SURAT LAMPIRAN PENAWARAN HARGA

NOMOR: 35/UMA-SPH/VIII/2016
PENGADAAN BELANJA BMHP BAHAN GIGI
UPTD YANKES KECAMATAN ARJASARI
KABUPATEN BANDUNG - THN 2016

NO NAMA BARANG BMHP MERK VOLUME

1 Alvolgyl SEPTODONT 4
2 Amalgam Vivacap NR2 INVOCLAR 1
3 Aniosyme Desinfektan Descoton Forte 1
4 Applicator Brush DEFEND 4
5 Biosel Biodinamika BIODINAMIKA 1
6 Bonding MEGADENTA 1
7 Bur Pita Kuning Lurus SHARP 3
8 Bur Pita Kuning Round SHARP 3
9 Biru Tulang Fissure Panjang SSW 2
10 Bur Tulang Fissure Pendek PRIMAX 2
11 Bur Tulang Round SSW 2
12 Cal LC Denpro DENPRO 1
13 Cresophene/Rockle SEPTODONT 4
14 Curaspon GELITASPHON 8
15 D-Pulp D-PULP 2
16 Endomethasone SEPTODONT 3
17 Guttae Percha 15-40 INDODENT 4
18 Guttae Percha 45-80 INDODENT 5
19 Jarum Citoject 0,3 x 16 mm MORITA 10
20 Jarum Ekstirpasi Uk. 14 - 45 DENTSPLY 2
21 Jarum Ekstirpasi Uk. 50 - 80 DENTSPLY 2
22 Jarum K File Uk. 15 - 40 dan 45 - 80 DENTSPLY 2
23 Jarum Morita 0,3 x 12 mm MORITA 2
24 Jarum Reamer Uk. 15 - 45 dan 50 - 80 DENTSPLY 2
25 Mata Bur Arkansas Bundar ALPINE 5
26 Mata Bur Arkansas Cemara ALPINE 4
27 Mata Bur Arkansas Fissure ALPINE 4
28 Mata Bur Arkansas Nyala Api ALPINE 4
29 Matrix band ivory CARLMARTIN 2
30 Matrix Band Lurus FKG 2
31 Matrix Holder Ivory YAMACO 2
32 Matrix Holder Lurus YAMACO 2
33 OCO Dental implant OCO 5
34 Oil Hight Speed Dental Unit BENDECT 2
35 Paper Point 15-40 INDODENT 4
36 Paper Point 45-80 INDODENT 4
37 Polishing strip MACRODONT 24
38 Saliva Ejector Disposible CROSS 11
39 Slaber Pasien RRC 4
40 Tambalan Composit (Ething , Bonding) COLTENE 3
41 Tip Scaler B5 2
 SATUAN HARGA SATUAN JUMLAH HARGA
BOTOL 450,000 1,800,000
Kotak 2,180,000 2,180,000
Galon/5 ltr 585,000 585,000
PAK/100 85,000 340,000
kit 320,000 320,000
BOTOL/5ML 320,000 320,000
BUAH 40,000 120,000
BUAH 40,000 120,000
BUAH 76,000 152,000
BUAH 140,000 280,000
BUAH 76,000 152,000
TUBE 228,000 228,000
BOTOL 674,000 2,696,000
BOX/50 PCS 387,000 3,096,000
TUBE/7,5 GR 410,000 820,000
BOTOL 645,000 1,935,000
PAK 45,000 180,000
PAK 45,000 225,000
BOX/100 158,000 1,580,000
SET 145,000 290,000
SET 145,000 290,000
SET 205,000 410,000
DUS 158,000 316,000
set 205,000 410,000
BUAH 29,000 145,000
BUAH 29,000 116,000
BUAH 29,000 116,000
BUAH 29,000 116,000
BUAH 140,000 280,000
BUAH 99,000 198,000
BUAH 125,000 250,000
BUAH 125,000 250,000
BOTOL/15 ML 130,000 650,000
KLG/450 ML 350,000 700,000
Lembar 45,000 180,000
Lembar 45,000 180,000
PAK/150 PCS 140,000 3,360,000
PAK/100 64,000 704,000
PAK/50 75,000 300,000
SET 1,750,000 5,250,000
SET/5 PCS 580,000 1,160,000
 Jumlah 32,800,000
PPn 10% 3,280,000
Jumlah total 36,080,000

