dokumen prakualifikasi kerentanan tanah (1)

8/16/2019 Dokumen Prakualifikasi Kerentanan Tanah (1)

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O K U M E N K U A L I F I K A S I

Nomor : Kns.1/Pokja 03/ is.ES M/L/APB /201/001

!an""a# : 0$ M%i 201

&n'&k

P%n"a(aan

Nama Pak%' P%k%rjaan : S'&() K%r%n'anan *%rakan !ana+ Ska#a 1 : 100.00 Di

Ka,&-a'%n In(ra"iri & !a+&n An""aran 201

Lokasi P%k%rjaan : Ka,&-a'%n In(ra"iri &

S&m,%r Dana : APBD Proinsi ia& !a+&n An""aran 201

Ni#ai Pa"& : -. 33$.0$.000

Ni#ai PS : -. 33$.0$$.000

K%#om-ok K%rja La)anan P%n"a(aan 03/ is.ES M/L 4Pokja 03/ is.ES M/L 5

!a+&n An""aran : 201


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Standar Dokumen Pengadaan Secara Elektronik

Jasa Konsultansi Badan Usaha

Metode e-Seleksi Umum(dengan Prakualifikasi)

AF!A ISI

BAB I. UM UM ....................................................................................................................... 1

BAB II. PEN*UMUMAN SELEKSI .......................................................................................... 3

BAB III. INS! UKS I KEPA A PESE!A 4IKP5 ........................................................................ $

A. UM UM .............................................................................................................................. $

2. LAAN*AN K OUPSI K OLUSI DAN NEPO!ISME 4KKN5 P ESEKON*KOLAN SE!A P ENIPUAN ..................................... 4 3. LAAN*AN P E!EN!AN*AN K EPEN!IN*AN ............................. ........................................................... .................. 5

$. SA!U DA!A K UALIFIKASI !IAP P ESE!A ....................................................... ......................................................... 5 6. BELAKUN7A K UALIFIKASI .................................................... ........................................................... .................. 5

. BIA7A K UALIFIKASI ........................................................................ ........................................................... ........ 5

B. OKUM EN KUALIFIK ASI .................................................................................................

ISI DOKUMEN K UALIFIKASI ................................................................................. ............................................... 6 8 BAASA DOKUMEN K UALIFIKASI .................................................... ........................................................... ........ 6

9 P EMBEIAN P ENELASAN 4APABILA DIPELUKAN5 ............................................................. ..................................... 6

10 P EUBAAN DOKUMEN K UALIFIKASI ..................................... ........................................................... .................. 7

;. P EN7 IAPA N OK UM EN KUALIF IKASI ............................................................................

11 BEN!UK DA!A K UALIFIKASI ........................................ ........................................................... ............................ 7

12 P AK!A IN!E*I!AS ..................................................... ........................................................... ............................ 7 13 P EN*ISIAN DA!A K UALIFIKASI ................................................................................................ ............................ 7

16 DA!A K UALIFIKASI !ELAMBA! ...................................................... ........................................................... ........ 9

E. E


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Metode e-Seleksi Umum

(dengan Prakualifikasi)

BAB I. UM UM

A. Dok&m%n K&a#i>ikasi ini (is&s&n ,%r(asarkan P%ra'&ran Pr%si(%n No. 6$ !a+&n 2010'%n'an" P%n"a(aan Baran"/asa P%m%rin'a+ ,%s%r'a -%r&,a+an (an a'&ran '&r&nann)a.

B. Da#am Dok&m%n K&a#i>ikasi ini (i-%r"&nakan -%n"%r'ian is'i#a+ (an sin"ka'an s%,a"ai

,%rik&' :-

asa Kons'ansi

: jasa #a)anan -ro>%siona# )an" m%m,&'&+kan k%a+#ian'%r'%n'& (i,%r,a"ai ,i(an" k%i#m&an )an" m%n"&'amakana(an)a o#a+ -ikir 4,rain?ar% 5@

- asa Kons'ansi

Kons'r&ksi

: a(a#a+ #a)anan jasa kons'ansi -%r%nanaan -%k%rjaankons'r&ksi (an #a)anan jasa kons'ansi -%n"a?asan-%k%rjaan kons'r&ksi )an" m%#i-&'i k%s%#&r&+an a'a&s%,a"ian ran"kaian k%"ia'an -%r%nanaan ,%s%r'a-%n"a?asan )an" m%nak&- jasa kons'ansi -%k%rjaanarsi'%k'&ra# si-i# m%kanika# %#%k'rika# (an 'a'a #in"k&n"anmasin"masin" ,%s%r'a k%#%n"ka-ann)a &n'&k m%?&j&(kans&a'& ,an"&nan a'a& ,%n'&k >isik #ain@

- PS : ar"a P%rkiraan S%n(iri@

- K%mi'raan/

K%rja Sama

O-%rasi4KSO5

: k%rjasama &sa+a an'ar -%n)%(ia )an" masin"masin" -i+akm%m-&n)ai +ak k%?aji,an (an 'an""&n" ja?a, )an" j%#as,%r(asarkan -%rjanjian '%r'is@

- L K

: L%m,ar Da'a K&a#i>ikasi@

- Pokja ULP

: K%#om-ok K%rja ULP )an" ,%r>&n"si &n'&k m%#aksanakan

-%mi#i+an P%n)%(ia Baran"/asa@

- LPSE

: La)anan P%n"a(aan S%ara E#%k'ronik a(a#a+ &ni' k%rjaK/L/D/I )an" (i,%n'&k &n'&k m%n)%#%n""arakan sis'%m-%#a)anan P%n"a(aan Baran"/asa s%ara %#%k'ronik@

- A-#ikasi SPSE :

A-#ikasi -%ran"ka' #&nak Sis'%m P%n"a(aan S%araE#%k'ronik 4SPSE5 ,%r,asis ?%, )an" '%r-asan" (i s%r%r LPSE

)an" (a-a' (iaks%s m%#a#&i ?%,si'% LPSE.

- Form Isian E#%k'ronik

: 'am-i#an/an'arm&ka -%makai ,%r,%n'&k "ra>is,%risi kom-on%n isian )an" (a-a' (iin-&' o#%+-%n""&na a-#ikasi@

- Form Isian E#%k'ronik

a'a K&a#i>ikasi

: Form isian %#%k'ronik -a(a a-#ikasi SPSE )an" (i"&nakan-%n)%(ia ,aran"/jasa &n'&k m%n"in-&'kan (anm%n"irimkan (a'a k&a#i>ikasi@

- ES%#%ksi :

Pros%s s%#%ksi &m&m (%n"an 'a+a-an s%s&ai P%r-r%s6$/2010 ,%s%r'a -%r&,a+an (an a'&ran '&r&nann)a. S%m&ais'i#a+ s%#%ksiC -a(a (ok&m%n ini m%r&j&k -a(a -%n"%r'ian%s%#%ksiC.


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;. S%#%ksi Um&m (%n"an -rak&a#i>ikasi ini (i,ia)ai (ari s&m,%r -%n(anaan s%,a"aimana )an" '%ran'&m (a#am LDK.

D. S%#%ksi ini '%r,&ka (an (a-a' (iik&'i o#%+ s%m&a -%s%r'a )an" ,%r,%n'&k ,a(an &sa+a a'a&K%mi'raan/KSO.

E. Pokja ULP m%n"&m&mkan -%#aksanaan S%#%ksi (%n"an -rak&a#i>ikasi m%#a#&i a#ama'?%,si'% K%m%n'%rian/L%m,a"a/P%m%rin'a+ Da%ra+/Ins'i'&si -a-an -%n"&m&manr%smi &n'&k mas)araka' (an Por'a# P%n"a(aan Nasiona# m%#a#&i LPSE.


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BAB II. PEN*UMUM AN SELEKSI

P%n"&m&man S%#%ksi '%ran'&m (a#am -a(a a-#ikasi SPSE


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BAB III. INS!UK SI KEPA A PESE!A 4IKP5

A. UMUM

1.

P%s%r'a

K&a#i>ikasi

1.1 Prak&a#i>ikasi ini '%r,&ka (an (a-a' (iik&'i o#%+ s%m&a -%s%r'a )an" ,%r,%n'&k ,a(an &sa+a 4-%r&sa+aan/ko-%rasi5 a'a&

K%mi'raan/KSO.

1.2 Da#am +a# -%s%r'a akan a'a& s%(an" m%#ak&kanK%mi'raan/KSO ,aik (%n"an -%r&sa+aan nasiona# ma&-&nasin" maka -%s%r'a +ar&s m%mi#iki -%rjanjian K%mi'raan/K%rjaSama O-%rasi )an" m%m&a' -%rs%n'as% K%mi'raan/KSO (an-%r&sa+aan )an" m%?aki#i K%mi'raan/KSO '%rs%,&'.

1.3 Un'&k ni#ai -%k%rjaan (i ,a?a+ -.10.000.000.000004s%-&+ mi#iar r&-ia+5 maka k%mi'raan/KSO +ar&s '%r(iri(ari -%r&sa+aan nasiona#.

1.$

P%s%r'a K%mi'raan/KSO (i#aran" &n'&k m%n"&,a+ P%rjanjianK%mi'raan/K%rja Sama O-%rasi.

1.6 Ba"i Ba(an Usa+a asa Kons'ansi Asin" )an" m%n"ik&'i-rak&a#i>ikasi +ar&s m%mi#iki ,&k'i Iin P%r?aki#an Ba(anUsa+a asa Kons'ansi Asin" (an m%#ak&kan k%rja sama &sa+a(%n"an -%r&sa+aan nasiona# (a#am ,%n'&k k%mi'raans&,kon'rak (an #ain#ain (a#am +a# '%r(a-a' -%r&sa+aannasiona# )an" m%mi#iki k%mam-&an (i ,i(an" )an",%rsan"k&'an.

2.

