THE WORLD BANIC OFFICIALTFVA 0 IBRD IDA I WORLD BANKGROUP DOCUMENTS Letter No. CD-099 WB VL 2015 June 8. 2015 H.E. Sudirman Said Minister of Energy and Mineral Resources Ministry of Encrgy and Mineral Resources JL Merdeka Selatan I 8 Jakarta 10110 Indonesia Dear Minister Said: Re: Indonesia Infrastructure Support (INIS) Trust Fund Grant No. TFOA0405 (Improving Energy Project Delivery Project) Additional Instructions: Disbursement I refer to the Letter Agreement (*Agrecrnent") between the Ministry of Energy and Mineral Resources (the "Recipient") and the International Bank for Reconstruction and Development International Development Association (-World Bank'*). acting as administrator of grant ftinds provided bN the Government of Australia, acting through the Department of Foreign Affairs and Trade ("Donor") under the Indonesia Infrastructure Support Trust Fund for the above-referenced project. dated June 8. 2015. The Agreement provides that the World Bank may issue additional instructions regarding the withdrawal of the proceeds of Grant No. TF0A0405 ("Grant"). This letter ("Disbursement Letter"), as revised trom time to time. constitutes the additional instructions. The attached Wor/d Bank Dishrwvement Guidelinc fr Proectis. dated May 1, 2006. ("Disbursement Guidelines") (Attachment 1). are an integral part of the Disbursement Letter. The manner in which the provisions in the Disbursement Guidelines apply to the Grant is specified below. Sections and subsections in parentheses below refer to the relevant sections and subsections in the Disbursement Guidelines and, unless otherwise defined in this letter, the capitalized terms used have the meanings ascribed to them in the Disbursement Guidelines. 1. Disbursement Arrangements (i) Disbursement Methods (section 2). The following Disbursement Methods may be used under the Grant: * Reimbursement * Advance (ii) Disbursement Deadline Date (subsection 3.7). The Disbursement Deadline Date is four (4) months after the Closing Date specified in the Letter Agreement. Any changes to this date will be notified by the World Bank. SEB Fower 2, 12' coor, end Sudirman . If you have any queries in relation to the above. please contact Chau-Ching Shen, Senior Finance Officer at loacupa oridhank.ru or the Disbursement Team in WBOJ using the above reference. Yours sincerely. Jose hin Ba, si ettc Acting Cou itry irect . Indonesia Attachments l I Wor/ld Bank DishuwnIC11t Gu1idlinIc\ for ProicCrS. dated May I, 2006 I Form for Authorized Signatures 3. Tern, and Conditions of LSc of Sccurc Id'ntification( Credcontials in connlilctlon 1ith L've of ELLIonw eat to PI Applicarwns and S'ppa0n DocIIncation, dated March I. 20I 3 4. Form of '-Interim Financial Report" Cc- Mr. Widhyawan Prawiraatmadja. Head Performance Management Unit Ministry of Energy and Mineral Resources .il. Merdeka Selatan I 8 lakarta 10110, Indonesia widhyawanla upk.esdm.go.id ISEB Tower 2. '21n Floor. Jr Jend Sudirman Kay 52-53, Jakarta 12190 2 6221 5299 3000 6+6221 5299 3111 t www worldbank orgid 10A0405 § of Q fune 8- 2015 Attachment 2 Form of Authorized Si2natorv Letter [Letterhead] Ministry of Energy and Mineral Resources [Street address [City] [Countrv DA FE] The World Bank Office Jakarta Jakarta Stock Exchange Building. Tower 2. 12"' Floor 11. Jenderal Sudirman Kay 52-53. Jakarta 12190. Indonesia Attention: [Country Director] Dear [Country Director]: RE. Indonesia Infrastructure Support (INIS) Trust Fund Grant No. - (Improving Energy Project Delivery Project) I refer to the Letter Agreement ('Agreernent") between the Ministr, of Energy and Mineral Resources (the "Recipient") and the International Bank for Reconstruction and Development International Development Association C'World Bank"). acting as administrator of grant finds provided by the Government of Australia, acting through the Department of Foreign Affairs and Trade ("Donor") under the Indonesia Infrastructure Support Trust Fund for the above-referenced project, dated . providing the above Grant. For the purposes of Section 3.04 (b) of the Standard Conditions. as defined in the Agreement, any ['one] of the persons whose authenticated specimen signatures appear below is authorized on behalf of the Recipient to sign applications for withdrawal under this Grant. For the purpose of deli\ ering Applications to the World Bank. '[eachl of the persons whose authenticated specimen signatures appears below is authorized on behalf of the Recipient. acting ntly, tod e