EFTA00606480.pdf

LSJ CONSTRUCTION Subcontractor Payout Project: Master Suite #1004 August 13, 2010 Trade: Foam Ceiling Moulding 2 Subcontractor Universal Foam, Inc. Insurance ex iration: Janu 0, 1900 Invoice # 2 Partial Final Phase # 06-201 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: $0.00 Total Payments Made to Date: $577.92 Total Current Payment Due: $1,014.02 ✓ Balance to Finish including Retainage: $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: $1,591.94 JEE approval attached Invoice Attached YES NO YES NO X X Submitted Bill Approved by: Gary Signed: Signed: Date: August 13, 2010 Date: August 13, 2010 Approved by: Encad Approved by: Sign / Signed: Date: ql\c0 \\O Date: c EFTA00606480  LSJ CONSTRUCTION PI*Xi Master Suit #1004 Supplier • hill legal name: Unlvenal Foam. Inc. Dale Revised Atzgaul 13. 2010 Phase # 06-201 Trade: Foam Calling Moulding Invoice /0: 2 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 07/30/10 722.40 CO#2 07130/10 291.82 COP CON C0115 RequislUon NI 07/21/10 Product 577.92 0.00 877.92 877.02 0.00 Requisition #2 07/30/10 Additional product 722.40 0.00 722.40 722.40 Requisition #3 07/30/10 Freight 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. Foam ceiling m109. CO#1 Additional Mktg. CO/S2 Fro ,ht CO#3 CON CONS Contracted To Date 1,59114 Delano or Contract writelainage EFTA00606481 Emad Hanna From: Monique Harry Sent: Friday, August 13, 2010 1:3 1:33 3 III 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  Invoke Date Invoice . 17639 E Colonial Drive 7130/2010 12375 Orlando, FL 32820 Bill To Job Name, Bldg/Lot Brice GordonfLS.I Brice Gordon/1.Si Little St. James Island Little St. James Island 6100 Red Hook Quarter 113 6100 Red 1look Quarter B3 St. Thomas, Vf 00802 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 54 24.08 1,300.32 COAT/PRIMER MADE IN USA Freight • TO HE DETERMINED WHEN ORDER IS READY 1 291.62 291.62 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