Laran"an

Kor&-si K o#&si

(an N %-o'ism%

4KKN5

P%rs%kon"ko#an

s%r'a P%ni-&an

2.1

P%s%r'a (an -i+ak )an" '%rkai' (%n"an -%n"a(aan ini,%rk%?aji,an &n'&k m%ma'&+i %'ika -%n"a(aan (%n"an 'i(akm%#ak&kan 'in(akan s%,a"ai ,%rik&':a. ,%r&sa+a m%m-%n"ar&+i an""o'a Pokja ULP (a#am ,%n'&k

(an ara a-a-&n &n'&k m%m%n&+i k%in"inan -%s%r'a )an",%r'%n'an"an (%n"an Dok&m%n K&a#i>ikasi (an/a'a&-%ra'&ran -%r&n(an"&n(an"an@

,. m%#ak&kan -%rs%kon"ko#an (%n"an -%s%r'a #ain &n'&km%n"a'&r +asi# s%#%ksi s%+in""am%n"&ran"i/m%n"+am,a'/m%m-%rk%i#/ m%nia(akan-%rsain"an )an" s%+a' (an/a'a& m%r&"ikan -i+ak #ain@(an/a'a&

.

m%m,&a' (an/a'a& m%n)am-aikan (ok&m%n (an/a'a&k%'%ran"an #ain )an" 'i(ak ,%nar &n'&k m%m%n&+i-%rs)ara'an (a#am Dok&m%n K&a#i>ikasi ini.

2.2 P%s%r'a )an" '%r,&k'i m%#ak&kan 'in(akan s%,a"aimana(imaks&( (a#am an"ka 2.1 (i a'as (ik%nakan sanksisanksis%,a"ai ,%rik&':a. sanksi a(minis'ra'i> s%-%r'i (i"&"&rkan (ari -ros%s

k&a#i>ikasi a'a& -%m,a'a#an k%#&san k&a#i>ikasi@,. sanksi -%nan'&man (a#am Da>'ar i'am@. "&"a'an s%ara -%r(a'a@ (an/a'a&(. -%#a-oran s%ara -i(ana k%-a(a -i+ak ,%r?%nan".


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2.3 P%n"%naan sanksi (i#a-orkan o#%+ -okja ULP k%-a(a PA/KPAs%s&ai (%n"an -%ra'&ran -%r&n(an"&n(an"an.

3.

Laran"an

P%r'%n'an"an

K%-%n'in"an

3.1 Para -i+ak (a#am m%#aksanakan '&"as >&n"si (an -%rann)am%n"+in(ari (an m%n%"a+ -%r'%n'an"an k%-%n'in"an -ara-i+ak )an" '%rkai' ,aik s%ara #an"s&n" ma&-&n 'i(ak#an"s&n".

3.2 P%r'%n'an"an k%-%n'in"an s%,a"aimana (imaks&( -a(a an"ka3.1 (ia'as an'ara #ain m%#i-&'i:a. Da#am sa'& ,a(an &sa+a an""o'a Dir%ksi a'a& D%?an

Komisaris s%,a"ai an""o'a Dir%ksi a'a& D%?anKomisaris -a(a Ba(an Usa+a #ainn)a )an" m%nja(i-%s%r'a -a(a S%#%ksi )an" sama@

,. Kons'an -%r%nana/-%n"a?as ,%r'in(ak s%,a"ai-%#aksana P%k%rjaan Kons'r&ksi )an"(ir%nanakann)a/(ia?asin)a k%&a#i (a#am-%#aksanaan Kon'rak P%n"a(aan P%k%rjaan !%rin'%"rasi@

.

Kons'an manaj%m%n kons'r&ksi ,%r-%ran s%,a"aiKons'an P%r%nana (an/a'a& Kons'an P%n"a?as@(. -%n"&r&s ko-%rasi -%"a?ai (a#am s&a'& K/L/D/I a'a&

anak -%r&sa+aan -a(a BUMN/BUMD )an" m%n"ik&'iP%n"a(aan Baran"/asa (an ,%rsain" (%n"an-%r&sa+aan #ainn)a (i#aran" m%ran"ka- s%,a"aian""o'a ULP a'a& -%ja,a' )an" ,%r?%nan" m%n%'a-kan-%m%nan" S%#%ksi@

%. PA KPA PPK an""o'a Pokja ULP (an/a'a& -%ja,a'#ainn)a )an" ,%r?%nan" ,aik #an"s&n" ma&-&n 'i(ak#an"s&n" m%n"%n(a#ikan a'a& m%nja#ankan -%r&sa+aan-%s%r'a@

>.

+&,&n"an an'ara 2 4(&a5 -%r&sa+aan )an"(ik%n(a#ikan ,aik #an"s&n" ma&-&n 'i(ak #an"s&n"o#%+ -i+ak )an" sama )ai'& #%,i+ (ari 60G 4#ima -&+-%rs%ra'&s5 -%m%"an" sa+am (an/a'a& sa#a+ sa'&-%n"&r&sn)a sama.

3.3 P%"a?ai K/L/D/I (i#aran" m%nja(i -%s%r'a k%&a#i &'i (i #&ar'an""&n"an K/L/D/I.

$.

Sa'& a'a

K&a#i>ikasi 'ia-

P%s%r'a

$.1. S%'ia- -%s%r'a ,aik a'as nama s%n(iri ma&-&n s%,a"ai an""o'ak%mi'raan/KSO +an)a (i-%r,o#%+kan &n'&k m%n)am-aikansa'& Da'a K&a#i>ikasi.

$.2. S%'ia- -%s%r'a )an" '%rmas&k (a#am k%mi'raan/KSO (i#aran"m%nja(i -%s%r'a ,aik s%ara s%n(iri ma&-&n s%,a"ai an""o'ak%mi'raan/KSO )an" #ain -a(a -ak%' -%k%rjaan )an" sama.

6.

B%r#ak&n)a

K&a#i>ikasi

K&a#i>ikasi ini +an)a ,%r#ak& &n'&k -ak%' -%k%rjaan )an" (is%,&'(a#am LDK.

.

Bia)a K&a#i>ikasi

.1 P%s%r'a s%-%n&+n)a m%nan""&n" ,ia)a &n'&k m%n"ik&'ik&a#i>ikasi ini.


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.2 Pokja ULP 'i(ak ,%r'an""&n" ja?a, a'as k%r&"ian a-a-&n )an"(i'an""&n" o#%+ -%s%r'a.

B. OKUM EN KUALIFIKASI

Isi ok&m%n

K&a#i>ikasi

.1 Isi Dok&m%n K&a#i>ikasi m%#i-&'i :a. Um&m@,.

P%n"&m&man -rak&a#i>ikasi. Ins'r&ksi K%-a(a P%s%r'a@(. L%m,ar Da'a K&a#i>ikasi@%. Pak'a In'%"ri'as 4&n'&k KSO5@>. Isian Da'a K&a#i>ikasi@

". P%'&nj&k P%n"isian Da'a K&a#i>ikasi@+. !a'a ;ara Ea#&asi K&a#i>ikasi@i. B%n'&k -%rjanjian K%mi'raan/K%rja sama O-%rasi 4KSO5.

.2 P%s%r'a ,%rk%?aji,an m%m%riksa k%s%#&r&+an isi Dok&m%nK&a#i>ikasi ini. K%#a#aian m%n)am-aikan k%'%ran"an )an"

(is)ara'kan (a#am Dok&m%n K&a#i>ikasi s%-%n&+n)a m%r&-akanr%siko -%s%r'a.

8

Ba+asa

ok&m%n

K&a#i>ikasi

Dok&m%n K&a#i>ikasi ,%s%r'a s%#&r&+ kor%s-on(%nsi '%r'is (a#am-ros%s k&a#i>ikasi m%n""&nakan Ba+asa In(on%sia.

9

P%m,%rian

P%nj%#asan

4a-a,i#a

(i-%r#&kan5

9.1 P%m,%rian -%nj%#asan (i#ak&kan s%ara on#in% m%#a#&i a-#ikasiSPSE s%s&ai ja(?a# (a#am a-#ikasi SPSE.

9.2 K%'i(akik&'s%r'aan -%s%r'a -a(a saa' -%m,%rian -%nj%#asan'i(ak (a-a' (ija(ikan (asar &n'&k m%no#ak/m%n""&"&rkan

-%na?aran.

9.3 A-a,i#a (i-%r#&kan Pokja ULP (a-a' m%m,%rikan in>ormasi )an" (ian""a- -%n'in" '%rkai' (%n"an (ok&m%n k&a#i>kasi.

9.$ Pokja ULP m%nja?a, s%'ia- -%r'an)aan )an" mas&k k%&a#i&n'&k s&,s'ansi -%r'an)aan )an" '%#a+ (ija?a,.

9.6 A-a,i#a (i-%r#&kan Pokja ULP -a(a saa' ,%r#an"s&n"n)a-%m,%rian -%nj%#asan (a-a' m%nam,a+ ?ak'& ,a'as ak+ir'a+a-an '%rs%,&' s%s&ai (%n"an k%,&'&+an.

9.

Da#am +a# ?ak'& 'a+a- -%nj%#asan '%#a+ ,%rak+ir P%n)%(ia asa Kons'ansi 'i(ak (a-a' m%n"aj&kan -%r'an)aan nam&nPokja ULP masi+ m%m-&n)ai 'am,a+an ?ak'& &n'&km%nja?a, -%r'an)aan )an" mas&k -a(a ak+ir ja(?a#.

9. A-a,i#a (i-%r#&kan Pokja ULP (a-a' m%m,%rikan -%nj%#asan4an"5.

9.8 k&m-an 'an)a ja?a, -a(a saa' -%m,%rian -%nj%#asan (a#ama-#ikasi SPSE m%r&-akan B%ri'a Aara P%m,%rian P%nj%#asan4BAPP5.


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10

P%r&,a+an

ok&m%n

K&a#i>ikasi

10.1 S%,%#&m ,a'as ak+ir ?ak'& -%n)am-aian Dok&m%n K&a#i>ikasiPokja ULP (a-a' m%n"&,a+ Dok&m%n K&a#i>ikasi (%n"anm%n%'a-kan A(%n(&m Dok&m%n K&a#i>ikasi.

10.2 S%'ia- A(%n(&m )an" (i'%'a-kan m%r&-akan ,a"ian )an" 'i(ak'%r-isa+kan (ari Dok&m%n K&a#i>ikasi (an (isam-aikan k%-a(as%m&a -%s%r'a.

10.3 Pokja ULP (a-a' m%n"&m&mkan A(%n(&m Dok&m%nk&a#i>ikasi (%n"an ara m%n"&n""a+ 4&-#oa(5 >i#% a(%n(&m(ok&m%n k&a#i>ikasi m%#a#&i a-#ikasi SPSE -a#in" #am,a' 24(&a5 +ari s%,%#&m ,a'as ak+ir -%mas&kan Da'a k&a#i>ikasi.A-a,i#a Pokja ULP akan m%n"&n""a+ 4&-#oa(5 >i#% a(%n(&mDok&m%n K&a#i>ikasi k&ran" (ari 2 4(&a5 +ari s%,%#&m ,a'asak+ir -%mas&kan Da'a k&a#i>ikasi maka Pokja ULP ?aji,m%n"&n(&rkan ,a'as ak+ir -%mas&kan Da'a k&a#i>ikasi.

