No.

Date:
SURAT PERINTAH KERJA / Work Order

Prov. Madila CRF No. PF No.

Admin

Type of Order Survey New Outage Relocation Terminate Others

1. CUSTOMER INFORMATION
PT Smartfren (SMART) Company
Company Name
Code
Company Type ISP NAP Telco Corporate Other
Company Address
Customer Name
Phone
Email
No.
Contact Persons Customer On Site Information *Please fill information below if customer on site is different with customer
name/company name in the column above

Name
Company Name
Phone
Email
No.
2. SERVICE DETAIL
Type of Service MATRIX GLOBAL IP
Capacity/Unit 2X 10G
Circuit ID 1005190001 & 1005190002
Type of Link
Interface MCS-PKU-UPS (xe-0/0/6 & xe-0/0/7)
Equipment
IP Block
IP Point to Point I IP Point to Point II 119.110.125.12/30
Termination
Location I
Termination
Location II
Yes Paid Unpaid
Setup Fee No

3. TEST RESULT
Ping Time Upload Download Destination

4. NETWORK DATA

We declare that the work as described above has been implemented and accepted.
5. OFFICER NAME
Customer PSB Officer PSB SPV

Name: Name: Name:

Date: Date: Date:

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