Penawar,
CV. USAHA MANDIRI ABADI

DIAN PRIATMAN
DIREKTUR
 SURAT PENGIRIMAN BARANG 100%
Nomor: 04/SPB/UMA/IX/2016, Tanggal 19 September 2016
Kepada Yth,
Penerima/Pemeriksa Barang
PENGADAAN BELANJA BMHP BAHAN GIGI
UPTD YANKES KECAMATAN ARJASARI
KABUPATEN BANDUNG - THN 2016
NO NAMA BARANG BMHP MERK VOLUME
1 Alvolgyl SEPTODONT 4
2 Amalgam Vivacap NR2 INVOCLAR 1
3 Aniosyme Desinfektan Descoton Forte 1
4 Applicator Brush DEFEND 4
5 Biosel Biodinamika BIODINAMIKA 1
6 Bonding MEGADENTA 1
7 Bur Pita Kuning Lurus SHARP 3
8 Bur Pita Kuning Round SHARP 3
9 Bur Tulang Fissure Panjang SSW 2
10 Bur Tulang Fissure Pendek PRIMAX 2
11 Bur Tulang Round SSW 2
12 Cal LC Denpro DENPRO 1
13 Cresophene/Endosoptone SEPTODONT 4
14 Curaspon GELITASPHON 8
15 D-Pulp D-PULP 2
16 Endomethasone SEPTODONT 3
17 Guttae Percha 15-40 INDODENT 4
18 Guttae Percha 45-80 INDODENT 5
19 Jarum Citoject 0,3 x 16 mm MORITA 10
20 Jarum Ekstirpasi Uk. 14 - 45 DENTSPLY 2
21 Jarum Ekstirpasi Uk. 50 - 80 DENTSPLY 2
22 Jarum K File Uk. 15 - 40 dan 45 - 80 DENTSPLY 2
23 Jarum Morita 0,3 x 12 mm MORITA 2
24 Jarum Reamer Uk. 15 - 45 dan 50 - 80 DENTSPLY 2
25 Mata Bur Arkansas Bundar ALPINE 5
26 Mata Bur Arkansas Cemara ALPINE 4
27 Mata Bur Arkansas Fissure ALPINE 4
28 Mata Bur Arkansas Nyala Api ALPINE 4
29 Matrix band ivory CARLMARTIN 2
30 Matrix Band Lurus FKG 2
31 Matrix Holder Ivory YAMACO 2
32 Matrix Holder Lurus YAMACO 2
33 OCO Dental implant OCO 5
34 Oil Hight Speed Dental Unit BENDECT 2
35 Paper Point 15-40 INDODENT 4
36 Paper Point 45-80 INDODENT 4
37 Polishing strip MACRODONT 24
38 Saliva Ejector Disposible CROSS 11
39 Slaber Pasien RRC 4
40 Tambalan Composit (Ething , Bonding) COLTENE 3
41 Tip Scaler B5 2

Penerima Barang,

.
%
016

SATUAN KETERANGAN
BOTOL
Kotak
Galon/5 ltr
PAK/100
kit
BOTOL/5ML
BUAH
BUAH
BUAH
BUAH
BUAH
TUBE
BOTOL
BOX/50 PCS
TUBE/7,5 GR
BOTOL
PAK
PAK
BOX/100
SET
SET
SET
DUS
set
BUAH
BUAH
BUAH
BUAH
BUAH
BUAH
BUAH
BUAH
BOTOL/15 ML
KLG/450 ML
Lembar
Lembar
PAK/150 PCS
PAK/100
PAK/50
 SET
SET/5 PCS

