Tagihan Apotek 19-23 Maret.xlsx
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APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 19 MARET 2018 No.
1
SUPPLIER
PARIT PADANG G
Factur Date
Due Date
AMOUNT
17-Feb-18
10-Mar-18
439,780
17-Feb-18
13-Mar-18
253,347
17-Feb-18
14-Mar-18
858,816
TOTAL
1,551,943
2
TOMBO URIP
07-Feb-18
09-Mar-18
625,037
625,037
3
UNITED DICO
26-Feb-18
09-Mar-18
1,069,882
1,069,882
4
SAKAJAYA MAKMUR
13-Feb-18
13-Mar-18
2,767,639
13-Feb-18
13-Mar-18
1,260,266
22-Feb-18
15-Mar-18
1,625,355
22-Feb-18
15-Mar-18
330,000
22-Feb-18
15-Mar-18
708,785
22-Feb-18
15-Mar-18
3,798,135
22-Feb-18
15-Mar-18
4,145,665
14-Feb-18
16-Mar-18
4,336,750
14-Feb-18
16-Mar-18
4,963,750
12-Feb-18
17-Mar-18
1,996,940
1,996,940
###
29,180,147
5
6 7
BSP
MENSA BINASUKSES MERAPI UTAMA
4,027,905
10,607,940
9,300,500
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 20 MARET 2018 No.
1
2
2
SUPPLIER
ENSAVAL PUTRA
KALISTA PRIMA
SOLACONE
Factur Date
Due Date
AMOUNT
15-Feb-18
17-Mar-18
143,902
15-Feb-18
17-Mar-18
6,201,662
19-Feb-18
21-Feb-18
2,750,000
19-Feb-18
21-Feb-18
361,245
19-Feb-18
21-Mar-18
2,913,570
20-Feb-18
22-Mar-18
5,432,487
20-Feb-18
22-Mar-18
2,027,300
08-Feb-18
10-Mar-18
976,937
09-Feb-18
12-Mar-18
5,016,000
13-Feb-18
12-Mar-18
564,135
13-Feb-18
12-Mar-18
507,999
13-Feb-18
12-Mar-18
1,657,700
11-Mar-18
11-Mar-18
935,000
###
TOTAL
19,830,166
8,722,771
935,000 29,487,937
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 21 MARET 2018 No.
SUPPLIER
Factur Date
Due Date
AMOUNT
TOTAL
1
MITRA SUMBER A
17-Feb-18
10-Mar-18
1,042,646
1,042,646
2
MENSA
17-Feb-18
13-Mar-18
4,963,750
4,963,750
3
APOTEK NARITA
12-Feb-18
14-Mar-18
1,158,600
14-Feb-18
09-Mar-18
380,500
4
BERKAH
15-Feb-18
09-Mar-18
1,560,000
5
APOTEK IMAM BOJOL
13-Feb-18
13-Mar-18
1,087,500
18-Jan-18
13-Mar-18
1,100,000
04-Feb-18
17-Mar-18
8,948,694
26-Feb-18
19-Mar-18
885,577
26-Feb-18
19-Mar-18
133,952
26-Feb-18
19-Mar-18
19,326
27-Feb-18
19-Mar-18
7,444,021
27-Feb-18
19-Mar-18
708,785
27-Feb-18
19-Mar-18
195,657
5
BSP
###
1,539,100 1,560,000 2,187,500
18,336,012
29,629,008
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 22 MARET 2018 No.
