Lampiran BA Aanwizjing Askes 2013
PANITIA PENGADAN BARANG/JASA
SEKRETARIAT DPRD KABUPATEN BONDOWOSO
TAHUN ANGGARAN 2013
______________________________________________________________
BERITA ACARA PENJELASAN PEKERJAAN
Nomor : 177/104/ASR/15.09/430.9/2013
Tanggal : 24 Mei 2013
Pada hari ini Jum’at Tanggal Dua Puluh Empat Bulan Mei Tahun Dua Ribu Tiga belas,
Panitia Pengadaan Barang /Jasa untuk kegiatan Pengadaan Jasa Jaminan Pemeliharaan
Kesehatan Pimpinan dan Anggota DPRD Tahun 2013, telah menyelenggarakan penjelasan
untuk pekerjaan Premi Asuransi Kesehatan. Penjelasan pekerjaan dilaksanakan melalui
aplikasi SPSE Kabupaten Bondowoso yang dimulai pukul 08.30 – 09.30 WIB.
Pokok-pokok Pejelasan :
1. Tambahan –tambahan (adendum) pengadaan
2. Tanya jawab calon peserta pengadaan
:
TIDAK ADA adendum dari panitia.
:
TIDAK ADA pertanyaaan dari peserta.
Demikian berita acara penjelasan pekerjaan ini dibuat dengan sebenarnya untuk
dimaklumi bagi pihak yang berkepentingan.
Bondowoso, 24 MEI 2013
PANITIA PENGADAAN BARANG/JASA
SEKRETARIAT DPRD KABUPATEN BONDOWOSO
1.
AGUS WINARNO, SE,M.Si
....................................
2.
PUTU BUDHI SETIAWAN, ST, MM
....................................
3.
IRA SOFIYANTI
....................................
LA MP IR A N
AA N WI ZI NG
B ER IT A
AC AR A
( P EN J EL AS A N
)
Nomor : 177/104/ASR/15.09/430.9/2013
Tanggal : 24 Mei 2013
untuk
Pengadaan
Jasa Jaminan Pemeliharaan Kesehatan Pimpinan dan Anggota DPRD
PANITIA PENGADAAN BARANG/JASA
SEKRETARIAT DPRD KABUPATEN BONDOWOSO
Tahun Anggaran 2013
1
BAB I. UMUM
A.
............................................................................................................................................................................ Tetap.
B.
............................................................................................................................................................................ Tetap.
C.
............................................................................................................................................................................ Tetap.
D.
............................................................................................................................................................................ Tetap.
E.
............................................................................................................................................................................ Tetap.
2
BAB II. PENGUMUMAN PELELANGAN DENGAN PASCAKUALIFIKASI
Pengumuman pelelangan tercantum dalam pada aplikasi SPSE
..........................................................TETAP.........................................................
3
BAB III. INSTRUKSI KEPADA PESERTA (IKP)
A. UMUM
1. Lingkup Pekerjaan
1.1
................................................................................................. Tetap
1.2
................................................................................................. Tetap
1.3
................................................................................................. Tetap
2. Sumber Dana
................................................................................................. Tetap
3. Peserta Pelelangan
3.1
................................................................................................. Tetap
3.2
................................................................................................. Tetap
3.3
................................................................................................. Tetap
4.1
................................................................................................. Tetap
4.2
................................................................................................. Tetap
5.1
................................................................................................. Tetap
5.2
................................................................................................. Tetap
5.3
................................................................................................. Tetap
4. Larangan Korupsi, Kolusi,
dan Nepotisme (KKN) serta
Penipuan
5. Larangan Pertentangan
Kepentingan
6. Satu Penawaran Tiap
................................................................................................. Tetap
Peserta
B.
DOKUMEN PENGADAAN
7. Isi Dokumen
8.1
................................................................................................. Tetap
8.2
................................................................................................. Tetap
8.3
................................................................................................. Tetap
8.4
................................................................................................. Tetap
Pengadaan
8. Bahasa Dokumen
................................................................................................. Tetap
Pengadaan
9. Pemberian Penjelasan
10. Perubahan Dokumen
9.1
................................................................................................. Tetap
9.2
................................................................................................. Tetap
9.3
................................................................................................. Tetap
9.4
................................................................................................. Tetap
9.5
................................................................................................. Tetap
10.1
................................................................................................. Tetap
10.2
................................................................................................. Tetap
10.3
................................................................................................. Tetap
10.4
................................................................................................. Tetap
10.5
................................................................................................. Tetap
Pengadaan
4
11. Tambahan Waktu
10.6
................................................................................................. Tetap
10.7
................................................................................................. Tetap
................................................................................................. Tetap
Pemasukan Dokumen
Penawaran
C. PENYIAPAN DOKUMEN PENAWARAN
12. Biaya dalam Penyiapan
13.1
................................................................................................. Tetap
13.2
................................................................................................. Tetap
14.1
................................................................................................. Tetap
14.2
................................................................................................. Tetap
14.3
................................................................................................. Tetap
14. Dokumen Penawaran
15.1
................................................................................................. Tetap
15. Harga Penawaran
16.1
................................................................................................. Tetap
16.2
................................................................................................. Tetap
16.3
................................................................................................. Tetap
17.1
................................................................................................. Tetap
17.2
................................................................................................. Tetap
17. Masa Berlaku Penawaran 18.1
................................................................................................. Tetap
Penawaran
13. Bahasa Penawaran
16. Mata Uang Penawaran
dan Cara Pembayaran
dan Jangka Waktu
Pelaksanaan
18.2
................................................................................................. Tetap
18. Pengisian Data Kualifikasi 19.1
................................................................................................. Tetap
19.2
................................................................................................. Tetap
20.1
................................................................................................. Tetap
20.2
................................................................................................. Tetap
20. Surat Jaminan Penawaran 21.1
................................................................................................. Tetap
21.2
................................................................................................. Tetap
21.3
................................................................................................. Tetap
21.4
................................................................................................. Tetap
21.5
................................................................................................. Tetap
21.6
.................................................................................................. tetap
19. Pakta Integritas
5
D. PEMASUKAN DOKUMEN PENAWARAN
21. Penyampulan dan
22.1
Penandaan Sampul
Penawaran
................................................................................................. Tetap
22.1.A) .................................................................................................
