SECOND ADDITIONAL FINANCING FOR THIRD WATER SUPPLY AND SANITATION FOR LOW INCOME COMMUNITIES / COMMUNITY BASSED WATER SUPPLY PROJECT FY FY 2020

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1 SECOND ADDITIONAL FINANCING FOR THIRD WATER SUPPLY AND SANITATION FOR LOW INCOME COMMUNITIES / COMMUNITY BASSED WATER SUPPLY PROJECT FY FY 2020 PENYEDIAAN AIR MINUM DAN SANITASI BERBASIS MASYARAKAT "PAMSIMAS" SATKER PENGEMBANGAN AIR MINUM BERBASIS MASYARAKAT (PAMBM) KEMENTERIAN PEKERJAAN UMUM & PERUMAHAN RAKYAT Nomor Loan : Loan IBRD 8578-ID Nama Konsultan : PT. VIRAMA KARYA (PERSERO) Paket : REGIONAL OVERSIGHT MANAGEMENT SERVICES (ROMS) - 8 Coverage Area : PROPINSI JAWA TENGAH, PROVINSI D.I YOGYAKARTA Nomor & Tanggal Kontrak : KU.08.08/Kontrak/ROMS-8/PAMBM/68/IV/2017, Tanggal 28 April 2017 Periode Kontrak : 28 April 2017 sd 27 Desember 2020 Amandemen Kontrak No. 1 : Tanggal 26 Januari 2018 Perihal Amandemen Kontrak : Pergantian Pejabat Pembuat Komitmen (PPK) Pembinaan Pelaksanaan Wilayah II NO. DESCRIPTION AMENDMENT No.1 NON BID [IDR] BID [IDR] (IDR) A PERSONNEL COST PROVINCIAL TEAM Jawa Tengah DI Yogyakarta DISTRICT TEAM Jawa Tengah DI Yogyakarta B REIMBURSABLE DIRECT COST JAWA TENGAH Duty Travel Mobilization and Demobilization Office Space (Rental) Office Consumable and Office Running Cot Office Equipment (Rental) Vehicle (Rental) Communication Training Media Sozialization Reporting DI YOGYAKARTA Duty Travel Mobilization and Demobilization Office Space (Rental) Office Consumable and Office Running Cot Office Equipment (Rental) Vehicle (Rental) Communication Training Media Sozialization C MANAGEMENT FEE (MF) MF on Fiied Reimbursable Direct Costs of B) D TOTAL BID PRICE (Excl. VAT) D-1 Amount Eligible for IBRD Funding & APBN RM D-2 Amount Eligible for IBRD Funding (80%) D-3 Amount Eligible for APBN RM (20%) D-4 VAT/PPN : 10% on the APBN portion E Value Of Contract (Incl. VAT 10% on the APBN portion)

2 I. BREAKDOWN REMUNERATION AMENDMENT No.1 No. POSITION / DISTRICT NAME INPUT VOLUME MINIMUM THP (person) (month) (month) (IDR/month) (IDR) A REMUNERATION A.1 JAWA TENGAH REGIONAL/PROVINCIAL TEAM Provincial Coordinator Susilo Tri Budiyono Co-Provincial Coordinator Surjadi Co-Provincial Coordinator Suharno Water Supply and Sanitation Specialist Jumingin Alwahyudi Financial Management Specialist FX Adhi Cahyo Nugroho Local Government Specialist Tony Subrata CD/ CB Coordinator Sri Wahyuni Data Management Analyst Tri Datha Younathan Office Manager Saparilla Computer Operator Levin Ardianto Office Boy Vivid Musa DISTRICT COORDINATOR [ Project-Nominated] District Coordinator Kudus Setiyanto District Coordinator Sragen Munti Sasromah, ST District Coordinator Grobogan Ir. Dodit Susherwanto District Coordinator Blora Dwi Andri Kurniawan, ST District Coordinator Rembang M. Adi Setiabela, ST District Coordinator Pati Edi Susanto, ST District Coordinator Demak Subandriyo District Coordinator Semarang Ir. Samina, M.Si District Coordinator Jepara Mudjiyanto, ST District Coordinator Cilacap Siti Zulaechah, ST District Coordinator Banyumas Muhtadin, SH District Coordinator Purbalingga Muh.Fuad Akhyar, ST District Coordinator Banjarnegara Mufarid Rohman, ST District Coordinator Kendal Indra Darmawan, ST District Coordinator Batang Pulung Sutrisno, ST District Coordinator Pekalongan Fianda Kusuma Dewi, ST District Coordinator Pemalang Rochmadi, ST District Coordinator Tegal Fachru Eko Rachmawan, ST District Coordinator Brebes Tanuri, ST District Coordinator Kebumen Tazrian Noordi, S.Sos District Coordinator Purworejo Ir. Diarna Isfandari District Coordinator Wonosobo Panggung Dwi Purwanto, ST District Coordinator Magelang Shodiq District Coordinator Boyolali Agus Purwanto, ST District Coordinator Klaten Mirza Rofik Effendi, ST District Coordinator Sukoharjo Saryanto, ST District Coordinator Wonogiri Ir. Nanung Sugiarta District Coordinator Karanganyar Rini Yuliasning, SE District Coordinator Temanggung Ir. Sukardiyanto CO-DISTRICT COORDINATOR [Project-Nominated] Co. District Coordinator / DFMA Kudus Hadi Karso Tejo Sarwono Co. District Coordinator / DFMA Sragen Wiranto Co. District Coordinator / DFMA Grobogan Y. Candi Binthara Co. District Coordinator / DFMA Blora Dyah Hari Ikawati Co. District Coordinator / DFMA Rembang Kridanto Co. District Coordinator / DFMA Pati Lasminah Co. District Coordinator / DFMA Demak Mashud Co. District Coordinator / DFMA Semarang Ema Sri Harjunijati Co. District Coordinator / DFMA Jepara Musadikin Co. District Coordinator / DFMA Cilacap Agus Purwanto, ST Co. District Coordinator / DFMA Banyumas Irfan Yunantoro Co. District Coordinator / DFMA Purbalingga Woro Suprihatin Co. District Coordinator / DFMA Banjarnegara Mohsal Swastanto Co. District Coordinator / DFMA Kendal Siti Imronah Co. District Coordinator / DFMA Batang Supriyadi Co. District Coordinator / DFMA Pekalongan Alik Makruf Co. District Coordinator / DFMA Pemalang Andi Setiawan Co. District