1
SUPPLIER
Factur Date
Due Date
AMOUNT
INDOFARMA
12-Feb-18
10-Mar-18
151,250
12-Feb-18
13-Mar-18
1,372,800
TOTAL
1,524,050
2
SAKAJAJA MAKMUR
15-Feb-18
14-Mar-18
2,005,496
3
MITRA SUMBER A
12-Feb-18
09-Mar-18
2,533,160
21-Feb-18
09-Mar-18
938,784
21-Feb-18
09-Mar-18
689,700
21-Feb-18
13-Mar-18
689,700
21-Feb-18
13-Mar-18
2,072,665
20-Feb-18
20-Mar-18
473,656
20-Feb-18
20-Mar-18
618,112
20-Feb-18
20-Mar-18
2,685,890
20-Feb-18
20-Mar-18
458,650
20-Feb-18
20-Mar-18
1,556,280
14-Feb-18
16-Mar-18
2,840,000
13-Feb-18
16-Mar-18
635,250
635,250
13-Feb-18
16-Mar-18
635,250
635,250
MILLENUM PHARMA 17-Feb-18
10-Mar-18
1,595,000
17-Feb-18
10-Mar-18
277,200
15-Feb-18
08-Mar-18
1,703,962
17-Feb-18
09-Mar-18
1,851,218
MENSA BINA SUKSES 17-Feb-18
17-Mar-18
562,419
562,419
17-Mar-18
3,971,000
3,971,000
###
30,317,442
4
5
ANUGRA ARGON
ANUGERAH PHARMI
6
BERKAH
7
MITRA MEDITAMA
8 9
DISTRIVERSA
10
SEJAHTERA
11 12
DAD
24-Feb-18
2,005,496 2,533,160
4,390,849
5,792,588
2,840,000
1,595,000 277,200 3,555,180
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 23 MARET 2018 No.
SUPPLIER
Factur Date
Due Date
AMOUNT
1
KIMIA FARMA
10-Mar-18
13-Mar-18
514,800
514,800
2
KALLISTA
19-Feb-18
13-Mar-18
812,075
812,075
28-Feb-18
21-Mar-18
5,327,045
28-Feb-18
21-Mar-18
43,943
28-Feb-18
21-Mar-18
446,508
01-Mar-18
22-Mar-18
564,333
01-Mar-18
22-Mar-18
2,964,931
02-Mar-18
23-Mar-18
2,210,116
15-Feb-18
08-Mar-18
2,145,000
15-Feb-18
08-Mar-18
2,033,570
11-Oct-17
01-Nov-17
2,236,300
17-Feb-18
10-Mar-18
313,500
19-Feb-18
13-Mar-18
4,608,450
20-Feb-18
13-Mar-18
1,180,850
21-Feb-18
14-Mar-18
3,226,300
22-Feb-18
15-Mar-18
788,975
3
4
BSP
DAD
###
***DETAIL AS ATTACHED*** NOTE Tanggal 19 MARET 2018 Tanggal 20 MARET 2018 Tanggal 21 MARET 2018 Tanggal 22 MARET 2018 Tanggal 23 MARET 2018
TOTAL
TOTAL
11,556,876
16,532,945
29,416,696
29,180,147 29,487,937 29,629,008 30,317,442 29,416,696
148,031,230
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 26 MARET 2018 No.
1
2
3
4 5
SUPPLIER
ANUGRAH PHARMINDO
SAKAJAJA MAKMUR
MITRA SUMBER ABDI
KALLISTA PRIMA BINA SAN PRIMA
Factur Date
Due Date
AMOUNT
26-Feb-18
28-Mar-18
1,392,930
26-Feb-18
28-Mar-18
742,363
27-Feb-18
28-Mar-18
1,583,330
28-Feb-18
30-Mar-18
1,616,824
28-Feb-18
30-Mar-18
1,464,243
28-Feb-18
30-Mar-18
3,002,401
15-Feb-18
13-Mar-18
3,618,505
17-Feb-18
15-Mar-18
1,396,753
20-Feb-18
15-Mar-18
2,754,871
20-Feb-18
15-Mar-18
1,000,729
14-Feb-18
07-Mar-18
1,604,687
14-Feb-18
08-Mar-18
1,615,220
19-Feb-18
12-Mar-18
1,723,876
19-Feb-18
12-Mar-18
1,053,797
22-Feb-18
17-Mar-18
2,086,749
22-Feb-18
17-Mar-18
752,400
20-Feb-18
17-Mar-18
449,762
05-Mar-18
26-Mar-18
687,060
05-Mar-18
26-Mar-18
1,161,545
###
TOTAL
9,802,091
8,770,858
5,997,580
3,288,911
1,848,605 29,708,045
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 27 MARET 2018 No.