Tetap
22.1.B) .................................................................................................
Tetap
22.1.C) .................................................................................................
Tetap
22.1.D) .................................................................................................
Tetap
22. Pemasukan/
23.1
................................................................................................. Tetap
Penyampaian Dokumen
Penawaran
23. Batas Akhir Waktu
24.1
................................................................................................. Tetap
24.2
................................................................................................. Tetap
Pemasukan Penawaran
24. Dokumen Penawaran
................................................................................................. Tetap
Terlambat
E.
PEMBUKAAN DAN EVALUASI PENAWARAN
25. Pembukaan Penawaran
26. Evaluasi Penawaran
26.1
................................................................................................. Tetap
26.2
................................................................................................. Tetap
26.3
................................................................................................. Tetap
26.4
26.5
................................................................................................. Tetap
................................................................................................. Tetap
26.6
................................................................................................. Tetap
27.1 ................................................................................................. Tetap
27.1.A)
................................................................................................. Tetap
27.1.B) ................................................................................................. Tetap
................................................................................................. Tetap
27.1.C) ................................................................................................. Tetap
27.1.D) ................................................................................................. Tetap
27.1.E) ................................................................................................. Tetap
27.1.F) ................................................................................................. Tetap
27.2 ................................................................................................. Tetap
27.3 ................................................................................................. Tetap
27.4 ................................................................................................. Tetap
27.5.A) .................................................................................................
6
Tetap
27.6.B
Evaluasi
Harga
................................................................................................. Tetap
27.6.B.1) .................................................................................................
Tetap
27.6.B.2) .................................................................................................
Tetap
27.6.B.3) .................................................................................................
Tetap
27.6.B.4) .................................................................................................
Tetap
27.6.B.5) .................................................................................................
Tetap
27. Evaluasi Kualifikasi
28. Pembuktian Kualifikasi
28.1
27.6.C
................................................................................................. Tetap
27.6.D
................................................................................................. Tetap
27.6.E
................................................................................................. Tetap
................................................................................................. Tetap
28.2
................................................................................................. Tetap
28.3
................................................................................................. Tetap
28.4
................................................................................................. Tetap
28.5
................................................................................................. Tetap
28.6
................................................................................................. Tetap
28.8
................................................................................................. Tetap
29.1
................................................................................................. Tetap
29.2
................................................................................................. Tetap
29.3
................................................................................................. Tetap
29.4
................................................................................................. Tetap
29.5
................................................................................................. Tetap
29.6
................................................................................................. Tetap
29.7
................................................................................................. Tetap
29.8
................................................................................................. Tetap
29.9 ................................................................................................. Tetap
F.
PENETAPAN PEMENANG PELELANGAN
29. Penetapan Pemenang
30.1
................................................................................................. Tetap
30.2
................................................................................................. Tetap
30.3
................................................................................................. Tetap
7
30. Pengumuman Pemenang
31. Sanggahan
32. Sanggahan Banding
................................................................................................. Tetap
32.1
................................................................................................. Tetap
32.2
................................................................................................. Tetap
32.3
................................................................................................. Tetap
32.4
................................................................................................. Tetap
32.5
................................................................................................. Tetap
33.1
................................................................................................. Tetap
33.2
................................................................................................. Tetap
33.3
................................................................................................. Tetap
33.4
................................................................................................. Tetap
33.5
................................................................................................. Tetap
33.6
................................................................................................. Tetap
33.7
................................................................................................. Tetap
G. PENUNJUKAN PEMENANG
33. Penunjukan
34.1
................................................................................................. Tetap
Penyedia
Barang/Jasa
34.2
................................................................................................. Tetap
34.3
................................................................................................. Tetap
34.4
................................................................................................. Tetap
34.5
................................................................................................. Tetap
34.6
................................................................................................. Tetap
34.7
................................................................................................. Tetap
34.8
................................................................................................. Tetap
34.9
................................................................................................. Tetap
34.10
................................................................................................. Tetap
34.11
................................................................................................. Tetap
34.12
................................................................................................. Tetap
34. BAHP, Berita Acara
Lainnya, dan Kerahasiaan
Proses
34.1
................................................................................................. Tetap
34.2
................................................................................................. Tetap
34.3
................................................................................................. Tetap
8
H. PELELANGAN GAGAL
35. Pelelangan
36.1
................................................................................................. Tetap
36.2
................................................................................................. Tetap
36.3
................................................................................................. Tetap
36.4
................................................................................................. Tetap
36.5
................................................................................................. Tetap
36.6
................................................................................................. Tetap
Gagal
I.
