LSJ CONSTRUCTION Subcontractor Payout Project: Mechanical Building #1002 Trade: Plumbing, Fire Protection Subcontractor Abbott & Lineham Mechanical Insurance expiration: March 26.2011 Invoice # Phase # Requi n #04 (154°15-500 °)1 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: February 2. 2011 Requisition #04 Partial X Final $287,100.00 $0.00 $0.00 $287,100.00 95% $272,745.00 a. Subcontractor/Supplier is liable, explain 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 Ilse Tax: I $13,637.25 $227,841.82 u/ $31,265.93 OK--- $27,992.25 None JEE approval attached YES NO Submitted Bill Signed: Date: February 2. 2l Approved by: Emad Signed: Date: O2.. $272,745.00 Invoice Attached YES NO X Approved by: Gary Signed: Date: February 2. 2011 Approved by: Signed: Date: EFTA_R1_02012203 EFTA02686499