LSJ, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802-1348 Tel: E-mail: Date of Request: Fax: Wire Transfer Request Form 12/5/11 Amount Requested: Payee: 51,080.00 Suc. J. Serralles Second, Inc Bank Name: Bank Account: Requested By: Bank of America Purpose / Description: Payee Address: Bank Address: PO Box 801201 Coto Laurel PR 00780-1201 100 West 33rd St New York NY 10001 Quickbooks Memo - Agricultural Inspection Charges/Labor Cost of Cancelled Order Special Notes / Instructions: Note: !gala has confirmed content of in invoice from Spanish to English Charges related to cancelled Ixora Flowers and other material G / L Account Information: G / L Description: Landscaping G / L Number: 60155f Authorization EFTA01172059 SUC. J. SERRALLES SECOND, INC. POBOX 801201 COTO LAUREL, PR 00780-1201 USA Tel. (787) 280-2221 / Fax (787)260-2227 Sold To: LSJ. LLC BRICE GORDON 6100 RED HOOK QUARTERS B-3 ST. THOMAS 00802 USV1 Number: Polio: on: 11.113.2011 1 11/302011 Ship BRICE GORDON To: 6100 RED HOOK QUARTERS 8.3 ST. THOMAS 00802 USV1 Reference • P.O. No. Customer No. it -11.157 Salesporson Snip Via Tams Code UPON Description/Comments Amount iLoo Cs Il er-l--.." Outribaski Gastos de man810 de matenales a fat Incluye furnipaci0n. ospeco0n y cargo de Tropical Growers pa carpi 1 v820n de kora, Due Date Amount Due Disc. Date Disc. Amount IKOlo, flals2JS 1.08000 c). Oilkd 12/52011 1.080 00 3 ( Au etinChi , miti l None: 000 Remit To: SUC. J. SERRALLES SECOND. INC P.O. SOX 801201 COTO LAUREL. PR 00780-/201 USA Subtotal before tams Total taxes Total amount Payment recast Discount taken Amount due 1.080 00 000 1.08000 000 000 1,080.00 EFTA01172060
