20250408_KLIN_Tanggapan atas Permintaan Penjelasan Bursa_31873401_lamp4.pdf

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POLICY SCHEDULE
PROPERTY ALL RISK

POLICY NO.

TYPE OF INSURANCE
THE INSURED
ADDRESS

PERIOD OF INSURANCE
CONSTRUCTION CLASS
OCCUPATION

RISK LOCATION

COVERAGE

INTEREST / SUM INSURED

DEDUCTIBLE

EXTENSION CLAUSES

PSNSIO109E.

HEAD OFFICE : Jl. TB. Simatupang Kav, Cilandak Timur, Jakarta Selatan 12560

: 205000109042400013

(Renewal) Previous Policy No. :
205000109042300034

: Property All Risk

: PT, KLINKO KARYA IMAJI TBK.

: Jl. Raya Driyorejo KM 25, Desa Semambung, Driyorejo, Gresik
: April 06, 2024 to April 06, 2025 at 12.00 o'clock noon local time.

I
2462 - Pabrik Peralatan RT / Sewing Work
Jl. Raya Driyorejo KM 25, Desa Semambung, Driyorejo, Gresik 61177

: All Risks of Physical Loss or Damage to the Insured property from any cause

(subject to Policy Exclusion)

: Section |: Material / Property Damage

-  Stocks IDR 4,486,987,651.00
-  Machineries IDR 5,810,350,586.00
- Building IDR 10,629,578,469.00

TOTAL Sum Insured IDR 20,926,916,706.00

1 - FLEXAS:01 Y of TSI or 5 Yo of Claim , whichever is higher

-. TSFWD, Landslide, Landslip and Subsidence (4.34) : 1095 of approved
claim, minimum IDR 10,000,000.00

- Others: IDR 1,000,000.00 for any one accident

-  RSMD (4.1A) # CC : 10 of approved claim, minimum IDR 10,000,000.00

- Vehicle Impact (4.11) : IDR 1,000,000.00 for a.o.a

! - General Interest Clause

- .yExira Contractual Obligation Exclusion Clause Y

- Escalation Clause (Max 1096 of claim)?

- “ Expediting Expenses Clause (1076 of claim) -

- 5Earthguake Exclusion Clause (for PAR only)

- “ Fire Brigades Charges Clause (Limit IDR 100,000,000.00) “

- JLeased Property Clause v

- / Flood, Windstorm, Tempest And Water Damage Endorsement (Code : 4.3

A

MX. Ai ane of Property Insured Clause “

- Impact by Own Vehicles Clause

- / Communicable Disease Endorsement LMA 5393

- /industries Seepage, Pollution and Contamination Exclusion Clause (NMA

1685) “

- wInternal Removal Clause v

- “Waiver Clause (article 1266 and 1267 KUHPer)

-/ Nverage Relicf Clause (8574 of TSI)

-w Fire Extinguishing Cost Clause (Limit IDR 100,000,000.00)

“Co-Insurance Clause

All Other Contents Clause (Limit per item IDR. 5.000.000, IDR. 50.000.000

inAggregate) v

- WAutomatic Reinstatement of TSI (subject to additional premium) «/
“Appraisement Clause (1074 of TSI)

Page | “4

No.00-1266146

PT JASARAHARJA PUTERA

Phone: (021)788-44444 | Fax. (021)788-41234 | Email: pusat@jrp.co.id

I8 JRP Insurance €9

FRM-OO1/TEK

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PSNSIOLU9E.

- WAwnings, Blinds, Signs or Other outdoor fixture or fitting clause (Limit 1046
of claim)
Banker's Clause (if any)

- “Burst Pipes Endorsement

- W Electronic Date Recognition Clause "A" .

- WProperty Data and Cyber Exclusion Clause LMA5401

- Y Loading and Unloading Clause

- VCivil Authorities Clause V

- VCost Of Re-Erection Clause (Limit 1096 of SI Machinery) “
- »Cancellation Clause (30 days except 3 days for RSMDCC 4.1 B/2007)
- “Capital Additions Clause (Limit 106 of claim)

- “Customer's Goods Clause

- “Loss Notification Clause (30 days) »

- Brand and Label Clause

-w Sanction and Limitation Exclusion Clause LMA 3100

- V Riots, Strikes, Malicious Damage, and Civil Commotions Endorsement
(Code : 4.1B / 2007)
-w Selling Price Clause

- V Electrical Short Circuit Clause (Limit IDR. 250.000.000 any one loss and
IDR. 1.000.000.000 in aggregate, applicable to items other than
machineries)

- V Services Clause

- “ Sue And Labour Clause

- w Dispute Clause

- WExpiry date clause

- y Removal Of Debris (1046 of TSI)

- “ Temporary Removal Clause

« W Terrorism and Sabotage Exclusion Clause

- “Transmission And Distribution Lines Exclusion Clause

- Total Asbestos Exclusion Clause

- Vehicle Load Clause

- “War and Civil War Exclusion Clause (NMA 464)

- /Structural Alteration Clause

-w Public Authorities Clause

- w Loss of Damaged Goods Clause

- WMinor Alterations and Repairs Clause

- V Misdescription Clause

- V Notification Clause ,

- WNominated Adjuster Clause : - PT. Atlas Adjusting Indonesia - PT. General
Adjuster - PT. Sedgwick Adjuster Indonesia - PT. SDP Crawford

