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BALIKPAPAN INFORMATION COPY ONLY Folio : Arrival : 29/01/17 | 13:18 Departure : 01/02/17 No. of Guest : 1/0 Room No : 05

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BALIKPAPAN INFORMATION COPY ONLY Folio : Arrival : 29/01/17 | 13:18 Departure : 01/02/17 No. of Guest : 1/0 Room No : 0517

Ibu Nurbany KEMENTERIAN PUPR INDONESIA

Page Cashier Cashier No

:1 : IKA : 55

Agent : Company : Group : NOVOTEL BALIKPAPAN 01/02/17 09:39:55 Date 29/01 30/01 31/01

Description

Reference

Room Charge Room Charge Room Charge

Debit

Credit

700,000 700,000 700,000

Balance : Rp 2,100,000,00

Tanda tangan/Signature NOVOTEL BALIKPAPAN Jl.Brigjen Ery Suparjan No.2 Balikpapan 76112 East Kalimantan – Indonesia

Fax

Telp +62 542 820820 +62 542 732999 [email protected]

www.novotel.com/asia www. novotelbalikpapan.com

Saya menyatakan bersedia bertanggung jawab atas biaya biaya yg timbul dan bersedia secara pribadimenanggung biaya biaya dimana perorangan, perusahaan atau asosiasi yang ditunjuk tidak menyelesaikan sebagian atau seluruh dari biaya biaya tersebut. I Agree that my liability for this bill is not walved and agree to be help personally liable in the event that the indicated Person,Company or Association fails to pay for any part or Full amount of this charge

BALIKPAPAN INFORMATION COPY ONLY Folio : Arrival : 29/01/17 | 13:18 Departure : 01/02/17 No. of Guest : 1/0 Room No : 0519

Ibu Wiwik Arma KEMENTERIAN PUPR INDONESIA

Page Cashier Cashier No

:1 : IKA : 55

Agent : Company : Group : NOVOTEL BALIKPAPAN 01/02/17 09:39:55 Date 29/01 30/01 31/01

Description

Reference

Room Charge Room Charge Room Charge

Debit

Credit

700,000 700,000 700,000

Balance : Rp 2,100,000,00

Tanda tangan/Signature NOVOTEL BALIKPAPAN Jl.Brigjen Ery Suparjan No.2 Balikpapan 76112 East Kalimantan – Indonesia

Fax

Telp +62 542 820820 +62 542 732999 [email protected]

www.novotel.com/asia www. novotelbalikpapan.com

Saya menyatakan bersedia bertanggung jawab atas biaya biaya yg timbul dan bersedia secara pribadimenanggung biaya biaya dimana perorangan, perusahaan atau asosiasi yang ditunjuk tidak menyelesaikan sebagian atau seluruh dari biaya biaya tersebut. I Agree that my liability for this bill is not walved and agree to be help personally liable in the event that the indicated Person,Company or Association fails to pay for any part or Full amount of this charge

BALIKPAPAN INFORMATION COPY ONLY Folio : Arrival : 29/01/17 | 13:18 Departure : 01/02/17 No. of Guest : 1/0 Room No : 0521

Ibu Musniaty KEMENTERIAN PUPR INDONESIA

Page Cashier Cashier No

:1 : IKA : 55

Agent : Company : Group : NOVOTEL BALIKPAPAN 01/02/17 09:39:55 Date 29/01 30/01 31/01

Description

Reference

Room Charge Room Charge Room Charge

Debit

Credit

700,000 700,000 700,000

Balance : Rp 2,100,000,00

Tanda tangan/Signature NOVOTEL BALIKPAPAN Jl.Brigjen Ery Suparjan No.2 Balikpapan 76112 East Kalimantan – Indonesia

Fax

Telp +62 542 820820 +62 542 732999 [email protected]

www.novotel.com/asia www. novotelbalikpapan.com

Saya menyatakan bersedia bertanggung jawab atas biaya biaya yg timbul dan bersedia secara pribadimenanggung biaya biaya dimana perorangan, perusahaan atau asosiasi yang ditunjuk tidak menyelesaikan sebagian atau seluruh dari biaya biaya tersebut. I Agree that my liability for this bill is not walved and agree to be help personally liable in the event that the indicated Person,Company or Association fails to pay for any part or Full amount of this charge

