AGENDA
SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO.’s 1-10
Tradition Town Hall 10799 SW Civic Lane OR
Join Zoom Meeting: https://us02web.zoom.us/j/84822859573?pwd=Q1ZXRWpZNkVkSG50ZXArYTJ4SEc4UT09 Meeting ID: 848 2285 9573
Dial In at: 1 929 436 2866 Port St. Lucie, FL 34987
REGULAR BOARD MEETING
May 1st, 2024
10:30 a.m.

Call to Order
Proof of Publication…	Page 1
Establish Quorum
Additions or Deletions
Comments from the Public Not on the Agenda
Consent Items
Approval of April 3rd, 2024, Regular Board Meeting Minutes	Page 2
Approve and Ratify 2020 Bond Requisition (No. 11); District No. 5 Special Assessment Bonds, Series 2020 (Community Infrastructure)	Page 6
Approve and Ratify 2020 Bond Requisition (No. 13); District No. 5 Special Assessment Bonds, Series 2020 (Community Infrastructure)	Page 23

Approve and Ratify 2020 Bond Requisition (No. 14); District No. 5 Special Assessment Bonds, Series 2020 (Community Infrastructure)	Page 70

Approve and Ratify 2022 Bond Requisition (No. 18); District No. 5 Special Assessment Bonds, Series 2022-1 (Community Infrastructure)	Page 214

Approve and Ratify 2022 Bond Requisition (No. 19); District No. 5 Special Assessment Bonds, Series 2022-1 (Community Infrastructure)	Page 358
Old Business
New Business
Consider Resolution No. 2024-11; Adopting Proposed Budget FY: 24/25 and Setting a Public Hearing (Budget Under Separate Cover)	Page 457
Administrative Matters
Manager’s Report
Attorney’s Report
Engineer’s Report
Financial Report (Under Separate Cover)	Page 461
Founder’s Report
Board Member Comments

Adjourn

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NOS. 1-10 FISCAL YEAR 2023/2024
REGULAR BOARD MEETING SCHEDULE
NOTICE IS HEREBY GIVEN that the Southern Grove Community Development District Nos. 1-10 (“Districts”) will conduct Regular Board Meetings of the Board of Supervisors (“Board”) for the purpose of conducting the business of the Districts that may properly come before the Board. The following meetings will be held at 10:30 a.m. at Tradition Town Hall located at 10799 SW Civic Lane, Port St. Lucie, Florida 34987 on the following dates:

*October 4, 2023*
November 1, 2023
December 6, 2023
*January 3, 2024*
February 7, 2024
March 6, 2024
*April 3, 2024*
May 1, 2024
June 5, 2024
*July 3, 2024*
August 7, 2024
September 4, 2024

*Irrigation Rate Committee Meeting – 9:00 a.m.
Southern Grove CDD Meeting – 10:30 a.m.
Tradition CDD Meeting – 11:00 a.m.

*An Irrigation Committee Meeting will take place at 9:00 a.m. at Tradition Town Hall located at 10799 SW Civic Lane, Port St. Lucie, Florida 34987 on the above dates, as indicated.*

The meetings are open to the public and will be conducted in accordance with the provisions of Florida law for community development districts. Meetings may be continued to a date, time and place to be specified on the record. A copy of the agenda for the meetings may be obtained from the Districts’ websites or at the offices of the District Manager, Special District Services, Inc., 10807 SW Tradition Square, Port St. Lucie, Florida.
There may be occasions when one or more Supervisors will participate by telephone; therefore, a speaker telephone may be present at the meeting location so that one or more Supervisors may attend the meeting and be fully informed of the discussions taking place.
Any person requiring special accommodations at these meetings because of a disability or physical impairment should contact the District Office at 772-345-5119 and/or toll free at 1-877-737-4922 at least five calendar days prior to the meeting. If you are hearing or speech impaired, please contact the Florida Relay Service at 1-800-955-8770, who can aid you in contacting the District Office.
Each person who decides to appeal any action taken at a meeting is advised that they will need a record of the proceedings and that accordingly, the person may need to ensure that a verbatim record of the proceedings is made, including the testimony and evidence upon which such appeal is to be based.
Meetings may be cancelled from time to time without advertised notice.

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NOS. 1-10
www.southerngrovecdd1.org

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO.’S 1-10
Tradition Town Hall 10799 SW Civic Lane OR
Join Zoom Meeting: https://us02web.zoom.us/j/3341025011?omn=82652625175 Meeting ID: 334 102 5011
Dial In at: 1 929 436 2866 Port St. Lucie, FL 34987
REGULAR BOARD MEETING
April 3, 2024
10:30 a.m.

CALL TO ORDER

The Regular Board Meeting of the Southern Grove Community Development District No’s. 1-10 of April 3rd ,2024, was called to order at 10:42 a.m. in the Tradition Town Hall located at 10799 SW Civic Lane, Port St. Lucie, Florida 34987.

PROOF OF PUBLICATION

Proof of publication was presented that showed notice of the Regular Board Meeting had been published in the St. Lucie News Tribune on September 25th, 2023, as legally required.

ESTABLISH A QUORUM

It was determined that the attendance of the following Supervisors constituted a quorum in District Nos. 1-10, and it was in order to proceed with the meeting.

CDD #’s 1-10			
Chairman/ Supervisor	Eric Sexauer: #1,2,3,5,9	Present	
Supervisor	Ricardo Mojica: #1,2,3,4,6,9	Present	
Supervisor / Vice Chair	Steven Dassa: #1,2,3,5,9	Absent	
Supervisor	William Pittsley: #1,2,5,9	Present	
Supervisor / Vice Chair	David Graham: #3,4,5,6,7,8,10	Present	
Supervisor	Stephen Okiye: #4,7,8,10	Present	
Supervisor	Tara Toto: #1,2,9	Present	
Chairman/Supervisor	Jennifer Davis: #3,4,6,7,8,10	Present	
Supervisor	Elijah Wooten: #7,8,10	Present	
Supervisor	Jeff Greenwalt : #7,8,10	Present (via Zoom)	

Staff members in attendance were:

District Manager	Frank Sakuma	Special District Services, Inc.	
Assistant District Manager	Jesse Wargo	Special District Services, Inc.	
District Manager	Stephanie Brown	Special District Services, Inc.	
District Engineer	Stef Matthes	Culpepper and Terpening	

District Counsel	Susan Garrett	Torcivia, Donlon, Goddeau & Rubin, P.A.	

Also present were: Dan Harrell, Esq.; Denise Ganz with Holland & Knight (See attached sign-in sheet).

ADDITIONS OR DELETIONS TO AGENDA

There were no additions or deletions to the agenda.

COMMENTS FROM THE PUBLIC FOR DISTRICT ITEMS NOT ON THE AGENDA

There were no comments from the public.

CONSENT ITEMS
Approval of March 6th, 2024, Regular Board Meeting Minutes
Approve and Ratify 2020 Purchase Order #SG-2024-04; Installation of Control Structure
Approve EW Consultants 2024-05 Monitoring and Maintenance Program
A Motion was made by CDD No. 1 Mr. Sexauer, seconded by Mr. Mojica passed unanimously by CDD No.1 to Approve all item(s) under Consent.
OLD BUSINESS

There were no matters of old business to come before the Board.

NEW BUSINESS

Summary of Matters Related to Bond Resolution Nos: 2024-07; 2024-08 and 2024-09

Mr. Sakuma notified the Board that the summary was provided in the Board package. The Board had no questions.
Resolution No. 2024-07 to be Adopted by Southern Grove CDD Nos 1,2,3,4,6,7,8,9 and 10; Approving the Joiner to a Ninth Supplemental Trust Indenture Relating to the Special Assessment Bonds, Series 2024 5 (Community Infrastructure)

A Motion was made by CDD Nos. 1,2,3,4,6, and 9, Mr. Sexauer, seconded by Mr. Mojica and passed unanimously by CDD Nos. 1,2,3,4,6,9 to approve the Joiner to a Ninth Supplemental Trust Indenture Relating to the Special Assessment Bonds Series 2024 5 (Community Infrastructure).

A Motion was made by CDD Nos. 7,8, and 10, Mr. Graham, seconded by Mr. Okiye and passed unanimously by CDD Nos. 7,8, and 10, to approve the Joiner to a Ninth Supplemental Trust Indenture Relating to the Special Assessment Bonds Series 2024 5 (Community Infrastructure).

Resolution No. 2024-08 to be Adopted by Southern Grove CDD Nos 1-10; Approving a Supplement to the Second Amended and Restated Master Engineer’s Report
A Motion was made by CDD Nos. 1,2,3,4,5,6 and 9, Mr. Sexauer seconded by Mr. Mojica and passed unanimously by CDD Nos. 1,2,3,4,5,6 and 9, to adopt Resolution No. 2024-08, approving a supplement to the second amended and restated master Engineer’s report.

A Motion was made by CDD Nos. 7,8, and 10, Mr. Davis seconded by Mr. Wooten and passed unanimously by CDD Nos. 7,8, and 10, to adopt Resolution No. 2024-08, approving a supplement to the second amended and restated master Engineer’s report.

Resolution No. 2024-09 to be Adopted by Southern Grove CDD Nos. 2,4,5,6,8,9 and 10; Approving the form of an Eighth Supplemental Assessment Methodology Report in Connection with the Southern Grove CDD No. 5 Special Assessment Bonds, Series 2024 (Community Infrastructure)

A Motion was made by CDD Nos. 2,5 and 9, Mr. Sexauer, seconded by Mr. Mojica and passed unanimously by CDD Nos. 2,5 and 9, to adopt Resolution No. 2024-09 approving the form of an eighth supplemental assessment methodology report in connection with the Southern Grove CDD No. 5 special assessment bonds, series 2024 (Community Infrastructure).

A Motion was made by CDD Nos. 4,6,8 and 10, Ms. Davis, seconded by Mr. Graham passed unanimously by CDD Nos. 4,6,8 and 10, to adopt Resolution No. 2024-09 approving the form of an eighth supplemental assessment methodology report in connection with the Southern Grove CDD No. 5 special assessment bonds, series 2024 (Community Infrastructure).

ADMINISTRATIVE MATTERS

Manager’s Report

There was no Manager’s report.

Attorney’s Report

There was no Attorney’s report.

Engineer’s Report
There was no Engineer’s report.
Financial Report
There was no financial report.
Founder’s Report

Mr. Sexauer stated that the Community Outreach meeting will be held in the Tradition Hall on April 16, 2024, at 11am. A box lunch will be provided at 11:30am.

BOARD MEMBER COMMENTS

There were no Board comments.

ADJORNMENT

There being no further business to come before the Boards, Mr. Sexauer adjourned the meeting at 10:51a.m.

Secretary/Assistant Secretary	Chair/Vice-Chair

Print Signature	Print Signature

REQUISITION NO._11	

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO. 5 SPECIAL ASSESSMENT BONDS, SERIES 2020
(COMMUNITY INFRASTRUCTURE)
The undersigned, a Responsible Officer of Southern Grove Community Development District No. 5 (the “Issuer”) hereby submits the following requisition for disbursement from the 2020-1 Acquisition and Construction Subaccount or 2020-2 Acquisition and Construction Subaccount (as indicated below) of the 2020 Acquisition and Construction Account created under and pursuant to the terms of the Master Trust Indenture from the Issuer to U.S. Bank National Association, as trustee (the “Trustee”), dated December 17, 2014, as supplemented by that certain Sixth Supplemental Indenture, dated as of June 1, 2020 (collectively, the “Indenture”), (all capitalized terms used herein shall have the meaning ascribed to such terms in this Indenture);
Requisition Number: 11
Name of Payee: Mattamy Palm Beach LLC
Amount Payable: $23,751.53
The undersigned hereby certifies that:

This requisition is for a Cost of the 2020 CI Project payable from the (check applicable item):

	 2020-1 Acquisition and Construction Subaccount that has not previously been paid

  X  2020-2 Acquisition and Construction Subaccount that has not previously been paid and all amounts on deposit in the 2020-1 Acquisition and Construction Subaccount have been requisitioned

AND

Each disbursement set forth above is a proper charge against the 2020-1 Acquisition and Construction Subaccount or 2020-2 Acquisition and Construction Subaccount noted above.

[Include if applicable:]

Each disbursement set forth above is made as payment of a portion of the purchase price payable for the 2020 CI Project pursuant to a written acquisition agreement between the District and the other party named therein and the undersigned represents that such agreement has not been modified or amended and is in full force and effect on the date hereof.

1

:�

SOUTHERN GROVE COMMUNITY DEVELOPMENT DIS RICT NO. 5

By_:

_,_/---=V' '----"-------------
Responsible Officer

Date:_a fc_';l,_,_L-_l_li_,	?0_2-	,_L(		_

The undersigned, an authorized representative of the Consulting Engineers to the Issuer, hereby certifies that this disbursement is for a Cost of the 2020 CI Project and is consistent with:
(i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the 2020 CI Project with respect to which such disbursement is being made; and (iii) the Engineer's Report as supplemented and amended through the date hereof.
The undersigned further certifies that (a) the improvements to be acquired with this disbursement will be (1) owned by the Issuer or another governmental entity and located on public property or within public rights of way or easements and (2) accessible by the general public and/or part of a public water management system; (b) the purchase price to be paid by the Issuer for the improvements to be acquired with this disbursement is no more than the lesser of (i) the fair market value of such improvements and (ii) the actual cost of construction of such improvements; (c) the plans and specifications for the improvements have been approved by all regulatory bodies required to approve them or such approval can reasonably be expected to be obtained; (d) all currently required approvals and permits for the acquisition, construction, reconstruction, installation and equipping of the portion of the 2020 CI Project for which disbursement is made have been obtained from all applicable regulatory bodies; and (e) subject to permitted retainage under the applicable contracts, the seller has paid all contractors, subcontractors, and materialmen that have provided services or materials in connection with the portions of the 2020 CI Project for which disbursement is made hereby, if acquisition is being made pursuant to an acquisition agreement.

[CONSUL/NGINEERS]

By:	
Name..P.	 "Butch" Terpening, P.E.
Title:	District Engineer
Date: April 11, 2024

2

APPROVED

4/11/2024

MATIAMY HOMES' CERTIFICATE OF COSTS SG - CDD SG Duda Canal (64228355)
FOR GOOD AND VALUABLE CONSIDERATION, the receipt and sufficiency of which are hereby acknowledged, Mattamy Palm Beach LLC ("Mattamy"), to the best of its knowledge, information, and belief, certifies to the Southern Grove Community Development District No. 5 ("District No. 5"), that the costs of the Work Product as defined and described as the Tradition Parkway Improvements, and as more particularly described in the attached Schedule 1 (the "Improvements"), are as follows:

Consultants - Surveyor, Engineer, Arch-LS,
Geo	
$	12,931.53	See Exhibit A	
Fees - Permit Fees
	Site Work- Earthwork, Drainage, Roadway, Curb. Sidwalk. Sewer. Water	$	10,820.00	See Exhibit B See Exhibit C	
4	Landscape & Irrigation		See Exihibit D	

TOTAL:	$	23,751.53

IN WITNESS WHEREOF, Mattamy has ca		this instru		be executed by its duly authorized agents, and its corporate seal affixed hereto, this 			day of	t..v'tl	, 2022.

MATTAMY PALM BEACH LLC, a

Delaware limited liability company

By:

Print Name:	Frank Covelli

Title:	VP Land Development

MATTAMY HOMES’ CERTIFICATE OF COSTS

EXHIBIT A

64228355 CDD SG Duda Canal

STORMWATER INSPECTIONS· EROSION CONTROL· GOPHER TORTOISE RELOCATION

#6847
Rec 11/8, Processed 11/9/21

1913 SW S Macedo
Blvd
Port Saint Lucie, FL 34984
Phone #	772-201-9604
Fax#  772-464-6116
tceservicesllc@grnaiI.corn

Invoice

DATE	IU\'Oice #	
11/2/2021	2546	

CLIENT

MATTAMV PALM BEACH, LLC 2500 QUANTUM LAKES DR. STE 215
80\'NTON BEACH, Fl

Item

INSPECTION

SWPPP F...

DESCRIPTION
SEPTEMBER/ OCTOBER SWPPP INSPECTIONS DUDA CANAL 9/30, 10/7, 10/10 RF, 10/14, 10/21, 10/28
*NO CHARGE FOR RAINFALLS*

SWPPP FOLDER

QlY

5

1

COST

625.00

800.00

TnaV\k HOU. for- HOU.V' Bu.SillleSSS - We a.ppr-ecia.te it ver-H VV\U.Cn!	TotalY

$1,425.00

STORMWATER INSPECTIONS • EROSION CONTROL • GOPHER TORTOISE RELOCATION

Invoice

DATE	Invoice#	
12/3/2021	2567	

1913 SW S Macedo
81\ld
Port Saint Lucie, FL 34984
Phone #	772-201-9604
Fax #	772-464-6116
tcesel'\licesllc@gmail.com

#6847

	CLIENT	
	
MATTAMY PALM BEACH, Ll.C 2500 QUANTUM LAKES DR. STE 215
BOYNTON BEACH, FL	
Item	DESCRIPTION	QTY	COST	

INSPECTION	NOVEMBER 2021 SWPPP INSPECTIONS DUDA CANAL
11-4, 11-11, 11-16 RF, 11-18, 11-22 RF, 11-29	
4	
500.00	
Tl-\aV\k !:jOU fol"' !:jOUV' BusiVl.esss - We appV'eciate it ver·!:j W1.ucl1!	Total:./	S5oo.oo	

1/8/22

STORMWATER INSPECTIONS· EROSION CONTROL· GOPHER TORTOISE RELOCATION

Invoice

DATE	Invoice#	
1/1/2022	2605	

	CLIENT	
	
MATTAMV PALM BEACH, LLC 2500 QUANTUM LAKES OR. STE 215
BOYNTON BEACH, FL	
Item	DESCRIPTION	QTY	COST	

INSPECTION	DUDA CANAL SWPPP INSPECTIONS DECEMBER 2021 12·2, 12-9, 12-16, 12-23, 12-30

TOTAL SUM DUE IS $625.00.	
5	
625.00	
ThaV\k !jOCA for- !jOLW BusiV\esss - We appreciate it ver-!j W\uch!	Total:	
S625.oo
,......_	/	

4906 Buchanan Drive Fort Pierce, FL 34982

Phone #	772-201-9604
Fax#  772-464-6116
tceservicesllc@grnail.com

#6847
1/8/22

STORMWATER INSPE;CTIONS • EROSION CONTROL· GOPHER TORTOISE RELOCATION

Invoice

DATE	ln'1oice #	
2/3/2022	2661	

4906 Buchanan Dri\'e Fort Pierce, FL 34982

Phone #	772-201-9604
Fax #	772-464-6116
tceservicesllc@gmail.com

#6847 3/18/22

CLIENT

MATTAMY PALM BEACH, U.C
2500 QUANTUM LAKES OR. STE 215
80\'NT0N BEACH, FL

Item

INSPECTION

DESCRIPTION
JANUARY 2022 SWPPP INSPECTIONS DUDA CANi\L
1-6, 1-11 Rf, 1-13, 1-17 RF, 1-20, 1-27

T0TAl SUM DUE IS $500.00.

QTY

4

COST

500.00

Tl,\aV\k HDCA for- HDCAY" BusiVleSss - We appreciate it veY-H Mucl,\!	Total:

$500.00
/lw	

13	';/

STORMWATER INSPECTIONS· EROSION CONTROL· GOPHER TORTOISE RELOCATION

Invoice

DATE	Invoice#	
3/1/2022	2697	

	CLIENT	
	
MATTAMV PALM BEACH, LLC 2500 QUANTUM lAKES DR. STE 215
BOYNTON BEACH, Fl	
Item	DESCRIPTION	QTY	COST	

INSPECJION	FEBRUARY 2022 SWPPP INSPECTIONS DUDA CANAL 2-3, 2-10, 2-17, 2-24
TOTAL SUM DUE IS $500.00	
4	

500.00	
Tha.,,k !:JOU. foy !:JOU.Y' Bu.si.,,esss - We appYeciate it veY'!:J vvi.u.ch!	Total:	
$500.00	

4906 Buchanan Drive Fort Pierce, FL 34982

Phone #	772-201-9604
Fax#  772-464-6116
tceservicesllc@gmail.com

#6847 3/18/22

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Ms. Lorie Maiorana
Senior Land Development Manager Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

June 15, 2021
Project No:	19-186.WA.02
Invoice No:	92161

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Kelly Cranford, PE
PO No:
Contract No:	64228355 WA No:

#64228355.1510.37420
pay as invoice 2/16/22

Project	19-186.WA.02	Mattamy - Cleveland Clinic/Duda Canal Fill SEFL.LandAP@mattamycorp.com
Lorie.Moccia@mattamycorp.com
Professional Services through May 31, 2021
Phase	7	General Engineering Services Tasks	7.1	General Engineering Services
Professional Personnel
Hours	Rate	Amount
Sr. Project Manager, PE	12.75	185.00	2,358.75
Project Engineer, EI	3.50	110.00	385.00
Sr. Construction Inspector	5.00	125.00	625.00
Sr. Engineering Technician	2.00	80.00	160.00
Totals	23.25	3,528.75
Total Labor	3,528.75

Phase	8	Reimbursable Expense
Unit Billing Blueprint Color Large Copy MILEAGE

Total this Invoice

85.50

 $3,614.25 

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Ms. Lorie Maiorana

64228355.1510.37420

Senior Land Development Manager Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

September 14, 2021
Project No:	19-186.WA.02
Invoice No:	93048

Processed 9/24/21

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Kelly Cranford, PE
PO No:
Contract No:	64228627.1510.37430 WA No:
Project	19-186.WA.02	Mattamy - Cleveland Clinic/Duda Canal Fill SEFL.LandAP@mattamycorp.com
Lorie.Moccia@mattamycorp.com
Professional Services through August 31, 2021
Phase	7	General Engineering Services	
Tasks	7.1	General Engineering Services	
Professional Personnel					
	Hours	Rate	Amount		
Principal Engineer, PE	1.00	210.00	210.00		
Sr. Project Manager, PE	5.25	185.00	971.25		
Project Engineer, PE	1.00	135.00	135.00		
Project Engineer, EI	6.00	110.00	660.00		
Sr. Construction Inspector	12.00	125.00	1,500.00		
Totals
Total Labor	25.25		3,476.25	
3,476.25	
Phase	8	Reimbursable Expense				
Unit Billing					
MILEAGE				
22.40	
		Total this	Invoice	$3,498.65	

Outstanding Invoices					
Number	Date	Balance				
92161	6/15/2021	3,614.25				
Total	3,614.25				

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Ms. Lorie Maiorana
Senior Land Development Manager Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

November 15, 2021
Project No:	19-186.WA.02
Invoice No:	93390

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Kelly Cranford, PE
PO No:
Contract No:	64228627.1510.37430 WA No:

64228355.1510.37420
1/10/22
pay as invoice

Project	19-186.WA.02	Mattamy - Cleveland Clinic/Duda Canal Fill SEFL.LandAP@mattamycorp.com
Lorie.Moccia@mattamycorp.com
Professional Services through October 31, 2021
Phase	7	General Engineering Services	
Tasks	7.1	General Engineering Services	
Professional Personnel					
	Hours	Rate	Amount		
Sr. Project Manager, PE	1.50	185.00	277.50		
Project Engineer, PE	.75	135.00	101.25		
Project Administrator/CSS	.50	125.00	62.50		
Project Engineer, EI	1.00	110.00	110.00		
Sr. Construction Inspector	.50	125.00	62.50		
Totals
Total Labor	4.25		613.75	
613.75	
Phase	8	Reimbursable Expense
Reimbursable Expenses
Reimbursable Expense
10/16/2021	Florida Department of
Environmental Protection	Florida Department of	420.00
Environmental Protection		
Total Reimbursables	420.00	420.00	
	Total this Invoice	$1,033.75	
Outstanding Invoices			
Number	Date
92161	6/15/2021	Balance
3,614.25		

Project

19-186.WA.02	Mattamy - Cleveland Clinic/Duda Canal Fi	Invoice 93048		9/14/2021	22.40
Total	3,636.65

93390

Page 2

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Ms. Lorie Maiorana
Senior Land Development Manager Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

December 31, 2021
Project No:	19-186.WA.02
Invoice No:	93746

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Kelly Cranford, PE
PO No:
Contract No:	6--4--2-2--8--6--2-7.1510.37430
WA No:

64228355.1510.37430

Project	19-186.WA.02	Mattamy - Cleveland Clinic/Duda Canal Fill SEFL.LandAP@mattamycorp.com
Lorie.Moccia@mattamycorp.com
Professional Services through December 31, 2021
Phase	7	General Engineering Services	
Tasks	7.1	General Engineering Services	
Professional Personnel	
Hours	Rate	Amount	
Sr. Project Manager, PE	3.00	185.00	555.00	
Totals	3.00		555.00	
Total Labor	555.00

Phase	8	Reimbursable Expense
Consultants

Reimbursable Consultant
12/21/2021	Advanced CAD Technology	Pipe Networks	679.88		
Total Consultants		679.88	679.88	
		Total this Invoice	$1,234.88	

Outstanding Invoices				
Number	Date	Balance	
92161	6/15/2021	3,614.25	
93048	9/14/2021	22.40	
93390	11/15/2021	1,033.75	
Total		4,670.40	

MATTAMY HOMES’ CERTIFICATE OF COSTS

EXHIBIT B

64228355 CDD SG Duda Canal

CHECK REQUEST

Request Date:		6/3/2021	

Requestor Name:	Jeremy/ Julie Hurst

Date Check Needed:		6/5/2021	

Mail check directly to the address provided
_x_		Return check to Requestor Other

PAY TO THE ORDER OF:	Crescent Bar Three Cattle Company
Address:	17075 Hammock Lane

Port Saint Lucie, FL 34987

Mailing
Instructions/ Remarks:

Amount of Check:		$10,820.00	

Purpose of Check:	Fence associated with Duda Canal

Vendor#:	419350 Cost Code:
Approved by:

** RECEIPT OR OTHER DOCUMENTATION MUST BE ATTACHED TO THIS REQUEST

CJ)\) - l) L	cil
(Q 42..288C65  .

May 27, 2021
Lorie Maiorana
Sr. Land Development Manager South East Florida Division Mattamy Homes USA
Re: Fencing the NE Corner of the Duda Canal Dear Lorie,
The following represents the fence cost associated with the area next to the Duda Canal. All fencing has been completed, we expect to have all cattle removed by early next week.
Right-of-way clearing and mowing for fencing =	$1,600.00
3 gates =	$ 300.00
3,960 ft. barb wire fencing @$2.00 per ft. (labor@ material)= $7,920.00
2 canal crossings @ $500.00 each =	$1,000.00	
Total Cost (Labor and Material) =	$10,820.00	
Please remit to:		
Crescent Bar Three Cattle Company 17075 Hammock Lane		
Port Saint Lucie, Fl 34987		
Any questions or concerns, please let me know.		
Sincerely,		

Ralp  ''Cap" Cain 111
Crescent Bar Three Cattle Company RC111/cc		

REQUISITION NO._13	

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO. 5 SPECIAL ASSESSMENT BONDS, SERIES 2020
(COMMUNITY INFRASTRUCTURE)
The undersigned, a Responsible Officer of Southern Grove Community Development District No. 5 (the “Issuer”) hereby submits the following requisition for disbursement from the 2020-1 Acquisition and Construction Subaccount or 2020-2 Acquisition and Construction Subaccount (as indicated below) of the 2020 Acquisition and Construction Account created under and pursuant to the terms of the Master Trust Indenture from the Issuer to U.S. Bank National Association, as trustee (the “Trustee”), dated December 17, 2014, as supplemented by that certain Sixth Supplemental Indenture, dated as of June 1, 2020 (collectively, the “Indenture”), (all capitalized terms used herein shall have the meaning ascribed to such terms in this Indenture);
Requisition Number: 13
Name of Payee: Mattamy Palm Beach LLC
Amount Payable: $459,850.90
The undersigned hereby certifies that:

This requisition is for a Cost of the 2020 CI Project payable from the (check applicable item):

	 2020-1 Acquisition and Construction Subaccount that has not previously been paid

  X  2020-2 Acquisition and Construction Subaccount that has not previously been paid and all amounts on deposit in the 2020-1 Acquisition and Construction Subaccount have been requisitioned

AND

Each disbursement set forth above is a proper charge against the 2020-1 Acquisition and Construction Subaccount or 2020-2 Acquisition and Construction Subaccount noted above.

[Include if applicable:]

Each disbursement set forth above is made as payment of a portion of the purchase price payable for the 2020 CI Project pursuant to a written acquisition agreement between the District and the other party named therein and the undersigned represents that such agreement has not been modified or amended and is in full force and effect on the date hereof.

1

::VEL?2=·5

SOUTHERN GROVE COMMUNITY

Responsible Officer
Date:	!Ir' ll.	/1	?u?-i	
The undersigned, an authorized representative of the Consulting Engineers to the Issuer, hereby certifies that this disbursement is for a Cost of the 2020 CI Project and is consistent with:
(i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the 2020 CI Project with respect to which such disbursement is being made; and (iii) the Engineer's Report as supplemented and amended through the date hereof.
The undersigned further certifies that (a) the improvements to be acquired with this disbursement will be (1) owned by the Issuer or another governmental entity and located on public property or within public rights of way or easements and (2) accessible by the general public and/or part of a public water management system; (b) the purchase price to be paid by the Issuer for the improvements to be acquired with this disbursement is no more than the lesser of (i) the fair market value of such improvements and (ii) the actual cost of construction of such improvements; (c) the plans and specifications for the improvements have been approved by all regulatory bodies required to approve them or such approval can reasonably be expected to be obtained; (d) all currently required approvals and permits for the acquisition, construction, reconstruction, installation and equipping of the portion of the 2020 CI Project for which disbursement is made have been obtained from all applicable regulatory bodies; and (e) subject to permitted retainage under the applicable contracts, the seller has paid all contractors, subcontractors, and materialmen that have provided services or materials in connection with the portions of the 2020 CI Project for which disbursement is made hereby, if acquisition is being made pursuant to an acquisition agreement.

[CONSULTING ENGINEERS]

F.

By: /	
Name:	"Butch" Terpening
Title:	District Engineer
Date: April 18, 2024

2

MATTAMY HOMES' CERTIFICATE OF COSTS
MXD 2 Lift Station (64228391 - SG lb/le)
FOR GOOD AND VALUABLE CONSIDERATION, the receipt and sufficiency of which are hereby acknowledged, Mattamy Palm Beach LLC ("Mattamy"), to the best of its knowledge, information, and belief, certifies to the Southern Grove Community Development District No. 5 ("District No. 5"), that the costs of the Work Product as defined and described as the MXD 2 Lift Station, and as more particularly described in the attached Schedule 1 (the "Improvements"), are as follows:

A. Consultants	$9,735.90	See Exhibit A	
B. Permit Fees	$0.00		
C. Site Work (net of Cost-Share)	$450,115.00	See Exhibit C	
D. Landscape & Irrigation	$0.00

Total: $459,850.90		

IN WITNESS WHEREOF, Mattamy has caused this instrument to be executed by its duly authorized agents, and its corporate seal affixed hereto, this _j_ day of February, 2024.

MATTAMY PALM BEACH LLC, a Delaware
lmllt	
By:		
Print
Title: Vice President

Schedule 1
Cost Classification	
Cost Description	Contract
#	
Invoice#	
Vendor	
Amount	
A	Consultants	N/A	91586	Culpepper & Terpening	$	8,895.90	
A	Consultants	N/A	93151	Culpepper & Terpening	$	840.00	
C	Site Work	6861	210576-1	Centerline, Inc.	$  70,273.74	
C	Site Work	6861	210576-2	Centerline, Inc.	$ 263,017.37	
C	Site Work	6861	210576-3	Centerline, Inc.	$	27,341.95	
C	Site Work	6861	210576-4	Centerline, Inc.	$ 135,875.76	
C	Site Work	6861	210576-5	Centerline, Inc.	$ 128,462.19	
C	Site Work	6861	210576-6	Centerline, Inc.	$  27,810.13	
C	Site Work	6861	210576-7	Centerline, Inc.	$  11,179.55	
C	Site Work	6861	210576-8	Centerline, Inc.	$  37,758.47	
C	Site Work	6861	210576-9	Centerline, Inc.	$	4,261.05	
C	Site Work	6861	210576-10	Centerline, Inc.	$	4,247.40	
C	Site Work	6861	210576-11	Centerline, Inc.	$	5,350.77	
C	Site Work	6861	210576-12	Centerline, Inc.	$  79,508.71	
C	Site Work	N/A		Thompson Thrift - Cost Share	$	(344,972)	
lrotal Due	s 459,sso.90 1

MATTAMY HOMES’ CERTIFICATE OF COSTS

EXHIBIT A

Invoice	Culpepper & Terpening, Inc.

Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Ms. Lorie Maiorana	April 12, 2021		
Senior Land Development Manager	Project No:	18-006.002	
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com	Invoice No:	91586	

Principal:
Project Manager:
PO No:
Contract No:
WA No:

James "Butch" Terpening. Jr., P.E. James "Butch" Terpening, Jr., P.E.

Project	18-006.002	Mattamy MXD 2 Parcel - Plat Preparation	-   Butch and engineering staff, sewer ana-trsis description for TK and Dennis, Plat approval process Professional Services through March 31. 2021

Phase	7	General Engineering Services		
Tasks	7.1	General Engineering Services				
Professional Personnel	
	Hours	Rate	Amount	
Principal Engineer, PE	17.00	210.00	3,570.00	
Sr. Engineering Technician	2.00	80,00	160,00	
Totals	19.00		3,730.00	

·

-	--·

Total Labor
Tasks	7.2	MXD Sewer Extension
Professional Personnel

3,730.00

	Hours	Rate	Amount		
Sr. Project Surveyor, PSM	1.00	165.00	165.00		
Project Engineer, El	36.25	110.00	3,987.50		
Project Manager	2.25	90.00	202.50		
Sr. Survey Technician	3.00	80.00	240.00		
Survey Crew GPS	3.00	145.00	435.00		
Totals	45.50		5,030.00		
Total Labor				5,030.00	
-Ph-as-e -----8------R-e-im-bu-rsa-bl-e E-x-pe-ns-e	■
Unit BIiiing Large Copy Blueprint Color

Project	18-006.002	Mattamy MXD 2 Parcel - Plat Preparation	Invoice	91586
MILEAGE

135.90

Total this Invoice	$8,895.90

Outstanding Invoices
Number
89743
Total

Date 10/5/2020

Balance
14,357.55
14,357.55

Page2

Project	18-006.002	Mattamy MXD 2 Parcel - Plat Preparation	Invoice	91586

Billing Backup
Culpepper & Terpening, Inc.	Invoice 91586 Dated 4/12/2021

Monday, April 12, 2021
3:44:07 PM

-	--·

-	--·

Project	 18-006.002		Mattamy MXD 2 Parcel - Plat Preparation Phase	7	General Engineering Services
Tasks	7.1	General Engineering Services
Professional Personnel

Principal Engineer, PE

Hours	Rate

Amount

Terpening, Jr., P.E., James	2/10/2021	2.50	210.00
"Butch"

525.00

Sewer extenion to TT site per tony
Terpening, Jr., P.E., James	2/11/2021	1.50	210.00 "Butch"

315.00

Sewer extenion to TT site per tony
Terpening, Jr., P.E., James	2/15/2021	.75	210.00 "Butch"

157.50

2/17/2021	1.00	210.00	210.00	

2/18/2021	
.50	
210.00	
105.00	

extension sewer plans to TT site Terpening, Jr., P.E., James
"Butch"
controactor coordination Terpening, Jr., P.E., James
"Butch"

sewer updates and reviews
Terpening, Jr., P.E., James	2/19/2021	1.00	210.00 "Butch"

210.00

contractor coordination on means and methods
Terpening, Jr., P.E., James	2/22/2021	1.00	210.00 "Butch"

210.00

PSLUSD comments and justification
Terpening, Jr., P.E., James	2/23/2021	1.00	210.00
"Butch"

210.00

legal call watermark and Mattamy
Terpening, Jr., P.E., James	3/1/2021	1.00	210.00
"Butch"

210.00

Zoom PSLUSD on VP Crossing
Terpening, Jr., P.E., James	3/12/2021	1.50	210.00 "Butch"

315.00

report update for PSLUSD
Terpening, Jr., P.E., James	3/15/2021	1.00	210.00 "Butch"

210.00

FDEP application forms for PSLUSD
Terpening, Jr., P.E., James	3/18/2021	1.00	210.00 "Butch"

210.00

zoom meeting tony PSLUSD eta
Terpening, Jr., P.E., James	3/22/2021	1.00	210.00
"Butch"

210.00

pslusd permit processing

Page3

Project	18-006.002	Mattamy MXD 2 Parcel - Plat Preparation	Invoice	91586 Terpening, Jr., P.E., James		3/24/2021	.50	210.00		105.00
"Butch"

3/26/2021	.75	210.00	157.50	

4/1/2021	
.50	
210.00	
105.00	

4/2/2021	
.50	
210.00	
105.00	

legal easements to Steve Parsons Terpening, Jr., P.E., James
"Butch"
contractor bid questions Terpening, Jr., P.E., James
"Butch"
SOW firethorn prices Terpening, Jr., P.E., James "Butch"
Easements Steve parsons Sr. Engineering Technician
Gao, Tao	3/17/2021	2.00	80.00	160.00
document delivery
Totals	19.00	3,730.00
Total Labor	3,730.00

Total this Tasks	$3,730.00

-Ta-sk-s -----7-.2-----M-X-D-Se-we-r -Ex-ten-si-on	--·
Professional Personnel
Hours	Rate	Amount
Sr. Project Surveyor, PSM

Kiernan, PSM, Thomas	3/23/2021	.50 165.00 UE Prep
Kiernan, PSM, Thomas	3/24/2021	.50 165.00 Verify tie-in Manhole
Project Engineer, El
Danielson, El, Luke	2/1/2021	2.25 110.00 Worked on the plans and submitted their current iteration to Butch.
Danielson, El, Luke	2/10/2021	7.50 110.00 Discussed changes to the plans with Butch, visited the site, and worked on adjusting said plans appropriately.
Danielson,El,Luke	2/11/2021	7.00	110.00 Adjusted the plans, discussed their status, made changes as needed, and sent them to Butch.
Danielson, El, Luke	2/12/2021	1.75	110.00 Sent the plans for the sewer extension to James Thomas, worked on the bid sheet, and sent said bid sheet to Butch.
Danielson, El, Luke	2/15/2021	.25	110.00 Discussed a small issue on the plans with Butch and corrected it.
Danielson, El, Luke	2/19/2021	4.00	110.00 Performed revisions based on what was desired by PSLUSD, created a sheet set to support the work, gave the plans to Butch,
adjusted based on his feedback, and sent the adjusted version of said plans back over.
Danielson, El, Luke	2/24/2021	.25	110.00 Adjusted the coordinates on the structure labels, published the plans, and sent them over to Butch.

82.50

82.50

247.50

825.00

770.00

192.50

27.50

440.00

27.50

Page4

Project	18-006.002	Mattamy MXD 2 Parcel -	Plat Preparation	Invoice	91586	
Danielson,	El, Luke	2/25/2021	.25	110.00	27.50		
Talked with Butch about the need to send project linework to Chris Hollen and subsequently emailed the requisite file to him.
Danielson, El, Luke	3/2/2021	.25	110.00	27.50
Discussed the lack of a reason for tying into manhole SMH-2 with Butch and gathered information on Kimley-Hom's original plans for the area, which I then sent him.
Danielson, El, Luke	3/8/2021	3.50	110.00	385.00
Worked on an FDEP wastewater permit application and sent a draft version to Butch.
Danielson, El, Luke	3/9/2021	.25	110.00	27.50
Updated the FDEP wastewater application and sent it to Butch.
Danielson, El, Luke	3/11/2021	2.00	110.00	220.00
Coordinated with Butch and Roberto concerning providing the FDEP wastewater application to Laney, stood by via phone for additional discussions on how to handle said application, and prepared an LOT for the submission.
Danielson, El, Luke	3/12/2021	.25	110.00	27.50
Created a pdf via scanning of the FDEP wastewater application to b submitted to Laney, fiiled said pdf, and had Donald deliver the physical copy.
Danielson, El, Luke	3/15/2021	.25	110.00	27.50
Added a few words to a sentence on the FDEP wastewater application and sent the sheet the adjustment was on over to Butch.

Danielson, El, Luke	3/18/2021	2.00	110.00 Coordinated with Butch, Kelly, and Ed concerning the project and made some changes to the plans.
Danielson, El, Luke	3/19/2021	2.00	110.00 Visited the proposed site to verify the location of a pertinent manhole and worked on the construction plans.
Danielson, El, Luke	3/20/2021	.50	110.00 Finalized adjustments to the plans and sent them over to Butch while filing them appropriately.
Danielson, El, Luke	3/22/2021	1.75	110.00 Adjusted the plans and passed them along to Butch after received some feedback.
Danielson, El, Luke	4/1/2021	.25 110.00 Tracked down the most recent set of plans for Tom and directed him to them.
Project Manager

220.00

220.00

55.00

192.50

27.50

Cabrera, El, Roberto	3/10/2021	.75	90.00	67.50
Its to pslusd & help luke
Cabrera, El, Roberto	3/15/2021	1.50	90.00	135,00 report & updated exhibits
Sr. Survey Technician
Hough, Bertice	3/23/2021	3.00	80.00	240.00
Prepare sketch and description of 2 easements Survey Crew GPS
Kiernan, Philip	3/24/2021	3.00	145.00	435.00
Page5

Project		18-006.002	Mattamy MXD 2 Parcel - Plat Preparation	Invoice	91586 As Built San MH#4 700'+/- South of lnnvovation Way

Totals	45.50
Total Labor

5,030.00
Total this Tasks Total this Phase

5,030.00
$5,030.00

$8,760.00

-Ph-a-se-----8------R-e-imb-u-rsa-ble-E-xp-en-se	--·

3/15/2021	Large Copy	2.0 Copies@0.35	.70	
3/15/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/15/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/15/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/15/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/15/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/15/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/15/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/15/2021	Large Copy	2.0 Copies @ 0.35	.70	
3/16/2021	Large Copy	3.0 Copies @ 0.35	1.05	
3/16/2021	Large Copy	22.0 Copies @ 0.35	7.70	
3/16/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/16/2021	Large Copy	4.0 Copies @ 0.35	1.40	
3/16/2021	Large Copy	5.0 Copies @ 0.35	1.75	
3/16/2021	Large Copy	73.0 Copies @ 0.35	25.55	
3/17/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/17/2021	Large Copy	3.0 Copies @ 0.35	1.05	
3/17/2021	Large Copy	2.0 Copies @ 0.35	.70	
3/17/2021	Large Copy	1.0 Copy@0.35	.35	
3/17/2021	Large Copy	1.0 Copy @ 0,35	.35	
3/17/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/18/2021	Large Copy	39.0 Copies @ 0.35	13.65	
3/23/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/23/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/23/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/23/2021	Large Copy	1.0 Copy@ 0.35	.35	
3/24/2021	Large Copy	1.0 Copy @ 0.35	.35	
3/24/2021	Large Copy	2.0 Copies @ 0.35	.70	
3/24/2021	Large Copy	2.0 Copies @ 0.35	.70	
3/24/2021	Large Copy	2.0 Copies @ 0.35	.70	
3/18/2021	Blueprint Color	36.0 BLUE-COLOR @ 1.50	54.00	
ILEAGE
3/17/2021	15.0 Miles @0.56	8.40	
3/24/2021	20.0 Miles @ 0.56	11.20		
			135.90	
	Total this Phase		$135.90	
	Total this Project		$8,895.90	

Unit BIiiing

M

Page6

Project	18-006.002	Mattamy MXD 2 Parcel - Plat Preparation	Invoice	91586
Total this Report	$8,895.90

Page7

Invoice	Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Ms. Lorie Maiorana
Senior Land Development Manager Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

September 16, 2021
Project No:	18-006.002
Invoice No:	93151

64228310.1510.37420
9/24/21 Processed

Principal:
Project Manager:
PO No:
Contract No:
WA No:

James 'Butch' Terpening, Jr., P.E. James 'Butch' Terpening, Jr., P.E.

Project	18-006.002	Mattamy MXD 2 Parcel - Plat Preparation
Butch and engineering staff, sewer analysis description for TK and Dennis, Plat approval process

-Pr-of-es-sio-n-al -Se-rv-ice-s-th-r

--h A-u-u-st-31-2-02-1	--·

Phase	7	General Engineering Services
Tasks	7.2	MXD Sewer Extension
Professional Personnel

Principal Engineer, PE
Totals
Total Labor

Hours
4.00
4.00

Rate
210.00

Amount
840.00
840.00

840.00

Total this Invoice

$840.009 rl

Outstanding Invoices
Number	
Date	
Balance	
92157	6/15/2021	1,673.25	
Total		1,673.25	

Project	18-006.002	Mattamy MXD 2 Parcel - Plat Preparation	Invoice	93151

Billing Backup
Culpepper & Terpening, Inc.

Thursday, September 16, 2021
Invoice 93151 Dated 9/16/2021	1:46:32 PM

Project Phase
Tasks

18-006.002
7
7.2

Mattamy MXD 2 Parcel - Plat Preparation General Engineering Services
MXD Sewer Extension

Professional Personnel

Principal Engineer, PE

Hours	Rate	Amount

Terpening, Jr., P.E., James	4/12/2021	2.00	210.00	420.00
"Butch"
sewerr alts with slopes
Terpening, Jr., P.E., James	4/20/2021	2.00	210.00	420.00
"Butch"
PSLUSD sewer NTP
Totals	4.00	840.00
Total Labor	840.00

Total this Tasks Total this Phase Total this Project Total this Report

$840.00

$840.00

$840.00

$840.00

Page 2

MATTAMY HOMES’ CERTIFICATE OF COSTS

EXHIBIT C

APPLICATION AND CERTIFICATE. FOR PAYMENT

AIA DOCUMENT G702

OUR INVOICE No. 21057•6-1

TO OWNER: Tradition CDC
Street Address City, State Zip

FROM CONTRACTOR;  CENTERLINE, INC.
2180 SW Poma Dlilte Palm Cily, FL 34990
(561) 689-3917
CONTRACT FOR:	Utility Sewer

PROJECT:
The Boardwalk at. Tradition LS#1

#6861
Rec 10/8 Processed 10/12/21

VIA ARCHITECT:

APPllCATtON NO.:
PERIOD TO: PROJECT NO.:

CONTRACT DATE:

Distribution to:
9/3012021 D OWNER
210576	□ ARCHITECT
X CONTRACTOR 8/2712021 O ENGINEER

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, In conneclion with lhe Conlracl.Continuation Sheet, AIA Document G703. is attached.

ORIGINAL CONTRACT  SUM ........•..... , ..............

735,321.27

The undersigned Contractor certifies that to the best or the Con!rac!or's knowledge, i.nformalion and belief the Work cove.,ed by this ,11,pplicalion for Paymenl has been completed in accordance w!lh the Contracl Documenls, that all amounts have been paid by the Conlractor for Work for which previous Certificates for Payment were issued and payments received' from the OWner, and that cu.rrent payment shown herein is now due.

Net change by Change Orders ............. ,	,.

..... .

0.00

CONTRACT SUM TO DATE (Line 1 + 2) ...... ,., .. ,... , ... .	$735,321.27

TOTAL COMPLETED & STORED TO DATE .. ,	,.
(Column G on G703)

7,808.19

RETAINAGE:
	10.0% of Completed Work, ...  (Columns D + E 011 G 703)

78,081.94

loa
County of:  MaI' h n

Subscribed and sworn to before me lh1s	p'g'-1h	day of

	10.0% of Stored Material ..... (Column Fon G703)
Total Retainage {line 5a + 5b or
Total In Column 1 of G703)

	0.00 

	7,806.19

Nolaiy Public 1	1'fs b b4:  =---l	...,:!!.!.. ":11. tt:E.a:,,!
My Commission explres:	-. "t:o·,·	i.ite o, rlorL'l :·

t

'·	&;mmii,lon ;; GG "12016	(
' M·i comm.b  lre1'itP 17 ion

need ,hTOU!it, National rfot ry	1

TOTAL EARNED lESS RETAINAGE ...................... .
(Line 4 less Une 5 Total)

	70,273.74 

A\11·" (
ARCHITECTS CERTIFICATE FOR PAYMENT
In accordance with the Conlract Documents, based on on-site observations and

ESS PREVIOUS CERTIFICATES FOR PAYMENT............ .
(IJne 6 from prior Certificate)

CURRENT PAYMENT DUE ....,. ...................... .

BALANCE TO FINISH, INCLUDING RETAINAGE
(IJne 3 less Line 6) ...., ."  ...............	66_5_,0_4_7_.5_3

0,00

9

,z $70,273.741	II

!tie data comp-rising this application, the Architect certifies to tfie•Owner Iha! to the best of Architect's knowledg,e, information and belief he Work has progressed
as ,Indicated, the quality of the Wo,k Is in accordance with the Contract Documents, and the Contractor is entiUed to payment of the AMOUNT CE;.wlED.
AMOUNT CERTIFIED .......... ,.. ,. , . . . . . .  . . 70  2 7)  ·
(atlach explanation If amount certified differs from the amount applied for. Initial all figures on this Application and on e Conti a_lion Sheet that are changed to
conform lo fhe amount oerl•i	, ,,,,_-r, -	/(;.,.,.,.1 - #0,

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total chang	.es -approve in previous	
- -- --·---·---	
---------·-----------	
months by Owner
Total approved this Month			
'	TOTALS			
fET CHANGES by Change Order			

Co.

CT;	-- e,,·"'	µ"T	
By:	Dale:	/b-  8- 'J.. I
This-Certffica e is not negoliabte. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are wllhout prejudice to any rights of the Owner or Conlractor under this Conlract.

39

APPLICATION AND CERTIFICATE FOR  PAYMENT	AIA DOCUMENT G702	OUR INVOICE No. 210576-2

TO OWNER: Mattamy Palm Beach, LLC
.2500 Quantum Lakes Dr #215 Boynton Bea.ch, FL 33426

FROM CONTRACTOR:  CENrfERLINE, INC.
2180 SW Poma Drive Palm City. FL 34990
{561) 689-3917
CONTRACT FOR:	Utility Sewer

PROJECT:
The Boardwalk at Tradition LS#1

VIA ARCHITECT:

#6861 Rec & Processed 10/20/21

Kimley-Hom

APPLICATION NO.: PERIOD TO: PROJECT NO.:
CONTRACT DATE:

Distribution to: 10/31/2021 L OWNER
210576	D ARCHITECT
X CONTRACTOR 10/7/2021 .J ENGINEER

CONTRACTOR'S APPLICATION FOR PAYMENT
Applicatlon is made forpaymer.l, as shown below, in oormection wilh U,e Contract Contlnuation Sheet AIA DoCllment G703. is attached.

ORIGINAL CONTRACT SUM .................... ,... ,.....

Net change by Change Orders ............................ .

CONTRACT SUM TO DATE (Line 1 +2) ............... _ ...  .

TOTAL COMPLETED & STORED TO DATE ................. .
(Column G on G703)

735.321.27

0.00

	$735,321.27

370,323.45

The undersigned Contractor certifies lhal lo ttie best of the Contractor's knowledge, l11formation and belief the Work covered by this Application tor Payment has been completed in acCQnlance wirlh the Contract Documents.
!hat an amounts have been paid by lhe Contraclor for Work for which
previous Certificates for Payment were Issued and payments reoelved from the Owner. and that current payment shown hereln is now due..

