EFTA02695566.pdf

LSJ, LLC 6100 Red Hook Quarters Suite 6-3 St. Tho - T I: Fax: 340-775-8108 E-mail: Wire Transfer Request Form Date of Request: 12/08/11 Amount Requested: 52,584.00 Payee: Suc. J. Serralles Second, Inc PO Box 801201 Payee Coto Laurel Address: PR 00780-1201 Bank Name: Bank of America 100 West 33rd St Bank New York Address: Bank Account: NY 10001 Requested By: Purpose / Description: Qulckbooks Memo: Purchase Jasmine/Citrus Fertilizer Special Notes / Instructions: G / L Account Information: G / L Description: Landscaping G / L Number: 60155f Authorization EFTA_R1_02046405 EFTA02695566  SUC.J. SERRALLES SECOND,INC. OBOX 801201 Number. 12012.2011 .070 LAUREL PR 00780.1201 Pape: USA Date: 12/6)2011 4 FUNOAOA e Fax (787) 260.2227 Sold LSJ LIC Ship BRICE GORDON To: BRICE GORDON To: 6100 RED HOOK QUARTERS 8-3 6100 RED HOOK QUARTERS 8 3 ST. THOMAS 00802 ST THOMAS 00802 USV1 USV1 Reference • P.O. No. Customer No. Salesperson Ship Via Tonne Code ST THOMAS 11-11.157 UPON Item No. Description/Comments Quantity UOM Unit Price Amount 01.11.24 JASMINE SAMBAS • I GAL 259 00000 C11.1 5000000 1,25000 PRODUCT OF PUERTO RICO 0111.25 CITRUS FERTILIZER IOM 20 00003 EACH 66 700000 1.33400 Due Date Amount Due Oise. Oat. Disc. Amount 12/15,2011 2.584 00 000 Remit To: Subtotal before taxes 2.684 00 SUC J SERRALLES SECOND. INC Total taxes 000 PO 80X801201 Total amount 2.584 00 COTO LAUREL. PR 00780-1201 Payment received 0.00 USA Discount taken 000 Amount din 2.584 00 EFTA_R1_02046406 EFTA02695567