LSJ CONSTRUCTION

LSJ CONSTRUCTION Subcontractor Payout Project: Master Suite #1004 Trade: Foam Ceiling Moulding Subcontractor Universal Foam, Inc. Insurance ex iration: Janu 0, 1900 Invoice # Phase # 2 06-201 Partial Final X Original Contract Sum: $577.92 Change Orders Submitted & Approved: $1,014.02 New Change Orders: $0.00 Total Work Contracted to Date: $1,591.94 Total Work Completed to Date: 100% $1,591.94 Less Retainage: August 13, 2010 2 Total Payments Made to Date: Total Current Payment Due: $1,014.02  Balance to Finish including Retainage: Sales Tax Liability: $0.00 $577.92 $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 Total Outlays for this contract incl. Sales or Use Tax: None JEE approval attached YES NO X Submitted Bill Signed: Date: August 13, 2010 Approved by: Encad Sign / Date: ql\c0 \\O c $1,591.94 Invoice Attached YES NO X Approved by: Gary Signed: Date: August 13, 2010 Approved by: Signed: Date: EFTA00606480 LSJ CONSTRUCTION PI*Xi Master Suit #1004 Supplier • hill legal name: Unlvenal Foam. Inc. Phase # 06-201 Trade: Foam Calling Moulding Invoice /0: 2 Dale Revised Atzgaul 13. 2010 Insurance explraSon: P ymont Partial Final X 1nm:ice/Reg/ Dale C/0 Amount Retainage Due Paid Date Paid Check* Balance I P.O. Amount 07/21/10 577.92 COLt1 CO#2 COP CON C0115 07/30/10 722.40 07130/10 291.82 RequislUon NI 07/21/10 Product 577.92 0.00 877.92 877.02 0.00 Requisition #2 07/30/10 Additional product Freight 722.40 0.00 722.40 722.40 Requisition #3 07/30/10 291.62 0.00 29112 291.62 Requisition #4 0.00 Total I. 1191.94 0.00 1.591.941 577.92 1,014.02 1 Contract Amount - Phase P.O. CO#1 CO/S2 CO#3 CON CONS Foam ceiling m109. Additional Mktg. Fro ,ht Contracted To Date Delano or Contract writelainage 1,59114 EFTA00606481 Emad Hanna From: Monique Harry Sent: Friday, August 13, 2010 1:33 1:3 III 3 1 To: Emad Hanna Subject: Universal Foam Attachments: Universal Foam Inc 1004 Req 2.pdf Emad, Attached for payment Universal Foam, Inc Req 2 in the amount of $1,014.02. Project 1004 Code 06-201. Monique EFTA00606482 17639 E Colonial Drive Orlando, FL 32820 Bill To Brice GordonfLS.I Little St. James Island 6100 Red Hook Quarter 113 St. Thomas, Vf 00802 Invoke Date Invoice . 7130/2010 12375 Job Name, Bldg/Lot Brice Gordon/1.Si Little St. James Island 6100 Red 1 look Quarter B3 00802 P.O. No. Terms Due Date Ship Date Project Order Number COD Due on receipt 8/312010 8/13/2010 10352 Desaiption Oty Rate Amount Ceiling Mold ® 3.755c5*x96% 1.09EFS, HARD COAT/PRIMER MADE IN USA Freight • TO HE DETERMINED WHEN ORDER IS READY 54 1 24.08 291.62 1,300.32 291.62 Thank you for your business. Subtotal 51591.94 Sales Tax (6.6%) so.00 Total $1591.94 Payments/Credits 8-577.92 Balance Due 51,014.02 o6- 0 EFTA00606483