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    L1885AAA

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    aris

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    © All Rights Reserved
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    L1885AAA

    Uploaded by

    aris
    11 views3 pages

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    L1885AAA

    Uploaded by

    aris

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    of 3

    8/1/24, 5:03 PM Insurer's Report

    No. Klaim: Tanggal: 01/08/2024


    Bengkel: HONDA SURABAYA CENTER (ISTANA MOBIL SURABAYA INDAH)
    REFERENSI
    Tertanggung: PURNO WIDODO No. Polis: 20022223001489
    Tanggal Kejadian: 14/07/2024 Jenis Klaim OD
    Sum Insured: Rp 200,250,000
    DESCRIPTION & IDENTIFICATION OF VEHICLE
    Nomor Polisi: L1885AAA Tipe: HATCHBACK - 5 DR
    Make & Model: HONDA JAZZ, 1.5 S GK58 (A) [2014] Reg. Date:
    No. Mesin: L15Z51232766 No. Rangka: MHRGK5860HJ801661

    Surveyed By: BAKTIAR ARIS WICAKSONO Ditangani Oleh: CHANDIKA ARIESTIANTO


    Surveyed On: 16/07/2024 Report On: 16/07/2024
    Report completed Report completed on
    BAKTIAR ARIS WICAKSONO 17/07/2024
    by: :

    TOTAL OFFER
    Offer Initiated By: BAKTIAR ARIS WICAKSONO on 17 Jul 2024 08:35
    Rep. Gross Total: Rp23,055,540 [Diff: Rp835,750, 3.62%]
    Approved Gross Total: Rp22,219,790
    + VAT (PPN) (11.00%): Rp2,444,177
    Jumlah Bruto Disetujui: Rp24,663,967
    - Deductible: Rp300,000
    Approved Gross Offer: Rp24,363,967
    - WHT (PPH) (2.00%): Rp25,362
    Jumlah Bersih (after WHT): Rp24,338,605
    (Tidak Betterment/Depreciation)

    COST OF CLAIMS Repairer's Our Offer Difference Diff %


    Parts 16,715,000 15,879,250 835,750 5.00
    Item Lain-lain 0 0 0
    Bahan Pengecatan 80.00/80.00% 5,072,432 5,072,432 0 0.00
    Labour 1,268,108 1,268,108 0 0.00
    Derek 0 0 0
    Total Bruto (Rp) 23,055,540 22,219,790 835,750 3.62
    + VAT (PPN) Lengkap (kecuali Lain-lain) 11.00/11.00% (Rp) 2,536,109 2,444,177 91,932 3.62
    Gross Amount (Rp) 25,591,649 24,663,967 927,682 3.62

    https://indonesia.merimen.com/claims/index.cfm?fusebox=MTRinsurer&fuseaction=gen_printrpt&caseid=6351546&tpins=0&CFID=82195202&CF… 1/3
    8/1/24, 5:03 PM Insurer's Report

    REPAIR DETAILS
    Referensi
    Part Source: MRM-ID Version: 2.8 (Last Synchronised: 30 Jul 2024)
    Parts: 144 HONDA JAZZ 1.5 S GK58 (A) [2014] (Katalog:Merimen Indonesia HONDA 2.8 [02/04/2024])
    Jasa: Repairer's (Price-denominated Standard List)
    Print Code: (Unsubmitted, no print-code for L1885AAA)
    Validity: These estimates are valid only if they contain the print code (above) on all estimate pages, running page numbers with
    the END OF ESTIMATES marker on the last estimate page
    Further Info: Items/values not in reference catalogue are prefixed with an asterisk *.

    Recommended Parts
    No. Qty Part No. Particulars Condition Svg Repairer's Harga Jumlah

    1 1 68100T5SZ20ZZ *TAIL GATE COMP - 4,815,000 F - 4,815,000 FP


    BACKDOOR
    2 1 73127TY0000 *RUBEER_WSHLD DAM - 115,000 F - 115,000 FP
    3 1 73226SZW000 *DAM_STD 5X5 S - 65,000 F - 65,000 FP
    4 1 73214T5A013 *RUBEER WSHLD DAM - 550,000 F - *550,000 FP
    5 1 SKF255U *SIKAFLEX 255 ULTRA BLACK CTR 310 - 360,000 F - *360,000 FP
    6 1 71501T5LT80ZZ *FACE_RR BUMPER IDE - 2,455,000 F - 2,455,000 FP
    7 1 33550T5AJ02 *LIGHT ASSY L TAIGT - 1,865,000 F - 1,865,000 FP
    STOPLAMP LH
    8 1 71515T5LT80 *DIFFUSER_RR BUMPER - 210,000 F - 210,000 FP
    9 1 SKFAUTO *SIKAFLEX AUTO WHITE 300 ML - 180,000 F - *180,000 FP
    10 1 84640T5A003ZA *LNG ASSY RR PANEL - 1,005,000 F - 1,005,000 FP
    11 1 74800T5SK61 *LOCK ASSY T/GATE - 1,070,000 F - 1,070,000 FP
    12 1 74440T5A003 *WTHSTRIP TAIL GATE - 235,000 F - 235,000 FP
    13 1 74820T5SK21 *OPEN STAY ASSY R - 385,000 F - 385,000 FP
    HIDROLIK BACKDOOR
    14 1 74870T5SK21 *OPEN STAY ASSY L - 385,000 F - 385,000 FP
    HIDROLIK BACKDOOR
    15 1 66100T5ST10ZZ *BACKPANEL - 3,020,000 F - 3,020,000 FP
    TIDAK DAPAT DIREPAIR KARENA RUSAK/MELENGKUNG
    PARAH
    F=Franchise part. P=PartDisc.
    Sub Total (Rp) 16,715,000 16,715,000
    - Part Discount on P Items 0.00/5.00% (Rp) 0 835,750

    Total Parts (Rp) 16,715,000 15,879,250

    Report was unsubmitted during this print-out.

    https://indonesia.merimen.com/claims/index.cfm?fusebox=MTRinsurer&fuseaction=gen_printrpt&caseid=6351546&tpins=0&CFID=82195202&CF… 2/3
    8/1/24, 5:03 PM Insurer's Report

    Recommended Item Lain-lain


    There are no new miscellaneous items selected.

    Recommended Jasa
    Tipe
    No Particulars Repairer's Jumlah
    Jasa

    Item Jasa
    1 G/C BACKDOOR Ganti 1,423,423 1,423,423
    2 B/P KACA BACKDOOR Ganti 1,261,261 1,261,261
    3 G/C BUMPER RR Ganti 1,009,010 1,009,010
    4 G/C BACKPANEL Ganti 1,261,261 1,261,261
    5 LANTAI BAGASI Ganti 872,072 872,072
    6 BUFFLE STOPLAMP / DUDUKAN Ganti 513,513 513,513
    Material:80%, Jasa:20%, Withholding Tax (PPH):2.00%

    Labour Cost (inclusive of taxes) (Rp) 6,340,540 6,340,540

    Report was unsubmitted during this print-out.

    < END OF REPORT >

    https://indonesia.merimen.com/claims/index.cfm?fusebox=MTRinsurer&fuseaction=gen_printrpt&caseid=6351546&tpins=0&CFID=82195202&CF… 3/3

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