LSJ CONSTRUCTION Subcontractor Payout Project: Mechanical Desal January 11, 2011 Trade: Concrete Formwork Requisition #11 Subcontractor Big Bear Construction, Inc. Insurance ex iration: March 1, 2011 Invoice # Phase # Requisition #11 03-120 Partial Final X Original Contract Sum: $821,461.00 Change Orders Submitted & Approved: $1,135.00 New Change Orders: $0.00 Total Work Contracted to Date: $822,596.00 Total Work Completed to Date: 100% $822,596.00 Less Retainage: $0.00 7 Total Payments Made to Date: $781,466.20 / Total Current Payment Due: 1 $41,129.80 0 k_ Balance to Finish including Retainage: $0.00 Sales Tax Liability: a. Subcontractor/Supplier is liable, explaii install only / tax included in contract b. Non-resident Subcontractor/Supplier Bond Applicable: c. Use Tax to be paid by our company: d. Shipping None Total Outlays for this contract incl. Sales or Use Tax: JEE approval attached YES NO X Submitted Bill Signed: Date: January 11, 2011 Approved by: Emad Signed: Date: srai.ACI \\\\V\ $822,596.00 Invoice Attached YES NO X Approved by: Gaap______ Signed: Date: J ary 11, 2011 Approved by: Signed: Date: EFTA01118395 LSJ CONSTRUCTI0N PrOtel kiechancal Desal )ubconlrec»7 Iun legal nam* Bh; Bese Cont.suction, Inc Piles.. 03120 Trede. COnCl eie Fcanwoni Imoice N ReOu‘Nbon III 1 Insurance ei:patron lAlar-11 Parer,: Rams Final X InvoecelRee4 Date C•O Amouni Retamage Due Paul Otte Pag Checke Balance COnlrecl ~Dum 03'11/10 821.461 00 CONI CON2 CON3 CO14 COe5 07712/10 4.835 00 12715'10 (3.700 00), Requsinon NI 03,31/'0 74.40000 3 720 00 70,68000 706800n --r 000 ~vima /72 04/30'10 44.475 00 2.22375 42.251 25 42.251 25 šž 000 Recnasitron7/3 05731710 120.700 00 6.035 00 114,665.00 114.665.00 Š 4-,. 000 Ra:40454.0n //4 06/31/10 72.025 00 1 601 25 68,423.75 68,423 75 e", 000 Requisčhon tt5 07121/10 57.325 00 2.86625 54,458.75 54,45:1 75 •,r 000 RegasMon776 06,25120 115.040 00 5.75200 109.288.00 109.2e800 , 000 Reqtatilion777 09724/10 57.255 00 2.862 75 54,392 25 54,392 25 Š 000 Requiabon 48 10/25110 119.845 00 5.99225 113.852.75 113.852 75 , 0.00 Reoursition119 11/24/10 123.920 00 6.196.00 117.724 00 117.724 00 .":"-- 000 FteXiu,SIIIOII x10 12/18'10 37.511 00 1.880 55 35 730.45 35.730 45 ar 0 00 RequiSilice N11 01/11/11 Rittenes. (41.129 80) 41.129 80 Total 822.596.00 0.00_ 622.596.00 7A1,466.20 41,129-190 Dale Ftewse0 January I1, 201 Contmet Amour* • Rnase Gotter.) Co,? CO172 CON3 Co" CO7/5 Corr-teie Form...ork PaI.461 00 Teench ;apport 4.835 00 Descnpoon Dann mating tepar (3.705 00) Descnpson De sen peon Descnption Descnpson Conlracteci To Dale Belma or °annal w/Releaage 922596 00 EFTA01118396 APPLICATION AND CERTIFICATION FOR PAYMENT ALA DOCUMENT 6702 0:011••••••••0515 Mug.. µ.51.