PT I N D@CEM ENT TU NGGAL PRAKARSATbK.

Kantor Pusat
Wisma lndocement, Lt. t3
Jl. Jenderal Sudirman Kav.7o-7t
iakarta rz9ro, lndonesia
Ielp '. +6zztz5tzsz''
Fax : +62 zt 57ol893
INDOCEMENT www.!ndocement.co.id
tEIDELBERGCFMENTCTUo

SURAT KETERAN ASAL BARANG

No. 0392llTP-Co RSE LA/TLD /xt I 2024

Yang bertanda tangan dibawah ini

Nama Arya Maulana Saifudin

iabatan Kepala Teknik Tambang PT lndocement Tunggal Prakarsa Tbk

Bertindak untuk dan atas nama serta mewakili PT indocement Tunggal Prakarsa Tbk P12 Tarjun yang
berlokasi di Desa Tarjun, Kecamatan Kelumpang Hilir, Kabupaten Kotabaru, Provinsi Kalimantan Selatan
memberikan Surat Keterangan Asal Barang terhadap komoditi sebagaimana tersebut di bawah ini :

Nama Barang Laterite Untuk Semen

Jumlah Muatan J 7.500 M/T (Jumlah akan disesuaikan setelah draft tongkang)
Pelabuhan Muat PT lndocement Tunggal Prakarsa Tbk Tarjun, Kab. Kotabaru Kalimantan Selatan
Pelabuhan Bongkar Garongkong Port - Sulawesi Selatan
Kapal Pengangkut TB. Oceanic 2 I BG. Azamara 2
ETA Loading 11 November 7024
B/L No.

Komoditi Laterite Untuk Semen tersebut berasal dan diproses dari tarnbang PT lndocement Tunggal
Prakarsa Tbk P12 Tarjun, berdasarkan Keputusan Gubernur Kalimantan Selatan No : 503/11.4-
30/DPMPfSPlKillzAz} Tentang Persetujuan Perubahan Masa Berlaku Perpanjangan Tahap Kedua lzin
Usaha Pertambangan Operasi Produksi Batuan Komoditas Laterite Kepada PT lndocement Tunggal
Pra ka rsa Tbk ( l(TB. 10041 U POP80075 - 025/KALSEL).

Demikian Surat Keterangan Asal Barang ini dibuat dengan sebenarnya serta untuk dapat dipergunakan
sebagaimana mestinya.

Dikeluarkan di : Tarjun
Pada Tanggal : 4 November 2024

PT IND PRAKARSA TbK.

Ma
Kepala T Tambang

PabikCileureup
ll
Telp
Fax
Mayor o[irg

i62 21
r +6221 87i2956
Iaya,tmaja
Citeureup, Bogorr68ro, lawa Sarai
3752812,87!a!l
Pabrik Palimanan
l1Raya Clrebon-Bandung xM. ,o
Pa Lnanan Ckebon 45r5r, lawa sarat
Telp :
Fu
+,4221r 141760
: +6141 t$517
Pabdk Ta4un
Dsa Tatun. Iec l( umpaig Hr] .
(e. (otabilu, klimartan Se daf
Telp : +62
Fax : +61
5r3 6roN
5r8 61090
ffiffi@@
" scs ,, scs
rtu)oe51o417r @turDro85
\ilEf! \#l
qgij|[:?, ffiro.osHonl
Shipping Instruction Date : 30 Oct 2024 Doc No. : PO401169

To : JAYA BERDIKARI CIPTA G858

JL. MAYOR OKING JAYAATMAJA CITEUREUP
CITEUREUP KABUPATEN BOGOR JAWA
BARAT
Phone: (+62)021-5152330 Fax:
Vessel Name : TB Oceanic 2 - Azamara 2
Transport Type : 1 - Ocean

Loading Point : Tarjun, Kalimantan Selatan Destination Point : Garongkong Port, Sulawesi Selatan
Payment Terms : 45 days

