LSJ CONSTRUCTION Subcontractor Payout Project: Flagpole Pool #1013 Trade: Pools SubcontractorVirgin Islands Gunite Pools Invoice # Phase # Requisition #1 13-150 Original Contract Sum: Change Orders Submitted & Approved: New Change Orders: Total Work Contracted to Date: Total Work Completed to Date: Less Retainage: Total Payments Made to Date: Total Current Payment Due: Balance to Finish including Retainage: Sales Tax Liability: a. Subcontractor/Supplier is liable, explaii Labor and materials b. Non-resident Subcontractor/Supplier Bond Applicable: c. Use Tax to be paid by our company: d. Shipping Total Outlays for this contract incl. Sales or Use Tax: Insurance expiration: May 14, 2011 16-Feb-11 Requisition #1 Partial X Final $200,000.00 $0.00 $0.00 $200,000.00 20% $40,000.00 $0.00 $0.00 $40,000.00 $160,000.00 incl. $40,000.00 JEE approval attached YES NO Submitted Bill Signed: Date: February 16, 2011 Approved by: Emad Signed: Date: YES X Invoice Attached NO Approved by: Signed: Date: EFTA01123615 LSJ CONSTRUCTION Project Flagpole Pool #1013 ontractor - full legal name: Virgin Islands Gunite Pools Phase # 13-150 Trade: Pools Invoice #: Requisition #1 Insurance expiration: 5114/11 Payment Partial Final X Invoice/Req# Date CIO Amount Retainage Due Paid Date Paid Check# Balance Contract 02/02/11 Pool 200.000.00 CO#1 CO#2 CO#3 CO#4 CO#5 • Requisition #1 Requisition #2 Requisition #3 Requisition #4 Requisition #5 Requisition #6 02/15/11 Deposit 40.000.00 0.00 40,000.00 ' 40,000.00 Steel Complete 0.00 0.00 0.00 Gunite Complete 0.00 0.00 0.00 Tile Complete 0.00 0.00 0.00 Balance 0.00 0.00 0.00 0.00 0.00 0.00 Total 40,000.00 0.00 40,000.00 0.00 40,000.00 Date Revised: February 16. 2011 Contract Amount - Phase contract CO# 1 CO#2 CO#3 CO#4 CO#5 Pool 200,000.00 - Description Contracted To Date Balance of Contract w/Retainage 200,000.00 160,000.00 EFTA01123616 Lake Havasu Gunite and ConcreteNirgin Island Gunite Pools lake Ilavasu Gunite and Concrete BILL TO • Move-In Draw Project: Flagpole Pool #1013 Activity DATE 02/15/2011 TERMS Duc on receipt Invoice INVOICE # 1002 DUE DATE 02/15/2011 AMOUNT DUE I ENCLOSED $40.000.001 Amount 40,000.00 TOTAL $40,000.00 EFTA01123617 Lake Havasu Gunite and Concrete / Virgin Islands Gunite Pools Bank Wire Instruction& Bank Information EFTA01123618