1
SUPPLIER
ENSEVAL PUTRA
2
LAB MEDIKA
3
MULTI DWI ABADI
4
UNITED DICO
Factur Date
Due Date
AMOUNT
22-Feb-18
24-Mar-18
365,079
23-Feb-18
25-Mar-18
795,118
23-Feb-18
25-Mar-18
1,739,925
24-Feb-18
26-Mar-18
438,900
26-Feb-18
28-Mar-18
5,087,500
26-Feb-18
28-Mar-18
5,215,013
28-Feb-18
30-Mar-18
7,700,000
28-Feb-18
15-Mar-18
1,837,660
01-Mar-18
31-Mar-18
907,318
22-Feb-18
23-Mar-18
428,193
21-Feb-18
23-Mar-18
404,206
20-Feb-18
15-Mar-18
127,962
20-Feb-18
15-Mar-18
408,790
07-Feb-18
14-Mar-18
117,167
07-Feb-18
14-Mar-18
2,139,764
09-Mar-18
16-Mar-18
2,164,800
###
TOTAL
24,086,513
832,399
536,752
4,421,731 29,877,395
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 28 MARET 2018 No.
1
2
3
SUPPLIER
MENSA BINASUKSES
BINA SAN PRIMA
MENSA BINASUKSES
Factur Date
Due Date
AMOUNT
26-Feb-18
28-Mar-18
556,512
27-Feb-18
29-Mar-18
4,963,750
27-Feb-18
29-Mar-18
2,873,750
06-Mar-18
27-Mar-18
834,900
06-Mar-18
27-Mar-18
446,508
06-Mar-18
27-Mar-18
573,065
06-Mar-18
27-Mar-18
5,198,817
07-Mar-18
28-Mar-18
1,529,550
07-Mar-18
28-Mar-18
3,085,830
07-Mar-18
28-Mar-18
325,556
07-Mar-18
28-Mar-18
88,396
07-Mar-18
28-Mar-18
2,871,792
17-Feb-18
19-Mar-18
4,158,000
23-Feb-18
25-Mar-18
2,079,000
###
TOTAL
8,394,012
14,954,414
6,237,000 29,585,426
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 29 MARET 2018 No.
SUPPLIER
Factur Date
Due Date
AMOUNT
1
DAD
2
23-Feb-18
16-Mar-18
5,287,195
26-Feb-18
19-Mar-18
1,544,510
BINA SAN PRIMA
09-Mar-18
30-Mar-18
2,410,624
2,410,624
3
ANUGRAH ARGON
06-Feb-18
27-Mar-18
1,203,485
1,203,485
4
MERAPI UTAMA
19-Feb-18
24-Mar-18
1,435,830
22-Feb-18
27-Mar-18
1,457,588
21-Feb-18
14-Mar-18
1,998,439
23-Feb-18
16-Mar-18
2,009,039
02-Feb-18
19-Mar-18
1,563,107
02-Feb-18
21-Mar-18
1,438,515
02-Feb-18
23-Mar-18
1,131,506
27-Feb-18
20-Mar-18
990,000
27-Feb-18
20-Mar-18
504,481
24-Feb-18
17-Mar-18
555,500
19-Feb-18
12-Mar-18
944,951
20-Feb-18
13-Mar-18
1,614,251
21-Feb-18
14-Mar-18
839,111
24-Feb-18
17-Mar-18
1,722,016
24-Feb-18
17-Mar-18
124,199
24-Feb-18
17-Mar-18
822,071
5
MITRA SUMBER
6
PENTA VALENT
7
PARIT PADANG G
8 9
SEJAHTERA SURYA SAKAJAJA MAKMUR
###
TOTAL
6,831,705
2,893,418
8,140,606
1,494,481 555,500 3,398,313 2,668,286
29,596,418
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 29 MARET 2018 No.
SUPPLIER
Factur Date
Due Date
AMOUNT
TOTAL
1
PT. HIS
20-Feb-18
20-Mar-18
369,915
369,915
2
PT. INDOLAB
19-Feb-18
19-Mar-18
3,046,000
3,046,000
3
PT. SABA INDOM
20-Feb-18
14-Mar-18
2,940,300
4
PT. AKURAT MITRA P
14-Feb-18
09-Mar-18
792,000
5
PT. ALIF MADIRI
15-Feb-18
09-Mar-18
792,000
792,000
7,940,215
7,940,215
2,940,300 792,000
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 30 MARET 2018 No.