PENANDATANGANAN KONTRAK
36. Penanda-
37.1
................................................................................................. Tetap
tanganan
Kontrak
37.2
................................................................................................. Tetap
37.3
................................................................................................. Tetap
37.4
................................................................................................. Tetap
37.5
................................................................................................. Tetap
37.6
................................................................................................. Tetap
37.7
................................................................................................. Tetap
37.8
................................................................................................. Tetap
37.9
................................................................................................. Tetap
9
BAB IV. LEMBAR DATA PEMILIHAN (LDP)
A. LINGKUP
1.
................................................................................................. Tetap
2.
................................................................................................. Tetap
3.
................................................................................................. Tetap
4.
................................................................................................. Tetap
5.
................................................................................................. Tetap
6.
................................................................................................. Tetap
PEKERJAAN
B. SUMBER DANA
................................................................................................. Tetap
C. JADWAL TAHAPAN ................................................................................................. Tetap
PEMILIHAN
D. MATA UANG
E.
F.
PENAWARAN DAN
CARA
PEMBAYARAN
MASA
BERLAKUNYA
PENAWARAN
JAMINAN
PENAWARAN
1.
2.
................................................................................................. Tetap
................................................................................................. Tetap
................................................................................................. Tetap
1. ................................................................................................. Tetap
2. ................................................................................................. Tetap
3. ................................................................................................. Tetap
4. ................................................................................................. Tetap
G. JADWAL
................................................................................................. Tetap
PEMASUKAN
DOKUMEN
PENAWARAN
H. BATAS AKHIR
................................................................................................. Tetap
PEMASUKAN
PENAWARAN
I. PEMBUKAAN
................................................................................................. Tetap
PENAWARAN
................................................................................................. Tetap
J. DOKUMEN
PENAWARAN
K. SANGGAHAN,
SANGGAHAN
BANDING DAN
PENGADUAN
1.
................................................................................................. Tetap
2.
................................................................................................. Tetap
3.
................................................................................................. Tetap
4.
................................................................................................. Tetap
5.
................................................................................................. Tetap
10
BAB V. LEMBAR DATA KUALIFIKASI (LDK)
A. Lingkup Kualifikasi
B. Persyaratan Kualifikasi
................................................................................................. Tetap
................................................................................................. Tetap
11
BAB VI. BENTUK DOKUMEN PENAWARAN
A.
BENTUK SURAT PENAWARAN [PESERTA BADAN USAHA/KEMITRAAN (KSO)] (UNTUK 1
(SATU) FILE
..............................................................................
TETAP
.....................................................................................................
12
B.
BENTUK PERJANJIAN KEMITRAAN/KERJA SAMA OPERASI (KSO)
CONTOH
..............................................................................
TETAP
.....................................................................................................
13
C.
BENTUK DOKUMEN PENAWARAN TEKNIS
DOKUMEN PENAWARAN TEKNIS
..............................................................................
TETAP
.....................................................................................................
14
D.
BENTUK JAMINAN PENAWARAN DARI BANK
CONTOH
..............................................................................
TETAP
.....................................................................................................
15
E.
BENTUK JAMINAN PENAWARAN DARI ASURANSI/PERUSAHAAN PENJAMINAN
CONTOH
..............................................................................
TETAP
.....................................................................................................
16
F.
BENTUK PAKTA INTEGRITAS
Dengan mendaftar sebagai peserta pemilihan pada aplikasi SPSE maka peserta telah
menyetujui dan menandatangani pakta integritas
[Contoh Pakta Integritas Badan Usaha Dengan Kemitraan]
PAKTA INTEGRITAS
..............................................................................
TETAP
.....................................................................................................
17
G.
DATA ISIAN KUALIFIKASI
Isian Data Kualifikasi bagi Peserta selain anggota Kemitraan/KSO berbentuk Form Isia n
Elektronik Data Kualifikasi yang tersedia pada aplikasi SPSE
[FORMULIR ISIAN KUALIFIKASI UNTUK KEMITRAAN/KSO]
..............................................................................
TETAP
.....................................................................................................
18
BAB VII. PETUNJUK PENGISIAN DATA KUALIFIKASI
..............................................................................
TETAP
.....................................................................................................
19
VIII. TATA CARA EVALUASI KUALIFIKASI
..............................................................................
TETAP
.....................................................................................................
20
BAB IX. BENTUK DOKUMEN KONTRAK
A.
BENTUK SURAT PERJANJIAN
..............................................................................
TETAP
.....................................................................................................
21
B.
BENTUK SURAT PERINTAH KERJA (SPK)
[kop surat K/L/D/I]
TETAP
22
BAB X. SYARAT-SYARAT UMUM KONTRAK (SSUK)
A.
KETENTUAN UMUM
1.
Definisi
2.
Penerapan
3.
Bahasa dan
Hukum
4.
Larangan
Korupsi, Kolusi,
dan Nepotisme
(KKN) serta
Penipuan
5.
Korespondensi
6.1
6.
Wakil Sah Para
Pihak
................................................................................................. tetap
7.
Perpajakan
................................................................................................. tetap
8.
Pengalihan
dan/atau
Subkontrak
[Pengabaian
9.
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
10. [Penyedia
Mandiri
................................................................................................. tetap
11. Kemitraan/KSO
................................................................................................. tetap
B.
