1. 20 PPWG
nUSA DUA
ACCSQ bali
The Th 13-17 may
ASEAN CONSULTATIVE COMMITTEE FOR STANDARDS AND QUALITY nadfc
Pharmaceutical Product Working Group 2013
Sekretariat Gabungan Perusahaan Farmasi Indonesia, Jl Angkasa No 20 A Kemayoran Jakarta 10620
Phone: +62 21 420 3040, Fax : +62 21 420 3047, 420 3048, Email : sekretariatgpfi@yahoo.com Official website : www.20thaccsq-ppwg.com
Hotel Reservation Form
Full Name Passport No./
(Mr / Mrs / Ms /Dr ) ID Card No.
Share With Passport No./
ID Card No.
Address
Phone No. Fax.No
Email
FLIGHT INFORMATION
Departure date Arrival date
Flight No.: Date : Time: Flight No.: Date : Time:
ROOM RESERVATION DETAILS
Check-in Date: Check-out Date:
HOTEL ACCOMODATION
A great range of accommodation has been secured at special price for participants attending this meeting. As the 20th ACCSQ-
PPWG Meeting falls in a reasonably busy time for Bali, we strongly recommend participants book their accommodation as early
as possible. These special hotel rates are applicable for reservation made before 30 April, 2013. Any reservation made after 30
April 2013 will be subject to room and price availability. The room rate is quoted per room per night, including breakfast for 2
persons and 21% tax and service charge.
Please tick your choice:
HOTEL NAME ROOM TYPE PRICE (IDR /US$)
 ourtyard Marriot Hotel (**** /4 stars)
C  Deluxe Garden room Rp 1,400,000 (US$ 143)
 Deluxe Pool view room Rp. 1,600,000 (USD 164)
 Premium Deluxe room Rp. 1,700,000 (USD 175)
 Deluxe Pool Terrace Rp. 2,050,000 (USD 210)
 ovotel Nusa Dua (**** /4 stars)
N  Deluxe room Rp 1,200,000 (US$ 123)
 One bedroom Suite Rp 1,750,000 (US$ 184)
 Two bedroom Suite Rp 2,500,000 (US$ 258)
 elia Bali Nusa Dua (***** /5 stars)
M  Deluxe room Rp 1,450,000 (US$ 148)
 Duplex Suite Rp 1,800,000 (US$ 188)
 Lagoon Access Suite Rp 3,200,000 (US$ 228)
 Deluxe room Rp 1,650,000 (US$ 168)
 Nusa Dua Beach Hotel (***** /5 stars)  Premier room Rp 1,850,000 (US$ 188)
 Palace Club room Rp 2,600,000 (US$ 268)
 Palace Club suite Rp 3,750,000 (US$ 288)

2. 20 PPWG
nUSA DUA
ACCSQ bali
The Th 13-17 may
ASEAN CONSULTATIVE COMMITTEE FOR STANDARDS AND QUALITY nadfc
Pharmaceutical Product Working Group 2013
Sekretariat Gabungan Perusahaan Farmasi Indonesia, Jl Angkasa No 20 A Kemayoran Jakarta 10620
Phone: +62 21 420 3040, Fax : +62 21 420 3047, 420 3048, Email : sekretariatgpfi@yahoo.com Official website : www.20thaccsq-ppwg.com
RESERVATION PAYMENT Method
The hotel requires security of payment to guarantee your hotel room. Payment can be made either by credit card (subject to 6%
administration fee) or through bank transfer (subject to local bank administration fee of USD 30.00 per remittance).
Bank Name : Bank Mandiri, Branch Kuta, Bali
Swift Code : BMRIIDJA
Bank Address : Jl. Raya Kuta 456 Kuta - Bali
Beneficiary : PT. MELALI BALI
USD account no. : 145 - 000 527 72 03
IDR account no. : 145 - 000 531 75 61
Hotel Reservation Contact:
PT MELALI BALI Jl. Dewi Sri, Complex The Lotus No.10 Kuta 80361 – Bali, Indonesia, Ph. +62 (361) 766156, Fax. +62 (361) 763435
info@melali-bali.com, www.melali-bali.com. Reservation Coordinator : Mrs. Maria Yovieta, Ph. +62852 3421 8484, maria.yovieta@melali-bali.com
Terms and conditions
1) Every reservation will be handled confidentially.
2) Reservation can only be accepted with full pre-payment (advance payment) to the organizer.
3) In case of cancellation the following terms applied:
• Cancellation made up to 30 days prior to check in date will be free from cancellation fee
• Cancellation made between 30 days to 10 days prior to check in date will be charged equivalent to one (1) night
of the room charge for each room cancelled.
• Cancellation made between 9 days to 4 days prior to check in date will be charged equivalent to two (2) night of
the room charge for each room cancelled.
• Cancellation made less than 4 days prior to check in date and in the case of no show will be charged equivalent
to 100% of the total night reserved.
Signature Date dd mm yy