[o5/ 410•.1 IVirgt5C1011. Ccecnctoggarg59, Mo Pa Wear gir. WO Ca tang." 4 swan WO: ''010 CONTRACTORS APPLICATION FOR PAYMENT WOW*, 4 ma a Waal ag agm pa. gn comma*, a TA C441•41 CognalgO4 Sat AM Lagaget GTO: a 32.1•105 ORiagg•Al CONTRACT514J I WOWS* lag Coro. Cogegs J CONTRACT sum TO DA TE :L n• I a 21 • TOTAL L€1ED&STCREC TO DATE g:aken,O ogosg RETNNACE SOS% N or CeggvertIggta‘414 g'tbcaccn Cage s0 • f crOnigg SOON Nat Stetga Varga 'Ca4eae a- G Try Rionago gifts Sa •SO Try. Gusto. MCOO!, • TOTAL EARNED LESS R55.50,5C4 nee 4 la 1.15 TO., I LESS PREVIOUS a 0fiFCM'ES FON PAWENY 404 0 It Ceara, • CURIKNI PAYANNIOUE m BALANCE •3 FIn6. ggeCgglIONOMiTAPOLE Se, 121 30 CC SSC! 444 OO 51 OSX SOI MOO at By 5e22 595S aS 44anal Wawa 04 an a gom• a 0 re Ogrotage. immygyam mama a ma im age% a I. a Nato , ro" Wrga Y1 ea CeingWg2 •• wawa a lye Casa CoOrna a n44400 gat tegn al is eggoig.g.gs ••• Apr. Is rogroggeagggsggimigtgNyggerg m4 own a Maas ammo Pa, 75 Oar 1•4 we rat gagmen nevi noel • a at CONTRACTOR. Sgag 46623 SILO SO. 73 141.,11 IA 511 12140 CHANCE .3.110. A SligAg Aire 4007ora'S ; CCCOC MIME COLMCNW0c1 100200 4Cita was Pv Oar S' 145 CO IC CO Cool 2000.44 04 lAY 4 I Se 9S Toys S' 135. NrS10-ANGES 2y Car Ca' 'Y. 115 ,\' RI Stag CC, IIII.(5011 PC Ca • • 201. 11.0100(0.110 tlWay gm. lee OMn ••••• ii. :rogyng.sengeggfl Caw CM 0 CERTIFICATE FOR PAYMENT wove., re..1, Uggrgal Dawn tag at era gamma a Fa owera ens .r*ca la falalo••••••••••••englp van, sot le Is NYa YeCava Wain arca agar. a mow 44 am gropma a.~Maga Ogg tea, 41 egg Non swam waft Car Naas Wile*Camaa • meant clahrt, AMOUNT CERTIFIED 54112980 Agtacr.uggigt05, • •(•••••••tte.14 *swot,. ge fig aggegal egg.gt, eg. Conairuc n Maggegv eve ••••••••• go t•6 04444/10,.. Cs F CO•legal•CA We. l`l0 we ••• geggr got "'usage,' AS/0-W Cill• III) • ...deo Mg Is ••• .7.•••••gve nn,gga %Surd* ears. .Iggl •14 µWag .. gm erdaatlegg u. gait 41,•:).••••• f CorritiOrgagghg :Vent 4A CC./..gglet. _gra? a 11A-•• Cel .(10 h.; rt. gga uI r 1021 L. it*. gg. • WC Una FOY °W.^ mmocaccar Ph• 0• 440"00 SY g•eggeloall a coNCHWO AM DOttleal 040* • C.gggl•CliggYi or COCantO Aolgigagory from IF ictnu< VS I 'T)\gg •(.4, A.1 M1 n v.• EFTA01118397 CONTINUATION SHEET AM DOCUMENT G703 AM Document 0702 APPLICATION AND CERTFICATION FOR PAYMENT comma erg APPLICATION NO. 11 Corcrac tors stoned ctn./matron is attached APPLICATION DATE' 0171 Mt In L844.441,O14 betw, arrocnts are stated to me nearest donee PERIOD TO: 01/11/11 Use Column Ion Conrad: velem varrat+e re:3one to line eons may adply A A C 0 e F C K i ITEM NO CESCRIPTIGN OF WORK SCHEMMO WORK COMPLETED MATERtALS PRESENTLY STORED 1NOT eV DA E) DORS) TOTAL COMPLETED MO STOREO TO DATE (IMF r % (0 • 0) BA.ANCE TO 'task (C • C1 RETA1NAGE (if VARIABLE RATE, VALUE FROM MEOWS APPLCATION OD • Er frnS PEROD 0000, Shoring Rental $68350.00 $68.350.00 $0.00 $0.00 0.1.50 00 100 00% 50.00 3417.50 00002 Tres and Accessores 528 500 CO 528.500 00 50.00 50.00 $28.500.00 100.00% 50.00 1425.03 00003 Form Rental $23.500.03 $23.500.00 $0 00 50.00 523.500 00 10300% 50.00 