1
2
SUPPLIER
INDOFARMA
BSP
Factur Date
Due Date
AMOUNT
22-Feb-18
19-Mar-18
121,199
19-Feb-18
13-Mar-18
3,120,516
08-Mar-18
29-Mar-18
264,000
08-Mar-18
29-Mar-18
29,106
08-Mar-18
29-Mar-18
76,484
08-Mar-18
29-Mar-18
6,872,250
TOTAL
3,241,715
7,241,840
3
APOTEK
07-Feb-18
15-Mar-18
1,650,000
1,650,000
4
APOTEK
08-Mar-18
15-Mar-18
1,800,000
1,800,000
5
SUMBER REJEKI
15-Feb-18
08-Mar-18
852,400
6
CV. BERKAH
28-Feb-18
08-Mar-18
4,144,000
11-Feb-18
08-Mar-18
3,880,000
7
KEBAYORAN
23-Feb-18
16-Mar-18
1,742,400
8
SAKAJAJA
27-Feb-18
13-Mar-18
1,766,600
20-Feb-18
13-Mar-18
516,780
9
INTISUMBER
21-Feb-18
14-Mar-18
1,089,127
22-Feb-18
15-Mar-18
1,472,384
###
***DETAIL AS ATTACHED*** NOTE Tanggal 26 MARET 2018
Tanggal 29 MARET 2018
29,708,045 29,877,395 29,585,426 29,596,418 7,940,215 LABORAT
Tanggal 30 MARET 2018
29,397,246
Tanggal 27 MARET 2018 Tanggal 28 MARET 2018 Tanggal 29 MARET 2018
TOTAL
852,400 8,024,000 1,742,400 2,283,380 2,561,511 29,397,246
156,104,745
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
PAYMENT REQUISITION
By CASH VALUE ON : 19 MARET 2018 No.
1
SUPPLIER
PARIT PADANG G
Factur Date
Due Date
AMOUNT
17-Feb-18
10-Mar-18
439,780
17-Feb-18
13-Mar-18
253,347
17-Feb-18
14-Mar-18
858,816
TOTAL
1,551,943
2
TOMBO URIP
07-Feb-18
09-Mar-18
625,037
625,037
3
UNITED DICO
26-Feb-18
09-Mar-18
1,069,882
1,069,882
4
SAKAJAYA MAKMUR
13-Feb-18
13-Mar-18
2,767,639
13-Feb-18
13-Mar-18
1,260,266
22-Feb-18
15-Mar-18
1,625,355
22-Feb-18
15-Mar-18
330,000
22-Feb-18
15-Mar-18
708,785
22-Feb-18
15-Mar-18
3,798,135
22-Feb-18
15-Mar-18
4,145,665
14-Feb-18
16-Mar-18
4,336,750
14-Feb-18
16-Mar-18
4,963,750
12-Feb-18
17-Mar-18
1,996,940
1,996,940
###
29,180,147
5
6 7
BSP
MENSA BINASUKSES MERAPI UTAMA
4,027,905
10,607,940
9,300,500
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 20 MARET 2018 No.
1
2
2
SUPPLIER
ENSAVAL PUTRA
KALISTA PRIMA
SOLACONE
Factur Date
Due Date
AMOUNT
15-Feb-18
17-Mar-18
143,902
15-Feb-18
17-Mar-18
6,201,662
19-Feb-18
21-Feb-18
2,750,000
19-Feb-18
21-Feb-18
361,245
19-Feb-18
21-Mar-18
2,913,570
20-Feb-18
22-Mar-18
5,432,487
20-Feb-18
22-Mar-18
2,027,300
08-Feb-18
10-Mar-18
976,937
09-Feb-18
12-Mar-18
5,016,000
13-Feb-18
12-Mar-18
564,135
13-Feb-18
12-Mar-18
507,999
13-Feb-18
12-Mar-18
1,657,700
11-Mar-18
11-Mar-18
935,000
###
TOTAL
19,830,166
8,722,771
935,000 29,487,937
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 21 MARET 2018 No.
