None $239,575.00 Invoice Attached YES NO X Approved by: G Signed: Date: June 3, 2010 Approved by: Signed: Date: LSJ CONSTRUCTION Subcontractor Payout Project: Mechanical Desal May 31, 2010 Trade: Concrete Formwork Requisition #03 Insurance ex.iration: March 1, 2011 Subcontractor Big Bear Construction, Inc. Invoice # Phase # Requisition #03 03-120 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: a. Subcontractor/Supplier is liable, explaii Partial X 29% Final $821,461.00 $0.00 $0.00 $821,461.00 $239,575.00 $11,978.75 $112,931.25 '‘Z -- $114,665.00 $593,864.75 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: JEE approval attached YES NO Submitted Bill Signed: Date: June 3, 2010 EFTA00722037