RETAINAGE;
	10.0% of Completed Work ...  3_7_,0_3_2_.3_5 (Columns D + E on G 703}

	10.0% of Stored Material .... _ (Column Fon G703)
Total Retainage (Line 5a + 5b or
Total in Column 1 of G700)

0.00

37,032.35

TOTAL EARNED LESS RETAINAGE ... _ .....,. ,... _	.. _
(ltne 4 less Une 5 Total)

LESS PREVIOUS CERTIFICATES FOR PAYMENT............ .
(Line 6 from pritlr Certificate)

CURRENT PAYMENT DUE ....... _ .............. .

13ALANCETO FINISH. INCLUDING RETAINAGE
{Line 3 less Line 6) .........................	4_0_2,0_30, . 6

	333,291.11 

70,273.74

vI	$263,017.371

ARCHITECrs CERTIFICATE FOR PAYMENT
In accordance wiltl the Contract D:ocuments, based on on-site obseJVations alild lhe data comprising this application, the Archltecl certifies to the Owner that to ltle best of Arohltecrs knowledge, information and belief lhe Work has progressoo
as indicated. the quality of the Work is in accordance with the Contract

7

Documents, and the Contractor is entiUed to payment oft.17e AMOUNT CERTIFIED.

t·

AMOUNTCERT'IFIED ........................	 J, 017	 J
(attaoh explanation if amount •certified differs from the amount applied for. lnilia'I au

Jo

figureso." th;s AppHealkm 	 '/ifi:"'11'"Sh,.l lhal ,,. chaoged to conform lo the amount .)	K'(.,. '•,- ffo,,,.-

'	L(i;	•

T	JV(••

CHANGE ORDER SUMMARY	AIDDITIONS	DEDUCTIONS	
Total ct,anges approve in previous months by Owner	-
fotal approved this Month	
-- ,.	 	-- -······------------	
JS.	TOTALS			
M=T CHANGES by Change Order			

f'..oJ• 	

By:	Date:	f/)· 1(}- '--	I
This Certlllcate is not negotiable. The AMOUNT CERTIFIED is payable only to lhe Contractor named herein. Issuance, payment and aoceplance of payment are withoL1t p.rejudlce lo any rights of the Owner or Contractor under this Conlract.

41

APPLICATION AND CERTIFICATE FOR PAYMENT	.AIA DOCUMENT G702	OUR INVOICE No. 210576•3

TO OWNER: Mattamy Palm Beach, ILLC 2500 Quantum Lakes Dr #215 Boynton Beach, FL 33426

fROM CONTRACTOR:	CENTERUNE, INC.

#6861

PROJECT:
The Boardwalk at Tradition LS#1

VIA ARCHITECT:

APPLICATION NO.: PERIOD TO: PROJECT NO.:
CONTRACT DATE:

Distribution to: 1/31/2022 D OWNER
210576	0 ARCHITECT
X CONTRACTOR 10/7/2021 D ENG:INEER

2180 SW Poma Drive Palm City, Fl 34990 (561} 689-3917
CONTRACT FOR:	Utility Sewer

2/15/22 Kimley-Hom

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment,·as shown below, in connection with lhe Contract Continuation Sheet, AlA Document G703, is attached.

ORIGINAL CONTRACTSUM ............................ .

Net change by Change Orders ..................... ,	_ .

735,32.1.27

0.00

The undersigned Contractor certifies tllat to the best of tile Contractors knowledge, infonnalion and bel'ief the Work covered by lhis Application fur
Payment has been completed in accordance with the Contract Documents,
that anamounts have been paid by the Contractor for Work for Which previous Certificates for Payment were Issued and payments received from the Owner, and that CUftenl.payment shown herein is now due.
CONTRACTOR:	_C_E_N_T_E_RL_I_N E, I_N_C .	_

CONTRACT SUM 1'0 DATE (Line 1 + 2) ................... .

$735,321.27

	::=,

Date:  / /3/ .kc..

TOTAL COMPLE1ED & STORED TO DATE .......... _ ....... .
(Column G on G7U3)

RETAINAGE:

400,703.40

	t)

	10.0% of Completed Work .... (Columns D + Eon G 703)
	10.0% of Stored Material ..... (Column F Olil G703)
Total Retainage (Une 5a + 5b or
Total in Column 1 of G703)

	40,070.34 

0.00

me thJs	.J J5"1-	day of

Subscribed and swpm to before

40,070.34

CURRENT PAYMENT DUE .. , ..................... ,.... .

$27,341.951

AMOUNT CERil'IFIED , .......... ,..... ,.. ....

2  7, J '•

9.r

""'""""71/,,_yJ

6. TOTAL EARNED LES$ RETAlNAGE .................. ,. ,.. .		360,633.06 	ARCHITECT'S CERTIFICATE FOR PAYMENT	
(Une 4 less Une 5 Totat)	'	In acoordancev.rith the Contract Documents, based on oil-site obs,ervatlons and.	
		the data comptising this application, lhe Archflect certifies to lhe Owner ttiat to the	
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT,	,.. ,..	333,291.11	best. of Architect's knowledge, information and belief the Work has progressed	
(Line 6 from prlorCertllicale,)		as indfcated, the quality of the Work is in accordance with the Contract: Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.	

BALANCE TO FINISH, INCLUDING RETAINAGE	(attach explanation if amount certified diffe<s fmrn the amount applied for. Initial an
(Line 3 less Line 6) . , .......... ,.......... 	3_'7_4_,6_88_.2_1	figures on tt,is Application and on the Continuatton Sheet that are changed to

Total changes approve in previous months by Owner
Totalapproved lhis Month

I
r·-······----·······-··--···-·--···

I

.by Change Order

NET CHANGES

TOTALS!

I\.)

DEDUCTmNs

!ADDITIONS

CHANGE ORDER SUMMARY

E ,;;;_"""1o ... 		I(._· ,-, - /,-_1..

,1

A ECT:	Pro,J•...,"T'"/f,1..,_	..
By:	Date:	.:2.-'f- Jo l

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named her,ein. Issuance, payment and acoeptance•of payment are without prejudice to any rights of the Owner or Contractor 'Under this Contract.

43

APPLJCATION AND CERTIFICATE FOR PAYMENT

AIA DOCUMENT G70.2

OUR INVOICE No..21057:6 4

TO OWNER: Mattamy Palm Beach, LLC
2500 Quantum Lakes Dr #215 Boynton Beach, FL 33426,

FROM CONTRACTOR:  CENTERLINE, INC.
2180 SW Poma Drive Palm City, FL 34990 (561} 689-3917
CONTRACT FOR:	Utility Sewer

#6861 2/24/22

PROJECT:
The Boardwatk at Tradition LS#1

VIA ARCHITECT:
Klmley"Hom

APPLICATION ND.:
PERIOD TO: PROJECT NO.:
CONTRACT □AT1E:

Distribution to:
2/2812022 D OWNER
210576	□ ARCHITECT
X CO TRACTOR 10/712021 0 ENGINEER

CONTRACTOR'S APPLICATION FOR PAYMENT
Appllcalion is made for payment; as shown below, in connection,with the Contract Continuation Sheet, AIA Document G703, is:atlactied.

ORIGINAL CONTRACT SUM_........................... .

Net change by Change Orders ....... ,............. ,... ,..

CONTRACT SUM TO DATE (Line 1 + 2) _	•

TOTAL COMPLETED & STORED TO DATE ....... _ ......... .
{Colurnn G Ofl G703)

RETAINAGE:
10.0% or Completed Work , ... 	5_5..:...1_16..:..7._65_

735,321.27

35,625..82

	$770,1147.09 

551,676.47

The undersigned Contractor certifies that to the best oftt,e contractor's nowledge, lnfonnation and belief Ille Wonk oovered by tllfiS Application for Payment has been completed In accordance with lhe Contract Documents, that art amounts have been paid by fue Contractor for Work for which previous Certificates for Payment were issued and payments received rom 1he Owner. and !hat current paymeflt shown herein is rrow due.

CONTRACTOR:	CENTERLINE, ING.
-==--_====-D-ate_&_ -2:Z-'

 --f)/1 Subscribed and sworn to before

r -tllf

r;_ t

me this	,,Jtr ',,L day of	r 'i, c;J..lX).:J..

(Columns D + E on G 703)
	10.0% of Stored Material ..... (Column ,F on G703)
Total Relainage (Line 5a + 5b or
Totalln Column 1 ofG703)

	0.00

	5.5,167.65 

Notary Public: +, 
My Comm[ssiolil expires:

"',0-Ct  	t7f:;:--(;':;;;- "2;,-...?. ... •	i"

:?;;; '

•"

<,.·;•:,�..	!COLER, PAY f.	P-,-_

1 ..	1-tolary Pu c - SL,1t i :'lcirr,1 1
. :. itrf_	Commirnon /I G(j Hf,l	!
M Comm i),pife 5 p 1,, 021 ••

TOTAL EARNED LESS RETAINAGE ...................... .
(Line 4 fess Line 5 Total)

LESS PREVIOUS CERTIFIICATES FOR PAYMENT	,.,.
(Line 6 from prior Certificate)

	496,508.82 

360,633.06

••• Bonded through r-latlooifl Nctar11mn

ARCHITEcrs CERTIFICATE FOR PAYM
In acco1dance wilh1he Contraot l□ocumems, oased on on-site observa ons and
lhe data comprising lhis application, the Arctiitect certifies to the Owner tnat to the best of Architect's knowledge, information and belief the Work has progressed
as Indicated, the quality·of the WoJk is in accordance with the Contract

Documents, and Iha Contractor Is entitled to payment of the AMOUNT CERTIFIED

CURRENT PAYMENT DUE	,..,.

.......•.......

v' $135,8,75.761

AMOUNT G.ERl't IEO	r

87.r.7

BALANCE TO FINISH, INCLUDING RETAINAGE
(Urie 3 less Llne 6) ................. ,,....	2_7_4 .4_3_8._2_7

(altacii explanation if anriount certified differs from 1-he_a_m_o_u_n_t a-1-p-p.,.. e-d"""fo_r .,..11n""'"1t:-ia:-Ia. ,11
figures on this A:pplicaticn and on ttip,Continuation Sheet that are changed to

p

roctoenform.,.lo the a Q1:1l'1 oerti 9(1.	IC:-'·r-  11	k,,

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approve in previous
morims by O'Wfler	
....---·-........	
------·-···----------	
[Total'	approved th Month			
I	TOTALS			
MET CHANGES by Change Order			

ARCM1TEGT: _..	:P"'b.	r-r,(4,._T" pf,  ,..,-.1: r 

-	By:	Date:	2_ -

'J3 - 

0  'J,.

This Certificate Is ool negotiable. The AMOUNT CERTIFIED js payable only lo the Contractor ruimed herein. l:.suance, payment a.nd a:cceptanoe of payment are without prejudice to any rigbts of the OIMler or Contractor L1nder t:his Contract

CONTINUATION SHEET

Contractors signed AIA Document G702, application & certificate for payment,

A		B	C						D	E	F	G	H	I	J	K	

ITEM NO.	

Cost Code	

DESCRIPTION OF WORK	

SCHEDULED VALUE	

CONTR QTY		

UNIT PRICE	
QTY TOTAL TO DATE		WORK COMPLETED		TOTAL
COMPLETED AND STORED TO DATE
(D+E+F)	
% COMP (G/C)	
BALANCE TO FINISH
(C-G)	

RET.
%	

RETAINAGE (G*J)	
									FROM PREVIOUS APPLICATION (D+E)	THIS APPLICATION	MATERIALS
PRESENTLY STORED
(NOT IN D OR E)						
1	30010	Mobilization (Utility)	$	40,000.00	1	LS	$	40,000.00	1	LS	$	40,000.00	$	-	$	-	$	40,000.00	100%	$	-	10%	$	4,000.00	
2	31245	Construction Survey (Utility)	$	11,470.73	1	LS	$	11,470.73	1	LS	$	10,323.66	$	1,147.07	$	-	$	11,470.73	100%	$	-	10%	$	1,147.07	
3	30030	NPDES Compliance and monitoring as needed	$	2,470.00	2	MO	$	1,235.00	2	MO	$	2,470.00	$	-	$	-	$	2,470.00	100%	$	-	10%	$	247.00	
4	37330	Density Testing	$	11,375.00	1	LS	$	11,375.00	1	LS	$	10,237.50	$	1,137.50	$	-	$	11,375.00	100%	$	-	10%	$	1,137.50	
		SUBTOTAL	$	65,315.73														
5	30020	Final Grade ROW South Side of Community Blvd. Fol	$	5,082.00	1400	SY	$	3.63	0	SY	$	-	$	-	$	-	$	-	0%	$	5,082	10%	$	-	
6	30020	Bahia Sod ROW South Side of Community Blvd. Follo	$	5,292.00	1400	SY	$	3.78	0	SY	$	-	$	-	$	-	$	-	0%	$	5,292	10%	$	-	
		SUBTOTAL	$	10,374.00														
7	31020	1" LS Water Service to Lift Station (Budget Est)	$	6,292.00	1	EA	$	6,292.00	0	EA	$	-	$	-	$	-	$	-	0%	$	6,292	10%	$	-	
		SUBTOTAL	$	6,292.00														
8	31010	8" Sewer Pipe (12'-14' cut)	$	50,405.85	255	LF	$	197.67	255	LF	$	50,405.85	$	-	$	-	$	50,405.85	100%	$	-	10%	$	5,040.59	
9	31010	Manhole (12'-14' cut)	$	65,951.36	4	EA	$	16,487.84	4	EA	$	65,951.36	$	-	$	-	$	65,951.36	100%	$	-	10%	$	6,595.14	
10	31010	Sanitary Line Testing	$	4,641.00	1	LS	$	4,641.00	0	LS	$	-	$	-	$	-	$	-	0%	$	4,641	10%	$	-	
		SUBTOTAL	$	120,998.21														
11	31010	6" PVC Pipe	$	9,724.00	275	LF	$	35.36	275	LF	$	9,724.00	$	-	$	-	$	9,724.00	100%	$	-	10%	$	972.40	
12	31010	6" HDPE Force Main - Directional Bore Under Commu	$	14,344.50	150	LF	$	95.63	150	LF	$	-	$	14,344.50	$	-	$	14,344.50	100%	$	-	10%	$	1,434.45	
13	31010	Connect to Existing with 16"x6" Cut-in MJ Tee	$	11,377.93	1	EA	$	11,377.93	0	EA	$	-	$	-	$	-	$	-	0%	$	11,378	10%	$	-	
14	31010	16" Gate Valve and Box Cut Into Existing Force Main	$	14,632.87	1	EA	$	14,632.87	0	EA	$	-	$	-	$	-	$	-	0%	$	14,633	10%	$	-	
15	31010	6" Gate Valve and Box	$	5,537.10	3	EA	$	1,845.70	2	EA	$	1,845.70	$	1,845.70	$	-	$	3,691.40	67%	$	1,846	10%	$	369.14	
16	31010	6" MJ DI Bend	$	4,527.90	5	EA	$	905.58	3	EA	$	2,716.74	$	-	$	-	$	2,716.74	60%	$	1,811	10%	$	271.67	
17	31010	Force Main Testing	$	2,681.25	1	LS	$	2,681.25	0	LS	$	-	$	-	$	-	$	-	0%	$	2,681	10%	$	-	
		SUBTOTAL	$	62,825.55														
18	31620	Lift Station (Entire Package)	$	414,057.18	1	EA	$  414,057.18	1	EA	$	207,028.59	$	132,498.30	$	-	$	339,526.89	82%	$	74,530	10%	$	33,952.69	
19	31620	4" Fiber Optic (Conduit)	$	20,347.20	785	LF	$	25.92	0	LF	$	-	$	-	$	-	$	-	0%	$	20,347	10%	$	-	
20	31620	4" Fiber Optic (Conduit) - Directional Bore Under Com	$	10,570.50	150	LF	$	70.47	0	LF	$	-	$	-	$	-	$	-	0%	$	10,571	10%	$	-	
21	31620	FO Cable (Budget Pricing Only. Fiber Optic Design no	$	14,305.50	935	LF	$	15.30	0	LF	$	-	$	-	$	-	$	-	0%	$	14,306	10%	$	-	
22	31620	PULL Boxes	$	6,423.60	4	EA	$	1,605.90	0	EA	$	-	$	-	$	-	$	-	0%	$	6,424	10%	$	-	
23	31620	Splice Boxes	$	1,605.90	1	EA	$	1,605.90	0	EA	$	-	$	-	$	-	$	-	0%	$	1,606	10%	$	-	
24	31620	Connect to Existing Fiber Optic	$	2,205.90	1	EA	$	2,205.90	0	EA	$	-	$	-	$	-	$	-	0%	$	2,206	10%	$	-	
		SUBTOTAL	$	469,515.78														
25		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
26		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
27		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
28		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
		SUBTOTAL:	$	735,321.27						$	400,703.40	$	150,973.07	$	-	$	551,676.47	75%	$	183,645	10%	$	55,167.65	
		CHANGES															
1	CO1-31010	Connect to Existing with 16"x6" Cut-in MJ Tee	$	(11,377.93)	1	EA	$  (11,377.93)	0	EA	$	-	$	-	$	-	$	-	0%	$	(11,378)	10%	$	-	
2	CO1-31010	16" Gate Valve and Box Cut Into Existing Force Main	$	(14,632.87)	1	EA	$  (14,632.87)	0	EA	$	-	$	-	$	-	$	-	0%	$	(14,633)	10%	$	-	
3	CO1-31010	16" Valve Insertion	$	47,047.00	1	EA	$	47,047.00	0	EA	$	-	$	-	$	-	$	-	0%	$	47,047	10%	$	-	
4	CO1-31010	16"x8" Tapping Sleev Valve w/ 8"x6" Reducer	$	14,589.62	1	EA	$	14,589.62	0	EA	$	-	$	-	$	-	$	-	0%	$	14,590	10%	$	-	
5	CO1-31010	0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
		SUBTOTAL:	$	35,625.82						$	-	$	-	$	-	$	-	0%	$	35,626	10%	$	-	
		TOTALS	$	770,947.09						$	400,703.40	$	150,973.07	$	-	$	551,676.47	72%	$	219,270.62	10%	$	55,167.65	

is attached.

AIA DOCUMENT G703

INVOICE No.	210576-4
APPLICATION NUMBER:	4
APPLICATION DATE:	28-Feb-22
PERIOD TO:	28-Feb-22

45

Cost Code	Scheduled Value	From Previous Ap This Application

Total Completed
and Stored	% Completed  Balance to Finish	Retainage

30010	40,000.00	40,000.00	0.00	0.00	40,000.00	100%	0.00	0.10	$	4,000.00	
31245	11,470.73	10,323.66	1,147.07	0.00	11,470.73	100%	0.00	0.10	$	1,147.07	
30030	2,470.00	2,470.00	0.00	0.00	2,470.00	100%	0.00	0.10	$	247.00	
37330	11,375.00	10,237.50	1,137.50	0.00	11,375.00	100%	0.00	0.10	$	1,137.50	
30020	10,374.00	0.00	0.00	0.00	0.00	0%	10,374.00	0.20	$	-	
31020	6,292.00	0.00	0.00	0.00	0.00	0%	629200%	0.10	$	-	
31010	183,823.76	130,643.65	16,190.20	0.00	146,833.85	80%	36,989.91	1.00	$	14,683.39	
31620	469,515.78	207,028.59	132,498.30	0.00	339,526.89	72%	129,988.89	0.70	$	33,952.69	

A		B	C						D	E	F	G	H	I	J	K	

ITEM NO.	

Cost Code	

DESCRIPTION OF WORK	

SCHEDULED VALUE	

CONTR QTY		

UNIT PRICE	
QTY TOTAL TO DATE		WORK COMPLETED		TOTAL
COMPLETED AND STORED TO DATE
(D+E+F)	
% COMP (G/C)	
BALANCE TO FINISH
(C-G)	

RET.
%	

RETAINAGE (G*J)	
									FROM PREVIOUS APPLICATION (D+E)	THIS APPLICATION	MATERIALS
PRESENTLY STORED
(NOT IN D OR E)						

46

CO1-31010	35,625.82	0.00	0.00	0.00	0.00	0%	35,625.82  0.50  $	-

47

#6861
4/7/22

The contract sum is correct, the amount is correct.
Working on internal code revision 4/7/22 please process payment, nothing incorrect about Vendor submission

CONTINUATION SHEET

Contractors signed AIA Document G702, application & certificate for payment,

A		B	C						D	E	F	G	H	I	J	K	

ITEM NO.	

Cost Code	

DESCRIPTION OF WORK	

SCHEDULED VALUE	

CONTR QTY		

UNIT PRICE	
QTY TOTAL TO DATE		WORK COMPLETED		TOTAL COMPLETED AND STORED TO DATE
(D+E+F)	
% COMP (G/C)	
BALANCE TO FINISH
(C-G)	

RET.
%	

RETAINAGE (G*J)	
									FROM PREVIOUS APPLICATION (D+E)	
THIS APPLICATION	MATERIALS PRESENTLY STORED
(NOT IN D OR E)						
1	30010	Mobilization (Utility)	$	40,000.00	1	LS	$	40,000.00	1	LS	$	40,000.00	$	-	$	-	$	40,000.00	100%	$	-	10%	$	4,000.00	
2	31245	Construction Survey (Utility)	$	11,470.73	1	LS	$	11,470.73	1	LS	$	11,470.73	$	-	$	-	$	11,470.73	100%	$	-	10%	$	1,147.07	
3	30030	NPDES Compliance and monitoring as needed	$	2,470.00	2	MO	$	1,235.00	2	MO	$	2,470.00	$	-	$	-	$	2,470.00	100%	$	-	10%	$	247.00	
4	37330	Density Testing	$	11,375.00	1	LS	$	11,375.00	1	LS	$	11,375.00	$	-	$	-	$	11,375.00	100%	$	-	10%	$	1,137.50	
		SUBTOTAL	$	65,315.73														
5	30020	Final Grade ROW South Side of Community Blvd. Fol	$	5,082.00	1400	SY	$	3.63	0	SY	$	-	$	-	$	-	$	-	0%	$	5,082	10%	$	-	
6	30020	Bahia Sod ROW South Side of Community Blvd. Follo	$	5,292.00	1400	SY	$	3.78	0	SY	$	-	$	-	$	-	$	-	0%	$	5,292	10%	$	-	
		SUBTOTAL	$	10,374.00														
7	31020	1" LS Water Service to Lift Station (Budget Est)	$	6,292.00	1	EA	$	6,292.00	1	EA	$	-	$	3,146.00	$	-	$	3,146.00	50%	$	3,146	10%	$	314.60	
		SUBTOTAL	$	6,292.00														
8	31010	8" Sewer Pipe (12'-14' cut)	$	50,405.85	255	LF	$	197.67	255	LF	$	50,405.85	$	-	$	-	$	50,405.85	100%	$	-	10%	$	5,040.59	
9	31010	Manhole (12'-14' cut)	$	65,951.36	4	EA	$	16,487.84	4	EA	$	65,951.36	$	-	$	-	$	65,951.36	100%	$	-	10%	$	6,595.14	
10	31010	Sanitary Line Testing	$	4,641.00	1	LS	$	4,641.00	0	LS	$	-	$	1,160.25	$	-	$	1,160.25	25%	$	3,481	10%	$	116.03	
		SUBTOTAL	$	120,998.21														
11	31010	6" PVC Pipe	$	9,724.00	275	LF	$	35.36	275	LF	$	9,724.00	$	-	$	-	$	9,724.00	100%	$	-	10%	$	972.40	
12	31010	6" HDPE Force Main - Directional Bore Under Commu	$	14,344.50	150	LF	$	95.63	150	LF	$	14,344.50	$	-	$	-	$	14,344.50	100%	$	-	10%	$	1,434.45	
13	31010	Connect to Existing with 16"x6" Cut-in MJ Tee	$	11,377.93	1	EA	$	11,377.93	1	EA	$	-	$	11,377.93	$	-	$	11,377.93	100%	$	-	10%	$	1,137.79	
14	31010	16" Gate Valve and Box Cut Into Existing Force Main	$	14,632.87	1	EA	$	14,632.87	1	EA	$	-	$	14,632.87	$	-	$	14,632.87	100%	$	-	10%	$	1,463.29	
15	31010	6" Gate Valve and Box	$	5,537.10	3	EA	$	1,845.70	3	EA	$	3,691.40	$	1,845.70	$	-	$	5,537.10	100%	$	-	10%	$	553.71	
16	31010	6" MJ DI Bend	$	4,527.90	5	EA	$	905.58	5	EA	$	2,716.74	$	1,811.16	$	-	$	4,527.90	100%	$	-	10%	$	452.79	
17	31010	Force Main Testing	$	2,681.25	1	LS	$	2,681.25	0	LS	$	-	$	938.44	$	-	$	938.44	35%	$	1,743	10%	$	93.84	
		SUBTOTAL	$	62,825.55														
18	31620	Lift Station (Entire Package)	$	414,057.18	1	EA	$  414,057.18	1	EA	$	339,526.89	$	37,265.15	$	-	$	376,792.03	91%	$	37,265	10%	$	37,679.20	
19	31620	4" Fiber Optic (Conduit)	$	20,347.20	785	LF	$	25.92	785	LF	$	-	$	20,347.20	$	-	$	20,347.20	100%	$	-	10%	$	2,034.72	
20	31620	4" Fiber Optic (Conduit) - Directional Bore Under Com	$	10,570.50	150	LF	$	70.47	150	LF	$	-	$	10,570.50	$	-	$	10,570.50	100%	$	-	10%	$	1,057.05	
21	31620	FO Cable (Budget Pricing Only. Fiber Optic Design no	$	14,305.50	935	LF	$	15.30	0	LF	$	-	$	-	$	-	$	-	0%	$	14,306	10%	$	-	
22	31620	PULL Boxes	$	6,423.60	4	EA	$	1,605.90	2	EA	$	-	$	3,211.80	$	-	$	3,211.80	50%	$	3,212	10%	$	321.18	
23	31620	Splice Boxes	$	1,605.90	1	EA	$	1,605.90	1	EA	$	-	$	802.95	$	-	$	802.95	50%	$	803	10%	$	80.30	
24	31620	Connect to Existing Fiber Optic	$	2,205.90	1	EA	$	2,205.90	0	EA	$	-	$	-	$	-	$	-	0%	$	2,206	10%	$	-	
		SUBTOTAL	$	469,515.78														
25		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
26		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
27		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
28		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
		SUBTOTAL:	$	735,321.27						$	551,676.47	$	107,109.94	$	-	$	658,786.41	90%	$	76,535	10%	$	65,878.64	
		CHANGES															
1	CO1-31010	Connect to Existing with 16"x6" Cut-in MJ Tee	$	(11,377.93)	1	EA	$  (11,377.93)	1	EA	$	-	$	(11,377.93)	$	-	$	(11,377.93)	100%	$	-	10%	$	(1,137.79)	
2	CO1-31010	16" Gate Valve and Box Cut Into Existing Force Main	$	(14,632.87)	1	EA	$  (14,632.87)	1	EA	$	-	$	(14,632.87)	$	-	$	(14,632.87)	100%	$	-	10%	$	(1,463.29)	
3	CO1-31010	16" Valve Insertion	$	47,047.00	1	EA	$	47,047.00	1	EA	$	-	$	47,047.00	$	-	$	47,047.00	100%	$	-	10%	$	4,704.70	
4	CO1-31010	16"x8" Tapping Sleev Valve w/ 8"x6" Reducer	$	14,589.62	1	EA	$	14,589.62	1	EA	$	-	$	14,589.62	$	-	$	14,589.62	100%	$	-	10%	$	1,458.96	
5	CO1-31010	0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
		SUBTOTAL:	$	35,625.82						$	-	$	35,625.82	$	-	$	35,625.82	100%	$	-	10%	$	3,562.58	
		TOTALS	$	770,947.09						$	551,676.47	$	142,735.76	$	-	$	694,412.23	90%	$	76,534.86	10%	$	69,441.22	

is attached.

AIA DOCUMENT G703

INVOICE No.	210576-5
APPLICATION NUMBER:	5
APPLICATION DATE:	31-Mar-22
PERIOD TO:	31-Mar-22

48

Cost Code	Scheduled Value	From Previous AThis Application

Total Completed
and Stored	% Completed

Balance to
Finish	Retainage

30010	40,000.00	40,000.00	0.00	0.00	40,000.00	100%	0.00	0.10	$	4,000.00	
31245	11,470.73	11,470.73	0.00	0.00	11,470.73	100%	0.00	0.10	$	1,147.07	
30030	2,470.00	2,470.00	0.00	0.00	2,470.00	100%	0.00	0.10	$	247.00	
37330	11,375.00	11,375.00	0.00	0.00	11,375.00	100%	0.00	0.10	$	1,137.50	
30020	10,374.00	0.00	0.00	0.00	0.00	0%	10,374.00	0.20	$	-	
31020	6,292.00	0.00	3,146.00	0.00	3,146.00	50%	314600%	0.10	$	314.60	

A		B	C						D	E	F	G	H	I	J	K	

ITEM NO.	

Cost Code	

DESCRIPTION OF WORK	

SCHEDULED VALUE	

CONTR QTY		

UNIT PRICE	
QTY TOTAL TO DATE		WORK COMPLETED		TOTAL COMPLETED AND STORED TO DATE
(D+E+F)	
% COMP (G/C)	
BALANCE TO FINISH
(C-G)	

RET.
%	

RETAINAGE (G*J)	
									FROM PREVIOUS APPLICATION (D+E)	
THIS APPLICATION	MATERIALS PRESENTLY STORED
(NOT IN D OR E)						

49

31010	183,823.76	146,833.85	31,766.35	0.00	178,600.20	97%	5,223.56	1.00	$ 17,860.02	
31620	469,515.78	339,526.89	72,197.60	0.00	411,724.48	88%	57,791.30	0.70	$ 41,172.45	
CO1-31010	35,625.82	0.00	35,625.82	0.00	35,625.82	100%	0.00	0.50	$	3,562.58	

694,412.23
Check?	Ready to Import

50

#6861
5/2/22

770,936.09

Vendor Sum to Date

Order Amount	Billed	Retained	Paid	Open Grand Total	$1,038,064.28 $694,412.22		$69,441.21		624,971.01-		$76,523.87

CONTINUATION SHEET

Contractors signed AIA Document G702, application & certificate for payment,
is attached.

AIA DOCUMENT G703

INVOICE No.  210576-6
APPLICATION NUMBER:	6
APPLICATION DATE:	30-Apr-22
PERIOD TO:	30-Apr-22

Cost Code	Scheduled Value	From Previous This Application

A		B	C						D	E	F	G	H	I	J	K	

ITEM NO.	

Cost Code	

DESCRIPTION OF WORK	

SCHEDULED VALUE	

CONTR QTY		

UNIT PRICE	

QTY TOTAL TO DATE		WORK COMPLETED		TOTAL COMPLETED AND STORED TO DATE
(D+E+F)	

% COMP (G/C)	

BALANCE TO FINISH
(C-G)	

RET.
%	

RETAINAGE (G*J)	
									FROM PREVIOUS APPLICATION (D+E)	
THIS APPLICATION	MATERIALS PRESENTLY STORED
(NOT IN D OR E)						
1	30010	Mobilization (Utility)	$	40,000.00	1	LS	$	40,000.00	1	LS	$	40,000.00	$	-	$	-	$	40,000.00	100%	$	-	10%	$	4,000.00	
2	31245	Construction Survey (Utility)	$	11,470.73	1	LS	$	11,470.73	1	LS	$	11,470.73	$	-	$	-	$	11,470.73	100%	$	-	10%	$	1,147.07	
3	30030	NPDES Compliance and monitoring as needed	$	2,470.00	2	MO	$	1,235.00	2	MO	$	2,470.00	$	-	$	-	$	2,470.00	100%	$	-	10%	$	247.00	
4	37330	Density Testing	$	11,375.00	1	LS	$	11,375.00	1	LS	$	11,375.00	$	-	$	-	$	11,375.00	100%	$	-	10%	$	1,137.50	
		SUBTOTAL	$	65,315.73														
5	30020	Final Grade ROW South Side of Community Blvd. Foll	$	5,082.00	1400	SY	$	3.63	1400	SY	$	-	$	5,082.00	$	-	$	5,082.00	100%	$	-	10%	$	508.20	
6	30020	Bahia Sod ROW South Side of Community Blvd. Follo	$	5,292.00	1400	SY	$	3.78	1400	SY	$	-	$	5,292.00	$	-	$	5,292.00	100%	$	-	10%	$	529.20	
		SUBTOTAL	$	10,374.00														
7	31020	1" LS Water Service to Lift Station (Budget Est)	$	6,292.00	1	EA	$	6,292.00	1	EA	$	3,146.00	$	-	$	-	$	3,146.00	50%	$	3,146	10%	$	314.60	
		SUBTOTAL	$	6,292.00														
8	31010	8" Sewer Pipe (12'-14' cut)	$	50,405.85	255	LF	$	197.67	255	LF	$	50,405.85	$	-	$	-	$	50,405.85	100%	$	-	10%	$	5,040.59	
9	31010	Manhole (12'-14' cut)	$	65,951.36	4	EA	$	16,487.84	4	EA	$	65,951.36	$	-	$	-	$	65,951.36	100%	$	-	10%	$	6,595.14	
10	31010	Sanitary Line Testing	$	4,641.00	1	LS	$	4,641.00	0	LS	$	1,160.25	$	-	$	-	$	1,160.25	25%	$	3,481	10%	$	116.03	
		SUBTOTAL	$	120,998.21														
11	31010	6" PVC Pipe	$	9,724.00	275	LF	$	35.36	275	LF	$	9,724.00	$	-	$	-	$	9,724.00	100%	$	-	10%	$	972.40	
12	31010	6" HDPE Force Main - Directional Bore Under Commu	$	14,344.50	150	LF	$	95.63	150	LF	$	14,344.50	$	-	$	-	$	14,344.50	100%	$	-	10%	$	1,434.45	
13	31010	Connect to Existing with 16"x6" Cut-in MJ Tee	$	11,377.93	1	EA	$	11,377.93	1	EA	$	11,377.93	$	-	$	-	$	11,377.93	100%	$	-	10%	$	1,137.79	
14	31010	16" Gate Valve and Box Cut Into Existing Force Main	$	14,632.87	1	EA	$	14,632.87	1	EA	$	14,632.87	$	-	$	-	$	14,632.87	100%	$	-	10%	$	1,463.29	
15	31010	6" Gate Valve and Box	$	5,537.10	3	EA	$	1,845.70	3	EA	$	5,537.10	$	-	$	-	$	5,537.10	100%	$	-	10%	$	553.71	
16	31010	6" MJ DI Bend	$	4,527.90	5	EA	$	905.58	5	EA	$	4,527.90	$	-	$	-	$	4,527.90	100%	$	-	10%	$	452.79	
17	31010	Force Main Testing	$	2,681.25	1	LS	$	2,681.25	0	LS	$	938.44	$	-	$	-	$	938.44	35%	$	1,743	10%	$	93.84	
		SUBTOTAL	$	62,825.55														
18	31620	Lift Station (Entire Package)	$	414,057.18	1	EA	$  414,057.18	1	EA	$	376,792.03	$	-	$	-	$	376,792.03	91%	$	37,265	10%	$	37,679.20	
19	31620	4" Fiber Optic (Conduit)	$	20,347.20	785	LF	$	25.92	785	LF	$	20,347.20	$	-	$	-	$	20,347.20	100%	$	-	10%	$	2,034.72	
20	31620	4" Fiber Optic (Conduit) - Directional Bore Under Com	$	10,570.50	150	LF	$	70.47	150	LF	$	10,570.50	$	-	$	-	$	10,570.50	100%	$	-	10%	$	1,057.05	
21	31620	FO Cable (Budget Pricing Only. Fiber Optic Design not	$	14,305.50	935	LF	$	15.30	935	LF	$	-	$	14,305.50	$	-	$	14,305.50	100%	$	-	10%	$	1,430.55	
22	31620	PULL Boxes	$	6,423.60	4	EA	$	1,605.90	4	EA	$	3,211.80	$	3,211.80	$	-	$	6,423.60	100%	$	-	10%	$	642.36	
23	31620	Splice Boxes	$	1,605.90	1	EA	$	1,605.90	1	EA	$	802.95	$	802.95	$	-	$	1,605.90	100%	$	-	10%	$	160.59	
24	31620	Connect to Existing Fiber Optic	$	2,205.90	1	EA	$	2,205.90	1	EA	$	-	$	2,205.90	$	-	$	2,205.90	100%	$	-	10%	$	220.59	
		SUBTOTAL	$	469,515.78														
25		0	$	-	0	$	-	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
26		0	$	-	0	$	-	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
27		0	$	-	0	$	-	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
28		0	$	-	0	$	-	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
		SUBTOTAL:	$	735,321.27						$	658,786.41	$	30,900.15	$	-	$	689,686.56	94%	$	45,635	10%	$	68,968.66	
		CHANGES															
1	CO1-31010	Connect to Existing with 16"x6" Cut-in MJ Tee	$	(11,377.93)	1	EA	$  (11,377.93)	1	EA	$	(11,377.93)	$	-	$	-	$	(11,377.93)	100%	$	-	10%	$	(1,137.79)	
2	CO1-31010	16" Gate Valve and Box Cut Into Existing Force Main	$	(14,632.87)	1	EA	$  (14,632.87)	1	EA	$	(14,632.87)	$	-	$	-	$	(14,632.87)	100%	$	-	10%	$	(1,463.29)	
3	CO1-31010	16" Valve Insertion	$	47,047.00	1	EA	$	47,047.00	1	EA	$	47,047.00	$	-	$	-	$	47,047.00	100%	$	-	10%	$	4,704.70	
4	CO1-31010	16"x8" Tapping Sleev Valve w/ 8"x6" Reducer	$	14,589.62	1	EA	$	14,589.62	1	EA	$	14,589.62	$	-	$	-	$	14,589.62	100%	$	-	10%	$	1,458.96	
5	CO1-31010	0	$	-	0	$	-	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
		SUBTOTAL:	$	35,625.82						$	35,625.82	$	-	$	-	$	35,625.82	100%	$	-	10%	$	3,562.58	
		TOTALS	$	770,947.09						$	694,412.23	$	30,900.15	$	-	$	725,312.38	94%	$	45,634.71	10%	$	72,531.24	

Total Completed
and Stored	% Completed

Balance to
Finish	Retainage

30010	40,000.00	40,000.00	0.00	0.00	40,000.00	100%	0.00	0.10	$ 4,000.00	
31245	11,470.73	11,470.73	0.00	0.00	11,470.73	100%	0.00	0.10	$ 1,147.07	
30030	2,470.00	2,470.00	0.00	0.00	2,470.00	100%	0.00	0.10	$	247.00	
37330	11,375.00	11,375.00	0.00	0.00	11,375.00	100%	0.00	0.10	$ 1,137.50	
30020	10,374.00	0.00	10,374.00	0.00	10,374.00	100%	0.00	0.20	$ 1,037.40	
31020	6,292.00	3,146.00	0.00	0.00	3,146.00	50%	314600%	0.10	$	314.60	
31010	183,823.76	178,600.20	0.00	0.00	178,600.20	97%	5,223.56	1.00	$17,860.02	
31620	469,515.78	411,724.48	20,526.15	0.00	432,250.63	92%	37,265.15	0.70	$43,225.06	
CO1-31010	35,625.82	35,625.82	0.00	0.00	35,625.82

725,312.38	100%	0.00	0.50	$ 3,562.58	

Order Amount	Billed Amount  Retained Amou Paid

Open

Grand Total	$  1,038,064.28  $ 694,412.22  $  69,441.21  624,971.01 $  76,523.87

Vendor Sum to Date 770,936.09

51

Check?	Ready to Import

APPUCATION AND CERTIFICATE FOR PAYMENT	AlA DOCUMENT G702	OUR INVOICE No. 21,0576-7

TO OWNER: Mattamy Palm Beach, LLC 2500 Quantum Lakes Dr #215 Boynton Beach, FL 33426

FROM CONTRACTOR.: CENTERLINE,.INC.

PROJECT:
The BoardwaiEk at Tradition LS#1

VIA ARCHITECT:

APPLICATION NO.: PERIOD TO!
PROJECT NO.: CONTRACT D,ATE:

Distribution o: 5/31/2022 □ OWNER
210576	D ARCHITECT
X CON RACTOR 1017/2021 □ ENGINEER

2180 SW Poma Drive Palm City, FL 34990
(561) 689-3917
CON'IBACT FOR:	Util ly Sewer
CONTRACTOR'S APPLICATION FOR PAYMENT
Appltcation ls made for p.ayment, as sholM1 below, in oonneclion with the Contract Continua-lion Sheet, AIA Document G703, is attached,

ORIGINAL    CONTRACT    SUM   ..................•..........

Net change by Change Orders ........................... .

CONTRACT SUM TO DATE (Line 1 + 2) ................... .

TOTAL COMPLETED & STORED TO DATE ................. .
{Column G on G703)

Killilley-Hom

735,321.27

35,625.82

	$770,947.09

737,734.10

Billed 725,312.37 Open 45,677.97
770,990.34
The L111dersigned Contractor cerlilies that to the best or the Contractor's knowledge, informalion aind elief lhe Work covered by lllis Application for Payment has been completed rir:iacoordance w'Plh I e Contract Dorumenl:s, U,at aU amounts have been paid by the Contractor for Worl< for which prevloos Certificates fur Payment were issued and payments received.from the Owner, and lhat CtJrrent payment shown herein is now due.

CONTRACTOR;	 C E=NT::::=E=RL=l=N=E ,l N=C 	:::--,:--,- 
0,,	 oateb/27/4:2

ot

Cou-nty #::M (.f I n

RETAINAGE:
10.0% of Completed Work. , ..	7_3-'-,77._3_.4_1
(Columns D +Eon G 703)

Subscribed and swom to before
me th.ls	J1- -I'	day of

'-'-""!:i:>=::	- --=---­

b,		10.0% of Stored Material .. , . (Column Fon G703)
Total Retalnage (Line Sa + 5b or
Tota1in Column 1 ofG703)

	0.00

	73,773.41

otary Publicfff@	l-H,_y ")'\,.L
My Commlssroo expires:	U

j,�

NICO E It PAYNE
ol •Y Public - Sl t of -=1ona.,
Commi ;,o;, i: GG120769	.
11,v Comm. E.xpues Si.",J 17, 1Q22 "
1!1111ded H,rou;ih ,tlom:I otary Assn. ',
--.-:.=.:a=-.:.,,• •..,,_.	i l

TOTAL EARNED LESS RETAINAGE ....................... .
(Line4 less Line 5 Total)

• ESS PREVIOUS CERTlFICATES FOR PAYMENT............ .
(Llne a from prior C.ertificate)

8, CURREINT PAYMENT DUE .......... ,.................. .

9. BALANCE TO FINISH, INCLUDING RETAlNAGE

	663,960.69 

652,781.14

	$11,179.SSii

ARCHITECTS CERTIFICATE FOR PAYMENT
In accordance wlt tile Contract Documents, based on on-site obse,vations and the data comprising this,appfication, I.he Architect certifies to the Owner that lo ihe best of Architect's knov.iedge, information and belief the Work has progressed,

171

as indicated, ltle quality of the Work is In accordance with the Contract. ents, and the Contracior is enti1Jed to paym,f lhe AM	u	Rrp.rp-

T CERTIF.IED ........................ / / 	•
-r,i?ach e.11planation if amount certlfied differs from the amounlapplled for. Initial all

(Une 3 less L1ne6)		10_6,9_8_6_.4_0

figures on this Appllca.tion

d 011 th	onlinualion Sheet that are changed o
I

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total manges approve in previous months by Ovme,
Total approved ltlls Month	........,.,. ---	
····------------------	
TOTALS			
NET CHANGES by Ohange Order			

{otz_

conformtotlileamo	c ·,1e .)

11</ :.,../ ..1

- lfiio.,...._

ARrE I:	L- -	.f"._u;:", ""'-• ._
By:	j-  -:J.7- J.o ;;}
Thls Certificate is nol negotiable. The AMOUNT CERTlf:IED is payable only to the Conlractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contra.ctor under this Contracl

CONTINUATION SHEET

Contractors signed AIA Document G702, application & certificate for payment,
is attached.

AIA DOCUMENT G703

INVOICE No.	210576-7
APPLICATION NUMBER:	7
APPLICATION DATE:	31-May-22
PERIOD TO:	31-May-22

53

A		B	C						D	E	F	G	H	I	J	K	

ITEM NO.	

Cost Code	

DESCRIPTION OF WORK	

SCHEDULED VALUE	

CONTR QTY		

UNIT PRICE	

QTY TOTAL TO DATE		WORK COMPLETED		TOTAL COMPLETED AND STORED TO DATE
(D+E+F)	

% COMP (G/C)	

BALANCE TO FINISH
(C-G)	

RET.
%	

RETAINAGE (G*J)	
									FROM PREVIOUS APPLICATION (D+E)	
THIS APPLICATION	MATERIALS PRESENTLY STORED
(NOT IN D OR E)						
1	30010	Mobilization (Utility)	$	40,000.00	1	LS	$	40,000.00	1	LS	$	40,000.00	$	-	$	-	$	40,000.00	100%	$	-	10%	$	4,000.00	
2	31245	Construction Survey (Utility)	$	11,470.73	1	LS	$	11,470.73	1	LS	$	11,470.73	$	-	$	-	$	11,470.73	100%	$	-	10%	$	1,147.07	
3	30030	NPDES Compliance and monitoring as needed	$	2,470.00	2	MO	$	1,235.00	2	MO	$	2,470.00	$	-	$	-	$	2,470.00	100%	$	-	10%	$	247.00	
4	37330	Density Testing	$	11,375.00	1	LS	$	11,375.00	1	LS	$	11,375.00	$	-	$	-	$	11,375.00	100%	$	-	10%	$	1,137.50	
		SUBTOTAL	$	65,315.73														
5	30020	Final Grade ROW South Side of Community Blvd. Fo	$	5,082.00	1400	SY	$	3.63	1400	SY	$	5,082.00	$	-	$	-	$	5,082.00	100%	$	-	10%	$	508.20	
6	30020	Bahia Sod ROW South Side of Community Blvd. Foll	$	5,292.00	1400	SY	$	3.78	1400	SY	$	5,292.00	$	-	$	-	$	5,292.00	100%	$	-	10%	$	529.20	
		SUBTOTAL	$	10,374.00														
7	31020	1" LS Water Service to Lift Station (Budget Est)	$	6,292.00	1	EA	$	6,292.00	1	EA	$	3,146.00	$	-	$	-	$	3,146.00	50%	$	3,146	10%	$	314.60	
		SUBTOTAL	$	6,292.00														
8	31010	8" Sewer Pipe (12'-14' cut)	$	50,405.85	255	LF	$	197.67	255	LF	$	50,405.85	$	-	$	-	$	50,405.85	100%	$	-	10%	$	5,040.59	
9	31010	Manhole (12'-14' cut)	$	65,951.36	4	EA	$	16,487.84	4	EA	$	65,951.36	$	-	$	-	$	65,951.36	100%	$	-	10%	$	6,595.14	
10	31010	Sanitary Line Testing	$	4,641.00	1	LS	$	4,641.00	0	LS	$	1,160.25	$	-	$	-	$	1,160.25	25%	$	3,481	10%	$	116.03	
		SUBTOTAL	$	120,998.21														
11	31010	6" PVC Pipe	$	9,724.00	275	LF	$	35.36	275	LF	$	9,724.00	$	-	$	-	$	9,724.00	100%	$	-	10%	$	972.40	
12	31010	6" HDPE Force Main - Directional Bore Under Comm	$	14,344.50	150	LF	$	95.63	150	LF	$	14,344.50	$	-	$	-	$	14,344.50	100%	$	-	10%	$	1,434.45	
13	31010	Connect to Existing with 16"x6" Cut-in MJ Tee	$	11,377.93	1	EA	$	11,377.93	1	EA	$	11,377.93	$	-	$	-	$	11,377.93	100%	$	-	10%	$	1,137.79	
14	31010	16" Gate Valve and Box Cut Into Existing Force Main	$	14,632.87	1	EA	$	14,632.87	1	EA	$	14,632.87	$	-	$	-	$	14,632.87	100%	$	-	10%	$	1,463.29	
15	31010	6" Gate Valve and Box	$	5,537.10	3	EA	$	1,845.70	3	EA	$	5,537.10	$	-	$	-	$	5,537.10	100%	$	-	10%	$	553.71	
16	31010	6" MJ DI Bend	$	4,527.90	5	EA	$	905.58	5	EA	$	4,527.90	$	-	$	-	$	4,527.90	100%	$	-	10%	$	452.79	
17	31010	Force Main Testing	$	2,681.25	1	LS	$	2,681.25	0	LS	$	938.44	$	-	$	-	$	938.44	35%	$	1,743	10%	$	93.84	
		SUBTOTAL	$	62,825.55														
18	31620	Lift Station (Entire Package)	$	414,057.18	1	EA	$  414,057.18	1	EA	$	376,792.03	$	12,421.72	$	-	$	389,213.75	94%	$	24,843	10%	$	38,921.37	
19	31620	4" Fiber Optic (Conduit)	$	20,347.20	785	LF	$	25.92	785	LF	$	20,347.20	$	-	$	-	$	20,347.20	100%	$	-	10%	$	2,034.72	
20	31620	4" Fiber Optic (Conduit) - Directional Bore Under Co	$	10,570.50	150	LF	$	70.47	150	LF	$	10,570.50	$	-	$	-	$	10,570.50	100%	$	-	10%	$	1,057.05	
21	31620	FO Cable (Budget Pricing Only. Fiber Optic Design n	$	14,305.50	935	LF	$	15.30	935	LF	$	14,305.50	$	-	$	-	$	14,305.50	100%	$	-	10%	$	1,430.55	
22	31620	PULL Boxes	$	6,423.60	4	EA	$	1,605.90	4	EA	$	6,423.60	$	-	$	-	$	6,423.60	100%	$	-	10%	$	642.36	
23	31620	Splice Boxes	$	1,605.90	1	EA	$	1,605.90	1	EA	$	1,605.90	$	-	$	-	$	1,605.90	100%	$	-	10%	$	160.59	
24	31620	Connect to Existing Fiber Optic	$	2,205.90	1	EA	$	2,205.90	1	EA	$	2,205.90	$	-	$	-	$	2,205.90	100%	$	-	10%	$	220.59	
		SUBTOTAL	$	469,515.78														
25		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
26		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
27		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
28		0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
		SUBTOTAL:	$	735,321.27						$	689,686.56	$	12,421.72	$	-	$	702,108.28	95%	$	33,213	10%	$	70,210.83	
		CHANGES															
1	CO1-31010	Connect to Existing with 16"x6" Cut-in MJ Tee	$	(11,377.93)	1	EA	$  (11,377.93)	1	EA	$	(11,377.93)	$	-	$	-	$	(11,377.93)	100%	$	-	10%	$	(1,137.79)	
2	CO1-31010	16" Gate Valve and Box Cut Into Existing Force Main	$	(14,632.87)	1	EA	$  (14,632.87)	1	EA	$	(14,632.87)	$	-	$	-	$	(14,632.87)	100%	$	-	10%	$	(1,463.29)	
3	CO1-31010	16" Valve Insertion	$	47,047.00	1	EA	$	47,047.00	1	EA	$	47,047.00	$	-	$	-	$	47,047.00	100%	$	-	10%	$	4,704.70	
4	CO1-31010	16"x8" Tapping Sleev Valve w/ 8"x6" Reducer	$	14,589.62	1	EA	$	14,589.62	1	EA	$	14,589.62	$	-	$	-	$	14,589.62	100%	$	-	10%	$	1,458.96	
5	CO1-31010	0	$	-	0	$ -	$	-	0	0	$	-	$	-	$	-	$	-	#DIV/0!	$	-	10%	$	-	
		SUBTOTAL:	$	35,625.82						$	35,625.82	$	-	$	-	$	35,625.82	100%	$	-	10%	$	3,562.58	
		TOTALS	$	770,947.09						$	725,312.38	$	12,421.72	$	-	$	737,734.10	96%	$	33,212.99	10%	$	73,773.41	

Cost Code	
Scheduled Value	From Previous	This Application		Total Completed
and Stored	% Completed	
Balance	
to Finish		Retainage	
30010	40,000.00	40,000.00	0.00	0.00	40,000.00	100%	0.00	0.10	$ 4,000.00	
31245	11,470.73	11,470.73	0.00	0.00	11,470.73	100%	0.00	0.10	$ 1,147.07	
30030	2,470.00	2,470.00	0.00	0.00	2,470.00	100%	0.00	0.10	$	247.00	

A		B	C						D	E	F	G	H	I	J	K	

ITEM NO.	

