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efta-efta00622593DOJ Data Set 9Other

$239,575.00

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DOJ Data Set 9
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efta-efta00622593
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
$239,575.00 Invoice Attached YES NO Approved by: G Signed: Date: June 3, 2010 Approved by: Signed: Date: LSJ CONSTRUCTION Subcontractor Payout Project: Mechanical Desal Trade: Concrete Formwork Subcontractor Big Bear Construction, Inc. Invoice # Phase # Requisition #03 03-120 Original Contract Sum: Change Orders Submitted & Approved: New Change Orders: Total Work Contracted to Date: Total Work Completed to Date: Less Retainage: Total Payments Made to Date: Total Current Payment Due: Balance to Finish including Retainage: Sales Tax Liability: a. Subcontractor/Supplier is liable, explaii Insurance ex May 31, 2010 Requisition #03 iration: March 1, 2011 Partial X 29% 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: Final $821,461.00 $0.00 $0.00 $821,461.00 $239,575.00 $11,978.75 $112,931.25 $114,665.00 $593,864.75 JEE approval attached YES NO Submitted Bill Signed: Date: June 3, 2010 None EFTA00622593 LSJ CONSTRUCTION Project Mechanical Desal ubcontraclor fun legal name. Big Bear Construction. Inc. Phase ft 03-120 Trade: Concrete Formwork Invoice It Reckisition N03 Date Revised May 31. 2010 Insurance expiration: 1-Mar-11 Payment Partial Final X oaiancefl 'Invoice/Reef, Date CIO Amount Retainer Due Paid Dale Paid Checke [Contract Amount 01/I IMO 821.461.00 COrtl Con CONS COW COPS Requisition NI 0341110 74.400.00 3.720.00 70.600.00 70.68000 ✓. 0.00 Requisition //2 04/30/10 44.475.00 2.223.75 42,251.25 42.25125  0.00 Requisition 63 05/31/10 120.70500 6.03500 114,865.00 114,466.00 Requisition 64 0.00 - 0.00 Requisition Nti 0.00 Requisition #6 0.00 Requisition #7 0.00 - Requisition NB 0.00 Requisition /19 0.00 114,666.001 IlTotst 1239.67500 11,978.75 227,696.26 112,931.26 Contract Amount -Phase Contract CON1 CON2 CON3 COW CONS Concrete Farm** 821.461.00 Description - Description Description Description Description Contracted To Dale Balance of Connect wlRelainage 821,461.00 593,864.75 EFTA00622594 APPLICATION AND CERTIFICATION FOR PAYMENT ALA DOCUMENT G702 0555456. t]: Ls 45:0 4.4 ~a 0154381 aaan uSa ~CO PRO aCT it. .IOatBan, air< FROM CONTRCTCR Cennac•ar~ S tar Careasa IK WO Ease 61~0 PUSS ker klan 00~ ...atC4Trat 3 Axiolm in rind Fn., $.112010 f /NI 00 TO 5/314010 reto.<6* • 91010 DMA 5.014010 CONTRACTORS APPLCATOR FOR PAYNE/4T ACIM•19.1.1, iMb te, Ilaymlier.8.