EFTA00622609.pdf

LSJ CONSTRUCTION Subcontractor Payout Project: Mechanical Desal December 15, 2010 Trade: Cistern Coatings Requisition #01 Subcontractor Phillip Mark Insurance ex iration: March 1, 2011 Invoice # Requisition #01 Partial Final Phase # 03-120 X Original Contract Sum: $3,700.00 Change Orders Submitted & Approved: $0.00 New Change Orders: $0.00 Total Work Contracted to Date: $3,700.00 Total Work Completed to Date: 100% $3,700.00 Less Retainage: $0.00 Total Payments Made to Date: $0.00 Total Current Payment Due: Balance to Finish including Retainage: I $3,700.00 / $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: $3,700.00 JEE approval attached Invoice Attached YES NO YES NO x x Approved by: Gary Signed: Date: December 15, 2010 Approved by: Signed: Date: EFTA00622609  ISJ CONSTRUCTION Prcsect Mechanics Desal iutcontraclor • lux legal name Phillip Mark Date Revised December 15 CO, r, Phase a 03.120 Trade Cistern Coating . BBC Invoice a Reputation *01 Insurance expiratiOn 1-031-11 Payment Partial Final X Invoice/R*0 Date GO Amount Retsina** Due Paid Dale Paid Check* Balance I Contract Amount 1207.10 Punch list touch up 3.70000 CONI CO* CO*3 COs* COS5 Requisition 01 '2 '1, 7 In Final 3 700 00 000 3.700 00 Requisition it7 3/00 00 Requisition *3 000 Requisition* 0 00 Requisition *5 0 00 Requisition t Requisition fa Requisition 88 Requisition * Total 3,700 00 000 i 3.76O 001 000 3,700 00 1 Contract Amour* - Phase Contract Cistern Coatings 3,700 00 COal Descnption CO* Descnption C003 Descnption Co.' Descnption COGS DeSCelphon Contracted To Date 3.700 00 Balance of Contract *Retsina*. EFTA00622610  Philip Mark Sub-Contractor LICENSED • • GENERAL BUILDER • CISTERN CLEANING • ROOFS nuNo • PAINTING • SWIMING POOLS FINISH WORK Collulor ESTATE WINTBERG Phone 6 -t > / ~Q~6i 51 111 No. I .137.6 9D /0 oc?:„. 3 cvl eCi,e , •( ST. THOMAS. U.S. V.I. 0O802 c_-•`( 0 \''\ \ )(Ac fc, 1J tvli CzvA (A)1,1 t .(f_ W)/\t i- c C.. C= cts fkoY('s(.6, ( ot) 41-7E_ 0\,6C-C%' - YA k S ('-A\ L,-\L) DA kC: Le A\ E ve' (4C VI Ey V\ IV\ ‘t 6 r- k ihry 6-k. I • •v 1, \ I r ' 2-, bl:161- tq 1- )CV.3 6CV\A r t1{ " t• 1, - F) r C, C )(-1,\ EFTA00622611