Cost Code	

DESCRIPTION OF WORK	

SCHEDULED VALUE	

CONTR QTY		

UNIT PRICE	

QTY TOTAL TO DATE		WORK COMPLETED		TOTAL COMPLETED AND STORED TO DATE
(D+E+F)	

% COMP (G/C)	

BALANCE TO FINISH
(C-G)	

RET.
%	

RETAINAGE (G*J)	
									FROM PREVIOUS APPLICATION (D+E)	
THIS APPLICATION	MATERIALS PRESENTLY STORED
(NOT IN D OR E)						
37330	11,375.00	11,375.00	0.00	0.00	11,375.00	100%	0.00	0.10	$ 1,137.50	
30020	10,374.00	10,374.00	0.00	0.00	10,374.00	100%	0.00	0.20	$ 1,037.40	
31020	6,292.00	3,146.00	0.00	0.00	3,146.00	50%	314600%	0.10	$	314.60	
31010	183,823.76	178,600.20	0.00	0.00	178,600.20	97%	5,223.56	1.00	$17,860.02	
31620	469,515.78	432,250.63	12,421.72	0.00	444,672.35	95%	24,843.43	0.70	$44,467.23	
CO1-31010	35,625.82	35,625.82	0.00	0.00	35,625.82	100%	0.00	0.50	$ 3,562.58	

54

APPLICATION AND,CERTIFICATE FOR PAYMENT

AIA DOCUMENT G702

OUR INVOICE No. 210576-8

TO OWNER: Mattamy Palm Beach, LlC
2500 Quantum Lakes Dr#215 Boynton Beach, FL 33426

PROJECT:
The Boardwalk at Tradition LS#1

APPLICATION NO.:
PERIOD TO: PROJECT NO.:
CONTRACT DATE:

Distrlbulion to;
6/30/2022 0 OWNER
210576	0 ARCHITECT
X CONTRACTOR 1017/2021 □ ENGINEER

IFROM CONTRACTOR: CENTERLINE, INC.
2180 SW Poma Dtive	VIA ARCHITECT:
Klmley-Horn	6861	
Palm City, FL 34990		7/15/2022	
(561) 689-3917
CONTRACT FOR:	Ulffily Sewer			

Note: Change Order for $24,140.00 has not been entered in JOE.

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, In co11neclion with the Contract Continuation Sheet, AJA !Document G703, Is attached.		The uf'\dersl_gned Contractor certifies that to !he best of the Contraclor's knowledge, information and belief the Wor1c covered by this Application for Payment has been completed ln accordance with the Contract Documems,
lhat all amounts have been paid by the Contractor ror Work for which	
1. ORIGINAL CONTRACT SUM ............................ .	735.321.27	previous Certificates for Payment were Issued and payments received from
llhe Owner, and lhat o.irren! payment shown herein is now due.	
2. Net cl1ange by Change Orders ............................ .	59,765.82		

CONTRACT SUM TO DATE (Line 1 4 2) ................... .

TOTA:L COMPLETED  & STORED  TO DATE  ...................
{Column G on G703)

RETAINAGE:
	10.0% of Completed Wolk .... 	7_7_,9_6_8_.80_ (Columns D + E on G 703)

$795,081.oy	 779,687.96

	10.0% of Stored Material ..... (Column Fon G703)
Total Retarna e (Line 5a + 5b or
Total in Col mn 1 of G703)

TOTAL EARNED LESS RETAINAGE ...................... .
{Line 4 less line 5 Total)

LESS PREVIOUS CERTIFICATES FOR PAYMENT............ .
{Line 6 from prior Certificate)

0.00

77.968.SO

	70"1.719.16 

663,960.69

In accordance with the Contract Documents, based on on-site observations and the data comprising this appllcation, the Architect certifies to the Owner that to i.he best of Archltecfs knowledge, 1nformation and !belief !ha Wolk has progressed
as Indicated, tt,e quality of the Work is tn accordance with the Contract Documents, and the•Contractor is entitled to paymen7of 1h AMOUNT CERTIFIED

CURRENT PAYMENT DUE ................ ,.... .. .......	.,.1	$_37_.,._758_.4_7i

Co;e		37	7S8. ¥7

. .

T CERTIFIED	I

BALANCE TO FINISH.,INGLLJDI G RETAINAGE

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCT	IIONS	
Total changes approve in previous rnonU,s by Owner
Total approved thiis Month	
..,........,.,	,_,.,,...	- - -•- -------------	
TOTALS			
i:iolET CHANGES by Change Order			

(Line 3 less Line 6) .......................	9_3 ,3_5_7_.9_3
-

(attach explanation If amount certified differa from the amount applied for. Initial all figures on thi,s..Appfica •	aml n	onlinuation Sheet !hat ai:ephanged to
conform to the amo  t	/(', ...,f t!f - f/,v""M..
fol!....	f?oie.e,-r		...tt.r
By:	Date:	7-12- W�,L

Th'is Certificate is not negotiable. The AMOUNT CERTIFIED Is payable only lo the Contractor named herein. Issuance, -payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor unde{ this Contract

CONJlNUAli ON SHEET

.AJAdocument g703

INVOICE No.	210576-B

Contractors signed A.IA Document G702, ·application & certifrc,ate for payment,
I• olliloh>ed.

APPUCATION NU.IIBER
APPllCATION DA1E:
PERIOD TO:

8
30-Jun-22
30-Jun-22

A	8	C

D	'I	E

F	I	G	H	K

1---WO · R K COMPI..EfE"'r'-a..aa=;D	-+-------11	TOTAL

ITEM ' Cosl Code NO.

DESCRIPTION OF WORI<.	SCHEDULED
VALUE.

CONIB
Q1Y

UNIT PRICE

QJY TOT& TO DATE

FROM PREVIOUS APPUCAlJON (D+E)

llilS APPLICATION

IIIAl1ERIALS I COMPtlETED
PRESENTLY I.AND STORED TO
STORED	i'	DATE
(NOT INOOR ;EJ I	(D•E•F)

E!AI.NIICETO
FINISH
<C-Gl

RET

I

%

RETA1NAGE
(G"JJ

l	300110
2	31245
3	30030
4	3733()

Mobilz.lllcn (\IUltlyJ	S
CcnsttucliOn St.SVa,y1u  ,	s
Nl?OES e	andmcr,nomg as	s
Dense,, iesi.ig	s
- ·---	Sllinoui:I$

40,00000'I

I

11,470.73 I
2.470.0D
11.37500
115.316.73

1 LS $
1 I.S 5
21 MO $
1 LS S

40..00000
11.470.73
1.235.00
11,m.011

1 LS_S
1 LS S
2t.lO-S
,-LS-$

40,00IJ.OO S
11,470]3  S
z.410,00 I$
n.37s.oo $

15	$	40.000.00
- S	-  $	11,470,73
- S	- S	2,47000
- 5	- $	11,375.00

100',, 5'
I $
1001' $,
lOO'!I S

4,llUOD
1,1.47.07
24700
1,137 50

6	.30020
6	30020

7	310201

Anal Grad'.e ROW Soulh Side of Cmtrnw'11y 81\,d. F
B21lla Sod ROW SoutllSid or Can11l111111i,Bhld. o( i
SUBTOTAL! S
rLs S""'1a!101Un  n.	_l
d	SUBTOTAL,,:S_ 

S,11112.00
5,292.00
10,374.00
6,.292.00
.29 ,

1400 SY  S
1400° SY $

1 EA $

6.292.00

.:ooiSY 5 1,oojSY' $

1IEA S

.S,O!l200 $
smoo  S,
3,14!)'.(JO S

- 5
- s
3.1 6.00 $

5,,08200
S,292.CIO

- $	6,292.00

100% S
100% S,

10'!'.fS

50020
521120

621920

ij	1010
9	31010
fO	31010

ll"S9'M!l'Pipej12"-1 ' cut/
Macv,:iii,(12'-14"cut)

s	!;0,,;0685
s	65.951,36
4,641.00

25'5 LF  S	197.67
4 EA  ,4B.7.84
1 lS $	4,641.00

-	ILF 5
4 EA S
o LS S

50. 05.85- $
65,951.36 $
1,16025 S
I

-  $
-5
- s

60,405.85
65,95136
1 \60.25

100% $
1001, S
2.5-% $

10% S
10%\_i
10'-'" $

5,04(159
6,6!l514
11SOO

U	31D101

6'"PVC Pipe

-------'SUBTOT L .s_ 120,1915.71
$,	s,n-1-00

275 LF  $

35.36

2751.JF  $

9,72400 ,.	5
I

$	9,72400

IOO'll, S

10':', $

972.40

3lDI0
11no
J,1010
31010
:lU)!O
:11010

6'" HOPE fruc" Marn- Direcliooal Bora Under Oorm, $ Connect lo Eldslilg"itll 16"x •eut MJTee•	 $ 16" GaleValv;,and,Bo•Cull oE><lslir.g forc-eMl>:1I S 6" Gate Valve.and	$
6'"  8-1	$
FtJft:IJ Main Tesmg	_	.$
SllBtoTAL $

14,344.50

11,37793I
14,,632.87
5,537.10
4.527.90
2.68125
'	-

95163,
11,377.00,
14,63'.2.!17
1,845.70
905 5!!
2,661.25

150, •F $
19.	$
1IEA ,s
3,EA I$
51EA I

:::·  :

olLS: s

14,3'14.6D 5-	-  $
11,3TI.93 S	- s
14.632.87	s
5.53710  S	- s
4.527.90 $	5
9ila44  $	s

$
l
Ii
s
t
$

14,344.iiO
11,377.93
14,632,87
6,5:3710
4;527.90
938_44

100% S
OO'ri, S, 100% s
100%1$
100% S
35 , $

1,743

Ul'l'o S
M• S
10 . S
10-.. S Ul'4 S 10'1b S

1.43445
1,13779
.463..29
55371
4S2.79
93,84

1,B  J162'0

LillStation (Enlfnl Pad<a!l")	S

414.057;!8

I EA $  41-4,05718 _

11EA s

20,702.86  S

$	409,915.61

99%S

4,141

IO'lli :S

40,991.66

19	31620
20	31620
21	31620
22	31620
2;i	31620
24	31620

4"Fib•r0ptic(Condllil)	S
<f',FiberCJptie(Co ) - Diroctk>nal Bore Undel'Ccr s FOCablo {Bu<i9etPIJCingQl1y,flbar(lp11c0esii;111!1S l'ULL8o1C85	$
Splice Boxes	$
9onnect to El<i•ti'l!I FibarOptic	.s

20,347.20
10,570.50
14,305.50
S,423.60_ 1,6815.90
2,205.90

™ I.F  $
150, ILF  $
935 ILF  $
4 EA,$
1 EA S
1 EA  5

2!i..92
7047
15.30
1,69590
,.60590
2,205.90

711511.F S
1!i0-# -
9:15'LF  S,

l

4 EA S
1 EA S
1 EA S

1□:570.50 S
14,:305.50 S
5,423.60  $
1.605-90 S
2,205.S0 :f

s
. s
$
- 5,
$

$	20,347.20
-  $	10,570.50
- s	14,30550
- $	6.423.60
$	1,BO!i,90
-  i	2,205.9:l

100!i $
i	s
10Cm
100'fo S
100% S
100¾ S

1()1!1, s
10%,_I
10% :s
10¥. 1>
'°" $
10% S

a:14,72
1,05705
1,4J0..55
64236
160 59
220.59

SIIIBTOTAl.t $	46t,51

0,
CJ)

A	I	B	C						'	O	E	F	0	il	I	J	K	

ITEM
NO	I

Co Code	

OESCRIPTIOl'l OF WORK	

SCHEDULEO VA!.. E	

CONTR
QlY		

UNrrPRICE	
OlY
TOTAL
lOOAlE		!NORK COMl'I..ETED		TOTAL COnlPLETED
A DSTOREDID OATE (0+8F)	,.
OOMP
(GJC)	
BALANCE TO
RN-5:H
(C-G)	

RET.
%	

RETAINAGE
(G'J}	
									FROM PREVjO\JS APPLICATION (O+E)	,HIS
Affl.lCATIO«	MATERIALS
PRESENTLY STORED
(NOTfN ,0 OR E)						
215		a	s	-	0 $.	S	,	0  OJS	- s	- $	·•	-	IIOIVIOI	$	iOo/o s
-	0  0 $_	- $	- s	$	-	#O!VIOI	:t	-	ID"I. S	-
-	- ·s	- s	s	-	
26		0	$	-	0_$. -		
27				
		0	s	0 ,J - $	·O ors	$	#{)!VIOi	1004 S
0	-	s	.	0 5 - $	0  0 $	- s	- $	-. s	#DIV/0!	-	1W. $	-
SllBTOl.Ai..;I 5	735,l'll,Zl	$	lOZ,108.26 $	t3,84a.a6  $	s	7U,9S7,14	99'/, $	9,3&4	wt.;s	72,595.71
CHANGES	,	•
CMnec.tlDExk,"'IJng \Otlh 1a· cu1-ln MJ Tee	,S	(11,:!17,931	&. s {11,377 9JJ	1 EA $	(11,377 93) $,	- s	11un rot	100¼ l,	-	10,-, S	(1,137.79)
·15• Gals Valve alld Box Cul tn10Emting Force Masi :S	(14,632.&ij'	 1 EA $ (14,632 87)	1 EA s		I14.6"3:!.871 $		 - s	(14:632..Sn	 10091. S	 -	10% l	(1,463:2'3) 16" Valve nse'1iorl	-  $		47.017.00	1 EA ,$	47..04700	 1 EA s	7.047.00  $	- s	. s		47,o,17'00	1 $	-	 to,t; s		4,704.70
16">18" f aw,ng Slee, ValveWI 8")(6" Re<lxer	s	14,56962	1 EA  s	14.509 5I2'	1 EA s	14,569.62 $	-	- s	14.569.62	10	s	-	10% S	M5896
/IJW stanaUtJ,0(2J	s	24,Wl\OO	1. LS $ 2 .14-0	1 LS $	- $	18,105.00 s	$	IS,70500	715/1&.	ll,005	,1oD'i,to. s	1,610 50
o	s	-	u s.. $	D ·o s	-'t	- 1.!	s	IIDl\/10I	$	-	s	-
SUBTOTAL: $	59,7&s;82	l	35,625'82 ' $	18,10UO  s	- $	5l,730.Al2	SO%$	5,1)3l;	iO'¼ $	S,313.INI	
21!  '			

1	
001-31010		
2	001-31010		
l	C01-3l'010		
4	OOt,31'010		
	001:a.io,a '		
-ij	00·1-31010 '		
		TOTALS	$	79S,087.09						s	mnuo	$	41,§l.86	$	-	$	775,687.96	!Ml"k $	15,399.13	.	lll'% $,	77,968..U.O	

I OISl uOlllp!el80
Cost Code	Scliewled Value	From Previous /This Appllcalfon	ard Stored	%Completed  Balance lo Finish	Relainage
30010	40,000.00	40,000.00	0,00	0.00	40,000.00	100%	0.00 0.10  $ 4,000.00
31.245	11,470.73	11,470..73	0.00	0.00	1'1,470.73	100%	0:00 0.10  $ 1,147.07
30030	2,470.00	2,470.00	0.00	0.00	2,470.00	100%	0.00 0.10  $	247.00
37330	11,375.00	11,375.00	0.00	0.00	11,375.00	100%	0.00 0.10  $ 1,137.50
30020	10,374.00	10,374.00	0.00	0.00	10,374.00	100%	0.00 0.20  $ 1,037.40
31;020	6,292.00	3,146.00	3,146.00	0.00	6,292.00	100%	0% 0.10  $	629.20
31010	183.,823.76	178,600.20	0.00	0.00  178,600.20	97'%	5,223.56 1.00  $17,860.02
31620	469,515.78	444,672.35	20,702.86	0.00  465,375.21	99%	4,140.57 0.70  $46.,537.52
C01-31010	59,765.82	35,625.82	18,105.00	0.00	53,730.82	90%	6,035.00 0.60  $ 5,373.08
779,687.96
Cheok?	Ready to Import

APPLICATION AND CERTIFICATE FOR PAYMENT	AIA DOCUMENT G702	OUR INVOICE No. 210576-9
TO OWNER: Matl:amy Paim Beach, LLC	PROJECT:	APPLICATION NO.:	9	Distribution lo:	
2500 Quantum Lakes Dr #215	The Boardwalk at Tradition LS#1	PERIOD TO:	7/31/2022	□ OW1NE:R	
Boynton Beach, FL 33426		PROJECT NO.;	210576	D ARCHITECT
X CONTRACTOR	
		CONTRACT DATE:	1017/2021	D ENGINEER	
FROM CONTRACTOR:	CENTERLINE, INC.	VIA ARCHITECT:				
2180 SW Poma Drive	Kimfey-Horn				

Palm arty, FL 34990
{561) 689-3917
CONTRACT FOR:	UH ty Sewer

Contract 6861

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as s.howr, be!ow, In connection with th,e Contract Continuation Sheet, AIA Document G703, .is altachad.

ORIGINAL   CONTRACT    SUM   .............................

Nel change by Change Orders ............................ .

CONTRACT SUM TO DATE (Line 1 + 2) .... ,....... ,... ,.. .

TOTAL COMPLETED  &  STORED TO DATE ...... ,.....,.....
(Column G on G703)

735,321.27

59,765.62
$795,087.os, 784-,422.46

The underslgned Contractor certifies 111al !o the best of the Contractor's knowledge, Information and bellef lhe Work co red by ihis Application foF Paymertt has been completed in accordance wilh the Contract Documents, that all amounts have beert paid by the Contractor for Work for !Mlich revious Certificates tor Payment were issued and payments r,eceh1ed from 'the Owne,, and tlhal currenl payment shown herein is now due,

RETAINAGE:
10.0% ofCompleteo Work		78,44225
(Corumns D + E on G 703)

	10.0% of Stored Material .,. (Col'umn f on G703)
Total Retainage (Line 5a + 5b or
Tota1in Column 1 of G703)

. , 	o_.o_o

	78,442.25 

tflCOL:. R, ?1WNE
!al r u!J111: • s,m "' Florida
Corm l ilO GG l207M
l,\y Coir.m. • Pir"" s,;, 17, 2CJ'.l.1
Bllnd d lhruu I, tlalioru,LNot r i\s n,

TOTAL EARNED LESS RETAINAG:E................ .
(Line 4 less Line 5 Total)

T  LESS PREVIOUS CERTIFICATES FOR PAYMfNT.........•....
(Line 6 from prior Certificate)
a CURRENT PAYMENT DlJE ............................. .

9.. BALANCE TO FINISH, INCLUDING RETAINAGE

	705,980.21

701,719.16

$4,261.051

ARCHITECT'S CERTIFICATE FOR PAYMEllli'J;
l'n accordance wiUi the Ccmlrac! Documents, based on on-sile observations and 1he data compris:lng lhis a.pplicallon, the Arctiitect certifies to Ille Owner lhat to the bes! of Architect's knowledge, information and belief the Work has progressed
as indicated, the·1:1u<1lity of tile Work is 1111accordance with the Contract Docurnef1ts, and lhe Contractor is entiUed to payment of tt,e AMOUNT CERTIFIED
[" O MOUNTCERTIFIED ..........- ............. ../  'I, J foJ. OS"
(attach explanation lf amoLJnt certified dlffers from the amount applied for. Initial all

CHANGE	,QRDER SUMMAJRY	ADDHIONS	DEDUCTIONS	
-:r:otal changes approve in previous monlhs by Owner
Tb1al aJJproved this Muntll	
-----------	·--···-·· --- ---··-··	
TOTALS			
IN@T CHANGES by Change Order			

(Line 3 less Line 6}. . . . . . . . . . . . . . . . .		8_9.:..,1_06_._88_

·

figures on this AppJicati	ation Sheet that are changed to conform to !he amo		/<,-,_ l.,y- t/o,,-...._

v,

fi0 I!.	:	l,;-;--tt;. ,	l'...o,,.:_.,.•  _M.,..4. J �..-
By:	Date:	8, 'J -  e,i.CJJ.J..

Thf:s Certificate is rto,t negoliable. The AMOUNT CERT!FIED is payable on1y to the
Contractor named herein. Issuance, paymen! and acceptance of payment are without prejudice lo any rights or the Owner or Contractor under this Contract

CONTINUATION SHEET	AIA DOCUMENT G700	INI/OCCE No.	210576·9

Contractors signed AIA Documen.t G702, ap,plication & certificate rar paym.emt,
fs--C:hed.

APPUCAllON NU BER:
APPI..ICAJKJINDATE:
PE.RIODTO:

9
31-Juf.-22
31.Jul-22

A		I	B	C						D	E	F	G	y	H	I	I   J	K	

ITEM
NO	

Casi Code	

OESCRJ?TKJN OF WOfU(.	

SCrlEDULED
VALUE	

CoOInIIIB		

UNlf PRICE	I	
OTY TOTA\. iO DA.T	

E	WORKCOMPLEll:D		TOTA!.
COMPLETED
AND STORED TO
D/111:	:1
1

Ii	
%
COMP	
BAlANCETO
Fl ISH
(C-G)	
RET
%	

RiETAINAGE
IG"J)	
										FROM PREVIOUS AP?UCATION (O,E)	
THIS
/IPPLICATIOO	•ATERIALS
PRESENllY
STORED							
												(NOTU'l DOR 'El		I	(D+E+F)		(GIC)				
1
2
3
4

5
6

7
.
8
9 
10

11
,12
'13
14
15
16
17

18
19
20
2:1
22
23
24	300;0,		o(UU ty)	s  4'1lJl00.00
comtrutllon s ·\tJ...tyj		$ 11,471173 N DES Ccm:pl1811oCe and moni omg eded s i. 70.00 Doosilr_H••IKl!I	---   --  $   11,376.00
	SUlilOTiM. S	5G t iS:	1
1
2
1	LS
1..5
r
MO
LS ,	$	40.000.00
$	U,470.73
s	1.235Oil
$	11.375.00		1 LS  S	40JXIOOO $	s	-
I LS I$	11.410.73 . S	. ,$	.
2oo·s	2,47000	. $	-
1'LS. $	1i ,375.00 , ,5	. '1	-
-	-	$	11.000.00
.s	11.,Slll.73
$	2<"7000
5	11.:mrno		;CO,.
100%
100%
100,.	$	10"/4 S
S	.	111'1o, J,
$	.	70% l
$	.	10% 1	4.000.00
1,147.07
247.00
1,13750	
	31245													
	30000													
	31330													
	80020		Fra  Grade ROW Soul/lSille  Gommuni!y Blyd, fc S	5.062.00
Bahia S<ld ROW S0IJ1h Si:ie of Commun11)' B!v<L Fol 1	5,292.00
_ -	SUBlOTAL] t  4.00
1"_!, Waler celolJll talionlBUd tEsO	s	6.2ll200
- -		SUBTOT L J  6,292:00.
S"5wte<Pjpo(12C1 'c;ull	-s	50,405.$S
(12'·14' CUtj	s	61l.95L'5
i aline Testing	---	..., $	41641 oo_
SUBTOTAL;$  '120,9911..U
	1
6"PVC Pipe	- $	9,724.00
6' HEIPEFora> Mail'I • ,al Bore Urde< Comm $	M,:i.14.50 I
ODmeci:loEldslin.,i¼ilh 16"xti•Cu1.-il M Tee	$	,,.an.ea
16"Gi11E Valve ancl BaxCIJI li1.1oElorsUng Fores Mala_ S	1◄.!ll2 B7 '
6" Gau, Val"" and Be•	s	5,537.10
6"MJ DIBertd	s	◄•.527,90
for<:,e lul Testing	s	2,681.20
I   -	SUBTOIAt:.I s	•z zus !
,:Ult S!alion(Eil&e Pad<!l,!!O)	3;  4 4,057.16
4" Fiber Opoc (COAdUII!	$	20,347.20
4· -Optic (C	-Direciioru!I Bore Un<ler o« 5	10.570.50
FOCable(Budgetf'lidllgOll,.Fl>eTOpticDesignp, $	14.W5 50
PUl.lfw.<es	$	6.4Zl60
Sj)ke 80,oe5 -	$	U,05,90
CGmecl ID Exls!qi_!lbel·Optic	s	U0!,90
---		SUBTOTAL s ◄6,,u •.1., I	14001SY	300
1400 SY , ,S	3.78,
,,, EA:	15,2!!200 I

255, lF  $	197157
4 EA  $	Hi.487.84
LS  $	4,641.00

276 LF  $	35.SS
100	LF  s	9563
1 EA  s  11.m.oo.
1 -EA  s  14,6:12.117'
3 EA  :;	l,!145.70
S EA  $	.58
1 LS  $	2,681.25

1 EA  $	414.05718
785 LF  $	25.92
150 LF  s	7047
935 LF  -$	15,30
4 EA  s	1,605 90
,1 EA $	1,60590
-E-A- :;	2,205.90	1400 S'f  $	5',082.00 $	. $	11200
1400 SY  $	5,292.00  s	$	-,$	5,292.00
l EA s	6.29200  $	- $	-  $	·6,292.00
255 l.f - s	50,405.85 .s	-	. s	50,405.85
·EA  Ii	G5,95l,'6  ,s	-	. 5	65 1.36
1 LS  $	1,16026  s	Z.320 50 s	- s	3.46075
I
215 LF  s	9,724:00  s	s	- s	9,72400
150 LIF	14.344,50 ' $,	- $	s	14,34450
1•EA $	'1377931S	- $	- s	11.377.95
1jEA $	14:632:87 I:.	- $	- s	14.632.87
3E,',  $	.5,5 7.10 -s	. $	. s	5,537,10
6EA s	4,527.!il!l $	5	. s	4,527.90
0 I.S :;	900.4  $	:.	. s	93!1-44

1 EA $,	409,915.61  s	- s	.s	4W,916.61
7ll5 l..F $	·20.34720  s	s	- s	20,3◄7.20
15111..F s	10.570,50 $	$	. s	Hl,57050
9351..F $	14,305 50  s	-s	. s	14,305 50
4 EA- $	5,423,6'-J s	$	- $	6,423.60
1JEA  $	,605.91J s	• 1s	$	1,60!5.90
11EA $	2,205	$	- s	-	2,205.90	

I	100'1, $	JO';  $	5G8'2(J
100'1, $	-	10S". :S,	52920
,oor, s	-	10'!!, s	62920
1	s	-	10'1'-, S	5•.04059
100% s	.	10'!,, S	6.595,14
75% S·	1,160·	100:'-'	!IOB

10071, S	-	10% $	972 0
JOO'i', s	.	10% S	.434,.115
100% s	-	lO'II, S	1,13779
10'1% $	-	10% s	1,46329
100% s	.	10'Yo S	5153.71 '
100'¥, S	10% S	4.5279
35o/o s	1,743	10l. s	11364

99% s	4,141	10'11i s	<0.991.66
100% s	10% s	2,034,72
100'11, s	\CW. S,	1,057.00
100'll, S	0% s	1.=S5
100'llo S	.	10% $	842.36
'IIJIJ%, s	.-	10,\, s	160.59
100% 5	o, s	220.59	
	30020							
	S1020							
	310 a							
	3Uml							
	31010							
	31010							
	31010							
	31010							
	31010							
	31010							
	31010							
	31010							
	
31							
	31620							
	31620							
	31620							
	31620							
	31620							
	31-620							

,

'

CJl
<O

A		B	C						D		E	F	G	H	I	J  I	K	

ITEM
l'IO	

Cosi Cod•	

DESCRIPTION OF WORK	

50-iEDULED VALUE	

CONTR QTY		

UNITPRJCE	
QTY OTA!.
TOOATE		WORK COM?U:TED		TOTI\L COMPLETED AND STORED TO DATE
(0<-8-F)	
I', COMP (GK:)	
BALANCE TO
FINISH
('C-G>	I

R  II	

RETAINl>.GE
(G"Jl	
											
llilS
,APPUQ\TIOO	MATERIAi..$ l'fiESENTILII' S,ORED
(MOTIN DOR El						
									APPUCA.TI!O
(D+E)								
2.6		0
O· 0
0
SUBTOTA.L:
CHANGES
Conned. lo Exi	16":<6" OuHn MJ Tee
16" Gate Valve and Boi<Cut Into E:d$tir,g FC>r<"·Main 16" Valve lnsertioo
16"xB,"TappingSleev Va!vew//S':,;/5" Reoicer
ARV 11\sr.ala.!Jon (2)	s	-
s	-
s	-
$	-
5	l"l5;,n1.Z7
s	(11,377. )
S	fl4,&lZAl7l
s	47,047.00
s	14.569.62
s	:2◄.l◄O.OO	
I	0 $ -
0 $ -
0 S -
0 $J -

11EA
1 EA
'IEA
11 LESAt	s	0
s	:1	oj 0
$	.	o, 0
i	.	0	0
I

$  (11.377!13)	1 EA
$  (14,632117}	1 EA
47.047.00	1 EA
$	14,589.62	I EA
$S, 24.'14000	1 tS	$	- s	-
$	s	-
S	$	-
5	- s
$	72$,917,14 $	Z,320,i(I
s	(11,377.93) S
s	(1◄,E::12.87) $"
s	7.04700  s
s	14.1589.62 s
s	ia,ltlli.00  $	2.4t4.00	$	.

1
$	-
l	-
s
s	-
!,
s
s	$	-
s	-
s
s	-
$	7211,ID.64

$	(11, .93!
s	(U. 871
s	7.047,00
s	, , 62
s	20.519.00	#DIV/0!	s
#OIVID!	s
I
1/VIV.ltll	s
#DNllll	s	-
99% S	7;044
10CW. $	.
1001% S	-
100% $	..
·100% S	-
65¾S	3,621	o,; s
10% S
10%
1()'fo �
10% s

10% 5
1()'11, S
10'11, S
!!!'lo, 5	

-
12.&21.n

(1,13779) (1A6329) 4,704 70
M5Bl!6
2.()5,1,SO	
w													
27													
2B													

\	COI-S1DID												
?	001-31010												
3	CO1-3T0 0												
4	COl•31Df0												
s	001-31010												
6	C0!-31010	11				0	$ -	$	D  0	$	S,		IIDfVIOI	10%		
		SUBTOTAL:	$	513,7 .82				s	.7311...132.	$	2,414.00		.$	,	$	511,144,62	'4¼	$	3/6'21	10'4 $,	5	,,614..48	
		TO'JA!.S	$	79.S,0117.118			I			s	779,687..96	I	4,734,50	s·	$	71M,,422.46		911'1'.	$	1,0,66	1o,;I i	78,442:.25	

1

I <Mal l...ompleteC
Cost Code	Sched!Aed Value	From Prevlous /This Application	and Stared	% Completed  Balance to Fnsh	Relatnage
30010	40,000.00	40,000.00	0.00	:0:00	40,000.00	100%	0.00 0.10  $ 4,000.00
31245	11,470•.73	11,470.73	0.00	0.00	111,470.73	100%	0.00 0.10  $ 1,147.07
30030	2,470.00	2,470...00	0.00	0.00	2,470.00	100%	0.00 0.10  $	247_00
37330	11,375.00	11,375.00	0.00	0.00	11,375.00	100%	0.00 0.10  $ 1,137.50
30020	10,374.00	10,374.00	0.00	0.00	10,374.00	100%	0.00 0.20  $ 1,037.40
31020	6,292..00	6,292.00	0.00	0.00	6,292.00	100%	·0% 0.10  $	629.20
31010	183,823.76	178,600.20	2,320.50	0.00  180,920.70	98%	2,903:06 1.00  $18,092.07
31620	469,515.78	465,375.21	0.00	0.00  465,375.21	99%	4,140.57 0.70  $46,537.52
C01-3Hl10	59,765.82	53,730.82	2,414..00•	0.00	56,144.82	94%	3,621.00 0.60  $ 5,614.48

784,422.46
Check?	Ready to Import

0)
0

6861

APPLICATION AND CERTIFICATE FOR PAYMENT	AIA DOCUMENT G702	OUR INVOICE No. 210576-11

TO OWNER: Mattamy Palm Beach, LLC 2500 Quantum Lakes Dr #215 Boynton Beach, FL 33426

FROM CONTRACTOR:	CENTERLINE,  INC.

PROJECT:
The Boardwalk at Tradition LS#1

VIA ARCHITECT:

APPLICATION NO.: PERIOD TO: PROJECT NO.:

CONTRACT DATE:

11	Distribution to: 11/30/2022 D OWNER
210576	D ARCHITECT
X CONTRACTOR 10/7/2021 D ENGINEER

2180 SW Poma Drive Palm City, FL 34990
(561) 689-3917
CONTRACT FOR:	Utility Sewer
CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract Continuation Sheet, AIA Document G703, is attached.

ORIGINAL CONTRACT SUM ...................... ,..... .

Net change by Change Orders ........................... .

Kimley-Horn

Inv 210576-11
#6861
Tod

735,321.27

59,765.82

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

Date: 11/EJl/2.L 

County of:	Ma r-h ()

CONTRACT SUM TO DATE (Line 1 + 2) ................... .		$795,087.09

TOTAL COMPLETED & STORED TO DATE ................. .
(Column G on G703)

RETAINAGE:
10.0% of Completed Work		7_9,_5_08_._7_1

795,087.09

Dec	zoz.--z_

Subscribed and sworn to before me this	J 6-l 	day of

(Columns D + E on G 703)
	10.0% of Stored Material ..... (Column Fon G703)
Total Retainage (Line 5a + 5b or
Total in Column 1 of G703)

	0.00 

79,508.71

6. TOTAL EARNED LESS RETAINAGE ............... ,...... .	715,578.38	ARCHITECT'S CERTIFICATE FOR PAYMEN	
(Line 4 less Line 5 Total)		In accordance with the Contract Documents, based on on-site observations and	
		the data comprising this application, the Architect certifies to the Owner that to the	
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT............ .	710,227.61	best of Architect's knowledge, information and belief the Work has progressed	
(Line 6 from prior Certificate)		as indicated, the quality of the Work is in accordance with the Contract	
		Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED	
8. CURRENT PAYMENT DUE ............................. .			

9. BALANCE TO FINISH, INCLUDING RETAINAGE		AMOUNT CERTIFIED ....................... .
(attach explanation if amount certified differs from t-he-am-o-un_t_a_p....,pl,...ie-d-::fo-.r-....,.ln....,i...,.tia. ,.1--,all	
(Line 3 less Line 6) .......................	7_9_,5_0_8._7_1		figures on this Application and on the Continuation Sheet that are changed to	
		conform to the amount certified.)	

CHANGE	ORDER	SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approve in previous months by Owner
l,otal approved this Month	
------------	
---------------------	
.I>,	TOTALS			
NET CHANGES by.Change Order			

ARCHITECT:		
-	By:	Date:		

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

65

A		B	C						D	E	F	G	H	I	J	K	

ITEM NO	

Cost Code	

DESCRIPTION OF WORK	

SCHEDULED VALUE	

CONTR QTY		

UNIT PRICE	
QTY TOTAL TO DATE		WORK COMPLETED		TOTAL COMPLETED ANO STORED TO DATE
(D+E+F)	
% COMP (GIC)	
BALANCE TO FINISH
(C-G)	

RET
%	

RETAINAGE (G'J)	
									FROM PREVIOUS APPLICATION (D+E)	
THIS APPLICATION	MATERIALS PRESENTLY STORED
(NOT IN DOR El						
25		0
a
0
a
SUBTOTAL:
CHANGES
Conneot to Existing with 16"x6" Cut-in MJ Tee
16" Gate Valve and Box Cut Into Existing Force Main 16" Valve Insertion
16"x8" Tapping Sleev Valve wl 8"x6" Reducer
ARV Installation (2)	$	-	o
$	-	o
$	.	0
$	o
$	735,321.27
s	(11,377 93)	1
$	(14,632.87)	,1
s	47,047 00
s	14,589.62	,1
$	24.140 00	$ -
s -
$ •
$ -

EA EA EA EA
LS	$	-
$	.
$	-
$	.

s  (11,377 93)
s  (14,632 87)
s	47,047 00
s	14,589 62
s	24,140 00	o s	.
0 $	.
0  0 S	-
0 S	.
$	729,375.97
1 EA  s	(11,377 93)
1:EA  s	(14,632 87)
liEA  s	47,047 00
1!EA  s	14,589.62
1 LS  s	24,14000	$	$	s
s	-  $	. s
$	- $	s
s	$	- s
s	5,945.30  $	s
S	-  $	-  s
S	-  s	s
s	s	s
s	-  s	s
s	s	- s	
.
.

735,321.27

(11,377 93)
(14,632 87)
47,047 00
14,58962
24.140 00	#DIV/0!	$	.	10%
#DIV/0!	$	-	10%
#DIV/QI	$	-	10%
#DIV/0!	$	.	10%
100% $	(0)	10%

100% $	10%
100% $	10%
100% $	10%
100% $	-	10%
100% $	.	10%	$
$
$
$
$	73,532.13

$	(1,137 79)
$	(1,463 29)
$	4,704 70
$	1,458 96
s	2,414 00	
26											
27											
28											

1	
CO1-31010										
2	CO1-31010										
3	CO1-31010										
4	CO1-31010										
5	CO1-31010										
6	CO1-31010	Cl	-	0	S •		0,	0		$	-	#DIV/0!	$	10%	$	
		SUBTOTAL:	$	59,765.82			$	59,765.82	$	- s	$	59,765.62	100'/,, $	10%	$	5,976.58	
		TOTALS	$	795,067.09						$	769,141.79	$	5,945.30	$	$	795,087.09	100'/q	$	(0.00)	10%	$	79,508,71	

1 ma, l,Omp1eIea
Cost Code	Scheduled Value	From Previous I This Application	andStored	% Completed  Balance to Finish	Retainage
30010	40,000.00	40,000.00	0.00		0.00	40,000.00	100%	0.00	0.10	$ 4,000.00	
31245	11,470.73	11,470.73	0.00		0.00	11,470.73	100%	0.00	0.10	$ 1,147.07	
30030	2,470.00	2,470.00	0.00		0.00	2,470.00	100%	0.00	0.10	$	247.00	
37330	11,375.00	11,375.00	0.00		0.00	11,375.00	100%	0.00	0.10	$ 1,137.50	
30020	10,374.00	10,374.00	0.00		0.00	10,374.00	100%	0.00	0.20	$ 1,037.40	
31020	6,292.00	6,292.00	0.00		0.00	6,292.00	100%	0%	0.10	$	629.20	
31010	183,823.76	182,019.04	1,804.73		0.00	183,823.76	100%	0.00	1.00	$18,382.38	
31620	469,515.78	465,375.21	4,140.57		0.00	469,515.78	100%	0.00	0.70	$46,951.58	
CO1-31010	59,765.82	59,765.82	0.00		0.00	59,765.82	100%	0.00	0.60	$ 5,976.58	
				
Check?		795,087.09
Ready to Import					

0)
0)

APPLICATION AND CERTIFICATE FOR PAYMENT	AIA DOCUMENT G702	OUR INVOICE No. 210576-12

TO OWNER: Mattamy Palm Beach, LLC 2500 Quantum Lakes Dr #215 Boynton Beach, FL 33426

PROJECT:
The Boardwalk at Tradition L5#1
RETENTION RELEASE

APPLICATION NO.: PERIOD TO: PROJECT NO.:

CONTRACT DATE:

12 Retainage Distribution to: 12/1/2022 D OWNER
210576	D ARCHITECT
X CONTRACTOR
10/7/2021 D ENGINEER

FROM CONTRACTOR:	CENTERLINE, INC.

VIA ARCHITECT:

Inv #210576-12/ Contract #6861

2180 SW Poma Drive	Kimley-Horn Palm City, FL 34990
(561) 689-3917
CONTRACT FOR:	Utility Sewer

Tod

CONTRACTOR'S APPLICATION FOR PAYMENT		The undersigned Contractor certifies that to the best of the Contractor's	
Application is made for payment, as shown below, in connection with the		knowledge, information and belief the Work covered by this Application for	
Contract Continuation Sheet, AIA Document G703, is attached.		Payment has been completed in accordance with the Contract Documents,	
		that all amounts have been paid by the Contractor for Work for which	
1. ORIGINAL CONTRACT SUM ............................ .	735,321.27	previous Certificates for Payment were issued and payments received from
the Owner, and that current payment shown herein is now due.	
2. Net change by Change Orders ........................... .	59,765.82		

CONTRACT SUM TO DATE (Line 1 + 2) ................... .

TOTAL COMPLETED & STORED TO DATE ................. .
(Column G on G703)

RETAINAGE:
0.0% of Completed Work		0.00
(Columns D + E on G 703)

$795,087.09	 795,087.09

	0.0% of Stored Material ..... (Column F on G703)
Total Retainage (Line 5a + 5b or
Total in Column 1 of G703)

0.00

;, Date: Jz/o 1/z	� 

County of:	t-J\C\(:b()

ate o.	orida

Subscribed and sworn to before me this	J..S-t	day of

0.00

6. TOTAL EARNED LESS RETAINAGE ...................... .	795,087.09	ARCHITECT'S CERTIFICATE FOR PAYMENT	
(Line 4 less Line 5 Total)		In accordance with the Contract Documents, based on on-site observations and	
		the data comprising this application, the Architect certifies to the Owner that to the	
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT............ .
(Line 6 from prior Certificate)	715,578.38	best of Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract	
		Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED	

CURRENT PAYMENT DUE ............................. .

BALANCE TO FINISH, INCLUDING RETAINAGE

CHANGE	ORDER	SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approve in previous months by Owner
llotal approved this Month	-. -..-..--.........	
---------------····-	
--.J	TOTALS			
NET CHANGES by Change Order			

(Line 3 less Line 6)		o_._oo_

-

$79,508.711MS

----------

AMOUNT CERTIFIED ...... ,	,.
(attach explanation if amount certified differs from the amount applied for. Initial all figures on this Application and on the Continuation Sheet that are changed to conform to the amount certified.)

ARCHITECT:		

By:	Date:

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AIA DOCUMENT G703	INVOICE No.  210576-12

Contractors signed AIA Document G702, application & certificate for payment,
is attached.

APPLICATION NUMBER: APPLICATION DATE:
PERIOD TO:

12 Retainage 1-Dec-22
1-Dec-22

A		B	C						D	I	E	F	G	H			K	

DESCRIPTION OF WORK	

SCHEDULED VALUE	

CONTR QTY		

UNIT PRICE	
QTY TOTAL TO DATE		WORK COMPLETED		TOTAL COMPLETED AND STORED TO DATE
(D+E+F)	
% COMP (GIC)	
BALANCE TO FINISH
(C-G)	

RET,
%	

RETAINAGE (G"J)	
									FROM PREVIOUS APPLICATION (D+E)	
THIS APPLICATION	MATERIALS PRESENTLY STORED
(NOT IN DOR E)						
1	3.0010	Mobilization (Utility)	S   40,000.00.
Construction Survey (Utility)	 $ 11,470,73 NPDES Compliance and monitoring as needed	 $	2,470.00 Density Testing	S   11.375.00
_		  SUBTOTAL'$   65,31!73 T
Final Grade ROW Soulh Side of Community Blvd Fe $	5,082,00 Bahia Sod ROW South Side of Comniunfty Blvd, Foll, $	5,292,00
SUBTOTAlj t_ :!7	1
1" LS Water Service to Lift Station {Bud9et Eslj	S   6,292,00
_  _    _	UBTOTAL	e·2112.oo I
8" Sewer Pipe (12'-14' cut)	S   50,405,85
Manhole (12'-14' cut)	S  65,951,36
Sanitary Line Testing	S   4,641,00
SUBTOTALJJ_ 120,998.21 :
	
6" PVC Pipe	S   9,724,00
6" HOPE Force Main - Directional Bore Under Comm $ 14,344.50 Connect to Existing with 16"x6" Cut-in MJ Tee	$ 11,377,93 16" Gate Valve and Box Cut Into Existing Force Main $	14,632.87 6" Gate Valve and Box			5,537,10
6" MJ DI Bend	4,527,90
Force Main Testing	2,681,25
I
SJJBTO L : $	62,825.55
Lift Station (Entire Package)	$  414,057,18
4" Fiber Optic {Conduit)	 $  20,347.20 4" Fiber Optic (Conduit) - Directional Bore Under Cor $  10,570.50 FO Cable (Budget Pricing Only Fiber Optic Design n, S 14,305,50 PULL Boxes	S   6,423,60
Splice Boxes	S   1,605.90
Connect to Existing Fiber Optic	S   2,205.90
	 s_u_er_o_r_A_L_._l-'s_4se,s1_s.1e i	1
1
2
1

1400
1400

1

255
4
1

275
150
1
1
3
5
1

1
785
150
935
4
1
1	LS LS MO LS

SY SY

EA

LF EA
LS

LF LF EA EA EA EA LS

EA LF LF LF EA EA EA	S	40,000,00
$	11,470 73
$	1,235 00
$	11,375 00

$	3_53
$	3.78

$	6,292-00

$	197 67
$	16,487 84
$	4,641 00

$	35 36
$	9563
$	11,377 93
$	14,632-87
$	1,845 70
$	905 58
$	2,68125

$  414,057 18
$	25 92
$	70.47
$	15 30
$	1,605 90
$	1,605.90
$	2,205 90	1 ,LS
l0LS
2'MO
1 LS

1400 SY
1400 SY

1 EA

255 LF
4 EA
1 LS

275 LF
150 LF
1 EA
1 EA
3 EA
5 EA
1 LS

1 EA
785 LF
150 LF
935 LF
4 EA
1 EA
1 EA	S	40,000.00
S	11,470 73
S	2,470 00
S	11,375,00

$	5,082 00
$	5,292_00

S	6,292 00

S	50,405,85
S-	65,951 36
$	4,641 00

$	9,724,00
$	14,344,50
$	11,377,93
$	14,632,87
$	5,537.10
$	4,527,90
$	2,681,25

$	414,057,18
$	20,347,20
$	10.570,50
$	14,305,50
$	6,423,60
$	1,605.90
$	2,205.90	S	s	- s	40:000,00
$	s	- $	11.470-73
$	s	-  $	2,470.00
$	s	$	11,37500

$	5,082 00
$	5,292 00

$	6,292 00

$	-  $	S,	50,405 85
$	$	s	65,951 36
$	-  $	s	4,641-00

$	$	s	9,724.00
$	$	- s	14,344 50
$	s	- s	11,377.93
$	s	- s	14,632 87
$	- s	- s	5,537 10
$	s	s	4,527.90
$	s	s	2,681.25

S	s	s	414,05718
S	s	s	20,347 20
S	s	s	10,570 50
S	s	$	14,305.50
S	s	$	6,423 60
S	- s	s	1,605.90
$	s	s	2,205 90	100%
100%
100%
100%

100%
100%

100%

100%
100%
100%

100%
100%
100%
100%
100%
100%
100%

100%
100%
100%
100%
100%
100%
100%	S	0% S
S	0% S
S	0% S
S	0% S

$	0% S
$	0% S

$	0% $

$	0% $
$	0% $
$	0% $

$	0% $
$	0% $
$	0% $
$	0% $
$	0% $
$	0% $
$	0% $

$	0'% $
$	0% $
$	0% $
$	0% $
$	0% $
$	0% $
$	0% $	
2	31245										
3	30030										
4	37330										
5	30020										
6	30020										
7	31020										
8	31010										
9	31010										
10	31010										
11	31010										
12	31010										
13	31010										
14	31010										
15	31010										
16	31010										
17	31010										

18	
31620										
19	31620										
20	31620										
21	31620										
22	31620										
23	31620										
24	31620										

CJ)
co

A		B	C						D		E	F	G	H	I	J	K	

ITEM NO	

Cost Code	

DESCRIPTION OF WORK	

SCHEDULED VALUE	

CONTR QTY		

UNIT PRICE	
QTY TOTAL TO DATE		WORK COMPLETED		TOTAL COMPLETED AND STORED TO DATE
(D+E+F)	

% COMP (GIG)	

BALANCE TO FINISH
(C-G)	

RET,
%	

RETAINAGE (G'J)	
									FROM PREVIOUS APPLICATION (D+E)	
THIS APPLICATION	MATERIALS PRESENTLY STORED
(NOT IN DOR E)						
25		0	s	0
0	s	.	0
s	.	0
s	o
SUBTOTAL: $	735,321.27
Connect to Existing with 16"x6" Cut-in MJ Tee	'$	(11,377,93)	,,
CHANGES
16" Gale Valve and Box Cut Into Existing Force Main $	(14,632.87)	,
16" Valve Insertion	$	47,047,00
16"x8"' Tapping Sleev Valve w/ 8"x6" Reducer	$	14,589,62	1
ARV Installation (2)	$	24,140.00	1	$ •	$	o  o $	s	., $	s	.
$	0  0 $	s	. $	s
s	.	0  o;$	s	.  $	s
s	0  0 $	s	$	. s
$	735,321.27  s	$	$	735,321.27
s  (11,377 93),	1 :EA  $	(11,377,93) S	. s	$	(11,377 93)
s  (14,632 87)	1IEA  $	(14,632.87) s	s	. $	(14,632.87)
s	47.04700	1[EA  s	47.047,00  s	$	. s	47.047.00
s	14.589 62	1 EA  $	14,589,62  s	$	$	14,589 62
24.14000	1 LS  $	24,140,00 s	s	$	24,140.00	#DIV/0I	s	.	0%
#DIV/0!	0%
#DIV/0!	s	0'%
#DIV/0!	s	.	0%
100% $	0%

100% S	.	0%
100% S	.	0%
100% s	.	0%
100%' s	0%
100% S	oa10	$	-
$
$
$	.
$
$	.
$	.
$	.
$
$	.	
26			$ •				
27			$ •				
28			$ •				

1	
CO1-31010		
EA				
2	CO1-31010		EA				
3	COl-31010		EA				
4	COl-31010		EA				
5	COl-31010		LS				
6	CO1-31010	o	$	o	$ •	s	0	0	S	s	s		$	.	#DIV/0!		s	0%	$	
		SUBTOTAL:  $	59,765.82 ,					$	59,765.82	$	$	.	$	59,765.82		100%	$	0%	$	.	
		TOTALS	$	795,087.09						$	795,087.09	$	-	$	$	795,087.09	100%	$	0%	$	

1 01aI 1..,ompIe1ea
Cost Code	Scheduled Value	From Previous I This Application	and Stored	% Completed  Balance to Finish	Retalnage
30010	40,000.00	40,000.00	0.00	0.00	40,000.00	100%	0.00	0.00	$	
31245	11,470.73	11,470.73	0.00	0.00	11,470.73	100%	0.00	0.00	$	
30030	2,470.00	2,470.00	0.00	0.00	2,470.00	100%	0.00	0.00	$	
37330	11,375.00	11,375.00	0.00	0.00	11,375.00	100%	0.00	0.00	$	
30020	10,374.00	10,374.00	0.00	0.00	10,374.00	100%	0.00	0.00	$	
31020	6,292.00	6,292.00	0.00	0.00	6,292.00	100%	0%	0.00	$	
31010	183,823.76	183,823.76	0.00	0.00	183,823.76	100%	0.00	0.00	$	
31620	469,515.78	469,515.78	0.00	0.00	469,515.78	100%	0.00	0.00	$	
CO1-31010	59,765.82	59,765.82	0.00	0.00	59,765.82	100%	0.00	0.00	$	

795,087.09
Check?	Error

rC.!ol

REQUISITION NO._14	

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO. 5 SPECIAL ASSESSMENT BONDS, SERIES 2020
(COMMUNITY INFRASTRUCTURE)
The undersigned, a Responsible Officer of Southern Grove Community Development District No. 5 (the “Issuer”) hereby submits the following requisition for disbursement from the 2020-1 Acquisition and Construction Subaccount or 2020-2 Acquisition and Construction Subaccount (as indicated below) of the 2020 Acquisition and Construction Account created under and pursuant to the terms of the Master Trust Indenture from the Issuer to U.S. Bank National Association, as trustee (the “Trustee”), dated December 17, 2014, as supplemented by that certain Sixth Supplemental Indenture, dated as of June 1, 2020 (collectively, the “Indenture”), (all capitalized terms used herein shall have the meaning ascribed to such terms in this Indenture);
Requisition Number: 14
Name of Payee: Mattamy Palm Beach LLC
Amount Payable: $207,378.72	[this requisition is 1 of 2 which
total $2,300,421.21]
The undersigned hereby certifies that:

This requisition is for a Cost of the 2020 CI Project payable from the (check applicable item):

	 2020-1 Acquisition and Construction Subaccount that has not previously been paid

  X  2020-2 Acquisition and Construction Subaccount that has not previously been paid and all amounts on deposit in the 2020-1 Acquisition and Construction Subaccount have been requisitioned

AND

Each disbursement set forth above is a proper charge against the 2020-1 Acquisition and Construction Subaccount or 2020-2 Acquisition and Construction Subaccount noted above.