Coordinator / DFMA Tegal Sugeng Co. District Coordinator / DFMA Brebes Sudiono Co. District Coordinator / DFMA Kebumen Dedy Hendratama Co. District Coordinator / DFMA Purworejo Asih Romadhonasari Co. District Coordinator / DFMA Wonosobo Harman Fanani Co. District Coordinator / DFMA Magelang Devi Rima Prahesti Co. District Coordinator / DFMA Boyolali Dita Nainalliya Co. District Coordinator / DFMA Klaten Vindriasih Mirdias Wiratiwi Co. District Coordinator / DFMA Sukoharjo Niken Wijayanti Co. District Coordinator / DFMA Wonogiri Wahyuni Tri Utami Co. District Coordinator / DFMA Karanganyar Retno Kustati Co. District Coordinator / DFMA Temanggung Suciyanto DISTRICT SUPPORT TEAM District Financial Management Assistant (DFMA) 4.1 Data Entry Operator and Adiminitration Officer (DEAO) Kudus Abdullah Nafi' Burhanudin Data Entry Operator and Adiminitration Officer (DEAO) Sragen Erdina Parwaningtyas Data Entry Operator and Adiminitration Officer (DEAO) Grobogan Tri Iswati Data Entry Operator and Adiminitration Officer (DEAO) Blora Fajar Ferdian Eka Sungkono Data Entry Operator and Adiminitration Officer (DEAO) Rembang Nur Dwi Gatot Subroto

3 AMENDMENT No.1 No. POSITION / DISTRICT NAME INPUT VOLUME MINIMUM THP (person) (month) (month) (IDR/month) (IDR) 4.6 Data Entry Operator and Adiminitration Officer (DEAO) Pati Erma Uswatun Hasanah K Data Entry Operator and Adiminitration Officer (DEAO) Demak Wiwik Wahyuningsih Data Entry Operator and Adiminitration Officer (DEAO) Semarang Erlyana Santi Data Entry Operator and Adiminitration Officer (DEAO) Jepara Halumma Lutfia Yuhanna Data Entry Operator and Adiminitration Officer (DEAO) Cilacap Harri Suratno Data Entry Operator and Adiminitration Officer (DEAO) Banyumas Rizka Ainurrokhim Data Entry Operator and Adiminitration Officer (DEAO) Purbalingga Dwi Setiawan Yulianto Data Entry Operator and Adiminitration Officer (DEAO) Banjarnegara Aghoes Widyantoko Data Entry Operator and Adiminitration Officer (DEAO) Kendal Bornea Galang Prasetya Data Entry Operator and Adiminitration Officer (DEAO) Batang Ikhwan Junaedi Data Entry Operator and Adiminitration Officer (DEAO) Pekalongan Yuni Riyanti Data Entry Operator and Adiminitration Officer (DEAO) Pemalang Bayu Hidayat Jati Data Entry Operator and Adiminitration Officer (DEAO) Tegal Rina Purwanti Data Entry Operator and Adiminitration Officer (DEAO) Brebes Fahmi Taufiq Data Entry Operator and Adiminitration Officer (DEAO) Kebumen Amri Ahmadi Data Entry Operator and Adiminitration Officer (DEAO) Purworejo Novi Rahmawaty Data Entry Operator and Adiminitration Officer (DEAO) Wonosobo Febriana Ika Setyarini Data Entry Operator and Adiminitration Officer (DEAO) Magelang Aryu F.D Data Entry Operator and Adiminitration Officer (DEAO) Boyolali Cornelius Winda Andriadi Data Entry Operator and Adiminitration Officer (DEAO) Klaten Herlina Pujiastuti Data Entry Operator and Adiminitration Officer (DEAO) Sukoharjo Wiji Lestari Data Entry Operator and Adiminitration Officer (DEAO) Wonogiri Enggar Prasetya Wibawa Data Entry Operator and Adiminitration Officer (DEAO) Karanganyar Pipin Puspitasari Data Entry Operator and Adiminitration Officer (DEAO) Temanggung Immanuel Maryanto Nugroho A.2 DI YOGYAKARTA PROVINCIAL TEAM Provincial Coordinator Dewa Bagus Sutrisno Water Supply and Sanitation Specialist To Be Name Financial Management Specialist Budi Waluyotomo Local Government Specialist To Be Name CD/ CB Coordinator Woro Tri Astuti Data Management Analyst Zainul Mushoffie Office Manager Eni Pujiastuti Computer Operator Muhammad Khafidh Amrullah Office Boy Didit Widayanto DISTRICT COORDINATOR [Project-Nominated] District Coordinator Kulon Progo Nur Khasani District Coordinator Bantul Ir. Tety Sirwanti District Coordinator Gunung Kidul* Haryono District Coordinator Sleman* ICB Eko Setyo Winanto CO-DISTRICT COORDINATOR [Project-Nominated] Co. District Coordinator / DFMA Kulon Progo Siska Indra Purnawati Co. District Coordinator / DFMA Bantul Doddy Indrianto Wicaksono DISTRICT SUPPORT TEAM District Financial Management Assistant (DFMA) Gunung Kidul* Toto Sumartono District Financial Management Assistant (DFMA) Sleman* Riskan Wahyudi Data Entry Operator and Adiminitration Officer (DEOAO) Kulon Progo Jony Widodo Data Entry Operator and Adiminitration Officer (DEOAO) Bantul Suwardiyono Data Entry Operator and Adiminitration Officer (DEOAO) Gunung Kidul* Andhika Adi Saputra Data Entry Operator and Adiminitration Officer (DEOAO) Sleman* Nowo Ruwandono Note : * New PAMSIMAS Districts