10.$ P%s%r'a (a-a' m%n"&n(&+ 4(o?n#oa(5 >i#% A(%n(&m Dok&m%nK&a#i>ikasi 4a-a,i#a a(a5 m%#a#&i a-#ikasi SPSE.

10.6 Pokja ULP (a-a' m%n"&n(&rkan ,a'as ak+ir ?ak'&-%mas&kan/-%n)am-aian Da'a K&a#i>ikasi a-a,i#a a(aA(%n(&m Dok&m%n K&a#i>ikasi.

. PEN7AM PAIAN A!A KUALIFIKASI

;. PEN7IAPAN OKUM EN KUALIFIKASI

11

B%n'&k a'a

K&a#i>ikasi

Da'a K&a#i>ikasi )an" (isam-aikan o#%+ -%s%r'a ,%r&-a Da'aK&a#i>ikasi )an" '%#a+ (iisi -a(a >orm isian %#%k'ronik (a'ak&a#i>ikasi -a(a a-#ikasi SPSE.

12

Pak'a In'%"ri'as 12.1

Pak'a In'%"ri'as ,%risi ikrar &n'&k m%n%"a+ (an 'i(akm%#ak&kan (an akan m%#a-orkan '%rja(in)a Ko#&si Kor&-si(an N%-o'ism% 4KKN5 s%r'a akan m%n"ik&'i -ros%s-%n"a(aan s%ara ,%rsi+ 'rans-aran (an -ro>%siona#.

12.2 D%n"an m%n(a>'ar s%,a"ai -%s%r'a -a(a s&a'& -ak%'-%k%rjaan m%#a#&i a-#ikasi SPSE maka -%s%r'a '%#a+m%nan(a'an"ani Pak'a In'%"ri'as k%&a#i &n'&k -%n)%(ia,aran"/jasa )an" m%#ak&kan K%mi'raan/K%rja Sama O-%rasi4KSO5 ,a(an &sa+a )an" (i'&nj&k m%?aki#iK%mi'raan/K%rja Sama O-%rasi 4KSO5 ?aji, m%n)am-aikan

-ak'a in'%"ri'as m%#a#&i >asi#i'as &n""a+an #ainn)a -a(a >ormisian %#%k'ronik (a'a k&a#i>ikasi (i a-#ikasi SPSE.

13

P%n"isian a'a

K&a#i>ikasi

13.1 P%n"isian Da'a K&a#i>ikasia. Da'a k&a#i>ikasi (isam-aikan m%#a#&i >orm isian

%#%k'ronik k&a#i>ikasi )an" '%rs%(ia -a(a a-#ikasi SPSE@,. ika >orm isian %#%k'ronik k&a#i>ikasi )an" '%rs%(ia -a(a

a-#ikasi SPSE ,%#&m m%n"akomo(ir (a'a k&a#i>ikasi )an"(is)ara'kan Pokja ULP maka (a'a k&a#i>ikasi '%rs%,&'(i&n""a+ 4&-#oa( 5 -a(a >asi#i'as -%n"&n""a+an #ain

)an" '%rs%(ia -a(a a-#ikasi SPSE@. D%n"an m%n"irimkan (a'a k&a#i>ikasi s%ara %#%k'ronik

-%s%r'a m%n)%'&j&i -%rn)a'aan s%,a"ai ,%rik&':


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1$

P%n)am-aian

a'a

K&a#i>ikasi

1$.1 P%s%r'a m%n"irimkan Da'a K&a#i>ikasi m%#a#&i a-#ikasi SPSEk%-a(a Pokja ULP s%s&ai ja(?a# )an" (i'%'a-kan.

1$.2 A-a,i#a ,%r(asarkan +asi# %a#&asi k&a#i>ikasi Pokja ULPm%n"an""a- a(a k%k&ran"an (a'a k&a#i>ikasi maka Pokja ULPm%min'a k%-a(a -%s%r'a &n'&k m%#%n"ka-i k%k&ran"an (a'a'%rs%,&' (an -%s%r'a m%m%n&+i -%rmin'aan Pokja ULP '%rs%,&'-a#in" #am,a' s%,%#&m ,a'as ak+ir -%mas&kan (a'a k&a#i>ikasi.

15 )an" ,%rsan"k&'an (an manaj%m%nn)a 'i(ak (a#am-%n"a?asan -%n"a(i#an 'i(ak -ai#i' (an k%"ia'an&sa+an)a 'i(ak s%(an" (i+%n'ikan@

25 )an" ,%rsan"k&'an ,%rik&' -%n"&r&s ,a(an &sa+a'i(ak mas&k (a#am (a>'ar +i'am@

35 )an" ,%r'in(ak &n'&k (an a'as nama ,a(an &sa+a'i(ak s%(an" (a#am m%nja#ani sanksi -i(ana@

$5

(a'a k&a#i>ikasi )an" (iisikan ,%nar (an jika(ik%m&(ian +ari (i'%m&kan ,a+?a (a'a/(ok&m%n

)an" (isam-aikan 'i(ak ,%nar (an a(a -%ma#s&anmaka (ir%k'&r &'ama/-im-inan -%r&sa+aan a'a&k%-a#a a,an" a'a& -%ja,a' )an" m%n&r&' -%rjanjiank%rja sama ,%r+ak m%?aki#i ,a(an &sa+a )an",%k%rja sama (an ,a(an &sa+a )an" (i?aki#i ,%rs%(ia(ik%nakan sanksi a(minis'ra'i> sanksi -%nan'&man(a#am (a>'ar +i'am "&"a'an s%ara -%r(a'a (an/a'a&-%#a-oran s%ara -i(ana k%-a(a -i+ak ,%r?%nan"s%s&ai (%n"an k%'%n'&an -%ra'&ran -%r&n(an"

&n(an"an@65 -im-inan (an -%n"&r&s ,a(an &sa+a ,&kan s%,a"ai-%"a?ai K/L/D/I a'a& -im-inan (an -%n"&r&s ,a(an&sa+a s%,a"ai -%"a?ai K/L/D/I )an" s%(an"m%n"am,i# &'i (i#&ar 'an""&n"an K/L/D/I@ (an

5 -%rn)a'aan #ain )an" m%nja(i s)ara' k&a#i>ikasi )an"'%ran'&m (a#am (ok&m%n -%n"a(aan.

(. Un'&k -%s%r'a )an" ,%r,%n'&k konsorsi&m/k%mi'raan/,%n'&k k%rjasama #ain -%mas&kan k&a#i>ikasi(i#ak&kan o#%+ ,a(an &sa+a )an" (i'&nj&k m%?aki#ikonsorsi&m/ k%mi'raan/,%n'&k k%rjasama #ain.

13.2

P%s%r'a ,%rk%?aji,an &n'&k m%n)%'&j&i Pak'a In'%"ri'as (anm%n"isi >orm isian %#%k'ronik (a'a k&a#i>ikasi (a#am a-#ikasiSPSE.

13.3 Pak'a In'%"ri'as (an Da'a K&a#i>ikasi (ian""a- '%#a+ (is%'&j&i(an (i'an(a'an"ani o#%+ -%s%r'a -%n"a(aan k%&a#i &n'&k-%s%r'a )an" m%#ak&kan K%mi'raan/K%rja Sama O-%rasi4KSO5 Pak'a In'%"ri'as (an (an Da'a K&a#i>ikasi(i'an(a'an"ani o#%+ -%ja,a' )an" m%n&r&' -%rjanjianK%mi'raan/K%rja Sama O-%rasi ,%r+ak m%?aki#iK%mi'raan/KSO.


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1$.3 P%s%r'a (a-a' m%n"irimkan k%k&ran"an (a'a k&a#i>ikasis%,a"aimana (imaks&( -a(a an"ka 1$.2 m%#a#&i >asi#i'as-%n"iriman (a'a k&a#i>ikasi )an" '%rs%(ia -a(a a-#ikasi SPSE.

16

a'a

K&a#i>ikasi

!%r#am,a'

16.1 Da'a K&a#i>ikasi +ar&s (isam-aikan m%#a#&i a-#ikasi SPSEk%-a(a Pokja ULP -a#in" #am,a' -a(a ?ak'& )an" (i'%n'&kano#%+ Pokja ULP.

16.2 S%'%#a+ ,a'as ak+ir ?ak'& -%mas&kan Da'a K&a#i>ikasi a-#ikasiSPSE m%no#ak s%'ia- Da'a K&a#i>ikasi )an" akan (ikirim.

E. Eikasi (a-a' (i,&ka -a(a saa' Da'a K&a#i>ikasi (i'%rimaPokja ULP -a(a a-#ikasi SPSE.

1

K%ra+asiaan

Pros%s

1.1 Pros%s %a#&asi k&a#i>ikasi ,%rsi>a' ra+asia (an (i#aksanakan

o#%+ -okja ULP s%ara in(%-%n(%n@

1.2 In>ormasi )an" ,%rkai'an (%n"an %a#&asi k&a#i>ikasi 'i(ak,o#%+ (i&n"ka-kan k%-a(a -ara -%s%r'a a'a& -i+ak #ain )an"'i(ak ,%rk%-%n'in"an +in""a +asi# k&a#i>ikasi (i&m&mkan@

1.3 S%'ia- &sa+a -%s%r'a m%nam-&ri -ros%s %a#&asi k&a#i>ikasiakan m%n"aki,a'kan (i'o#akn)a Da'a K&a#i>ikasi )an",%rsan"k&'an.

18

K#ari>ikasi (an

Kon>irmasi

K&a#i>ikasi

18.1 Da#am m%n"%a#&asi(a'a k&a#i>ikasi -okja ULP (a-a'm%#ak&kan k#ari>ikasi '%r+a(a- +a#+a# )an" 'i(ak j%#as (a#am

(a'a k&a#i>ikasi. P%s%r'a +ar&s m%m,%rikan 'an""a-an a'ask#ari>ikasi. K#ari>ikasi 'i(ak ,o#%+ m%n"&,a+ s&,s'ansi.K#ari>ikasi (an 'an""a-an a'as k#ari>ikasi +ar&s (i#ak&kans%ara '%r'is@

18.2 !%r+a(a- +a#+a# )an" (ira"&kan ,%rkai'an (%n"an (a'ak&a#i>ikasi Pokja ULP (a-a' m%#ak&kan kon>irmasik%,%narann)a '%rmas&k -%ninja&an #a-an"an k%-a(a -i+ak-i+ak/ins'ansi '%rkai'@

18.3 asi# k#ari>ikasi/kon>irmasi (a-a' m%n""&"&rkan -%na?aran.

