 85 hk

54 MEJA GYNEKOLOGI 1 44,209,000.00 95 hk

55 INFANT WARMER 1 377,300,000.00 90 hk

56 MESIN ANESTESI 1 1,250,000,000.00 85 hk

57 DR XRAY IMAGINE SYSTEM 1 819,999,999.00 95 hk

58 EEG 1 441,000,000.00 Neurosoft 85 hk

59 AC 1 PK 2 5,000,000.00 14 HK

60 Printer EPSON 3 5,053,020.00

14 hk
61 Hardisk External 1 1,203,100.00

62 Genset 1 1,490,225,000.00
 REKAPAN PENGADAAN 2021

Lama
Jumlah
No Nama Barang / Ket No. Kontrak Tgl. Kontrak Nilai Kontrak Pelaksana Pimpinan Alamat NPWP Bank No. Rekening No. Bast Tgl. Bast No. SP2D Tgl. SP2D Harga Satuan Merek Pelaksanaa Ruangan
Barang
n

Jl. Durian, Kel.

Bank Sulutgo 8948/24-
1 Rehab Ruang Kantor 1 050/RSUD.O/0959.b/VIII/2021 09 Agustus2021 39,100,000.00 CV. ALFA INDORAYA Anton Lagona Tomulabutao Selatan, Kec. 94.046.072.8-822.000 00301520007865 445/RSUD.O/1969/X/2021 11 Oktober 2021 2-Nov-21 39,100,000.00 60 HK RUANG KTU
Cabang Gorontalo 21/1.02.1.2/2021
Dungingi
5228/24-
100% 445/RSUD.O/0859/VII/2021 26 Juli 2021 30 Juli 2021 118,995,500.00
21/1.02.1.2/2021
Bank Sulutgo
Rehab Gedung 3789/24-
2 30% 03/SPK/PGD/R.UGD/RSUD OT/V/2021 24 Mei 2021 183,070,000.00 CV. YENTRI JAYA Agussalim Laiya Desa Hulawa Kec. Telaga 02.836940.3-822.000 Cabang Pembantu 04901520000053 17 juni 2021 54,921,000.00 120 HK
UGD/screening 21/1.02.1.2/2021
Telaga 183,070,000.00
14075/24-
5% 445/RSUD.O/2649/XII/2021 21 Desember 2021 27 Desember 2021 9,153,500.00
21/1.02.1.2/2021

5225/24-
100% 445/RSUD.O/0854/VII/2021 26 Juli 2021 30 Juli 2021 118,950,000.00
21/1.02.1.2/2021
183,000,000.00
Bank Sulutgo
CV. MUDA KARYA Jl. Sawit Kel. Tuladenggi 3775/24-
3 Rehab IPSRS 30% 03/SPK/PKP/R.IPSRS/RSUD OT/V/2021 26 Juli 201 183,000,000.00 Ibrahim Mardjun 03.170.850.6-822.000 Cabang Pembantu 04901520001195 17 juni 2021 54,900,000.00 120 HK
PERKASA Kec. Dungingi 21/1.02.1.2/2021
Telaga
14051/24-
5% 445/RSUD.O/2651/XII/2021 21 Desember 2021 27 Desember 2021 9,150,000.00
21/1.02.1.2/2021
RUANG
CV. ELPUTRA Andi Eduard Jl. Bali, Kel. Paguyaman, 9543/24-
4 Pemeliharaan Ruang UGD 050/RSUD.O/1218/IX/2021 21-Sep-21 25,840,650.00 85.248.365.0-822.000 Bank BNI 0723566485 445/RSUD.O/2050/X/2021 21 Oktober 2021 9-Nov-21 25,840,650.00 30 HK TUNGGU
PERSADA Lesnussa Kec. Kota Tengah 21/1.02.1.2/2021
UGD
Pemeliharaan Ruang CV. ELPUTRA Andi Eduard Jl. Bali, Kel. Paguyaman, 9545/24- PERBAIKAN
5 050/RSUD.O/1217/IX/2021 21-Sep-21 8,519,720.00 85.248.365.0-822.001 Bank BNI 0723566486 445/RSUD.O/2045/X/2021 22 Oktober 2021 9-Nov-21 8,519,720.00 31 HK
Manajemen PERSADA Lesnussa Kec. Kota Tengah 21/1.02.1.2/2021 PINTU
Bank Sulutgo
Pemeliharaan Gedung 2392/24-
6 100% 03/SPK/PGP/RSUD.OT./IV/2021 9-Apr-21 19,800,000.00 CV. YENTRI JAYA Agussalim Laiya Desa Hulawa Kec. Telaga 02.836.940.3-822.000 Cabang Pembantu 04901520000053 445/RSUD.O/0406/IV/2021 19-Apr-21 03 Mei 2021 19,800,000.00 30 hk
Perawatan 21/1.02.1.2/2021
Telaga