4 REIMBURSABLE DIRECT COSTS B REIMBURSABLE COST B.1 REIMBURSABLE COST JAWA TENGAH 1 DUTY TRAVEL Uji Petik/ Spot Checking Provincial Team to District and New Villages with RKM (Calon Desa Sasaran) a Transport lokal 3,5 years x 27 person x 1 time x 1 trip pers-trip fixed rate b Akomodasi 3,5 years x 27 person x 1 time x 3 days pers-day fixed rate c Uang saku 3,5 years x 27 person x 1 time x 4 days pers-day ceilling rate Provincial Team to District and Old Villages a Transport lokal 3,5 years x 27 person x 1 time x 1 trip pers-trip fixed rate b Akomodasi 3,5 years x 27 person x 1 time x 1 days pers-day fixed rate c Uang saku 3,5 years x 27 person x 1 time x 2 days pers-day ceilling rate District Team to New Villages with RKM (Calon Desa Sasaran-Baru) a Transport lokal 29 district x 3,5 years x 12 person x 1 time x 1 trip pers-trip fixed rate b Uang saku 29 district x 3,5 years x 12 person x 1 time x 2 days pers-day ceilling rate District Team to Old Villages with RKM (Calon Desa Sasaran-Perbaikan Kinerja dan Pengembangan) a Transport lokal 29 district x 3,5 years x 12 person x 1 time x 1 trip pers-trip fixed rate b Uang saku 29 district x 3,5 years x 12 person x 1 time x 2 days pers-day ceilling rate 1.2 Monitoring, Supervision and Strenghtening Provincial Team to District a Transport lokal 8 person x 3,5 years x 6 time x 1 trip pers-trip fixed rate b Akomodasi 8 person x 3,5 years x 6 time x 3 days pers-day fixed rate c Uang saku 8 person x 3,5 years x 6 time x 4 days pers-day ceilling rate 1.3 Coordination Meeting Provincial Coordination Meeting (District Team to Province) a Transport lokal 29 district x 3 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate b Fullboard Package for Participant from District 29 district x 3 person x 3,5 years x 2 time x 2 days pers-day fixed rate c Fullboard Package for Participant from Province 8 person x 3,5 years x 2 time x 2 days pers-day fixed rate d Uang saku for district team 29 district x 3 person x 3,5 years x 2 time x 3 days pers-day ceilling rate e Material Kit 95 person x 3,5 years x 2 time x 1 set set fixed rate Special Meeting at District Level (for Provincial Team), by request a Transport lokal 8 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate b Akomodasi 8 person x 3,5 years x 2 time x 2 days pers-day fixed rate c Uang saku 8 person x 3,5 years x 2 time x 3 days pers-day ceilling rate Special Meeting at Provincial Level (for District Team), by request a Transport lokal 29 district x 1 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate b Akomodasi 29 district x 1 person x 3,5 years x 2 time x 2 days pers-day fixed rate c Uang saku 29 district x 1 person x 3,5 years x 2 time x 3 days pers-day ceilling rate Special Meeting at National Level (for Provincial Team), by request a Air Fare Tickets 2 person x 3,5 years x 2 time x 1 trip pers-trip ceilling rate b Taksi dari dan ke Bandara 2 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate c Akomodasi 2 person x 3,5 years x 2 time x 2 days pers-day fixed rate d Uang saku 2 person x 3,5 years x 2 time x 3 days pers-day ceilling rate National Coordination Meeting (for Provincial Team), by request a Air Fare Tickets 2 person x 3,5 years x 2 time x 1 trip pers-trip ceilling rate b Taksi dari dan ke Bandara 2 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate c Akomodasi 2 person x 3,5 years x 2 time x 2 days pers-day fixed rate d Uang saku 2 person x 3,5 years x 2 time x 3 days pers-day fixed rate District Coordination Meeting (with TFM and STBM Faskab) and MIS Day a Meals, Snack 483 person + 29 district x 6 person x 44 month pack-pers fixed rate 1.4 Expert Group Meeting (EGM) Provincial Level EGM (District Team to Province) a Transport lokal 29 district x 3 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate b Fullboard Package for Participant from District 29 district x 3 person x 3,5 years x 2 time x 2 days pers-day fixed rate c Fullboard Package for Participant from Province 8 person x 3,5 years x 2 time x 2 days pers-day fixed rate d Uang saku for District Team 29 district x 2 person x 3,5 years x 2 time x 3 days pers-day ceilling rate e Material Kit 95 person x 3,5 years x 2 time x 1 set set fixed rate Central Level EGM (for Provincial Team) a Air Fare Tickets 8 person x 3,5 years x 2 time x 1 trip pers-trip ceilling rate b Taksi dari dan ke Bandara 8 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate c Akomodasi (by NMC) covered by NMC pers-day d Uang saku 8 person x 3,5 years x 2 time x 3 days pers-day fixed rate

5 2 MOBILIZATION AND DEMOBILIZATION Air Fare Tickets [Jakarta-Banda Aceh-Jakarta] a Provincial Coordinator 1 person x 1 r-trip pers-trip ceilling rate b Co. Provincial Coordinator 2 person x 1 r-trip pers-trip ceilling rate c Water Supply and Sanitation Specialist 1 person x 1 r-trip pers-trip ceilling rate d Financial Management Specialist 1 person x 1 r-trip pers-trip ceilling rate e Local Government Specialist 1 person x 1 r-trip pers-trip ceilling rate f CD / CB Coordinator 1 person x 1 r-trip pers-trip ceilling rate g Data Management Analyst 1 person x 1 r-trip pers-trip ceilling rate 2.2 Taksi dari dan ke Bandara 8 person x 1 r-trip pers-trip fixed rate 3 OFFICE SPACE - Rental Provincial Team 1 office x 44 month office-mth fixed rate 3.2 District Team 29 office x 44 month office-mth fixed rate 4 OFFICE RUNNING COST AND CONSUMABLE COST