19

Ea#&asi

K&a#i>ikasi

19.1

Ea#&asi K&a#i>ikasi +an)a ,%r(asarkan Da'a K&a#i>ikasi )an"(ikirimkan m%#a#&i >orm isian %#%k'ronik (a'a k&a#i>ikasi )an"'%r(iri (ari:a. -%ni#aian P%rs)ara'an A(minis'rasi K&a#i>ikasi )an"

(i#ak&kan (%n"an Sis'%m *&"&r@ (an,. %a#&asi P%rs)ara'an !%knis K&a#i>ikasi )an" (i#ak&kan

(%n"an Sis'%m Ni#ai &n'&k m%n"+asi#kan ;a#on Da>'arP%n(%k.

19.2 !a'a ;ara Ea#&asi K&a#i>ikasi (i#ak&kan s%s&ai (%n"an Ba,ikasi ini.


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19.3 Pokja ULP m%n"in-&'kan +asi# %a#&asi k&a#i>ikasi -a(aa-#ikasi SPSE.

19.$ A-a,i#a -%s%r'a )an" #&s %a#&asi k&a#i>ikasi k&ran" (ari 34'i"a5 -%s%r'a maka -rak&a#i>ikasi (in)a'akan "a"a#.

20

P%m,&k'ian

K&a#i>ikasi

20.1 P%m,&k'ian k&a#i>ikasi '%r+a(a- -%s%r'a )an" m%m%n&+i-%rs)ara'an k&a#i>ikasi (i#ak&kan s%'%#a+ %a#&asik&a#i>ikasi/s%,%#&m -%n"&m&man (a>'ar -%n(%k kons'an.

20.2 P%m,&k'ian k&a#i>ikasi (i#ak&kan (i #&ar a-#ikasi SPSE4o>>#in% 5.

20.3 P%m,&k'ian k&a#i>ikasi (i#ak&kan (%n"an ara m%#i+a'(ok&m%n as#i a'a& r%kaman )an" s&(a+ (i#%"a#isir o#%+ -i+ak

)an" ,%r?%nan" (an m%min'a r%kamann)a. Da#am-%m,&k'ian k&a#i>ikasi (a-a' (i+a(iri o#%+ ?aki# )an"m%n%rima k&asa )an" sa+.

20.$

A-a,i#a -%s%r'a 'i(ak +a(ir (a#am -%m,&k'ian k&a#i>ikasi (an'%#a+ (i,%rikan k%s%m-a'an s%r'a '%n""an" ?ak'& )an" #o"is(an &k&- maka -%s%r'a (i"&"&rkan.

20.6 Da#am 'a+a- -%m,&k'ian k&a#i>ikasi Pokja ULP 'i(ak -%r#&m%min'a s%#&r&+ (ok&m%n k&a#i>ikasi a-a,i#a -%s%r'a s&(a+-%rna+ m%#aksanakan -%k%rjaan )an" s%j%nis (an/a'a& (a'ak&a#i>ikasi -%n)%(ia s&(a+ '%r%ri>ikasi (a#am Sis'%m In>ormasiKin%rja P%n)%(ia 4SIKaP5.

20. Pokja ULP m%#ak&kan k#ari>ikasi (an/a'a& %ri>ikasi k%-a(a

-%n%r,i' (ok&m%n a-a,i#a (i-%r#&kan.

20. A-a,i#a +asi# -%m,&k'ian k&a#i>ikasi (i'%m&kan -%ma#s&an(a'a -%s%r'a (i"&"&rkan (an ,a(an &sa+a (imas&kkan (a#amDa>'ar i'am.

20.8 A-a,i#a -%s%r'a )an" #&s -%m,&k'ian k&a#i>ikasi k&ran" (ari3 4'i"a5 maka s%#%ksi (in)a'akan "a"a#.

F. ASIL KUALIFIKASI

21

P%n%'a-an

asi#

K&a#i>ikasi

21.1 S%m&a -%s%r'a )an" #&s -%m,&k'ian k&a#i>ikasi (imas&kkan

o#%+ Pokja ULP k% (a#am Da>'ar P%n(%k 4s+or'#is' 5 -a#in"k&ran" 3 4'i"a5 (an -a#in" ,an)ak 6 4#ima5 -%s%r'a (ari (a>'ar-%s%r'a )an" '%#a+ #&s -%m,&k'ian k&a#i>ikasi ,%r(asarkan&r&'an -%rin"ka' '%r,aik.

21.2 Pokja ULP m%n"in-&'kan (a>'ar -%n(%k s%,a"aimana(imaks&( -a(a an"ka 21.1 -a(a a-#ikasi SPSE.

22

P%m,%ri'a+&an

(an

P%n"&m&man

asi# k&a#i>ikasi s%'%#a+ (i'%'a-kan o#%+ Pokja ULP (i,%ri'a+&kank%-a(a s%#&r&+ -%s%r'a (an (i&m&mkan o#%+ Pokja ULP m%#a#&i

a-#ikasi SPSE s%,a"aimana )an" '%ran'&m (a#am LDK.


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11




asi#

K&a#i>ikasi

21

K&a#i>ikasi

U#an"

21.1 A-a,i#a j&m#a+ -%s%r'a )an" #&s k&a#i>ikasi k&ran" (ari 34'i"a5 maka (i#ak&kan -%n"&m&man an" -rak&a#i>ikasi.

21.2 ika s%'%#a+ k&a#i>ikasi an" '%rn)a'a -%s%r'a )an" #&sk&a#i>ikasi ,%rj&m#a+ k&ran" (ari 3 4'i"a5 maka Pokja ULPm%#anj&'kan -ros%s s%#%ksi.

22

P%n"&n(&+an

4(o?n#oa(5

ok&m%n

P%mi#i+an

P%s%r'a )an" mas&k (a#am (a>'ar -%n(%k (a-a' m%n"&n(&+4(o?n#oa( 5 Dok&m%n P%mi#i+an &n'&k m%mas&kkan -%na?aran.


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BAB Iikasi

S%,a"aimana )an" '%ran'&m (a#am a-#ikasi SPSE

.

P%rs)ara'an

K&a#i>ikasi

1. P%s%r'a K&a#i>ikasi ,a(an &sa+a +ar&s m%mi#iki s&ra' iin&sa+a :

• SBU Bi(an" asa S&r%) 41.SS5 S&, La)anan S&r%)

*%o#o"i (an *%o>isika 41.SS.05 a'a& K#asi>ikasi

Kons'ansi S-%sia#is S&, K#asi>ikasi asa P%m,&a'an

Pros-%k'&s *%o#o"i (an * %o>isika 4SP 301 5 K&a#i>ikasi K

Scan Asli SBU yang dipersyaratkan agardiunggah (upload) pada fasilitas

pengunggahan lain yang tersedia padaaplikasi SPSE apabila scan asli SBU tidak

diupload, maka dinyatakan tidak memenuhi persyaratan kualifikasi.

• SI!U/ O / DOMISILI )an" masi+ ,%r#ak&@

• !DP )an" masi+ ,%r#ak&

• SIUK )an" masi+ ,%r#ak&

2. P%s%r'a K&a#i>ikasi Ba(an Usa+a asa Kons'ansi Asin" +ar&sm%mi#iki ,&k'i Iin P%r?aki#an Ba(an Usa+a asa Kons'ansiAsin".

3. -%r&sa+aan )an" ,%rsan"k&'an (an manaj%m%nn)a 'i(ak(a#am -%n"a?asan -%n"a(i#an 'i(ak -ai#i' k%"ia'an&sa+an)a 'i(ak s%(an" (i+%n'ikan (an/a'a& (ir%ksi )an",%r'in(ak &n'&k (an a'as nama -%r&sa+aan 'i(ak s%(an"(a#am m%nja#ani sanksi -i(ana@

$. sa#a+ sa'& (an/a'a& s%m&a -%n"&r&s (an ,a(an &sa+an)a'i(ak mas&k (a#am (a>'ar +i'am@

6. m%mi#iki NP=P (an '%#a+ m%m%n&+i k%?aji,an -ajak 'a+&n'%rak+ir 4SP! !a+&n minima# 20165@


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. m%m-%ro#%+ -a#in" s%(iki' 1 4sa'&5 -%k%rjaan s%,a"ai-%n)%(ia jasa kons'ansi (a#am k&r&n ?ak'& $ 4%m-a'5'a+&n '%rak+ir ,aik (i #in"k&n"an -%m%rin'a+ ma&-&ns?as'a '%rmas&k -%n"a#aman s&,kon'rak k%&a#i P%n)%(ia

)an" ,ar& ,%r(iri k&ran" (ari 3 4'i"a5 !a+&n@

. M%mi#iki k%mam-&an m%n)%(iakan -%rsoni# )an"(i-%r#&kan &n'&k -%#aksanaan -%k%rjaan :

&m#a+ -%rsoni# s%,an)ak 12 Oran" )an" '%r(iri (ari : 1 Oran" K%'&a !%am/!%am L%a(%r

Minima# S2 *%o#o"i -%n"a#aman k%rja minima# 10 !a+&n

1 Oran" A+#i *%o#o"i !%knikMinima# S1 *%o#o"i -%n"a#aman minima# 6 'a+&n

1 Oran" Asis'%n A+#i 1 Oran" S&r%)or 1 Oran" O-%ra'or Kom-&'%r

1 Oran" S%kr%'aris 1 Oran" Dra>'%r 6 Oran" !%na"a Loka#

8. M%mi#iki k%mam-&an m%n)%(iakan >asi#i'as (an -%ra#a'an )an" (i-%r#&kan &n'&k -%#aksanaan -%k%rjaan :

1 Uni' A#a' Son(ir 2 Uni' Kom-as *%o#o"i 2 Uni' -a#& *%o#o"i

2 Uni' *PS

B&k'i K%-%mi#ikan a#a' 4mi#ik s%n(iri/S%?a5 )an"(i-%rs)ara'kan +ar&s (a-a' (i,&k'ikan -a(a saa' -%m,&k'iank&a#i>ikasi.