SUPPLIER
Factur Date
Due Date
AMOUNT
TOTAL
1
MITRA SUMBER A
17-Feb-18
10-Mar-18
1,042,646
1,042,646
2
MENSA
17-Feb-18
13-Mar-18
4,963,750
4,963,750
3
APOTEK NARITA
12-Feb-18
14-Mar-18
1,158,600
14-Feb-18
09-Mar-18
380,500
4
BERKAH
15-Feb-18
09-Mar-18
1,560,000
5
APOTEK IMAM BOJOL
13-Feb-18
13-Mar-18
1,087,500
18-Jan-18
13-Mar-18
1,100,000
04-Feb-18
17-Mar-18
8,948,694
26-Feb-18
19-Mar-18
885,577
26-Feb-18
19-Mar-18
133,952
26-Feb-18
19-Mar-18
19,326
27-Feb-18
19-Mar-18
7,444,021
27-Feb-18
19-Mar-18
708,785
27-Feb-18
19-Mar-18
195,657
5
BSP
###
1,539,100 1,560,000 2,187,500
18,336,012
29,629,008
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 22 MARET 2018 No.
1
SUPPLIER
Factur Date
Due Date
AMOUNT
INDOFARMA
12-Feb-18
10-Mar-18
151,250
12-Feb-18
13-Mar-18
1,372,800
TOTAL
1,524,050
2
SAKAJAJA MAKMUR
15-Feb-18
14-Mar-18
2,005,496
3
MITRA SUMBER A
12-Feb-18
09-Mar-18
2,533,160
21-Feb-18
09-Mar-18
938,784
21-Feb-18
09-Mar-18
689,700
21-Feb-18
13-Mar-18
689,700
21-Feb-18
13-Mar-18
2,072,665
20-Feb-18
20-Mar-18
473,656
20-Feb-18
20-Mar-18
618,112
20-Feb-18
20-Mar-18
2,685,890
20-Feb-18
20-Mar-18
458,650
20-Feb-18
20-Mar-18
1,556,280
14-Feb-18
16-Mar-18
2,840,000
13-Feb-18
16-Mar-18
635,250
635,250
13-Feb-18
16-Mar-18
635,250
635,250
MILLENUM PHARMA 17-Feb-18
10-Mar-18
1,595,000
17-Feb-18
10-Mar-18
277,200
15-Feb-18
08-Mar-18
1,703,962
17-Feb-18
09-Mar-18
1,851,218
MENSA BINA SUKSES 17-Feb-18
17-Mar-18
562,419
562,419
17-Mar-18
3,971,000
3,971,000
###
30,317,442
4
5
ANUGRA ARGON
ANUGERAH PHARMI
6
BERKAH
7
MITRA MEDITAMA
8 9
DISTRIVERSA
10
SEJAHTERA
11 12
DAD
24-Feb-18
2,005,496 2,533,160
4,390,849
5,792,588
2,840,000
1,595,000 277,200 3,555,180
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 23 MARET 2018 No.
SUPPLIER
Factur Date
Due Date
AMOUNT
1
KIMIA FARMA
10-Mar-18
13-Mar-18
514,800
514,800
2
KALLISTA
19-Feb-18
13-Mar-18
812,075
812,075
28-Feb-18
21-Mar-18
5,327,045
28-Feb-18
21-Mar-18
43,943
28-Feb-18
21-Mar-18
446,508
01-Mar-18
22-Mar-18
564,333
01-Mar-18
22-Mar-18
2,964,931
02-Mar-18
23-Mar-18
2,210,116
15-Feb-18
08-Mar-18
2,145,000
15-Feb-18
08-Mar-18
2,033,570
11-Oct-17
01-Nov-17
2,236,300
17-Feb-18
10-Mar-18
313,500
19-Feb-18
13-Mar-18
4,608,450
20-Feb-18
13-Mar-18
1,180,850
21-Feb-18
14-Mar-18
3,226,300
22-Feb-18
15-Mar-18
788,975
3
4
BSP
DAD
###
***DETAIL AS ATTACHED*** NOTE Tanggal 19 MARET 2018 Tanggal 20 MARET 2018 Tanggal 21 MARET 2018 Tanggal 22 MARET 2018 Tanggal 23 MARET 2018
TOTAL
TOTAL
11,556,876
16,532,945
29,416,696
29,180,147 29,487,937 29,629,008 30,317,442 29,416,696
148,031,230
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 26 MARET 2018 No.
