PT EGIS INTERNATIONAL INDONESIA Mission Order / Report of Expenses

(To be cpmpleted at lest 48 hrs before departure)

Mission order n°: Date : 07 Aug' 2018

Report of expenses Employee name :

SEPTIYAN EKA WIBISANA
n°:

Employee number: Department : Operation

User
Position : Assistant Engineer Operation
department :

PURPOSE OF THE MISSION (to be filled by the Employee)

Indonesia City of the Lampung

Country of the mission :
mission :
Project number : PS126 Name of Project : Proyek Pendampingan Desain Toll Terbanggi - Kayu Agung

Means of transport : by Air Plan

Purpose of the mission : Assist Lead Structure to deliver alternate design for Slab, PGN Bridge.

Real (to be filled by

Schedule Forecasted (to be filled by employee) employee after the
mission)
Date Time Date Time

Departure date : 8/8/2018 4:00 8/8/2018 4:00

Return date : 8/11/2018 17:30 8/11/2018 17:30

CONDITIONS OF MISSION
Recommendation : Be sure to have taken all the needed phone numbers from the office and from the site (hotels, clients, partners, colleagues,.....…)

a/ Particular conditions

Other currency used (except IDR, EUR, USD) - if applicable : -

b/ Budget of mission: c/ Real cost of mission:

Claimable Cash Statement of expenses (After return)

Amount Qty Total Paid by Egis Object No
to Client Advance

Currency Currency Amount Currency Qty Total Currency

Y/N Y/N Y/N
Perdiem (if applicable)* 400,000.00 IDR 4.00 1,600,000.00 IDR NO YES 400,000.00 IDR 4.00 1,600,000.00 IDR
IDR IDR NO NO Online Taxi 178,000.00 IDR 1 178,000.00 IDR
Taxi or general transport
IDR IDR NO NO Train 106,923.00 IDR 1 106,923.00 IDR
Airplane IDR IDR YES NO NO Airplane IDR IDR
Hotel IDR 3 IDR YES NO YES Hotel IDR 3 IDR
IDR IDR NO NO IDR IDR
Gasoline
EUR EUR NO NO EUR EUR

Meals with client (each NO NO

count for 0,5 perdiem) NO NO
IDR IDR NO NO Hostel 100,000.00 IDR 1 100,000.00 IDR
Miscellaneous
IDR IDR NO NO Toll & Airport Parking 35,000.00 IDR 1 35,000.00 IDR

Claimable Non Claimable Total Claimable Non Claimable Total

IDR 1,600,000.00 1,600,000.00 IDR IDR 2,019,923.00 2,019,923.00 IDR
USD USD USD USD
EUR EUR EUR EUR
- - - -
Equivalent TOTAL IDR 1,600,000.00 1,600,000.00 IDR Equivalent TOTAL IDR 2,019,923.00 2,019,923.00 IDR

Cash advance amount Cash return Cash Adv. Reimbursement

Exchange currency rate to IDR
1,600,000.00 IDR IDR IDR
on date of Mission Order Note : no Cash 419,923.00
Note : no Cash
Advance if amount
EUR 14,925.38 USD USD Reimbursement if amount USD
paid by Company
or see sheet paid by Company directly
Exchange Rate Online directly EUR EUR EUR
"Exchange rate"
USD 13,325.00 - - -
or see sheet Equivalent Equivalent Equivalent
Exchange Rate Online 1,600,000.00 IDR IDR 419,923.00 IDR
"Exchange rate" TOTAL TOTAL TOTAL
-
* Perdiem are calculated on the following formula basis : (number of nights out of home) + (0,5 if the mission is
Total reimbursement 419,923.00 IDR
Exchange Rate Online over before 12:00 AM or if the mission finishes later than 12:00 AM).
Besides, each lunch or dinner with invitation of the client costs 0,5 perdiem. To be paid by the company to the employee

Signature of employee Signature of employee’s Head of Dept./ H.R. Signature of President Director

Report about mission:

Yes / No
Minutes of meeting
Other Date: Date: Date:

Mandatory for reimbursement. cc. : - Employee - Related Head of Department / Director / President Director
Form should be return at the latest three working days
Form to be submitted at least: 48 Hours before departure if airplane is necessary, 24 Hours if no plane
Reimbursement: after return, or on date of time sheets, at the earliest.
In case of departure without form completed, there will be no cash advance
In case of delay without reasons, a malus will be applied.
All thermic papers should be copied on Xerox machine
together with original
All proof of expenses should be given, and classified by
This is an individual form, each employee has to complete one before departure, for Insurance especially date.
Notes or Comments :

C:\Users\Septiyan\Downloads\180808_MO_Lampung ke-2_Septiyan