Pengirim barang,
CV. USAHA MANDIR

DIAN PRIATMAN
DIREKTUR
 FAKTUR BARANG
NOMOR: 40/UMA-Fact/IX/2016, tgl, 19 September 2016

PENGADAAN BELANJA BMHP BAHAN GIGI

UPTD YANKES KECAMATAN ARJASARI
KABUPATEN BANDUNG - THN 2016

NO NAMA BARANG BMHP VOLUME SATUAN

1 Alvolgyl 4 BOTOL
2 Amalgam Vivacap NR2 1 Kotak
3 Aniosyme Desinfektan 1 Galon/5 ltr
4 Applicator Brush 4 PAK/100
5 Biosel Biodinamika 1 kit
6 Bonding 1 BOTOL/5ML
7 Bur Pita Kuning Lurus 3 BUAH
8 Bur Pita Kuning Round 3 BUAH
9 Biru Tulang Fissure Panjang 2 BUAH
10 Bur Tulang Fissure Pendek 2 BUAH
11 Bur Tulang Round 2 BUAH
12 Cal LC Denpro 1 TUBE
13 Cresophene/Rockle 4 BOTOL
14 Curaspon 8 BOX/50 PCS
15 D-Pulp 2 TUBE/7,5 GR
16 Endomethasone 3 BOTOL
17 Guttae Percha 15-40 4 PAK
18 Guttae Percha 45-80 5 PAK
19 Jarum Citoject 0,3 x 16 mm 10 BOX/100
20 Jarum Ekstirpasi Uk. 14 - 45 2 SET
21 Jarum Ekstirpasi Uk. 50 - 80 2 SET
22 Jarum K File Uk. 15 - 40 dan 45 - 80 2 SET
23 Jarum Morita 0,3 x 12 mm 2 DUS
24 Jarum Reamer Uk. 15 - 45 dan 50 - 80 2 set
25 Mata Bur Arkansas Bundar 5 BUAH
26 Mata Bur Arkansas Cemara 4 BUAH
27 Mata Bur Arkansas Fissure 4 BUAH
28 Mata Bur Arkansas Nyala Api 4 BUAH
29 Matrix band ivory 2 BUAH
30 Matrix Band Lurus 2 BUAH
31 Matrix Holder Ivory 2 BUAH
32 Matrix Holder Lurus 2 BUAH
33 OCO Dental implant 5 BOTOL/15 ML
34 Oil Hight Speed Dental Unit 2 KLG/450 ML
35 Paper Point 15-40 4 Lembar
36 Paper Point 45-80 4 Lembar
37 Polishing strip 24 PAK/150 PCS
38 Saliva Ejector Disposible 11 PAK/100
39 Slaber Pasien 4 PAK/50
40 Tambalan Composit (Ething , Bonding) 3 SET
41 Tip Scaler 2 SET/5 PCS
NG
September 2016

HARGA SATUAN JUMLAH HARGA

450,000 1,800,000
2,180,000 2,180,000
585,000 585,000
85,000 340,000
320,000 320,000
320,000 320,000
40,000 120,000
40,000 120,000
76,000 152,000
140,000 280,000
76,000 152,000
228,000 228,000
674,000 2,696,000
387,000 3,096,000
410,000 820,000
645,000 1,935,000
45,000 180,000
45,000 225,000
158,000 1,580,000
145,000 290,000
145,000 290,000
205,000 410,000
158,000 316,000
205,000 410,000
29,000 145,000
29,000 116,000
29,000 116,000
29,000 116,000
140,000 280,000
99,000 198,000
125,000 250,000
125,000 250,000
130,000 650,000
350,000 700,000
45,000 180,000
45,000 180,000
140,000 3,360,000
64,000 704,000
75,000 300,000
1,750,000 5,250,000
 580,000 1,160,000
Jumlah 32,800,000
PPn 10% 3,280,000
Jumlah total 36,080,000

Penawar,
CV. USAHA MANDIRI ABADI

DIAN PRIATMAN
DIREKTUR