- V Non-Invalidation Clause

- “ Reinstatement Value Clause

- “ Outbuildings Clause

- V Institute Radioactive Contamination, Chemical, Biological, Bio-Chemical
and Electromagnetic Weapons Exclusion (CI 370)

- W Payment on Account Clause (2596) W

- W Prorata Refund Premium Glause (subject to no claim)
- “ Property Damage Clarification Clause

- V Premises Clause V'

- V Payment Of Premium Warranty Clause (30 days)

- “ Workmen's Clause

- WNuclear energy liability exclusion clause

PT JASARAHARJA PUTERA

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Page 20f3 A |

HEAD OFFICE : Jl. TB: Simatupang KavI, Cilandak Timur, Jakarta Selatan 12560 No.00-1266147

Phone: (021)788-44444 | Fax: (021)788-41234 | Email: pusat@jrp.co.id

PB JRPInsurance 2 insurani

FRM-oov/tEk |

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RATE « 2. RSMD (4.14) # CC 0.00001 Yo
-  FLEXAS OJK 2017 0.12850 Yo
- Others 0.00001 Yo
- TSFWD 4.3A 0.04500 Yo
PREMIUM CALCULATION 8
- FLEXAS OJK 2017 IDR 20,926,916,706.00 x 0.1285Y4 IDR 26,891,087.97
April 06, 2024 - April 06, 2025
-. TSFWD 4.3A IDR 20,926,916,706.00 x 0.045 IDR 9,417,112.52
April 06, 2024 - April 06, 2025
- RSMD (41A) # CC IDR 20,926,916,706.00 x 0.0000174 IDR 2,092.69
April 06, 2024 - April 06, 2025
( - Others IDR 20,926,916,706.00 x 0.00001Y4 IDR 2,092.69
April 06, 2024 - April 06, 2025 ,
TOTAL PREMIUM IDR 36,312,385.87
Discount (7,5096) IDR -2,723,428.94
Biaya Polis & Materai IDR 60,000.00
Materai Kwitansi IDR 10,000.00
TOTAL IDR 33,658,956.94
Name of Co-Insurers and their respective shares :

Leader : PT ASURANSI JASARAHARJA PUTERA (30.00 0)
Member : ASURANSI JASA INDONESIA (25.00 96)
Member : ASURANSI DAYIN MITRA TBK (20.00 42)
Member : SAHABAT INSURANCE (15.00 96)

Member : BOSOWA ASURANSI (10.00 Yo)

Surabaya, April 03, 2024
PT ASURANSI JASARAHARJA PUTERA

Se anal pukara
( GMETSI
JATALX 140410096

A Ngr Henry Darmawan
Branch Manager

PSNSIOLO9E. Page 30f3

PT JASARAHARJA PUTERA
HEAD OFFICE : Jl. TB, Simatupang Kav, Cilandak Timur, Jakarta Selatan 12560 No.00-1266148
Phone: (021)788-44444 | Fax: (021)788-41234 | Email: pusat@jrp.coid

FRM-001/TEK

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Attaching to and forming part of Policy No. 205000109402400013

Co-Insurance Clauses

Being a CO-INSURER of the under mentioned insurance companies, they shall, each for themselves

and not one for the other, severally and independently have the right and assume the liabilities in

proportion to their respective shares as mentioned below.

PT. JASA RAHARJA PUTERA, as the representative of the Co - Insurers shall attend to all matters in

connection with this Co - Insurance including collection of insurance premiums and claims handling,

however settlement of claims shall be handled independently by each member of this Co - Insurance.

Any agreement or decision which may be made between the assured and PT JASA RAHARJA PUTERA

in connection with this CO-INSURANCE shall be final and binding upon all CO-INSURERI/S).

Nevertheless any revision or alteration in rate, terms and conditions of the policy or any increase of

liability over and above the initial Sum Insured will be subject to prior agreement of CO-INSURERIS). |
Any notice which may be given by the Insured to PT JASA RAHARJA PUTERA in writing or otherwi: 3
shall be deemed as given to all CO-INSURER/(S) ti $ 1
Names of CO-INSURER/S) and their respective shares are as shown. e " “Pa

Surabaya, 03 April 2024
Leader :

4 ASURANSI JASA RAHARJA PUTERA (share 30 96)

Member :

PT. ASURANSI JASA INDONESIA (share 2596)

PT. ASURANSI DAYIN MITRA TBK (share 2096)

PT. SAHABAT INSURANCE (share 1596)

PT JASARAHARJA PUTERA
HEAD OFFICE : Jl. TB. Simatupang Kavi, Cilandak Timur, Jakarta Selatan 12560
Phone: (021)788-44444 | Fax. (021)788-41234 | Email: pusat@jrp.co.id

Ban BB es "DIBERI KASI AIA Kom OOD EK

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PT. BOSOWA ASURANSI (share 1046)

PT JASARAHARJA PUTERA
HEAD OFFICE : Jl. TB. Simatupang Kavi, Cilandak Timur, Jakarta Selatan 12560
Phone: (021)788-44444 | Fax. .(021)788-41234.| Email: pusat@jrp.co.id

FRM-002/TEK |

'8 JRP Insurance €9