EFTA01199015.pdf

Gu]£stream' A OSNIMAL DYNAMICS COMPANY PRELIMINARY INVOICE ParUModel GIV AC Serial No./Tail No.: 1085 / N212JE Bldg C.-FAX 561-681-9392 - \Vest Palm Beach, Florida 33406 Mail Remittance To: Overnight Remittance To: Wire Remittance To: Gulfstream Aerospace Corporation Gulfstream Aerospace Corporation (Box 0 730349) Gulfstream Aerospace Corporation P.O. Box 730349 do JP Morgan Chase Bank, NA JP Morgan Chase Bank, NA Dallas, Texas 75373-0349 ATTN: Dallas National Wholesale Lockbox TX l-0029 Chicago, IL 60670 14800 Frye Road Account No. Ft. Worth, TX 76155 Fedwire Routing No. (ABA) 021 000 021 S.W.I.F.T. CHASUS33 ACH Credit Routing No. (ABA)071 000013 Invoice Number: 7115002835 Bill To: JEGE LLC Invoice Date: 10/19/2015 C/O GALAXY AVIATION INC Customer ID: MTN: LARRY VISOSKI P.O. Number: 3800 SOUTHERN BLVD, SUITE 204 Repair Station: FAA CRS PB8R624N WEST PALM BEACH, Florida 33406 In Date: 10/17/2015 United States Out Date: 10/18/2015 Payment Type: CIA - Wire Payment Terms: Title: JEGE LLC INVOICE SUMMARY FOR WORK ORDER NUMBER: SC18229 Time & Materials Flat Rate Total Labor USD: $0.00 $1,333.50 $1,333.50 Parts USD: $21,807.49 $53.00 $21,860.49 Services USD: $0.00 $1,200.00 $1,200.00 Detail Subtotal USD: $21,807.49 $2,586.50 $24,393.99 Subtotal USD: $24,393.99 Funds on Deposit USD: 50.00 Total USD: $24,393.99 For detail description of the work complied with see the Work Order Detail report. Unless otherwise indicated, all financial values listed in this document are in US Dollars (USD). GAC_WorkOrderPreliminaryInvoice.rpt 2011 Page 1 of 6 Printed: 10/19/2015 10:51:53A1 Ree EFTA01199015  Bill To: JEGE LLC WO It SC18229 Invoice Number: 7115002835 Item: 1 Airframe Culfstream CV Drop In N212JE Team Manager: Cyrus Hassibi Part/Model k: GIV Customer Coordinator: Frank Wiltshire AC Serial NoJTail No.: 1085 / N212JE TSN/TS0: 9072.5 CSN/CS0: 4181 Aircraft Time: 9072.5 Discrepancy: 1.1 Return to Service FAR Part 91. Resolution: ACTT: 9072.5 ACTL: 4181 DATE: 10/18/2015 I certify that the maintenance listed was performed in accordance with current Federal Aviation Regulations and is approved for return to service with regards to the maintenance accomplished. Further details are on file at this repair station under the above work order. A copy of the work order has been provided to the operator. Jamie Traver, DQR Inspector Gulfstream West Palm Beach, FL 33406 FAA CRS PB8R624N Labor USD: No Charge N/ C Discrepancy: 1.2 Inbound Inspection Resolution: Complied with Inbound Inspection IAW GAC PBI M 001 Rev 3 Labor USD: No Charge N/ C Discrepancy: 13 Tool Clearance Resolution: Removed all tooling from A/C Discrepancy: 1.4 Protect Aircraft Interior Resolution: Protected AMC as required. For detail description of the work complied with see the Work Order Detail report. Unless otherwise indicated, all financial values listed in this document are in US Dollars (USD). GAC_Work0rderPreliminaryInvoice.rpt 2011 Page 2 of 6 Printed: 10/19/2015 10:51:53A1 aces EFTA01199016  Bill To: JEGE LLC WO #: SC18229 Invoice Number: 7115002835 Discrepancy: 1.5 Towing (Does not include Hangar Moves) Resolution: Towed A/C as required. Discrepancy: 1.6 Billable Consumables & Shop Supplies Resolution: N/A Billing Method Hours Rate total Pans USD: Flat Rate $53,00 Total USD: $53.00 Discrepancy: 1.7 COMPLY WITH OUTBOUND INSPECTION Resolution: COMPLIED WITH OUTBOUND INSPECTION IAW CAC-NH-W-002 Labor USD: No Charge N/ C Discrepancy: 1.8 HazMat - Identify & provide a manifest, and a Shipper's Declaration for Dangerous Goods for all hazardous materials that are loaded aboard any aircraft. FAR Part 121 or 135 Operators will provide a hazardous material notification letter required by FAR 135.505 (e) prior to maintenance at this Repair Station iaw FAR 145.206 (a) (b). If there is to be loading of hazardous materials it shall be complied with by Hazmat trained authorized GAC-PBI personnel only. Resolution: N/A For detail description of the work complied with see the Work Order Detail report. Unless otherwise indicated, all financial values listed in this document are in US Dollars (USD). GAC_WorkOrderPreliininaryInvoice.rpt 2011 Page 3 of 6 Printed: 10/19/2015 10:51:53AI Rex EFTA01199017  Bill To: JEGE LLC WO It SC18229 Invoice Number: 7115002835 Item: 8 