!"! # $%& &'! "! !! !(! !)$! &(*! &(! !) !&(!+
, ! # $%& &'! "! !! !(! & -!.!)! !)$! &(*!
&(! !) !&(!+
/ , ! # $%& &'! "! !! !(! &'! *! -! ! "$
!)$! &(*! &(! !) !&(!+
/ & !. )$'!" # $%& &'! "! !! !(! &'! *! ! "$ & $($) (# (!% -! & !)! !)$! &(*! &(! !) !&(!+
/ / , ! # $%& &'! "! !! !(! &'! *! ! "$ (# (!%
-! &( & !)! !)$! &(*! &(! !) !&(!+
0/ , ! & &( %!! &%1 !2! !&(!+
($"! &%&( )!+! ( ! "!"
3 4
. 0
! " # $ %
$%'!+ & -!.!)! "' !&(!+
$%'!+ & -!.!)! !&(!+
& '
& ' ( "
& ' ) *+ *&+*,*+ ,
$%'!+ &'! *! -! ! "$ 5/ 5 /505/60
& & ' "
& & ' ) !+,! +*-
+-& +-& +-& ' .
/+**0+!/,+-!-& /+**0+!/,+-!-& , ' ,0*+ 0 +0//
$%'!+ &'! *! ! "$ / 75/ 5/0 0
$%'!+ &'! *! !&(!+ 8/009/58 / ::
; 8/009/58 / ::
& ,! ! &'! "! !! !(! !)$! &(*! &(! !) !&(!+ .&( ( <$'!
=
4
& , ! * / - 1 , 2 ! 2 * 2 /
+
&+ + ' ( " / 80/ 00/670 / / :/09 / 80/ 00/670 5 5/ 50/56: 5/ 5 /505/60
&+&+ ' " / :0/ 7 / 66 0/ :5/ 67/069 0/:98/858/ 07 /8 / 77/896 / 75/ 5/0 0
,+ + 3
,+&+ 3
Surabaya, Menyetujui, Sekretaris Daerah