EFTA00621644.pdf

LSJ CONSTRUCTION Subcontractor Payout Project: Flagpole Pool #1013 Trade: Plaster Subcontractor Phillip Mark Invoice # Phase # Requisition #1 09-200 Original Contract Sum: Change Orders Submitted & Approved: New Change Orders: Total Work Contracted to Date: Insurance ex•iration: Ma 14.2012 Partial July 18, 2011 Requisition #1 Final X $11,212.12 $1,899.76 $0.00 $13,111.88 Total Work Completed to Date: 100% $13,111.88 Less Retainage: $0.00 Total Payments Made to Date: $0.00 Total Current Payment Due: $13,111.88 694 Balance to Finish including Retainage: $0.00 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: $13,111.88 incl. JEE approval attached YES NO X Submitted Bill Signed: Date: July 18. 2011 Approved by: Emad Signed: Date: Invoice Attached YES NO Approved by: Gary Signed: Date: July 18, 2011 Approved by: Signed: Date: EFTA00621644 LSJ CONSTRUCTION Project Flagpole Pool 51013 ontractor lull legal name: Philip Mark Phase N 09-200 Trade. Plaster Invoice Requisition #1 Insurance expiration: 5/14112 Payment Partial Final X Invoice/Reg# Dale C/O Amount Retainage Due Paid Date Paid Check./ Balance I Contract 07/11/1 1 In tenor plaster 11.212 12 CO#1 CO#2 CON3 CO#4 'CONS 07/13111 Sheds Structure 1.899.76 Requisition N1 Requisition N2 Requisition #3 Requisition*. Requisition #5 Requisition #6 07/17/11 Final 13.111.138 0.00 13,111.88 1111188 0.00 000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total 13,111.88 0.00 11111.88 0.00 13,111.88 I Date Revised: July 16. 2011 Contract Amount - Phase contract CO#1 CO#2 CONS CO#4 CONS Cistern Coatings Shade Structure 11.212.12 1.899 76 Contracted To Date Balance of Contract vdRetairtage 13,111.88 0.00 EFTA00621645 Phillip Mark Sub-Contractor LICENSED GENERAL BUILD. 0 CISTERN CLEANING • ROOFS TILING • PAINTING • SWIMING POOLS -ANISH WORK Cellular: (340) 998.3655 Phoro: (340)777.5820 HOSPITAL GROUND NO. 171 ST. THOMAS, U.S. V.1.00802 i I c -1 75 e710 rt) 775 4 \cc ,c1 e. (-\\ \\. \ C A/kW (k t 6: k AV\ n‘ i sC ) . -N(.,/c,f1.1)1YI(4 (k% A/ /(I tfi ke, 1 5 2_, /4 / "fi ("' 11 1C 1r( I rt j ► / 111 2— 11, 1Z El s grit By EFTA00621646 • -4. foRtis. 4 Peel L a. 025:ba 7/ 76. 4.256 3231 /Q1 _7 8 a5.0 .?.(4, 321p. 38 ..3lca.. x. r ., EFTA00621647 Phillip Mark Sub-Contractor LICENSED GENERAL BUILDER 0 CISTERN CLEANING • ROOFS TILING • PAINTING • SWINK. POOL'S FINISH WORK Cellu(ar. (340) 998.3655 Phor.o (340)777-5820 HOSPITAL GROUND No. 171 ST. THOM AD. U.S. 0.1.00002 t'\\\ \nc - 1 )ickr' ( F ) tCc \\ ft \c- ))\ c -)ec-17- Or (tY . -11' 1 In i fin ref 7- H nt • 5-0 ( , ,((a( r-or. (ar (\ k) Hoi:Ark Rfl trl 11 I)) II EFTA00621648 I! .?1\014) I HiN5, '\) 7-1e-11 CAC, x 1.97;,,1 3 4, —29 si4+ `X 8" = 3?.1 s9 -14 -ZV A'c." x (6. SFr/ /1'22, r7 ,sei. -72 EFTA00621649