BALIKPAPAN INFORMATION COPY ONLY Folio : Arrival : 29/01/17 | 13:18 Departure : 01/02/17 No. of Guest : 1/0 Room No : 0523

Ibu Sari Nurfadillah SE KEMENTERIAN PUPR INDONESIA

Page Cashier Cashier No

:1 : IKA : 55

Agent : Company : Group : NOVOTEL BALIKPAPAN 01/02/17 09:39:55 Date 29/01 30/01 31/01

Description

Reference

Room Charge Room Charge Room Charge

Debit

Credit

700,000 700,000 700,000

Balance : Rp 2,100,000,00

Tanda tangan/Signature NOVOTEL BALIKPAPAN Jl.Brigjen Ery Suparjan No.2 Balikpapan 76112 East Kalimantan – Indonesia

Fax

Telp +62 542 820820 +62 542 732999 [email protected]

www.novotel.com/asia www. novotelbalikpapan.com

Saya menyatakan bersedia bertanggung jawab atas biaya biaya yg timbul dan bersedia secara pribadimenanggung biaya biaya dimana perorangan, perusahaan atau asosiasi yang ditunjuk tidak menyelesaikan sebagian atau seluruh dari biaya biaya tersebut. I Agree that my liability for this bill is not walved and agree to be help personally liable in the event that the indicated Person,Company or Association fails to pay for any part or Full amount of this charge

BALIKPAPAN INFORMATION COPY ONLY Folio : Arrival : 29/01/17 | 13:18 Departure : 01/02/17 No. of Guest : 1/0 Room No : 0525

Bapak Syubbanul Muslimin KEMENTERIAN PUPR INDONESIA

Page Cashier Cashier No

:1 : IKA : 55

Agent : Company : Group : NOVOTEL BALIKPAPAN 01/02/17 09:39:55 Date 29/01 30/01 31/01

Description

Reference

Room Charge Room Charge Room Charge

Debit

Credit

700,000 700,000 700,000

Balance : Rp 2,100,000,00

Tanda tangan/Signature NOVOTEL BALIKPAPAN Jl.Brigjen Ery Suparjan No.2 Balikpapan 76112 East Kalimantan – Indonesia

Fax

Telp +62 542 820820 +62 542 732999 [email protected]

www.novotel.com/asia www. novotelbalikpapan.com

Saya menyatakan bersedia bertanggung jawab atas biaya biaya yg timbul dan bersedia secara pribadimenanggung biaya biaya dimana perorangan, perusahaan atau asosiasi yang ditunjuk tidak menyelesaikan sebagian atau seluruh dari biaya biaya tersebut. I Agree that my liability for this bill is not walved and agree to be help personally liable in the event that the indicated Person,Company or Association fails to pay for any part or Full amount of this charge

BALIKPAPAN INFORMATION COPY ONLY Folio Arrival Departure No. of Guest Room No

Bapak A Pisal KEMENTERIAN PUPR

: : 29/01/17 | 13:18 : 01/02/17 : 1/0 : 0527

INDONESIA Page Cashier Cashier No

:1 : IKA : 55

Agent : Company : Group : NOVOTEL BALIKPAPAN 01/02/17 09:39:55 Date 29/01 30/01 31/01

Description

Reference

Room Charge Room Charge Room Charge

Debit

Credit

700,000 700,000 700,000

Balance : Rp 2,100,000,00

Tanda tangan/Signature NOVOTEL BALIKPAPAN Jl.Brigjen Ery Suparjan No.2 Balikpapan 76112 East Kalimantan – Indonesia

Fax

Telp +62 542 820820 +62 542 732999 [email protected]

www.novotel.com/asia www. novotelbalikpapan.com

Saya menyatakan bersedia bertanggung jawab atas biaya biaya yg timbul dan bersedia secara pribadimenanggung biaya biaya dimana perorangan, perusahaan atau asosiasi yang ditunjuk tidak menyelesaikan sebagian atau seluruh dari biaya biaya tersebut. I Agree that my liability for this bill is not walved and agree to be help personally liable in the event that the indicated Person,Company or Association fails to pay for any part or Full amount of this charge