PROPOSAL SPONSORSHIP REVIEW

NO. SPR : 02/IV/15/SR-CSR

I Data Validation
a Requester Organization : Karang Taruna Tambang Nikel Sejahtera (Village Youth Organization)

b Under Responsibility by : Hartiman, S.STP (Acting Village Leader of Bahomoahi)

c Activity : Sport Event for Bahomoahi

d Date of Proposal : 01-Apr-15

e Date of event/ activity : Apr-15

f Places of event/ activity : Desa Bahomoahi, Kecamatan Bungku Timur

g Requester Proposal : 13.050.000 (IDR)

h Area of Beneficiaries : Ring 1 Ring 2 Ring 3

i Target Group of Beneficiaries : Personal Community Organization Government Apparatus
j Category : Infrastructure Livelihood Community Empowerment Local Government

Evaluation Score
ll Evaluation Parameter Remark
3 2 1
Proposed by head of Karang Taruna, acknowledge by
a Documents completeness
Acting Village Leader of Bahomoahi & Head of BPD

b The activity implemented in the area surounding company scope of work Ring 1, Bahomoahi Village, Sub distric Bungku Timur

Participation from the company will create a good image and networking formally or Participation will create a good image and networking for
c
informally community especially youth generation of Bahomoahi
Requester Organization has a power/ potential to influence the public opinion and local Karang Taruna Tambang Nikel Sejahtera Bahomoahi has a
d
government policy member from all the youth/ young man of Bahomoahi

e Timing dan urgency/ conflic resolution Accommodate the youth interest and athletic potential

Beneficiaries are from local community especially youth

f Benefited to beneficiaries/ community
generation of Bahomoahi

g Increase the opportunity of economic livelihood program/ Income generating activity

h Activities are part of Corporate Social Reponsibility Program CSR Donation, category Community Empowerment

i Allocated budgeting Not yet allocated

Appraisal Total Score 9 8 1 18

Realization Index and Donation Donation Recommendation

Donation Realization : 8 - 12 : max 25 % (as authority )

1. Total score < 8 : Company not participate 13 - 17 : max 50 % (as authority )
2. Total skor ≥ 8 : Company need to participate 18 - 22 : max 75 % (as authority )
23 - 27 : max 100 % (as authority )

III Rekomendation from Verification Team :

a Total Score : 18 Point Prepared By Known By,
b Donation Recommendation : 75%
b Recommended to : Participate Not participate

c Maximum participation : 9.787.500 (IDR) Syamsudin. A Eko Setyawan Sidiq Sahid Agung Riyadi
d Site Recommendation : 8.500.000 (IDR) Comdev Sptd KTT Coordinator

IV Remark and Management Approval

: Participate : Not participate Approved By : Participate : TNot participate Approved By
Remark : Remark :

Riyanti Kutty Nurinda Nikita Novikov

GM complience and Legal Direktur