LSJ CONSTRUCTION Subcontractor Payout Project: Existing Compound Remodel #1009 Trade: Doors / Frames Subcontractor Tom Hoch Design Insurance ex iration: Manua 0. 1900 Invoice # 2 Partial Final Phase # 08-21e X May 14, 2010 2 Original Contract Sum: Change Orders Submitted & Approved: New Change Orders: Total Work Contracted to Date: Total Work Completed to Date: 48% $51,976.00 $0.00 $0.00 $51,976.00 $24,886.50 / Less Retainage: $0.00 Total Payments Made to Date: $2,197.00 9 ". Total Current Payment Due: I $22,689.50 . Balance to Finish including Retainage: $27,089.50 Sales Tax Liability: 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 Total Outlays for this contract incl. Sates or Use Tax: $24,886.50 None JEE approval attached YES NO Submitted Bill Signed: Date: May 14, 2010 Approved by: Emad Signed: Date: Invoice Attached YES NO X Approved by: Gary • Signed: Date: May 14. 2010 Approved by: Signed: Date: EFTA00622450