Provincial Team 1 office x 44 month office-mth fixed rate 4.2 BOP for District Team 29 office x 44 month office-mth fixed rate 5 OFFICE EQUIPMENT - Rental Provincial Team a Notebook Computer 8 person x 1 unit x 44 month unit-mth fixed rate b Portable Computer + Desk + Chair 2 person x 1 unit x 44 month unit-mth fixed rate c Inkjet Printer + Scan + Copy (2 No.) 1 office x 2 unit x 44 month unit-mth fixed rate d Digital Camera (2 No.) 1 office x 2 unit x 44 month unit-mth fixed rate e Projector + Screen 1 office x 1 unit x 44 month unit-mth fixed rate 5.2 District Team a Notebook Computer for DC 29 Districts x 1 person x 1 unit x 44 month unit-mth fixed rate b Notebook Computer for Co. DC 29 Districts x 1 person x 1 unit x 44 month unit-mth fixed rate c Notebook Computer for DFMA - Districts x 1 person x 1 unit x 44 month unit-mth fixed rate d Portable Computer + Desk + Chair for DEAO 29 person x 1 unit x 44 month unit-mth fixed rate e Inkjet Printer + Scan + Copy 29 office x 1 unit x 44 month unit-mth fixed rate f Digital Camera 29 office x 2 unit x 44 month unit-mth fixed rate g GPS 29 office x 2 unit x 44 month unit-mth fixed rate h Projector + Screen 29 office x 1 unit x 44 month unit-mth fixed rate 6 VEHICLE - Rental Car include Driver & O&M for Provincial Team 1 office x 2 unit x 44 month unit-mth fixed rate 6.2 Car include Driver & O&M for District Team 29 office x 1 unit x 44 month unit-mth fixed rate a BBM (gasoline) for Monitoring, Evaluation and Strengthening 29 office x 1 unit x 44 month unit-mth fixed rate 7 COMMUNICATION Telephone, Postage and Internet Connection for Provincial Team 1 office x 44 month unit-mth fixed rate 7.2 Telephone, Postage and Internet Connection for Distrcit Team 29 office x 44 month unit-mth fixed rate 8 TRAINING On the Job Training (OJT) for TFM: including E-Learning a Training Material + Kit 483 person + 3 person x 44 month No fixed rate b Full-day Package for TFM 483 person + 3 person x 44 month No fixed rate 8.2 District Training for Kader AMPL of new Villages a Uang harian for Participants 565 villages x 2 person x 4 days x 3 years pers-day ceilling rate b Fullboard Package for Participant 565 villages x 2 person x 3 days x 3 years pers-day fixed rate c Fullboard Package for Pemandu 29 district x 2 person x 3 days x 3 years pers-day fixed rate d Fullboard Package for DPMU 29 district x 2 person x 3 days x 3 years pers-day fixed rate e Transportasi Participant (only for kader AMPL) person x 1 r-trip x 3 years pers-trip fixed rate f Training Kit person x 1 set x 3 years set fixed rate g Training Material person x 1 set x 3 years set fixed rate h Spanduk 29 district x 1 unit x 3 years unit fixed rate i Reporting 29 district x 1 ls x 3 years ls fixed rate 8.3 District Training for Kader AMPL of old Villages a Uang harian Paket Fullboard for Participant villages 1 person x 3 days pers-day ceilling rate b Fullboard Package for Participant villages 1 person x 2 days pers-day fixed rate c Fullboard Package for Pemandu 29 district x 2 person x 2 days x 3 years pers-day fixed rate d Fullboard Package for DPMU 29 district x 2 person x 2 days x 3 years pers-day fixed rate e Transportasi Participant person x 1 r-trip pers-trip fixed rate f Training Kit person x 1 set set fixed rate g Training Material person x 1 set set fixed rate h Spanduk 29 district x 1 unit x 3 years unit fixed rate i Reporting 29 district x 1 ls x 3 years ls fixed rate

6 8.4 District Training for BPSPAM (new Villages) a Uang harian Paket Fullboard for Participant 565 villages x 2 person x 4 days x 3 years pers-day ceilling rate b Fullboard Package for Participant 565 villages x 2 person x 3 days x 3 years pers-day fixed rate c Fullboard Package for Pemandu 29 district x 2 person x 3 days x 3 years pers-day fixed rate d Fullboard Package for DPMU 29 district x 2 person x 3 days x 3 years pers-day fixed rate e Transportasi Participant person x 1 r-trip x 3 years pers-trip fixed rate f Training Kit person x 1 set x 3 years set fixed rate g Training Material person x 1 set x 3 years set fixed rate h Spanduk 29 district x 1 unit x 3 years unit fixed rate i Reporting 29 district x 1 ls x 3 years ls fixed rate 8.5 District Training for BPSPAM of old Villages a Uang harian Paket Fullboard villages x 1 person x 4 days pers-day ceilling rate b Fullboard Package for Participant villages x 1 person x 3 days pers-day fixed rate c Fullboard Package for Pemandu 29 district x 2 person x 3 days x 3 years pers-day fixed rate d Fullboard Package for DPMU 29 district x 2 person x 3 days x 3 years pers-day fixed rate e Transportasi Participant person x 1 r-trip pers-trip fixed rate f Training Kit person x 1 set set fixed rate g Training Material person x 1 set set fixed rate h Spanduk 29 district x 1 unit x 3 years unit fixed rate i Reporting 29 district x 1 ls x 3 years ls fixed rate 8.6 District Workshop for Socialization RAD AMP for new districts - - a Fullday Package for