[Include if applicable:]

Each disbursement set forth above is made as payment of a portion of the purchase price payable for the 2020 CI Project pursuant to a written acquisition agreement between the District and the other party named therein and the undersigned represents that such agreement has not been modified or amended and is in full force and effect on the date hereof.

1

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO. 5

By:
Responsible Officer

/-	/-+

Date:	/!,ff( '-	I r &/ zL,./

The undersigned, an authorized representative of the Consulting Engineers to the Issuer, hereby certifies that this disbursement is for a Cost of the 2020 CI Project and is consistent with:
(i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the 2020 CI Project with respect to which such disbursement is being made; and (iii) the Engineer's Report as supplemented and amended through the date hereof.

The undersigned further certifies that (a) the improvements to be acquired with this disbursement will be (1) owned by the Issuer or another governmental entity and located on public property or within public rights of way or easements and (2) accessible by the general public and/or part of a public water management system; (b) the purchase price to be paid by the Issuer for the improvements to be acquired with this disbursement is no more than the lesser of (i) the fair market value of such improvements and (ii) the actual cost of construction of such improvements; (c) the plans and specifications for the improvements have been approved by all regulatory bodies required to approve them or such approval can reasonably be expected to be obtained; (d) all currently required approvals and permits for the acquisition, construction, reconstruction, installation and equipping of the portion of the 2020 CI Project for which disbursement is made have been obtained from all applicable regulatory bodies; and (e) subject to permitted retainage under the applicable contracts, the seller has paid all contractors, subcontractors, and materialmen that have provided services or materials in connection with the portions of the 2020 CI Project for which disbursement is made hereby, if acquisition is being made pursuant to an acquisition agreement.

[CONSULTING ENGINEERS]
By:	Ll/ 
Name: ....;;J;..;;...=u_;_..;;cB""'u=tc=h;_"....;..T-=-e"""rp'--Ce=n=in""'g'--  	_
Title: ---'D"-'i-=-st=ri-=-ct'"""'E=n..c.ag=in'-'-e"-'e'--'-r		_ Date:	A pr_il_1_8 , 2_0_2_4	_

2

MATTAMY HOMES' CERTIFICATE OF COSTS
SG Hegener Drive (FKA Paar Drive - 64228384)
FOR GOOD AND VALUABLE CONSIDERATION, the receipt and sufficiency of which are hereby acknowledged, Mattamy Palm Beach LLC ("Mattamy"), to the best of its knowledge, information, and belief, certifies to the Southern Grove Community Development District No. 5 ("District No. 5"), that the costs of the Work Product as defined and described as SG Hegener Drive (FKA Paar Drive), and as more particularly described in the attached Schedule 1 (the "Improvements"), are as follows:

A. Consultants		$80,695.96	See Exhibit A	
B. Permit Fees		$5,686.00	See Exhibit B	
C. Site Work		$2,048,673.70	See Exhibit C	
D. Landscape &	Irrigation	$165,365.55

Total: $2,300,421.21	See Exhibit D	

IN WITNESS WHEREOF, Mattamy has caused this instrument to be executed by its duly authorized agents, and its corporate seal affixed hereto, th igs-ltw-.day of February, 2024.

MATTAMY PALM BEACH LLC, a Delaware
limit n	
By: -	-­
Print Name: Karl Albertson Title: Vice President

Schedule 1
Cost Classification	
Cost Description	
Invoice Date	Contract
#	
Invoice#	
Vendor	
Amount	
A	Consultants	6/30/2022	6679	147641012-0622	Kimley-Horn & Associates	$	1,560.00	
A	Consultants	7/31/2022	6679	147641012-0722	Kimley-Horn & Associates	$	4,025.00	
A	Consultants	8/31/2022	6679	147641012-0822	Kimley-Horn & Associates	$	7,487.63	
A	Consultants	9/30/2022	6679	147641012-0922	Kimley-Horn & Associates	$	3,695.00	
A	Consultants	1/31/2023	6679	147641012-0123	Kimley-Horn & Associates	$	7,390.00	
A	Consultants	2/28/2023	6679	147641012-0223	Kimley-Horn & Associates	$	7,390.00	
A	Consultants	5/31/2023	6679	147641012-0523R	Kimley-Horn & Associates	$	11,085.00	
A	Consultants	6/30/2023	6679	147641012-0623	Kimley-Horn & Associates	$	3,695.00	
A	Consultants	7/31/2023	6679	147641012-0723	Kimley-Horn & Associates	$	3,784.08	
A	Consultants	8/31/2023	6679	147641012-0823	Kimley-Horn & Associates	$	3,695.00	
A	Consultants	10/31/2023	6679	147641012-1023	Kimley-Horn & Associates	$	3,695.00	
A	Consultants	5/2/2023	N/A	445391RA	Caulfield & Wheeler	$	775.00	
A	Consultants	8/25/2023	N/A	4450006	Caulfield & Wheeler	$	1,435.00	
A	Consultants	9/18/2023	N/A	4450545	Caulfield & Wheeler	$	560.00	
A	Consultants	10/25/2023	N/A	4451852	Caulfield & Wheeler	$	1,320.00	
A	Consultants	11/28/2023	N/A	4452691	Caulfield & Wheeler	$	420.00	
A	Consultants	3/20/2023	6813	34416	Lucido & Associates	$	1,375.00	
A	Consultants	7/19/2023	6813	34663	Lucido & Associates	$	2,750.00	
A	Consultants	9/30/2022	7657	7657-1	GFA International, Inc.	$	5,310.00	
A	Consultants	10/31/2022	7657	7657-2	GFA International, Inc.	$	2,790.00	
A	Consultants	11/30/2022	7657	7657-3	GFA International, Inc.	$	1,720.00	
A	Consultants	2/28/2023	7657	7657-4	GFA International, Inc.	$	845.00	
A	Consultants	4/30/2023	7657	7657-5	GFA International, Inc.	$	2,190.50	
A	Consultants	5/31/2023	7657	7657-6	GFA International, Inc.	$	786.25	
A	Consultants	6/30/2023	7657	7657-7	GFA International, Inc.	$	125.00	
A	Consultants	8/30/2023	7657	7657-8	GFA International, Inc.	$	792.50	
B	Permit Fees	4/18/2022	N/A	2687855	HUB International	$	5,686.00	
C	Site Work	8/15/2022	8365	120557	H and J Contracting Inc.	$	77,935.50	
C	Site Work	10/24/2022	8365	120957	H and J Contracting Inc.	$	8,883.00	
C	Site Work	11/21/2022	8365	121021	Hand J Contracting Inc.	$	8,883.00	
C	Site Work	1/16/2023	8365	121111	Hand J Contracting Inc.	$	42,997.50	
C	Site Work	2/13/2023	8365	121160	Hand J Contracting Inc.	$	232,700.40	
C	Site Work	2/28/2023	8365	121211	Hand J Contracting Inc.	$	132,082.20	
C	Site Work	4/13/2023	8365	121273	Hand J Contracting Inc.	$	10,100.70	
C	Site Work	6/30/2023	N/A	220017-2	Hand J Contracting Inc.	$	10,080.00	
C	Site Work	8/22/2023	N/A	220007-3	Hand J Contracting Inc.	$	840.00	
C	Site Work	8/22/2023	N/A	220007-10	Hand J Contracting Inc.	$	780.00	
C	Site Work	10/31/2023	8365	121666	H and J Contracting Inc.	$	107,564.40	
C	Site Work	8/22/2023	N/A	220017-6	H and J Contracting Inc.	$	4,200.00	
C	Site Work	9/7/2022	7757	2022-106	Pipeline Utilities Inc	$	204,327.99	
C	Site Work	10/5/2022	7757	2022-122	Pipeline Utilities Inc	$	149,449.37	
C	Site Work	10/31/2022	7757	2022-138	Pipeline Utilities Inc	$	146,310.66	
C	Site Work	11/30/2022	7757	2022-150	Pipeline Utilities Inc	$	100,471.50	
C	Site Work	3/1/2023	7757	2023-034	Pipeline Utilities Inc	$	142,832.70	
C	Site Work	6/30/2023	7757	2023-068	Pipeline Utilities Inc	$	188,097.97	
C	Site Work	8/31/2023	7757	2023-099	Pipeline Utilities Inc	$	11,029.50	
C	Site Work	8/31/2023	7757	2023-100	Pipeline Utilities Inc	$	104,724.41	
C	Site Work	5/5/2023	8838	8838-1	Richard and Rice Construction	$	19,816.83	
C	Site Work	5/12/2023	8838	8838-2	Richard and Rice Construction	$	31,258.98	
C	Site Work	6/9/2023	8838	8838-3	Richard and Rice Construction	$	9,056.34	
C	Site Work	8/22/2023	8838	8838-4	Richard and Rice Construction	$	69,681.40	
C	Site Work	9/13/2023	8838	8838-5	Richard and Rice Construction	$	44,303.03	
C	Site Work	11/14/2023	8838	8838-6	Richard and Rice Construction	$	97,530.42	
C	Site Work	11/21/2023	8838	8838-7	Richard and Rice Construction	$	30,183.00	
C	Site Work	6/22/2023	8903	22800-19856	Precision Contracting Services	$	9,549.00	
C	Site Work	7/19/2023	8959	8959-1	Cobra Construction	$	47,703.51	

C	Site Work	10/17/2023	8959	8959-2	Cobra Construction	$	5,300.39	

D	Landscape and
Irrigation	
5/30/2023	
8369	
8369-1	
LSP Nursery, Inc	
$	98,567.55	

D	Landscape and
Irrigation	
7/31/2023	
8369	
8369-2	
LSP Nursery, Inc	
$	30,150.00	

D	Landscape and
Irrigation	
7/27/2023	
N/A	
1457	
Southeast Sod LLC	
$	17,415.00	

D	Landscape and
Irrigation	
8/21/2023	
N/A	
1490	
Southeast Sod LLC	
$	14,553.00	

D	Landscape and
Irrigation	
9/8/2023	
N/A	
1521	
Southeast Sod LLC	
$	4,680.00	
		
	Total Due	$ 2,300,421.21	

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0622
ATTN: TONY PALUMBO	Invoice Date:	Jun 30, 2022
2500 QUANTUM LAKES DRIVE	Invoice Amount: $1,560.00
SUITE 215	Contract 6679	Project No:	147641012 BOYNTON BEACH, FL 33426		Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Jun 30, 2022	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	8,840.00	1,560.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	16,625.00	0.00	16,625.00	95.00%	875.00	
TASK 8 BID COORDINATION	3,500.00	350.00	0.00	350.00	10.00%	3,150.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	0.00	0.00	0.00	0.00%	73,900.00	
REIMBURSEMENT BUDGET	8,000.00	140.31	0.00	140.31	1.75%	7,859.69	
Subtotal	181,100.00	93,755.31	1,560.00	95,315.31	52.63%	85,784.69	
Total	1,560.00		

		

Total Invoice: $1,560.00

75

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$1,560.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 6/30/2022 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: F8C6A861-01E0-429B-AC9A-87B87D4034D2
www.docverify.com

Page 1 of 1

187B87D4034D2

F8C6A861-01E0-429B-AC9A-87B87D4034D2 --- 2022/07/20 08:30:18 -8:00

KHA Project #:147641012	Invoice #: 147641012-0622

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		7/20/2022	

KIMLEY-HORN AND ASSOCIATES, INC.

97CE8D65D77E

Heather Stone
Signed on 2022/07/20 08:32:47 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 20th day of July, 2022, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	as identification.

2EC9F7CF5939

Signed on 2022/07/20 08:32:47 -8:00

My commission expires:
5/18/2023
Notary Public

Lisa M. Hill
Commission # GG 310574
Notary Public - State of Florida
My Commission Expires May 18, 2023

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2022/07/20 08:32:47 PST	2EC9F7CF5939

76

DocVerify ID: F8C6A861-01E0-429B-AC9A-87B87D4034D2
www.docverify.com

Generated Cover Page	87B87D4034D2

147641012 ROL 2022-06_.pdf

DocVerify ID:	F8C6A861-01E0-429B-AC9A-87B87D4034D2 Created:	 July 20, 2022 08:30:18 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
July 20, 2022 08:32:47 -8:00 [97CE8D65D77E] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Lisa M Hill (LMH)
July 20, 2022 08:32:47 -8:00 [2EC9F7CF5939] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

77

#6679/ CC 37420
10-31-2022
Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0722
ATTN: TONY PALUMBO	Invoice Date:	Jul 31, 2022
2500 QUANTUM LAKES DRIVE	Invoice Amount: $4,025.00
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Jul 31, 2022	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	16,625.00	875.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	350.00	3,150.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	0.00	0.00	0.00	0.00%	73,900.00	
REIMBURSEMENT BUDGET	8,000.00	140.31	0.00	140.31	1.75%	7,859.69	
Subtotal	181,100.00	95,315.31	4,025.00	99,340.31	54.85%	81,759.69	
Total	4,025.00		

$4,025.00

	

Total Invoice:

78

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: 5FF4722B-ED07-4764-9629-4894F11102E9
www.docverify.com

Generated Cover Page	4894F11102E9

147641012 ROL 2022-07	.pdf

DocVerify ID:	5FF4722B-ED07-4764-9629-4894F11102E9
Created:	August 16, 2022 08:39:28 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
August 16, 2022 08:42:03 -8:00 [BB96E9FDD4FC] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Lisa M Hill (LMH)
August 16, 2022 08:42:03 -8:00 [2E813253FEAA] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

79

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$4,025.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 7/31/2022 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: 5FF4722B-ED07-4764-9629-4894F11102E9
www.docverify.com

Page 1 of 1

14894F11102E9

5FF4722B-ED07-4764-9629-4894F11102E9 --- 2022/08/16 08:39:28 -8:00

KHA Project #:147641012	Invoice #: 147641012-0722

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		8/16/22	

KIMLEY-HORN AND ASSOCIATES, INC.

BB96E9FDD4FC

Heather Stone
Signed on 2022/08/16 08:42:03 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 16th day of August, 2022, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.

2E813253FEAA

Signed on 2022/08/16 08:42:03 -8:00

My commission expires:
	5/18/2023	
Notary Public

Lisa M. Hill
Commission # GG 310574
Notary Public - State of Florida
My Commission Expires May 18, 2023

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2022/08/16 08:42:03 PST	2E813253FEAA

80

#6679/ CC 37420
9-22-2022
Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0822
ATTN: TONY PALUMBO	Invoice Date:	Aug 31, 2022
2500 QUANTUM LAKES DRIVE	Invoice Amount: $7,487.63
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Aug 31, 2022	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	0.00	7,390.00	7,390.00	10.00%	66,510.00	
REIMBURSEMENT BUDGET	8,000.00	140.31	97.63	237.94	2.97%	7,762.06	
Subtotal	181,100.00	99,340.31	7,487.63	106,827.94	58.99%	74,272.06	
Total	7,487.63		

$7,487.63

	

Total Invoice:

81

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

MATTAMY PALM BEACH, LLC ATTN: TONY PALUMBO
2500 QUANTUM LAKES DRIVE SUITE 215
BOYNTON BEACH, FL 33426

COST PLUS MAX
KHA Ref # 147641012.3-22343017			

Invoice Invoice
Project Project Project	

Task	
Description	
Hrs/Qty	
Rate	Current Amount Due	
REIMBURSEMENT BUDGET	TRAVEL - MEALS			27.63	
	VEHICLE MILEAGE	112.0	0.625	70.00	
TOTAL REIMBURSEMENT BUDGET	112.0		97.63	
TOTAL LABOR AND EXPENSE DETAIL			97.63	

No:	147641012-0822
Date:	Aug 31, 2022
No:	147641012 Name:	PAAR DRIVE
Manager: KLEIER, ERIC

This page is for informational purposes only. Please pay amount shown on cover page.

82

32CLB

DocVerify ID: C5AE98E0-7FB4-46A9-BA7A-150D578FADF8
www.docverify.com

Generated Cover Page	150D578FADF8

147641012 ROL 2022-08	.pdf

DocVerify ID:	C5AE98E0-7FB4-46A9-BA7A-150D578FADF8
Created:	September 15, 2022 07:00:41 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

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E-Signature Summary

E-Signature 1: Heather Stone (HS)
September 15, 2022 07:07:45 -8:00 [F6D6CBE45FCB] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Lisa M Hill (LMH)
September 15, 2022 07:07:45 -8:00 [3E5F6B0B701E] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

83

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$7,487.63	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 8/31/2022 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: C5AE98E0-7FB4-46A9-BA7A-150D578FADF8
www.docverify.com

Page 1 of 1

1150D578FADF8

C5AE98E0-7FB4-46A9-BA7A-150D578FADF8 --- 2022/09/15 07:00:41 -8:00

KHA Project #:147641012	Invoice #: 147641012-0822

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		9/15/22	

KIMLEY-HORN AND ASSOCIATES, INC.

F6D6CBE45FCB

Heather Stone
Signed on 2022/09/15 07:07:45 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 15th day of September, 2022, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.

3E5F6B0B701E

Signed on 2022/09/15 07:07:45 -8:00

My commission expires:
	5/18/2023	
Notary Public

Lisa M. Hill
Commission # GG 310574
Notary Public - State of Florida
My Commission Expires May 18, 2023

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2022/09/15 07:07:45 PST	3E5F6B0B701E

84

#6679/ CC 37430
10-25-2022
Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0922
ATTN: TONY PALUMBO	Invoice Date:	Sep 30, 2022
2500 QUANTUM LAKES DRIVE	Invoice Amount: $3,695.00
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Sep 30, 2022	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	7,390.00	3,695.00	11,085.00	15.00%	62,815.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	0.00	237.94	2.97%	7,762.06	
Subtotal	181,100.00	106,827.94	3,695.00	110,522.94	61.03%	70,577.06	
Total	3,695.00		

		

Total Invoice:  $3,695.00 

85

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: 3EB5CA9E-6FFC-4FFF-9E05-7C9161253FF2
www.docverify.com

Generated Cover Page	7C9161253FF2

147641012 ROL 2022-09	.pdf

DocVerify ID:	3EB5CA9E-6FFC-4FFF-9E05-7C9161253FF2
Created:	October 18, 2022 05:54:07 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
October 18, 2022 06:02:45 -8:00 [1C13321642B0] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Lisa M Hill (LMH)
October 18, 2022 06:02:45 -8:00 [907D9FDA8572] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

86

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$3,695.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 9/30/2022 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: 3EB5CA9E-6FFC-4FFF-9E05-7C9161253FF2
www.docverify.com

Page 1 of 1

17C9161253FF2

3EB5CA9E-6FFC-4FFF-9E05-7C9161253FF2 --- 2022/10/18 05:54:07 -8:00

KHA Project #:147641012	Invoice #: 147641012-0922

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		10/18/22	

KIMLEY-HORN AND ASSOCIATES, INC.

1C13321642B0

Heather Stone
Signed on 2022/10/18 06:02:45 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 18th day of October, 2022, by Heather Stone, Assistant Secretary of Kimley-Horn and

907D9FDA8572

Signed on 2022/10/18 06:02:45 -8:00

Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	as identification.
My commission expires:
	5/18/2023	
Notary Public

Lisa M. Hill
Commission # GG 310574
Notary Public - State of Florida
My Commission Expires May 18, 2023

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2022/10/18 06:02:45 PST	907D9FDA8572

87

6679/ JDE Line 9 Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0123
ATTN: TONY PALUMBO	Invoice Date:	Jan 31, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $7,390.00 
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Jan 31, 2023	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	11,085.00	7,390.00	18,475.00	25.00%	55,425.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	0.00	237.94	2.97%	7,762.06	
Subtotal	181,100.00	110,522.94	7,390.00	117,912.94	65.11%	63,187.06	
Total	7,390.00		

	

Total Invoice: $7,390.00

88

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: 1BEC088E-B082-4853-BEBF-124B0F9F6BE3
www.docverify.com

Generated Cover Page	124B0F9F6BE3

147641012 ROL 2023-01	.pdf

DocVerify ID:	1BEC088E-B082-4853-BEBF-124B0F9F6BE3
Created:	February 14, 2023 09:42:42 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
February 14, 2023 09:48:47 -8:00 [3FF517BF6395] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Lisa M Hill (LMH)
February 14, 2023 09:48:47 -8:00 [C36804D667C8] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

89

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$7,390.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 1/31/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: 1BEC088E-B082-4853-BEBF-124B0F9F6BE3
www.docverify.com

Page 1 of 1

1124B0F9F6BE3

1BEC088E-B082-4853-BEBF-124B0F9F6BE3 --- 2023/02/14 09:42:42 -8:00

KHA Project #:147641012	Invoice #: 147641012-0123

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		2/14/23	

KIMLEY-HORN AND ASSOCIATES, INC.

3FF517BF6395

Heather Stone
Signed on 2023/02/14 09:48:47 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 14th day of February, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.

C36804D667C8

Signed on 2023/02/14 09:48:47 -8:00

My commission expires:
5/18/2023

Notary Public

Lisa M. Hill
Commission # GG 310574
Notary Public - State of Florida
My Commission Expires May 18, 2023

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2023/02/14 10:48:47 PST	C36804D667C8

90

6679/ JDE Line 9: $7,390.00
Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0223
ATTN: TONY PALUMBO	Invoice Date:	Feb 28, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount: $7,390.00
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Feb 28, 2023	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	18,475.00	7,390.00	25,865.00	35.00%	48,035.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	0.00	237.94	2.97%	7,762.06	
Subtotal	181,100.00	117,912.94	7,390.00	125,302.94	69.19%	55,797.06	
Total	7,390.00		

		

Total Invoice: $7,390.00

91

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: 5E3C2F52-1F3F-4A88-9A5D-9DD46F702D4C
www.docverify.com

Generated Cover Page	9DD46F702D4C

147641012 ROL 2023-02	.pdf

DocVerify ID:	5E3C2F52-1F3F-4A88-9A5D-9DD46F702D4C
Created:	March 14, 2023 06:54:53 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
March 14, 2023 07:00:10 -8:00 [34B06DC9504D] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Tammy L Scarlott (TLS)
March 14, 2023 07:00:10 -8:00 [D6A287C06016] [134.238.172.9]

tammy.scarlott@kimley-horn.com

I, Tammy L Scarlott, did witness the participants named above electronically	 sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

92

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$7,390.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 2/28/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

KHA Project #:147641012	Invoice #: 147641012-0223

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		3/13/23	

KIMLEY-HORN AND ASSOCIATES, INC.

By:

34B06DC9504D

Heather Stone
Signed on 2023/03/14 07:00:10 -8:00

HEATHER STONE
Assistant Secretary

DocVerify ID: 5E3C2F52-1F3F-4A88-9A5D-9DD46F702D4C
www.docverify.com

Page 1 of 1

19DD46F702D4C

5E3C2F52-1F3F-4A88-9A5D-9DD46F702D4C --- 2023/03/14 06:54:53 -8:00

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 13th day of March, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.

D6A287C06016

Signed on 2023/03/14 07:00:10 -8:00

My commission expires:
12/03/2024

Notary Public

Tammy L. Scarlott Commission # HH 68903 Notary Public - State of Florida
My Commission Expires Dec 03, 2024

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2023/03/14 07:00:10 PST	D6A287C06016

93

6679/ Line 9 Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0523R
ATTN: TONY PALUMBO	Invoice Date:	May 31, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $11,085.00
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through May 31, 2023
Southern Grove -Port St. Lucie	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	25,865.00	11,085.00	36,950.00	50.00%	36,950.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	0.00	237.94	2.97%	7,762.06	
Subtotal	181,100.00	125,302.94	11,085.00	136,387.94	75.31%	44,712.06	
Total	11,085.00		

		

Total Invoice: $11,085.00

94

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: 14275A6F-CE56-4D87-BA7C-B2996D3C097D
www.docverify.com

Generated Cover Page	B2996D3C097D

147641012 ROL 2023-05R	.pdf

DocVerify ID:	14275A6F-CE56-4D87-BA7C-B2996D3C097D Created:	 June 27, 2023 13:09:43 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
June 27, 2023 13:13:35 -8:00 [D021F549F418] [130.41.174.195]

heather.stone@kimley-horn.com (Principal)

E-Signature Notary: Lisa M Hill (LMH)
June 27, 2023 13:13:35 -8:00 [2A18ED004B94] [130.41.174.195]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

95

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$11,085.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 5/31/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

KHA Project #:147641012	Invoice #: 147641012-0523R

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		6/27/23	

KIMLEY-HORN AND ASSOCIATES, INC.

D021F549F418

Heather Stone
Signed on 2023/06/27 13:13:35 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 27th day of June, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as

identification.

My commission expires:

Lisa M. Hill
Commission # HH 363807
Notary Public - State of Florida
My Commission Expires May 18, 2027

	5/18/2027	

Signed on 2023/06/27 13:13:35 -8:00
Notary Public

2A18ED004B94

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

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Notary Stamp 2023/06/27 13:13:35 PST

2A18ED004B94

DocVerify ID: 14275A6F-CE56-4D87-BA7C-B2996D3C097D
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1B2996D3C097D

14275A6F-CE56-4D87-BA7C-B2996D3C097D --- 2023/06/27 13:09:43 -8:00

96

6679
JDE Line 9 Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0623
ATTN: TONY PALUMBO	Invoice Date:	Jun 30, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $3,695.00 
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE -CONTRACT 6679
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679
For Services Rendered through Jun 30, 2023	Southern Grove -Port St. Lucie	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	36,950.00	3,695.00	40,645.00	55.00%	33,255.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	0.00	237.94	2.97%	7,762.06	
Subtotal	181,100.00	136,387.94	3,695.00	140,082.94	77.35%	41,017.06	
Total	3,695.00		

		

Total Invoice: $3,695.00

97

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: B08AC5BF-2B8F-4BFB-BDA8-F9D0042F1CD4
www.docverify.com

Generated Cover Page	F9D0042F1CD4

147641012 ROL 2023-06	c.pdf

DocVerify ID:	B08AC5BF-2B8F-4BFB-BDA8-F9D0042F1CD4 Created:	 July 17, 2023 12:57:08 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
July 17, 2023 13:13:11 -8:00 [0D109010ED68] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)

E-Signature Notary: Lisa M Hill (LMH)
July 17, 2023 13:13:11 -8:00 [3B114208CBFE] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

98

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$3,695.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 6/30/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: B08AC5BF-2B8F-4BFB-BDA8-F9D0042F1CD4
www.docverify.com

Page 1 of 1

1F9D0042F1CD4

B08AC5BF-2B8F-4BFB-BDA8-F9D0042F1CD4 --- 2023/07/17 12:57:08 -8:00

KHA Project #:147641012	Invoice #: 147641012-0623

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		7/17/23	

KIMLEY-HORN AND ASSOCIATES, INC.

0D109010ED68

Heather Stone
Signed on 2023/07/17 13:13:11 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 17th day of July, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and

3B114208CBFE

Signed on 2023/07/17 13:13:11 -8:00

Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.
My commission expires:
	5/18/2027	
Notary Public

Lisa M. Hill
Commission # HH 363807
Notary Public - State of Florida
My Commission Expires May 18, 2027

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Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2023/07/17 13:13:11 PST	3B114208CBFE

99

6679
JDE Line 9: $3,695.00 JDE CO #1: $89.08
Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0723
ATTN: TONY PALUMBO	Invoice Date:	Jul 31, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $3,784.08 
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE -CONTRACT 6679
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679
For Services Rendered through Jul 31, 2023	Southern Grove -Port St. Lucie	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	40,645.00	3,695.00	44,340.00	60.00%	29,560.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	89.08	327.02	4.09%	7,672.98	
Subtotal	181,100.00	140,082.94	3,784.08	143,867.02	79.44%	37,232.98	
Total	3,784.08		

	

Total Invoice: $3,784.08

100

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

MATTAMY PALM BEACH, LLC ATTN: TONY PALUMBO
2500 QUANTUM LAKES DRIVE SUITE 215
BOYNTON BEACH, FL 33426

COST PLUS MAX
KHA Ref # 147641012.3-25506388			

Invoice No Invoice Da
Project No Project Na Project Ma	

Task	
Description	
Hrs/Qty	
Rate	Current Amount Due	
REIMBURSEMENT BUDGET	VEHICLE MILEAGE	136.0	0.655	89.08	
TOTAL REIMBURSEMENT BUDGET	136.0		89.08	
TOTAL LABOR AND EXPENSE DETAIL			89.08	

:
te:
:
me: nager:

147641012-0723
Jul 31, 2023
147641012
PAAR DRIVE -CONTRACT 6679
KLEIER, ERIC

This page is for informational purposes only. Please pay amount shown on cover page.

101

32CLB

DocVerify ID: D3B5B3DB-C210-42A0-B704-269FE54FAB36
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Generated Cover Page	269FE54FAB36

147641012 ROL 2023-07	c.pdf

DocVerify ID:	D3B5B3DB-C210-42A0-B704-269FE54FAB36
Created:	August 14, 2023 08:10:03 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
August 14, 2023 08:14:41 -8:00 [96D5BE45BAC3] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)

E-Signature Notary: Tammy L Scarlott (TLS)
August 14, 2023 08:14:41 -8:00 [EFDA7853BD97] [134.238.172.9]
tammy.scarlott@kimley-horn.com
I, Tammy L Scarlott, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

102

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$3,784.08	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 7/31/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: D3B5B3DB-C210-42A0-B704-269FE54FAB36
www.docverify.com

Page 1 of 1

1269FE54FAB36

D3B5B3DB-C210-42A0-B704-269FE54FAB36 --- 2023/08/14 08:10:03 -8:00

KHA Project #:147641012	Invoice #: 147641012-0723

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		8/14/23	

KIMLEY-HORN AND ASSOCIATES, INC.

96D5BE45BAC3

Heather Stone
Signed on 2023/08/14 08:14:41 -8:00

By:

HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 14th day of August, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and

EFDA7853BD97

Signed on 2023/08/14 08:14:41 -8:00

Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.
My commission expires:
12/03/2024
Notary Public

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Tammy L. Scarlott Commission # HH 68903 Notary Public - State of Florida
My Commission Expires Dec 03, 2024

DocVerify

Notary Stamp 2023/08/14 08:14:41 PST	EFDA7853BD97

103

6679/ JDE Line 9 Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0823
ATTN: TONY PALUMBO	Invoice Date:	Aug 31, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $3,695.00 
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE -CONTRACT 6679
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679
For Services Rendered through Aug 31, 2023	Southern Grove -Port St. Lucie	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	44,340.00	3,695.00	48,035.00	65.00%	25,865.00	
REIMBURSEMENT BUDGET	8,000.00	327.02	0.00	327.02	4.09%	7,672.98	
Subtotal	181,100.00	143,867.02	3,695.00	147,562.02	81.48%	33,537.98	
Total	3,695.00		

		

Total Invoice: $3,695.00

104

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	31CLB

DocVerify ID: F0069F49-C369-4D50-89C2-3B5E5E2F0FA0
www.docverify.com

Generated Cover Page	3B5E5E2F0FA0

147641012 ROL 2023-08	c.pdf

DocVerify ID:	F0069F49-C369-4D50-89C2-3B5E5E2F0FA0
Created:	September 15, 2023 05:02:27 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
September 15, 2023 05:06:05 -8:00 [B818039758D1] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)

E-Signature Notary: Tammy L Scarlott (TLS)
September 15, 2023 05:06:05 -8:00 [C89A7B2D1D49] [134.238.172.9]
tammy.scarlott@kimley-horn.com
I, Tammy L Scarlott, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

105

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of	$3,695.00	,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices

dated	8/31/2023	to

on the job of

MATTAMY PALM BEACH, LLC PAAR DRIVE

Description Of Property

DocVerify ID: F0069F49-C369-4D50-89C2-3B5E5E2F0FA0
www.docverify.com

Page 1 of 1

13B5E5E2F0FA0

F0069F49-C369-4D50-89C2-3B5E5E2F0FA0 --- 2023/09/15 05:02:27 -8:00

KHA Project #:147641012	Invoice #: 147641012-0823

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on	9/14/23

KIMLEY-HORN AND ASSOCIATES, INC.

B818039758D1

Heather Stone
Signed on 2023/09/15 05:06:05 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 14th day of September, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and

C89A7B2D1D49

Signed on 2023/09/15 05:06:05 -8:00

Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.
My commission expires:
12/03/2024
Notary Public

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Tammy L. Scarlott Commission # HH 68903 Notary Public - State of Florida
My Commission Expires Dec 03, 2024

DocVerify

Notary Stamp 2023/09/15 05:06:05 PST	C89A7B2D1D49

106

6679/ JDE Line 9 Frank

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-1023
ATTN: TONY PALUMBO	Invoice Date:	Oct 31, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $3,695.00 
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE -CONTRACT 6679
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679
For Services Rendered through Oct 31, 2023	Southern Grove -Port St. Lucie	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	48,035.00	3,695.00	51,730.00	70.00%	22,170.00	
REIMBURSEMENT BUDGET	8,000.00	327.02	0.00	327.02	4.09%	7,672.98	
Subtotal	181,100.00	147,562.02	3,695.00	151,257.02	83.52%	29,842.98	
Total	3,695.00		

		

Total Invoice: $3,695.00

107

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	31CLB

DocVerify ID: 44A8E1D1-C871-4C8F-9013-87D3DE61A686
www.docverify.com

Generated Cover Page	87D3DE61A686

147641012 ROL 2023-10	c.pdf

DocVerify ID:	44A8E1D1-C871-4C8F-9013-87D3DE61A686
Created:	November 14, 2023 10:00:10 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
November 14, 2023 10:03:13 -8:00 [824108FE0B99] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)

E-Signature Notary: Tammy L Scarlott (TLS)
November 14, 2023 10:03:13 -8:00 [694B8F7AF09D] [134.238.172.9]
tammy.scarlott@kimley-horn.com
I, Tammy L Scarlott, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

108

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$3,695.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 10/31/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: 44A8E1D1-C871-4C8F-9013-87D3DE61A686
www.docverify.com

Page 1 of 1

187D3DE61A686

44A8E1D1-C871-4C8F-9013-87D3DE61A686 --- 2023/11/14 10:00:10 -8:00

KHA Project #:147641012	Invoice #: 147641012-1023

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		11/14/23	

KIMLEY-HORN AND ASSOCIATES, INC.

824108FE0B99

Heather Stone
Signed on 2023/11/14 10:03:13 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 14th day of November, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and

694B8F7AF09D

Signed on 2023/11/14 10:03:13 -8:00

Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.
My commission expires:
12/03/2024
Notary Public

Tammy L. Scarlott Commission # HH 68903 Notary Public - State of Florida
My Commission Expires Dec 03, 2024

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2023/11/14 11:03:13 PST	694B8F7AF09D

109

64228384.1510.37580
Tyler

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4446663
Date	05/02/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through May 02, 2023

Professional Services
Hourly - Surveying Services

02/20/2023
Professional Land Surveyor

Hours	Rate

Billed Amount

Hourly	2.00	140.00	280.00
CALC PAAR ROAD SIDEWALKS NORTH SIDE PER TYLER
02/21/2023
Field Survey Crew-GPS
Hourly	3.00	165.00	495.00
STAKE 10 AND 12 FT WALKS NORTH SIDE OF PAAR. FROM POWERLINES WEST TO ROUNDABOUT. MATTAMY PORTION
Professional Services subtotal	5.00	775.00

775.00 

Invoice total

Aging Summary
Invoice Number	
Invoice Date	
Outstanding	
Current	
Over 30	
Over 60	
Over 90	
Over 120	
4446663	05/02/2023	775.00	775.00					
	Total	775.00	775.00	0.00	0.00	0.00	0.00	

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.

Office: 561-392-1991 Fax: 561-750-1452

64228384.1510.37580
Tyler

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4445391RA
Date	05/02/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through May 02, 2023

Professional Services
Hourly - Surveying Services

02/20/2023
Professional Land Surveyor

Hours	Rate

Billed Amount

Hourly	2.00	140.00	280.00
CALC PAAR ROAD SIDEWALKS NORTH SIDE PER TYLER
02/21/2023
Field Survey Crew-GPS
Hourly	3.00	165.00	495.00
STAKE 10 AND 12 FT WALKS NORTH SIDE OF PAAR. FROM POWERLINES WEST TO ROUNDABOUT. MATTAMY PORTION
Professional Services subtotal	5.00	775.00

775.00 

Invoice total

Aging Summary
Invoice Number	
Invoice Date	
Outstanding	
Current	
Over 30	
Over 60	
Over 90	
Over 120	
4445391R	05/02/2023	775.00	775.00					
	Total	775.00	775.00	0.00	0.00	0.00	0.00	

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.
Office: 561-392-1991 Fax: 561-750-1452

64228384.1510.37580
Tyler

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4450006
Date	08/25/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through July 30, 2023

Professional Services
Hourly - Surveying Services

07/05/2023
Field Survey Crew-GPS

Hours	Rate

Billed Amount

Hourly	2.00	165.00	330.00
STAKE NORTH RIGHT OF WAY
Professional Land Surveyor
Hourly	2.00	140.00	280.00
CALC NORTH ROW OF PAAR ROAD PER TYLER MATTAMY
07/17/2023
Field Survey Crew-GPS

Hourly
RESTAKE KNOCKED OUT STAKES FOR WALKS AND CHECK OTHERS 1000FT	5.00	165.00	825.00	
Professional Services subtotal	9.00		1,435.00	
				
		Invoice total	1,435.00	

Aging Summary
Invoice Number	

Invoice Date	

Outstanding	

Current	

Over 30	

Over 60	

Over 90	

Over 120	
4450006	08/25/2023	1,435.00	1,435.00					
	Total	1,435.00	1,435.00	0.00	0.00	0.00	0.00	

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.
Office: 561-392-1991 Fax: 561-750-1452

64228384.1510.37580
Tyler

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4450545
Date	09/18/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through September 03, 2023

Professional Services
Hourly - Surveying Services

08/08/2023
Professional Land Surveyor

Hours	Rate

Billed Amount

Hourly		4.00	140.00	560.00	
CALC DRIVEWAYS AND WALKS PAAR ROAD					
	Professional Services subtotal	4.00		560.00	
			Invoice total	560.00 	
Aging Summary
Invoice Number	Invoice Date	Outstanding	

Current	Over 30	

Over 60	

Over 90	

Over 120	
4450545	09/18/2023	560.00	560.00				
Total	560.00	560.00	0.00	0.00	0.00	0.00	

 

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.
Office: 561-392-1991 Fax: 561-750-1452

64228384.1510.37580
Frank

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4451852
Date	10/25/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through October 01, 2023

Professional Services
Hourly - Surveying Services

08/04/2023
Field Survey Crew-GPS

Hours	Rate

Billed Amount

Hourly	3.00	165.00	495.00
STAKE AND GRADE WALKS AND RAMPS
08/08/2023
Field Survey Crew-GPS
Hourly	5.00	165.00	825.00
STAKE DRIVEWAYS SIDEWALKS ON PARR
Professional Services subtotal	8.00	1,320.00

 1,320.00 

Invoice total

Aging Summary
Invoice Number	
Invoice Date	
Outstanding	
Current	
Over 30	
Over 60	
Over 90	
Over 120	
4450545	09/18/2023	560.00		560.00				
4451852	10/25/2023	1,320.00	1,320.00					
	Total	1,880.00	1,320.00	560.00	0.00	0.00	0.00	

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.
Office: 561-392-1991 Fax: 561-750-1452

64228384.1510.37580
Jonas

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4452691
Date	11/28/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through October 29, 2023

Professional Services
Contract - Surveying Services

10/10/2023
Professional Land Surveyor

Hours	Rate

Billed Amount

Contract	3.00	140.00	420.00
CALC FENCING PAAR ROAD NORTH SIDE PER JONAS
Professional Services subtotal	3.00	420.00

420.00 

Invoice total

Aging Summary
Invoice Number	
Invoice Date	
Outstanding	
Current	
Over 30	
Over 60	
Over 90	
Over 120	
4451852	10/25/2023	1,320.00		1,320.00				
4452691	11/28/2023	420.00	420.00					
	Total	1,740.00	420.00	1,320.00	0.00	0.00	0.00	

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.
Office: 561-392-1991 Fax: 561-750-1452

701 SE Ocean Boulevard Stuart, FL 34994
(772) 220-2100

6813
Tyler

MATTAMY HOMES - SOUTHEAST FLORIDA DIVISION ANTHONY PALUMBO
2500 QUANTUM LAKES BOULEVARD SUITE 215
BOYNTON BEACH, FL 33426

Invoice number	34416
Date	03/20/2023

Project 20-276.31 PAAR DRIVE EXTENSION - LANDSCAPE ARCHITECTURE

Professional Services for the period: 2/1/23 to 2/28/23

Contract
Description	Amount	Percent
Complete	Total
Billed	Prior Fee
Billings	Current
Billed	
PARTS A & B: DESIGN DEVELOPMENT (CONCEPT	21,500.00
DESIGN) & LANDSCAPE CONSTRUCTIONS DOCS	100.00	21,500.00	21,500.00	0.00	
PART C: SITE VISITS	5,500.00	25.00	1,375.00	0.00	1,375.00	
Total	27,000.00	84.72	22,875.00	21,500.00	1,375.00	

			Invoice total	1,375.00	
					
Aging Summary								
Invoice Number	Invoice Date	Outstanding	Current	Over 30	Over 60	Over 90	Over 120	
34416	03/20/2023	1,375.00	1,375.00					
	Total	1,375.00	1,375.00	0.00	0.00	0.00	0.00	

Project Manager

STEVEN GARRETT

701 SE Ocean Boulevard Stuart, FL 34994
(772) 220-2100

6813
Tyler

MATTAMY HOMES - SOUTHEAST FLORIDA DIVISION ANTHONY PALUMBO
2500 QUANTUM LAKES BOULEVARD SUITE 215
BOYNTON BEACH, FL 33426

Invoice number	34663
Date	07/19/2023

Project 20-276.31 PAAR DRIVE EXTENSION - LANDSCAPE ARCHITECTURE

Professional Services for the period: 6/1/23 to 6/30/23

Contract
Description	Amount	Percent
Complete	Total
Billed	Prior Fee
Billings	Current
Billed	
PARTS A & B: DESIGN DEVELOPMENT (CONCEPT	21,500.00
DESIGN) & LANDSCAPE CONSTRUCTIONS DOCS	100.00	21,500.00	21,500.00	0.00	
PART C: SITE VISITS	5,500.00	75.00	4,125.00	1,375.00	2,750.00	
Total	27,000.00	94.91	25,625.00	22,875.00	2,750.00	
					
			Invoice total	 2,750.00 	
Aging Summary								
Invoice Number	Invoice Date	Outstanding	Current	Over 30	Over 60	Over 90	Over 120	
34663	07/19/2023	2,750.00	2,750.00					
	Total	2,750.00	2,750.00	0.00	0.00	0.00	0.00	

Project Manager

STEVEN GARRETT

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Pag _1 of 2_

TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR):  GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

Inv #7657-1
10-11-2022
Tyler

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL
3310.2200200.0000

APP.	# 1

PERIOD TO; 09/30/2022

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below. in connection with the Contract Continuation Sheet, Documenl G703, must be attached.

1. ORIGINAL CONTRACT SUM	$17,160.00	
2. Net change by Change Orders	 $		
3. CONTRACT SUM TO DATE (Line 1 =/- 2)		$17,160.00		
4. TOTAL COMPLETED & STORED TO DATE	$5,310.00	

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

5. RETAlNAGE

(Column G on G703)

10% of Completed Work 	
(Column D + Eon G703
10% Stored Material	NIA

Total Retainage (Line Sa+ Sb] or
(Total in Column I of G703)		

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been completed In accordance with the Contract Documents, that all amounts have been
paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is
now due.

TOTAL EARNED
(line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from !!!l!ll Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

$5,310.00

$5.310.00	MS

$11,850.00

CONTRA	 ('j
BY	DATE

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on site observations and the data comprising the above application. the Architect certifies to the Owner that to the inclcated, the quallily of lhe Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

State of:	Florida	CountyA_	rai t-Luci1/
Subscribed d s rn .,?ti /	day of	,	2022
NotaryPublic_·	/	.	,.<(iflii,?-,. CandaceAzzopar9,
My Comm1s	n Expires: 08/28123	r�· A·t', Comm #GG908
t -	• E p1res A.ugus; 1 lt_
-:.U i- •	- - iaf\

AMOUNT CERTIFIED..............................................	$5,310:-/fo
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

 By:	Date:	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENTG703	PAGE OF PAGES2of2

AJA Document G702. APPLICATION AND CERTIFICATION FOR PAYMENT. contammg
Contractors signed cenificat1on 1s attached.
In tablllat1ons below, nmounts are stated to the nearest dollar
Use Column I on Contracts where variable retainage for line items may apply

APPLICATION NO:	1
APPLICATION DATE:	09/30/22
PERIOD TO:	09/30/22
GFA'S PROJECT NO: 3310. 2200200

A	B	Quan1ty	Umt	Uni1 Price	C	D	E	F	G	H	

ITEM	DESCRIPTION
OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO					VALUE	FROM PREVIOUS	TI	-asPERIOD	PRESENTLY	COMPLETED	(GTC)	TO FINlSH	
						APPLICATION		STORED	AND STORED		(C-G)	
						(D t-E)		(NOTIN	TO DATE			
								DORE)	(Dt-E+F)			
												
	Construction Material Testing				$17,160.00		$5,310.00		$5,310.00	30.94%	11,85000	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00					0.00%		
	Chanoe Orders:								,,	0.00%		
	GRAND TOTALS				$17,160.00	$0.00	$5,310.00	$0.00	$5,310.00	30.94%	11,850.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

September 30, 2022
Project: No:	3310.2200200.0000
Invoice No:	00650120

Terms: Net 30 days
We accept American Express, Visa, Master Card, Discover, and ACH

Project:	3310.2200200.0000	Parr Drive Improvements

Location:

Parr Drive
Port St Lucie, FL

Professional Services through October 31, 2022

Phase	3310
Unit Billing
Administration Fee

In-Place Density Test - Soils

CMT Parr Drive Improvements

0.5 Hours @ 50.00	25.00

8/17/2022	WO# 278404	11.0 Tests @ 25.00	275.00	
8/25/2022	WO # 278513	2.0 Tests @ 25.00	50.00	
8/29/2022	WO # 280636	2.0 Tests @ 25.00	50.00	
8/30/2022	WO # 280637	6.0 Tests @ 25.00	150.00	
8/31/2022	WO # 279222	1.0 Test @ 25.00	25.00	
9/1/2022	WO # 279223	7.0 Tests @ 25.00	175.00	
9/2/2022	WO # 279224	11.0 Tests @ 25.00	275.00	
9/6/2022	WO # 279871	12.0 Tests @ 25.00	300.00	
9/7/2022	WO # 279872	8.0 Tests @ 25.00	200.00	
9/8/2022	WO # 279873	3.0 Tests @ 25.00	75.00	
9/9/2022	WO # 279874	5.0 Tests @ 25.00	125.00	
9/12/2022	WO # 280615	2.0 Tests @ 25.00	50.00	
9/30/2022	Log Book - Force Main	18.0 Tests @ 25.00	450.00	

Laboratory Proctor Test (Each)
9/13/2022	5728
Log Book Creation Professional Engineer (Per Hr.)
Project Manager/Quality Control Technician Time (Per Hr.)

1.0 Test @ 105.00	105.00

1.0 Book @ 1,500.00	1,500.00

5.0 Hours @ 125.00	625.00

1.0 Hour @ 85.00	85.00

11.0 Hours @ 70.00	770.00

Total Units	5,310.00	5,310.00
Total this Phase	$5,310.00

120

Total this Invoice	$5,310.00

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	f>c1g 1_ of 2

TO:	Mattmay Homes
2401 Quantum lakes Drive Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

Inv #7657-2
11-2-2022
Tyler

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL
3310.2200200.0000

APP.	# 2

PERIOD TO: 10/31/2022

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

1. ORIGINAL CONTRACT SUM	$17,160.00	
2. Net change by Change Orders	$	
3. CONTRACT SUM TO DATE (Line 1 =/- 2)	$17,160.00	
4. TOTAL COMPLETED & STORED TO DATE		$8,100.00		

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

RETAINAGE

(Column G on G703)

10% of Completed Work 	
(Column D + Eon G703
10% Stored Material	N/A

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due

CONTRACTOR_		-

Total Retainage (Line Sa + Sb) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from Jl!!.Q! Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)
State of:	Flori•da Subscribed anzswbezfoome this

	$8,100.00	

	$5,310.00	

	$2,790.00	/vf S	
	$9,060.00	

Dv	'	arn

Sair! c	2022
Co""

BY		 		\Z

DATE

Notary Public·
<1J.J.IY Commiss•i	:	/281.!3

.\5-/aayof	/t AJTfJi?Af   ;��cit'c,��r}
[«	/., Expires August ?8 ,,_.

'----"..·.--·;·..it..'-'/ Bool'oo- Thn• --

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with lhe Contract Document, based on on-site observations and the data comprising lhe above application, the Architect certifies to lhe Owner Iha! !a lhe incicated, the qualilty of the Work is in accordance with the Contract Documents. and the Contractor ,s entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED .............	$2,790.00

(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

By:	Date:

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENTG703	PAGE OF' PAGES2ol2

AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT. containing
Contractor's signed cert1fication 1s attached
In tabularions below. amounts arc stated to the nearest dollar
Use Column I on Contracts where variable retamage for line items may apply.