PELAKSANAAN, PENYELESAIAN, PERUBAHAN, DAN PEMUTUSAN KONTRAK
B.1 Pelaksanaan Pekerjaan
12. Jadwal
Pelaksanaan
Pekerjaan
15.1
................................................................................................. tetap
13. Surat Perintah
17.1
Mulai Kerja
(SPMK)
B.2 Pengendalian Waktu
................................................................................................. tetap
14. Waktu
Penyelesaian
Pekerjaan
15. Perpanjangan
Waktu
................................................................................................. tetap
................................................................................................. tetap
B.3 Penyelesaian Kontrak
16. Serah Terima
Pekerjaan
17. [Pengambilalihan
B.4 Perubahan Kontrak
................................................................................................. tetap
................................................................................................. tetap
23
18. Perubahan
Kontrak
................................................................................................. tetap
19. Keadaan Kahar
................................................................................................. tetap
B.6 Penghentian dan Pemutusan Kontrak
20. Penghentian
Kontrak
21. Pemutusan
Kontrak
................................................................................................. tetap
................................................................................................. tetap
22. Pemutusan
Kontrak oleh PPK
23. Pemutusan
Kontrak oleh
Penyedia
24. Pemutusan
Kontrak akibat
lainnya
C.
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
HAK DAN KEWAJIBAN PENYEDIA
25. Hak dan
Kewajiban
Penyedia
................................................................................................. tetap
26. Penggunaan
................................................................................................. tetap
Dokumen Kontrak
dan Informasi
27. Hak Atas
Kekayaan
Intelektual
28. Penanggungan
dan Risiko
................................................................................................. tetap
29. Kepemilikan
Dokumen
................................................................................................. tetap
................................................................................................. tetap
30. Kerjasama Antara
Penyedia dan Sub
Penyedia
31. Usaha Mikro,
Usaha Kecil dan
Koperasi Kecil
32. Pembayaran
Denda
D.
................................................................................................. tetap
................................................................................................. tetap
HAK DAN KEWAJIBAN PPK
33. Hak dan
Kewajiban PPK
34. Fasilitas
35. Peristiwa
Kompensasi
E.
................................................................................................. tetap
................................................................................................ tetap
................................................................................................. tetap
................................................................................................. tetap
PEMBAYARAN KEPADA PENYEDIA
36. Harga Kontrak
37. Pembayaran
................................................................................................. tetap
................................................................................................. tetap
24
38. Penangguhan
F.
PENGAWASAN MUTU
39. Pengawasan dan
Pemeriksaan
G.
................................................................................................. tetap
................................................................................................. tetap
PENYELESAIAN PERSELISIHAN
40. Penyelesaian
Perselisihan
................................................................................................. tetap
41. Itikad Baik
................................................................................................. tetap
25
BAB XI SYARAT-SYARAT KHUSUS KONTRAK (SSKK)
A. Korespondensi
B. Wakil Sah Para
Pihak
C. Tanggal Berlaku
Kontrak
................................................................................................. tetap
................................................................................................. tetap
D. Jadwal
Pelaksanaan
Pekerjaan
................................................................................................. tetap
E. [Masa
Pemeliharaan
................................................................................................. HAPUS
F. [Pedoman
Pengoperasian
dan Perawatan
................................................................................................. HAPUS
G. Pembayaran
Tagihan
H. Pencairan
Jaminan
I. Tindakan
Penyedia yang
Mensyaratkan
Persetujuan PPK
atau Pengawas
Pekerjaan
................................................................................................. HAPUS
J.
................................................................................................. tetap
K.
L.
M.
N.
O.
P.
Q.
R.
Kepemilikan
Dokumen
Fasilitas
Sumber
Pembiayaan
Pembayaran Uang
Muka
Pembayaran
Prestasi Pekerjaan
Peristiwa
Kompensasi
Denda
[Penyesuaian
Harga
Sanksi
S. Penyelesaian
Perselisihan
................................................................................................. tetap
................................................................................................. HAPUS
................................................................................................. HAPUS
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. HAPUS
................................................................................................. tetap
................................................................................................. HAPUS
................................................................................................. tetap
................................................................................................. HAPUS
................................................................................................. tetap
................................................................................................. tetap
26
Lampiran A – Syarat-Syarat Khusus Kontrak
Personil, Subpenyedia, dan Peralatan
-
................................................................................................. HAPUS
27
BAB XII. SPESIFIKASI TEKNIS
................................................................................................. tetap
28
BAB XIII. DAFTAR KUANTITAS DAN HARGA
................................................................................................. tetap
29
Daftar 1: Mata Pembayaran Umum1
.............................................. TETAP .....................................................................
1
Mata Pembayaran Umum memuat rincian komponen pekerjaan yang bersifat umum.
30
Daftar 2: Mata Pembayaran Pekerjaan Utama: __________1
.............................................. TETAP .....................................................................
31
32
Daftar 3: Mata Pembayaran ______________________1
.............. TETAP ...........................
33
Daftar Rekapitulasi
................................................................................................. tetap
34
BAB XIV. BENTUK DOKUMEN LAIN
A. BENTUK SURAT PENUNJUKAN PENYEDIA BARANG/JASA (SPPBJ)
................................................................................................. tetap
35
B. BENTUK SURAT PERINTAH MULAI KERJA (SPMK)
................................................................................................. tetap
36
C. BENTUK SURAT-SURAT JAMINAN
JAMINAN SANGGAHAN BANDING DARI BANK
................................................................................................. tetap
Bondowoso, 24 MEI 2013
PANITIA PENGADAAN BARANG/JASA
SEKRETARIAT DPRD KABUPATEN BONDOWOSO
1.
AGUS WINARNO, SE,M.Si
....................................
2.
PUTU BUDHI SETIAWAN, ST, MM
....................................
3.
IRA SOFIYANTI
....................................