9. M%mi#iki -%n"a#aman -a(a K#asi>ikasi Bi(an"Bi(an" asa

S&r%) 41.SS5 S&, La)anan S&r%) *%o#o"i (an *%o>isika

41.SS.05 a'a& K#asi>ikasi Kon s'ansi S-%sia#is S&, K #asi>ikasi

asa P%m,&a'an Pros-%k'&s *%o#o"i (an *%o>isika 4SP

3015

(%n"an 'o'a# ,o,o' -%ni#aian s%,%sar 100G '%r(iri (ari :

a.

P%n"a#aman -a(a -%k%rjaan s%j%nis (%n"an ,o,o' $6G@,. K%s%s&aian ,%saran ni#ai -%k%rjaan s%j%nis )an" -%rna+(is%#%saikan (%n"an ni#ai -%k%rjaan )an" akan(ikom-%'isikan (%n"an ,o,o' 36G@

. P%n"a#aman P%k%rjaan -a(a #okasi )an" sama -a(a 'in"ka'Ka,&-a'%n/Ko'a (%n"an ,o,o' 16G@

(. Domisi#i P%r&sa+aan In(&k 4'in"ka' Proinsi/ Ka,&-a'%n/Ko'a k%&a#i Proinsi DKI akar'a5 (%n"an ,o,o' 6G@

%. j&m#a+ a5 ,5 5 (an (5sama (%n"an 100G.


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10. M%mi#iki !%na"a A+#i !%'a- (%n"an k&a#i>ikasi

- K%'&a !%am/!%am L%a(%rMinima# S2 *%o#o"i -%n"a#aman k%rja minima# 10!a+&nA+#i *%o(%si

- A+#i *%o#o"i !%knik

Minima# S1 *%o#o"i -%n"a#aman minima# 6 'a+&n11. Da#am +a# -%s%r'a akan m%#ak&kan k%mi'raan:

a. ?aji, m%m-&n)ai -%rjanjian K%rja SamaO-%rasi/k%mi'raan )an" m%m&a' -%rs%n'as% k%mi'raan(an -%r&sa+aan )an" m%?aki#i k%mi'raan '%rs%,&'@ (an

,. -%ni#aian k&a#i>ikasi -a(a an"ka 1 s/( (i#ak&kan'%r+a(a- s%'ia- -%s%r'a )an" '%r"a,&n" (a#amKSO/K%mi'raan.

. -%ni#aian k&a#i>ikasi -a(a an"ka 89 (an 10 (i#ak&kan'%r+a(a- "a,&n"an (ari -%s%r'a )an" m%#ak&kanKSO/K%mi'raan.

(.

k%&a#i -a(a an"ka 9., -%ni#aian (i#ak&kan &n'&k#%a(>irm ,a"i -%s%r'a )an" m%#ak&kan KSO/K%mi'raan.

E.

San""a+an

K&a#i>ikasi (an

P%n"a(&an

1. San""a+an !i(ak (i-%r#&kan.

2. P%n"a(&an (a-a' (isam-aikan (i #&ar a-#ikasi SPSE 4o>>#in% 5(i'&j&kan k%-a(a

APIP Proinsi ia&.


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15





BAB


18/32

16





;on'o+ Pak'a In'%"ri'as Ba(an Usa+a D%n"an K%mi'raan

PAK!A IN!E*I!AS

Kami )an" ,%r'an(a 'an"an (i ,a?a+ ini:

1. Nama : HHHHHHHHHH nama ?aki# sa+ ,a(an &sa+a

No. I(%n'i'as : HHHHHHHHHH (iisi nomor K!P/SIM/Pas-or

a,a'an : HHHHHHHHHH

B%r'in(ak &n'&k (an a'asnama

: P!/;'ar i'am(i"&"a' s%ara -%r(a'a (an/a'a& (i#a-orkan s%ara -i(ana.

HHHHHHHHHH '%m-a' HH 'an""a# HHHHHHHHHH ,an 20HH 'a+&n

Nama P%n)%(ia Nama P%n)%(ia Nama P%n)%(ia

'an(a 'an"an 'an(a 'an"an 'an(a 'an"an nama #%n"ka- nama #%n"ka- nama #%n"ka-

Aan'&mkan 'an(a 'an"an (an nama s%'ia- an""o'a K%mi'raan


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17





BAB


20/32

18





DFO0MULI0 ISIAN KUALIFIKASI UN!UK KEMI!0AAN/KSO

Sa)a )an" ,%r'an(a 'an"an (i ,a?a+ ini:

Nama : HHHHHHHHHH (iisi nama ?aki# sa+ ,a(an &sa+a

No. I(%n'i'as : HHHHHHHHHH (iisi (%n"an no.K!P/SIM/-as-or

a,a'an : HHHHHHHHHHHH (iisi s%s&ai ja,a'an

B%r'in(ak &n'&k(an a'as nama

: HHHHHHHHHHHHHHHHHHH (iisi nama ,a(an &sa+a

A#ama' : HHHHHHHHHHHHHHHH

!%#%-on/Fa : HHHHHHHHHHHHHHHH

Emai# : HHHHHHHHHHHHHHHH

m%n)a'akan (%n"an s%s&n""&+n)a ,a+?a:

1. sa)a s%ara +&k&m &n'&k (an a'as nama -%r&sa+aan/ ko-%rasi/k%mi'raan/KSO,%r(asarkan HHHHHHHHHH ak'a -%n(irian/ an""aran (asar/s&ra' k&asa (is%,&'kans%Aara j%#as nomor (an 'an""a# ak'a -%n(irian/an""aran (asar/s&ra'k&asa/P%rjanjian K%rja Sama O-%rasi. ika K%mi'raan maka (i'am,a+ S&ra' P%rjanjianK%mi'raan/K%rja Sama O-%rasi. @

2. sa)a ,&kan s%,a"ai -%"a?ai K/L/D/I ,a"i -%"a?ai K/L/D/I )an" s%(an" A&'i (i#&ar'an""&n"an K/L/D/I (i'is s%,a"ai ,%rik&' : Sa)a m%r&-akan -%"a?ai K/L/D/I

)an" s%(an" A&'i (i#&ar 'an""&n"an K/L/D/IC @

3. sa)a 'i(ak s%(an" m%nja#ani sanksi -i(ana@

$. sa)a 'i(ak s%(an" (an 'i(ak akan '%r#i,a' -%r'%n'an"an k%-%n'in"an (%n"an -ara-i+ak )an" '%rkai' #an"s&n" ma&-&n 'i(ak #an"s&n" (a#am -ros%s -%n"a(aan ini@

6. ,a(an &sa+a )an" sa)a ?aki#i 'i(ak mas&k (a#am Da>'ar i'am 'i(ak (a#am-%n"a?asan -%n"a(i#an 'i(ak -ai#i' (an k%"ia'an &sa+an)a 'i(ak s%(an" (i+%n'ikan@

. sa#a+ sa'& (an/a'a& s%m&a -%n"&r&s ,a(an &sa+a )an" sa)a ?aki#i 'i(ak mas&k (a#amDa>'ar i'am@

.

(a'a(a'a ,a(an &sa+a )an" sa)a ?aki#i a(a#a+ s%,a"ai ,%rik&':


21/32

19





A.

a'a A(m inis'rasi

1. Nama 4Ba(an Usa+a5 : HHHHHHHHH

2. S'a'&s : P&sa' ;a,an"

3.

A#ama' Kan'or P&sa' : HHHHHHHHHH

No. !%#%-on : HHHHHHHHHH

No. Fa : HHHHHHHHHH

EMai# : HHHHHHHHHH

$.

A#ama' Kan'or ;a,an" : HHHHHHHHHH HHHHHHHHHH HHHHHHHHHH HHHHHHHHHH

No. !%#%-on :

No. Fa :

EMai# :

B.

Lan(asan &k&m P%n(irian Ba(an Usa+a

1. Ak'% P%n(irian P%r&sa+aan/An""aran Dasar Ko-%rasi

a. Nomor : HHHHHHHHHH

,. !an""a# : HHHHHHHHHH

. Nama No'aris : HHHHHHHHHH

(. Nomor P%n"%sa+an

K%m%n'%rian &k&m (an AM

4&n'&k )an" ,%r,%n'&k P!5

: HHHHHHHHHH

2. P%r&,a+an !%rak+ir Ak'%P%n(irian/An""aran Dasar

a. Nomor : HHHHHHHHHH

,. !an""a# : HHHHHHHHHH

. Nama No'aris : HHHHHHHHHH

(. Nomor P%rs%'&j&an

K%m%n'%rian &k&m (an AM

4&n'&k )an" ,%r,%n'&k P!5

: HHHHHHHHHH

;.

P%n"&r&s Ba(an Usa+a

No. Nama No. I(%n'i'as a,a'an (a#am Ba(an

Usa+a

.

Iin Usa+a

1.

No. S&ra' Iin Usa+a HHHHHH : HHHHHHHHHHHHHHHH !an""a# HHHHHHHHHH

2.

Masa ,%r#ak& iin &sa+a : HHHHHHHHHH

3. Ins'ansi -%m,%ri iin &sa+a

$.

K&a#i>ikasi Usa+a

6.

K#asi>ikasi Usa+a

: HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH

HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH


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20





E.

Iin Lainn)a 4a-a,i#a (i-%rs)ara'kan5

1. No. S&ra' Iin HHHHHHHHHHHH : HHHHHHHHHHHHHHHH !an""a# HHHHHHHHHH

2.

Masa ,%r#ak& iin : HHHHHHHHHH

3.

Ins'ansi -%m,%ri iin : HHHHHHHHHH

F.

a'a K%&an"an

1. S&s&nan K%-%mi#ikan Sa+am 4&n'&k P!5/S&s&nan P%s%ro 4&n'&k ;


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21





. a'a P%n"a#aman P%r&sa+aan a#am K&r&n =ak'& $ !a+&n !%rak+ir

4&n'&k P%n) %(ia )an" '%#a+ ,%r(iri #%,i+ (ari 3 'a+&n a 'a& #%,i+5.