APPLICATION NO:	2
APPUCATION DATE:	10/31/22 PERIOD TO:	 10/31/22
GFA'S PROJECT NO: 3310. 2200200

A	B	Quanny	Unit	Unit Price	C	D	E	F	G	H	

ffEM	DESCRIPTION
OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
8ALANCE	
NO.					VALUE	FROM PREVIOUS	THlS PERIOD	PRESENTLY	COMPLETED	(G+C)	TO FINISH	
						APPLICATION		STORED	AND STORED		{C-G)	
						(D+E)		(NOTIN	TO DATE			
								DORE)	(D+E+FJ			
												
	Construction Material Testing				S17.16000	$5,310.00	$2,790.00		sa.100.00	4720%	9,060.00	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00					0.00%		
	ChanAe Orders:									0.00%		
	GRAND TOTALS				$17,160.00	$5,310,00	$2.790,00	$0.00	$8.100.00	47.20%	9,060.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

October 31, 2022
Project: No:	3310.2200200.0000
Invoice No:	00655486

Terms: Net 30 days
We accept American Express, Visa, Master Card, Discover, and ACH

Project:	3310.2200200.0000	Parr Drive Improvements

Location:

Parr Drive
Port St Lucie, FL

Professional Services through October 31, 2022

Phase	3310
Unit Billing
Administration Fee

10/4/2022	WO # 282220	4.0 Tests @ 25.00	100.00	
10/5/2022	WO # 282221	7.0 Tests @ 25.00	175.00	
10/6/2022	WO # 282510	6.0 Tests @ 25.00	150.00	
10/7/2022	WO # 282512	7.0 Tests @ 25.00	175.00	
10/10/2022	WO # 282513	2.0 Tests @ 25.00	50.00	
10/21/2022	WO # 283971	4.0 Tests @ 25.00	100.00	
10/24/2022	WO # 284057	5.0 Tests @ 25.00	125.00	
10/25/2022	WO # 284147	5.0 Tests @ 25.00	125.00	
10/31/2022	Log Book - Force main	30.0 Tests @ 25.00	750.00	
aboratory Proctor Test (Each)
10/10/2022	5969	1.0 Test @ 105.00	105.00	

In-Place Density Test - Soils

CMT Parr Drive Improvements
0.25 Hours @ 50.00	12.50

L

123

Professional Engineer (Per Hr.) Project Manager/Quality Control Technician Time (Per Hr.)
Total Units

2.0 Hours @ 125.00	250.00
0.5 Hours @ 85.00	42.50

2,790.00	2,790.00	
Total this Phase	$2,790.00	
Total this Invoice	$2,790.00	

9.0 Hours @ 70.00	630.00

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of 2

TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

7657-3

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL

APP.	#3

PERIOD TO: 11/30/2022

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove
Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

12-1-2022
Tyler

3310.2200200.0000

APPLICATION FOR PAYMENT

Application Is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

1. ORIGINAL CONTRACT SUM		$17,160.00		
2. Net change by Change Orders	 $		
3. CONTRACT SUM TO DATE (Line 1 ;;/- 2)	$17,160.00	
4. TOTAL COMPLETED & STORED TO DATE	$9,820.00	

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

RETAINAGE

(Column G on G703)

10% of Completed Work 	
(Column D .. E on G703
10% Stored Material	NIA

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been
paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due.

Total Retainage (Line 5a + 5b) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from llliQ! Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

$9,820.00

$8,100.00

	$1,120.00MS	
	$7,340.00	

::NT	

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contracl Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the lncicated, the quallity of the Work is in accordance with the Contract Documents, and the Contractor 1s entitled to payment of the AMOUNT CERTIFIED.

DATE\

MyCommi  • n	xpires:	a  JO' )	J	tfll1\ Comm #GG908R,

Slate of:

Florida

Countyfl°1/	Saint Lucie

Subscribed ands omlo)"'	r•Yof/ V

Notary Public·

-9'(F	·

(}@I.bv.

,...;f¥1J'P, _;,,,. Candace AZZORara'

.2022

D	f>	:::>	\i i/ ExpiresAugt,S·?S !Ot
·•,, 0 r.. •  Rrvvfod ,.,no,">'fY' ili•
AMOUNT CERTIFIED..............................................	$1,720.00
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

 By:	Date:	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	A/A DOCUMENTG703	PAGE OF PAGES 2-of 2

AIA Docume111 G702, APPLICATION AND CERTIFICATION FOR PAYMENT. containing
Contrac1or1s signed certification is attached.
ln tabulations below, amounts are stated to the neares1 dollar.
Use Column I on Contracts where variable retainage for line items may apply.

APPLICATION NO:	3
APPLICATION DATE:	11/30/22
PERIOD TO:	11/30/22
GFA'S PROJECT NO: 3310. 2200200

A	B	Quanitv	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRJPTION
OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	THIS PERIOD	PRESENTLY	COMPLETED	(G-C)	TO FINISH	
						APPLICAT!ON		STORED	AND STORED		(C-0)	
						(D+E)		(NOTIN	TO DATE			
								DORE)	(D+E+F)			
												
	Construction Material Testing				$17,160.00	$8,100.00	$1,720.00		$9,820.00	57.23%	7,340.00	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00					000%		
	Change Orders:									0.00%		
	GRAND TOTALS				$17,160.00	$8,100.00	$1,720.00	$0.00	$9,820.00	57.23%	7,340.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document 0401 - Certification of Document's Authenticity

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

November 30, 2022
Project: No:	3310.2200200.0000
Invoice No:	00663178

Terms: Net 30 days
We accept American Express, Visa, Master Card, Discover, and ACH

Project:	3310.2200200.0000	Parr Drive Improvements

Location:

Parr Drive
Port St Lucie, FL

126

Professional Services through November 30, 2022
Phase	3310	CMT Parr Drive Improvements
Unit Billing
Administration Fee
11/30/2022	0.5 Hours @ 50.00	25.00
In-Place Density Test - Soils	
10/26/2022	WO#284148	3.0 Tests @ 25.00	75.00	
10/27/2022	WO#284149	13.0 Tests @ 25.00	325.00	
11/4/2022	WO#285232	4.0 Tests @ 25.00	100.00	
11/30/2022	Logbook - Force Main	24.0 Tests @ 25.00	600.00	
Professional Engineer (Per Hr.)	
11/30/2022	1.0 Hour @ 125.00	125.00		
Project Manager/Quality Control				
	1.0 Hour @ 85.00	85.00		
Technician Time (Per Hr.)				
	5.5 Hours @ 70.00	385.00		
Total Units		1,720.00	1,720.00	
Total this Phase	$1,720.00

Total this Invoice	$1,720.00

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR	PAYMENT			Page 1 of	
TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436	PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL	APP.

PERIOD	#4

TO: 2/28/2023	

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Mater als Testing, Inspections
APPLICATION FOR PAYMENT

7657-4
Tyler

3310.2200200.0000

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

1. ORIGINAL CONTRACT SUM		$17,160.00		
2. Net change by Change Orders	$	
3. CONTRACT SUM TO DATE (Line 1 =/- 2)		$17,160.00		
4. TOTAL COMPLETED & STORED TO DATE		$10,665.00		

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

RETAINAGE

(Column G on G703)

10% of Completed Work 	
(Column D + E on G703
10% Stored Material	N/A

Total Retainage (Line Sa + Sb) or
(Total in Column I of G703)		

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Worl< for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due.

TOTAL EARNED
(Line 4 less Line S Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from I!!!.!!! Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE

Slate of:

Florida

CONTRACTOR

Subscribed and sworn to before me this '?

,, _f	( _ ..,

BY

 	

DATE

Notary Public:
My Commissionires:

•

J-ocf'

JENNIFERRB
MYCOMMISSION I HH323323
EXPIRES:February 18.2027

(Line 3 less Line 6)

	$10,665.00	

	$9,820.00,L,_	
	$845.oo Y!_MS	
	$6,495.00	

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the incicated, the qualiity of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED		$845.00	
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

By:	Date:

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE OF PAGES2of2

AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below. amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

APPLICATION NO:	4
APPLICATION DATE:	02/24/23
PERlOD TO:	02/28/23
GFA'SPROJECTNO: 3310.2200200

A	B	Ouanfr\.·	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	THISPERJOD	PRESENTLY	COMPLETED	IG+C)	TOFINJSH	
						APPLICATION		STORED	AND STORED		(C-GI	
						tD+E)		(NOT IN	TO DATE			
								DORE)	(D+E+FI			
												
	Construction Material Testing				$17,160.00	$9,820.00	$845.00		$10,665.00	62.15%	6,495.00	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00				$0.00	0.00%		
	Change Orders:								$0.00	0.00%		
	GRAND TOTALS				$17,160.00	$9,820.00	$845.00	$0.00	$10,665.00	62.15%	6,495.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

February 27, 2023
Project: No:	3310.2200200.0000
Invoice No:	00687201

Terms: Net 30 days
We accept American Express, Visa, Master Card, Discover, and ACH

Project:	3310.2200200.0000	Parr Drive Improvements

Location:

Parr Drive
Port St Lucie, FL

Professional Services through February 28, 2023
Phase	3310	CMT Parr Drive Improvements
Unit Billing
Administration Fee
2/28/2023	1.0 Hour @ 50.00	50.00
In-Place Density Test - Soils	
2/1/2023	WO# 291657	4.0 Tests @ 25.00	100.00	
2/9/2023	WO# 292400	7.0 Tests @ 25.00	175.00	
2/17/2023	WO# 292998	4.0 Tests @ 25.00	100.00	
Professional Engineer (Per Hr.)	
2/28/2023	1.0 Hour @ 125.00	125.00		
Project Manager/Quality Control				
	1.0 Hour @ 85.00	85.00		
Technician Time (Per Hr.)				
	3.0 Hours @ 70.00	210.00		
Total Units		845.00	845.00	
	Total this Phase		$845.00	
	Total this Invoice		$845.00	

129

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Pa_g_e 1 of 2

TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

7657-5
Tyler

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL
3310.2200200.0000

APP.	# 5

PERIOD TO: 04/30/2023

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE (Line 1 =/- 2)
TOTAL COMPLETED & STORED TO DATE
(Column G on G703)

	$17,160.00	
 $	
	$17,160.00;:l	
	$12,855.50	

RETAINAGE

10% of Completed Work 	
(Column D + E on G703
10% Stored Material	N/A

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been
paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due.

Total Retainage (Line 5a + 5b} or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from er!Qr Certificate}
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

s

State of:	Florida

	$12,855.50	

	$10,665.00	
	$2,190.50	MS
$4,304.50

Countx <}f r _  Saint Lucie

::NTRA

DATE.5

fore	is} /
MyCommi  i	)J-i tb_

day of / V \j\-'.(

.,. Candace ,c.,z.zoparai
\ comm.#GG9088' 1e,io2;

"

it)
'

ARCHITECT'S CERTIFICATE FOR PAYMENT

AMOUNT   CERTIFIED ..............................................

	$2,190.50	

In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the incicated, the qualiity of the Work is in accordance w h the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

 By:	Date:	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE OF PAGES 2 of 2

AJA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

APPLICATION NO:	5
APPLICATION DATE:	04/26/23
PERIOD TO:	04/30/23
GFA'S PROJECT NO: 3310. 2200200

A	B	Ouanitv	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION
OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	THIS PER1OD	PRESENTLY	COMPLETED	(G+C)	TOFINJSH	
						APPLICATION		STORED	AND STORED		(C-G)	
						(D+E)		(NOTJN	TO DATE			
								DORE)	(D+E+Fl			
												
	Construction Material Testing				$17,160.00	$10,665.00	$2,190.50		$12,855.50	74.92%	4,304.50	

												

												

												

												

												
												
									-			

												

												

												
												
	Subtotal				$17,160.00				$0.00	0.00%		
	Chanae Orders:								$0.00	0.00%		
	GRAND TOTALS				$17,160.00	$10,665.00	$2,190.50	$0.00	$12,855.50	74.92%	4,304.50	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

INVOICE	
Ptease Make Payable to: Universal Engineering Sciences
Remit to: P.O. Box 735401, Chicago, IL 60673-5401	
Billing questions contact: uesar@leamues.com	

607 NW Commodity Cove, Port St. Lucie, FL 34986 I p 772-924-35751 r 772-924-3580

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

April 26, 2023 Project: No: Invoice No:

3310.2200200.0000
00704651

TERMS: Net 30 Days
We accept American Express, Visa
Master Card, Discover, and ACH	

Project:
Location:

3310.2200200.0000
Parr Drive
Port St Lucie, FL

Parr Drive Improvements

Phase	3310	GMT Parr Drive Improvements
Unit Billing
Laboratory Proctor Test (Each)
12/8/2022	Lab ID 6462	1.0 TEST@ 95.00

95.00

In-Place Density Test - Soils	
12/8/2022	WO#287476	10.0 Tests@ 23.00	230.00	
12/29/2022	Log Book - Water Densities	56.0 Tests @ 23.00	1,288.00	
4/21/2023
Administration Fee	WO# 296308	6.0 Tesis @ 25.00

0.5 Hours@ 50.00	150.00

25.00	
Professional Engineer (Per Hr.)	
12/31/2022
Project Manager/Quality Control	0.5 Hours@ 125.00

0.5 Hours @ 85.00	62.50

42.50	
Technician Time (Per Hr.)			
4.25 Hours @ 70.00	297.50		
Total Units	2,190.50	2,190.50	

Total this Phase Total this Invoice

$2,190.50

$2,190.50

132

SUBCONTRACTOR/VENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of

TO:	Mattmay Homes
2401 Quantum Lakes Drive

PROJECT:	Paar Drive Improvements
Paar Drive

APP.	#6

Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove
Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

7657-6
Tyler

Port St Lucie, FL 3310.2200200.0000

PERIOD TO: 05/31/2023

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE (Line 1 =/- 2)
TOTAL COMPLETED & STORED TO DATE
(Column G on G703)

$17,160.00

 $	
	$17,160.00	
	$13,641.75	

RETAINAGE

10% of Completed Work 	
(Column D +Eon G703
10% Stored Material	N/A

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor. and the current payment shown here is now due.

Total Retainage (Line 5a + 5b) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from JWQ! Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE

�Y,o

(Line 3 less Line 6)
State of:
Subscn 'bedan swo[ t Florida

Countyr.

	$13,641.75	

	$12,855.50	

	$786.25 ,L MS	
$3,518.25

, 2023

CONTRACTOR

(.	Notary Public:	. o....

....reme t ilt\"7	day of C(\Y.{,, Saint Lucie

BY	DATE

My Comm;.,	/	/	'-( e

i

xp1res:	'{  b	�	fJ_

VY\{.	

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the incicated, the qualiity of the Work is in accordance wtth the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED		$786.25	
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

 By:	Date:	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE OF PAGES2of2

AJA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.

APPLICATION NO: APPLICATION DATE:
PERIOD TO:

6
05/31/23
05/31/23

Use Column I on Contracts where variable retainage for line items may apply.

GFA'S PROJECT NO: 3310.2200200

A	B	Ouanil'I	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	nns PERIOD	PRESENTLY	COMPLETED	(G+C)	TOFINISH	
						APPLICATION		STORED	AND STORED		(C-G)	
						(D+EI		(NOTIN	TO DATE			
								DORE)	(D+E+F)			
												
	Construction Materlal TestlnQ				$17,160.00	$12,855.50	$786.25		$13,641.75	79.50%	3,518.25	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00				$0.00	0.00%		
	Change Orders:								$0.00	0.00%		
	GRAND TOTALS				$17,160.00	$12,855.50	$786.25	$0.00	$13,641.75	79.50%	3,518.25	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

INVOICE	
Please Make Payable to: Universal Engineering Sciences	
Remit to: P.O. Box 735401, Chicago, IL 60673-5401	
Billing questions contact: uesar@teamues.com	

607 NW Commodity Cove, Port St. Lucie, FL 34986 | p 772-924-3575 | f 772-924-3580

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

Project:	3310.2200200.0000	Parr Drive Improvements

May 31, 2023
Project: No:	3310.2200200.0000
Invoice No:	00719046

TERMS: Net 30 Days
We accept American Express, Visa Master Card, Discover, and ACH	

Location:

Parr Drive
Port St Lucie, FL

Professional Services through June 30, 2023
Phase	3310	CMT Parr Drive Improvements
Unit Billing
Administration Fee
5/31/2023	0.25 Hours @ 50.00	12.50

5/19/2023	WO # 269439	6.0 Tests @ 25.00	150.00	
5/24/2023	WO # 300816	2.0 Tests @ 25.00	50.00	

In-Place Density Test - Soils
Professional Engineer (Per Hr.)
5/31/2023	0.5 Hours @ 125.00	62.50
Project Manager/Quality Control

Technician Time (Per Hr.)

0.25 Hours @ 85.00	21.25
7.0 Hours @ 70.00	490.00

Total Units	786.25	786.25
Total this Phase	$786.25
Total this Invoice	$786.25

135

	

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of 2

TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

7657-7
Tyler

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL
3310.2200200.0000

APP.	#7

PERIOD TO: 06/30/2023

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE (Line 1 =/- 2)
TOTAL COMPLETED & STORED TO DATE
(Column G on G703)

	$17,160.00	
 $	
$17,160.00 .-..-.;z_
	$13,766.75	

RETAINAGE

10% of Completed Work 	
(Column D + E on G703
10% Stored Material	N/A

The undersigned SubcontractorNendor certifies that to the best of his knowledge infonnation and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due.

CONTRACTOR

Total Retainage (Line 5a + 5b) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Tota
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from llli!1! Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

{_p

	$13,766.75	

	$13,641.75	
	$125.oo ._L MS	
$3,393.25

State of:	Florida			Coun		paint Lucie Subscribed nd swfrn to)'	m this	ay	of	U\.

2023

VJ

y	,

BY	DATE 7\ 1e\1.\ 

NotaryPubh	/
My Commission Expires:

.-,\ iYz•,,,_ Candace AZZORara:

.J	,.,	•·	Jfr'

&/7 2-	f A .,\. Comm.#GG9088'3.
'CJ-'	\¾,,.._.,.'<!/ E xP1resA	JA

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the incicated, the qualiity of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED-.............................................	'""$125.00
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

By:	Date:

 ugus;

,•,• :;

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE OF PAGES 2 of 2

AJA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

APPLTCATION NO:	7
APPLICATION DATE:	06/30/23
PER10D TO:	06/30/23
GFA'S PROJECT NO: 3310. 2200200

A	B	Quanitv	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	TIIISPERIOD	PRESENTLY	COMPLETED	(G•C)	TO FINISH	
						APPLICATION		STORED	AND STORED		(C-Gl	
						(D+E)		(NOTIN	TO DATE			
								DORE)	(D+E+F}			
												
	Construction Material Testlnq				$17,160.00	$13,641.75	$125.00		$13,766.75	80.23%	3,393.25	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00				$0.00	0.00%		
	ChanQe Orders:								$0.00	0.00%		
	GRAND TOTALS				$17,160.00	$13,641.75	$125.00	$0.00	$13,766.75	80.23%	3,393.25	
Users may obtain validation of this document by requesting of the license a completed AIA Document 0401 - Certification of Document's Authenticity

INVOICE	
Please Make Payable to: Universal Engineering Sciences	
Remit to: P.O. Box 735401, Chicago, IL 60673-5401	
Billing questions contact: uesar@teamues.com	

607 NW Commodity Cove, Port St. Lucie, FL 34986 | p 772-924-3575 | f 772-924-3580

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

Project:	3310.2200200.0000	Parr Drive Improvements

June 29, 2023
Project: No:	3310.2200200.0000
Invoice No:	00723860

TERMS: Net 30 Days
We accept American Express, Visa
Master Card, Discover, and ACH	

Location:

Parr Drive
Port St Lucie, FL

Professional Services through June 30, 2023
Phase	3310	CMT Parr Drive Improvements
Unit Billing
Administration Fee
0.25 Hours @ 50.00	12.50
In-Place Density Test - Soils
6/7/2023	WO# 301892	1.0 Test @ 25.00	25.00
Professional Engineer (Per Hr.)

Project Manager/Quality Control Technician Time (Per Hr.)

0.25 Hours @ 125.00	31.25
0.25 Hours @ 85.00	21.25
0.5 Hours @ 70.00	35.00

Total Units	125.00	125.00
Total this Phase	$125.00
Total this Invoice	$125.00

138

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of 2

TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR):  GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

7657-8
Tyler

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL
3310.2200200.0000

APP.	# 8

PERIOD TO: 08/30/2023

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE (Line 1 =/- 2)
TOTAL COMPLETED & STORED TO DATE
(Column G on G703)

$17,160.00

z

$

	$17,160.00	
$14,559.25

RETAINAGE

10% of Completed Work 	
(Column D + E on G703
10% Stored Material	NIA

The undersigned SubcontractorNendor certifies that to the best of his knowledge lnfom,a on and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due.

Total Retainage (line Sa• Sb) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from J!!lQ!: Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

	$14,559.25	

	$13,766.75	

	$792.so	MS	
$2,600.75

State of:

Florida

County of:	Sain.t. Lucie

CONTRACT

Subscribedsom to before me this Notary Public·	-:C
.  .	.
My Comm1ss10	xpIres:

fj, \ Notary Public· State of Flo a

··· • i,,'•,.	ROXANN TAYLOR

.	023
nd

BY

 	

DATE	1'.)

\-0...•.�l,..<-/ My Commission# HH 169275

Comm. Expires Aug 28, 2025

'•,.?,• f:'SQndedthrough National Notary A;sr..

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the lncicated, the qualiity of the Work is in accordance w h the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED......................... ..":':'.. :'?.. '.":':.. ':":..w  w-	-  -$792.50
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

By:	Date:

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENTG703	PAGE OF PAGES 2 of 2

AIA Docwnent G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.

APPLICATION NO:
APPLICATION DATE:
PERIOD TO:

8
08/30/23
08/30/23

Use Column I on Contracts where variable retainage for line items may apply.	GFA'S PROJECT NO: 3310. 2200200

A	B	Quanir:y	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION OF WORK				
SCHEDULED	
WORK COMPLETED	
MArnRIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	TinSPERJOD	PRESENTLY	COMPLETED	(G+C)	TOFINISH	
						APPLICATION		STORED	AND STORED		(C-Gi	
						(D+EI		(NOTIN	TO DATE			
								DORE]	(D+E+F)			
												
	Construetion Material Testing				$17,160.00	$13,766.75	$792.50		$14,559.25	84.84%	2,600.75	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00				$0.00	0.00%		
	ChallQe Orders:								$0.00	0.00%		
	GRAND TOTALS				$17,160.00	$13,766.75	$792.50	$0.00	$14,559.25	84.84%	2,600.75	
Users may obtain validation of this document by requesting of the license a completed AIA Document 0401 - Certification of Document's Authenticity

INVOICE	
Please Make Payable to: Universal Engineering Sciences	
Remit to: P.O. Box 735401, Chicago, IL 60673-5401	
Billing questions contact: uesar@teamues.com	

607 NW Commodity Cove, Port St. Lucie, FL 34986 | p 772-924-3575 | f 772-924-3580

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

Project:	3310.2200200.0000	Paar Drive Improvements

August 30, 2023
Project: No:	3310.2200200.0000
Invoice No:	00742579

TERMS: Net 30 Days
We accept American Express, Visa
Master Card, Discover, and ACH	

Location:

Parr Drive
Port St Lucie, FL

Professional Services through August 31, 2023
Phase	3310	Paar Drive Improvements
Unit Billing
Administration Fee

In-Place Density Test - Soils

1.0 Hour @ 50.00	50.00

8/8/2023	WO# 306391	5.0 Tests @ 25.00	125.00	
8/9/2023	WO# 306504	9.0 Tests @ 25.00	225.00	

Professional Engineer (Per Hr.) Project Manager/Quality Control Technician Time (Per Hr.)

0.5 Hours @ 125.00	62.50
1.0 Hour @ 85.00	85.00
3.5 Hours @ 70.00	245.00

Total Units	792.50	792.50
Total this Phase	$792.50
Total this Invoice	$792.50

141

Invoice # 2687855	Page 1 of 1	
ACCOUNT NUMBER	DATE	
MATTHOM-01	04/18/2022	
BALANCE DUE ON	AMOUNT DUE	
04/18/2022	$5,686.00	

Hub International Midwest West
Phone: 630-468-5600
Fax:

Pay My Bill Online
Visit our online portal to easily and securely pay your HUB invoice using your banking information (ACH)
www.hubinternational.com/paymybill

Darryl Dawe Mattamy Homes
66 Wellington Street West, Suite 5500 Toronto, ON M5K 1G8

Bond (Renewable)			PolicyNumber:	SUR0074053	Effective:	04/15/2022	to	04/15/2023	
									
Item #	Trans Eff Date	Due Date	Trans	Description				Amount	
30659456	04/15/2022	04/18/2022	NEWB	Mattamy Homes Palm Beach, LLC				$5,686.00	
Subd. City of Port St. Lucie, FL; Southern Grove 4C (Parr Drive) $1,263,467.40	Policy Invoice Balance:	$5,686.00	
	Total Invoice Balance:	$5,686.00	

*** PREMIUM FINANCING OPTIONS MAY BE AVAILABLE UPON REQUEST; PLEASE CONTACT YOUR HUB REPRESENTATIVE ***
*** PLEASE RETURN A COPY OF THIS INVOICE WITH YOUR CHECK, AND REFERENCE ON THE PAYMENT YOUR INVOICE #	2687855 ***

PAY BY CHECK
Please remit your payment to:
HUB International
55 East Jackson Boulevard Suite 14th Floor
Chicago, IL 60604

ADDITIONAL PAYMENT OPTIONS

More detailed information about how Hub International is compensated can be found at hubinternational.com behind the "How We Get Paid" tab.

142

HROBINSON

APPLICATION AND CERTIFICATE FOR PAYMENT

Invoice #:  120557

To Owner:

Mattamy Palm Beach LLC	Project:
2500 Quantum Lakes Drive, Suite 215

Boynton Beach, FL 33426

22-0017- CDD SG Parr Road

#8365-1
8-19-2022
Tyler

Application No. :

Period To:

1

06/30/2022

Distribution to :
Owner Architect/Engineer Contractor

From Contractor:

Contract For:

H and J Contracting Inc. 3160 Fairlane Farms Road
Wellington, FL 33414
64228384

Via Architect/Engineer:

Project Nos:

Contract Date:

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

1. Original Contract Sum . . . . . . . . . . . . . . . . . . . . . . . .	$1,034,777.00	
2. Net Change By Change Order . . . . . . . . . . . . . . . . . . . .	$0.00	
3. Contract Sum To Date . . . . . . . . . . . . . . . . . . . . . . . . . .	$1,034,777.00	
4. Total Completed and Stored To Date . . . . . . . . . . . . . . .	$86,595.00	
5. Retainage:		

CONTRACTOR:

SUZETTE ANDRIANO
H and J Contracting Inc.MY COMMISSION # HH 010148

EXPIRES: July 10, 2024
Bonded Thru Notary Public Underwriters

By:	Date: 7/7/22	
Jeremy Rury - Vice President

10.00%

of Completed Work

$8,659.50

State of: Florida

Subscribed and sworn to before me this

7th

County of:Palm Beach
day of July, 2022

b.	0.00% of Stored Material

Total Retainage . . . . . . . . . . . . . . . . . . . . . . . . . . .

$0.00

$8,659.50

Notary Public:
My Commission expires:

July 10, 2024

Total Earned Less Retainage . . . . . . . . . . . . . . . . . . .

Less Previous Certificates For Payments . . . . . . . . . .
Current Payment Due . . . . . . . . . . . . . . . . . . . . . . . . .

$77,935.50

$0.00
$77,935.50

ARCHITECT'S/ ENGINEER'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, and belief, the Work has progressed as indicated ,
the quality of the Work is in accordance with the Contract Documents , and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

Balance To Finish, Plus Retainage . . . . . . . . . . . . . . .	$956,841.50

AMOUNT CERTIFIED

$77,935.50

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total Approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
Net Changes By Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.)

ARCHITECT/ ENGINEER:

08/15/2022

___________________

By:			Date:	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

143

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

1
06/30/22
06/30/22

Invoice # :

120557

Contract : 22-0017- CDD SG Parr Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	0.00	1,770.00	0.00	1,770.00	10.00%	15,930.00	177.00	
	Survey									
110	Clear & Grub Site	28,290.00	0.00	28,290.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	0.00	2,760.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	0.00	47,025.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	0.00	6,750.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	0.00	0.00	0.00	0.00	0.00%	16,200.00	0.00	
300	12 Compacted Subgrade	21,840.00	0.00	0.00	0.00	0.00	0.00%	21,840.00	0.00	
305	16 FDOT Rock Base LBR100	216,580.00	0.00	0.00	0.00	0.00	0.00%	216,580.00	0.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	0.00	0.00	0.00	0.00%	115,200.00	0.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	0.00	0.00	0.00	0.00	0.00%	80,660.00	0.00	
335	Drop Curb	4,484.00	0.00	0.00	0.00	0.00	0.00%	4,484.00	0.00	
340	Type RA Curb	9,900.00	0.00	0.00	0.00	0.00	0.00%	9,900.00	0.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	0.00	86,595.00	0.00	86,595.00	8.37%	948,182.00	144	8,659.50	

APPLICATION AND CERTIFICATE FOR PAYMENT

Invoice #:  120957

To Owner:

Mattamy Palm Beach LLC	Project:
2500 Quantum Lakes Drive, Suite 215

Boynton Beach, FL 33426

22-0017- CDD SG Parr Road

#8365-2
10-25-2022

Application No. :

Period To:

2

10/31/2022

Distribution to :
Owner Architect/Engineer Contractor

From Contractor:

H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414

Via Architect/Engineer:

Tyler

Project Nos:

Contract For:	64228384

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

Contract Date:

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown

1. Original Contract Sum . . . . . . . . . . . . . . . . . . . . . . . .	$1,034,777.00	
2. Net Change By Change Order . . . . . . . . . . . . . . . . . . . .	$0.00	
3. Contract Sum To Date . . . . . . . . . . . . . . . . . . . . . . . . . .	$1,034,777.00	
4. Total Completed and Stored To Date . . . . . . . . . . . . . . .	$96,465.00	
5. Retainage:		

herein is now due. CONTRACTOR:

SUZETTE ANDRIANO
H and J Contracting Inc.MY COMMISSION # HH 010148
EXPIRES: July 10, 2024
Bonded Thru Notary Public Underwriters

By:	Date: 10/18/22	
Jeremy Rury - Vice President

a.	10.00%  of Completed Work

State of: Florida

County of: Palm Beach

b.	0.00% of Stored Material

$9,646.50
$0.00

Subscribed and sworn to before me this Notary Public:

18th

day of	October, 2022

Total Retainage . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Earned Less Retainage . . . . . . . . . . . . . . . . . . .

Less Previous Certificates For Payments . . . . . . . . . .
Current Payment Due . . . . . . . . . . . . . . . . . . . . . . . . .

$9,646.50

$86,818.50

$77,935.50
$8,883.00

My Commission expires: July 10, 2024

ARCHITECT'S/ ENGINEER'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, and belief, the Work has progressed as indicated ,
the quality of the Work is in accordance with the Contract Documents , and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

Balance To Finish, Plus Retainage . . . . . . . . . . . . . . .	$947,958.50

AMOUNT CERTIFIED

$8,883.00

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total Approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
Net Changes By Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.)

ARCHITECT/ ENGINEER:

10/24/2022

_____________________

By: 		Date:	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

145

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

2
10/31/22
10/31/22

Invoice # :

120957

Contract : 22-0017- CDD SG Parr Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	1,770.00	1,770.00	0.00	3,540.00	20.00%	14,160.00	354.00	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	0.00	8,100.00	0.00	8,100.00	50.00%	8,100.00	810.00	
300	12 Compacted Subgrade	21,840.00	0.00	0.00	0.00	0.00	0.00%	21,840.00	0.00	
305	16 FDOT Rock Base LBR100	216,580.00	0.00	0.00	0.00	0.00	0.00%	216,580.00	0.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	0.00	0.00	0.00	0.00%	115,200.00	0.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	0.00	0.00	0.00	0.00	0.00%	80,660.00	0.00	
335	Drop Curb	4,484.00	0.00	0.00	0.00	0.00	0.00%	4,484.00	0.00	
340	Type RA Curb	9,900.00	0.00	0.00	0.00	0.00	0.00%	9,900.00	0.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	86,595.00	9,870.00	0.00	96,465.00	9.32%	938,312.00	146	9,646.50	

APPUCATION AND CERTIFICATE FOR PAYMENT	Invoice#:  12J02l

To Owner.	Mall:amy Palm Beach LLC
2500 Quantum Lakes Driive, Suite 215

Boynton Beach, FL 33426
From Coniractor:	H and J Contracting lnr:.

Projecl.:  22-0017- COD SG Parr Road	Appllcalion No. :	3
Ple'rloclTo:	11/30/2022.
Via

Dislributi1m le :
CJ	Owner
C:J	Archi!ec1/Ehglnllilr
[==:J  Contractor
c:=i
c=J

3160 Fairtane Farms Road Wellington, FL 33414
Contract !For:	64228384

Alchifecl/Eg13jnur.	8365

FrojeclNos:

Contract Date:

CONTRACTOR'S APPLICATION FOR PAYMENT
Ap,plicalion is ma<le ror pa.ymenl. "<''i soown below, In connecoon with lhe ConlracL
COnlinualioo Slieel is attached.

Original Contract Sum
Net Chan.ge By Chal"lge Order .. , ................ .

$1,034,777.00
$0,00

The undersigned Contractor certifies tl7at to the best of the Contractor's knowledge, information, and belief, the work covered by this Application forl"a9ment ha,s been completed in accordance with the Contract Documents. That all amounts have,been paid by the Contractor for Work for which previous Certillcales for Payment were issued and payments received from the Owner, and that current payment shown

04

herein is now due.	SUZETTE ANDRIANO
CONTRACTOR:	Hand J Contracttng Inc. MY COMMISSION# HH 010148
EXP:IRES: July 10, 2024

Contract Sum To Date . , ................... ,....

$1,034,777.00		

Bo.nded Thru Notary Public Underwriters

Total Completed and Stornd To Date .............. .
Relainage:

$106.,335.00

By;	/ 	Date:  11/16/22
Jeremy 1Rury-\7ice President

Palm Beach

a.	10.00¼ of Completed Work

0.00¾ of Stored Material

$10,633.50
$0.00

Stale ot: Florida

S�3a:iz A�

Suoscribed and sworn to before me lhi 16th .
Notary Public:
My Commission expl'to/ July 10, 2024

County or: day of

November, 2022

Total Retainage .................... ,	,

Total Earned Less Retalnaga , . , ....... ,....... .

Less Previous Certificates For Payments ......... .
Current Payment Due ........................ .

Balance To Finish, Plus Retainage ... , ....... ,,..

$10,633.50

$95.701.50

$86,818,SJC
$8,883.00

$939,075.50

ARCHITECTS/ ENGINEER'S CERTllrlCATE FOR PAYMENT
In accordar-1ce with the Contract Documents, based on on-site observations and'Ule da1a cornpris·ing lhe above application, li:1e Architect certifies to the Owner that to the bes-tof the Architect's !cnowledg.e, inforrnalion, and belief, the Work has progressed as indicated,
lhe qualrty of the Work. is in accordance with the Co11lracl Documents, and lne Contractor is enliUed lo payment of the AMOUNT CERTIFIED,

AMOU.NT CERTIFIED	$8,883.00

(Attach explanation if amount cerfifierJ rJJffers·from /heamount applied. Initial all figures on thisAppf"ICBtron al'ld on the

iCHANGE ORDER SUMMARY	Addit1ons	Deductions	
1  Total change
1I' In pre\'ious	s a,p,Jll"o,,
,moolhs by	ed
·Owner	$0.00	$0.00	
Total Approved this Mon!.h	$0.00	$0.00	
i
TOTALS	so.co	$0.00	
Net Changes By Change Order	$0.00	

Corr!inuatlon Sheet thal ate changed to conform ,vtlh the amount certified.)
:

'	ARCHl NG	
By:---w--2-Date: fJ-Z.1-lvt.t
This Certific te fs not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment. and aoceptance of payment are without prejudice- to any rights of the Owner or Contractor under this Contract.

147

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

3
11/30/22
11/30/22

Invoice # :

121021

Contract : 22-0017- CDD SG Parr Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	3,540.00	1,770.00	0.00	5,310.00	30.00%	12,390.00	531.00	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	8,100.00	8,100.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	0.00	0.00	0.00	0.00	0.00%	21,840.00	0.00	
305	16 FDOT Rock Base LBR100	216,580.00	0.00	0.00	0.00	0.00	0.00%	216,580.00	0.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	0.00	0.00	0.00	0.00%	115,200.00	0.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	0.00	0.00	0.00	0.00	0.00%	80,660.00	0.00	
335	Drop Curb	4,484.00	0.00	0.00	0.00	0.00	0.00%	4,484.00	0.00	
340	Type RA Curb	9,900.00	0.00	0.00	0.00	0.00	0.00%	9,900.00	0.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	96,465.00	9,870.00	0.00	106,335.00	10.28%	928,442.00	148
10,633.50	

APPLICATION AND CERTIFICATE FOR PAYMENT	1nvoice#:  121111

To Owner:	Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215

Project: 22-0017- CDD SG Paar Road	Application No. :	4

Distribution to :

C:J

Owner
c:=I Architect/Engineer

Boynton Beach, FL 33426 From Contractor:	H and J Contracting Inc.
3160 Fairlane Farms Road Wellington, FL 33414

Via Architect/Engineer:

8365-4
Tyler

Period To:	12/31/2022

Project Nos:

[=:J  Contractor
[=:J
C:J

Contract For:

64228384

Contract Data:

CONTRACTOR'S APPLICATION FOR PAYMENT
AppllcaUon Is made for payment, as shown below, In connection with lhe ContracL ConUnuaUon Sheet is allached.

Original Contract Sum ........................ .

$1,034,777.00

The undersigned Contractor certifies that lo the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown
here1n Is now due.	SUZETTE ANDRIANO
.	MY COMMISSION# HH 010148

Net Cliange By Change Order ........... ,	,..
Contract Sum To Date .. _ ...................... .

$0.00
$1,034,777,00

CONTRACTOR:

HandJ Contracting Inc. EXPIRES: July 10, 2024

Bonded Thru Notary Public Underwriters

4T.otal Completed and Stored To Date .............. .

Retalnage:

$154,110.00

·----	1--,,L.- 		Date:_1_/4_/2_3_

ice President

a,	10.00%  of Completed Work

b.	0.00% of Stored Material

$15,411.00
$0.00

Stale of: Florida
Subscribed and sworn to before me this 4th
Notary Publlc:Su �	A
My Commission e	: July 10, 2024

County of: Palm Beach
day of	January, 2023

Total Retalnage , .......................... .

Total Earned Less Retainage .................. .

Less Previous Certificates For Payments	,.
Current Payment Due ........................ .

$15,411.00

$138,699.00

$95,701.50
$42,997.50

Engineer's Approval
The engineer, through periodic onsite observations. agrees with the requested payment amount based on onsite progress and the. eng1neer sees no reason why payment should not be made. This work has been completed, but has not been certified to the municipality or considered 100% complete until a final walk-lhfough, and approval by the municipality has occurred. It is the contractor's obli_gation to maintain the construoted Improvements until such time. The engineer does not warrant the completed work or perform dally observations
to make sure that the completed work is being maintained.

Balance To Finish, Plus Relainage .. _ ........... .	$896,078.00

AMOUNT CERTIFIED	$42,991.soMS
(Attach explanallon if amount certified differs from Iha amount applied. /nitlal al/ figures on this Application and on Iha Continua/ion Sheet that are changed lo conform with the amount certified,)

CHANGE ORDER SUMMARY
Total changes approved
in previous months by Owner
Total Approved lhis Month

Net Changes By Change Order

	Additions

$0.00	Deductions

$0.00	
	$0.00	$0.00	
TOTALS	$0.00	$0.00	
	$0.00		

ARCHITECT/ ENGINEER:
By:,	

Date: / -	Jb- lo  23

This Certificate is not negotiable. The AMOUNT CERTIFIED 1s payable only lo the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

149

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

4
12/31/22
12/31/22

Invoice # :

121111

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	5,310.00	0.00	0.00	5,310.00	30.00%	12,390.00	531.00	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	16,200.00	0.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	0.00	15,288.00	0.00	15,288.00	70.00%	6,552.00	1,528.80	
305	16 FDOT Rock Base LBR100	216,580.00	0.00	32,487.00	0.00	32,487.00	15.00%	184,093.00	3,248.70	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	0.00	0.00	0.00	0.00%	115,200.00	0.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	0.00	0.00	0.00	0.00	0.00%	80,660.00	0.00	
335	Drop Curb	4,484.00	0.00	0.00	0.00	0.00	0.00%	4,484.00	0.00	
340	Type RA Curb	9,900.00	0.00	0.00	0.00	0.00	0.00%	9,900.00	0.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	106,335.00	47,775.00	0.00	154,110.00	14.89%	880,667.00	150
15,411.00	

APPLICATION AND CERTIFICATE FOR PAYMENT	lavoice #:  12}) 60

To Owner:	Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215

PrQject: 22-0017- COD SG Paar Road	Application No.;	5
Inv #121160

Distribution lo :

c:::J

Owner
[:=I  Architect/Engineer

Boynton Beach, FL 33426

8365-5

Period To:	01/31/2023

[:=J Contractor
c::::::J

From Contractor:

Contract For:

H and J Contracting Inc. 3160 Fairlane Farms Road
Wellington, FL 33414
64228384

Via
Architect/Engineer:

Tyler

CJ
Project Nos:

Contract Date:

CONTRACTOR'S APPLICATION FOR PAYMENT
AppllcaUon Is made for payn,en1. as shown below, in connection with Iha Contract. Continuation Sheet is attached,

Original Contract Sum ....................... .

$1,034,777 .DO

The undersigned Contractor certifies that to the best of the Contractor's knowledge, fnformation, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. Thal all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were Issued and payments received from the Owner, and that current payment shown
herein is now due.	SUZETTE ANDRIANO
.	MY COMMISSION# HH 010148

Net Change By Change Order ........ ,.......... .
Contract Sum To Dale .............. _ .  ..  _ .... .

$0.00
$1.034,777.0o\/'

CONTRACTOR:

HandJ Contracting lnc'EXPIRES: July 10, 2024

Bonded Thru Notary Public Underwriters

Total Completed and Stored To Date ... 	........ .

Retainage:
10.00% of Completed Work
$41,266.60

$412,666.00

By:	 r		Date: 1/18/23
Jeremy Rury:JCePresident
State of: Florida
Subscribed and sworn to before me this t1h_

Coun\y of: Palm Beach
day of	January, 2023

0.00% of Stored Material

Total Retainage	,..

6T.otal Earned Less Retainage .................. .

Less Previous Certificates For Payments ......... .
Current Payment Due ........................ .

$0.00

$41,266.60

$371,399.40

$138,699.00
$232,700.40

Notary Publfc: Su,3 ,t(/�
MyCommissionexrc,s: July 10, 2024

Engineer's Approval
The engfneer, through periodic onsite obse111ations, agrees with the requested payment amount based on onsite progress and the engineer sees no reason why payment should not be made. This work has been completed, but has not been certified to the municipality or considered 100% complete until a fina,l walk-through, and approval by the municipality has occurred. Ills the contractor's obligation to maintain the constructed Improvements until such time. The engineer does not warrant the completed work or perform da,lly observations to make sure that the completed work is being maintained

Balance To Finish, Plus Retainage ..  _.   . _	_.

$663,377.60

AMOUNT CERTIFIED	$232.100.4M0	S

CHANGE ORDER SUMMARY
Total changes approved
in previous rnonlhs by Owner
Total Approved this Month

Additions

Deductlons

TOTALS

$0.00

$0.00

Net Changes By Change Order

$0.00

(Attaoh explanat./on if amount certified differs from the amount app/led, In/tis/ all figures on this Appl/cation and an the Continuation Shaet that are ohanged to conform with the amount certified.)

$0.00	$0.00	ARCHITECT/ ENGINEER:		
$0.00	$0.00	By:		rm(/_	Date: l. :1.3_- 2--'	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance. payment, and acceptance of payment are without prejudice to a;,y rights of the Owner or Contractor under this Contract.

151

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

5
01/31/23
01/31/23

Invoice # :

121160

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	5,310.00	4,425.00	0.00	9,735.00	55.00%	7,965.00	973.50	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	16,200.00	0.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	15,288.00	6,552.00	0.00	21,840.00	100.00%	0.00	2,184.00	
305	16 FDOT Rock Base LBR100	216,580.00	32,487.00	162,435.00	0.00	194,922.00	90.00%	21,658.00	19,492.20	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	0.00	0.00	0.00	0.00%	115,200.00	0.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	0.00	80,660.00	0.00	80,660.00	100.00%	0.00	8,066.00	
335	Drop Curb	4,484.00	0.00	4,484.00	0.00	4,484.00	100.00%	0.00	448.40	
340	Type RA Curb	9,900.00	0.00	0.00	0.00	0.00	0.00%	9,900.00	0.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	154,110.00	258,556.00	0.00	412,666.00	39.88%	622,111.00	152
41,266.60	

APPLICATION AND CERTIFICATE FOR PAYMENT	Invoice#:  121211

To Owner:		Mattamy Palm Beach LLC	Project: 22-0017- CDD SG Paar Road 2600 Quantum Lakes Drive, Suite 215

Application No_ :	6

Distribution to :

C=:J

Owner
C=:J Architect/Engineer

Boynton Beach, FL 33426
From Contractor:	H and J Contracting Inc.	Via

Inv 121211-6
8365
Tyler

Period To:	02/28/2023

c:J	Contractor
c:J
[:=I

Contract For:

3160 Fairlane Farms Road Wellington, FL 33414
64228384

Archltec Engineer:

Project Nos:

Contract Date:

**This Pay App does not included JDE CO #1

CONTRACTOR'S APPLICATION FOR PAYMENT
Application Is made for payment, as shown below, In connection with the ContracL Conllnuatton Sheet ls attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed In accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which prevlous Certificates for Payment were issued and payments received from the Owner, and that current pc1yment shown

Original Contract Sum ..	................... .

Net Change By Change Order ................... .

$1,034,777.00
$0.00

herein is now due. CONTRACTOR:

SUZETTE ANDRIANO

4

Hand J Contracting Inc. MY COMMISSION# HH 010148
EXPIRES: July 10, 2024

Contract Sum To Date ............. ,........ _ ..  .

$1,034,777.00		

Bonded Thru Notary Public Underwriters

Total Completed and Stored To Date	, ..
Relainage:
10.00% of Completed Work
$55,942.40

$559,424.00

By:	'J'7	,.	Date: 2/20/23
Jeremy Rury - e President
State of: Florida
Subscribed and sworn to before me this 20th

County of: Palm Beach
day of	Florida, 2023

-	0.00% of Stored Material

Total  Retalnage       ...........................

Tota'! Earned Less Relainage _ .............. _ ..  .

Less Previous Certificates For Payments	_.
Current Payment Due ...... _ .. _ ...... _ .. _ .... .

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous monlhs by Owner	$0.00	$0.00	
Total Approved this Month	$0.00	$0.00	

TOTALS	$0.00	$0.00	
Net Chang.es By Change Order	$0.00	

Balance To Finish, Plus Retainage ...... ,....... .

$0.00

$55,942.40

$503,481.60

$371,399.40
$132,082.20

$531,295.40

Notary Public: Su '0177L A,,,,	MA
My Commissfon ex '-July i()','	-

Engineer's Approval
The engineer, through periodic onsite observations, agrees with the requested payment amount based on onsite progress and the en_gineer sees no reason why payment should not be made. Thls work has been completed, but has not been certified to the munlcipality or considered 100% complete until a final
walk-through, all testing, and approval by the municipality has occurred. It is the contractor's obligation to maintain the constructed improvements until such time. The engineer does not warrant the completed work or perform daily observations to make sure that the completed work is being maintained.
AMOUNT CERTIFIED	$132,082.20 MS
(Attach e'l<fJ/anatfon If amounl certified differs from /he amount applied. tnltiel all figures- on this Application and on the Continuation Sheet that ere changed to conform with the amount cerlified.)

ARCHITECT/ ENGINEER:
By:	1%@1	�		Date: 1- 2_K - 2 3
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this.Contract.

153

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

6
02/28/23
02/28/23

Invoice # :

121211

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	9,735.00	0.00	0.00	9,735.00	55.00%	7,965.00	973.50	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	16,200.00	0.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	21,840.00	0.00	0.00	21,840.00	100.00%	0.00	2,184.00	
305	16 FDOT Rock Base LBR100	216,580.00	194,922.00	21,658.00	0.00	216,580.00	100.00%	0.00	21,658.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	115,200.00	0.00	115,200.00	100.00%	0.00	11,520.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	80,660.00	0.00	0.00	80,660.00	100.00%	0.00	8,066.00	
335	Drop Curb	4,484.00	4,484.00	0.00	0.00	4,484.00	100.00%	0.00	448.40	
340	Type RA Curb	9,900.00	0.00	9,900.00	0.00	9,900.00	100.00%	0.00	990.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	412,666.00	146,758.00	0.00	559,424.00	54.06%	475,353.00	154
55,942.40	

APPLICATION AND CERTIFICATE FOR PAYMENT	Invoice#:  121273

To Owner:	Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215

Project:  22-0017- COD SG Paar Road	Application No. :	7
Inv #121273-7

Distribution to :
Owner
[:=J  Architect/Engineer

Boynton Beach, FL 33426

8365

Period To:	03/31/2023

c::::::J Contractor
r:::::J

From Contractor:

Contract For:

H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414
8365

Via Architect/Engineer:

Tyler

Project Nos: Contract Date:

CONTRACTOR'S APPLICATION FOR PAYMENT
Ai,plicalion is made for payment, as shown below, fn connection with the Contract
ConUnuation Sheet Is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the Work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were Issued and payments received from the Owner, and that current payment shown

Original Contract Sum .. _ .. _ ................. .
Net Change By Change Order ..... , .... , ........ .
Contract Sum To Date ......................... .

$1,034,777.00
$11,088.00
$1,045,865.00

herein is now due. CONTRACTOR:

SUZETTE ANDRIANO
Hand J Contracting Inc. MY COMMISSION # HH 010148
EXPIRES: July 10, 2024
Bonded Thru Notary Public Underwriters

Total Completed and Stored To Dale .............. .

5R. etainage:
10.00'll,  of Completed Work
$57,064.70

$570,647.00

By:	�<		Date:3115/23
Jeremy Ru	e President
State of: Florida
Subscribed ands to before me this 16tj, .

County ot Palm Beach
dayof	March, 2023

0.00% of Stored Material

Total Retainage ........................... .

Total Earned Less Retainage

Less Previous Certificates For Payments ......... .
o.irrent Payment Due ............... , ......... .

Balance To Finish, Plus Retainage .............. .

$0.00

$67,064.70

$513,582.30

$503,481.60
$10,100.70

$532,282.70

Notary Public:	0ugrd.:a,, A
My Commission expirt51 July 10, 2024

Engineer's Approval
The engineer, through periodic onsite observations, agrees with the requested payment amount based on onslle progress and the engineer sees no reason why payment should not be made. This work has been completed, but has not been certilied to the municipality or considered 1OOo/o complete until a flnal walk-through, all testing, and approval by the municipality has occurred. ll is the contractor's obligation to maintain the cons1ructed improvements until such time. The engineer does not warrant the compleled
work or perform daily observations to make sure that the completed work is being maintained.