10 1 40,799,999.99

11 1 48,599,999.99
18 Februari PT. TAWADA Hariadi, S. Si. Jl. Metro Latimojong KCP Pondok 445/RSUD.O/0720.c/VI/ 9311/24- 110,400,000.00
Pemeliharaan Alkes Radiologi 050/RSUD.O/0086.a/II/2021 131,400,000.00 01.903.521.1.026.000 2373555088 21 Juni 2021 5-Nov-21
2021 HEALTHCARE Apt Makassar Indah 2021 21/1.01.1.2/2021
12 2 10,500,000.01

13 2 10,500,000.01

13810/24- 24 Desember
100 161,025,000.00
Bank Sulutgo 21/1.02.1.2/2021 2021
01 Desember CV. ADE PUTRA
14 Pemeliharaan Paving Block 050/RSUD.O/2366/XII/2021
2021 169,500,000 JAYA
Hendra Kumai Desa Hulawa Kec. Telaga 72.698.410.7-822.000 Cabang Pembantu 04901520000077 445/RSUD.O/2623/XII/2021 17 Desember 2021 14097/24-
Telaga 27 Desember
5% 21/1.02.1.2/202 8,475,000
2021
1
14462/24- 30 Desember
100% 80,370,000.00 30 hk
21/1.02.1.2/2021 2021
01 Desember Jl. Teknik Desa Luwoo, Bank Mandiri
15 Rehab Ruang Kelas III 050/RSUD.O/2360/XII/2021 84,600,000.00 CV. ARYA PRATAMA Siswanto Akili 66.133.928.3-822.000 1500011048640 445/RSUD.O/2753/XII/2021 27 Desember 2021
2021 Kec. Telaga Jaya Cabang Gorontalo
14467/24- 30 Desember
5% 4,230,000.00
21/1.02.1.2/2021 2021

14473/24- 30 Desember
100% 159,125,000.00
21/1.02.1.2/2021 2021
1 Desember Desa Lemito Kec. Lemito Bank Sulutgo
16 Rehab Ruang Kelas II 050/RSUD.O/2369/XII/2021 167,500,000.00 CV. LOVANDA PRIMA Anton Lagona 02.394.833.4-822.000 01001520000483 445/RSUD.O/2759/XII/2021 27 Desember 2021 30 HK
2021 Kab. Pohuwato Cabang Marisa
14490/24- 30 Desember
5% 8,375,000.00
21/1.02.1.2/2021 2021

14346/24- 28 Desember
100% 142,025,000.00
Bank Sulutgo 21/1.02.1.2/2021 2021
1 Desember
17 Pemeliharaan Gedung TB 050/RSUD.O/2363XII/2021 149,500,000.00 CV. YENTRI JAYA Agussalim Laiya Desa Hulawa Kec. Telaga 02.836.940.3-822.000 Cabang Pembantu 04901520000053 445/RSUD.O/2647/XII/2021 21 Desember 2021 30 hk
2021
Telaga 14429/24- 29 Desember
5% 7,475,000.00
21/1.02.1.2/2021 2021

1,161,830,370.00 1,140,830,370.00
 131,400,000.00 1,000,910,650.00
8,519,720.00

1,021,910,650.00
 1161830370

21,000,000.00 1,030,430,370.00

1060903788 100,926,582.00
 DED RSUD OTANAHA

NO. TANGGAL
NO URAIAN NILAI PELAKSANA NO SP2D NILAI SP2D TGL SP2D NO BAST TGL BAST KET
KONTRAK KONTRAK

050/ 445/
Pembayaran 100% Atas Pekerjaan RSUD.O/ 25 Oktober CV. ARSY 11467/24- 07 RSUD.O/ 050/RSUD.O/
Jasa Konsultasi Perencanaan (DED) 2062/X/ 2021 42,000,000.00 ENGINEERING 21/1.02.1.2 42,000,000.00 Desember 2283/XI/ 22-Nov-21
2366/XII/2021
CONSULTANT /2021 2021
2021 2021
03/SPK/JK- 445/
Pembayaran 100% Atas Pekerjaan CV. WINTECH 2213/24-
Jasa Konsultasi Perencanaan DED/ 7-Apr-21 33,000,000.00 PRATAMA 21/1.02.1.2 33,000,000.00 27 Aril RSUD.O/ 19-Apr-21
RSUD.O/ 2021 0396/IV/
Arsitektur (DED Rehab UGD) KONSULTANT /2021
IV/2021 2021/2021

