LSJ CONSTRUCTION Subcontractor Payout Project: Mechanical Desal January 11, 2011 Trade: Concrete Formwork Requisition #11 Subcontractor Big Bear Construction, Inc. Insurance ex iration: March 1, 2011 Invoice # Phase # Requisition #11 03-120 Partial Final X Original Contract Sum: $821,461.00 Change Orders Submitted & Approved: $1,135.00 New Change Orders: $0.00 Total Work Contracted to Date: $822,596.00 Total Work Completed to Date: 100% $822,596.00 Less Retainage: $0.00 7 Total Payments Made to Date: $781,466.20 / Total Current Payment Due: 1 $41,129.80 0 k_ Balance to Finish including Retainage: $0.00 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 None Total Outlays for this contract incl. Sales or Use Tax: JEE approval attached YES NO X Submitted Bill Signed: Date: January 11, 2011 Approved by: Emad Signed: Date: srai.ACI \\\\V\ $822,596.00 Invoice Attached YES NO X ap______ Approved by: Ga Signed: Date: J ary 11, 2011 Approved by: Signed: Date: EFTA01118395