LSJ CONSTRUCTION Subcontractor Payout Project: Main House Remodel Trade: Tile Subcontractor Dennis Boone Insurance ex iration: Janua 0,1900 Invoice # Phase # 2 09-600 Partial X Final Original Contract Sum: Change Orders Submitted & Approved: New Change Orders: Total Work Contracted to Date: Total Work Completed to Date: Less Retainage: Total Payments Made to Date: Total Current Payment Due: Balance to Finish including Retainage: Sales Tax Liability: August 13, 2010 2 74% $8,618.00 $0.00 $0.00 $8,618.00 $6,350.00 -7 $0.00 $4,000.00 V $2,350.00 V` K- $2,268.00 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 Total Outlays for this contract incl. Sales or Use Tax: None $6,350.00 JEE approval attached YES NO X Submitted Bill Signed: Date: August 13, 2010 Approved by: Emad Signed: Date: CD\ itol Invoice Attached YES NO Approved by: Ga Signed: Date: Au ust 13, 2010 Approved by: Signed: Date: EFTA00622482