4Un'&k P%n)%(ia

)an" ,ar& ,%r(iri k&ran" (ari 3 'a+&n 'i(ak ?aji, m%n"isi 'a,%# ini5

No.NamaPak%'

P%k%rjaan

in"kasanLin"k&-

P%k%rjaan

Lokasi

P%m,%ri!&"as/P%ja,a'

P%m,&a' Komi'm%nKon'rak

!an""a# S%#%saiP%k%rjaan

B%r(asarkan

NamaA#ama'/!%#%-on

No /!an""a#

Ni#ai Kon'rakBA

S%ra+!%rima

1 2 3 $ 6 8 9 10

K. a'a P%k%rjaan )an" s%(an" (i#aksanakan

No.Nama

P%k%rjaan

Bi(an"/ S&,Bi(an"

P%k%rjaanLokasi

P%m,%ri !&"as/ P%ja,a'P%m,&a' Komi'm%n

Kon'rak Pro"r%s !%rak+ir

NamaA#ama'/!%#%-on

No/!an""a#

Ni#ai Kon'rak4%nana5

4G5

Pr%s'asiK%rja4G5

1 2 3 $ 6 8 9 10

D%mikian Formir Isian K&a#i>ikasi ini sa)a ,&a' (%n"an s%,%narn)a (an -%n&+ rasa'an""&n" ja?a,. ika (ik%m&(ian +ari (i'%m&i ,a+?a (a'a/(ok&m%n )an" sa)a sam-aikan'i(ak ,%nar (an a(a -%ma#s&an maka sa)a ,%rs%(ia (ik%nakan sanksi ,%r&-a sanksia(minis'ra'i> sanksi -%nan'&man (a#am Da>'ar i'am "&"a'an s%ara -%r(a'a (an/a'a&-%#a-oran s%ara -i(ana k%-a(a -i+ak ,%r?%nan" s%s&ai (%n"an k%'%n'&an -%r&n(an"&n(an"an.

HHHHHHHHHH '%m-a' HH 'an""a# HHHHHHHHHH ,an 20HH 'a+&n

P%n)%(ia

r%ka'kan ma'%rai - .000 (an 'an(a 'an"an

4nama #%n"ka- 5


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22

Standar Dokumen Pengadaan



BAB a (an %mai# kan'or a,an" ,a(an

&sa+a )an" (a-a' (i+&,&n"i a-a,i#a -%s%r'a ,%rs'a'&s kan'or a,an".

B.

Lan(asan &k&m P%n(irian Ba(an Usa+a

1. Diisi (%n"an nomor 'an""a# nama No'aris -%n%r,i' ak'a -%n(irian

-%r&sa+aan/an""aran (asar ko-%rasi s%r'a &n'&k ,a(an &sa+a )an" ,%r,%n'&kP%rs%roan !%r,a'as (iisi nomor -%n"%sa+an K%m%n'%rian &k&m (an AM.

2. Diisi (%n"an nomor 'an""a# (an nama No'aris -%n%r,i' Ak'a P%r&,a+an '%rak+ir,a(an &sa+a a-a,i#a a(a. K+&s&s &n'&k P%rs%roan !%r,a'as jika '%r(a-a' -%r&,a+annama an""o'a Dir%ksi (an/a'a& D%?an Komisaris -a(a -%m,&k'ian k&a#i>ikasi-%s%r'a m%n&nj&kkan as#i (an m%m,%rikan sa#inan B&k'i P%m,%ri'a+&an (ariNo'aris s%#ak& k&asa Dir%ksi )an" '%#a+ (iaj&kan m%#a#&i Sismin,ak&m a'as Ak'aP%r&,a+an '%rak+ir.

;.

P%n"&r&s Ba(an Usa+a

1. Diisi (%n"an nama nomor K!P/SIM/Pas-or (an ja,a'an (a#am ,a(an &sa+aa-a,i#a ,%r,%n'&k P%rs%roan !%r,a'as.

2.

Diisi (%n"an nama nomor K!P (an ja,a'an (a#am ,a(an &sa+a.

.

Iin Usa+a

%nis iin &sa+a (is%s&aikan (%n"an ,i(an" &sa+a (an -%r'&ran -%r&n(an"&n(an"an.Un'&k -%rs)ara'an -%riinan ,a"i -%n)%(ia asin" (is%s&aikan (%n"an -rak'%k ,isnisin'%rnasiona# (an/a'a& k%'%n'&an n%"ara asa# -%n)%(ia jasa.

!a,%# Iin Usa+a

1. Diisi (%n"an j%nis s&ra' iin &sa+a nomor (an 'an""a# -%n%r,i'ann)a.2. Diisi (%n"an masa ,%r#ak& s&ra' iin &sa+a.3. Diisi (%n"an nama ins'ansi -%n%r,i' s&ra' iin &sa+a.

$.

Diisi (%n"an k&a#i>ikasi &sa+a6.

Diisi (%n"an k#asi>ikasi &sa+a

E.

Iin #ainn)a 4a-a,i#a (i-%rs)ara'kan5

1. Diisi (%n"an j%nis s&ra' iin nomor (an 'an""a# -%n%r,i'ann)a.2. Diisi (%n"an masa ,%r#ak& s&ra' iin.3. Diisi (%n"an nama ins'ansi -%n%r,i' s&ra' iin.

F.

a'a K%&an"an

1. Diisi (%n"an nama nomor K!P/SIM/-as-or a#ama' -%mi#ik sa+am/-%rs%ro (an-%rs%n'as% k%-%mi#ikan sa+am/-%rs%ro.

2. Pajak

a.

Diisi NP=P ,a(an &sa+a.,.

Diisi nomor (an 'an""a# ,&k'i La-oran Pajak !a+&n '%rak+ir ,%r&-a SP!!a+&nan.


25/32

23





P%rs)ara'an -ajak s%,a"aimana (imaks&( -a(a nomor 2 (ik%A&a#ikan &n'&k -%n)%(ia asin" 4k+&s&s &n'&k In'%rna'iona# ;om-%'i'ii% Bi((in"5 .

*.

a'a P%rsona#ia 4!%na"a a+ #i '%'a-5

Diisi (%n"an nama 'an""a#/,an/'a+&n #a+ir 'in"ka' -%n(i(ikan4SL!P/SL!A/S1/S2/S35 ja,a'an (a#am -%k%rjaan )an" -%rna+ (i#aksanakan #ama-%n"a#aman k%rja -ro>%si/k%a+#ian s%s&ai (%n"an S&ra' K%'%ran"an A+#i/S&ra'k%'%ran"an '%ram-i# (an 'a+&n -%n%r,i'an s%r'i>ika'/ijaa+ (ari s%'ia- '%na"aa+#i/'%knis )an" (i-%r#&kan.

.

a'a Fasi#i'as/P%ra#a'an/P%r#%n"ka-an 4jika (is)ara'kan o#%+ Pokja ULP5

Diisi (%n"an j%nis j&m#a+ ka-asi'as -a(a saa' ini m%r%k (an 'i-% 'a+&n -%m,&a'ankon(isi 4(a#am -%rs%n'as%5 #okasi k%,%ra(aan saa' ini (an s'a'&s k%-%mi#ikan 4mi#iks%n(iri/s%?a ,%#i/ (&k&n"an s%?a5 (ari masin"masin" >asi#i'as/ -%ra#a'an/-%r#%n"ka-an. B&k'i S'a'&s k%-%mi#ikan +ar&s (a-a' (i'&nj&kkan -a(a ?ak'&P%m,&k'ian K&a#i>ikasi.

I.

a'a P%n"a#aman P%r&sa+aan )an" Sama/S%j%nis (a#am K&r&n =ak'& 10 4S%-&+5

!a+&n !%rak+ir (%n"an S&,,i(an" Pak%' P%k%rjaan )an" ikom-%'isikan

Diisi (%n"an nama -ak%' -%k%rjaan ,i(an"/s&,,i(an" -%k%rjaan )an" (i-%rs)ara'kan#okasi '%m-a' -%#aksanaan -%k%rjaan nama (an a#ama'/'%#%-on (ari -%m,%ri'&"as/P%ja,a' P%m,&a' Komi'm%n nomor/'an""a# (an ni#ai kon'rak 'an""a# s%#%sai-ak%' -%k%rjaan m%n&r&' kon'rak (an 'an""a# ,%ri'a aara s%ra+ '%rima &n'&kmasin"masin" -ak%' -%k%rjaan s%#ama 10 4s%-&+5 'a+&n '%rak+ir.

.

a'a P%n"a#aman P%r&sa+aan (a#am K&r&n = ak'& $ 4%m-a'5 !a+&n !%rak+ir 4&n'&k

P%n)%(ia )an" '%#a+ ,%r(iri #%,i+ (ari 3 'a+& n a'a& #%,i+5.

Diisi (%n"an nama -ak%' -%k%rjaan #okasi '%m-a' -%#aksanaan -%k%rjaan nama (ana#ama'/'%#%-on (ari -%m,%ri '&"as/P%ja,a' P%m,&a' Komi'm%n nomor/'an""a# (anni#ai kon'rak s%r'a -%rs%n'as% -ro"r%s m%n&r&' kon'rak (an -%rs%n'as% -r%s'asi k%rja

'%rak+ir &n'&k P%n)%(ia )an" '%#a+ ,%r(iri k&ran" (ari 3 'a+&n a'a& #%,i+. Un'&kP%n)%(ia )an" ,ar& ,%r(iri k&ran" (ari 3 'a+&n 'i(ak ?aji, m%n"isi 'a,%# ini.

K.

a'a P%k%rjaan )an" s%(an" i#aksanakan

Diisi (%n"an nama -ak%' -%k%rjaan ,i(an"/s&,,i(an" -%k%rjaan (an #okasi '%m-a'-%#aksanaan -%k%rjaan nama (an a#ama'/'%#%-on (ari -%m,%ri '&"as/P%ja,a' P%m,&a'Komi'm%n nomor/'an""a# (an ni#ai kon'rak s%r'a -%rs%n'as% -ro"r%s m%n&r&' kon'rak(an -%rs%n'as% -r%s'asi k%rja '%rak+ir.


26/32

24





S&ra' P%rjanjian K%m i'raan/KSO

SUA! PEANIAN KEMI!AAN/

KEA SAMA OPEASI 4KSO5

S%+&,&n"an (%n"an s%#%ksi -%k%rjaan HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH )an"-%m,&kaan -%na?arann)a akan (i#ak&kan (i HHHHHHHHHHHHHHHHHHHHHHHH -a(a 'an""a#

HHHHHHHHHHHHH 20HHH maka : HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH nama -%s%r'a 1 HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH nama -%s%r'a 2 HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH nama -%s%r'a 3 HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH (an s%'%r&sn)a

,%rmaks&( &n'&k m%n"ik&'i s%#%ksi (an -%#aksanaan kon'rak s%ara ,%rsamasama (a#am ,%n'&kk%mi'raan/K%rja Sama O-%rasi 4KSO5.