AMOUNT CERTIFIED	$10,100.70MS

CHANGE ORDER SUMMARY
Total changes approved
In previous months by Owner
Total Approved this Month

Net Changes By Change Order	

TOTALS	Additions	Deductions	
		$0.00	$0.00	
		$11,088.00	$0.00	
		$11,088.00	$0.00	
		$11,088.00		

(Attach explanation if amount certified differs from the amount applied. Initial all figuras on this Application and on the Continuation Shea/ that are changed to oonform with the amount certified./

&	

ARCHITECT/ ENGINEER:
By: EoR Ber 	Date:  '	I3 - 2 3
This Certificate is not negotiable. The AMOUNT CERTIFIED Is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

155

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

7
03/31/23
03/31/23

Invoice # :

121273

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	9,735.00	2,655.00	0.00	12,390.00	70.00%	5,310.00	1,239.00	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	16,200.00	0.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	21,840.00	0.00	0.00	21,840.00	100.00%	0.00	2,184.00	
305	16 FDOT Rock Base LBR100	216,580.00	216,580.00	0.00	0.00	216,580.00	100.00%	0.00	21,658.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	115,200.00	0.00	0.00	115,200.00	100.00%	0.00	11,520.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	80,660.00	0.00	0.00	80,660.00	100.00%	0.00	8,066.00	
335	Drop Curb	4,484.00	4,484.00	0.00	0.00	4,484.00	100.00%	0.00	448.40	
340	Type RA Curb	9,900.00	9,900.00	0.00	0.00	9,900.00	100.00%	0.00	990.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
CO1.01	2" Asphalt Bottom Lift Type SP	14,112.00	0.00	14,112.00	0.00	14,112.00	100.00%	0.00	1,411.20	
CO1.02	1" Asphalt Top Lift Type SP	8,064.00	0.00	0.00	0.00	0.00	0.00%	8,064.00	0.00	
CO1.03	Customer Discount	-11,088.00	0.00	-5,544.00	0.00	-5,544.00	50.00%	-5,544.00	-554.40	
Grand Totals	1,045,865.00	559,424.00	11,223.00	0.00	570,647.00	54.56%	475,218.00	156
57,064.70	

64228384.1510.31045
Tyler

From :

Invoice
H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414 US

Bill to:

Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #

Disc Date

Customer Ref

Terms

Invoice Date

Due Date

Invoice #

334262

Ship to:

2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #	Customer Ref	Invoice #	Invoice Date	Due Date	Disc Date	Terms	
1534	Southern Grove Paar	220017-2	06/30/23	06/30/23		Due Upon Receipt	

Mth/Trans	Line	Description	Contract	Item		Unit Price	Quantity	Amount	
06/23 618	1	Replace & Repour RA Curb	22-0017-	1	0.000	20,160.00	
240 LF @ $84.00
06/23 618	

2	

Credit for RA Curb	

22-0017-	

1	

0.000	

-10,080.00	
120 LF @ ($84.00)	

Notes:
Southern Grove Paar Curb Repairs	Total Sales Tax		10,080.00	
	Less Retainage			
	Total Due		10,080.00	

From :

Invoice
H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414 US

64228384.1510.3xxxx
Tyler to Provide CC

Bill to:

Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #

Disc Date

Customer Ref

Terms

Invoice Date

Due Date

Invoice #

334262

Ship to:

2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #	Customer Ref	Invoice #	Invoice Date	Due Date	Disc Date	Terms	
1534	Southern Grove 4C	220017-3	08/22/23	08/22/23		Due Upon Receipt	

Mth/Trans	Line	Description	Contract	Item		Unit Price	Quantity	Amount	
08/23 162	1	Paar Rd Clean Up	22-0017-	1	0.000	840.00	

Notes:
Southern Grove 4C Paar Rd	Total Sales Tax		840.00	
	Less Retainage			
	Total Due		840.00	

64228357.1510.3xxxx
Tyler to provide CC

From :

Invoice
H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414 US

Bill to:

Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #

Disc Date

Customer Ref

Terms

Invoice Date

Due Date

Invoice #

334262

Ship to:

2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #	Customer Ref	Invoice #	Invoice Date	Due Date	Disc Date	Terms	
1534	Southern Grove 4C	220007-10	08/22/23	08/22/23		Due Upon Receipt	

Mth/Trans	Line	Description	Contract	Item		Unit Price	Quantity	Amount	
08/23 156	1	Sidewalk Grading	22-0007-	1	0.000	780.00	

Notes:
Southern Grove 4C	Total Sales Tax		780.00	
	Less Retainage			
	Total Due		780.00	

APPLICATION AND CERTIFICATE FOR PAYMENT

Invoice #:  121666

To Owner:

Mattamy Palm Beach LLC	Project:
2500 Quantum Lakes Drive, Suite 215

Boynton Beach, FL 33426

22-0017- CDD SG Paar Road

Inv #121666-8

Application No. :

Period To:

8

10/31/2023

Distribution to :
Owner Architect/Engineer Contractor

From Contractor:

H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414

Via Architect/Engineer:

8365
Frank

Project Nos:

Contract For:	8365

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

Contract Date:

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown

1. Original Contract Sum . . . . . . . . . . . . . . . . . . . . . . . .	$1,034,777.00	
2. Net Change By Change Order . . . . . . . . . . . . . . . . . . . .	$32,468.50	
3. Contract Sum To Date . . . . . . . . . . . . . . . . . . . . . . . . . .	$1,067,245.50	
4. Total Completed and Stored To Date . . . . . . . . . . . . . . .	$690,163.00	
5. Retainage:		

herein is now due. CONTRACTOR:

H and J Contracting Inc.

SUZETTE ANDRIANO
MY COMMISSION # HH 010148 EXPIRES: July 10, 2024
Bonded Thru Notary Public Underwriters

By:	Date: 10/19/23	

Jeremy Rury - Vice President

10.00%

of Completed Work

State of: Florida

County of:Palm Beach

b.	0.00% of Stored Material

$69,016.30
$0.00

Subscribed and sworn to before me this19th Notary Public:
My Commission expireJs:uly 10, 2024

day of

October, 2023

Total Retainage . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Earned Less Retainage . . . . . . . . . . . . . . . . . . .

Less Previous Certificates For Payments . . . . . . . . . .
Current Payment Due . . . . . . . . . . . . . . . . . . . . . . . . .

$69,016.30

$621,146.70

$513,582.30
$107,564.40

In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, and belief, the Work has progressed as indicated ,
the quality of the Work is in accordance with the Contract Documents , and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

ARCHITECT'S/ ENGINEER'S CERTIFICATE FOR PAYMENT
The engineer, through periodic onsite observations, agrees with the requested
payment amount based on onsite progress and the engineer sees no reason why payment should not be made. This work has been completed, but has not been certified to the municipality or considered 100% complete until a final
walk-through, all testing, and approval by the municipality has occurred. It is the contractor’s obligation to maintain the constructed improvements until such time. The engineer does not warrant the completed work or perform daily observations

Balance To Finish, Plus Retainage . . . . . . . . . . . . . . .	$446,098.80

AMOUNT CERTIFIED

$107,564.40

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous months by Owner	$11,088.00	$0.00	
Total Approved this Month	$21,380.50	$0.00	
TOTALS	$32,468.50	$0.00	
Net Changes By Change Order	$32,468.50	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.)

ARCHITECT/ ENGINEER:

__________

___________

By:			Date:_ 11/15/23 	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	Page 2 of 3

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

8
10/31/23
10/31/23

Invoice # :

121666

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	12,390.00	1,770.00	0.00	14,160.00	80.00%	3,540.00	1,416.00	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	16,200.00	0.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	21,840.00	0.00	0.00	21,840.00	100.00%	0.00	2,184.00	
305	16 FDOT Rock Base LBR100	216,580.00	216,580.00	0.00	0.00	216,580.00	100.00%	0.00	21,658.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	115,200.00	0.00	0.00	115,200.00	100.00%	0.00	11,520.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	80,660.00	0.00	0.00	80,660.00	100.00%	0.00	8,066.00	
335	Drop Curb	4,484.00	4,484.00	0.00	0.00	4,484.00	100.00%	0.00	448.40	
340	Type RA Curb	9,900.00	9,900.00	0.00	0.00	9,900.00	100.00%	0.00	990.00	
345	Type D Curb	5,428.00	0.00	5,428.00	0.00	5,428.00	100.00%	0.00	542.80	
350	Concrete Sidewalk 6	224,400.00	0.00	49,087.50	0.00	49,087.50	21.88%	175,312.50	4,908.75	
355	ADA Ramp	41,850.00	0.00	41,850.00	0.00	41,850.00	100.00%	0.00	4,185.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
CO1.01	2" Asphalt Bottom Lift Type SP	14,112.00	14,112.00	0.00	0.00	14,112.00	100.00%	0.00	1,411.20	
CO1.02	1" Asphalt Top Lift Type SP	8,064.00	0.00	0.00	0.00	0.00	0.00%	8,064.00	0.00	
CO1.03	Customer Discount	-11,088.00	-5,544.00	0.00	0.00	-5,544.00	50.00%	-5,544.00	-554.40	
CO2.01	6" Temp Solid White & Yellow Line	4,180.50	0.00	4,180.50	0.00	4,180.50	100.00%	0.00	418.05	
	Paint									
CO2.02	8" White Line - Paint	192.00	0.00	192.00	0.00	192.00	100.00%	0.00	19.20	
CO2.03	12" Temp White Solid Paint	180.00	0.00	180.00	0.00	180.00	100.00%	0.00	18.00	
CO2.04	24" Temp White Solid Paint	828.00	0.00	828.00	0.00	828.00	100.00%	0.00	82.80	
CO2.05	18" Yellow Line - Paint	420.00	0.00	420.00	0.00	420.00	100.00%	0.00	42.00	
CO2.06	Temp Paint Yield Bars	360.00	0.00	360.00	0.00	360.00	100.00%	0.00	36.00	
CO2.07	Yield Street Message Temp Paint	240.00	0.00	240.00	0.00	240.00	100.00%	0.00	24.00	
CO2.08	FDOT R03-17/R03-17BP	635.00	0.00	635.00	0.00	635.00	100.00%	0.00	63.50	
CO2.09	FDOT R03-17/R03-17AP	635.00	0.00	635.00	0.00	635.00	100.00%	0.00	161	63.50	

CONTINUATION SHEET	Page 3 of 3

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

8
10/31/23
10/31/23

Invoice # :

121666

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
CO2.10	FDOT R4-7 Keep Right Sign 24 X 30/	1,270.00	0.00	1,270.00	0.00	1,270.00	100.00%	0.00	127.00	
	OM1-1									
CO2.11	FDOT W11-2 - 30 X 30 Crosswalk	5,080.00	0.00	5,080.00	0.00	5,080.00	100.00%	0.00	508.00	
	Sign/W16-7pl									
CO2.12	FDOT R1-2 Yield Sign 36 X 36	2,540.00	0.00	2,540.00	0.00	2,540.00	100.00%	0.00	254.00	
CO2.13	FDOT R6-4a	2,420.00	0.00	2,420.00	0.00	2,420.00	100.00%	0.00	242.00	
CO2.14	FDOT R2-1 Speed Limit Sign - 24 X	635.00	0.00	635.00	0.00	635.00	100.00%	0.00	63.50	
	30									
CO2.15	FDOT Case 2 18 X18	1,125.00	0.00	1,125.00	0.00	1,125.00	100.00%	0.00	112.50	
CO2.16	R1-2 Yield Sign 18 X 18	640.00	0.00	640.00	0.00	640.00	100.00%	0.00	64.00	
Grand Totals	1,067,245.50	570,647.00	119,516.00	0.00	690,163.00	64.67%	377,082.50	162
69,016.30	

64228384.1510.3xxxx
Tyler to Provide CC

From :

Invoice
H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414 US

Bill to:

Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #

Disc Date

Customer Ref

Terms

Invoice Date

Due Date

Invoice #

334262

Ship to:

2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #	Customer Ref	Invoice #	Invoice Date	Due Date	Disc Date	Terms	
1534	Southern Grove 4C	220017-6	08/22/23	08/22/23		Due Upon Receipt	

Mth/Trans	Line	Description	Contract	Item		Unit Price	Quantity	Amount	
08/23 165	1	Road Prepping ADA Ramps 2	22-0017-	1	0.000	4,200.00	

Notes:
Southern Grove 4C Paar Road	Total Sales Tax		4,200.00	
	Less Retainage			
	Total Due		4,200.00	

Page 1 of 1

163

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:
Mattamy Homes
2500 Quantum Lakes Blvd Ste 215 Attn: Frank Covelli
FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court Riviera Beach, FL 33404
CONTRACT FOR: Paar Road • 64228384

PROJECT:
Paar Road - Utilities

VIA ARCHITECT: Kimley Hom

APPLICATION NO: APPLICATION DATE:

PERlODTO:

PROJECT NO: CLIENT REFERENCE: CONTRACT DATE:

8/31/2022
2022-106
8/1/22-8/31/22

64228384
Paar Road - Pipeline Utilities

Distribution to: c=]oWNER c:::JARCHITECT c:::J CONTRACTOR
c:::J
c:::J

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

I. ORIGINAL CONTRACT SUM	$	906,517.45	
2. Net change by Change Orders	$	0.00	
3. CONTRACTSUMTODATE(Linel±2)	$	906,517.45	
4. TOTAL COMPLETED & STORED TO	$	227,031.10	

CONTRACTOr· ...	I l)k. .

y

, }._(	.  .	-

DATE	(Column G on G703)
5. RETAINAGE:
a		10 % of Completed Work	$ (Column D + E on G703)

	22,703.11 

f  ,\ '\,;·  ') I	I
By:	 ..,"-/ ',:::_..,,,,7\/	,'

State of:
Subscribed and sworn to before me this /') Qj

Date:
Coooty o.t ;:._-.D()llfitl)5t. IIIIM:DGG::•-.R.1t/E.Ql S
day of	. •	Notal'V Public
s,ate of Flonda

0 % of Stored Material	$		
(ColumnF on G703)
Total Retainage (Lines Sa+ Sb or

Notary Public:	i  [/	,

l

My Commission expires:	•	I

, -	•·

Commit 1-1tt169929 E.,(pires 8/26/2015

Total in Column I ofG703)	$ 	22,703.11	ARCHITECT'S CERTIFICATE.FOR PAYMENT	
6. TOTAL EARNED LESS RETAlNAGE	$ 	204,327.99	In accordance with the Contract Documents, based on on-site observations and the data	
(Line 4 Less Line S Total)		comprising the application, the Architect certifies to the Owner that to the best of the	
7. LESS PREVIOUS CERTIFICATES FOR		Architect's knowledge, information and belief the Work has progressed as indicated,	
PAYMENT (Line 6 from prior Certificate)	$ 	0.00	the quality of the Work is in accordance with the Contract Documents, and the Contractor	
8. CURRENTPAYMENTDUE	$ 	204.327.99	is entitled to payment of the AMOUNT CERTIFIED.	
9. BALANCE TO FINISH, INCLUDING RETAINAGE	$ 	702,189.46		
(Line 3 less Line 6)		AMOUNT CERTIFIED ........... $		204,327.99 	

CHANGE"'ORDER SUMMA.RY	ADDlTIONS	DEDUCTIONS	
Total changes approved
in previous months by Owner		
$0.00
$0.00
$0.00	
$0.00	
Total approved this Month			$0.00	
TOTALS			$0.00	
NET CHANGES by Change Order	$0.00	

(Attach e:,;planation if amount certified differs from the amount applied. Jnitial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.)
:CIDTECT·:	Date:  09/07/2022

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AIA DOCUME"1T G702 • APPLICATION AND CERTIFICATION FDR PAYMENT· 1992 EDITION· AIA • 101992	THE AMERICAN INSTITUTE OF ARCHrfECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292
Users may obtain validation of this docu·ment by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

164

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 1
APPLICATIO ON DATE: 8/31/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 8/1/22-8/31/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE
Phase - Cost Code	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00
$0.00	
-	
-	$0.00
$0.00	$0.00
$0.00	-
-	0%
0%	$51,500.00
$0.00	$0.00
$0.00	
	Subtotal			$51,500.00	$0.00	-	$0.00	$0.00	$0.00	0%	$51,500.00	$0.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	-	-	$0.00	$0.00	-	0%	$26,210.25	$0.00	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	-	$0.00	$0.00	-	0%	$2,060.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-	-	$0.00	$0.00	-	0%	$3,440.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	-	-	$0.00	$0.00	-	0%	$17,700.00	$0.00	
31020	Water Fittings	10	$	840.00	$8,400.00	-	-	$0.00	$0.00	-	0%	$8,400.00	$0.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	-	-	$0.00	$0.00	-	0%	$4,660.00	$0.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-	-	$0.00	$0.00	-	0%	$4,000.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-	-	$0.00	$0.00	-	0%	$555.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	-	-	$0.00	$0.00	-	0%	$25,090.00	$0.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-	-	$0.00	$0.00	-	0%	$2,200.00	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$94,315.25	-	-	$0.00	$0.00	-	0%	$94,315.25	$0.00	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	-	-	$0.00	$0.00	-	0%	$2,600.00	$0.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	-	920	$161,000.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	-	-	$0.00	$0.00	-	0%	$4,929.00	$0.00	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	-	-	$0.00	$0.00	-	0%	$6,460.00	$0.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	-	-	$0.00	$0.00	-	0%	$54,810.00	$0.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	-	-	$0.00	$0.00	-	0%	$24,750.00	$0.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	-	-	$0.00	$0.00	-	0%	$31,960.00	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$399,209.00	-		$161,000.00	$0.00	161,000.00	40%	$238,209.00	$16,100.00	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	-	63	$4,249.35	$0.00	4,249.35	33%	$8,498.70	$424.94	
31015	24" RCP	819	$	89.35	$73,177.65	-	305	$27,251.75	$0.00	27,251.75	37%	$45,925.90	$2,725.18	
31015	30" RCP	108	$	120.00	$12,960.00	-	45	$5,400.00	$0.00	5,400.00	42%	$7,560.00	$540.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	-	-	$0.00	$0.00	-	0%	$19,110.00	$0.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	-	1	$9,450.00	$0.00	9,450.00	33%	$18,900.00	$945.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	-	-	$0.00	$0.00	-	0%	$34,830.00	$0.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	-	2	$19,680.00	$0.00	19,680.00	33%	$39,360.00	$1,968.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	-	-	$0.00	$0.00	-	0%	$121,277.50	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$361,493.20	-		$66,031.10	$0.00	66,031.10	18%	$295,462.10	$6,603.11	
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	-		$0.00	$0.00	$0.00	0%	$51,500.00	$0.00	
	31020	Water	$94,315.25	$94,315.25	-		$0.00	$0.00	$0.00	0%	$94,315.25	$0.00	
	31620	Force Main	$399,209.00	$399,209.00	-		$161,000.00	$0.00	$161,000.00	40%	$238,209.00	$16,100.00	
	31015	Drainage	$361,493.20	$361,493.20	-		$66,031.10	$0.00	$66,031.10	18%	$295,462.10	$6,603.11	
	GRAND TOTALS			$906,517.45	$0.00		$227,031.10	$0.00	227,031.10	25%	$547,424.15	$22,703.11	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 1
APPLICATIO ON DATE: 8/31/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 8/1/22-8/31/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE
Phase - Cost Code	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						

Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT 0702	PAGE ONE OF TWO PAGES

TO OWNER:
Mattamy Homes
2500 Quantum Lakes Blvd Ste 215
Attn: Frank Covelli
FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court Riviera Beach, FL 33404
CONTRACT FOR: Paar Road - 64228384

PROJECT:
Paar Road - Utilities

VIA ARCHITECT: Kimley Hom

7757
10/15/22

APPLICATION NO: APPLICATION DATE:

PERIOD TO:

PROJECT NO: CLIENT REFERENCE: CONTRACT DATE:

2
9/30/2022
2022-122
9/]/22 - 9/30/22

64228384
Paar Road - Pipeline Utilities

Distribution to: C}OWNER C}ARCHITECT C]coNTRACTOR
CJ
CJ

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, A1A Document G703, is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amoWits have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that curre1;1t payment shown herein is now due.
n_,

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACTSUMTODATE(Line I ±2)
TOTAL CO!\1PLETED & STORED TO
DATE	(Column Gon G703)
RETAINAGE:

$	906,517.45

V

$ 	0.00 
$	906,s 11.4s
$ 		39_3"",0_85_._95_

CYO·N_T_RA ,,7_TO.-:::;.·_... ) B 

Date:	j/3v/zi,.
A	''	7

	IO % of Completed Work	$ (Column D +Eon 0703)

	39,308.60 

State of:fL	County of: f.:.I
Subscribed and sworn to before me this	day of Scp-N _.,.b .,	ZO"

	0 % of Stored Material	$		 (Column Fon 0703)
Total Retainage (Lines Sa+ Sb or

Notary Public:	 ""----- My Commission expires:

Total in Column I ofG703)
TOTAL EARNED LESS RETAINAGE
(Line 4 Less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificate)
CURRENTPAYMENTDUE
BALANCE TO FrNISH, lNCLUDING RETAINAGE

$	39,308.60
$	,-35=3-,1=1=1."0'"36.,...	

1/ 

$ ,	 204,327.99 v
149,449.37
$ 		55_2.:.,7_40_._I0_

ARCHITECT'S CERTIFICATE FOR P
In accordance with the Contract Documents, based on on-site obse comprising the application, the Architect certifies to the Owner that Architect's knowledge, information and belief the Work has progre the quality of the Work is in accordance with the Contract Docume is entitled to payment of the AMOUNT CERTIFIED.

KYLES KOPF
tiffilry Public-State of Florida
¼i\;ommission # H-H 132031
~ea My Commission Expires
'	May 21, 2025

(Line 3 less Line 6)

AMOUNT CERTIFIED	$

149,449.37

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTJONS	
Total changes approved
in previous months by Owner	
$0.00	
$0.00	
Total approved this Month	$0.00	$0,00	
TOTALS	$0.00	$0.00	
NET CHANGES by Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial al/figures on this Application and on/he Continuation Sheet that are changed to conform with the amotmt certified.)

------------

ARyB.·.CHITECT:	10/05/2022
-	Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herem. lssuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AIA DOCUMENT G702 • APPLICATION AND CERTIFICATION FOR PAYMENT· 1992 EDITION· AIA • <il1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE.. N.W., WASHINGTON, DC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document 0401 - Certification of Document's Authenticity from the Licensee.

167

CONTINUATION SHEET	AJA DOCUMENT G703
AlA Document 0702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is att1ched.
ln tabulations below, amounts are stated to the nearest dollar.
Use ColumnI on Contracts where variable retainage for Line itemsmay apply.

PAGETWO OFT'NO PAGES
APPLJCATION NO: 2 APPLICATIONONDATE: 9/30/22
PERIOD TO: 911/22 - 9/30/22
PROJECT NO: 64228384

G

CUENT REF: Paar Road - P11 ehne Uti]1"t1es

A
-:vo,

B
---·- lvNv,· Wvi."-£'1.

l,lU:mt1ty

PRJCE

D	E
V{l,,_RK

F
MAiCNJ\J..S

·~·~	,.

H
OA!.AN<.,o

I
K.1:.1,... ,,.A,u;t:.

CODE
P1wa.-c 1eo&

VALUE

fRuM Pl'I..C..- •...,.,.,.;, Al'PLICATION (D+EJ

OTYTHIS PERIOD

ltU;:i l,,;l\.lVV

PRESENTLY STORED (NOT IN DORE)

COMPLETED AND STORED TO DATE (D+E+F)

(G+C)

TO FINISH (C-G)

(IF VARJABLE
RATE)

10%

31245

General
Survey, Layout. & As-Buills

Subtotal Water

l	$51,500.00

$51.500.00
$0.00
$51,500.00

0
-
SO.DO	-

$12,875.00
$0.00
SI 2,875.00

$0.00
$0.00
$0.00

12.875.00

Sl2.875.00

25%
0%
25%

$38,625.00
S0.00
$38.625.00

$1,287.50
$0.00
SI ,287.50

31020
31020

31020
31020
31020
31020
31020
31020
31020
31020

31620
31620
31620
31620
31620
31620
31620

31015
31015
31015
31015
31015
31015
31015
31015

-

Water Main- 8" C-900
Water Pressure Test

Water Main Sample Points Water Main Fill & Flush Water Fittings
Water Main s Gnte Valve w/Box
Water Main 211 BlowoffTemporruy for Testing,
Adjust Valve Box
W!l.ter Main 16 x 8 Tapping Sleeve & Valve 211 Blowoff -Temprary for Testing

Subtotal
Force M!l.in
Force Main - 8" C-900 Force M!l.in - 16"C-900 Force Ma.in - Pr ure Test Connect to E::cisting FM Force Main Fittings
Force M:i.in 16'1 &.i.te Valve w/Box Foree Main ARV Assembly

Subtot:i.1 Drninage 18" RCP
24" RCP
30" RCP
Storm Se\.VerInspection
Inlet - Type P-5 Inlet -Type J-5 Inlet Type P-6 Edge Drain

Subtotal
SUMMARY BY COST CODE
31245
31020
31620
31015

GRANDTOTA!.S

297
1

4
2
10
2
2
l
2
1

26
1,564
1,590
1
14
2
z

189
819
108
l
3
2
6
3,490

General Water Force Main Drainage

$	88.25
s	2,060.00

$	860.00
s	8.850.00
$	840.00
s	2,330.00
s	2,000.00
s	555.00
$	12,545.00
$	2,200.00

s	100.00
s	175.00
$	3.10
$	6,460.00
$	3,915.00
s	12,375.00
s	15,980.00

$	67.45
$	89.35
$	120.00
$	19,110.00
$	9,450.00
$	17,415.00
s	9,840.00
$	34.75

$51,500,00
$94,315-25
S399,209.00
$361,493-20

$26,210.25
$2,060.00

$3,440.00
$17.700.00
$8.400.00
$4,660.00
$4,000.00
$555.00
S25,090.00
$2,200.00
SO.DO S94.315.25
SO.OD
$2,600.00
$273,700.00
$4,929.00
$6,460.00
$54,810.00
S24,750.00
$31,960.00
S0.00
$399,209.00

$12,748.05
$73,177.65
$12,960.00
$19.110.00
$28,350.00
$34,830.00
$59,040.00
$121,277.50
$0.00
$361,493.20

$51,500.00
$94,315.25
$399,209.00
$361,493.20

$906,517.45

-

,

161,000.00

-

161,000.00

4,249
27,252
5,400
-
9,450
-
19,680
-
-
66,031.10

-
-
161,000.00
66,031.10

$16 I,000.00

297
-
-
-
10
2

-
-

26

-

126
414
63

2

4

$26,210.25
$0.00

$0.00
$0.00
$8,400.00
$4,660.00
$0.00
$0.00
$0.00
$0.00
$0.00
$39,270.25

$2,600.00
S0.00 S0.00
So.oo
SO.OD SO.OD SO.DO S0.00
$2,600.00

$8,498.70
$36,990.90
$7,560.00
$0.00
Sl8,900.00
$0.00 539,360.00
$0.00
$0.00
$111,309.60

$12,875.00
$39,270-25
$2,600.00
SI 11,309.60

$166,054.85

$0.00
$0.00

S0.00 SO.DO SO.OD
$0.00
$0.00
$0,00
so.oo
SO.DO SO.OD SO.OD

$0.00
SO.OD
$0.00
SO.DO
$0.00
SD.00
$0.00
S0.00
$0.00

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00

$0.00
$0.00
$0.00
$0.00

$0.00

26,210.25

8.400.00
4,660.00
-
-
-
.
39.270.25

2,600.00
161,000.00
-
-
-
-
-
-
163,600.00

12,748.05
64,242.65
12,960.00
-
28,350.00

59,040.00

I77.340.70

$12,875.00
$39.270-25
$163,600.00
$177,340.70

393,085.95

100%
0%

0%
0%
100%
100%
0%
0%
0%
0%
0%
42%

100%
59%
0%
0%
0"/4
O"I,
O"/,
0%
41%

100"/4
88¾
100%
0%
100%
0%
100%
0%
0"/4
49%

25%
42%
41%
49%

43%

$0.00
$2,060,00

$3,440.00
$17,700.00
$0,00
$0.00
$4,000.00
$555.00
$25,090,00
$2,200.00
S0.00
$55,045 00

SD.OD S112,700.00
$4,929.00
$6,460.00
$54,810.00
$24,750.00
$31,960.00
SO.OD SlJS,609.00

SD.OD 58,935.00
$0.00 519,110.00
$0.00
$34,830.00
$0.00
$121.277.50
$0.00
$184.152.50

$38.625.00
$55,045.00
$235,609.00
$184,152.50

$513.43 I.SO

$2,621.03
$0.00

$0.00
SO.DO
$840.00
$466,00
$0.00
$0.00
$0.00
SO.OD SO.DO
$3.927.03

S260.00
SI 6,100.00
so.oo
S0.00 SO.OD SO.DO SO.OD SO.DO S16,360.00

Sl.274.81 S6.424.27
$1,296.00
$0.00
$2,835.00
$0.00
$5,904.00
$0.00
SO.OD S17.734.07

$1,287.50
$3,927.03
$16,360.00
$17,734.07

$39,308.60

AIA DOCUMENT G7m • CONTINUATION SHEET FOR G702-1992 EOmON • A!A ·<!'J'1992
THE AMERICAN INSTITUTE OF ARCHITECTS, 17'J5 NEW YORK AVENUE. N,W, WASHINGTON. D.C. 2COOS62J2

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE'tWO Ol=T"NO PAGES

AlA Document 0702, APPLICATION AND CERTIFICATION FOR PAYMENT, ccntainins
Contractor's sigoed certification is :mached.
ln tabulations below, amounts are sr:ued 101he nc3rest doUar.
Use Columnl on Contracts \Vhcre variable retainage for line items may apply,

APPLICATION NO: 2 APPLI CATl OMON DATE: 9/30122
PERIOD TO: 9/1/22 - 9/30122
PROJECT NO: 64228384
CLIENT REF· Paar Raad - Pineline Utilities

A	B				D	,.,	I	E	F	G	H	!	
u,i"
CODE
l'll•t•CJW.Clldc	DESCRll'flON OrWu,u,.	l.,lUMllty	PN t

..	..,..,,	ULED
VALUE	w,n	MA,-uAL
PRESENTLY STORED (NOTIN DORE]	T"",:ru.
COMPLETED AND STORED TO DATE IP+E+Fl	o/,
(G+C)	B~~-
TO FlNISH (C-GJ	=•=•A<,t (IF VAR.IABLE
RATE)
lOf	
					vM c=uvua
APPLlCATJON
(D +E)	QTYTHIS	•a •~vv
PERJOD	I						
					Authent.ic.ity							

Users may obtain valldaUon of llus document by requesting of the license a completed AIA Document D401 - Cert1f1cation of Documents

AIA OOCUMENT G703 • CCMTINUATION SH'EET FOR G70'2, 1992 eomoN • AlA • c:n992
THE AMERICAN !NSTTTUTE Of AACHrrECTS. 1735 NEW YORK AVENUE. N,w. WA-SHINGTON, a.c. :lOOJG-5232

EXHIBITD-1
CONTRACTOR'S CONDITIONAL RELEASE OF LIEN

OWNER: CONTRACTOR: PROPERTY:

Mattarny Hornes USA Pipeline Utilities, Inc.
Southern Grove 4C - Paar Rd.

CONTRACTDATED: 2.17.2022

FOR WORK AND MATERIALS FURNISHED THROUGH SEPTEMBER 30TH 2022

The undersigned, which provided services, materials or equipment for the above Property in accordance with a contract with the Owner identified above, conditioned upon receipt of payment in the amount of $149,449.37, hereby waives and releases all claims for, liens and rights of lien now existing represents full payment received by the undersigned (exclusive of contractual retainage) for work, services, materials and/or equipment fumished in connection with the above Property to the date of this release.

This Release of Lien may be relied upon by purchasers procuring improvements from Owner, by mortgagees making mortgage loans to said purchasers, and title insurance companies insuring titles for said purchasers and shall run to the benefit of any such persons/entities and their successors and assigns.

IN WITNESS WHEREOF, the undersigned has hereunto set his hand and seal [as the duly authorized officer/partner of the undersigned] this  day of    , 20_

NAME:  C:_V\. r-'"7_,	i) lt t_o K	_
TITLE:    v_/7	 _

STATE OF fl.-

CORPORATE/PARTNERSHIP ACKNOWLEDGMENT

COUNTY OF r IP\ c.h,
On this 7	day ofOc--\cbllr , ,	before me, personally appeared &o..,y Dv'-ot	, the VP	of	1= ,.	,who I am satisfied is the person w	•		the within Instrument and he/she did acknowledge that he/she signed and deliver		t as th		officer] partner] above stated, and that the
foregoing instrument is the act and deed of sa1	----...		artners  NOTARYPUBLIC	.
MY COMMISSIO IRES:

,,,:}V�ff,,,

KYLE S KOPF

	Notary Public-State of Florida

�/;>i ,,_,;:.	My Commission Expires

:.	;	Commission II HH 132031

11,,,, ..0,1,'	May 21, 2025

Owner Initials	
170

APPLICATION AND CERTIFICATION FOR PAYMENT	AIA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:

PROJECT:

APPLICATION NO:	3	Distribution to:

Mattamy Homes	Paar Road - Utilities	APPLICATION DATE:		10/31/2022	OWNER 2500 Quantum Lakes Blvd Ste 215			2022-138	ARCHITECT
Attn: Frank Covelli	PERIOD TO:	10/1/22 - 10/31/22	CONTRACTOR

FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court

VIA ARCHITECT: Kimley Horn
7757-3
Tyler

PROJECT NO:	64228384

Riviera Beach, FL 33404	CLIENT REFERENCE:	Paar Road - Pipeline Utilities
CONTRACT FOR: 7757	CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT	The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment, as shown below, in connection with the Contract.	information and belief the Work covered by this Application for Payment has been Continuation Sheet, AIA Document G703, is attached.	completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

ORIGINAL CONTRACT SUM	$	906,517.45
Net change by Change Orders	$	50,377.40	CONTRACTOR:
CONTRACT SUM TO DATE (Line 1 ± 2)	$	956,894.85
TOTAL COMPLETED & STORED TO	$	555,653.35
DATE	(Column G on G703)	By:	Date:
RETAINAGE:
	10 % of Completed Work	$	55,565.34	State of:	County of: (Column D + E on G703)			Subscribed and sworn to before me this	 day of
0 % of Stored Material	$	Notary Public:
(Column F on G703)	My Commission expires:
Total Retainage (Lines 5a + 5b or

500,088.02

Total in Column I of G703)	$	55,565.34	ARCHITECT'S CERTIFICATE FOR PAYMENT
TOTAL EARNED LESS RETAINAGE	$	In accordance with the Contract Documents, based on on-site observations and the data
(Line 4 Less Line 5 Total)	comprising the application, the Architect certifies to the Owner that to the best of the

353,777.36
146,310.66
456,806.84

LESS PREVIOUS CERTIFICATES FOR	Architect's knowledge, information and belief the Work has progressed as indicated,

PAYMENT (Line 6 from prior Certificate)	$
CURRENT PAYMENT DUE	$
BALANCE TO FINISH, INCLUDING RETAINAGE	$

the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Line 3 less Line 6)	AMOUNT CERTIFIED . . . . . . . . . . . $	146,310.66

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
NET CHANGES by Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.) ARCHITECT:
By:	Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AIA DOCUMENT G702 · APPLICATION AND CERTIFICATION FOR PAYMENT · 1992 EDITION · AIA · ©1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

171

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 3
APPLICATIO ON DATE: 10/31/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 10/1/22 - 10/31/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	12,875.00		0	$12,875.00	$0.00	25,750.00	50%	$25,750.00	$2,575.00	
				$0.00	-	-		$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$51,500.00	$12,875.00	-	$12,875.00	$0.00	$25,750.00	50%	$25,750.00	$2,575.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25			$0.00	$0.00	26,210.25	100%	$0.00	$2,621.03	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	-		$0.00	$0.00	-	0%	$2,060.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-	-		$0.00	$0.00	-	0%	$3,440.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	-		2	$17,700.00	$0.00	17,700.00	100%	$0.00	$1,770.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00			$0.00	$0.00	8,400.00	100%	$0.00	$840.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00			$0.00	$0.00	4,660.00	100%	$0.00	$466.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-	-		$0.00	$0.00	-	0%	$4,000.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-	-		$0.00	$0.00	-	0%	$555.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	-		2	$25,090.00	$0.00	25,090.00	100%	$0.00	$2,509.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-	-		$0.00	$0.00	-	0%	$2,200.00	$0.00	
				$0.00	-	-		$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$94,315.25	39,270.25	-	$42,790.00	$0.00	82,060.25	87%	$12,255.00	$8,206.03	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00		$0.00	$0.00	2,600.00	100%	$0.00	$260.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00		$0.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	-	-	$0.00	$0.00	-	0%	$4,929.00	$0.00	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	-	-	$0.00	$0.00	-	0%	$6,460.00	$0.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	-	14	$54,810.00	$0.00	54,810.00	100%	$0.00	$5,481.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	-	2	$24,750.00	$0.00	24,750.00	100%	$0.00	$2,475.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	-	-	$0.00	$0.00	-	0%	$31,960.00	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$399,209.00	163,600.00		$79,560.00	$0.00	243,160.00	61%	$156,049.00	$24,316.00	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$1,274.81	
31015	24" RCP	819	$	89.35	$73,177.65	64,243	100	$8,935.00	$0.00	73,177.65	100%	$0.00	$7,317.77	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$1,296.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	-		$0.00	$0.00	-	0%	$19,110.00	$0.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$2,835.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	-	2	$34,830.00	$0.00	34,830.00	100%	$0.00	$3,483.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$5,904.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	-		$0.00	$0.00	-	0%	$121,277.50	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$361,493.20	177,340.70		$43,765.00	$0.00	221,105.70	61%	$140,387.50	$22,110.57	
	Change Order 1			$0.00	-		$0.00	$0.00	$0.00	0%	$0.00	$0.00	
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	-	(675)	($118,125.00)	$0.00	($118,125.00)	100%	$0.00	($11,812.50)	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	-	(2)	($24,750.00)	$0.00	($24,750.00)	100%	$0.00	($2,475.00)	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	-	(14)	($54,810.00)	$0.00	($54,810.00)	100%	$0.00	($5,481.00)	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	-	1,564	$143,262.40	$0.00	$143,262.40	100%	$0.00	$14,326.24	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	-	2	$9,300.00	$0.00	$9,300.00	100%	$0.00	$930.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	-	14	$28,700.00	$0.00	$28,700.00	100%	$0.00	$2,870.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	-		$0.00	$0.00	$0.00	0%	$66,800.00	$0.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 3
APPLICATIO ON DATE: 10/31/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 10/1/22 - 10/31/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	12,875.00		$12,875.00	$0.00	$25,750.00	50%	$25,750.00	$2,575.00	
	31020	Water	$94,315.25	$94,315.25	39,270.25		$42,790.00	$0.00	$82,060.25	87%	$12,255.00	$8,206.03	
	31620	Force Main	$399,209.00	$399,209.00	163,600.00		$79,560.00	$0.00	$243,160.00	61%	$156,049.00	$24,316.00	
	31015	Drainage	$361,493.20	$361,493.20	177,340.70		$43,765.00	$0.00	$221,105.70	61%	$140,387.50	$22,110.57	
	CO1-31620		($16,422.60)	($16,422.60)	-		($16,422.60)	$0.00	($16,422.60)	100%	$0.00	($1,642.26)	
	CO1-31015		$66,800.00	$66,800.00	-		$0.00	$0.00	$0.00	0%	$66,800.00	$0.00	
	GRAND TOTALS			$956,894.85	393,085.95		$162,567.40	-	$555,653.35	58%	$401,241.50	$55,565.34	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AIA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:

PROJECT:

APPLICATION NO:	4	Distribution to:

Mattamy Homes	Paar Road - Utilities	APPLICATION DATE:		11/30/2022	OWNER 2500 Quantum Lakes Blvd Ste 215			2022-150	ARCHITECT
Attn: Frank Covelli	PERIOD TO:	11/1/22 - 11/30/22	CONTRACTOR

FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court Riviera Beach, FL 33404

VIA ARCHITECT: Kimley Horn

7757-4
Tyler

PROJECT NO:	64228384
CLIENT REFERENCE:	Paar Road - Pipeline Utilities

CONTRACT FOR: 7757	CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT	The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment, as shown below, in connection with the Contract.	information and belief the Work covered by this Application for Payment has been Continuation Sheet, AIA Document G703, is attached.	completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

ORIGINAL CONTRACT SUM	$	906,517.45
Net change by Change Orders	$	50,377.40	CONTRACTOR:
CONTRACT SUM TO DATE (Line 1 ± 2)	$	956,894.85
TOTAL COMPLETED & STORED TO	$	667,288.35

DATE	(Column G on G703)	By:	Date:
RETAINAGE:
	10 % of Completed Work	$	66,728.84	State of:	County of: (Column D + E on G703)			Subscribed and sworn to before me this	 day of
0 % of Stored Material	$	Notary Public:
	
(Column F on G703)	My Commission expires:
Total Retainage (Lines 5a + 5b or

600,559.52

Total in Column I of G703)	$	66,728.84	ARCHITECT'S CERTIFICATE FOR PAYMENT
TOTAL EARNED LESS RETAINAGE	$	In accordance with the Contract Documents, based on on-site observations and the data
(Line 4 Less Line 5 Total)	comprising the application, the Architect certifies to the Owner that to the best of the

500,088.02
100,471.50
356,335.34

LESS PREVIOUS CERTIFICATES FOR	Architect's knowledge, information and belief the Work has progressed as indicated,

PAYMENT (Line 6 from prior Certificate)	$
CURRENT PAYMENT DUE	$
BALANCE TO FINISH, INCLUDING RETAINAGE	$

the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Line 3 less Line 6)	AMOUNT CERTIFIED . . . . . . . . . . . $	100,471.50

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
NET CHANGES by Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.) ARCHITECT:
By:	Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AIA DOCUMENT G702 · APPLICATION AND CERTIFICATION FOR PAYMENT · 1992 EDITION · AIA · ©1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

174

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 4
APPLICATIO ON DATE: 11/30/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 11/1/22 - 11/30/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	25,750.00		0	$12,875.00	$0.00	38,625.00	75%	$12,875.00	$3,862.50	
				$0.00	-	-		$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$51,500.00	$25,750.00	-	$12,875.00	$0.00	$38,625.00	75%	$12,875.00	$3,862.50	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25		$0.00	$0.00	26,210.25	100%	$0.00	$2,621.03	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	-	$0.00	$0.00	-	0%	$2,060.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-	-	$0.00	$0.00	-	0%	$3,440.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	17,700.00		$0.00	$0.00	17,700.00	100%	$0.00	$1,770.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00		$0.00	$0.00	8,400.00	100%	$0.00	$840.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00		$0.00	$0.00	4,660.00	100%	$0.00	$466.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-	-	$0.00	$0.00	-	0%	$4,000.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-	-	$0.00	$0.00	-	0%	$555.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	25,090.00		$0.00	$0.00	25,090.00	100%	$0.00	$2,509.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-	-	$0.00	$0.00	-	0%	$2,200.00	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$94,315.25	82,060.25	-	$0.00	$0.00	82,060.25	87%	$12,255.00	$8,206.03	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00			$0.00	$0.00	2,600.00	100%	$0.00	$260.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00			$0.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	-	-		$0.00	$0.00	-	0%	$4,929.00	$0.00	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	-	-		$0.00	$0.00	-	0%	$6,460.00	$0.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	54,810.00			$0.00	$0.00	54,810.00	100%	$0.00	$5,481.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	24,750.00			$0.00	$0.00	24,750.00	100%	$0.00	$2,475.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	-		2	$31,960.00	$0.00	31,960.00	100%	$0.00	$3,196.00	
				$0.00	-	-		$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$399,209.00	243,160.00		$31,960.00	$0.00	275,120.00	69%	$124,089.00	$27,512.00	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$1,274.81	
31015	24" RCP	819	$	89.35	$73,177.65	73,178		$0.00	$0.00	73,177.65	100%	$0.00	$7,317.77	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$1,296.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	-		$0.00	$0.00	-	0%	$19,110.00	$0.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$2,835.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	34,830		$0.00	$0.00	34,830.00	100%	$0.00	$3,483.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$5,904.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	-		$0.00	$0.00	-	0%	$121,277.50	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$361,493.20	221,105.70		$0.00	$0.00	221,105.70	61%	$140,387.50	$22,110.57	
	Change Order 1			$0.00	-		$0.00	$0.00	$0.00	0%	$0.00	$0.00	
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	(118,125.00)		$0.00	$0.00	($118,125.00)	100%	$0.00	($11,812.50)	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	(24,750.00)		$0.00	$0.00	($24,750.00)	100%	$0.00	($2,475.00)	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	(54,810.00)		$0.00	$0.00	($54,810.00)	100%	$0.00	($5,481.00)	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	143,262.40		$0.00	$0.00	$143,262.40	100%	$0.00	$14,326.24	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	9,300.00		$0.00	$0.00	$9,300.00	100%	$0.00	$930.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	28,700.00		$0.00	$0.00	$28,700.00	100%	$0.00	$2,870.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	-	167	$66,800.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 4
APPLICATIO ON DATE: 11/30/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 11/1/22 - 11/30/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
									$0.00				
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	25,750.00		$12,875.00	$0.00	$38,625.00	75%	$12,875.00	$3,862.50	
	31020	Water	$94,315.25	$94,315.25	82,060.25		$0.00	$0.00	$82,060.25	87%	$12,255.00	$8,206.03	
	31620	Force Main	$399,209.00	$399,209.00	243,160.00		$31,960.00	$0.00	$275,120.00	69%	$124,089.00	$27,512.00	
	31015	Drainage	$361,493.20	$361,493.20	221,105.70		$0.00	$0.00	$221,105.70	61%	$140,387.50	$22,110.57	
	CO1-31620		($16,422.60)	($16,422.60)	(16,422.60)		$0.00	$0.00	($16,422.60)	100%	$0.00	($1,642.26)	
	CO1-31015		$66,800.00	$66,800.00	-		$66,800.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	
	GRAND TOTALS			$956,894.85	555,653.35		$111,635.00	-	$667,288.35	70%	$289,606.50	$66,728.84	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AIA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:

PROJECT:

7757-5

APPLICATION NO:	5	Distribution to:

Mattamy Homes	Paar Road - Utilities

Tyler

APPLICATION DATE:	3/31/2023	OWNER

2500 Quantum Lakes Blvd Ste 215	2023-034	ARCHITECT
Attn: Frank Covelli	PERIOD TO:	3/1/23 - 3/31/23	CONTRACTOR

FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court

VIA ARCHITECT: Kimley Horn

**This Pay App does not include JDE CO #5 for $18,886.00

PROJECT NO:	64228384

Riviera Beach, FL 33404	CLIENT REFERENCE:	Paar Road - Pipeline Utilities
CONTRACT FOR: 7757	CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT	The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment, as shown below, in connection with the Contract.	information and belief the Work covered by this Application for Payment has been Continuation Sheet, AIA Document G703, is attached.	completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

ORIGINAL CONTRACT SUM	$	906,517.45
Net change by Change Orders	$	253,426.65	CONTRACTOR:
CONTRACT SUM TO DATE (Line 1 ± 2)	$	1,159,944.10
TOTAL COMPLETED & STORED TO	$	825,991.35

DATE	(Column G on G703)	By:	Date:
RETAINAGE:
	10 % of Completed Work	$	82,599.14	State of:	County of: (Column D + E on G703)			Subscribed and sworn to before me this	 day of
0 % of Stored Material	$	Notary Public:
	
(Column F on G703)	My Commission expires:
Total Retainage (Lines 5a + 5b or
Total in Column I of G703)	$	82,599.14	ARCHITECT'S CERTIFICATE FOR PAYMENT
TOTAL EARNED LESS RETAINAGE	$	743,392.22	In accordance with the Contract Documents, based on on-site observations and the data (Line 4 Less Line 5 Total)			comprising the application, the Architect certifies to the Owner that to the best of the
LESS PREVIOUS CERTIFICATES FOR				Architect's knowledge, information and belief the Work has progressed as indicated, PAYMENT (Line 6 from prior Certificate)	$	600,559.52	the quality of the Work is in accordance with the Contract Documents, and the Contractor
CURRENT PAYMENT DUE	$	142,832.70	is entitled to payment of the AMOUNT CERTIFIED.
BALANCE TO FINISH, INCLUDING RETAINAGE	$	416,551.89
(Line 3 less Line 6)	AMOUNT CERTIFIED . . . . . . . . . . . $	142,832.70

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
NET CHANGES by Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.) ARCHITECT:
By:	Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AIA DOCUMENT G702 · APPLICATION AND CERTIFICATION FOR PAYMENT · 1992 EDITION · AIA · ©1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

177

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 5
APPLICATIO ON DATE: 3/31/223	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 3/1/23 - 3/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	38,625.00	0.25	$12,875.00	$0.00	51,500.00	100%	$0.00	$5,150.00	
	Subtotal			$51,500.00	$38,625.00	-	$12,875.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25		$0.00	$0.00	26,210.25	100%	$0.00	$2,621.03	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	-	$0.00	$0.00	-	0%	$2,060.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-		$0.00	$0.00	-	0%	$3,440.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	17,700.00		$0.00	$0.00	17,700.00	100%	$0.00	$1,770.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00		$0.00	$0.00	8,400.00	100%	$0.00	$840.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00		$0.00	$0.00	4,660.00	100%	$0.00	$466.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-		$0.00	$0.00	-	0%	$4,000.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-		$0.00	$0.00	-	0%	$555.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	25,090.00		$0.00	$0.00	25,090.00	100%	$0.00	$2,509.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-		$0.00	$0.00	-	0%	$2,200.00	$0.00	
	Subtotal			$94,315.25	82,060.25	-	$0.00	$0.00	82,060.25	87%	$12,255.00	$8,206.03	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00	

-

-	

1	$0.00	$0.00	2,600.00	100%	$0.00	$260.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00			$0.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	-			$0.00	$0.00	-	0%	$4,929.00	$0.00	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	-			$6,460.00	$0.00	6,460.00	100%	$0.00	$646.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	54,810.00			$0.00	$0.00	54,810.00	100%	$0.00	$5,481.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	24,750.00			$0.00	$0.00	24,750.00	100%	$0.00	$2,475.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	31,960.00			$0.00	$0.00	31,960.00	100%	$0.00	$3,196.00	
					-									
	Subtotal			$399,209.00	275,120.00		$6,460.00	$0.00	281,580.00	71%	$117,629.00	$28,158.00	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$1,274.81	
31015	24" RCP	819	$	89.35	$73,177.65	73,178		$0.00	$0.00	73,177.65	100%	$0.00	$7,317.77	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$1,296.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	-		$0.00	$0.00	-	0%	$19,110.00	$0.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$2,835.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	34,830		$0.00	$0.00	34,830.00	100%	$0.00	$3,483.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$5,904.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	-	3,025	$105,118.75	$0.00	105,118.75	87%	$16,158.75	$10,511.88	
				$0.00	-	-							
	Subtotal			$361,493.20	221,105.70		$105,118.75	$0.00	326,224.45	90%	$35,268.75	$32,622.45	
	Change Order 1												
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	(118,125.00)		$0.00	$0.00	($118,125.00)	100%	$0.00	($11,812.50)	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	(24,750.00)		$0.00	$0.00	($24,750.00)	100%	$0.00	($2,475.00)	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	(54,810.00)		$0.00	$0.00	($54,810.00)	100%	$0.00	($5,481.00)	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	143,262.40		$0.00	$0.00	$143,262.40	100%	$0.00	$14,326.24	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	9,300.00		$0.00	$0.00	$9,300.00	100%	$0.00	$930.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	28,700.00		$0.00	$0.00	$28,700.00	100%	$0.00	$2,870.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 5
APPLICATIO ON DATE: 3/31/223	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 3/1/23 - 3/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
	Subtotal			$50,377.40	50,377.40		$0.00	$0.00	50,377.40	100%	$0.00	$5,037.74	
	Change Order 2												
C02-31620	CONDUIT - F&I open trench 2" PVC	3,200	$52.75	$168,800.00			$0.00	$0.00	$0.00	0%	$168,800.00	$0.00	
	Subtotal			$168,800.00	-	-	-	-	-	0%	$168,800.00	-	
	Change Order 3												
CO3-34010	2" CONDUIT INSTALLATION	1,120	$13.75	$15,400.00		1,120	$15,400.00	$0.00	$15,400.00	100%	$0.00	$1,540.00	
CO3-34010	4" CONDUIT INSTALLATION	65	$32.05	$2,083.25		65	$2,083.25	$0.00	$2,083.25	100%	$0.00	$208.33	
CO3-34010	6" CONDUIT INSTALLATION	230	$40.20	$9,246.00		230	$9,246.00	$0.00	$9,246.00	100%	$0.00	$924.60	
CO3-31245	Survey, Layout, & As-Builts	1	$2,600.00	$2,600.00		1	$2,600.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	Subtotal			$29,329.25	-	1,416.00	$29,329.25	$0.00	$29,329.25	100%	$0.00	$2,932.93	
	Change Order 4												
CO4-31015	Raise Existing Drainage Tops	2	$2,460.00	$4,920.00		2	$4,920.00	$0.00	$4,920.00	100%	$0.00	$492.00	
	Subtotal			$4,920.00	-	2.00	4,920.00	-	4,920.00	100%	$0.00	492.00	
									-				
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	38,625.00		$12,875.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	31020	Water	$94,315.25	$94,315.25	82,060.25		$0.00	$0.00	$82,060.25	87%	$12,255.00	$8,206.03	
	31620	Force Main	$399,209.00	$399,209.00	275,120.00		$6,460.00	$0.00	$281,580.00	71%	$117,629.00	$28,158.00	
	31015	Drainage	$361,493.20	$361,493.20	221,105.70		$105,118.75	$0.00	$326,224.45	90%	$35,268.75	$32,622.45	
	CO1-31620		($16,422.60)	($16,422.60)	(16,422.60)		$0.00	$0.00	($16,422.60)	100%	$0.00	($1,642.26)	
	CO1-31015		$66,800.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	
	CO2-31620	Fiber Optic	$168,800.00	$168,800.00	-		-	-	-	0%	$168,800.00	-	
	CO3-34010	Conduit	$26,729.25	$26,729.25	-		$26,729.25	$0.00	$26,729.25	100%	$0.00	2,672.93	
	CO3-31245	General	$2,600.00	$2,600.00			$2,600.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	CO4-31010	Drainage	$4,920.00	$4,920.00	-		$4,920.00	$0.00	4,920.00	100%	$0.00	$492.00	
	GRAND TOTALS			$1,159,944.10	667,288.35		$158,703.00	$0.00	$825,991.35	71%	$333,952.75	$82,599.14	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AL4. DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:
Mattarny Homes

PROJECT:
Paar Road - Utilities

7757-6
Tyler

APPLICATION NO: APPLICATION DATE:

6
6/30/2023

Distribution to: [:=]OWNER

2500 Quantum Lakes Blvd Ste 215
Attn: Frank Covelli
FROM CONTRACTOR:

VIA ARCHITECT: Kimley Hom

PERIOD TO:

2023-068
6/1/23 - 6/30/23

[:=]ARCHITECT [:=]CONTRACTOR
[:=J

Pipeline Vtilitics Inc 3610 Fiscal Court Riviera Beach. FL 33404
CONTRACT FOR: 7757

**This Pay App excludes JDE CO's #5 & #6 ($33,884.45 total)

PROJECT NO: CLIENT REFERENCE: CONTRACT DATE:

64228384
Paar Road - Pipeline Utilities

[:=J

CONTRACTOR'S APPLICATION FOR PAYMENT

Application is made for payment, as shown below, in connection with the Contract Continuation Sheet, AlA Document G703, is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

I. ORlGINAL CONTRACT $UM
Net change by Change Orders
CONfRACT SUM TO DATE (Line l ± 2)
TOTAL COMPLETED & STORED TO
DATE	(Column G on G703)

0

RETAINAGE:

$	906.517.45
$	253.426.65 
S	1.159.944.10

_·	!)"\IIRY �- 	C

$	l.034.989.10

Bsyw: , ,If.-·	Th. ,  7/1,.