Applications. and evidence in support thereofon the terms and conditions specified by the World Bank. [This confirms that the Recipient is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to the World Bank by InNtruction to the Recipient ihen sending tis letter o the World Bank Stipulate if more than one person needs to siign -pphcations. a n d how% man or wk hich posit ions, and i an thrchok applk Plca" dc/crcI it% f No i I? in vinal Iler tha i I,et io thc 1iorl,d BanA Iin,truction to the Recipient Stipulate if more lhan one person needs to 1,nii si n Applicantons. it so. plca,e indicate the actual flurner P/ea"(e dclctlu Ontorn1th in final liHt that i"'ct to iIhc Iforld Bank Instruction to the Recipient ( E c this hracket if any one ot the au1thorized persons ma, sign, if thi i* not appicahle. please delete PlleaPi c de/cil o o t oit t iii final eicr that iL scti I, thc lol/ Bnk in. ructiCIOn to the RecipiCI L c this bracket only if seral inh idual must lomil1 sign Cach Application it this is not applicable, Please delete cP/ca.c dc/cIc ihIN looooi /oti liuil L'ttr r/a i t c to t h at- tr Batik iSEB Tower 2. 12" Floor, Ji jend Sudirman Kay 52-53. Jakarta 12'90 4 g -6221 5299 3000 * +6221 5299 3111 1'# www worldbank org/:c 1 H\0405 6 June X 2015 electronic means. In fill recognition that the World Bank shall rely upon such representations and warranties. including without limitation, the representations and warranties contained in the T01iNs and (onditions of v of Secure Idcenrtication Clde'ntia6IA to C-nn1 iontiOl with Use of(Elctirona MfCan1s it PrOCeSS ,lIppliCatliiS andl Sujpporting Docitum ination (-Terrns and Conditions of L'se of SIDC"'). the Recipient represents and warrants to the World Bank that it will cause such persons to abide by those terms and conditions. This Authorization replaces and supersedes any Authorization currently in the World Bank records with respect to this Agreement. [Namej. [position] Specimen Signature [Namel. [position] Specimen Signature [Name]. [position] Specimen Signature_ Yours truly, ,signcd [Position] instruction to the Recipient Xdd thme paragrajph it the RccipicnIt iSIC to au1t1orIZC Ih hted persons to accept Secure ident Iication ('redclithil, nd to debt er Applititons hv clecitronic eican, it Ohis i, not applicahlc. pcease delctc the prraimph PleaIo' d/ie 1/is 1rlot, in ijial l dvir tat 1, sent to the 4rld Bank iSEB Tower 2. 12t' Floor J1 jena Sudirman Kay 52-53. Jakarta 12190 S +6221 5299 3000 * +6221 5299 3111 O#www worldbanK org/ld I FOA0405 June 8 201i Attachment 3 Terms and Conditions of Use of Secure Identification Credentials in connection with Use of Electronic Means to Process Applications and Supporting Documentation March 1. 201 The World Bank (Bank) will provide secure identification credentials (SIDC) to permit the Borrower to deliver applications for withdraxal and applications fior special commitments under the Agreement(s) and supporting documentation (such applications and supporting documentation together referred to in these Terms and Conditions of Use as Applications) to the Bank electronically. on the terms and conditions of use specified herein. SIDC can be either: (a) hardware-based (Physical Token). or (b) sofIware-based (Soft Token). The Bank reserves the right to determine which type of SIDC is most appropriate. A. Identification of Users. I The Borrower will be required to identify in a completed Authorized Signatory Letter (ASL) duly delivered to and received by the Bank each person who will be authorized to deliver Applications. The Bank will provide SIDC to each person identified in the ASL (Signatory), as provided below. The Borrower shall also immediately notify the Bank if a Signatory is no longer authorized by the Borrower to act as a Signatory. 2. Each Signatory must register as a user on the Bank's Client Connection (CC) website (https cientennection orddhanK.or;) prior to receipt of his her SIDC. Registration on CC will require that the Signatory establish a CC password (CC Password). The Signatory shall not reveal his, her CC Password to anyone or store or record the CC Password in written or other fom. Upon registration as a CC user, the Signatory will be assigned a unique identifying account name. B. Initialization of SIDC. 1. Prior to initialization of SIDC by a Signatory, the Signatory will acknowledge having read. understood and agreed to be bound bv these Terms and Conditions of Use. 2. Where a Physical Token is to be used. promptly upon receipt of the Physical Token, the Signatory will access CC using his;her account name and CC Password and register his her Physical Token and set a personal identification number (PIN) to be used in connection wxith the use of his, her Physical Token, after which the Physical Token will be initialized for use by the Signatory exclusively for purposes of delivering Applications. Where a Soft Token is to "Bank" includes IBRD and IDA. -Borrovver" includes the borrower of'ai IBRD loan. IDA credit. or Project Preparation [acilit advance and the recipient ofa grant. ISEB Tower 2. 