Approved by: Emad LSJ CONSTRUCTION Subcontractor Payout Project: Existing Compound Renovations #1009 Trade: Roofing Assembly Subcontractor Blue Water Construction L Invoice # Phase # Original Contract Sum: Change Orders Submitted & Approved: New Change Orders: Total Work Contracted to Date: Requisition #01 07-412 Total Work Completed to Date: Less Retainage: Total Payments Made to Date: Total Current Payment Due: Balance to Finish including Retainage: Sales Tax Liability: July 29, 2010 Requisition #01 Insurance expiration: July 31, 2010 Partial Final X $4.284.00 $0.00 $0.00 $4,284.00 100% $4,284.00 a. Subcontractor/Supplier is liable, explaii install only / tax included in contract b. Non-resident Subcontractor/Supplier Bond Applicable: c. Use Tax to be paid by our company: d. Shipping I $4,284.00 $0.00 $0.00 / $0.00 None Total Outlays for this contract incl. Sales or Use Tax: JEE approval attached YES NO Submitted III Signed: Date: July 29, 2010 Signed: Date: 1 $4,284.00 • , Invoice Attached YES NO X Approved by: Signed: Date: July 29, 2010 Approved by: Signed: Date: EFTA00622435