EFTA00622577.pdf

LSJ CONSTRUCTION Subcontractor Payout Project: Mechanical Desal Trade: Concrete Formwork Subcontractor Big Bear Construction, Inc. Invoice # Phase # Requisition #11 03-120 January 11, 2011 Requisition #11 Insurance ex iration: March 1. 2011 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 Total Payments Made to Date: $781,466.20 Total Current Payment Due: I $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 Total Outlays for this contract incl. Sales or Use Tax: None JEE approval attached YES NO X Submitted Big Signed: Date: January 11. 2011 Approved by: Emad Signed: Date: fpr,Na_Ag \\ \ $822,596.00 Invoice Attached YES NO X Approved by: Ga Signed: Date: .1.3!-Tuary 11 20, 1 Approved by: Signed: Date: EFTA00622577 LSJ CONSTRUCTION AtbconIracior Project Mechanical Desat lull legal name By Bear Conszruceon. Inc Phase 4 03.120 Trade. Concrete Formwork invoice a Requation et I Dale Revised January 11.201• Insurance espiralion 1 Mar•I I Payment Penal Final X 'Avoca/Regis Dale C1O Amount Retainer Due Pad Date Pad °lecke Balance I Contract Amount 0Y11/10 821.461.00 COM C042 C043 cots coos 07/12/10 4.83500 12115710 (3,700 00 Re. ..-ition et 03/31/i0 74 4C0 00 3 720 00 70 680 CO 70 680 Oo 000 I figalin 42 NOIMIE 44.475 00 2.223 75 42,251 25 42.251 2r. d,. 000 Re. &lion 43 OS C 120.700.00 6.035 00 114.665 00 114 66500 or 0110 RequisAtion 44 06/31/10 72.025 00 3.601 15 68,423 75 68.423 75 ,, 000 RegoiSitton 45 07/21/10 57.32500 2.86625 54,458.75 54.456.75 .." 000 Regarabon #6 08/25,10 115.040 00 5.75200 109,288.00 109.268 00 IL_ 000 Requisition la 09124/10 57.255 00 2.86275 54.392 25 54,392 25 i 000 Requallion 48 10/25710 119.845 00 5.992 25 113852 75 1 1 3.852 75 0.80 Bowsaw *79 11124/10 123.920 00 6.19600 117 724 00 117.724 no ./ 000 Requisition 410 12/16110 37.611 00 1.880 55 35,73045 35.730 45 000 Requisition 011 01711/11 Retainage (41 129 80 41.12980 Total 822,59600 000 622,596 00 781.486.20 41 12980) Contract Amount Phase Contract COSI con C063 COS4 C045 Ceeciele Foirrneoth 821.46100 Trench soXiOn 4.83500 DOSCTIO0041 Cistern coaling repair 13100 00) DeSenpliCin Description Descnolion Deson01.00 Conuacnxi To Dale Balance of Connect wRela.nago 822.6%00 EFTA00622578 APPLICATION AND CERTIFICATION FOR PAYMENT AIR DOCUMENTGTO N IAA VO, AAP,. 04 A IA. Mw TIN likey :Can VACI*I Al illsAitavivAnn of *.t t4143 LAP!, Lawn rye“ :08)t APAI l.rYµµl ANN -tans TROsett • • 120 11 • I1011 110 1 0 b...• AA OOH la ••201, CONTRACTORS APPMATION FOR DAYNENT NA0cmcn 0 Ain* Advnem lL 1190i 04104 cor-nto• NtAvz C<ATAN Contnavon STAN 414 Zoc.ortAt G732 4 iTacTea I Qftalhal CC.STRACTSVU 2 Weer birCINATA 0,00 . 