1211 Floor Ji Jend Sudirmar Kay 52-53, Jakaria 12190 8 6221 5299 3000 0 p6221 5299 3111 ( www:worldbank.org/d ITOA0~40 5 S oJ,1 uric 8, 2() 1 be used. the Signatory will access CC using his her account name and CC Password and set a personal identification number (PIN) to be used in connection with the use of his/her Soft Token, after which the Soft Token will be initialized for use by the Signatory exclusively for purposes of delivering Applications. Upon initialization of the SIDC, the Signatory w ill be a -SIDC User". The Bank will maintain in its database a user account (Account) for each SIDC User for purposes of managing the SIDC of the SIDC User. Neither the Borrower nor the SIDC User will have any access to the Account. 3. Prior to first use of the SIDC by the SIDC User, the Borrower shall ensure that the SIDC Lser has received training materials provided by the Bank in use of the SIDC C. Use of SIDC. 1I Use of the SIDC is strictly limited to use in the delivery of Applications by the SIDC User in the manner prescribed by the Bank in the Agreement(s) and these Terms and Conditions. Any other use of the SIDC is prohibited. 2. The Bank assumes no responsibility or liability whatsoever for any misuse of the SIDC by the SIDC User. other representatives of the Borrower. or third parties. The Borrower undertakes to ensure, and represents and warrants to the Bank (such representation and warranty being expressly relied upon by the Bank in granting SIDC) that each SIDC User understands and will abide by, these Terms and Conditions of Use. including w,,ithout limitation the following: 4 Security 4 1. The SIDC User shall not reveal his her PIN to anyone or store or record the PIN in written or other lorm 4.2. The SIDC User shall not allow anyone else to utilize his her SIDC to deliver an Application to the Bank. 4 3. The SIDC User shall always logout from CC when not using the system. Failure to logout properly can create a route into the system that is unprotected. 4.4 If the SIDC User believes a third party has learned his,her PIN or has lost his,her Physical Token heishe shall immediately notify cicniconnuction ( w oribank.oru. 4.5. The Borrower shall immediately noti fy the Bank at cei coinnccl It wi orldbink.ure of any lost, stolen or compromised SIDC. and take other reasonable steps to ensure such SIDC are disabled immediately. ISEB Tower 2. 1211 Floor JI Jend, Sudirman Kav 52-53. Jakarta 12190 3 6221 5299 3000 &+6221 5299 3111 Oiwww worldbankorg/id IT0At)0405 9 Q ine . 20 15 5. Reservation of Right to Disable SIDC 5.1. The Borrower shall reserve the rig,ht to re,oke the authorization of a SIDC User to use a SIDC for any reason. 5.2. The Bank reserves the right, in its sole discretion, to temporarily or permanently disable a SIDC. de-activate a SIDC User's Account or both. 6. Care of Physical Tokens 6.1 Physical Jokens will remain the property of the Bank. 6.2. The Bank will physically deliver a Physical Token to each Signatory designated to receive one in a manner to be determined by and satisfactory to the Bank. 6.3. Physical Tokens contain delicate and sophisticated instrumentation and therefore should be handled with due care. and should not be immersed in liquids, exposed to extreme temperatures. crushed or bent. Also. Physical Tokens should be kept more than five (5) cm from devices that generate electromagnetic radiation (EMR). such as mobile phones. phone- enabled PDAs, smart phones and other similar devices. Physical Tokens should be carried and stored separate from any EMR device. At close range (less than 5 cm). these devices can output high levels of EMR that can interfere w ith the proper operation of electronic equipment. including the Physical Token. 