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Quotation EL's Yogya

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QUOTATION SLIP

NO. 0017/PAR/ I/ 2020

TYPE OF INSURANCE : PROPERTY ALL RISKS INSURANCE amended with Riots, Strikes, malicious
Damage plus Civil Commotion (RSMDCC)

WORDING : IAR - Munich Re Version amended with RSMDCC (Code : RSMD 4.1B/2007)

INSURED NAME : CHARLES

BUSINESS : All operations of the Insured including but not limited to occupation and
all other activities related to the Insured’s business, and any other occupation
in which the Insured become engaged

INSURANCE PERIOD : To be advised (both dates inclusive at 12.00 noon local time)

RISK LOCATION : EL’S Computer. Jl CSimanjutak No38,Terban,Yogyakarta

COVERAGE : All Risks of Physical Loss or of Damage to the Insured property from any c ause
except as hereinafter excluded (subject to Policy Exclusions)

TOTAL SUM INSURED : IDR 3 ,000,000,000

INTEREST INSURED : Material Damage :


Inventory IDR 200,000,000
Stock IDR 2,800,000,000

RATE : PROPERTY DAMAGE :


- Material Damage
FLEXAS : 0.1520%
(DAI Code : 2934)
TSFWD : 0.0450%
OTHER : 0.0010%
RSMDCC : 0.0010%
IoV : 0,0010%

DEDUCTIBLE : Material Damage (Applicable for each and every loss)


- Fire, Lightning, Explosion, Aircraft Damage & Smoke : 5% of loss,
minimum IDR 0.1% of TSI
- Riot, Strike and Malicious Damage : 10% of loss, minimum IDR
10,000,000
- Civil Commotion : 10% of loss, minimum IDR 10,000,000
- Flood, Windstorm, Tempest, Water Damage, Landslide, Landslip and
Subsidence : 10% of loss
- Other Causes : IDR 2,500,000
- Burglary : 5% of loss, minimum IDR 2,500,000

ADDITIONAL CLAUSES : APPLICABLE FOR ALL SECTION OF PROPERTY AND EARTHQUAKE


- Appraisement Clause
- Alterations Clause (30 Days)
- Average Relief (85%)
- Automatic Reinstatement of Sum Insured (Subject to additional premium)
- Capital additional Clause (10% of SI)
- Civil Authorities Clause
- Cyber Risk Exclusion Clause - NMA 2915
- Dispute Clause
- Extra Contractual Obligation Exclusion Clause
- Electrical circuit Clause
- Electronis Data Endorsement B
- Earthquake Exclusion Clause
- Flood, Windstorm, Tempest and Water Damage Endorsement (4.3A)
- Fire Brigades Charges Clause (Limit : IDR 50,000,000)
- Fire and Extinguishing Cost Clause (Limit : IDR 50,000,000)
- General Interest Clause
- Industries, Seepage, Pollution and Contamination C lause (NMA 1685)
- Internal Removal Clause
- IT Hazard Clarification Agreement - NMA 2912
- Indonesian Jurisdiction Clause
- Landslip, Landslide & Subsidence Clause
- Leased Property Clause
- Minor Alterations and Repairs Clause
- Misdescription Clause
- Notice of Cancellation Clause (30 Days, except 3 Days for RSMDCC)
- Non Automatic Renewal Clause
- Nuclear Enerrgy Risk Exclusion Clause – NMA 1994
- Property Damage Clarification Clause
- Removal of debris ( max 10 % of sum insured)
- Reinstatement Value Clause
- Riot, Strikes and Malicious Damage and Civil Endorsement (4.1/B 2007)
- Smoke and Vehicle Impact Endorsement (Code : 4.11-01/12/1998)
- Terrorism Exclusion Endorsement - NMA 2910
- Transmission and Distribution Lines Exclusion Clause
- War and Civil War Exclusion Clause
- Workmen’s Clause
- Dispute Clause
PREMIUM CALCULATION : 1. PROPERTY DAMAGE :
- Material Damage
FLEXAS :IDR 3,000,000,000 x 0.1520% = IDR 4 ,560,000
TSFWD :IDR 3,000,000,000 x 0.0450 = IDR 1,350,00
OTHER :IDR 3,000,000,000 x 0.0010% = IDR 30,000
IoV :IDR 3,000,000,000 x 0,0010% = IDR 30,000
RSMDCC:IDR 3,000,000,000 x 0.0010% = IDR 30,000
Policy Cost + Stamp Duty = IDR 42,000

Total Premium for Property Damage = IDR 6 ,042,000

Yogyakarta, January 22, 2020 Confirmation


Sign on Behalf of
PT Asuransi MAG (a Fairfax Company)

Hadi Prasetiyawan ( ............................................ )

Branch Manager

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