1175.00 00004 Insurance 58.500 CC $6.500.00 50 00 50.00 58.50000 100 CO% 50.00 42500 00005 Frelont 519.50000 $19500.00 50 .00 50.00 $19.50000 10000% 50.00 975.00 00006 Forming Wirral, 55.000 03 55.000.00 $0.00 $0.00 55.000 00 100.00% 50.00 25000 000O7 Misc Manners $1000000 510.000 00 50.00 50 00 $10.00000 100.00% 50.00 500.03 00006 Misc Sae Woo $30.75000 $30.75000 $0 00 $0.00 530.75000 10000% 50 00 1537.50 00009 Base Slab Form $16.70003 516.700.00 SO 00 SO 00 $16.70010 ico 00% 50.00 835 00 00010 Base Slab RerrecrcIng $34600.03 $34.600.00 50.00 $0 00 534.800 00 100.00% $0 00 1740.00 00011 Base Slab Pea $5150.03 $5.950.00 50 00 50 00 $5.950 CO 10000% $0.00 297 50 00012 Base 'Nees Form $56300.00 $56.300.00 $0.00 $0.00 $56.300.00 10000% 50.00 2815.00 00013 Base wails Reedorcing 532.70000 $32.700.00 $0 00 S000 532.70000 100.00% 50.00 163500 00014 Base Walls Pour $6.30000 $6.330.00 50 .00 50.00 58.300 00 100.00% 50.00 31500 00015 let Elevated Stab Form EV 950 CO 541.950.00 5000 $0.00 $41.95000 100 00% 50 00 2097.50 00016 157 Enwaied Stab Romforong $3725000 $37.250.00 $0.00 $0.00 $37,25000 100.00% $0 00 1862.50 00017 Is, Verramo Stab Po✓ $8400.00 58.403.00 5000 50.00 58.400.0O 10000% 50 .00 420.00 00018 1st Fr. Waits Form $79 000 00 579.000.00 5000 50.00 579.00000 100130% 50 .00 3950 00 00019 1st Fl. Was Re-Ova/0 $41700.00 541.700 00 $000 50.00 $31700.0O 100.00% 50.00 2085.00 00020 i a FL Walls Pour $5 600 00 $5.630.00 $0 00 $000 $5.60000 100.00% $0.00 260 00 00021 Rod Slab Form $54 650.00 $54.650.00 5000 50 00 554.650.00 ICC 00% 50 .00 2732 50 00022 Roof Slab R.:women $42 500 CC 542500.00 50 00 50.00 542.500 00 10000% 50.001 212500 00023 Roof Slab Pour 59.10D 03 50100 00 50 00 50.00 59.10000 10300% sack) 1 455 06 00024 Parapet Wall Foes" $11 450.00 511.45000 50 00 50.00 511.45000 100.00% 50.001 572.50 00025 Parapet Wall Renformrg $2.800.00 $2.80000 $000 $0 00 $2.80000 100 00% 50 .00 14O00 00026 Parapet Wall Poi( $3.300.00 $1300.00 SO 00 50.00 51300.00 100 00% $0 .00 165.00 00027 Chereetel 534228 00 534 228.00 50 00 $000 534,228 00 10000% 50.00 1711 40 00028 Profit 5102.683 00 5102.683r® SO 00 SO 00 5102.683.00 100.00% $0.00 5134 15 00029 OO41 Trencn Su000re0B Credit $4.835.00 $463500 $0 00 so.00 $4.83500 1® 00% 50.00 241 75 00030 CO42Phdo Mark BacLonarGe 753 700.001 (53.700 OP' 50 00 50 00 ;53.70000) 100.00% 50 00 185.00 . 00031 50 00 50 00 50.00 50.00 HDMO' $0.00 0.03 03032 50.00 $000 $0.00 $0 00 rrOMOr 5000 000 GRAND TOTALS $822 596 OC 5822,596.00 So CO 5000 5822.596 00 10000% 50 .00 $41 129 SC EFTA01118398 Emad Hanna From: Eve Febe Sent: Tuesday, 11, 2011 To: Emad Hanna Cc: Monique Harry Subject: Big Bear Construction, Inc Req. #11 1010 Attachments: Big Bear Construction , Inc Req. #11.pdf Good Afternoon Emad, Attachment for payment Big Bear Construction. Inc Req. #11. In the amount of $41,129.80. Project 1010 Code 03-120. Eve 1 EFTA01118399