SEKRETARIAT DPRD KABUPATEN BONDOWOSO
TAHUN ANGGARAN 2013
______________________________________________________________
BERITA ACARA PENJELASAN PEKERJAAN
Nomor : 177/104/ASR/15.09/430.9/2013
Tanggal : 24 Mei 2013
Pada hari ini Jum’at Tanggal Dua Puluh Empat Bulan Mei Tahun Dua Ribu Tiga belas,
Panitia Pengadaan Barang /Jasa untuk kegiatan Pengadaan Jasa Jaminan Pemeliharaan
Kesehatan Pimpinan dan Anggota DPRD Tahun 2013, telah menyelenggarakan penjelasan
untuk pekerjaan Premi Asuransi Kesehatan. Penjelasan pekerjaan dilaksanakan melalui
aplikasi SPSE Kabupaten Bondowoso yang dimulai pukul 08.30 – 09.30 WIB.
Pokok-pokok Pejelasan :
1. Tambahan –tambahan (adendum) pengadaan
2. Tanya jawab calon peserta pengadaan
:
TIDAK ADA adendum dari panitia.
:
TIDAK ADA pertanyaaan dari peserta.
Demikian berita acara penjelasan pekerjaan ini dibuat dengan sebenarnya untuk
dimaklumi bagi pihak yang berkepentingan.
Bondowoso, 24 MEI 2013
PANITIA PENGADAAN BARANG/JASA
SEKRETARIAT DPRD KABUPATEN BONDOWOSO
1.
AGUS WINARNO, SE,M.Si
....................................
2.
PUTU BUDHI SETIAWAN, ST, MM
....................................
3.
IRA SOFIYANTI
....................................
LA MP IR A N
AA N WI ZI NG
B ER IT A
AC AR A
( P EN J EL AS A N
)
Nomor : 177/104/ASR/15.09/430.9/2013
Tanggal : 24 Mei 2013
untuk
Pengadaan
Jasa Jaminan Pemeliharaan Kesehatan Pimpinan dan Anggota DPRD
PANITIA PENGADAAN BARANG/JASA
SEKRETARIAT DPRD KABUPATEN BONDOWOSO
Tahun Anggaran 2013
1
BAB I. UMUM
A.
............................................................................................................................................................................ Tetap.
B.
............................................................................................................................................................................ Tetap.
C.
............................................................................................................................................................................ Tetap.
D.
............................................................................................................................................................................ Tetap.
E.
............................................................................................................................................................................ Tetap.
2
BAB II. PENGUMUMAN PELELANGAN DENGAN PASCAKUALIFIKASI
Pengumuman pelelangan tercantum dalam pada aplikasi SPSE
..........................................................TETAP.........................................................
3
BAB III. INSTRUKSI KEPADA PESERTA (IKP)
A. UMUM
1. Lingkup Pekerjaan
1.1
................................................................................................. Tetap
1.2
................................................................................................. Tetap
1.3
................................................................................................. Tetap
2. Sumber Dana
................................................................................................. Tetap
3. Peserta Pelelangan
3.1
................................................................................................. Tetap
3.2
................................................................................................. Tetap
3.3
................................................................................................. Tetap
4.1
................................................................................................. Tetap
4.2
................................................................................................. Tetap
5.1
................................................................................................. Tetap
5.2
................................................................................................. Tetap
5.3
................................................................................................. Tetap
4. Larangan Korupsi, Kolusi,
dan Nepotisme (KKN) serta
Penipuan
5. Larangan Pertentangan
Kepentingan
6. Satu Penawaran Tiap
................................................................................................. Tetap
Peserta
B.
DOKUMEN PENGADAAN
7. Isi Dokumen
8.1
................................................................................................. Tetap
8.2
................................................................................................. Tetap
8.3
................................................................................................. Tetap
8.4
................................................................................................. Tetap
Pengadaan
8. Bahasa Dokumen
................................................................................................. Tetap
Pengadaan
9. Pemberian Penjelasan
10. Perubahan Dokumen
9.1
................................................................................................. Tetap
9.2
................................................................................................. Tetap
9.3
................................................................................................. Tetap
9.4
................................................................................................. Tetap
9.5
................................................................................................. Tetap
10.1
................................................................................................. Tetap
10.2
................................................................................................. Tetap
10.3
................................................................................................. Tetap
10.4
................................................................................................. Tetap
10.5
................................................................................................. Tetap
Pengadaan
4
11. Tambahan Waktu
10.6
................................................................................................. Tetap
10.7
................................................................................................. Tetap
................................................................................................. Tetap
Pemasukan Dokumen
Penawaran
C. PENYIAPAN DOKUMEN PENAWARAN
12. Biaya dalam Penyiapan
13.1
................................................................................................. Tetap
13.2
................................................................................................. Tetap
14.1
................................................................................................. Tetap
14.2
................................................................................................. Tetap
14.3
................................................................................................. Tetap
14. Dokumen Penawaran
15.1
................................................................................................. Tetap
15. Harga Penawaran
16.1
................................................................................................. Tetap
16.2
................................................................................................. Tetap
16.3
................................................................................................. Tetap
17.1
................................................................................................. Tetap
17.2
................................................................................................. Tetap
17. Masa Berlaku Penawaran 18.1
................................................................................................. Tetap
Penawaran
13. Bahasa Penawaran
16. Mata Uang Penawaran
dan Cara Pembayaran
dan Jangka Waktu
Pelaksanaan
18.2
................................................................................................. Tetap
18. Pengisian Data Kualifikasi 19.1
................................................................................................. Tetap
19.2
................................................................................................. Tetap
20.1
................................................................................................. Tetap
20.2
................................................................................................. Tetap
20. Surat Jaminan Penawaran 21.1
................................................................................................. Tetap
21.2
................................................................................................. Tetap
21.3
................................................................................................. Tetap
21.4
................................................................................................. Tetap
21.5
................................................................................................. Tetap
21.6
.................................................................................................. tetap
19. Pakta Integritas
5
D. PEMASUKAN DOKUMEN PENAWARAN
21. Penyampulan dan
22.1
Penandaan Sampul
Penawaran
................................................................................................. Tetap
22.1.A) .................................................................................................