Mechanical Team Manager: Cyrus Ilassibi Part/Model #: Customer Coordinator: Frank Wiltshire AC Serial No./Tail No.: TSN/TSO: CSN/CSO: Aircraft Time: Discrepancy: 8.1 Customer states RH Main Boost Pump is intermittent. Request to replace the RH Main Boost Pump and RII EMI Filter. Resolution: Removed right main fuel boost pump P/N 1159SCP011-7, S/N 256. Installed a repaired pump PIN 1159SCP011-7, S/N 9908-0604. Removed right main fuel pressure switch P/N 8125-20, S/N 4287 from removed pump and installed same serviceable switch P/N 8125-20, S/N 4287 on replacement pump. Removed right fuel boost pump EMI filter P/N 1159SCP011-13, S/N 1589. Installed a new EMI filter P/N 1159SCP011-13, S/N 01651. Performed nessary ops and leak checks, no defects noted. Ref: GIV MM sec 28-05-02 and 28-05-00. Billing Method flours Rate Total Labor USD: Flat Rate $1,333.50 Parts USD: Time and Material $21,806.71 Total USD: $23,140.21 Parts: Ref. No. Part number: Description Quantity Sell price USD Extended USD 8.1 #1 1159SCP0I1-B FILTER, EMI I $12,067.81 $12,067.81 8.1 #2 1159SCP0I1-7 PUMP, FUEL BOOST I $9,735.00 $9,735.00 8.1 #3 MS29513-121 PACKING I S0.78 $0.78 8.1 #4 MS295I3-125 PACKING I S0.78 $0.78 8.1 45 MS29512-06 O-RING, TUBE FITTING PACKING 1 $0.78 $0.78 WI #6 MS29513-12I PACKING I S0.78 $0.78 8.1 #7 MS295I3-125 PACKING I S0.78 $0.78 Discrepancy: 8.2 CMP GIV 282016 Fuel Boost Pump (Right Main) - Removal Installation Resolution: COMPLIED WITH CMP GIV 282016 Fuel Boost Pump (Right Main) - Removal / Installation. Removed P/N 1159SCP011-7, S/N 256. Installed P/N 1159SCP011-7, S/N 9908-0604. Parts USD: No Charge N/ C Discrepancy: 8.3 CMP GIN' 282044 Fuel Boost Pump Electromagnetic Interference Filter (Right) - Removal / Installation For detail description of the work complied with see the Work Order Detail report. Unless otherwise indicated, all financial values listed in this document are in US Dollars (USD). GAC_WorkOrderPreliminaryInvoice.rpt 2011 Page 4 of 6 Printed: 10/19/2015 10:51:53AI Ree EFTA01199018  Bill To: JEGE LLC WO t/: SC 18229 Invoice Number: 7115002835 Resolution: COMPLIED WITH CMP GIV 282044 Fuel Boost Pump Electromagnetic Interference Filter (Right) - Removal / Installation. Removed P/N 1159SCP011-13, S/N 1589. Installed P/N 1159SCP011-13, S/N 01651. Parts USD: No Charge N/ C Discrepancy: 8.4 CMP GIN' 284052 Fuel Boost Pump Pressure Switch (Right Main) - Removal / Installation Resolution: COMPLIED WITH CMP GIV 284052 Fuel Boost Pump Pressure Switch (Right Main) - Remo N al Installation. Removed P/N 8125-20, S/N 4287. Installed PIN 8125-20, S/N 4287. Billing Method flours Rate Total Parts USD: Time and Material $0.78 Total USD: $0.78 Pans: Ret No. Part number: Description Quantity Sell price USD Extended USD 8.4 #3 MS29512-04 O'RING-TUBE FITTING, PACKING 1 $0.78 $0.78 Discrepancy: 8.5 CMP GIV 282038 Fuel Pump Auto Change - Operational Test Resolution: COMPLIED WITH CMP GIV 282038 Fuel Pump Auto Change - Operational Test Item: 10 Outstanding Parts, Materials, and / or Services Team Manager: Cyrus Hassibi Pan/Model #: Customer Coordinator: Frank Wiltshire AC Serial No/Tail No.: TSN/TSO: CSN/CSO: Aircraft Time: Discrepancy: 10.1 Customer approved part to be shipped via counter to counter/courier services. Resolution: Customer approved courier services to deliever ENII filet er PN 20024-3 from Savannah to NH. Billing Method Hours Rate Total Services USD: Flat Rate $1.200.00 Total USD: $1,200.00 For detail description of the work complied with see the Work Order Detail report. Unless otherwise indicated, all financial values listed in this document are in US Dollars (USD). GAC_WorkOrderPreliminaryInvoice.rpt 2011 Page 5 of 6 Printed: 10/19/2015 10:51:53A/ itet EFTA01199019  Bill To: JEGE LLC WO #: SC18229 Invoice Number: 7115002835 Communications concerning disputed debts, including a check or other instrument tendered as full satisfaction of a debt, must be forwarded to: Gulfstream Aerospace Atm: Credit Manager MIS B-05 PO BOX 2206, Savannah, GA 31402 For detail description of the work complied with see the Work Order Detail report. Unless otherwise indicated, all financial values listed in this document are in US Dollars (USD). GAC_WorkOrderPreliininaryInvoicelpt 2011 Page 6 of 6 Printed: 10/19/2015 10:51:53A1 ace EFTA01199020