EFTA00609275.pdf

LSJ CONSTRUCTION Subcontractor Payout Project: Main House #1011 October 7, 2010 Trade: Coral Tile Req. #4 Subcontractor LMT International Insurance ex • iration: January O. 1900 Invoice # Req. #4 Partial Final Phase # 09-601 X Original Contract Sum: $11,350.00 Change Orders Submitted & Approved: $3,810.50 New Change Orders: $0.00 Total Work Contracted to Date: $15,160.50 Total Work Completed to Date: 100% $15,160.50 Less Retainage: $0.00 Total Payments Made to Date: S13,041.50 Total Current Payment Due: $2,119.00 OA.— Balance to Finish including Retainage: $0.00 Sales Tax Liability: a. Subcontractor/Supplier is liable, explaiiinstall only / tax included in contract b. Non-resident Subcontractor/Supplier Bond Applicable: c. Use Tax to be paid by our company: d. Shipping None Total Outlays for this contract incl. Sales or Use Tax: S15,160.50 JEE approval attached Invoice Attached YES NO YES NO X Submitted Bill Approved by: Ga Signed: Signed: Date: Ost.olltr 7. 2010 October 7, 2010 Em ioidiA) ad Approved by: Signed: Date: EFTA00609275  LSJ CONSTRUCTION Project Main House #1011 Supplier - full legal name LSAT iniernationai Dale Revised October 7. 2010 Phase # 09601 Trade. Coral Tile Invoice /7 Rea a4 insurance expiration Payment Partial Final X rPti- dfkLnouni_ ivoiterReqd CC:01 Date 084)5710 08109/10 CIO Amount 11 350 00 3.383 00 Relainage Due Paid Date Paid Cheeldt Balance I COQ -.. 427 50 CONS C004 coos i Revisits:41Ni, __ 5.675.00 _ 000 5.67500 6* 5.675 00 000 Requisition a2 C O. 1.69150 0.00 1,691 50 'V t.69150 000 Requisition #3 51175 00 0.00 5.675.00 e 5.6/5.00 000 Regui 11:r 44 _ . _ Balance 2.11900 0.00 2.119.00 2.11900 Total j 15.16050 0.00 15.160 50 13.041.50 2.119(T01 Contract Amount • Phase Coral Tile 11.35000 CO#1 Oisences 3 383 00 DescnPlon CCM PavetS 427 50 Description COI* - DeStnplion CON'S Deeciaason CON5 Desawnen Contracted to Dale isiesso I Balance of Contract w/Reteinage EFTA00609276  LMT International Invoice No. 154 LAM INTERNATIONAL. .__,_ raytimiet li ner ctn Itlbj la es Ir:- Deposit Comments Amount Due TOTAL I $ 3.810.50 Name 50% Deposit 50% FOB Pod of on9n CC # Expires Thank you for your business THANK YOU FOR YOUR BUSINESS EFTA00609277