10 % of Completed Work	$
(Column D +Eon G703)

	103.498.91 

Subscnbed and sworn tl;J)mbe . r:,� "· £\  .. ounty offl)-

Notary Public
State of Flo• riJdOa NES

0 % of Stored Material	$		
(Column Fon G703)
Total Retainage (Lines 5a + 5b or

NotaryPublic:	IS	y of  S  •	,.
MyCommission expire.s·	.",",-...-£..:	o-
r.,i,CE , 1'o

Comm# HH169929
Expires 8/26/20"25

Total in Column I ofG703)

$	103,498.91	

ARCHfT.ECT'S CERTIFICATE FOR PAYMENT

AMOUNT CERTIFIED ........... $	188.097.97MS
CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	(Attach explanation if amormr certified differs from the amount applied. fnirial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.)
:CHITEC"!  f[	07/06/2023
Date:	
Total changes approved
in previous months by Owner	$0.00	$0.00		
Total approved this Month	$0.00	$0.00		
TOTALS	$0.00	$0.00	This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.	
NET CHANGES by Change Order	$0.00		

6. TOTAL EARNED LESS RETAINAGE	$	931.490.19		In accordance with the Contract Documents, based on on-site observations and the data	
(Line 4 Less Line 5 Total)
7. LESSPREVIOUSCERTIFICATESFOR
PAYMENT (Line 6 from prior Certificate)	

$	743.392.22		comprising the application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated,
the quality of the Work is in accordance with the Contract Documents, and the Contractor	
8. CURRENTPAYMENTDUE	$	188,097.97	is entitled to payment of the AMOUNT CERTIFIED.	
9. BALANCE TO FINISH, INCLUDING RETAINAGE	$	228.453.91		
(Line 3 less Line 6)			

All\ DOCUMENT G702 • APPLICATION AND CERTIFICATION FOR PAYMENT· 1992 EDITION· AIA • 11)1992.	THE AMERICAN INSTmJTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W.. WASHINGTON, DC 2000&-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

180

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 6
APPLICATIO ON DATE: 6/30/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 6/1/23 - 6/30/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	51,500.00	100%	$0.00	$5,150.00	
	Subtotal			$51,500.00	$51,500.00	-	$0.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25		$0.00	$0.00	26,210.25	100%	$0.00	$2,621.03	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	-	$0.00	$0.00	-	0%	$2,060.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-		$0.00	$0.00	-	0%	$3,440.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	17,700.00		$0.00	$0.00	17,700.00	100%	$0.00	$1,770.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00		$0.00	$0.00	8,400.00	100%	$0.00	$840.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00		$0.00	$0.00	4,660.00	100%	$0.00	$466.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-		$0.00	$0.00	-	0%	$4,000.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-		$0.00	$0.00	-	0%	$555.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	25,090.00		$0.00	$0.00	25,090.00	100%	$0.00	$2,509.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-		$0.00	$0.00	-	0%	$2,200.00	$0.00	
	Subtotal			$94,315.25	82,060.25	-	$0.00	$0.00	82,060.25	87%	$12,255.00	$8,206.03	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00		$0.00	$0.00	2,600.00	100%	$0.00	$260.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00		$0.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	-	1,590	$4,929.00	$0.00	4,929.00	100%	$0.00	$492.90	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	6,460.00		$0.00	$0.00	6,460.00	100%	$0.00	$646.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	54,810.00		$0.00	$0.00	54,810.00	100%	$0.00	$5,481.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	24,750.00		$0.00	$0.00	24,750.00	100%	$0.00	$2,475.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	31,960.00		$0.00	$0.00	31,960.00	100%	$0.00	$3,196.00	
					-	-							
	Subtotal			$399,209.00	281,580.00		$4,929.00	$0.00	286,509.00	72%	$112,700.00	$28,650.90	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$1,274.81	
31015	24" RCP	819	$	89.35	$73,177.65	73,178		$0.00	$0.00	73,177.65	100%	$0.00	$7,317.77	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$1,296.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	-	1	$19,110.00	$0.00	19,110.00	100%	$0.00	$1,911.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$2,835.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	34,830		$0.00	$0.00	34,830.00	100%	$0.00	$3,483.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$5,904.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	105,119	465	$16,158.75	$0.00	121,277.50	100%	$0.00	$12,127.75	
				$0.00	-	-							
	Subtotal			$361,493.20	326,224.45		$35,268.75	$0.00	361,493.20	100%	$0.00	$36,149.32	
	Change Order 1												
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	(118,125.00)		$0.00	$0.00	($118,125.00)	100%	$0.00	($11,812.50)	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	(24,750.00)		$0.00	$0.00	($24,750.00)	100%	$0.00	($2,475.00)	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	(54,810.00)		$0.00	$0.00	($54,810.00)	100%	$0.00	($5,481.00)	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	143,262.40		$0.00	$0.00	$143,262.40	100%	$0.00	$14,326.24	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	9,300.00		$0.00	$0.00	$9,300.00	100%	$0.00	$930.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	28,700.00		$0.00	$0.00	$28,700.00	100%	$0.00	$2,870.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 6
APPLICATIO ON DATE: 6/30/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 6/1/23 - 6/30/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
	Subtotal			$50,377.40	50,377.40		$0.00	$0.00	50,377.40	100%	$0.00	$5,037.74	
	Change Order 2												
C02-31620	CONDUIT - F&I open trench 2" PVC	3,200	$52.75	$168,800.00		3,200	$168,800.00	$0.00	$168,800.00	100%	$0.00	$16,880.00	
	Subtotal			$168,800.00	-	3,200.00	168,800.00	-	168,800.00	100%	$0.00	16,880.00	
	Change Order 3												
CO3-34010	2" CONDUIT INSTALLATION	1,120	$13.75	$15,400.00	15,400.00		$0.00	$0.00	$15,400.00	100%	$0.00	$1,540.00	
CO3-34010	4" CONDUIT INSTALLATION	65	$32.05	$2,083.25	2,083.25		$0.00	$0.00	$2,083.25	100%	$0.00	$208.33	
CO3-34010	6" CONDUIT INSTALLATION	230	$40.20	$9,246.00	9,246.00		$0.00	$0.00	$9,246.00	100%	$0.00	$924.60	
CO3-31245	Survey, Layout, & As-Builts	1	$2,600.00	$2,600.00	2,600.00		$0.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	Subtotal			$29,329.25	29,329.25	-	$0.00	$0.00	$29,329.25	100%	$0.00	$2,932.93	
	Change Order 4												
CO4-31015	Raise Existing Drainage Tops	2	$2,460.00	$4,920.00	4,920.00		$0.00	$0.00	$4,920.00	100%	$0.00	$492.00	
	Subtotal			$4,920.00	4,920.00	-	-	-	4,920.00	100%	$0.00	492.00	
									-				
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	31020	Water	$94,315.25	$94,315.25	82,060.25		$0.00	$0.00	$82,060.25	87%	$12,255.00	$8,206.03	
	31620	Force Main	$399,209.00	$399,209.00	281,580.00		$4,929.00	$0.00	$286,509.00	72%	$112,700.00	$28,650.90	
	31015	Drainage	$361,493.20	$361,493.20	326,224.45		$35,268.75	$0.00	$361,493.20	100%	$0.00	$36,149.32	
	CO1-31620		($16,422.60)	($16,422.60)	(16,422.60)		$0.00	$0.00	($16,422.60)	100%	$0.00	($1,642.26)	
	CO1-31015		$66,800.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	
	CO2-31620	Fiber Optic	$168,800.00	$168,800.00	-		168,800.00	-	168,800.00	100%	$0.00	16,880.00	
	CO3-34010	Conduit	$26,729.25	$26,729.25	26,729.25		$0.00	$0.00	$26,729.25	100%	$0.00	2,672.93	
	CO3-31245	General	$2,600.00	$2,600.00			$0.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	CO4-31010	Drainage	$4,920.00	$4,920.00	4,920.00		$0.00	$0.00	4,920.00	100%	$0.00	$492.00	
	GRAND TOTALS			$1,159,944.10	823,391.35		$208,997.75	$0.00	$1,034,989.10	89%	$124,955.00	$103,498.91	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:
Mattamy Homes
2500 Quantum Lakes Blvd Ste 215 Attn: Frank Covelli

PROJECT:
Paar Road - Utilities

7757-7
Tyler

APPLICATION NO:	7
APPLICATION DATE:	8/31/2023
2023-099
PERIOD TO:	7/1/23 - 8/31/23

Distribution to:
C]OWNER C]ARCHITECT
CJCONTRACTOR

FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court Riviera Beach, FL 33404
CONTRACT FOR: 7757

VIA ARCHITECT: Kimley Hom
**This Pay App excludes JDE CO's #5 & #6 (Total: $33,884.45)

Cl
CJ
PROJECT NO:	64228384
CLIENT REFERENCE:	Paar Road - Pipeline Utilities
CONTRACT DATE:

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AlA Document G703, is attached.

By:

I	{Jfa1;r:: -;_	

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

,	,

,

1. ORIGINAL CONTRACT SUM	$	906,517.45	
2. Net change by Change Orders	$	253,426.65	
3. CONTRACT SUM TO DATE (Line 1 ± 2)	$	1,159,944.10	
4. TOTAL CO"MPLETED & STORED TO	$	1,047,244.10	

DATE	(Column G on G703)

Date:

9/t./Z

RETAINAGE:
	10 % of Completed Work	$ (Column D +Eon G703)

	104,724.41 

State of: Subscribed and sw

v	OQNAt.Oeb ._JoNES
Notary Pu I 1c
State of Florida

	0 % of Stored Material	$		 (Column F on G703)
Total Retainage (Lines Sa+ Sb or

Notary Public:
My Commission expires:

0	comm# HH169929
......r,,,,.ce , ...,..,,· • Expires 8/26/2025

(Line 3 less Line 6)

AMOUNT CERTIFIED ........... $	11,029.so	MS

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved
in nrevious months by Owner	
$0.00	
$0.00	
Total approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
NET CHANGES by Change Order	$0.00	

Total in Column I of G703)	$	104,724.41		ARCHITECT'S CERTIFICATE FOR PAYMENT	
6. TOTAL EARNED LESS RETAINAGE	$	942,519.69		In accordance with the Contract Documents, based on on-site observations and the data	
(Line 4 Less Line 5 Total)			comprising the application, the Architect certifies to the Owner that to the best of the	
7. LESS PREVIOUS CERTIFICATES FOR			Architect's knowledge, information and belief the Work has progressed as indicated,	
PAYMENT (Line 6 from prior Certificate)	$	931,490.19			the quality of the Work is in accordance with the Contract Documents, and the Contractor	
8. CURRENT PAYMENT DUE	$	11,029.50			is entitled to payment of the AMOUNT CERTIFIED.	
9. BALANCE TO FINISH, INCLUDING RETAINAGE	$	217,424.41			

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.) ARCIDTECT:
By: 	 Date: 	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herem. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AJA DOCUMENT G702 • APPLICATION AND CERTIFICATION FOR PAYMENT· 1992 EDITION· AJA • ©1992	Tl-IE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 2000&-5292
Users may obtain validation of this document by requesting a completed AIA Document 0401 - Certification of Document's Authenticity from the Licensee.

183

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 7
APPLICATIO ON DATE: 8/31/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 7/1/23 - 8/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	51,500.00	100%	$0.00	$5,150.00	
	Subtotal			$51,500.00	$51,500.00	-	$0.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25		$0.00	$0.00	26,210.25	100%	$0.00	$2,621.03	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	1	$2,060.00	$0.00	2,060.00	100%	$0.00	$206.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-	4	$3,440.00	$0.00	3,440.00	100%	$0.00	$344.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	17,700.00		$0.00	$0.00	17,700.00	100%	$0.00	$1,770.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00		$0.00	$0.00	8,400.00	100%	$0.00	$840.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00		$0.00	$0.00	4,660.00	100%	$0.00	$466.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-	2	$4,000.00	$0.00	4,000.00	100%	$0.00	$400.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-	1	$555.00	$0.00	555.00	100%	$0.00	$55.50	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	25,090.00		$0.00	$0.00	25,090.00	100%	$0.00	$2,509.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-	1	$2,200.00	$0.00	2,200.00	100%	$0.00	$220.00	
	Subtotal			$94,315.25	82,060.25	-	$12,255.00	$0.00	94,315.25	100%	$0.00	$9,431.53	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00		$0.00	$0.00	2,600.00	100%	$0.00	$260.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00		$0.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	4,929.00		$0.00	$0.00	4,929.00	100%	$0.00	$492.90	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	6,460.00		$0.00	$0.00	6,460.00	100%	$0.00	$646.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	54,810.00		$0.00	$0.00	54,810.00	100%	$0.00	$5,481.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	24,750.00		$0.00	$0.00	24,750.00	100%	$0.00	$2,475.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	31,960.00		$0.00	$0.00	31,960.00	100%	$0.00	$3,196.00	
					-	-							
	Subtotal			$399,209.00	286,509.00		$0.00	$0.00	286,509.00	72%	$112,700.00	$28,650.90	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$1,274.81	
31015	24" RCP	819	$	89.35	$73,177.65	73,178		$0.00	$0.00	73,177.65	100%	$0.00	$7,317.77	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$1,296.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	19,110		$0.00	$0.00	19,110.00	100%	$0.00	$1,911.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$2,835.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	34,830		$0.00	$0.00	34,830.00	100%	$0.00	$3,483.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$5,904.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	121,278		$0.00	$0.00	121,277.50	100%	$0.00	$12,127.75	
				$0.00	-	-							
	Subtotal			$361,493.20	361,493.20		$0.00	$0.00	361,493.20	100%	$0.00	$36,149.32	
	Change Order 1												
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	(118,125.00)		$0.00	$0.00	($118,125.00)	100%	$0.00	($11,812.50)	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	(24,750.00)		$0.00	$0.00	($24,750.00)	100%	$0.00	($2,475.00)	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	(54,810.00)		$0.00	$0.00	($54,810.00)	100%	$0.00	($5,481.00)	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	143,262.40		$0.00	$0.00	$143,262.40	100%	$0.00	$14,326.24	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	9,300.00		$0.00	$0.00	$9,300.00	100%	$0.00	$930.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	28,700.00		$0.00	$0.00	$28,700.00	100%	$0.00	$2,870.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 7
APPLICATIO ON DATE: 8/31/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 7/1/23 - 8/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
	Subtotal			$50,377.40	50,377.40		$0.00	$0.00	50,377.40	100%	$0.00	$5,037.74	
	Change Order 2												
C02-31620	CONDUIT - F&I open trench 2" PVC	3,200	$52.75	$168,800.00	168,800.00		$0.00	$0.00	$168,800.00	100%	$0.00	$16,880.00	
	Subtotal			$168,800.00	168,800.00	-	-	-	168,800.00	100%	$0.00	16,880.00	
	Change Order 3												
CO3-34010	2" CONDUIT INSTALLATION	1,120	$13.75	$15,400.00	15,400.00		$0.00	$0.00	$15,400.00	100%	$0.00	$1,540.00	
CO3-34010	4" CONDUIT INSTALLATION	65	$32.05	$2,083.25	2,083.25		$0.00	$0.00	$2,083.25	100%	$0.00	$208.33	
CO3-34010	6" CONDUIT INSTALLATION	230	$40.20	$9,246.00	9,246.00		$0.00	$0.00	$9,246.00	100%	$0.00	$924.60	
CO3-31245	Survey, Layout, & As-Builts	1	$2,600.00	$2,600.00	2,600.00		$0.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	Subtotal			$29,329.25	29,329.25	-	$0.00	$0.00	$29,329.25	100%	$0.00	$2,932.93	
	Change Order 4												
CO4-31015	Raise Existing Drainage Tops	2	$2,460.00	$4,920.00	4,920.00		$0.00	$0.00	$4,920.00	100%	$0.00	$492.00	
	Subtotal			$4,920.00	4,920.00	-	-	-	4,920.00	100%	$0.00	492.00	
									-				
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	31020	Water	$94,315.25	$94,315.25	82,060.25		$12,255.00	$0.00	$94,315.25	100%	$0.00	$9,431.53	
	31620	Force Main	$399,209.00	$399,209.00	286,509.00		$0.00	$0.00	$286,509.00	72%	$112,700.00	$28,650.90	
	31015	Drainage	$361,493.20	$361,493.20	361,493.20		$0.00	$0.00	$361,493.20	100%	$0.00	$36,149.32	
	CO1-31620		($16,422.60)	($16,422.60)	(16,422.60)		$0.00	$0.00	($16,422.60)	100%	$0.00	($1,642.26)	
	CO1-31015		$66,800.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	
	CO2-31620	Fiber Optic	$168,800.00	$168,800.00	168,800.00		-	-	168,800.00	100%	$0.00	16,880.00	
	CO3-34010	Conduit	$26,729.25	$26,729.25	26,729.25		$0.00	$0.00	$26,729.25	100%	$0.00	2,672.93	
	CO3-31245	General	$2,600.00	$2,600.00			$0.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	CO4-31010	Drainage	$4,920.00	$4,920.00	4,920.00		$0.00	$0.00	4,920.00	100%	$0.00	$492.00	
	GRAND TOTALS			$1,159,944.10	1,032,389.10		$12,255.00	$0.00	$1,047,244.10	90%	$112,700.00	$104,724.41	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:
Mattamy Homes
2500 Quantum Lakes Blvd Ste 215

PROJECT:
Paar Road - Utilities 7757-8
Frank

APPLICATION NO:	8
APPLICATION DATE:	8/31/2023
2023-100

Distribution to:
OWNER ARCHITECT

Attn: Frank Covelli
FROM CONTRACTOR:
Pipeline Utilities Inc

 RETAINAGE RELEASE  PERIOD TO:	7/1/23 - 8/31/23
VIA ARCHITECT: Kimley Hom
**This Pay App excludes JDE CO's #5 & #6

CONTRACTOR

3610 Fiscal Court Riviera Beach, FL 33404 CONTRACT FOR: 7757

(Total: $33,884.45)

PROJECT NO:	64228384
CLIENT REFERENCE:	Paar Road - Pipeline Utilities
CONTRACT DATE:

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AlA Document G703, is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

DATE	(Column G on G703)
RETAINAGE:

Date:

"

I. ORIGINAL CONTRACT SUM	$	906,517.45		
2. Net change by Change Orders	$	253,426.65	CONTRACTOR:	
3. CONTRACT SUM TO DATE (Line 1 ± 2)	$ 	1,159,944.10 		
4. TOTAL COMPLETED & STORED TO	$	1,047,244.10		

"\A....-::2_ Jv.1 ):::	m;\ Y  Notary Public

0 % of Completed Work	$

SBtya,te of:	•I	-,	

Sta<e of Flo"·••

(Column D +Eon G703)
	0 % of Stored Material	$		 (Column Fon G703)
Total Retainage (Lines 5a + 5b or

Subscribed and sworn t51l:le:t'6re me this Notary Public:	_,/ 1

My Commission e;qiires:

o	.,_	$g Comm# HH169929
.•.,,"""tee ,9"•'b	Expires 8/26/2025

Total in Column I of G703)

$	0.00

ARCHITECT'S CERTIFICATE FOR PAYMENT

TOTAL EARNED LESS RETAINAGE
(Line 4 Less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificate)	$	1,047,244.10

$	942,519.69	In accordance with the Contract Documents, based on on-site observations and the data comprising the application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated,
the quality of the Work is in accordance with the Contract Documents, and the Contractor	
8. CURRENTPAYMENTDUE	$	104,724.41	is entitled to payment of the AMOUNT CERTIFIED.	
9. BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6)	$ 	112,700.00 	
AMOUNT CERTIFIED ........... $	104,724.41	

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	(Attach explanation if amount certified differs from the amount applied. Initial all figures on this
Application and onthe Continuation Sheet that are changed to conform with the amount certified.)
ARCHITECT:
By:	Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herem. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.	
Total changes approved
in previous months by Owner	$0.00	
$0.00		
Total approved this Month	$0.00	$0.00		
TOTALS	$0.00	$0.00		
NET CHANGES by Change Order	$0.00		
AJA DOCUMENT G702 • APPLICATION AND CERTIFICATION FOR PAYMENT· 1992 EDITION· AJA • ©1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 2000&-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

186

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 8
APPLICATIO ON DATE: 8/31/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 7/1/23 - 8/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	51,500.00	100%	$0.00	$0.00	
	Subtotal			$51,500.00	$51,500.00	-	$0.00	$0.00	$51,500.00	100%	$0.00	$0.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25		$0.00	$0.00	26,210.25	100%	$0.00	$0.00	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	2,060.00		$0.00	$0.00	2,060.00	100%	$0.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	3,440.00		$0.00	$0.00	3,440.00	100%	$0.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	17,700.00		$0.00	$0.00	17,700.00	100%	$0.00	$0.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00		$0.00	$0.00	8,400.00	100%	$0.00	$0.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00		$0.00	$0.00	4,660.00	100%	$0.00	$0.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	4,000.00		$0.00	$0.00	4,000.00	100%	$0.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	555.00		$0.00	$0.00	555.00	100%	$0.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	25,090.00		$0.00	$0.00	25,090.00	100%	$0.00	$0.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	2,200.00		$0.00	$0.00	2,200.00	100%	$0.00	$0.00	
	Subtotal			$94,315.25	94,315.25	-	$0.00	$0.00	94,315.25	100%	$0.00	$0.00	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00		$0.00	$0.00	2,600.00	100%	$0.00	$0.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00		$0.00	$0.00	161,000.00	59%	$112,700.00	$0.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	4,929.00		$0.00	$0.00	4,929.00	100%	$0.00	$0.00	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	6,460.00		$0.00	$0.00	6,460.00	100%	$0.00	$0.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	54,810.00		$0.00	$0.00	54,810.00	100%	$0.00	$0.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	24,750.00		$0.00	$0.00	24,750.00	100%	$0.00	$0.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	31,960.00		$0.00	$0.00	31,960.00	100%	$0.00	$0.00	
					-	-							
	Subtotal			$399,209.00	286,509.00		$0.00	$0.00	286,509.00	72%	$112,700.00	$0.00	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$0.00	
31015	24" RCP	819	$	89.35	$73,177.65	73,178		$0.00	$0.00	73,177.65	100%	$0.00	$0.00	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$0.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	19,110		$0.00	$0.00	19,110.00	100%	$0.00	$0.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$0.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	34,830		$0.00	$0.00	34,830.00	100%	$0.00	$0.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$0.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	121,278		$0.00	$0.00	121,277.50	100%	$0.00	$0.00	
				$0.00	-	-							
	Subtotal			$361,493.20	361,493.20		$0.00	$0.00	361,493.20	100%	$0.00	$0.00	
	Change Order 1												
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	(118,125.00)		$0.00	$0.00	($118,125.00)	100%	$0.00	$0.00	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	(24,750.00)		$0.00	$0.00	($24,750.00)	100%	$0.00	$0.00	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	(54,810.00)		$0.00	$0.00	($54,810.00)	100%	$0.00	$0.00	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	143,262.40		$0.00	$0.00	$143,262.40	100%	$0.00	$0.00	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	9,300.00		$0.00	$0.00	$9,300.00	100%	$0.00	$0.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	28,700.00		$0.00	$0.00	$28,700.00	100%	$0.00	$0.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$0.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 8
APPLICATIO ON DATE: 8/31/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 7/1/23 - 8/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
	Subtotal			$50,377.40	50,377.40		$0.00	$0.00	50,377.40	100%	$0.00	$0.00	
	Change Order 2												
C02-31620	CONDUIT - F&I open trench 2" PVC	3,200	$52.75	$168,800.00	168,800.00		$0.00	$0.00	$168,800.00	100%	$0.00	$0.00	
	Subtotal			$168,800.00	168,800.00	-	-	-	168,800.00	100%	$0.00	-	
	Change Order 3												
CO3-34010	2" CONDUIT INSTALLATION	1,120	$13.75	$15,400.00	15,400.00		$0.00	$0.00	$15,400.00	100%	$0.00	$0.00	
CO3-34010	4" CONDUIT INSTALLATION	65	$32.05	$2,083.25	2,083.25		$0.00	$0.00	$2,083.25	100%	$0.00	$0.00	
CO3-34010	6" CONDUIT INSTALLATION	230	$40.20	$9,246.00	9,246.00		$0.00	$0.00	$9,246.00	100%	$0.00	$0.00	
CO3-31245	Survey, Layout, & As-Builts	1	$2,600.00	$2,600.00	2,600.00		$0.00	$0.00	$2,600.00	100%	$0.00	$0.00	
	Subtotal			$29,329.25	29,329.25	-	$0.00	$0.00	$29,329.25	100%	$0.00	$0.00	
	Change Order 4												
CO4-31015	Raise Existing Drainage Tops	2	$2,460.00	$4,920.00	4,920.00		$0.00	$0.00	$4,920.00	100%	$0.00	$0.00	
	Subtotal			$4,920.00	4,920.00	-	-	-	4,920.00	100%	$0.00	-	
									-				
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	$51,500.00	100%	$0.00	$0.00	
	31020	Water	$94,315.25	$94,315.25	94,315.25		$0.00	$0.00	$94,315.25	100%	$0.00	$0.00	
	31620	Force Main	$399,209.00	$399,209.00	286,509.00		$0.00	$0.00	$286,509.00	72%	$112,700.00	$0.00	
	31015	Drainage	$361,493.20	$361,493.20	361,493.20		$0.00	$0.00	$361,493.20	100%	$0.00	$0.00	
	CO1-31620		($16,422.60)	($16,422.60)	(16,422.60)		$0.00	$0.00	($16,422.60)	100%	$0.00	$0.00	
	CO1-31015		$66,800.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$0.00	
	CO2-31620	Fiber Optic	$168,800.00	$168,800.00	168,800.00		-	-	168,800.00	100%	$0.00	16,880.00	
	CO3-34010	Conduit	$26,729.25	$26,729.25	26,729.25		$0.00	$0.00	$26,729.25	100%	$0.00	2,672.93	
	CO3-31245	General	$2,600.00	$2,600.00			$0.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	CO4-31010	Drainage	$4,920.00	$4,920.00	4,920.00		$0.00	$0.00	4,920.00	100%	$0.00	$492.00	
	GRAND TOTALS			$1,159,944.10	1,044,644.10		$0.00	$0.00	$1,047,244.10	90%	$112,700.00	$20,304.93	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF 2 PAGES

TO OWNER:
Mattany Palm Beach, LLC

PROJECT:	PRM
Tradition COD SG PAAR ROAD

APPLICATION#: PERIOD TO:

1
05/05/23

Distribution to:

2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426
FROM CONTRACTOR:
Richard and Rice Construction
1219 W Newport Center Dr. Deerfield Beach, FL 33442

8950 SW PAAR DR
Port Saint Lucie, FL 34987
PROPOSAL#
1119652

8838-1
Tyler

PROJECT NOS: CONTRACT DATE:

04/18/23

Owner
Const. Mgr Architect Contractor

 CONTRACT FOR:	PARR ROAD	

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment. as shown below, in connection with the Contract. Continuation Sheet is attached.

ORIGINAL CONTRACT SUM------	$	288,582.00
Net change by Change Orders	$

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner. and that current payment shown therein is now due.

CONTRACT SUM TO DATE (Line 1 +/- 2)	$1	2-88-,S-8-2-.0--10
TOTAL COMPLETED & STORED TO DATE-$	22,018.70

By:
&o 

Date: <,,�.���--,o,1,,,,.

=

l Ti	,-I..,	--	/ MIS.S/o'•	'-:.

(Column G on Continuation Sheet)

sl

RETAINAGE:
	10.0% of Completed Work		2,201.871 (Columns D+E on Continuation Sheet)			

State of:		 t 10/i	f ,-·cPNuMBER lj,\ -=:_

:-'g

County of:	_	:: If-:	HH 109652	: •

.	: z·	EXPIRES,. m -

X..

/ f

Subs nbed and sworn to bef		.	--.,March2B,2025

meth1s	dayof	_,')O		-:. ·-,

  	ofStored Material	sl	I

£.---"	

,.... ;".-:'..••r,n,l_1lJ,	•• - '< ,._,

(Column F on Continuation Sheet)
Total Retainage (Line Sa+ Sb or

(Line4 less Line5 Total)

Notary Public:	<::::\	,,,,,,Au/'/•c••5•\•3·\,b. ,,,''

Total in Column 1 of Continuation Sheet--	$1	2,201.871	CERTIFICATE FOR PAYMENT	
6. TOTAL EARNED LESS RETAINAGE·---	$	19,816.83	In a  ance with Contract  uments. based on on-site observations and the data comprising	

My Commission expires:{	µ11n�	,,,,,, 11,,,,,,,

7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ,-----------	and behef the Work has progressed as indicated, the quality of the Work is in accordance with the

I	I  apphca 1on, the Architect certifies to the OWner that to the best or the Arehttect's knOWledge, information

(Line 6 from prior Certificatei-----
CURRENT PAYMENT DUE------

$	Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

$_	19,816.83.  MJ

---,----------

BALANCE TO FINISH, INCLUDING RETAINAGE		
(Line 3 less Line 6)	$	268,765.17

AMOUNT CERTIFIED	$
(AItach explanation if amount certified differs from the amount applied for. Initial all figures on this application and on the Continuation Sheet that are changed to conform to the amount certified.)

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous months by Owner			
Total aooroved this Month			
TOTALS			
NET CHANGES bv ChanQe Order		

By:	Date: 	
This Certificate is not negoUable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance or payment are without prejudice to any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET	Page2of	2 Pa es

ATTACHMENT TO PAY APPLICATION
PROJECT:
Tradition CDD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie, FL 34987

APPLICATION NUMBER:	1
APPLICATION DATE:	05/05/23
PERIOD TO:	5-May-23
Project CODE:

A	B	C	D	E	F	G	H	I	
Item No.	Description of Work	Scheduled Value	Work Completed	Materials Presently Stored (Not In
DorE)	Total Completed And Stored To Date
(D + E + F)	%
(G/C)	Balance To Finish (C-G)	Retainage	
			From Previous Application (D+ E)	This Period						
1	Flatwork - 4,070sf Poured - L&M	288,582.00		22,018.70		22,018.70	8%	266,563.30	2,201.87	
2										
3										
4										
5										
6										
7										
8										
9										
10										
11										
12										
13										
14										
15										
16										
17										
18										
19										
20										
21										
22										
23										
24										
25										
26										
27										
28										
	SUBTOTALS PAGE 2	288,582.00		22,018.70		22,018.70	8%	266,563.30	2,201.87	

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF  2 PAGES

TO OWNER:
Mattany Palm Beach, LLC
2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426
FROM CONTRACTOR:

PROJECT:	PRM
Tradition COD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie, FL 34987
PROPOSAL#

APPLICATION#: 2
PERIOD TO:	05/12/22
PROJECT NOS:

CONTRACT DATE:	04/18/23

Distribution to:

Owner Const. Mgr Architect

Richard and Rice Construction 1219 W Newport Center Dr.
Deerfield Beach, FL 33442
CONTRACT FOR:	PARR ROAD

1119652

8838-2
Tyler

Contractor

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

ORIGINAL CONTRACT SUM-----	$1--	2_8_8,,_5_82_._00--1
Net change by Change Orders-------	$
1	1
CONTRACT SUM TO DATE (Line 1 +/- 2)	$	288,582.00
TOTAL COMPLETED & STORED TO DATE-$	S6, 750.90 
(Column G on Continuation Sheet)
RETAINAGE:
10.0% of Completed Work	$I	5,67S.o9I
(Columns D+E on Continuation Sheet)	-------
			of Stored Material	$.	.... (Column F on Continuation Sheet)
Total Retainage (Line Sa+ Sb or
Total in Column 1 of Continuation Sheet--
TOTAL EARNED LESS RETAINAGE---

The undersigned Contractor certlfies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due.
CONTRACTOR: Richard and Rice Construction Co. Inc

By:

tate of: County of:

(Line 6 from prior Certificate)-----
8. CURRENT PAYMENT DUE------
9B.ALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6)	$ -----23-7,'S-06-.1-9 ----

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous
months by Owner			
Total aooroved this Month			
TOTALS			
NET CHANGES by Change Order		

By:	-------------------	Date:------
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET	Page 2 of	2	Pages

ATTACHMENT TO PAY APPLICATION
PROJECT:
Tradition COD SG PAAR ROAD 8950 SW PAAR DR

A	B	C	D	E	F	G	H	I	
Item No.	Description of Work	Scheduled Value	Work Completed	Materials Presently Stored (Not In
D orE)	Total Completed And Stored To Date
(D+ E +F)	%
(G/C)	Balance To Finish (C-G)	Retainage	
			From Previous Application (D+E)	This Period						
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28	Flatwork - 4,070sf Poured - L&M Flatwork - 6,420sf Poured - L&M	288,582.00		22,018.70
34,732.20		22,018.70
34,732.20	8%	266,563.30
(34,732.20}	2,201.87
3,473.22	
	SUBTOTALS PAGE 2	288,582.00		56,750.90		56,750.90	20%	231,831.10	5,675.09	

Port Saint Lucie, FL 34987

APPLICATION NUMBER: 2 APPLICATION DATE:	S-/t812023-
PERIOD TO:	51f272023
Project CODE:

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF 2 PAGES

TO OWNER:
Mattany Palm Beach, LLC

PROJECT:	PRM
Tradition CDD SG PAAR ROAD

APPLICATION#: PERIOD TO:

3	Distribution to:

06/09/23

2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426
FROM CONTRACTOR:
Richard and Rice Construction 1219 W Newport Center Dr.
Deerfield Beach, FL 33442
CONTRACT FOR:	PARR ROAD

8950 SW PAAR DR
Port Saint Lucie, FL 34987
PROPOSAL#
1119652

8838-3
Tyler

PROJECT NOS: CONTRACT DATE:

PRM

04/18/23

Owner Const. Mgr Architect Contractor

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

ORIGINAL CONTRACT SUM---	$	288,582.00
1	1
Net change by Change Orders-----	$,	,
CONTRACT SUM TO DATE (Line 1 +/- 2)	$	288,582.00 V
TOTAL COMPLETED & STORED TO DATE-$	66,813.50 

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due.

(Column G on Continuation Sheet)
RETAINAGE:

S

By:

,,,,,,,,,,,,,,,,,

C  tyof f: Broward

,,,':11.. , -�-���
..,.'

100'',,,

	10.0% of Completed Work	$I.	6"'"'",6_8_1_.3 .SI (Columns D+E on Continuation Sheet)				

\it1i1ss, --	......

:: :	=

Subscribed aA, sworn to bef		{	:·oO NUMBER ,i.,-.._
me this	l	 day of 		202--3	...,	HH 109652	•.•

....,.,,..-,---of Stored Material	$I.... ------

\	=  z:	EXPIRES ;:{g

.	:. 0 :	Maftl\ 2.8,2025	: -.:: ::

(Column F on Continuation Sheet) Total Retainage (Line Sa+ 5b or
Total in Column 1 of Continuation Sheet------
TOTAL EARNED LESS RETAINAGE---

Notary Public:	,,.......-	-:.	-  "'	:s
MyCommissione 	\:l-·:	/�./
$$1--1-----6_,6_8_1_.3--151	CERTIFICATE FOR PAYMENT	',,,,	//c"5ta'li j•'
_	60,132.15	In a=rdance with Contract Documents, based on on-site observations and the' <ff.H lA'1!1n g

(Line4 less Line5 Total)	application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information

7

. LESS PREVIOUS CERTIFICATES FOR PAYMENT		andbelief the Work has progressed as indicated, thequality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Line 6 from prior Certificate)-----
CURRENT PAYMENT DUE------
BALANCE TO FINISH, INCLUDING RETAINAGE

$$1	51,075.811

MS

--_----9 ,o-ss-.3-4_
AMOUNT CERTIFIED	$	_

(Line 3 less Line 6)	$ ----228,-44-9.8-5 ---

(Attach explanation if amount certified differs from the amount applied for. Initial all figures on this application and on the Continuation Sheet that are changed to conform to the amount certified.)

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous
months by Owner			
Total approved this Month			
TOTALS			
NET CHANGES by Change Order		

By:	------------------- Date: -------
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice lo any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET

Page 2 of	2

Pages

ATTACHMENT TO PAY APPLICATION	APPLICATION NUMBER:	3

PROJECT:
Tradition CDD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie, FL 34987

APPLICATION DATE:
PERIOD TO:
Project CODE:

06/09/23
9-Jun-23 PRM

A	B	C	D	E	F	G	H	I	
Item No.	Description of Work	Scheduled Value	Work Completed	Materials Presently Stored (Not In
D or E)	Total Completed And Stored To Date
(D + E + F)	% (G/C)	Balance To Finish (C - G)	Retainage	
			From Previous Application
(D + E)	This Period						
1	Flatwork - 4,070sf Poured - L&M - (1-2)	288,582.00	22,018.70			22,018.70	8%	266,563.30	2,201.87	
2	Flatwork - 6,420sf Poured - L&M - (3-4)		34,732.20			34,732.20		(34,732.20)	3,473.22	
3	Flatwork - 1,860sf Poured - L&M - (5)			10,062.60		10,062.60		(10,062.60)	1,006.26	
4										
5										
6										
7										
8										
9										
10										
11										
12										
13										
14										
15										
16										
17										
18										
19										
20										
21										
22										
23										
24										
25										
26										
27										
28										
	SUBTOTALS PAGE 2	288,582.00	56,750.90	10,062.60		66,813.50	23%	221,768.50	6,681.35	

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF 2. PAGES

TO OWNER:
Mattamy Palm Beach, LLC
2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426

PROJECT:	PRM
Tradition COD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie, FL 34987

APPLICATION #: PERIOD TO: PROJECT NOS:

4
08/22/23
PRM

Distribution to:

Owner Const. Mgr

FROM CONTRACTOR:
Richard and Rice Construction 1219 W Newport Center Or.
Deerfield Beach, FL 33442
CONTRACT FOR:	PARR ROAD

PROPOSAL#
1119652

8838-4 Revised Tyler

CONTRACT DATE:

04/18/23

Architect Contractor

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract Continuation Sheet is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due

ORIGINAL CONTRACT SUM----------------------	$ t-- 	2_8_8..c,,_58_2_._0--i0	CONTRACTOR:  Richard and Rice Construction Co. Inc
Net change by Change Orders------------------	$	-21,893.00			j 	, 	
CONTRACT SUM TO DATE (Line 1 +/-2)	$:==========2=6=6=,6=89=·=oo:
TOTAL COMPLETED & STORED TO DATE-$	144,237.28 
(Column G on Continuation Sheet)
RETAINAGE:
10.0% of Completed Work	$ 1	1_4, 4_23_._73 1
(Columns D+E on Continuation Sheet)		
			of Stored Material	$	------ (Column F on Continuation Sheet)
Total Retainage (Line Sa+ Sb or

Total in Column 1 of Continuation Sheet-------
TOTAL EARNED LESS RETAINAGE-----------
(line 4 less Line 5 Total)

 $-$	4_,4_2_3_.7_3  I
.	129,813.55

In accordance with Contract Documents, based on on-site observations and the data comprising application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information

LESS PREVIOUS CERTIFICATES FOR PAYMENT

and belief the Work has progressed as indicated, the quality of the Work is in accordance with the
Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(line 6 from prior Certificate)------------------
CURRENT PAYMENT DUE--------·-··········--···
BALANCE TO FINISH, INCLUDING RETAINAGE

$$1	,-13-2-,1--,5I
.	69,681.40.	
MS

AMOUNT CERTIFIED -------------·-·············-----$------------

(Line 3 less Line 6)	$ 	13_6..c,,8_7_5_.4 5	_

(Attach explanation if amount certified differs from /he amount applied for. Initial alt figures on this appfication and on the Continuation Sheet that are changed to conform to the amount certified.)

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous
months by Owner		
-$21,893.00	
Total approved this Month			
TOTALS		-$21,893.00	
NET CHANGES by Change Order	-$21,893.00	

By:		 Date: 	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner of Contractor under this Contract.

By:-  t/k'l.rV-:	 C(/-----.. (t=t't1

Date:

CERTIFICATE FOR PAYMENT

,,,,,,111111\'

CONTINUATION SHEET	Page 2 of	2	Pages

ATTACHMENT TO PAY APPLICATION
PROJECT:
Tradition COD SG PAAR ROAD
8950 SW PAAR DR

A	B				D	E	F	G	H	I	
Item
No.	Description of Work	QUANTITY (SQF)	PRICE	Scheduled Value	Work Completed	Materlals Presently Stored (Not In
DorEJ	Total Completed And Stored To Date
(D+ E+ Fl	%
(G/CJ	Balance To Finish (C ·GI	Retalnage	
					From Previous Application (D+EJ	This Period						
1	4" Flatwork 3000PSI	4070	$	5.41
$	5.41
$	5.41
$	5.41

$	5.41
$	6.12
$	12.50
$	285.00	$  22,018.70
$  34,732.20
$  10,062.60
$  99,316.78
$ (21,893.00)
$  96,563.09
$  12,515.40
$	3,112.50
$  10,260.00	$	22,018.70
$	34,732.20
$	10,062.60			$	22,018.70
$	34,732.20
$	10,062.60
$	99,316.78
$  (21,893.00)
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	100%
100%
100%
100%	$	.
$	.
$	.
$	.
$	.
$	96,563.09
$	12,515.40
$	3,112.50
$	10,260.00
$	.
$	.
$	.
$	.
$	.
s	.
$	.
$	.
$	-
$	.-
$
$	-
$	-
$	-
$	-
$	-
$	-
$	-	2,201.87	
	4" Flatwork 3000PSI											
2		6420									3,473.22	
	4" Flatwork 3000PSI											
3		1860									1,006.26	
												
4	4" Flatwork 3000PSI	18358				$	99,316.78					9,931.68	
6	CHANGE ORDER #1 • Prop# 1119778					$  (21,893.00)					(2,189.30)	
7	4" Flatwork 3000PSI	17849										
8	6" Flatwork 3000PSI	2045										
9	Flatwork Curb • 249 LF	249										
10	Trucated Domes	36										
11												
12												
13												
14												
15												
16												
17												
18												
19												
20												
21												
22												
23												
24												
25												
26												
27												
28												
	SUBTOTALS PAGE 2	50,887.00		$ 266,688.27	$	66,813.50	$	77,423.78		$ 144,237.28	54%	$ 122,450.99	14,423.73	

Port Saint Lucie, FL 34987

APPLICATION NUMBER:	4
APPLICATION DATE:	8122/2023
PERIOD TO:	8122/2023
Project CODE:	PRM

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF  2 PAGES

TO OWNER:
Mattamy Palm Beach, LLC
2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426
FROM CONTRACTOR:
Richard and Rice Construction 1219 W Newport Center Dr.

PROJECT:	PRM
Tradition COD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie, FL 34987
PROPOSAL#
1119652

8838-5
Frank

APPLICATION#: PERIOD TO: PROJECT NOS:

CONTRACT DATE:

5
09/13/23
PRM

04/18/23

Distribution to:

Owner Const. Mgr Architect Contractor

Deerfield Beach, FL 33442
CONTRACT FOR:	PARR ROAD

**This Pay App does not include JDE CO #3 for $28,937.00

CONTRACTOR'S APPLICATION FOR PAYMENT
Application 1s made for payment, as shown below, in connection with the Contract Continuation Sheet is attached

ORIGINAL CONTRACT SUM-------------------	$.	2_8_8"-,5_8_2._0_,0
Net change by Change Orders------------------	$,	-_1_5	,6_8_9_.0_,0
CONTRACT SUM TO DATE (Line 1 +/- 2)	$	272,893.00

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Cert1f1cates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due.

TOTAL COMPLETED & STORED TO DATE-$
(Column G on Continuation Sheet)
RETAINAGE:

	193,462.78 

\\I  I II It I/I
,,,,'' - - ! i''',,,.,

County of: Broward	,,' :-;..v,,ss10A·,·.	"-:.
'	• 0'11!'.	El'- ·v  •	'

	10.0% of Completed Work	sl.	1_9,'-3_46,;_;.._29_,I (Columns D+E on Continuation Sheet)				
		of Stored Material	$,	. (Column F on Continuation Sheet)
Total Retainage (Line 5a + 5b or

Subscribed '1nd sworn to before	,..,,,	2 .-·CJ \l 'L	\
me this	d yof	o1l.Q..e/: d	:	"- \ Ei i::g

·\%·,	--"t-/

£/'	:: -z.:	-	--s=
Notary Pu li :	..	::::...--c	--
My Comm1ss1on expires:28125	",,. t>.·•. ·,j,½0,,,'
1

Total in Column 1 of Continuation Sheet---···--

$1_.	1_9,_3_4_6._2--191	CERTIFICATE FOR PAYMENT

',	1,111;,,,,"

TOTAL EARNED LESS RETAINAGE-----------	.$

174,116.49	In accordance with Contract Documents, based on on-site observations and the data comprising

(Line4 less Line5 Total)	application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information

M

S

LESS PREVIOUS CERTIFICATES FOR PAYMENT	and beliefthe Work has progressed as indicated, thequality of the Work is 1n accordance with the Contract Documents, and the Contractor 1s entitled to payment of the AMOUNT CERTIFIED.

(Line 6 from prior Certificate)--------------
CURRENT PAYMENT DUE-------·-···-··--·--·---·

$$1	129,813.551

1--.	44 :..,3;.._o3-.o;,.;;.J3

BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6)	$ 	9_8.:....,7_7_6_.5_1_

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous months by Owner	
$6,204.00	
-$21,893.00	
Total approved this Month			
TOTALS	$6,204.00	-$21,893.00	
NET CHANGES by Change Order	-$15,689.00	

AMOUNT CERTIFIED ---------·--·	$	 _
(Attach explanation if amount certified differs from the amount applied for /n,t,al all figures on this application and on the Continuation Sheet that are changed to conform to the amountcertified.)

By:		 Date: -------
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein Issuance. payment and acceptance of payment are without pre1udice to any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET	Page 2 of	2	Pages

ATTACHMENT TO PAY APPLICATION
PROJECT:

.