6.4. Without derogating from these Terms and Conditions of Use. other technical instructions on the proper use and care of Physical Tokens are available at http: www.rsa.com. 7. Replacement 7.1. Lost, damaged. compromised (in terms of 4.5. above) or destroyed Physical Tokens will be replaced at the expense of the Borrower 7 2 The Bank reserves the right, in its sole discretion. not to replace any Physical Token in the case of misuse. or not to reactik ate a SIDC User's Account. ISEB Tower 2. 12'" Floor, JI Jend Sudirman Kay 52 53 Jakarta 12190 -6221 5299 3000 -6221 5299 30 1 <* www woridbank.org/d 1-A Loan abc ........ DesignatedlSpecial Account Activity Statement for the Reporting Period ....... Bank and Account No.: USD Part I 1. Cummulative advances to end of current reporting period 2. Cummulative expenditures to end of last reporting period 3. Outstanding advances to be accounted (1-2) 0 Part II 4. Opening SA balance at beginning of reporting period (as of ......... ust be same 5. Add/Substract:Cummulative adjustments (if any) * as item 3 6. Advances from the World Bank during reporting period 7 add 5 and 6 Op 8 Outstanding advances to be accounted for (4+7) (must oe same as item 31 0 -- must reconcile with 9. Closing SA balance at end of current reporting (as of ...... . ...) Expenditures in this 10. Add/substract: Cummulative adjusment (if any) Quater from wes 11. Expenditures for current reporting period Special Account. i.e. 12. Add 10+11 0 Form IFR-2 13. Add 9+12 0 14 Difference (if any) 8-13 0 must reconcile Part III with Form ID, Part II ~ Column (f) 15. Total Forecasted amount to be paid by World Bank 16. Less Closing SA balance (as per item 9) - 0 17. Cumulative adjustment (if any) **** 18 Add 16+17 0 19 Cash requirement from WB for next six months (15-18) 0 20 Amount requested for advance to SA (rounding) * Explanation for item 5 (if not zero): IFMR & AW Ref. Amount (+/-) Remarks Explanation for item 10 (if not Zero): FMR & AW Ref. Amount +i-) Remarks Explanation for item 14 (if not Zero): FMR & AW Ref. Amount (+/-) Remarks Explanation for item 17 (if not Zero): FMR & AW Ref. Amount (+/-) Remarks 1-C2 Loan abc ........ Statement of Expenditures for those NOT Subject to Prior Review Quarter: -- Ln/CrITF No. Sheet No. 1 2 3a 3b 4 5 6 7 8 9 10 11 12 Item Disbursement Category Office Cross-Ref Date of Contract Supplier/ Contract Total Amount WB Amount of Exchange Amount No. Issuing SP2D Payment No. Contractor Value Paid to Financing WB portIon Rate Charged Cat No. Description SP2D No. (SP2D) and Date Name (incl. Add) Contractor paid Applied to SA kGOI+IBRD+PPN) (USD eqv) (1) Category 1 / 2 3 Subtotal (2) Category 2 4 5 6 Subtotal (3) Category 3 7 8 9 Subtotal (4) Category 4 10 11 12 Subtotal GRAND TOTAL / Please have a separate line item if the WB' financing percentage is different 1-D Loan abc ........ Project Cash Forecast For the Quarter Ending mm/ddlyyyy (a) (b) (c)=(a)+(b) (d) (e) ( GOI+WB GOI+WB Total Cash GOI WB WB Disbursement Category Cash Requirement Cash Requirement Requirement for Cash Requirement Cash Requirement Cash Requirement for Quarter ending for Quarter ending next two quarters next two quarters next two quarters next two quarters mm/dd/yyyy mm/ddlyyyy (six months) (six months) (six months) (six months) (IDR) (IDR) (IDR) (IDR) (IDR) (USD) 1 .. 2 ... 3 ... 4 ... Non Bank Financed (Rupiah Murni) Total NOTE: must reconcile with Exchange rate applied = Rp........ ........I USD Form 1A Item 15 IFR-2 Loan abc ...... Project Uses of Funds by Category for the quarter ending ............ Expenditures in the Current Quarter Uses of Funds (by Category) / GOI Others Outstan charged to charged to Total counterpart Donor SBUN ding WB Sp.Acc WB Sp.Acct Rp Rp Rp Rp Rp US$ 1 2 3 4 5 6 7 1 ... 2 ... 3 ... 4 ... Non Bank Financed (Rupiah Murni) Total Uses of Fund Average Exchange rate: mut oncilej-______ lwi Form IFR must reconcile with Form 1A item 11 Expenditures in Year to Date Uses of Funds (by Category) */ GOI Others Outstan charged to charged to Total counterpart Donor SBUN ding WB Sp.Acc WB Sp.Acct Rp Rp Rp Rp Rp US$ 8 9 10 11 12 13 14 1 ... 2 ... 3 ... 4 ... Non Bank Financed (Rupiah Murni) Total Uses of Fund must reconcile" Average Exchange rate: with Form IFR1 Cumulative Expenditures to Date Uses of Funds (by Category) */ GOI Others Outstan charged to charged to Total counterpart Donor SBUN ding WB Sp.Acc WB Sp.Acct Rp Rp _ Rp Rp Rp IUS$ 15 16 17 18 19 20 21 2 ... 3 ... 4 ... Non Bank Financed (Rupiah Murni) Total Uses of Fund Average Exchange rate: must reconcie with Form IFRI *Please have a seperate line item if the WB' financing percentage is different