Participant - district x 15 person x 1 days x 1 years pers-day fixed rate b Fullday Package for Pemandu - district x 2 person x 1 days x 1 years pers-day fixed rate c Fullday Package for DPMU - district x 2 person x 1 days x 1 years pers-day fixed rate d Training Kit - district x 19 person x 1 set x 1 years set fixed rate e Training Material - district x 19 person 1 set x 1 years set fixed rate f Spanduk - district x 1 unit x 1 years unit fixed rate g Reporting - district x 1 ls x 1 years ls fixed rate 8.7 District Workshop for Expose RAD AMPL for new District - - a Fullday Package for Participant - district x 15 person x 1 days x 1 years pers-day fixed rate b Fullday Package for Pemandu - district x 2 person x 1 days x 1 years pers-day fixed rate c Fullday Package for DPMU - district x 2 person x 1 days x 1 years pers-day fixed rate d Training Kit - district x 19 person x 1 set x 1 years set fixed rate e Training Material - district x 19 person x 1 set x 1 years set fixed rate f Spanduk - district 1 unit x 1 years unit fixed rate g Reporting - district 1 ls x 1 years ls fixed rate 8.8 District Workshop for Review and Monitoring RAD AMPL for all districts a Fullday Package for Participant 29 district x 15 person x 3 days x 3 years pers-day fixed rate b Fullday Package for Pemandu 29 district x 2 person x 3 days x 3 years pers-day fixed rate c Fullday Package for DPMU 29 district x 2 person x 3 days x 3 years pers-day fixed rate d Training Kit 29 district x 19 person x 1 set x 3 years set fixed rate e Training Material 29 district x 19 person x 1 set x 3 years set fixed rate f Spanduk 29 district x 1 unit x 3 years unit fixed rate g Reporting 29 district x 1 ls x 3 years ls fixed rate 8.9 District Workshop Keberlanjutan & Pengembangan Asosiasi a Uang harian Paket Fullday for Participant villages x 1 person x 3 days pers-day ceilling rate b Fullday Package for Participant villages x 1 person x 2 days pers-day fixed rate c Fullday Package for Pemandu 29 district x 2 person x 2 days x 3 years pers-day fixed rate d Fullday Package for DPMU 29 district x 2 person x 2 days x 3 years pers-day fixed rate e Transportasi Participant person x 1 r-trip pers-trip fixed rate f Training Kit person x 1 set set fixed rate g Training Material person x 1 set set fixed rate h Spanduk 29 district x 1 unit x 3 years unit fixed rate i Reporting 29 district x 1 ls x 3 years ls fixed rate 8.10 District Pelatihan Penguatan Pemerintah Desa & Kecamatan a Fullboard Package for Participant village kec. x 1 person x 3 days pers-day fixed rate b Fullboard Package for Pemandu 29 district x 2 person x 3 days x 3 years pers-day fixed rate c Fullboard Package for PPMU 29 district x 2 person x 3 days x 3 years pers-day fixed rate d Transportasi Participant person x 1 r-trip pers-trip fixed rate e Training Kit person x 1 set set fixed rate f Training Material person x 1 set set fixed rate g Spanduk 29 district x 1 unit x 3 years unit fixed rate h Reporting 29 district x 1 ls x 3 years ls fixed rate

7 8.11 Provincial Pelatihan Asosiasi BPSPAM a Uang harian Paket Fullboard for Participant 29 district x 2 person x 4 days x 3 years pers-day ceilling rate b Fullboard Package for Participant 29 district x 2 person x 3 days x 3 years pers-day fixed rate c Fullboard Package for Pemandu 2 person x 3 days x 3 years pers-day fixed rate d Fullboard Package for PPMU 2 person x 3 days x 3 years pers-day fixed rate e Transportasi Participant 29 district x 2 person x 1 r-trip x 3 years pers-trip fixed rate f Training Kit 62 person x 1 set x 3 years set fixed rate g Training Material 62 person x 1 set x 3 years set fixed rate h Spanduk 1 unit x 3 years unit fixed rate i Reporting 1 ls x 3 years ls fixed rate 8.12 Provincial Training for Preparing RAD AMPL a Uang harian Paket Fullboard 29 district x 4 person x 5 days x 1 years pers-day ceilling rate b Fullboard Package for Participant 29 district x 4 person x 4 days x 1 years pers-day fixed rate c Fullboard Package for Pemandu 4 person x 4 days x 1 years pers-day fixed rate d Fullboard Package for PPMU 2 person x 4 days x 1 years pers-day fixed rate e Transportasi Participant 29 district x 4 person x 1 r-trip x 1 years pers-trip fixed rate f Training Kit 122 person x 1 set x 1 years set fixed rate g Training Material 122 person x 1 set x 1 years set fixed rate h Spanduk 1 unit x 1 years unit fixed rate i Reporting 1 ls x 1 years ls fixed rate 8.13 Provincial Workshop Integration RAD AMPL with RPJMD/RKPD a Fullboard Package for Participant 29 district x 2 person x 2 days x 3 years pers-day fixed rate b Fullday Package for Pemandu 29 district x 3 person x 2 days x 3 years pers-day fixed rate c Fullday Package for PPMU 29 district x 2 person x 2 days x 3 years pers-day fixed rate d Training Kit 63 set x 3 years set fixed rate e Training Material 63 set x 3 years set fixed rate f Spanduk 1 unit x 3 years unit fixed rate g Reporting 1 ls x 3 years ls fixed rate 8.14 Provincial