3 CONTRACT Cutd IODATE0.AT 1 e 21 4 roma COLRETE06 STOIC to DATE teAtroGynali 6 AllustmTI SOPAt. COnttesed WAN kratteemen Ka n0•e or @Mt 308% 030:04 1ddloc• Kira I on ow*. TyAI RADARia flees So • 10a IRAN, Cowin ATI OM, 6 TOTAL EARNED LESS RITAINACE An ILAN tat STARA • LESS ANEMIA Ca TO CATES SOR 0 4TACIT Oat honor, Ceuta, CURRI N MEAN WE • BALANCE TO ANSA NC:LA1hGRE TAINCE are A Asa „re A 'he Catnon conk. Al Pee LAY 0t3 Ornalse•irawallP nun/win 414 4/ t. eldo k a.. w 444sitata..0. IA)/p/ %S tar tereW41.14404444 AIN'T Cengi Dawns. OM 4.0/4144.04 619 0. a, Cosy ito IA.A own•CIAIRC41.04%, P•aal moo And Ad .D4 r, A , A, vend Pie A, 4 O..* ato Ow A.se‘ 441/140141awn ram • VA Oa 141 TO CONTRACTOR: 51 73333 Si. 1 2960 SOD, SAZ2 6S6 3C By GO NAT CA.10 0Cm/AINC 56125%60 SL11NN ST61.46620 $ 71 110' /0 S11.120 do 511 1 2903 CHANGE ORDAR SURVART 4030•ONS I OCCUCTIOKS TVS 00•00.600 ,140 n Ammo ~RS WCAnin 5' 136 00 I I003 Toed some TAS W. VOA SO 0 TO. 1AS S. WOO SO 0, NET CAANAMS Ay:MAN/ IAN' I SLIM% I sum AAnttcsi sed isnAT, Y..n re on • .•4t UT ttaiNVO, Co" V Aare CERTIFICATE FOR PAYMENT ▪ ocArrirot wa.v.i.nau Osama mud Tv no am canes++ Aromm:A TI. CAmAtsvm Amnon. V4A014, W4.0.10.4 tan , ne.~...r. COW4tk. • Ogee SOAWC CfAtif CO AMOUNT CENTIME° Sat 12950 Alm 'aline I 1 1,001C•4100 4,44ribiAte IM•frA119.4weTo 44•4440:0 ot ...4a gm w. tose0.04 CORWIN 100 Ifinerder By 0-1:1/2-// • • sa, 'OMNI* CIPT0 eD• stole sak NIA :sinew la ow. Alin* 401.104.40444 e • .4nm. net ate YCrjNW 99.. OIII:crena • CC.C.Neil it e' Mel CA AIN Ate CIA TM' IA 'ova *CP CA %di k 0/4 14 MN Obtain .0 1.0.000 eo 01. document by Anau0st4 a C0001•144 AM 0•Nonom 0101 .CmtlIcation a Oocoment's Aka/memory Pam Me License. , A • IA AI. p. rui 4.1).114.',... ,A , 4•1.,C. JAN I I 20I) Sire• I of I EFTA00622579 CONTINUATION SHEET Am DOCUMENT 0703 An Document 6702. APPLICATION AND CERTIFICAT ION FOR PAYMENT coniamag APPLICATION NO. 11 Contractor's signed cortScation is arached APPLICATION DATE 01/11/11 In labuLINOn$ below. amounts art statue 10 tImt nearest dollar PERIOD TO 01/11/11 Use Column Ion Contracts where variable retainage Iv hat COM; Ma apply A B C D E a 0 N i ITEM 40 CESCRPTION CF WORN SCHEDULED WORK COMPLETED MATERIALS PRESENTLY STORED t7r07 IN Dila) 0 ORE) rcrk, COMPLETED AND STORED TO DATE 10.641 5. (G • Ci CALONCE ro FINISH IC • G1 RETANAGE la VARMSLE RATE, VALUE FROM PREVIOUS APPLICATION tO • Et THIS PEROD 00001 Shourg Rental $68350.00 S68.350 00 50.00 5000 $68.35000 10000% $0 00 3417.50 00002 Ties WM ACCeSSOPOS $28500.00 628 500 00 50.00 5000 528.500 00 100 CO% S0.00 1125 03 00003 Form Regal 523.500 03 523.500.00 50 00 $0 00 523.50000 10000% $0.00 1175.00 00004 Insurance $8.500.03 $8.500.00 $0 00 SO CO 18.50300 