Pembayaran 100% Atas Jasa 03/SPK/JK- CV. ARSY 5996/24- 20 445/

PGWSN/ 24 MEI 2021 RSUD.O/ 28 JULI 03/SPK/PGD/
Konsultasi Pengawasan Pekerjaan 16,500,000.00 ENGINEERING 21/1.02.1.2 16,500,000.00 AGUSTUS R.UGD/RSUD
Rehab IPSRS dan Rehab UGD RSUD.OT/ CONSULTANT /2021 2021 0871/VII/ 2021 OT/V/2021
V/2021 2021

Pembayaran 100% Atas Pekerjaan 050/ 445/

14308/24- 28 23 KDP
Belanja Jasa Konsultasi Konstruksi RSUD.O/ 01 JULI 2021
476,553,000.00 PT. SADHYA 20/1.02.1.2
RSUD.O/
95,310,600.00 Desember Desember PEKERJAAN
Perencanaan Desain Perencanaan 0751/VII/ GRAHACARA 2690/XII/
/2021 2021 2021 IPAL
Fisik PEN (DED IPAL/wtp) 2021 2021

050/ 445/
Pembayaran 80% Atas Pekerjaan 6931/24- KDP
RSUD.O/ 01 JULI 2021
476,553,000.00 PT. SADHYA 20/1.02.1.2 381,242,400.00 23-Sep-21
RSUD.O/ 27 Agustus PEKERJAAN
Belanja Jasa Konsultasi
Perencanaan (DED IPAL/WTP) 0751/VII/ GRAHACARA /2021 1089.c/ 2021 IPAL
2021 VIII/2021
 KDP
050/ CV. CIVIL PEKERJAAN
Pembayaran 100% Atas Pekerjaan 7043/24- 445/
RSUD.O/ 30 Agustus ARCH LAPISAN
Jasa Konsultasi Perencanaan Desain 49,300,000.00 20/1.02.1.2 49,300,000.00 27-Sep-21 RSUD.O/ 24-Sep-21
Fisik Lapisan Timbal Ruang Radiologi 1093/VIII/ 2021 ENGINEERING /2021 IX/2021 TIMBAL
2021 CONSULTANT RUANG
RADIOLOGI

Pembayaran 100% Atas Pekerjaan 050/ 445/PPHP-

Belanja Jasa Konsultasi RSUD.O/ CV. FATEK 11776/24- 09 FHO/ KDP
01 JULI 2021 238,099,400.00 ENGINEERING 30/1.02.1.2 28.571.928 Desember 18-Nov-21 PEKERJAN
Perencanaan (DED Modular 0753/VII/ 2337/XI/
CONSULTANT /2021 2021 MOT
Operating Theatre) 2021 2021

Pembayaran 85% Atas Pekerjaan 050/

CV. FATEK 8499/24- KDP
Belanja Jasa Konsultasi RSUD.O/ 26 Oktober
1 JULI 2021 238,099,400.00 ENGINEERING 30/1.02.1.2 9,523,976.00 PEKERJAN
Perencanaan (DED Modular 0753/VII/ 2021
CONSULTANT /2021 MOT
Operating Theatre) 2021

Pembayaran 80% Atas Pekerjaan 050/ 445/

Belanja Jasa Konsultasi RSUD.O/ CV. FATEK 5940/24- 25 Agustus RSUD.O/ 09 Agustus KDP
1 JULI 2021 238,099,400.00 ENGINEERING 30/1.02.1.2 152,383,616.00 PEKERJAN
Perencanaan (DED Modular 0753/VII/ 2021 0959/VIII/ 2021
CONSULTANT /2021 MOT
Operating Theatre Ruang Operasi) 2021 2021

Pembayaran 20% Atas Pekerjaan 050/ CV. FATEK 5157/24- KDP

Belanja Jasa Konsultasi RSUD.O/ 27 juli
1 JULI 2021 238,099,400.00 ENGINEERING 21/1.02.1.2 47,619,880.00 PEKERJAN
Perencanaan (DED Modular 0753/VII/ 2021
CONSULTANT /2021 MOT
Operating Theatre Ruang Operasi) 2021

238,099,400.00
49,300,000.00
476,553,000.00
42,000,000.00
33,000,000.00
16,500,000.00

855,452,400.00
01 Desember 050/RSUD.O/ 01 Desember 050/RSUD.O/ 1 Desember 050/RSUD.O/ 1 Desember
2021 169,500,000 2360/XII/2021 2021
84,600,000.00
2369/XII/2021 2021
167,500,000.00
2363XII/2021 2021

03/SPK/PKP/
24 Mei 2021 183,070,000.00 R.IPSRS/RSUD 26 Juli 201 183,000,000.00
OT/V/2021
149,500,000.00