Workshop Reviewing RAD AMPL a Fullboard Package for Participant 29 district x 4 person x 2 days x 3 years pers-day fixed rate b Fullboard Package for Pemandu 4 person x 2 days x 3 years pers-day fixed rate c Fullboard Package for PPMU 2 person x 2 days x 3 years pers-day fixed rate d Training Kit 122 person x 1 set x 3 years set fixed rate e Training Material 122 person x 1 set x 3 years set fixed rate f Spanduk 1 unit x 3 years unit fixed rate g Reporting 1 ls x 3 years ls fixed rate 8.15 Cost of "Basic Program" to The District Association a Old District 29 district x 3 years No fixed rate b New District - district x 2 years No fixed rate 9 MEDIA SOCIALIZATION Printing Media Sozialization and Distribution Cost Spanduk 565 villages x 2 set x 2 theme No fixed rate Poster for Villages 565 villages 5 set x 10 theme No fixed rate Poster for Districts 3 years x 29 district x 5 set x 10 theme No fixed rate Poster for Provinces 3 years x 1 province x 5 set x 10 theme No fixed rate Distribusi fixed rate 10 REPORTING Inception Report 1 time copies fixed rate 10.2 Monthly Report 9 time x 4 years x 10 copies copies fixed rate 10.3 Quarterly Report 3 time x 4 years x 10 copies copies fixed rate 10.4 Special Report 3 time x 10 copies copies fixed rate 10.5 Annual Report 3 time x 10 copies copies fixed rate 10.6 Financial Management Report (FMR) 3 time x 10 copies copies fixed rate 10.7 Draft Final Report 1 time x 10 copies copies fixed rate 10.8 Final Report 1 time x 10 copies copies fixed rate

8 B REIMBURSABLE COST B.2 REIMBURSABLE DI YOGYAKARTA 1 DUTY TRAVEL Uji Petik/ Spot Checking Provincial Team to District and New Villages with RKM (Calon Desa Sasaran) a Transport lokal 3,5 years x 27 person x 1 time x 1 trip pers-trip fixed rate b Akomodasi 3,5 years x 27 person x 1 time x 1 days pers-day fixed rate c Uang saku 3,5 years x 27 person x 1 time x 2 days pers-day ceilling rate Provincial Team to District and Old Villages a Transport lokal 3,5 years x 27 person x 1 time x 1 trip pers-trip fixed rate b Akomodasi 3,5 years x 27 person x 1 time x 1 days pers-day fixed rate c Uang saku 3,5 years x 27 person x 1 time x 2 days pers-day ceilling rate District Team to New Villages with RKM (Calon Desa Sasaran-Baru) a Transport lokal 4 district x 3,5 years x 12 person x 1 time x 1 trip pers-trip fixed rate b Uang saku 4 district x 3,5 years x 12 person x 1 time x 2 days pers-day ceilling rate District Team to Old Villages with RKM (Calon Desa Sasaran-Perbaikan Kinerja dan Pengembangan) a Transport lokal 4 district x 3,5 years x 12 person x 1 time x 1 trip pers-trip fixed rate b Uang saku 4 district x 3,5 years x 12 person x 1 time x 2 days pers-day ceilling rate 1.2 Monitoring, Supervision and Strenghtening Provincial Team to District a Transport lokal 6 person x 3,5 years x 6 time x 1 trip pers-trip fixed rate b Akomodasi 6 person x 3,5 years x 6 time x 3 days pers-day fixed rate c Uang saku 6 person x 3,5 years x 6 time x 4 days pers-day ceilling rate 1.3 Coordination Meeting Provincial Coordination Meeting (District Team to Province) a Transport lokal 4 district x 3 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate b Fullboard Package for Participant from District 4 district x 3 person x 3,5 years x 2 time x 2 days pers-day fixed rate c Fullboard Package for Participant from Province 6 person x 3,5 years x 2 time x 2 days pers-day fixed rate d Uang saku for district team 4 district x 3 person x 3,5 years x 2 time x 3 days pers-day ceilling rate e Material Kit 18 person x 3,5 years x 2 time x 1 set set fixed rate Special Meeting at District Level (for Provincial Team), by request a Transport lokal 6 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate b Akomodasi 6 person x 3,5 years x 2 time x 2 days pers-day fixed rate c Uang saku 6 person x 3,5 years x 2 time x 3 days pers-day ceilling rate Special Meeting at Provincial Level (for District Team), by request a Transport lokal 4 district x 1 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate b Akomodasi 4 district x 1 person x 3,5 years x 2 time x 2 days pers-day fixed rate c Uang saku 4 district x 1 person x 3,5 years x 2 time x 3 days pers-day ceilling rate Special Meeting at National Level (for Provincial Team), by request a Air Fare Tickets 2 person x 3,5 years x 2 time x 1 trip pers-trip ceilling rate b Taksi dari dan ke Bandara 2 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate c Akomodasi 2 person x 3,5 years x 2 time x 2 days pers-day fixed rate d Uang saku 2 person x 3,5 years x 2 time x 3 days pers-day ceilling rate National Coordination Meeting (for Provincial Team), by request a Air Fare Tickets 2 person x 3,5 years x 2 time x 1 trip pers-trip ceilling rate b Taksi dari dan ke Bandara 2 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate c Akomodasi 2 person x 3,5 years x 2 time x 2 days pers-day fixed rate d Uang saku 2 person x 3,5 years x 2 time x 3 days pers-day fixed rate