103.00% 50.00 425.03 00005 Fregnt 519.500.03 $19.930.00 $0 00 50.00 519.50000 10000% 5000 975.03 00008 Forming materials $500000 55.000 00 5000 $0.00 55.00000 100.00% 50 00 250.00 00007 Ms: Materials 510000.00 $10.03000 50 00 50 .00 510.000 CO 10300% 50 00 500.00 00008 Mem Site Work 530 750 00 530.75000 50 00 550 00 530.750.00 1(000% 50.00 1537.50 00009 Base Stab Form 516 70000 $16.700.03 $0 00 5000 516.70000 '0300% 50 00 835 00 00010 Base Slat Reader/On 534000.00 534.000.00 $000 50.00 $34.000.00 100 00% $000 1740.00 00011 Base Slat Pout 55 950 DO 55.950 OD $0 00 $0 00 55.950 CO '0000% $0.00 297.50 00012 Base Wats Form $56.300.00 $56.300.00 $0 00 50.00 $56.30000 10000% $0.00 281500 00013 Oast Wilt Rein/196812 $32 700.03 $32.700.00 $O 00 $0.00 532.700 CO 10000% $0.00 1635 00 00014 Basewatc Pour 56.30000 56.300 00 5000 50.00 58.30000 '0000% $0.00 31500 00015 1st Elevates Slab Form $4195000 541.95000 SO 00 $0 00 $41.950.00 10000% 50.00 2097.50 00016 1SI EPPrelee Slab Reirkircos $37 250.00 537.250.00 $0 .00 $0.00 537.250 CO 100 00% 50 00 1862 50 00017 1st Elevateo Slab Pour $5.400.00 58.400.00 50.00 50.00 56.403 00 103 00% 50.00 ' 420.00 00018 1st FT. Was For. $79 000 00 $7900000 $0 00 50.00 57903000 '00 00% 50.00 395000 00019 1s1 F1 Was Reeforcirop $41700.00 541700.00 50.00 50.00 $41.70000 10000% 50.00 2085.00 00020 ist Ft. Was Pax 55 800 00 55.600.00 50 00 50 .00 55.600 00 109.00% 50 00 280 CO 00021 Root Slab Form 554.650 X 554.650 03 S000 56 .00 554.650130 100.00% 50.00 2732 50 00022 Rod Stab Reinforcing $4250000 542.500.00 50 00 $0.00 542.50000 10000% S0.00, 2125 00 00023 Root Slab Par 59.10000 $9.10000 $0 00 50.00 59.10000 10000% 50.00 455 00 00024 Parapet Will Form Si 1.450 X 511.45000 50 00 $0.00 $11,45000 100.00% 50.00 572 50 0002.5 Parapet Wall Reeitorcog 52 800 00 $280000 50 00 50 00 52.80003 103.00% 50.00 140 00 00026 Palatal Wall Pouf $3.300.00 $3.300.00 SO 00 SO 00 $3.300 00 100 00% 50 00 165 00 00027 Overhead $34228.00 534 228.00 50 00 SO CC 534,22800 100.03% 5000 1711.40 00028 Proca 5102.683.00 5102.683.00 50 00 50 00 5102.68300 100.00% 50.03 5134 15 00029 CC)" Trench StsoonNB Credit 5483500 5483500 50 00 50 00 $4,83500 10300% 50 00 2417$ 00030 C042PNip 141.* BEL:84W (53 700 0)) i$3 700 00' 50 00 5000 iS3 700 0:4 10000% 50 00 -185.00 00031 5000 5000 50 00 50 00 40N00' 5000 0.00 00032 50.00 50 CO 50.00 SO CO 401VrOr 50.00 000 GRAND TOTALS 5822 596 30 5822 596 CO 50 00 5000 5822,596 00 leo 005/ 50 00 541 129 BC EFTA00622580 Emad Hanna From: Eve Febe Sent: Tuesday, Jam l iwyrt l :0 8. To: Emad Hanna Cc: Monique Harry Subject: Big Bear Construction, Inc Req. k11 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 EFTA00622581