Tetap
22.1.B) .................................................................................................
Tetap
22.1.C) .................................................................................................
Tetap
22.1.D) .................................................................................................
Tetap
22. Pemasukan/
23.1
................................................................................................. Tetap
Penyampaian Dokumen
Penawaran
23. Batas Akhir Waktu
24.1
................................................................................................. Tetap
24.2
................................................................................................. Tetap
Pemasukan Penawaran
24. Dokumen Penawaran
................................................................................................. Tetap
Terlambat
E.
PEMBUKAAN DAN EVALUASI PENAWARAN
25. Pembukaan Penawaran
26. Evaluasi Penawaran
26.1
................................................................................................. Tetap
26.2
................................................................................................. Tetap
26.3
................................................................................................. Tetap
26.4
26.5
................................................................................................. Tetap
................................................................................................. Tetap
26.6
................................................................................................. Tetap
27.1 ................................................................................................. Tetap
27.1.A)
................................................................................................. Tetap
27.1.B) ................................................................................................. Tetap
................................................................................................. Tetap
27.1.C) ................................................................................................. Tetap
27.1.D) ................................................................................................. Tetap
27.1.E) ................................................................................................. Tetap
27.1.F) ................................................................................................. Tetap
27.2 ................................................................................................. Tetap
27.3 ................................................................................................. Tetap
27.4 ................................................................................................. Tetap
27.5.A) .................................................................................................
6
Tetap
27.6.B
Evaluasi
Harga
................................................................................................. Tetap
27.6.B.1) .................................................................................................
Tetap
27.6.B.2) .................................................................................................
Tetap
27.6.B.3) .................................................................................................
Tetap
27.6.B.4) .................................................................................................
Tetap
27.6.B.5) .................................................................................................
Tetap
27. Evaluasi Kualifikasi
28. Pembuktian Kualifikasi
28.1
27.6.C
................................................................................................. Tetap
27.6.D
................................................................................................. Tetap
27.6.E
................................................................................................. Tetap
................................................................................................. Tetap
28.2
................................................................................................. Tetap
28.3
................................................................................................. Tetap
28.4
................................................................................................. Tetap
28.5
................................................................................................. Tetap
28.6
................................................................................................. Tetap
28.8
................................................................................................. Tetap
29.1
................................................................................................. Tetap
29.2
................................................................................................. Tetap
29.3
................................................................................................. Tetap
29.4
................................................................................................. Tetap
29.5
................................................................................................. Tetap
29.6
................................................................................................. Tetap
29.7
................................................................................................. Tetap
29.8
................................................................................................. Tetap
29.9 ................................................................................................. Tetap
F.
PENETAPAN PEMENANG PELELANGAN
29. Penetapan Pemenang
30.1
................................................................................................. Tetap
30.2
................................................................................................. Tetap
30.3
................................................................................................. Tetap
7
30. Pengumuman Pemenang
31. Sanggahan
32. Sanggahan Banding
................................................................................................. Tetap
32.1
................................................................................................. Tetap
32.2
................................................................................................. Tetap
32.3
................................................................................................. Tetap
32.4
................................................................................................. Tetap
32.5
................................................................................................. Tetap
33.1
................................................................................................. Tetap
33.2
................................................................................................. Tetap
33.3
................................................................................................. Tetap
33.4
................................................................................................. Tetap
33.5
................................................................................................. Tetap
33.6
................................................................................................. Tetap
33.7
................................................................................................. Tetap
G. PENUNJUKAN PEMENANG
33. Penunjukan
34.1
................................................................................................. Tetap
Penyedia
Barang/Jasa
34.2
................................................................................................. Tetap
34.3
................................................................................................. Tetap
34.4
................................................................................................. Tetap
34.5
................................................................................................. Tetap
34.6
................................................................................................. Tetap
34.7
................................................................................................. Tetap
34.8
................................................................................................. Tetap
34.9
................................................................................................. Tetap
34.10
................................................................................................. Tetap
34.11
................................................................................................. Tetap
34.12
................................................................................................. Tetap
34. BAHP, Berita Acara
Lainnya, dan Kerahasiaan
Proses
34.1
................................................................................................. Tetap
34.2
................................................................................................. Tetap
34.3
................................................................................................. Tetap
8
H. PELELANGAN GAGAL
35. Pelelangan
36.1
................................................................................................. Tetap
36.2
................................................................................................. Tetap
36.3
................................................................................................. Tetap
36.4
................................................................................................. Tetap
36.5
................................................................................................. Tetap
36.6
................................................................................................. Tetap
Gagal
I.