District Coordination Meeting (with TFM and STBM Faskab) and MIS Day a Meals, Snack 31 person + 4 district x 6 person x 44 month pack-pers fixed rate 1.4 Expert Group Meeting (EGM) Provincial Level EGM (District Team to Province) a Transport lokal 4 district x 3 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate b Fullboard Package for Participant from District 4 district x 3 person x 3,5 years x 2 time x 2 days pers-day fixed rate c Fullboard Package for Participant from Province 6 person x 3,5 years x 2 time x 2 days pers-day fixed rate d Uang saku for District Team 4 district x 2 person x 3,5 years x 2 time x 3 days pers-day ceilling rate e Material Kit 18 person x 3,5 years x 2 time x 1 set set fixed rate Central Level EGM (for Provincial Team) a Air Fare Tickets 6 person x 3,5 years x 2 time x 1 trip pers-trip ceilling rate b Taksi dari dan ke Bandara 6 person x 3,5 years x 2 time x 1 trip pers-trip fixed rate c Akomodasi (by NMC) covered by NMC pers-day d Uang saku 6 person x 3,5 years x 2 time x 3 days pers-day fixed rate

9 2 MOBILIZATION AND DEMOBILIZATION Air Fare Tickets [Jakarta-Banda Aceh-Jakarta] a Provincial Coordinator 1 person x 1 r-trip pers-trip ceilling rate b Co. Provincial Coordinator - person x 1 r-trip pers-trip ceilling rate c Water Supply and Sanitation Specialist 1 person x 1 r-trip pers-trip ceilling rate d Financial Management Specialist 1 person x 1 r-trip pers-trip ceilling rate e Local Government Specialist 1 person x 1 r-trip pers-trip ceilling rate f CD / CB Coordinator 1 person x 1 r-trip pers-trip ceilling rate g Data Management Analyst 1 person x 1 r-trip pers-trip ceilling rate 2.2 Taksi dari dan ke Bandara 6 person x 1 r-trip pers-trip fixed rate 3 OFFICE SPACE - Rental Provincial Team 1 office x 44 month office-mth fixed rate 3.2 District Team 4 office x 44 month office-mth fixed rate 4 OFFICE RUNNING COST AND CONSUMABLE COST Provincial Team 1 office x 44 month office-mth fixed rate 4.2 BOP for District Team 4 office x 44 month office-mth fixed rate 5 OFFICE EQUIPMENT - Rental Provincial Team a Notebook Computer 6 person x 1 unit x 44 month unit-mth fixed rate b Portable Computer + Desk + Chair 2 person x 1 unit x 44 month unit-mth fixed rate c Inkjet Printer + Scan + Copy (2 No.) 1 office x 2 unit x 44 month unit-mth fixed rate d Digital Camera (2 No.) 1 office x 2 unit x 44 month unit-mth fixed rate e Projector + Screen 1 office x 1 unit x 44 month unit-mth fixed rate 5.2 District Team a Notebook Computer for DC 4 Districts x 1 person x 1 unit x 44 month unit-mth fixed rate b Notebook Computer for Co. DC 2 Districts x 1 person x 1 unit x 44 month unit-mth fixed rate c Notebook Computer for DFMA 2 Districts x 1 person x 1 unit x 44 month unit-mth fixed rate d Portable Computer + Desk + Chair for DEAO 4 person x 1 unit x 44 month unit-mth fixed rate e Inkjet Printer + Scan + Copy 4 office x 1 unit x 44 month unit-mth fixed rate f Digital Camera 4 office x 2 unit x 44 month unit-mth fixed rate g GPS 4 office x 2 unit x 44 month unit-mth fixed rate h Projector + Screen 4 office x 1 unit x 44 month unit-mth fixed rate 6 VEHICLE - Rental Car include Driver & O&M for Provincial Team 1 office x 2 unit x 44 month unit-mth fixed rate 6.2 Car include Driver & O&M for District Team 4 office x 1 unit x 44 month unit-mth fixed rate a BBM (gasoline) for Monitoring, Evaluation and Strengthening 4 office x 1 unit x 44 month unit-mth COMMUNICATION Telephone, Postage and Internet Connection for Provincial Team 1 office x 44 month unit-mth fixed rate 7.2 Telephone, Postage and Internet Connection for Distrcit Team 4 office x 44 month unit-mth fixed rate 8 TRAINING On the Job Training (OJT) for TFM: including E-Learning a Training Material + Kit 31 person + 3 person x 44 month No fixed rate b Full-day Package for TFM 31 person + 3 person x 44 month No fixed rate 8.2 District Training for Kader AMPL of new Villages a Uang harian for Participants 49 villages x 2 person x 4 days x 3 years pers-day ceilling rate b Fullboard Package for Participant 49 villages x 2 person x 3 days x 3 years pers-day fixed rate c Fullboard Package for Pemandu 4 district x 2 person x 3 days x 3 years pers-day fixed rate d Fullboard Package for DPMU 4 district x 2 person x 3 days x 3 years pers-day fixed rate e Transportasi Participant (only for kader AMPL) 98 person x 1 r-trip x 3 years pers-trip fixed rate f Training Kit 114 person x 1 set x 3 years set fixed rate g Training Material 114 person x 1 set x 3 years set fixed rate h Spanduk 4 district x 1 unit x 3 years unit fixed rate i Reporting 4 district x 1 ls x 3 years ls fixed rate 8.3 District Training for Kader AMPL of old Villages a Uang harian Paket Fullboard for Participant 255 villages 1 person x 3 days pers-day ceilling rate b Fullboard Package for Participant 255 villages 1 person x 2 days pers-day fixed rate c Fullboard Package for Pemandu 4 district x 2 person x 2 days x 3 years pers-day fixed rate d Fullboard Package for DPMU 4 district x 2 person x 2 days x 3 years pers-day fixed rate e Transportasi Participant 255 person x 1 r-trip pers-trip fixed rate f Training Kit 271 person x 1 set set fixed rate g Training Material 271 person x 1 set set fixed rate h Spanduk 4 district x 1 unit x 3 years unit fixed rate i Reporting 4 district x 1 ls x 3 years ls fixed rate

