LSJ CONSTRUCTION Subcontractor Payout Project: Mechanical Building #1002 Trade: Fuel Piping February 2, 2011 Requisition #03 Subcontractor Abbott & Lineham Mechanical Insurance ex 'ration: March 26. 2011 Invoice # Phase # Requisition #03 15-310 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 install only / tax included in contract b. Non-resident Subcontractor/Supplier Bond Applicable: 95% c. Use Tax to be paid by our company: d. Shipping Total Outlays for this contract incl. Sales or Use Tax: $96,217.00 $0.00 $0.00 $96,217.00 $91,406.15 $4,570.31 $55,860.00L-" $30,975.84 0,k_ $9,381.16 None JEE approval attached YES NO A $91,406.15 YES x Invoice Attached NO Submitted Bill Signed: Date: February 2. 2011 Approved by: Emad Signed: / Date: Approved by: Gary Signed: Date: February 2, 2011 Approved by: Signed: Date: EFTA01069452