~ Oro«. in ~tab rif• fir C0, 011. Caaralial 54.441. AU OtatneetGra. a 01~2 I ~Al CONTACT SUE 2. Net 490•04 ty ChrRO Otters 3 CONTRACT Vitro DATER" I F 2) 4 TOTAL COUPLITIO &STORM 6C DATE ICUS, G on G703) 5 RETAINAGE SØ %Of Conoeced ~lc Ins httdaten 42.4).~ • E cs 0703) 5 OA tortetteltrenat Itotat cA 0/03T Taal RabraPt, araS 54 • 50 or Taal Otani , I 0.67121 6 TOTAL EARNED LESS RUMNAGE 41.9* 4 Lass le* 5 T0191 LESS ~US CERTIFICATES IFOR PAYMENT tat S IromtnCetEs149) CuRRENT PAY4.46.2 DUE 9 IIAMDCE 74)1144191.11K.AUCING RETAtUGE ea 3 Ins La 4/ ins anrs Ceenait 4naaala 444~4.41414 bad ~wan aped 4445$ ~Oa let Paw« ?as ~4 eemprs$ nnavatane Inir ~ma Oreacias tlui N•50477 1a• Wm OW in f'ane> ~tin 04a~ Wawa hoer 4 ab. 444•41 One thrall ~MI Were a ereata $131.46100 CONTRACTOR: 5000 $1471A1100 by 1144•CcemDtamn NC. 5219.576 00 $17 A78 7$ KIM 1)1071 75 $227.5131525 5~01 Caren/ arrur Mr1 am•w Mere ow Wm 4.74 Nam ask waaaaaa, sea CERTIFICATE FOR PAYMENT $11293125 4/4 acamaame ~la Cowed 0.4.44n. lamas 0564•445~40 4r4 45» raw* as Ss, Maresffixta.14~ aviter 044. Oweimannaga ~grim tiltai in•••••4 ••••114 5114,414140 •"" stone tan Gala Doan et ~nor • «Ma a **Alai« CERallED I/936U is ~NM OROCA SUm~Y ADoillONS DEDUCTIONS Traser4V941 ØØ an a tams it 0~ $0.00 $0 00 167443970•496is Nfl 5000 1000 TOTALS $0 00 PIN NE7 omNcAs gowns OA« 5000 AMOUNT GERM REO 1114.665.00 Ilea ~yawn 44~ ow444 4451‘6, tas Ac~a4 al an CaniaMen 96.4 ea nee rocatab e. net ainfsil C By Date: 1544 a444aa •ne 7.4~ Mair Tia10 • saa. ca5 Sao Caw 54~ ~so 64~ ea wawa of 5., an w e 4,44444 a in laba d to Ora a arraaa 46:4 as Caftan MA 000~4T CM ~Oak aN 440 Calltatiaram ICA PATIENT .092~ &A 0.932 U1444 marfatife ~dada, . «at% Mammal bynasneag • waphned Chawrela I 0401. Ceruhcation d Decwainrs AImMIb112ROAMLRM.441. ha ~CAM Man" Olt A.C.4714414 54,4 5644 Per Mw 4644~4014 OC 400555400 Samarv SLAMS 1 or I EFTA00622595 CONTINUATION SHEET .414 DOCUMENT D703 At& Document G702, APPLY:01710N AND CERTIFICATION FOR PAYMENT. contemning APPLICATION NO: 3 ComraClOr5 signed cerbfic.abon is attached. APPLICATION DATE ' 05/24/10 In tabulations beam. amounts we stated to the nearest delta/. PERIOD TO: 05/31/10 Use Column I on Contracts were vertab1e relarago !or line items may softly. A a c 0 I E r G H I TEM NO OESaainsout OF WORK SCHEMED WORK COMPLETED MATERIALS PRESENTLY STORED (NOT et 0 8 E) DOPE) TOTAL COMPLETED ANO STORED TO DATE (D•E•FI % (6•C) BALANCE T0 FINISal r0 • 6) RETAHAGE OF VAR/ABLE RATE) VALUE FROM PREVIOUS AP:LIGATION (0 • E) 1X15 PERIOD 00001 Swan) Rental $64.350.00 50.00 $68350.00 50.00 $68.350.00 100.00% 50.00 3417.50 00002 Ties and Accessories 528.50003 320.000.00 10.00 $0.00 $20.000.00 70.10% 58.500.60 1000.00 00003 Form Rental $23.50300 $23.500.00 $0.00 $0.00 523.50100 100.00% 50.00 1175.00 00004 Insurance $1.500.00 $6.5430.00 $0.00 50.00 58.500.00 100.00% 50.00 425.00 00005 Freight 519.500.03 $15.000.00 $0.00 $0.00 515.000.00 76.92% $4500.00 750 CO 00006 Forming Materials $5.000.00 $0.00 $1,000.00 $0.00 51030.00 20.00% 54000.00 50 00 00007 Misc. Maceriais $10.000.00 $0.00 $1.000.00 $0.00 $1.000.00 10.00% 5900000 60 00 Misc. Site Work 530.75103 53.075.00 50.00 $000 $3075.00 10.00% 527.67500 153.75 00009 BOW Slab FOITT1 $16.700.00 $15.000.00 SI /00.00 $0.00 516.70300 100.00% $0.00 835.00 00010 Base Stab Reinforcing 534.800.00 517.403.00 $17.400.00 50.00 $34.800.00 100.00% 50.00 1740.00 00011 Brno Stab Pour 35.950 00 5000 35.950.00 $0.00 $5.950.00 I 100.00% $0.00 297.50 00012 Base Wails Form 556.30000 50.00 55.63000 50.00 5503000 10.00% $5017000 281 50 00011 Ban Wails Rankoc.ng $32.700.00 30 00 $3.270.00 $0.00 53.270.00 10.00% $29.430.03 163.50 00014 Base Wails Pour 56.300.00 SOW $0.00 50.00 $0 .00 0.00% $6.300.00 000 00015 1st Elevated Slab Form $41.950.00 3000 50.00 50.00 30.00 0.00% $41.950.00 0.00 00016 1st Elevated Slab Reinforcing 337.25000 $000 so.00 $0.00 $0.00 0.00% $37.250.00 0.00 00017 1st Elevated Slab Pour 55.40000 50.00 30.00 30.00 $0.00 0.00% $8.400.03 0.00 00018 1st Fl. Walls Form 579.000 00 50.00 $0.00 $000 50.00 0.00% 579.030.00 0.00 00019 1st Fl. Walls Rein/atone $41/0000 $0.00 $0.00 50.00 50.00 0.00% $41.700.03 0.00 00020 1st Fl. Wails Pour 55.600.10 $0.00 $0.00 $0.00 30.00 0.00% 55.600.00 0.00 00021 Roof Slab Form $54.650.00 $0.00 50.00 $0.00 50.00 0.00% 554.650.00 0.00 00022 Root Slab Rotriforcep $42.500.00 $0.00 $0.00 $0.00 $0.00 0.00% $42.530.00 0.03 00023 Roof Slab Pour $9.10000 $0.00 $0.00 $0.00 $0.00 0.00% $910000 000 00024 Parapet wall Form $11.45000 $0.00 $0.00 $0.00 50.00 0.00% $11.450.03 0.00 00025 Parapet Wall Reinforcing 52.80000 50.00 50.00 $0.00 50.00 0.00% 52.800.03 0.00 00026 Parapet Wall Pour 53.300.00 50.00 50.00 50.03 50.00 0.00% $3.300.00 0.00 00027 Overhead $34.22800 $4.100.00 54.100 00 $0.00 $8.20000 23.98% 526 028 CO 410.00 00028 Profit 3102.683.00 $12300.00 $12.310.00 50.00 $24.600.00 23.96% 578.08300 1230.00 00029 $0.00 50.00 $0.00 $0.00 elledit 30.00 0.00 00030 $0.00 50.00 $0.00 50.00 #0800! $0.00 0.00 00031 10.00 50.00 30.00 50.00 "DNA)! 50.00 0.00 00032 50.00 50.00 $0.00 $0.00 tiON/Ot 50.00 0.00 GRAND TOTALS $821.461.00 3118.875.00 5120.730.00 $O 00 $239.575.00 29.16% 5581 686.03 $11978.75 EFTA00622596

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Phone227.5131525
Phone4714414
Phone5017000
Phone5503000
Phone5900000
Phone7443970
Tail #N03

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