10 8.4 District Training for BPSPAM (new Villages) a Uang harian Paket Fullboard for Participant 49 villages x 2 person x 4 days x 3 years pers-day ceilling rate b Fullboard Package for Participant 49 villages x 2 person x 3 days x 3 years pers-day fixed rate c Fullboard Package for Pemandu 4 district x 2 person x 3 days x 3 years pers-day fixed rate d Fullboard Package for DPMU 4 district x 2 person x 3 days x 3 years pers-day fixed rate e Transportasi Participant 98 person x 1 r-trip x 3 years pers-trip fixed rate f Training Kit 114 person x 1 set x 3 years set fixed rate g Training Material 114 person x 1 set x 3 years set fixed rate h Spanduk 4 district x 1 unit x 3 years unit fixed rate i Reporting 4 district x 1 ls x 3 years ls fixed rate 8.5 District Training for BPSPAM of old Villages a Uang harian Paket Fullboard 255 villages x 1 person x 4 days pers-day ceilling rate b Fullboard Package for Participant 255 villages x 1 person x 3 days pers-day fixed rate c Fullboard Package for Pemandu 4 district x 2 person x 3 days x 3 years pers-day fixed rate d Fullboard Package for DPMU 4 district x 2 person x 3 days x 3 years pers-day fixed rate e Transportasi Participant 255 person x 1 r-trip pers-trip fixed rate f Training Kit 271 person x 1 set set fixed rate g Training Material 271 person x 1 set set fixed rate h Spanduk 4 district x 1 unit x 3 years unit fixed rate i Reporting 4 district x 1 ls x 3 years ls fixed rate 8.6 District Workshop for Socialization RAD AMP for new districts a Fullday Package for Participant 2 district x 15 person x 1 days x 1 years pers-day fixed rate b Fullday Package for Pemandu 2 district x 2 person x 1 days x 1 years pers-day fixed rate c Fullday Package for DPMU 2 district x 2 person x 1 days x 1 years pers-day fixed rate d Training Kit 2 district x 19 person x 1 set x 1 years set fixed rate e Training Material 2 district x 19 person 1 set x 1 years set fixed rate f Spanduk 2 district x 1 unit x 1 years unit fixed rate g Reporting 2 district x 1 ls x 1 years ls fixed rate 8.7 District Workshop for Expose RAD AMPL for new District a Fullday Package for Participant 2 district x 15 person x 1 days x 1 years pers-day fixed rate b Fullday Package for Pemandu 2 district x 2 person x 1 days x 1 years pers-day fixed rate c Fullday Package for DPMU 2 district x 2 person x 1 days x 1 years pers-day fixed rate d Training Kit 2 district x 19 person x 1 set x 1 years set fixed rate e Training Material 2 district x 19 person x 1 set x 1 years set fixed rate f Spanduk 2 district 1 unit x 1 years unit fixed rate g Reporting 2 district 1 ls x 1 years ls fixed rate 8.8 District Workshop for Review and Monitoring RAD AMPL for all districts a Fullday Package for Participant 4 district x 15 person x 3 days x 3 years pers-day fixed rate b Fullday Package for Pemandu 4 district x 2 person x 3 days x 3 years pers-day fixed rate c Fullday Package for DPMU 4 district x 2 person x 3 days x 3 years pers-day fixed rate d Training Kit 4 district x 19 person x 1 set x 3 years set fixed rate e Training Material 4 district x 19 person x 1 set x 3 years set fixed rate f Spanduk 4 district x 1 unit x 3 years unit fixed rate g Reporting 4 district x 1 ls x 3 years ls fixed rate 8.9 District Workshop Keberlanjutan & Pengembangan Asosiasi a Uang harian Paket Fullday for Participant 255 villages x 1 person x 3 days pers-day ceilling rate b Fullday Package for Participant 255 villages x 1 person x 2 days pers-day fixed rate c Fullday Package for Pemandu 4 district x 2 person x 2 days x 3 years pers-day fixed rate d Fullday Package for DPMU 4 district x 2 person x 2 days x 3 years pers-day fixed rate e Transportasi Participant 255 person x 1 r-trip pers-trip fixed rate f Training Kit 271 person x 1 set set fixed rate g Training Material 271 person x 1 set set fixed rate h Spanduk 4 district x 1 unit x 3 years unit fixed rate i Reporting 4 district x 1 ls x 3 years ls fixed rate 8.10 District Pelatihan Penguatan Pemerintah Desa & Kecamatan a Fullboard Package for Participant 255 village + 17 kec. x 1 person x 3 days pers-day fixed rate b Fullboard Package for Pemandu 4 district x 2 person x 3 days x 3 years pers-day fixed rate c Fullboard Package for PPMU 4 district x 2 person x 3 days x 3 years pers-day fixed rate d Transportasi Participant 272 person x 1 r-trip pers-trip fixed rate e Training Kit 288 person x 1 set set fixed rate f Training Material 288 person x 1 set set fixed rate g Spanduk 4 district x 1 unit x 3 years unit fixed rate h Reporting 4 district x 1 ls x 3 years ls fixed rate