Description
No. PO No Supplier Item UoM Quantity B/L No
(Name And Specification)
006000000000
Laterite ¦ T|R: Fe2O3=60.0%|
O191 - INDOCEMENT
1. I140920 001 <45.0%, Fe=42.0%|<31½%, MT 7,500.000
TUNGGAL PRAKARSA TBK
MC=30.0%|>35.0%,
TiO2=1.0%|-

Remark : 1. Laterite For Plant P15&15 ITP Maros 2. Actual Quantity

based on quantity was stated on BL 3. Tug Boat Oceanic 2,
Barge Azamara 2 4. ETA Loading Nov 11 2023 5. Qty +/- 10%
 CODE NAME “CONGENBILL” EDITION 1994 Page 2
BILL OF LADING B/L No.
Shipper
TO BE USED WITH CHARTER-PARTIES 001/TSR-BTL/BL/XI/24
PT. INDOCEMENT TUNGGAL PRAKARSA TBK
LEVEL 13, WISMA INDOCEMENT KAV 70-71
JL. JEND. SUDIRMAN, JAKARTA 12910, INDONESIA

Consignee

TO ORDER

Notify address

TO ORDER

Vessel Port of loading

TB. OCEANIC 2 JETTY ITP TARJUN TARJUN, KALIMANTAN SELATAN

BG. AZAMARA 2

Port of discharge

GARONGKONG PORT, SULAWESI SELATAN

Shipper’s description of goods

Gross weight

LATERITE 7,500.192 MT
(of which on deck at Shipper’s risk; the Carrie not
being responsible for loss or damage howsoever arising)

Freight payable as per At the port of loading in apparent good order and
CHARTER-PARTY dated ………………………………………….… SHIPPED condition on board the Vessel for carriage to the port
of Discharge or so near thereto as she may safety get
the goods specified above. Weight, measure, quality, quantity, condition,
FREIGHT ADVANCE. contents and value unknown.
Received on account of freight : IN WITNESS where of the Master or Agent of the said Vessel has signed
the number of Bills of lading indicated below all of his tenor and date any
one of which being accomplished the others shall be void.
…………………………………………………………………………. FOR CONDITIONS OF CARRIAGE SEE OVERLEAF

Time used for loading ………………..…Days..……………..hours.

Freight payable at Place and date of issue
TARJUN, NOVEMBER 13TH, 2024
Number of original Bs / L Signature
3 (Three) For and On Behalf of The Master
Printed and soid
TB. OCEANIC 2 - BG. AZAMARA 2
By Wyt&Zonen. B. V., Rotterdam (phone: (31) 010- Capt. INDRAWAN SIMATUPANG
4252627 By the authority of the Balitic and International
Maritime Council (BIMCO), Copenhagen

PT. TIDAR SAMUDERA RAYA

As Agent For The Master
 Jl. Raya Provinsi ( Gor Seribun Belakang PLN ) RT. 16 Kel Batulicin
Kec. Batulicin, Kab. Tanah Bumbu, Kalimantan Selatan
Telp : 089673396919 & 08115409594 Email : [email protected]

PORT OF LOADING : JETTY ITP TARJUN, KALIMANTAN SELATAN PORT OF DISCHARGE : GARONGKONG PORT, SULAWESI SELATAN

VESSEL : TB. OCEANIC 2 / BG. AZAMARA 2 CAPTAIN : INDRAWAN SIMATUPANG

FLAG : INDONESIA / INDONESIA GROOS TONAGE / GT : 173 GT / 3102 GT

DESCRIPTION WEIGHT AND FREIGHT

C / M NO. SHIPPER CONSIGNEE NOTIFY ADDRESS
OF GOODS OR MEASUREMENT AND
REMARKS

PT. INDOCEMENT TUNGGAL PERKARSA TBK TO ORDER TO ORDER

001/TSR-
LEVEL 13, WISMA INDOCEMENT KAV 70-71
BTL/CM//XI/ JL. JEND. SUDIRMAN, JAKARTA 12910,
24 INDONESIA

Tarjun, November 13 th, 2024

PT. TIDAR SAMUDERA RAYA

As Agent