LSJ CONSTRUCTION Subcontractor Payout Project: Flagpole / Pool #1013 Trade: Electrical Subcontractor Michael J. Glidden Electrical Services, Inc. Insurance ex•iration: May 14.2011 Invoice # Phase # Requisition #1 16-000 Partial X 10-Jan-11 Requisition #1 Final Original Contract Sum: $23,750.00 Change Orders Submitted & Approved: $0.00 New Change Orders: $0.00 Total Work Contracted to Date: $23,750.00 Total Work Completed to Date: 53% $12,500.00 Less Retainage: $0.00 Total Payments Made to Date: $0.00 Total Current Payment Due: $12,500.00 Balance to Finish including Retainage: $11,250.00 Sales Tax Liability: a. Subcontractor/Supplier is liable, explaii Labor and materials b. Non-resident Subcontractor/Supplier Bond Applicable: c. Use Tax to be paid by our company: d. Shipping incl. Total Outlays for this contract incl. Sales or Use Tax: $12,500.00 JEE approval attached YES NO X Submitted Bill Signed: Date: January 10, 2011 Approved by: Emad Signed: Date: Invoice Attached YES NO X Approved by: Garyk Signed: Date: January 10, 2011 Approved by: Signed. Date. EFTA00607965