EFTA00724690.pdf

LSJ CONSTRUCTION Subcontractor Payout Project: Kitchen Renovation #1007 September 27, 2010 Trade: Doors Requisition #01 Subcontractor Al Development, LLC Insurance ex iration: March 1, 2011 Invoice # Phase # Requisition #01 08-210 Partial X Final Original Contract Sum: Change Orders Submitted & Approved: New Change Orders: Total Work Contracted to Date: $16,382.00 $0.00 $0.00 $16,382.00 Total Work Completed to Date: 50% $8,191.00 Less Retainage: Total Payments Made to Date: Total Current Payment Due: $8,191.00 Balance to Finish including Retainage: $8,191.00 Sales Tax Liability: $0.00 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 $0.00 None Total Outlays for this contract incl. Sales or Use Tax: $8,191.00 JEE approval attached YES NO X Submitted Bill Signed: Date: September 27, 2010 Approved by: Emad Signed: Date: Invoice Attached YES NO X Approved by: Gary Signed: Date: September 27, 2010 Approved by: Signed: Date: EFTA00724690 LSJ CONSTRUCTION Priciest Kitchen Renovation #1007 ≥ubcontractor - full legal name: Al Development. LIC Phase N 08.210 Trade: Doors Invoice N: Requisition k01 Insurance expiration: 1-Mar-11 Payment Partial Final X Invoice,Req0 Date C/0 Amount Retainage Due Paid Date Paid Check# Balance Contract Amount 09'27/10 16.382 00 COM CO#2 CON3 CO#4 CO#5 Requisition NI 03'31/10 Deposit 8.19100 000 8.191 00 8.191 00 Requisition #2 Balance 0.00 Requisition #3 0.00 Requisition #4 0.00 Requisition #5 0.00 Requisition #6 Requisition #7 Requisition #8 Requisition #9 Total 8.19100 0.00 8.191.00 0.00 8.191.001 Date Revised September 27. 2010 Contract Amount - Phase Contract CON1 CO#2 CO#3 CO#4 COtt5 Shuners. Door panels 16.382 00 Descn ion Descnption Descnphon Descnption Descnption Contracted To Date Balance of Contract wiRetainage 16,382 00 8,191 00 EFTA00724691