1
2
3
4 5
SUPPLIER
ANUGRAH PHARMINDO
SAKAJAJA MAKMUR
MITRA SUMBER ABDI
KALLISTA PRIMA BINA SAN PRIMA
Factur Date
Due Date
AMOUNT
26-Feb-18
28-Mar-18
1,392,930
26-Feb-18
28-Mar-18
742,363
27-Feb-18
28-Mar-18
1,583,330
28-Feb-18
30-Mar-18
1,616,824
28-Feb-18
30-Mar-18
1,464,243
28-Feb-18
30-Mar-18
3,002,401
15-Feb-18
13-Mar-18
3,618,505
17-Feb-18
15-Mar-18
1,396,753
20-Feb-18
15-Mar-18
2,754,871
20-Feb-18
15-Mar-18
1,000,729
14-Feb-18
07-Mar-18
1,604,687
14-Feb-18
08-Mar-18
1,615,220
19-Feb-18
12-Mar-18
1,723,876
19-Feb-18
12-Mar-18
1,053,797
22-Feb-18
17-Mar-18
2,086,749
22-Feb-18
17-Mar-18
752,400
20-Feb-18
17-Mar-18
449,762
05-Mar-18
26-Mar-18
687,060
05-Mar-18
26-Mar-18
1,161,545
###
TOTAL
9,802,091
8,770,858
5,997,580
3,288,911
1,848,605 29,708,045
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 27 MARET 2018 No.
1
SUPPLIER
ENSEVAL PUTRA
2
LAB MEDIKA
3
MULTI DWI ABADI
4
UNITED DICO
Factur Date
Due Date
AMOUNT
22-Feb-18
24-Mar-18
365,079
23-Feb-18
25-Mar-18
795,118
23-Feb-18
25-Mar-18
1,739,925
24-Feb-18
26-Mar-18
438,900
26-Feb-18
28-Mar-18
5,087,500
26-Feb-18
28-Mar-18
5,215,013
28-Feb-18
30-Mar-18
7,700,000
28-Feb-18
15-Mar-18
1,837,660
01-Mar-18
31-Mar-18
907,318
22-Feb-18
23-Mar-18
428,193
21-Feb-18
23-Mar-18
404,206
20-Feb-18
15-Mar-18
127,962
20-Feb-18
15-Mar-18
408,790
07-Feb-18
14-Mar-18
117,167
07-Feb-18
14-Mar-18
2,139,764
09-Mar-18
16-Mar-18
2,164,800
###
TOTAL
24,086,513
832,399
536,752
4,421,731 29,877,395
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 28 MARET 2018 No.
1
2
3
SUPPLIER
MENSA BINASUKSES
BINA SAN PRIMA
MENSA BINASUKSES
Factur Date
Due Date
AMOUNT
26-Feb-18
28-Mar-18
556,512
27-Feb-18
29-Mar-18
4,963,750
27-Feb-18
29-Mar-18
2,873,750
06-Mar-18
27-Mar-18
834,900
06-Mar-18
27-Mar-18
446,508
06-Mar-18
27-Mar-18
573,065
06-Mar-18
27-Mar-18
5,198,817
07-Mar-18
28-Mar-18
1,529,550
07-Mar-18
28-Mar-18
3,085,830
07-Mar-18
28-Mar-18
325,556
07-Mar-18
28-Mar-18
88,396
07-Mar-18
28-Mar-18
2,871,792
17-Feb-18
19-Mar-18
4,158,000
23-Feb-18
25-Mar-18
2,079,000
###
TOTAL
8,394,012
14,954,414
6,237,000 29,585,426
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 29 MARET 2018 No.