Kami m%n)%'&j&i (an m%m&'&skan ,a+?a

1. S%ara ,%rsamasama:

a. M%m,%n'&k k%mi'raan/KSO (%n"an nama k%mi'raan/KSO a(a#a+ HHHHHHHHHHHHHHHHHHHHHHH

,. M%n&nj&k HHHHHHHHHHHHHHHHHHHHHHHHH nama -%s%r'a 1 s%,a"ai -%r&sa+aan&'ama 4#%a(in" >irm5 &n'&k k%mi'raan/KSO (an m%?aki#i s%r'a ,%r'in(ak &n'&k (ana'as nama k%mi'raan/KSO.

. M%n)%'&j&i a-a,i#a (i'&nj&k s%,a"ai -%m%nan" ?aji, ,%r'an""&n" ja?a, ,aik s%ara,%rsamasama a'a& masin"masin" a'as s%m&a k%?aji,an s%s&ai k%'%n'&an (ok&m%nkon'rak.

2.

K%ik&'s%r'aan mo(a# 4s+arin"5 s%'ia- -%r&sa+aan (a#am k%mi'raan/KSO a(a#a+: HHHHH nama -%s%r'a 1 s%,%sar HHHHH G 4HHHHHHHHHHHHHHHHHHHH -%rs%n5 HHHHH nama -%s%r'a 1 s%,%sar HHHHH G 4HHHHHHHHHHHHHHHHHHHH -%rs%n5 HHHHH nama -%s%r'a 1 s%,%sar HHHHH G 4HHHHHHHHHHHHHHHHHHHH -%rs%n5 HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH (an s%'%r&sn)a.

3. Masin"masin" -%s%r'a an""o'a k%mi'raan/KSO akan m%n"am,i# ,a"ian s%s&ai s+arin" '%rs%,&' -a(a ,&'ir 2. (a#am +a# -%n"%#&aran k%&n'&n"an (an k%r&"ian (arik%mi'raan/KSO.

$. P%m,a"ian s+arin" (a#am k%mi'raan/KSO ini 'i(ak akan (i&,a+ ,aik s%#ama masa

-%na?aran ma&-&n s%-anjan" masa kon'rak k%&a#i (%n"an -%rs%'&j&an '%r'is'%r#%,i+ (a+& (ari Pokja ULP a'a& P%ja,a' P%m,&a' Komi'm%n 4PPK5 (an -%rs%'&j&an,%rsama s%ara '%r'is (ari masin"masin" an""o'a k%mi'raan/KSO.

6. !%r#%-as (ari s+arin" )an" (i'%'a-kan (ia'as masin"masin" an""o'a k%mi'raan/KSOakan m%#ak&kan -%n"a?asan -%n&+ '%r+a(a- s%m&a as-%k -%#aksanaan (ari -%rjanjianini '%rmas&k +ak &n'&k m%m%riksa k%&an"an -%rin'a+ -%m,%#ian 'an(a '%rima (a>'ar-%ra#a'an (an '%na"a k%rja -%rjanjian s&,kon'rak s&ra'm%n)&ra' '%#%ks (an #ain#ain.

. =%?%nan" m%nan(a'an"ani &n'&k (an a'as nama k%mi'raan/KSO (i,%rikan k%-a(a HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH nama ?aki# -%s%r'a )an" (i,%ri k&asa (a#amk%(&(&kann)a s%,a"ai -%mim-in/(ir%k'&r &'ama -%r&sa+aan

HHHHHHHHHHHHHHHHHHH nama -%s%r'a 1 ,%r(asarkan -%rs%'&j&an '%r'is (ari HHHHHHHHHHHHHHHHHHH nama -%s%r'a 2 HHHHHHHHHHHHHHHHHHH nama -%s%r'a 3

C O N T O H


27/32

25





HHHHHHHHHHHHHHHHHHH (an s%'%r&sn)a s%+&,&n"an (%n"an s&,s'ansi (an s%m&ak%'%n'&an (a#am s%m&a (ok&m%n )an" akan (i 'an(a'an"ani.

. P%rjanjian ini akan ,%r#ak& s%jak 'an""a# (i'an(a'an"ani.

8. P%rjanjian ini s%ara o'oma'is m%nja(i ,a'a# (an 'i(ak ,%r#ak& #a"i ,i#a s%#%ksi 'i(ak(im%nan"kan o#%+ -%r&sa+aan k%mi'raan/KSO.

9.

P%rjanjian ini (i,&a' (a#am ran"ka- HHHHH 4HHHHHHHHHHHHHHHHHHH5 )an" masin"masin" m%m-&n)ai k%k&a'an +&k&m )an" sama.

EN*AN KESEPAKA!AN INI

s%m&a an""o'a k%mi'raan/KSO m%m,&,&+kan 'an(a 'an"an (i HHHHHHHHHHHHHHHHHHH -a(a +ari HHHHHHHHHHHHHH 'an""a# HHHHHHHHHHHHHH ,an HHHHHHHHHHHHHH 'a+&n HHHHHHHHHHHHHH.

P%n)%(ia 1 P%n)%(ia 2 P%n)%(ia 3

4HHHHHHHHHHHHHH5 4HHHHHHHHHHHHHH5 4HHHHHHHHHHHHHH5

(an s%'%r&sn)a

4HHHHHHHHHHHHHH5

;a'a'an :S&ra' P%rjanjian K%mi'raan/K%rja Sama O-%rasi ini +ar&s (i,&a' (i a'as k%r'as s%"%#/,%rma'%rai.


28/32

26





BAB ikasi )an" '%r(iri (ari:1. -%ni#aian P%rs)ara'an A(minis'rasi K&a#i>ikasi )an" (i#ak&kan (%n"an Sis'%m *&"&r@

(an2. %a#&asi P%rs)ara'an !%knis K&a#i>ikasi )an" (i#ak&kan (%n"an Sis'%m Ni#ai &n'&k

m%n"+asi#kan ;a#on Da>'ar P%n(%k.

B. P%ni#aian P%rs)ara'an A(minis'rasi K&a#i>ikasi +ar&s m%m%n&+i -%rs)ara'an s%,a"ai,%rik&':

1. (a'a k&a#i>ikasi &n'&k -%s%r'a )an" m%#ak&kan k%mi'raan/K%rja Sama O-%rasi(isam-aikan o#%+ -%ja,a' )an" m%n&r&' -%rjanjian K%mi'raan/ K%rja Sama O-%rasi,%r+ak m%?aki#i K%mi'raan/KSO@

2. m%mi#iki s&ra' iin &sa+a s%s&ai (%n"an -%ra'&ran -%r&n(an"&n(an"an s%s&ai-%rs)ara'an LDK@

3. -%r&sa+aan )an" ,%rsan"k&'an (an manaj%m%nn)a 'i(ak (a#am -%n"a?asan-%n"a(i#an 'i(ak -ai#i' k%"ia'an &sa+an)a 'i(ak s%(an" (i+%n'ikan (an/a'a& (ir%ksi

)an" ,%r'in(ak &n'&k (an a'as nama -%r&sa+aan 'i(ak s%(an" (a#am m%nja#ani sanksi-i(ana@

$. sa#a+ sa'& (an/a'a& s%m&a -%n"&r&s (an ,a(an &sa+an)a 'i(ak mas&k (a#am (a>'ar+i'am@

6. m%mi#iki NP=P (an '%#a+ m%m%n&+i k%?aji,an -%r-ajakan 'a+&n -ajak '%rak+ir 4SP!!a+&nan s%s&ai )an" (i-%rs)ara'kan -a(a LDK5P%rs)ara'an -%r-ajakan (ik%A&a#ikan &n'&k P%n)%(ia asin" 4k+&s&s &n'&kIn'%rna'iona# ;om-%'i'i% Bi((in"5 @

. m%m-%ro#%+ -a#in" s%(iki' 1 4sa'&5 -%k%rjaan s%,a"ai -%n)%(ia jasa kons'ansi (a#amk&r&n ?ak'& $ 4%m-a'5 'a+&n '%rak+ir ,aik (i #in"k&n"an -%m%rin'a+ ma&-&n s?as'a'%rmas&k -%n"a#aman s&,kon'rak@

. m%mi#iki k%mam-&an -a(a s&, ,i(an" -%k%rjaan )an" s%s&ai@

8.

m%mi#iki k%mam-&an m%n)%(iakan >asi#i'as (an -%ra#a'an s%r'a -%rsoni# )an"(i-%r#&kan &n'&k -%#aksanaan -%k%rjaan@9. m%n)am-aikan (a>'ar -%ro#%+an -%k%rjaan )an" s%(an" (ik%rjakan@10. (a#am +a# -%s%r'a akan m%#ak&kan k%mi'raan/KSO:

a. ?aji, m%m-&n)ai -%rjanjian K%rja Sama O-%rasi/k%mi'raan )an" m%m&a'-%rs%n'as% k%mi'raan (an -%r&sa+aan )an" m%?aki#i k%mi'raan '%rs%,&'@

,. %a#&asi -%rs)ara'an a(minis'rasi k&a#i>ikasi -a(a an"ka 1 sam-ai (%n"an an"ka (i#ak&kan '%r+a(a- s%#&r&+ -%s%r'a )an" '%r"a,&n" (a#am K%rja SamaO-%rasi/k%mi'raan@

. %a#&asi -%rs)ara'an -a(a an"ka 8 %a#&asi -%rs)ara'an (i"a,&n"kan s%,a"ai%a#&asi k%mi'raan/KSO.

11. m%mi#iki s%r'i>ika' manaj%m%n m&'& ISO a'a& -%rs)ara'an #ain s%-%r'i -%ra#a'an

k+&s&s '%na"a a+#i s-%sia#is )an" (i-%r#&kan a'a& -%n"a#aman '%r'%n'& a-a,i#a(is)ara'kan. Un'&k Ba(an Usa+a )an" ,%rmi'ra -%rs)ara'an ini (is)ara'kan ,a"i-%r&sa+aan )an" m%#aksanakan -%k%rjaan )an" m%m,&'&+kan s%r'i>ika' a'a&-%rs)ara'an #ainn)a '%rs%,&'@

12. ,a"i -%s%r'a &n'&k -%k%rjaan kom-#%ks )an" akan m%#ak&kan k%mi'raan/k%rja samao-%rasi +ar&s m%m,&a' S&ra' P%rjanjian K%mi'raan/K%rja Sama O-%rasi

;. P%s%r'a )an" m%m%n&+i P%rs)ara'an A(minis'rasi K&a#i>ikasi (i#anj&'kan (%n"anm%#ak&kan Ea#&asi P%rs)ara'an !%knis K&a#i>ikasi.