PENANDATANGANAN KONTRAK
36. Penanda-
37.1
................................................................................................. Tetap
tanganan
Kontrak
37.2
................................................................................................. Tetap
37.3
................................................................................................. Tetap
37.4
................................................................................................. Tetap
37.5
................................................................................................. Tetap
37.6
................................................................................................. Tetap
37.7
................................................................................................. Tetap
37.8
................................................................................................. Tetap
37.9
................................................................................................. Tetap
9
BAB IV. LEMBAR DATA PEMILIHAN (LDP)
A. LINGKUP
1.
................................................................................................. Tetap
2.
................................................................................................. Tetap
3.
................................................................................................. Tetap
4.
................................................................................................. Tetap
5.
................................................................................................. Tetap
6.
................................................................................................. Tetap
PEKERJAAN
B. SUMBER DANA
................................................................................................. Tetap
C. JADWAL TAHAPAN ................................................................................................. Tetap
PEMILIHAN
D. MATA UANG
E.
F.
PENAWARAN DAN
CARA
PEMBAYARAN
MASA
BERLAKUNYA
PENAWARAN
JAMINAN
PENAWARAN
1.
2.
................................................................................................. Tetap
................................................................................................. Tetap
................................................................................................. Tetap
1. ................................................................................................. Tetap
2. ................................................................................................. Tetap
3. ................................................................................................. Tetap
4. ................................................................................................. Tetap
G. JADWAL
................................................................................................. Tetap
PEMASUKAN
DOKUMEN
PENAWARAN
H. BATAS AKHIR
................................................................................................. Tetap
PEMASUKAN
PENAWARAN
I. PEMBUKAAN
................................................................................................. Tetap
PENAWARAN
................................................................................................. Tetap
J. DOKUMEN
PENAWARAN
K. SANGGAHAN,
SANGGAHAN
BANDING DAN
PENGADUAN
1.
................................................................................................. Tetap
2.
................................................................................................. Tetap
3.
................................................................................................. Tetap
4.
................................................................................................. Tetap
5.
................................................................................................. Tetap
10
BAB V. LEMBAR DATA KUALIFIKASI (LDK)
A. Lingkup Kualifikasi
B. Persyaratan Kualifikasi
................................................................................................. Tetap
................................................................................................. Tetap
11
BAB VI. BENTUK DOKUMEN PENAWARAN
A.
BENTUK SURAT PENAWARAN [PESERTA BADAN USAHA/KEMITRAAN (KSO)] (UNTUK 1
(SATU) FILE
..............................................................................
TETAP
.....................................................................................................
12
B.
BENTUK PERJANJIAN KEMITRAAN/KERJA SAMA OPERASI (KSO)
CONTOH
..............................................................................
TETAP
.....................................................................................................
13
C.
BENTUK DOKUMEN PENAWARAN TEKNIS
DOKUMEN PENAWARAN TEKNIS
..............................................................................
TETAP
.....................................................................................................
14
D.
BENTUK JAMINAN PENAWARAN DARI BANK
CONTOH
..............................................................................
TETAP
.....................................................................................................
15
E.
BENTUK JAMINAN PENAWARAN DARI ASURANSI/PERUSAHAAN PENJAMINAN
CONTOH
..............................................................................
TETAP
.....................................................................................................
16
F.
BENTUK PAKTA INTEGRITAS
Dengan mendaftar sebagai peserta pemilihan pada aplikasi SPSE maka peserta telah
menyetujui dan menandatangani pakta integritas
[Contoh Pakta Integritas Badan Usaha Dengan Kemitraan]
PAKTA INTEGRITAS
..............................................................................
TETAP
.....................................................................................................
17
G.
DATA ISIAN KUALIFIKASI
Isian Data Kualifikasi bagi Peserta selain anggota Kemitraan/KSO berbentuk Form Isia n
Elektronik Data Kualifikasi yang tersedia pada aplikasi SPSE
[FORMULIR ISIAN KUALIFIKASI UNTUK KEMITRAAN/KSO]
..............................................................................
TETAP
.....................................................................................................
18
BAB VII. PETUNJUK PENGISIAN DATA KUALIFIKASI
..............................................................................
TETAP
.....................................................................................................
19
VIII. TATA CARA EVALUASI KUALIFIKASI
..............................................................................
TETAP
.....................................................................................................
20
BAB IX. BENTUK DOKUMEN KONTRAK
A.
BENTUK SURAT PERJANJIAN
..............................................................................
TETAP
.....................................................................................................
21
B.
BENTUK SURAT PERINTAH KERJA (SPK)
[kop surat K/L/D/I]
TETAP
22
BAB X. SYARAT-SYARAT UMUM KONTRAK (SSUK)
A.
KETENTUAN UMUM
1.
Definisi
2.
Penerapan
3.
Bahasa dan
Hukum
4.
Larangan
Korupsi, Kolusi,
dan Nepotisme
(KKN) serta
Penipuan
5.
Korespondensi
6.1
6.
Wakil Sah Para
Pihak
................................................................................................. tetap
7.
Perpajakan
................................................................................................. tetap
8.
Pengalihan
dan/atau
Subkontrak
[Pengabaian
9.
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
10. [Penyedia
Mandiri
................................................................................................. tetap
11. Kemitraan/KSO
................................................................................................. tetap
B.