SUPPLIER
Factur Date
Due Date
AMOUNT
1
DAD
2
23-Feb-18
16-Mar-18
5,287,195
26-Feb-18
19-Mar-18
1,544,510
BINA SAN PRIMA
09-Mar-18
30-Mar-18
2,410,624
2,410,624
3
ANUGRAH ARGON
06-Feb-18
27-Mar-18
1,203,485
1,203,485
4
MERAPI UTAMA
19-Feb-18
24-Mar-18
1,435,830
22-Feb-18
27-Mar-18
1,457,588
21-Feb-18
14-Mar-18
1,998,439
23-Feb-18
16-Mar-18
2,009,039
02-Feb-18
19-Mar-18
1,563,107
02-Feb-18
21-Mar-18
1,438,515
02-Feb-18
23-Mar-18
1,131,506
27-Feb-18
20-Mar-18
990,000
27-Feb-18
20-Mar-18
504,481
24-Feb-18
17-Mar-18
555,500
19-Feb-18
12-Mar-18
944,951
20-Feb-18
13-Mar-18
1,614,251
21-Feb-18
14-Mar-18
839,111
24-Feb-18
17-Mar-18
1,722,016
24-Feb-18
17-Mar-18
124,199
24-Feb-18
17-Mar-18
822,071
5
MITRA SUMBER
6
PENTA VALENT
7
PARIT PADANG G
8 9
SEJAHTERA SURYA SAKAJAJA MAKMUR
###
TOTAL
6,831,705
2,893,418
8,140,606
1,494,481 555,500 3,398,313 2,668,286
29,596,418
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 29 MARET 2018 No.
SUPPLIER
Factur Date
Due Date
AMOUNT
TOTAL
1
PT. HIS
20-Feb-18
20-Mar-18
369,915
369,915
2
PT. INDOLAB
19-Feb-18
19-Mar-18
3,046,000
3,046,000
3
PT. SABA INDOM
20-Feb-18
14-Mar-18
2,940,300
4
PT. AKURAT MITRA P
14-Feb-18
09-Mar-18
792,000
5
PT. ALIF MADIRI
15-Feb-18
09-Mar-18
792,000
792,000
7,940,215
7,940,215
2,940,300 792,000
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
APOTEK AL AZIZ Jl. Erlangga - Wironini, Pasuruan Telp. (0343)423390
PAYMENT REQUISITION
By CASH VALUE ON : 30 MARET 2018 No.
1
2
SUPPLIER
INDOFARMA
BSP
Factur Date
Due Date
AMOUNT
22-Feb-18
19-Mar-18
121,199
19-Feb-18
13-Mar-18
3,120,516
08-Mar-18
29-Mar-18
264,000
08-Mar-18
29-Mar-18
29,106
08-Mar-18
29-Mar-18
76,484
08-Mar-18
29-Mar-18
6,872,250
TOTAL
3,241,715
7,241,840
3
APOTEK
07-Feb-18
15-Mar-18
1,650,000
1,650,000
4
APOTEK
08-Mar-18
15-Mar-18
1,800,000
1,800,000
5
SUMBER REJEKI
15-Feb-18
08-Mar-18
852,400
6
CV. BERKAH
28-Feb-18
08-Mar-18
4,144,000
11-Feb-18
08-Mar-18
3,880,000
7
KEBAYORAN
23-Feb-18
16-Mar-18
1,742,400
8
SAKAJAJA
27-Feb-18
13-Mar-18
1,766,600
20-Feb-18
13-Mar-18
516,780
9
INTISUMBER
21-Feb-18
14-Mar-18
1,089,127
22-Feb-18
15-Mar-18
1,472,384
###
***DETAIL AS ATTACHED*** NOTE Tanggal 26 MARET 2018
Tanggal 29 MARET 2018
29,708,045 29,877,395 29,585,426 29,596,418 7,940,215 LABORAT
Tanggal 30 MARET 2018
29,397,246
Tanggal 27 MARET 2018 Tanggal 28 MARET 2018 Tanggal 29 MARET 2018
TOTAL
852,400 8,024,000 1,742,400 2,283,380 2,561,511 29,397,246
156,104,745
APPROVED BY,
CHECK BY
PREPARED BY
Dr. Ferry Fairus
Alif Doni B
Ulfatuz Zyainab
TTD SUPPLIER
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