D. A-a,i#a 'i(ak a(a P%s%r'a )an" m%m%n&+i P%rs)ara'an A(minis'rasi K&a#i>ikasi makas%#%ksi (in)a'akan "a"a#.


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E. Ea#&asi P%rs)ara'an !%knis K&a#i>ikasi (%n"an kri'%ria -%ni#aian -%n"a#aman -%r&sa+aan-a(a -%k%rjaan )an" s%j%nis (an kom-#%ksi'as )an" s%'ara s%r'a k%(&(&kan -%s%r'a s%,a"ai,%rik&' :

1. P%n"a#aman -a(a -%k%rjaan s%j%nis@Di+i'&n" j&m#a+ -ak%' -%n"a#aman -%r&sa+aan -a(a -%k%rjaan )an" s%s&ai (%n"an

)an" (i-%rs)ara'kan (a#am L%m,ar Da'a K&a#i>ikasi 4LDK5 &r&> D an"ka 2 &m#a+-ak%' -%n"a#aman -%r&sa+aan )an" -a#in" ,an)ak (ija(ikan -%m,an(in" &n'&km%n(a-a'kan ni#ai. Ni#ai )an" (i-%ro#%+ (ika#i (%n"an ,o,o' )an" (i'%n'&kan (a#amLDK. &m&san -%n"+i'&n"an s%,a"ai ,%rik&':

NP X =

× 100 × Bobot Sub Unsur

K%'%ran"an: Nama -%r&sa+aan -%s%r'a k&a#i>ikasiNP Ni#ai P%n"a#aman

PP &ma+ P%n"a#aman P%r&sa+aan

;on'o+ :Nama

P%r&sa+aan

&m#a+ Pak%'

P%n"a#aman

S%j%nis

Bo,o'

4$066G5

Ni#ai P%n"a#aman

1 2 3 4

P!. A 20 $0G 20

40 × 100 × 40% = 20

P!. B 10 $0G 10

40

× 100 × 40% = 10

P!. ; $04'%r'in""i5

$0G 40

40 × 100 × 40% = 40

2. K%s%s&aian ,%saran ni#ai -%k%rjaan s%j%nis )an" -%rna+ (is%#%saikan (%n"an ni#ai-%k%rjaan )an" akan (ikom-%'isikan (i+i'&n" ,%r(asarkan

ni#ai kon'rak '%r'in""i.

Ni#ai kon'rak kon'rak '%r'in""i )an" sama (%"an a'a& #%,i+ ,%sar (ari PS (i,%ri ni#aimaksima# (an '%'a- 4(a-a' (ikon%rsi ,%r(asarkan ni#ai -a(a saa' -%k%rjaan(i#aksanakan5. Ni#ai kon'rak )an" k&ran" (ari PS (i,%ri ni#ai (%n"an ara

m%m,an(in"kan ni#ai kon'rak '%rs%,&' (%n"an ni#ai PS -ak%' -%k%rjaan.&m&san -%r+i'&n"an s%,a"ai ,%rik&':

a5 Un'&k ni#ai kon'rak '%r'in""i #%,i+ ,%sar a'a& sama (%n"an PS.

!"# = $&'&( × 100)

,5 Un'&k ni#ai kon'rak k&ran" (ari PS.

!"# =*+,* !&-(.,/ .(*-*

3"# × 100 × &'&(

Keterangan :NKPS = Nilai Kesesuaian Pekerjaan Sejenis


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;on'o+ :PS - 600.000.000

Nama

P%r&sa+aan

NP!

4-5

Bo,o'

436$6G5

NKPS

1 2 3 4

P!. A 1.000.000.000 $6G 45

P!. B 660.000.000 $6G 45

P!. ; $00.000.000 $6G 36

3. P%n"a#aman P%k%rjaan -a(a #okasi )an" sama -a(a 'in"ka' Ka,&-a'%n/Ko'a@Di+i'&n"

j&m#a+ -ak%'

-%n"a#aman -%r&sa+aan -a(a -%k%rjaan )an" s%s&ai -a(a

'in"ka' Ka,&-a'%n/Ko'a. &m#a+ -ak%' -%n"a#aman -%r&sa+aan )an" -a#in" ,an)ak-a(a 'in"ka' Ka,&-a'%n/Ko'a '%rs%,&' (ija(ikan -%m,an(in" &n'&k m%n(a-a'kanni#ai. Ni#ai )an" (i-%ro#%+ (ika#i (%n"an ,o,o' )an" (i'%n'&kan (a#am LDK. &m&san-%n"+i'&n"an s%,a"ai ,%rik&':

" 5 = 6"" 5

6"" .(*-* × 100 × &'&( #7' 8-97.

K%'%ran"an: Nama -%r&sa+aanNPL Ni#ai P%n"a#aman (i Lokasi

PPL &m#a+ P%n"a#aman P%r&sa+aan (i Lokasi

;on'o+ :a5 Lokasi -%k%rjaan (i Ka,&-a'%n )an" ,%ra(a (i Proinsi 7.

Nama

P%r&sa+aan

&m#a+ Pak%'

P%n"a#aman

S%j%nis -a(a

Ka,&-a'%n/Ko'a

HHHHHHHHHH

Bo,o'

4616G5

Ni#ai P%n"a#aman

S%j%nis -a(a

Ka,&-a'%n/Ko'a

4NPL5

1 2 3 4

P!. A 104'%r'in""i5

10G 10

10 × 100 × 10% = 10

P!. B 10G :

10 × 100 ×10% = :

P!. ; 8 10G ;

10 × 100 ×10% = ;

,5 Lokasi -%k%rjaan (i ?i#a)a+ Proinsi DKI akar'aUn'&k j&m#a+ -ak%' -%n"a#aman s%j%nis (i ?i#a)a+ Proinsi DKI akar'a 'i(ak(i,%(akan ?i#a)a+ a(minis'rasi (i ,a?a+n)an)a.


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Nama

P%r&sa+aan

&m#a+ Pak%'

P%n"a#aman

S%j%nis (i

Proinsi KI

akar'a

Bo,o'

4616G5

Ni#ai P%n"a#aman

S%j%nis -a(a

Ka,&-a'%n/Ko'a

4NPL5

1 2 3 4

P!. A 104'%r'in""i5

10G 10

10 × 100 × 10% = 10

P!. B 10G :

10

× 100 ×10% = :

P!. ; 8 10G ;

10 × 100 ×10% = ;

$. Domisi#i P%r&sa+aan In(&k 4'in"ka' Proinsi/Ka,&-a'%n/Ko'a k%&a#i Proinsi DKI akar'a5.

;on'o+:a5 Lokasi -%k%rjaan (i Ka,&-a'%n Proinsi 7.

Nama

P%r&sa+aan

omisi#i

P%r&sa+aan In(&k

Bo,o'

46G5

Ni#ai omisi#i

4Bo,o' 1005

1 2 3 4

P!. A Proinsi 7 6G 6

P!. B Ka,&-a'%n 6G 6

P!. ; Proinsi DKI 6G 0

,5 Lokasi -%k%rjaan (i Ko'a akar'a P&sa' Proinsi DKI akar'a 'i(ak -%r#& (i,%rikan,o,o' -%ni#aian.

Nama

P%r&sa+aan

omisi#i

P%r&sa+aan In(&k

Bo,o'

40G5

Ni#ai omisi#i

4Bo,o' 1005

1 2 3 4

P!. A Proinsi 7 0G 0

P!. B Ka,&-a'%n 0G 0

P!. ; Proinsi DKI 0G 0


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6. &m#a+ ,o,o' 1 2 3 (an $ sama (%n"an 100G

;on'o+:Nama

P%r&sa+aan

Ni#ai

P%n"a#aman

NKPS Ni#ai

P%n"a#aman

S%j%nis -a(a

Ka,&-a'%n/Ko'a

Ni#ai

omisi#iJ5

!o'a#

Bo,o' $0G Bo,o' $6G Bobot 10% Bobot 5% 100%

1 2 3 4 5 6

P!. A 20 $6 10 6 80P!. B 10 $6 6 P!. ; $0 3 8 0 8$

J5 Li+a' on'o+ -a(a an"ka $ +&r&> a5

F. P%s%r'a )an" m%m%n&+i P%rs)ara'an !%knis K&a#i>ikasi (imas&kan s%,a"ai ;a#on Da>'arP%n(%k (i#anj&'kan (%n"an P%m,&k'ian K&a#i>ikasi.

*. A-a,i#a 'i(ak a(a )an" m%m%n&+i P%rs)ara'an !%knis k&a#i>ikasi maka s%#%ksi (in)a'akan "a"a#.

. Pokja ULP m%m%riksa (an m%m,an(in"kan an'ara -%rs)ara'an -a(a Dok&m%n K&a#i>ikasi(%n"an (a'a k&a#i>ikasi -%s%r'a )an" '%ran'&m -a(a a-#ikasi SPSE (a#am +a#:

1. k%#%n"ka-an Da'a K&a#i>ikasi@ (an2. -%m%n&+an -%rs)ara'an k&a#i>ikasi.

I. Formir Isian K&a#i>ikasi &n'&k KSO )an" 'i(ak (i,&,&+i ma'%rai 'i(ak (i"&"&rkan-%s%r'a (imin'a &n'&k m%m,a)ar (%n(a ma'%rai s%s&ai k%'%n'&an -%ra'&ran -%r&n(an"&n(an"an.

. A-a,i#a (i'%m&kan +a#+a# (an/a'a& (a'a )an" k&ran" j%#as maka Pokja ULP (a-a'm%min'a -%s%r'a &n'&k m%n)am-aikan k#ari>ikasi s%ara '%r'is nam&n 'i(ak ,o#%+m%n"&,a+ s&,s'ansi Da'a K&a#i>ikasi )an" '%#a+ (ikirimkan m%#a#&i a-#ikasi SPSE.

K. Ea#&asi K&a#i>ikasi ,%#&m m%r&-akan kom-%'isi maka (a'a k&a#i>ikasi )an" k&ran" (a-a'(i#%n"ka-i -a#in" #am,a' s%,%#&m ,a'as ak+ir -%mas&kan Da'a K&a#i>ikasi.

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