PELAKSANAAN, PENYELESAIAN, PERUBAHAN, DAN PEMUTUSAN KONTRAK
B.1 Pelaksanaan Pekerjaan
12. Jadwal
Pelaksanaan
Pekerjaan
15.1
................................................................................................. tetap
13. Surat Perintah
17.1
Mulai Kerja
(SPMK)
B.2 Pengendalian Waktu
................................................................................................. tetap
14. Waktu
Penyelesaian
Pekerjaan
15. Perpanjangan
Waktu
................................................................................................. tetap
................................................................................................. tetap
B.3 Penyelesaian Kontrak
16. Serah Terima
Pekerjaan
17. [Pengambilalihan
B.4 Perubahan Kontrak
................................................................................................. tetap
................................................................................................. tetap
23
18. Perubahan
Kontrak
................................................................................................. tetap
19. Keadaan Kahar
................................................................................................. tetap
B.6 Penghentian dan Pemutusan Kontrak
20. Penghentian
Kontrak
21. Pemutusan
Kontrak
................................................................................................. tetap
................................................................................................. tetap
22. Pemutusan
Kontrak oleh PPK
23. Pemutusan
Kontrak oleh
Penyedia
24. Pemutusan
Kontrak akibat
lainnya
C.
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. tetap
HAK DAN KEWAJIBAN PENYEDIA
25. Hak dan
Kewajiban
Penyedia
................................................................................................. tetap
26. Penggunaan
................................................................................................. tetap
Dokumen Kontrak
dan Informasi
27. Hak Atas
Kekayaan
Intelektual
28. Penanggungan
dan Risiko
................................................................................................. tetap
29. Kepemilikan
Dokumen
................................................................................................. tetap
................................................................................................. tetap
30. Kerjasama Antara
Penyedia dan Sub
Penyedia
31. Usaha Mikro,
Usaha Kecil dan
Koperasi Kecil
32. Pembayaran
Denda
D.
................................................................................................. tetap
................................................................................................. tetap
HAK DAN KEWAJIBAN PPK
33. Hak dan
Kewajiban PPK
34. Fasilitas
35. Peristiwa
Kompensasi
E.
................................................................................................. tetap
................................................................................................ tetap
................................................................................................. tetap
................................................................................................. tetap
PEMBAYARAN KEPADA PENYEDIA
36. Harga Kontrak
37. Pembayaran
................................................................................................. tetap
................................................................................................. tetap
24
38. Penangguhan
F.
PENGAWASAN MUTU
39. Pengawasan dan
Pemeriksaan
G.
................................................................................................. tetap
................................................................................................. tetap
PENYELESAIAN PERSELISIHAN
40. Penyelesaian
Perselisihan
................................................................................................. tetap
41. Itikad Baik
................................................................................................. tetap
25
BAB XI SYARAT-SYARAT KHUSUS KONTRAK (SSKK)
A. Korespondensi
B. Wakil Sah Para
Pihak
C. Tanggal Berlaku
Kontrak
................................................................................................. tetap
................................................................................................. tetap
D. Jadwal
Pelaksanaan
Pekerjaan
................................................................................................. tetap
E. [Masa
Pemeliharaan
................................................................................................. HAPUS
F. [Pedoman
Pengoperasian
dan Perawatan
................................................................................................. HAPUS
G. Pembayaran
Tagihan
H. Pencairan
Jaminan
I. Tindakan
Penyedia yang
Mensyaratkan
Persetujuan PPK
atau Pengawas
Pekerjaan
................................................................................................. HAPUS
J.
................................................................................................. tetap
K.
L.
M.
N.
O.
P.
Q.
R.
Kepemilikan
Dokumen
Fasilitas
Sumber
Pembiayaan
Pembayaran Uang
Muka
Pembayaran
Prestasi Pekerjaan
Peristiwa
Kompensasi
Denda
[Penyesuaian
Harga
Sanksi
S. Penyelesaian
Perselisihan
................................................................................................. tetap
................................................................................................. HAPUS
................................................................................................. HAPUS
................................................................................................. tetap
................................................................................................. tetap
................................................................................................. HAPUS
................................................................................................. tetap
................................................................................................. HAPUS
................................................................................................. tetap
................................................................................................. HAPUS
................................................................................................. tetap
................................................................................................. tetap
26
Lampiran A – Syarat-Syarat Khusus Kontrak
Personil, Subpenyedia, dan Peralatan
-
................................................................................................. HAPUS
27
BAB XII. SPESIFIKASI TEKNIS
................................................................................................. tetap
28
BAB XIII. DAFTAR KUANTITAS DAN HARGA
................................................................................................. tetap
29
Daftar 1: Mata Pembayaran Umum1
.............................................. TETAP .....................................................................
1
Mata Pembayaran Umum memuat rincian komponen pekerjaan yang bersifat umum.
30
Daftar 2: Mata Pembayaran Pekerjaan Utama: __________1
.............................................. TETAP .....................................................................
31
32
Daftar 3: Mata Pembayaran ______________________1
.............. TETAP ...........................
33
Daftar Rekapitulasi
................................................................................................. tetap
34
BAB XIV. BENTUK DOKUMEN LAIN
A. BENTUK SURAT PENUNJUKAN PENYEDIA BARANG/JASA (SPPBJ)
................................................................................................. tetap
35
B. BENTUK SURAT PERINTAH MULAI KERJA (SPMK)
................................................................................................. tetap
36
C. BENTUK SURAT-SURAT JAMINAN
JAMINAN SANGGAHAN BANDING DARI BANK
................................................................................................. tetap
Bondowoso, 24 MEI 2013
PANITIA PENGADAAN BARANG/JASA
SEKRETARIAT DPRD KABUPATEN BONDOWOSO
1.
AGUS WINARNO, SE,M.Si
....................................
2.
PUTU BUDHI SETIAWAN, ST, MM
....................................
3.
IRA SOFIYANTI
....................................