Tradition COD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie FL 34987

APPLICATION NUMBER: APPLICATION DATE:
PERIOD TO:
Projecl CODE:

5
9/13/2023
9/13/2023
PRM

A	B				D	E	F	G	H	I	
Item
No.	Description of Work	QUANTITY (SQF)	PRICE	Scheduled Value	Work Comoleted	Materials Presently Stored (Not In
Dor El	Total Completed And Stored To Date
ID+ E+ Fl	%
(G/C)	Balance To Finish (C-G)	Retalnage	
					From Previous
Application
(D+E)	This Period						
	4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
CHANGE ORDER #1 - Prop# 1119778
4" Flatwork 3000PSI
CHANGE ORDER #2 - Prop# 304905 (Pump
4" Flatwork 3000PSI
6" Flatwork 3000PSI Flatwork Curb - 249 LF Trucated Domes	4070
6420
1860
18358
1
9099
1
8750
2045
249
36	$	5.41
$	5.41
$	5.41
$	5.41
$	1.00
$	5.41
$	6,204.00
$	5.41
$	6.12
$	12.50
$	285.00	$  22,016.70
$  34,732.20
$  10,062.60
$  99,316.78
$ (21,893.00)
$  49,225.59
$	6,204.00
$  47,337.50
$  12,515.40
$	3,112.50
$  10,260.00	$	22,016.70
$	34,732.20
$	10,062.60
$	99,316.78
$  (21,893.00)	

$	49,225.59		$	22,016.70
$	34,732.20
$	10.062.60
$	99,316.76
$  (21,893.00)
$	49,225.50
$	-
$	-
$	-
$	-
$	-
$	.
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	100%
100%
100%
100%
100%
100%	$	-
$	-
$	-
$	-
$	-
$	-
$	6,204.00
$	47,337.50
$	12,515.40
$	3,112.50
$	10,260.00
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	2,201.67
3,473.22
1,006.26
9,931.68
(2,189.30)
4,922.56	
	SUBTOTALS PAGE 2	50,869.00		$  272,892.27	$ 144,237.26	$	49,225.59		$ 193,462.78	71%	$	79,429.40	19,346.29	

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF 2 PAGES

TO OWNER:
Mattamy Palm Beach, LLC
2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426
FROM CONTRACTOR:

PROJECT:	PRM
Tradition CDD SG PAAR ROAD
8950 SW PAAR DR
Port Saint Lucie, FL 34987
PROPOSAL#

APPLICATION #: PERIOD TO: PROJECT NOS:

CONTRACT DATE:

6
11/14/24
PRM

04/18/23

Distribution to:

Owner
Const. Mgr Architect

Richard and Rice Construction 1219 W Newport Center Dr.
Deerfield Beach, FL 33442

1119652

8838-6
Frank

Contractor

 CONTRACT FOR:	PARR ROAD	

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

ORIGINAL CONTRACT SUM---------------------	$1--	2_8_8:_,5_82_._oo-l
Net change by Change Orders-----------------	$	13,248.00
CONTRACT SUM TO DATE (Line1 +/- 2)	$1	3-0_1.,.8.._30 00-l	
TOTAL COMPLETED & STORED TO DATE-$	301,830.00 
(Column G on Continuation Sheet)
RETAINAGE:
	10.0% of Completed Work	$._I 	3-'0,'--1_83_.o_o_.l (Columns D+E on Continuation Sheet)				
	-,--_of Stored Material	$I....	. (Column F on Continuation Sheet)
Total Retainage (Line 5a + 5b or		

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due.

Total in Column 1 of Continuation Sheet--------
TOTAL EARNED LESS RETAINAGE-----------
(Line 4 less Line 5 Total)

$1--	3_0;_1,_83_._oo-l

$.	2_1_1'-,6_47_._oo-'

LESS PREVIOUS CERTIFICATES FOR PAYMENT

(Line 6 from prior Certificate)---------

$===========1=7=4=,1=16=-=58=

CURRENT PAYMENT DUE	--·
BALANCE TO FINISH, INCLUDING RETAINAGE

$		91_.

,s_Jo_.4M.2

S
AMOUNT CERTIFIED -----

-----,	$	 _

(Line 3 less Line 6)	$	3_0-'-1,_8_3_.0_0

_	(Attach explanation if amount certified differs from the amount applied for. Initial all figures on this application and on the Continuation Sheet that are changed to conform to the amount certified.)

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous months by Owner	
$35,141.00	
-$21,893.00	
Total approved this Month			
TOTALS	$35,141.00	-$21,893.00	
NET CHANGES by Change Order	$13,248.00	

By:		 Date: -------
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET	Page 2 of	2	Pages

ATTACHMENT TO PAY APPLICATION
PROJECT:
Tradition COD SG PAAR ROAD

..

8950 SW PAAR DR
Port Saint Lucie FL 34987

APPLICATION NUMBER: APPLICATION DATE:
PERIOD TO:
Projoc:ICOOE:

6
911312023
9/1312023
PRM

A	B				D	E	F	G		H	I	
Item
No.	Description of Work	QUANTITY (SQF)	PRICE	Scheduled Value	Work ComDleted	Materials
Presently Stored (Not In
DorE>	Total
Completed And Stored To Date
(D+E+F)	%
(GIC)	Balance To Finish (C-G)	Retalnage	
					From Previous
Application
(D+E)	This Period						
	4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
CHANGE ORDER #1 • Prop# 1119778
4" Flatwork 3000PSI
CHANGE ORDER #2 - Prop# 304905 (Pump CHANGE ORDER #3 - Prop# 1119909 (6")
4" Flatwork 3000PSI
6" Flatwork 3000PSI Flatwork Curb • 249 LF Trucated Domes	4070
6420
1860
18358
1
9099
1
1
8750
2045
249
36	$	5.41
$	5.41
$	5.41
$	5.41
$	1.00
$	5.41
$	6,204.00
$	28,937.00
$	5.41
$	6.12
$	12.50
$	285.00	$  22,018.70
$  34,732.20
$  10,062.60
$  99,316.78
$ (21,893.00)
$  49,225.59
$	6,204.00
$  28,937.00
$  47,337.50
$  12,515.40
$	3,112.23
$  10,261.00	$	22,018.70
$	34,732.20
$	10,062.60
$	99,316.78
$  (21,893.00)
$	49,225.59	

$	6,204.00
$	28,937.00
$	47,337.50
$	12,515.40
$	3,112.23
$	10,261.00		$	22,018.70
$	34,732.20
$	10,062.60
$	99,316.78
$  (21,893.00)
$	49,225.59
$	6,204.00
$	28,937.00
$	47,337.50
$	12,515.40
$	3,112.23
$	10,261.00
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	.-
$	100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%	$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	.-
$	.
$
$	.-
$
$	-	2,201.87
3,473.22
1,006.26
9,931.68
(2,189.30)
4,922.56
620.40
2,893.70
4,733.75
1,251.54
311.22
1,026.10	
	SUBTOTALS PAGE 2	50,890.00		$ 301,830.00	$ 193,462.87	$ 108,367.13		$ 301,830.00	100%	$	-	30,183.00	

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF  2 PAGES

TO OWNER:
Mattamy Palm Beach, LLC
2500 Quantum Lakes Dr., Suite 215

PROJECT:	PRM
Tradition COO SG PAAR ROAD 8950 SW PAAR OR

APPLICATION#: PERIOD TO: PROJECT NOS:

7
11/21/23
PRM

Distribution to:

Owner

Boynton Beach, FL 33426
FROM CONTRACTOR:
Richard and Rice Construction

Port Saint Lucie, FL 34987 PROPOSAL#
1119652

8838-7
Jonas

CONTRACT DATE:

04/18/23

Const. Mgr Architect
Contractor

1219 W Newport Center Dr.
Deerfield Beach, FL 33442
CONTRACT FOR:	PARR ROAD
CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

ORIGINAL CONTRACT  SUM--------------------	$ .	2_8-'8,'--5_82_._oo_,
Net change by Change Orders-----------------	$	'-1.;..3•:..;2_4.;..8. 0 0
CONTRACT SUM TO DATE (Line 1 +/- 2)	$	301,830.00
TOTAL COMPLETED & STORED TO DATE-$	301,830.00
(Column G on Continuation Sheet)
RETAINAGE:
	10.0% of Completed Work	$l.		3_0-'-,1_8_3._0 ,0I (Columns D+E on Continuation Sheet)					
	-,-_ of Stored Material	$.._ 	, (Column F on Continuation Sheet)
Total Retainage (Line 5a + 5b or
Total in Column 1 of Continuation Sheet-----	$	30,183.00
1------------'	I
TOTAL EARNED LESS RETAINAGE--------	$	271,647.00

RETAINAGE RELEASE

Subscribed and sworn to bei e me this	_6_	day of

Notary Public:
My Commission expires:	03
CERTIFICATE FOR PAYMENT

,,,,	C,	\,,

/;(IJ,t:h'\

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner. and that current payment shown therein is now due.

Inaccordance with Contract Documents, based on on-site observations and the data comprising

(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR PAYMENT

L---------'	'

application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated. the quality of the Work is in accordance with the
Contract Documents. and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Line6 from prior Certificate)-----	$-----2-7-1-,6-4	7_0_0
CURRENT PAYMENT DUE ----·	$===========3=0:,1=8=3=.o:oM0i
BALANCE TO FINISH, INCLUDING RETAINAGE	AMOUNT CERTIFIED--------.$	 _

(Line 3 less Line 6)	$ 		....:.3..:..0:....c1,..:..8.:...3.....:.0..:..0	_

(Attach explanation if amount certified differs from the amount applied for. Initial all figures on this application and on the Continuation Sheet that are changed to confonn to tile amount certified.)

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous months by Owner	
$35,141.00	
-$21,893.00	
Total approved this Month			
TOTALS	$35,141.00	-$21,893.00	
NET CHANGES by Chanoe Order	$13,248.00	

By:			Date: 	 _
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET	Page 2 of	2	Pages

ATTACHMENT TO PAY APPLICATION
PROJECT:
Tradition CDD SG PAAR ROAD 8950 SW PAAR DR

A	B				D	I	E	F	G	H	I	
Item
No.	Description of Work	QUANTITY (SQF)	PRICE	Scheduled
Value	Work Comnleted	Materials Presently Stored (Notln DorE)	Total Completed And Stored To Data (D+E+F)	%
(G/C)	Balance To Finish (C-G)	Retalnage	
					From Previous
Appllc:atlon (D+E)	This Period						
	4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
CHANGE ORDER #1 - Prop# 1119778
4" Flatwork 3000PSI
CHANGE ORDER #2 - Prop# 304905 (Pump CHANGE ORDER #3 - Prop# 1119909 (6")
4" Flatwork 3000PSI
6" Flatwork 3000PSI Flatwork Curb - 249 LF Trucated Domes	4070
6420
1860
18358
1
9099
1
1
8750
2045
249
36	$	5.41
$	5.41
s	5.41
$	5.41
s	1.00
$	5.41
$	6,204.00
$	28,937.00
$	5.41
$	6.12
$	12.50
$	285.00	$  22,018.70
$  34,732.20
$  10,062.60
$  99,316.78
$ (21,893.00)
$  49,225.59
$	6,204.00
$  28,937.00
$  47,337.50
$  12,515.40
$	3,113.23
$  10,260.00	$	22,018.70
$	34,732.20
$  10,062.60
$	99,316.78
$  (21,893.00
$	49.225.59
$	6,204.00
$	28,937.00
$	47,337.50
$  12,515.40
$	3,113.23
$	10,260.00	

)		$	22,018.70
$	34,732.20
$	10,062.60
$	99,316.78
$  (21,893.00)
$	49.225.59
$	6,204.00
$	28.937.00
$	47,337.50
$  12,515.40
$	3,113.23
$	10,260.00
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	100%
100%
100%
100%
100%
100°.<.
100%
100%
100%
100%
100%
100%	$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	.-
$
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	2,201.87
3,473.22
1,006.26
9,931.68
(2,189.30)
4,922.56
620.40
2,893.70
4,733.75
1,251.54
311.32
1,026.00	
	SUBTOTALS PAGE 2	50,890.00		$ 301,830.00	$ 301,830.00	$	-		$ 301,830.00	100%	$	-	30,183.00	

Port Saint Lucie FL 34987

APPLICATION NUMBER: APPLICATION DATE:
PERIOD TO:
P,ojedCODE:

7
1112112023
1112112023
PRM

8959-1
Tyler

PAGE 10F 2 PAGES

FROM: COBRA CONSTRUCTION
151 NW 18th Ave Delray Beach, FL 33444

TEL: 561-276-3820
FAX:

CONTRACTOR: Mattamy Homes
2500 Quantum Lakes Dr. Ste 215 Boynton Beach, FL 34986

TEL: 561-914-8725 FAX:

PROJECT: PAAR DRIVE - ROUND ABOUT CONTRACT:

APPLICATION NO: 001 APPLICATION DATE: 07/19/23
PERIOD FROM: 7/1/23-7/31/23

APPLICATION FOR PAYMENT

Analysis of adjusted contract amount to date:

Original contract sum
Net change by change orders

$ 		$=5..;;;.i3,.,;;..;00:;.;:;3.9.,;;..;0 
$ 	$:,;...;;.0.0...:: 0

3. Adjusted contract amount		$	$53,003.90	
Analysis of work performed:

4. Cost of original contract work to date:		

$	$53,003.90	
5. Extra work performed to date:		$	$0.00	
6. Total cost of work performed to date:		$	$53,003.90	
7. Less Retainage: 10.0%		$	$5,300.39	
8. Net amount earned to date		$	$47,703.51	
9. Billed on previous estimates		$	$0.00	
10. Net amount payable this period	1	$	$41,103.s1MS	

The undersigned Contractor certifies that to the best of the Contractor's knowledge. information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents. that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein Is now due.

CONTRACTOR: COBRA CONSTRUCTION
fl	
,_c£o:;;.....:;	 Date: 7/l	/'Z.3
RON SPADA PRESIDENT
State of: Florida	County of: Palm Beach

My Commission expires: 	

LOR.ITHERESE GULOTTA MY COMMISSION# HH 318866
EXPIRES: November 14, 2023

203

-

r:-,r.-r

Cc ,(	,-J/�.
-·  -,  L--··LJL  : . =, -,
CONSTRUCTION,INC

Cobra Construction, Inc.
151 NW 18th Ave Delray Beach, FL 33444
TREVOR@COBRAPAVERS.COM

1•{ c·)·,)r <r-T·,_;,,/ \.
., ---  !_  - L-\.-  ,.,_, ...
CONSTRUCTION, IN(.
i--

JOB NAME:	PAAR DRIVE - ROUND ABOUT

FROM: COBRA CONSTRUCTION
151 NW 18th Ave Delray Beach, FL
ZIP: 33444
TEL: 561-276-3820 FAX:

TO: Mattamy Homes
2500 Quantum Lakes Dr. Ste 215 Boynton Beach, FL 34986

TEL: 561-914-8725
FAX:

APPLICATION NUMBER: 1 APPLICATION DATE: 7/19/2023
PERIOD FROM: 7/1/23-7/31/23 CONTRACT NUMBER:

ITEM	DESCRIPTION OF WORK	QUANTITY

CONTRACT

UNIT UNIT PRJCE

TOTAL AMOUNT

PREVIOUS

QUANTITIES

CURRENT

TOTAL

PREVIOUS

AMOUNT$

PERIOD

TO DATE

%COMP TO DATE

6" STAMPED CONCRETE

2,518	SF

$21.05

$53,003.90

2518.00

2518.00

$0.00

$53,003.90

$53,003.90

100.0%

TOTALS:

$53,003.90

0.00

2518.00

2518.00

$0.00

$53,003.90

$53,003.90

100.0%

204

FROM: COBRA CONSTRUCTION
151 NW 18th Ave Delray Beach, FL 33444

8959-2
Frank
RETAINAGE RELEASE

PAGE 1OF 2 PAGES

TEL: 561-276-3820 FAX:

CONTRACTOR: Mattamy Homes
2500 Quantum Lakes Dr. Ste 215 Boynton Beach, FL 34986

TEL: 561-914-8725 FAX:

PROJECT: PAAR DRIVE - ROUND ABOUT CONTRACT:

APPLICATION NO: 2R APPLICATION DATE: 10/17/23
PERIOD FROM: RETAINAGE

APPLICATION FOR PAYMENT

Analysis of adjusted contract amount to date:

Original contract sum
Net change by change orders
Adjusted contract amount Analysis of work performed:
Cost of original contract work to date:
Extra work performed to date:
Total cost of work performed to date:
Less Retainage:  0.0%
Net amount earned to date
Billed on previous estimates

$ 		$53,_00_3_.9_0
$	$0.00
$ --$-5-3,-00-3-.9-0

$	-- $53-,00-3.-90
$	$0.00

$ 		$---5 .3,'--00_3_.9_0
$	$0.00
$	--$-5-3,-00-3-.9-0
$	$47,703.51	

Net amount payable this period	2R

$	ss,aoo.agMS

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents. that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein Is now due.

CONTRACTOR: COBRA CONSTRUCTION
_......,,,...­
i#:7 ¢* === -==a:a--:.._===-====-=-

Date: lD l \71a:>

State ot Florida

RON SPADA PRESIDENT

County of: Palm Beach

Subscribed and sworn to before me this \ 1 	day of	OC:tolo tr \	;)..0  ;>...3 Notary Publi	1'11A_ Jlw>M./ RJ:itl/J
My Commission expires:	//-/1/'-cJ.7 

LORI THERESE GULOTTA MY COMMISSION# HH 446960
EXPIRES: November 14, 2027

205

-

( (_<2ii}:-\ _;, ;;_; ,:>
( 0 N,ST RUCTION, IN(;

Cobra Construction, Inc.

151 NW 18th Ave Delray Beach, FL 33444
TREVOR@COBRAPAVERS.COM

JOB NAME:	PAAR DRIVE - ROUND ABOUT

FROM: COBRA CONSTRUCTION
151 NW 18th Ave Delray Beach, FL
ZIP: 33444
TEL: 561-276-3820 FAX:

TO: Mattamy Homes
2500 Quantum Lakes Dr. Ste 215 Boynton Beach, FL 34986

TEL: 561-914-8725 FAX:

APPLICATION NUMBER: 2R APPLICATION DATE: 10/17/2023
PERIOD FROM: RETAINAGE CONTRACT NUMBER:

	CONTRACT	QUANTITIES	AMOUNT$		

ITEM	
DESCRIPTION OF WORK	
QUANTITY	
UNIT	
UNIT PRICE	TOTAL AMOUNT	
PREVIOUS	
CURRENT	
TOTAL	
PREVIOUS	
PERIOD	
TO DATE	
%COMP TO DATE	
											
	6" STAMPED CONCRETE	2,518	SF	$21.05	$53,003.90	2518.00		2518.00	$53,003.90	$0.00	$53,003.90	100.0%	

													

													

													

													

													

													

													

													
													
	TOTALS:				$53,003.90	2518.00	0.00	2518.00	$53,003.90	$0.00	$53 003.90	100.0%	

206

APPLICATION AND CERTIFICATE FOR PAYMENT	AIA DOCUMENT G702	PAGE ONE OF	PAGES

□ ARCHITECT

TO:	Mattamy (Jacksonville) Partnership, PROJECT: Paar Dr.

APPLICATION NO:

1	Distribution to:

1000 Summit Tower Blvd. Ste. 500
Orlando, FL 32810
Phone: Fax:
FROM (SubcontractoiLSP Nursery, Inc
521 Thor Ave. Palm Bay, Fl 32909 FEIN: 59-3-134924
Phone: 321-72-1-6176 Fax: 321-728-1053
CONTRACT FOR:

Port Si. Lucie, FL

VIA (Engineer):

8369-1
Tyler

PERIOD TO: 5/3012023
ARCHITECT'S PROJECT NO:
Project Manager:

CONTRACT DATE:

□OWNER CONTRACTOR

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Owner
TOTAL	ADDITIONS	DEDUCTIONS	

0.00	
Approved this Month			
Number	Date Approved			

1				
2				
3			-	
4			-	
5		-	-
-	
TOTALS	-	-	
Net change by Change Orders	-	-	

CONTRACTOR'S APPLICATION FOR PAYMENT

Application is made for Payment, as shown below. in connection with the Contract, Continuation Sheet,
AJA Document G703, is attached.

I. ORJGlNAL CONTRACT SUM	$	368,992.00	
2. Net change by Change Orders	$	-	
3. CONTRACT SUM TO DATE	$	368,992.00	
4. TOTAL COMPLETED & STORED TO DATE	$	109,519.50	

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor

(Column G on G703)
RETAINAGE
	lQ¾ of Completed Work (Column D +Eon 0703)
 	% of Stored Material
(Column Fon G703)
Total Retainage (Line SA+ Sb or Total in Column I ofG703)
TOTAL EARNED LESS RETAINAGE
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificates)

$	10,951.95

$ ------
$	10,951.95
$	98,567.55

$	-

r----

for work which previous Certificates for Payment were issued and payments received from the Owner. and that current payment shown herein is now due.

CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)
State of:	Florida

$
$

County of:	Brevard

9s,s67ss

MS

270.424.45

By:		

Date: 	5/25/2023	

25th,i-.?,YPijf!-Y of MtAf,1.ANDASElB	2023

Notary Public:

·;J"

*	Commission# HH 177078

ARCHITECTS CERTIFICATE FOR PAYMENT

My Commission exp_ires: AMOUNT CERTIFIED

* .,.,, -'·

Exp·iresN ovem1'Jer 21, 2025
aor,ded ThrJ 3 •\No!e.rySensces

$

In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality
of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Attach explanation if amount certified differs from the amount applied for.) ARCI-IlTECT:

By:	Date: 	 _
This Certificate is not negotiable.	The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or

	Contractor under this Contract.	

Schedule of Values	AIA DOCUMENT G703	PAGE 2	OF  2	PAGES

AIA Document G702
Subcontractor: L.S.P. Nursery, Inc. 521 Thor Ave Palm Bay, Fl 32909 (EIN 59-3434924) Project: Paar Dr.
Project Estimate No.:12067

APPLICATION NUMBER: APPLICATION DATE:
PERIOD TO: AROiITECT'S PROJECT NO:

1
5/25/2023
5/30/2023

A	B	C	D	E	G	H	I	
ITEM NO.	DESCRIPTION OF WORK	SCHEDULED VALUE	FROM PREVIOUS APPLICATION	THIS PERIOD	COMPLETED TO
DATE	¾(G+C)	BALANCE TO FINISH (C-G)	RETAINAGE (10%)	
		
QUANTITY	
AMOUNT	
AMOUNT	
AMOUNT	
QUANTITY	
%			
1	Irrigation mainline	I	109,519.50	-	$	109,519.50
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	109,519.50
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-	100%	-	$10,951.95	
2	Irrigation Lateral lines, heads, etc.	1	150,000.00	-			0%	150,000.00	$0.00	
3	Landscaping - Trees	J	31,825.00	-			0%	31,825.00	$0.00	
4	Landscaping - Palms	J	13,200.00	-			0%	13,200.00	$0.00	
5	Landscaping - 3 gallon Plants	I	2,522.00	-			0%	2,522.00	$0.00	
6	Landscaping - 1 gallon Plants	I	346.50	-			0%	346.50	$0.00	
7	Mulch	1•5	1,935.00	-			0%	1,935.00	$0.00	
8	Floratarn Sou	126,1-00	58,144.00	-			0%	58,144.00	$0.00	
9	Root Barrier	100	1,500.00	-			0%	1,500.00	$0.00	
10							#DIV/0!	-	$0.00	
11							#DIV/Of	-	$0.00	
12							#DIV/0!	-	$0.00	
13							#DIV/0!	-	$0.00	
14							#DIV/0!	-	$0.00	
15							#DIV/0!	-	$0.00	
16							#DIV/0!	-	$0.00	
17							#DIV/Of	-	$0.00	
18							#DIV/0!	-	$0.00	
19							#DIV/Of	-	$0.00	
20							#DIV/0!	-	$0.llO	
21							#DIVJO!	-	$0.00	
22							#DIV/0!	-	$0.00	
23							#DIV/0!	-	$0.00	
24							#DIV/0!	-	$0.00	
25							#DIV/0!	-	$0.00	
26							#DIV/0!	-	$0.00	
27							#DIV/0!	-	$0.00	
28							#DIV/0!	-	$0.00	
	Total	368,992.00	-	109,519.50	109,519.50		259,472.50	20a$10,951.95	

APPLICATION AND CERTIFICATE FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF	PAGES

TO:	Mattamy (Jacksonville) Partnership, PROJECT: Paar Dr.

APPLICATrON NO:

Distribution to:

1000 Summit Tower Blvd. Ste. 500
Orla11do, FL 32810
Pfwue: Fax:
FROM (Subcontracto LSP Nursery, Inc
521 71wr Ave. Palm Bay, Fi 32909 1·1"/N: 5'J-3./3.JY2-I
Phone: 321-72./-6/76 Fax: 3}/.72X-W53
CONTRACT FOR:

Port St. Lucie, FL

VIA (Engineer):

8369-2
Tyler

PERIOD TO: 7/31I202.'I
ARCHITECT'S PROJECT NO:
Project Manager:

CONTRACT DATE:

□OWNER
0 ARCHITECT
0 CONTRACTOR

CHANGE ORDER SUMMARY	
Change Orders approved in previous 111u11lhs by Owner
TOTAL	ADDITIONS	DEDUCTIONS	

0.00	
Approved this Month			
Number	Date Approved			

I				
2				
3			-	
4			-	
5		-	-
-	
TOTALS	-	-	
Net change by Change Orders	-	-	

CONTRACTOR'S APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract, Continuation Sheet,
AJA Document G703, is attached.

The undersigned Contractor certifies that to the hest of the Contractor's knowledge, infonnation and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for work which previous Certificates for Payment were issued and payments rec ived from the

I. ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE
TOTAL COMPLETED & STORED TO DATE
(Column G on 0703)
RETAINAGE
	l0% of Completed Work (Column D +Eon G703)
	 %ofStored Material
(Column Fon 0703)
Total Retainage (Line 5A + 5b or Total in Column I of G703)
TOTAL EARNED LESS RETAINAGE
(Linc 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificates)
CURRENT PAYMENT DUE

$	368,992.00
$
$	3-68-,9-9-2.-0-0
S	143,019.50

$	1-U-l!f.i-)j
$ ------
$	14,301.95
$	128,717.55

$	98,567-55	
$	10,Ho.oo 'vf,,

Owner, and that current payment shown herein is now due.

BALANCE TO FINISH, PLUS RETAIN AGE

$	240,274.45	/V/ \

CONTRACTOR: LSP Nursery, Inc.

./.
/

(Linc 3 less Line 6)
State of:	Florida
Subscribed and sworn to before me this
·1  1· .

County of:	Brevard
25th	day of July
fi',1 Pv.,<,

2023
AMANDA SEIB

By:			Date: 	7/1512023	

Notary Public: ( <, ,,}_ -
"aA(;  l...,,-
My Commission_expires:

.;:o_.......¥. c,
*

Commission# MH 177078 Expkts Novemi,er 21, 2025
E>:.A, ...!llunBco.i e -!ak•) Se, x&

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, infom1ation and belief the Work has progressed as indicated, the quality
of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the /\MOUNT CERTIFIED.

AMOUNT CERTIFIED	$

(Attach explanation if amount certified differs from the amount applied for.) ARCHITECT:

By:	Date: 	.,...._
This Certificate is not negotiable.	The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or

	Contractor under this Contract.	

Schedule of Values	AIA DOCUMENT G703	PAGE 2	OF  2	PAGES
AIA Document G702				APPLICATION NUMBER:	2	
Subcontractor: L.S.P. Nursery, Inc.	521 Thor Ave Palm Bay, Fl	32909	(EIN 59-3434924)	APPLICATION DATE:	7/25/2023	
Project: Paar Dr.				PERIOD TO:	7/31/2023	
Project Estimate No.: 12067				ARCHITECT'S PROJECT NO:		

A	B	C	D	E	G	H	I	
ITEM NO.	DESCRIPTION OF WORK	SCHEDULED VALUE	FROM PREVIOUS APPLICATION	THIS PERIOD	COMPLETED TO
DATE	% (G+C)	BALANCE TO FINISH (C-G)	RETAINAGE (10%)	
		
QUANTITY	
AMOUNT	
AMOUNT	
AMOUNT	
QUANTITY	
%			
1	33055: Irrigation mainline	1	109,519.50	109,519.50	$	-	109,519.50	100%	-	$10,951.95	
2	33055: Irrigation Lateral lines, heads, etc.	1	150,000.00	-	$	25,000.00	25,000.00	17%	125,000.00	$2,500.00	
3	33210: Landscaping - Trees	1	31,825.00	-	$	8,500.00	8,500.00	27%	23,325.00	$850.00	
4	33210: Landscaping - Palms	1	13,200.00	-	$	-	-	0%	13,200.00	$0.00	
5	33210: Landscaping - 3 gallon Plants	1	2,522.00	-	$	-	-	0%	2,522.00	$0.00	
6	33210: Landscaping - 1 gallon Plants	1	346.50	-	$	-	-	0%	346.50	$0.00	
7	33210: Mulch	45	1,935.00	-	$	-	-	0%	1,935.00	$0.00	
8	33210: Floratam Sod	126,400	58,144.00	-	$	-	-	0%	58,144.00	$0.00	
9	33210: Root Barrier	100	1,500.00	-	$	-	-	0%	1,500.00	$0.00	
10					$	-	-	#DIV/0!	-	$0.00	
11					$	-	-	#DIV/0!	-	$0.00	
12					$	-	-	#DIV/0!	-	$0.00	
13					$	-	-	#DIV/0!	-	$0.00	
14					$	-	-	#DIV/0!	-	$0.00	
15					$	-	-	#DIV/0!	-	$0.00	
16					$	-	-	#DIV/0!	-	$0.00	
17					$	-	-	#DIV/0!	-	$0.00	
18					$	-	-	#DIV/0!	-	$0.00	
19					$	-	-	#DIV/0!	-	$0.00	
20					$	-	-	#DIV/0!	-	$0.00	
21					$	-	-	#DIV/0!	-	$0.00	
22					$	-	-	#DIV/0!	-	$0.00	
23					$	-	-	#DIV/0!	-	$0.00	
24					$	-	-	#DIV/0!	-	$0.00	
25					$	-	-	#DIV/0!	-	$0.00	
26					$	-	-	#DIV/0!	-	$0.00	
27					$	-	-	#DIV/0!	-	$0.00	
28					$	-	-	#DIV/0!	-	$0.00	
	Total	368,992.00	109,519.50	33,500.00	143,019.50		225,972.50	210 $14,301.95	

Southeast Sod LLC
6054 SW 52ND TER
Palm City, FL 34990 US
+1 7722605907

64228384.1510.30510
Tyler

southeastsodllc@gmail.com		

INVOICE				
BILL TO	INVOICE	1457		
Mattamy Homes	DATE	07/27/2023		
	TERMS	Due on receipt		
	DUE DATE	07/27/2023		
JOB NAME
South Side of parr				
QTY  DESCRIPTION		RATE	AMOUNT	
38,700  Sq Ft of Floratam Sod Deliver & Installed		0.45	17,415.00	

Attn: Tyler	

SUBTOTAL	

17,415.00	
	TAX	0.00	
	TOTAL	17,415.00	
	
BALANCE DUE	 $17,415.00 	

Southeast Sod LLC
6054 SW 52ND TER
Palm City, FL 34990 US
+1 7722605907
southeastsodllc@gmail.com

INVOICE
BILL TO
Mattamy Homes

Tyler to Code, please

INVOICE	1490
DATE	08/21/2023
TERMS	Due on receipt
DUE DATE	08/21/2023

JOB NAME
 Kenley-Open Space/Paar/Berm/Mdl

QTY  DESCRIPTION	RATE	AMOUNT

34,650  Sq Ft of Floratam Sod Deliver & Installed	0.42	14,553.00

Attn: Tyler	SUBTOTAL	14,553.00 TAX		0.00
TOTAL	14,553.00

BALANCE DUE	$14,553.00

Southeast Sod LLC
6054 SW 52ND TER
Palm City, FL 34990 US
+1 7722605907

64228384.1510.33210
Tyler

southeastsodllc@gmail.com		

INVOICE		
BILL TO		INVOICE	1521	
Mattamy Homes		DATE	09/08/2023	
		TERMS	Due on receipt	
		DUE DATE	09/08/2023	
JOB NAME
Parr Water Line				
QTY  DESCRIPTION			RATE	AMOUNT	
18,000  Sq Ft of Bahia Sod Deliver & Installed			0.26	4,680.00	

Attn: Tyler	
SUBTOTAL		
4,680.00	
	TAX		0.00	
	TOTAL		4,680.00	
				
	BALANCE DUE		$4,680.00	

2022 ACQUISITION AND CONSTRUCTION ACCOUNT REQUISITION REQUISITION NO. 18	
SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO. 5

SPECIAL ASSESSMENT BONDS, SERIES 2022-1 (COMMUNITY INFRASTRUCTURE)
and
SPECIAL ASSESSMENT BONDS, SERIES 2022-2 (COMMUNITY INFRASTRUCTURE) (FEDERALLY TAXABLE)

The undersigned, a Responsible Officer of Southern Grove Community Development District No. 5 (the “Issuer”) hereby submits the following requisition for disbursement from the 2022 Acquisition and Construction Account created under and pursuant to the terms of the Master Trust Indenture from the Issuer to U.S. Bank Trust Company, National Association, as trustee (the “Trustee”), dated December 17, 2014, as supplemented by that certain Eighth Supplemental Indenture, dated as of December 1, 2022 (collectively, the “Indenture”), (all capitalized terms used herein shall have the meaning ascribed to such terms in this Indenture);
Requisition Number: 18

Name of Payee: Mattamy Palm Beach LLC

Amount Payable: $2,093,042.49	[this requisition is 2 of 2 total: $2,300,421.21

The undersigned hereby certifies that (check the applicable box in 1. below):
This requisition is for a Cost of the 2022-1 CI Project payable from the 2022-1 Acquisition and Construction Subaccount and does not include any Cost related to the TIM Project   X   
AND/OR

This requisition is for a Cost of the 2022-2 CI Project payable from the 2022-2 Acquisition and Construction Subaccount 	

AND

Each disbursement set forth above is a proper charge against the 2022-1 Acquisition and Construction Subaccount or the 2022-2 Acquisition and Construction Subaccount, as applicable.

[Include if applicable]

1

Each disbursement set forth above is made as payment of a portion of the purchase price for the 2022-1 CI Project or 2022-2 CI Project, as applicable, or repayment of advances for 2022- 2 CI Project, in either case, pursuant to a written agreement between the District and the other party named therein receiving payment and the undersigned represents that such agreement has not been modified or amended and is in full force and effect on the date hereof.

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO. 5

By:
Responsible Officer
Date:_	 ./lz_t1_"1c_l_L-_1	,1,.	zv_-_2 +-V 
T	I
The undersigned, an authorized representative of the Consulting Engineer to the Issuer, hereby certifies that this disbursement is for a Cost of the 2022-1 CI Project and/or 2022-2 CI Project, as applicable, and is consistent with: (i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the 2022-1 CI Project and/or 2022-2 CI Project, as applicable, with respect to which such disbursement is being made; and (iii) the Engineer's Report as supplemented and amended through the date hereof.

The undersigned further certifies that (a) the improvements to be acquired with this disbursement will be (1) owned by the Issuer or another governmental entity and located on public property or within public rights of way or easements and (2) accessible by the general public and/or part of a publie water management system; (b) the purchase price to be paid by the Issuer for the improvements to be acquired with this disbursement is no more than the lesser of (i) the fair market value of such improvements and (ii) the actual cost of construction of such improvements; (c) the plans and specifications for the improvements have been approved by all regulatory bodies required to approve them or such approval can reasonably be expected to be obtained; (d) all currently required approvals and permits for the acquisition, construction, reconstruction, installation and equipping of the portion of the 2022-1 CI Project and/or 2022-2 CI Project for which disbursement is made have been obtained from all applicable regulatory bodies; and (e) subject to permitted retainage under the applicable contracts, the seller has paid all contractors, subcontractors, and materialmen that have provided services or materials in connection with the portions of the 2022-1 CI Project and/or 2022-2 CI Project for which disbursement is made hereby, if acquisition or reimbursement is being made pursuant to an agreement.

[CONSULTING ENGINEER]

By:		/
Name:		J Butch" Terpening Title:			District Engineer Date:	April 18, 2024

2

MATTAMY HOMES' CERTIFICATE OF COSTS
SG Hegener Drive (FKA Paar Drive - 64228384)
FOR GOOD AND VALUABLE CONSIDERATION, the receipt and sufficiency of which are hereby acknowledged, Mattamy Palm Beach LLC ("Mattamy"), to the best of its knowledge, information, and belief, certifies to the Southern Grove Community Development District No. 5 ("District No. 5"), that the costs of the Work Product as defined and described as SG Hegener Drive (FKA Paar Drive), and as more particularly described in the attached Schedule 1 (the "Improvements"), are as follows:

A. Consultants		$80,695.96	See Exhibit A	
B. Permit Fees		$5,686.00	See Exhibit B	
C. Site Work		$2,048,673.70	See Exhibit C	
D. Landscape &	Irrigation	$165,365.55

Total: $2,300,421.21	See Exhibit D	

IN WITNESS WHEREOF, Mattamy has caused this instrument to be executed by its duly authorized agents, and its corporate seal affixed hereto, th igs-ltw-.day of February, 2024.

MATTAMY PALM BEACH LLC, a Delaware
limit n	
By: -	-­
Print Name: Karl Albertson Title: Vice President

Schedule 1
Cost Classification	
Cost Description	
Invoice Date	Contract
#	
Invoice#	
Vendor	
Amount	
A	Consultants	6/30/2022	6679	147641012-0622	Kimley-Horn & Associates	$	1,560.00	
A	Consultants	7/31/2022	6679	147641012-0722	Kimley-Horn & Associates	$	4,025.00	
A	Consultants	8/31/2022	6679	147641012-0822	Kimley-Horn & Associates	$	7,487.63	
A	Consultants	9/30/2022	6679	147641012-0922	Kimley-Horn & Associates	$	3,695.00	
A	Consultants	1/31/2023	6679	147641012-0123	Kimley-Horn & Associates	$	7,390.00	
A	Consultants	2/28/2023	6679	147641012-0223	Kimley-Horn & Associates	$	7,390.00	
A	Consultants	5/31/2023	6679	147641012-0523R	Kimley-Horn & Associates	$	11,085.00	
A	Consultants	6/30/2023	6679	147641012-0623	Kimley-Horn & Associates	$	3,695.00	
A	Consultants	7/31/2023	6679	147641012-0723	Kimley-Horn & Associates	$	3,784.08	
A	Consultants	8/31/2023	6679	147641012-0823	Kimley-Horn & Associates	$	3,695.00	
A	Consultants	10/31/2023	6679	147641012-1023	Kimley-Horn & Associates	$	3,695.00	
A	Consultants	5/2/2023	N/A	445391RA	Caulfield & Wheeler	$	775.00	
A	Consultants	8/25/2023	N/A	4450006	Caulfield & Wheeler	$	1,435.00	
A	Consultants	9/18/2023	N/A	4450545	Caulfield & Wheeler	$	560.00	
A	Consultants	10/25/2023	N/A	4451852	Caulfield & Wheeler	$	1,320.00	
A	Consultants	11/28/2023	N/A	4452691	Caulfield & Wheeler	$	420.00	
A	Consultants	3/20/2023	6813	34416	Lucido & Associates	$	1,375.00	
A	Consultants	7/19/2023	6813	34663	Lucido & Associates	$	2,750.00	
A	Consultants	9/30/2022	7657	7657-1	GFA International, Inc.	$	5,310.00	
A	Consultants	10/31/2022	7657	7657-2	GFA International, Inc.	$	2,790.00	
A	Consultants	11/30/2022	7657	7657-3	GFA International, Inc.	$	1,720.00	
A	Consultants	2/28/2023	7657	7657-4	GFA International, Inc.	$	845.00	
A	Consultants	4/30/2023	7657	7657-5	GFA International, Inc.	$	2,190.50	
A	Consultants	5/31/2023	7657	7657-6	GFA International, Inc.	$	786.25	
A	Consultants	6/30/2023	7657	7657-7	GFA International, Inc.	$	125.00	
A	Consultants	8/30/2023	7657	7657-8	GFA International, Inc.	$	792.50	
B	Permit Fees	4/18/2022	N/A	2687855	HUB International	$	5,686.00	
C	Site Work	8/15/2022	8365	120557	H and J Contracting Inc.	$	77,935.50	
C	Site Work	10/24/2022	8365	120957	H and J Contracting Inc.	$	8,883.00	
C	Site Work	11/21/2022	8365	121021	Hand J Contracting Inc.	$	8,883.00	
C	Site Work	1/16/2023	8365	121111	Hand J Contracting Inc.	$	42,997.50	
C	Site Work	2/13/2023	8365	121160	Hand J Contracting Inc.	$	232,700.40	
C	Site Work	2/28/2023	8365	121211	Hand J Contracting Inc.	$	132,082.20	
C	Site Work	4/13/2023	8365	121273	Hand J Contracting Inc.	$	10,100.70	
C	Site Work	6/30/2023	N/A	220017-2	Hand J Contracting Inc.	$	10,080.00	
C	Site Work	8/22/2023	N/A	220007-3	Hand J Contracting Inc.	$	840.00	
C	Site Work	8/22/2023	N/A	220007-10	Hand J Contracting Inc.	$	780.00	
C	Site Work	10/31/2023	8365	121666	H and J Contracting Inc.	$	107,564.40	
C	Site Work	8/22/2023	N/A	220017-6	H and J Contracting Inc.	$	4,200.00	
C	Site Work	9/7/2022	7757	2022-106	Pipeline Utilities Inc	$	204,327.99	
C	Site Work	10/5/2022	7757	2022-122	Pipeline Utilities Inc	$	149,449.37	
C	Site Work	10/31/2022	7757	2022-138	Pipeline Utilities Inc	$	146,310.66	
C	Site Work	11/30/2022	7757	2022-150	Pipeline Utilities Inc	$	100,471.50	
C	Site Work	3/1/2023	7757	2023-034	Pipeline Utilities Inc	$	142,832.70	
C	Site Work	6/30/2023	7757	2023-068	Pipeline Utilities Inc	$	188,097.97	
C	Site Work	8/31/2023	7757	2023-099	Pipeline Utilities Inc	$	11,029.50	
C	Site Work	8/31/2023	7757	2023-100	Pipeline Utilities Inc	$	104,724.41	
C	Site Work	5/5/2023	8838	8838-1	Richard and Rice Construction	$	19,816.83	
C	Site Work	5/12/2023	8838	8838-2	Richard and Rice Construction	$	31,258.98	
C	Site Work	6/9/2023	8838	8838-3	Richard and Rice Construction	$	9,056.34	
C	Site Work	8/22/2023	8838	8838-4	Richard and Rice Construction	$	69,681.40	
C	Site Work	9/13/2023	8838	8838-5	Richard and Rice Construction	$	44,303.03	
C	Site Work	11/14/2023	8838	8838-6	Richard and Rice Construction	$	97,530.42	
C	Site Work	11/21/2023	8838	8838-7	Richard and Rice Construction	$	30,183.00	
C	Site Work	6/22/2023	8903	22800-19856	Precision Contracting Services	$	9,549.00	
C	Site Work	7/19/2023	8959	8959-1	Cobra Construction	$	47,703.51	

C	Site Work	10/17/2023	8959	8959-2	Cobra Construction	$	5,300.39	

D	Landscape and
Irrigation	
5/30/2023	
8369	
8369-1	
LSP Nursery, Inc	
$	98,567.55	

D	Landscape and
Irrigation	
7/31/2023	
8369	
8369-2	
LSP Nursery, Inc	
$	30,150.00	

D	Landscape and
Irrigation	
7/27/2023	
N/A	
1457	
Southeast Sod LLC	
$	17,415.00	

D	Landscape and
Irrigation	
8/21/2023	
N/A	
1490	
Southeast Sod LLC	
$	14,553.00	

D	Landscape and
Irrigation	
9/8/2023	
N/A	
1521	
Southeast Sod LLC	
$	4,680.00	
		
	Total Due	$ 2,300,421.21	

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0622
ATTN: TONY PALUMBO	Invoice Date:	Jun 30, 2022
2500 QUANTUM LAKES DRIVE	Invoice Amount: $1,560.00
SUITE 215	Contract 6679	Project No:	147641012 BOYNTON BEACH, FL 33426		Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Jun 30, 2022	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	8,840.00	1,560.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	16,625.00	0.00	16,625.00	95.00%	875.00	
TASK 8 BID COORDINATION	3,500.00	350.00	0.00	350.00	10.00%	3,150.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	0.00	0.00	0.00	0.00%	73,900.00	
REIMBURSEMENT BUDGET	8,000.00	140.31	0.00	140.31	1.75%	7,859.69	
Subtotal	181,100.00	93,755.31	1,560.00	95,315.31	52.63%	85,784.69	
Total	1,560.00		

		

Total Invoice: $1,560.00

219

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$1,560.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 6/30/2022 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: F8C6A861-01E0-429B-AC9A-87B87D4034D2
www.docverify.com

Page 1 of 1

187B87D4034D2

F8C6A861-01E0-429B-AC9A-87B87D4034D2 --- 2022/07/20 08:30:18 -8:00

KHA Project #:147641012	Invoice #: 147641012-0622

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		7/20/2022	

KIMLEY-HORN AND ASSOCIATES, INC.

97CE8D65D77E

Heather Stone
Signed on 2022/07/20 08:32:47 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 20th day of July, 2022, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	as identification.

2EC9F7CF5939

Signed on 2022/07/20 08:32:47 -8:00

My commission expires:
5/18/2023
Notary Public

Lisa M. Hill
Commission # GG 310574
Notary Public - State of Florida
My Commission Expires May 18, 2023

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2022/07/20 08:32:47 PST	2EC9F7CF5939

220

DocVerify ID: F8C6A861-01E0-429B-AC9A-87B87D4034D2
www.docverify.com

Generated Cover Page	87B87D4034D2

147641012 ROL 2022-06_.pdf

DocVerify ID:	F8C6A861-01E0-429B-AC9A-87B87D4034D2 Created:	 July 20, 2022 08:30:18 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
July 20, 2022 08:32:47 -8:00 [97CE8D65D77E] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Lisa M Hill (LMH)
July 20, 2022 08:32:47 -8:00 [2EC9F7CF5939] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

221

#6679/ CC 37420
10-31-2022
Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0722
ATTN: TONY PALUMBO	Invoice Date:	Jul 31, 2022
2500 QUANTUM LAKES DRIVE	Invoice Amount: $4,025.00
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Jul 31, 2022	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	16,625.00	875.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	350.00	3,150.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	0.00	0.00	0.00	0.00%	73,900.00	
REIMBURSEMENT BUDGET	8,000.00	140.31	0.00	140.31	1.75%	7,859.69	
Subtotal	181,100.00	95,315.31	4,025.00	99,340.31	54.85%	81,759.69	
Total	4,025.00		

$4,025.00

	

Total Invoice:

222

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: 5FF4722B-ED07-4764-9629-4894F11102E9
www.docverify.com

Generated Cover Page	4894F11102E9

147641012 ROL 2022-07	.pdf

DocVerify ID:	5FF4722B-ED07-4764-9629-4894F11102E9
Created:	August 16, 2022 08:39:28 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
August 16, 2022 08:42:03 -8:00 [BB96E9FDD4FC] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Lisa M Hill (LMH)
August 16, 2022 08:42:03 -8:00 [2E813253FEAA] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

223

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$4,025.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 7/31/2022 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: 5FF4722B-ED07-4764-9629-4894F11102E9
www.docverify.com

Page 1 of 1

14894F11102E9

5FF4722B-ED07-4764-9629-4894F11102E9 --- 2022/08/16 08:39:28 -8:00

KHA Project #:147641012	Invoice #: 147641012-0722

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		8/16/22	

KIMLEY-HORN AND ASSOCIATES, INC.

BB96E9FDD4FC

Heather Stone
Signed on 2022/08/16 08:42:03 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 16th day of August, 2022, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.

2E813253FEAA

Signed on 2022/08/16 08:42:03 -8:00

My commission expires:
	5/18/2023	
Notary Public

Lisa M. Hill
Commission # GG 310574
Notary Public - State of Florida
My Commission Expires May 18, 2023

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2022/08/16 08:42:03 PST	2E813253FEAA

224

#6679/ CC 37420
9-22-2022
Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0822
ATTN: TONY PALUMBO	Invoice Date:	Aug 31, 2022
2500 QUANTUM LAKES DRIVE	Invoice Amount: $7,487.63
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Aug 31, 2022	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	0.00	7,390.00	7,390.00	10.00%	66,510.00	
REIMBURSEMENT BUDGET	8,000.00	140.31	97.63	237.94	2.97%	7,762.06	
Subtotal	181,100.00	99,340.31	7,487.63	106,827.94	58.99%	74,272.06	
Total	7,487.63		

$7,487.63

Total Invoice:

225

	

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

MATTAMY PALM BEACH, LLC ATTN: TONY PALUMBO
2500 QUANTUM LAKES DRIVE SUITE 215
BOYNTON BEACH, FL 33426

COST PLUS MAX
KHA Ref # 147641012.3-22343017			

Invoice Invoice
Project Project Project	

Task	
Description	
Hrs/Qty	
Rate	Current Amount Due	
REIMBURSEMENT BUDGET	TRAVEL - MEALS			27.63	
	VEHICLE MILEAGE	112.0	0.625	70.00	
TOTAL REIMBURSEMENT BUDGET	112.0		97.63	
TOTAL LABOR AND EXPENSE DETAIL			97.63	

No:	147641012-0822
Date:	Aug 31, 2022
No:	147641012 Name:	PAAR DRIVE
Manager: KLEIER, ERIC

This page is for informational purposes only. Please pay amount shown on cover page.

226

32CLB

DocVerify ID: C5AE98E0-7FB4-46A9-BA7A-150D578FADF8
www.docverify.com

Generated Cover Page	150D578FADF8

147641012 ROL 2022-08	.pdf

DocVerify ID:	C5AE98E0-7FB4-46A9-BA7A-150D578FADF8
Created:	September 15, 2022 07:00:41 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
September 15, 2022 07:07:45 -8:00 [F6D6CBE45FCB] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Lisa M Hill (LMH)
September 15, 2022 07:07:45 -8:00 [3E5F6B0B701E] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

227

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$7,487.63	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 8/31/2022 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: C5AE98E0-7FB4-46A9-BA7A-150D578FADF8
www.docverify.com

Page 1 of 1

1150D578FADF8

C5AE98E0-7FB4-46A9-BA7A-150D578FADF8 --- 2022/09/15 07:00:41 -8:00

KHA Project #:147641012	Invoice #: 147641012-0822

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		9/15/22	

KIMLEY-HORN AND ASSOCIATES, INC.

F6D6CBE45FCB

Heather Stone
Signed on 2022/09/15 07:07:45 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 15th day of September, 2022, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.

3E5F6B0B701E

Signed on 2022/09/15 07:07:45 -8:00

My commission expires:
	5/18/2023	
Notary Public

Lisa M. Hill
Commission # GG 310574
Notary Public - State of Florida
My Commission Expires May 18, 2023

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2022/09/15 07:07:45 PST	3E5F6B0B701E

228

#6679/ CC 37430
10-25-2022
Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0922
ATTN: TONY PALUMBO	Invoice Date:	Sep 30, 2022
2500 QUANTUM LAKES DRIVE	Invoice Amount: $3,695.00
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Sep 30, 2022	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	7,390.00	3,695.00	11,085.00	15.00%	62,815.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	0.00	237.94	2.97%	7,762.06	
Subtotal	181,100.00	106,827.94	3,695.00	110,522.94	61.03%	70,577.06	
Total	3,695.00		

		

Total Invoice:  $3,695.00 

229

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: 3EB5CA9E-6FFC-4FFF-9E05-7C9161253FF2
www.docverify.com

Generated Cover Page	7C9161253FF2

147641012 ROL 2022-09	.pdf

DocVerify ID:	3EB5CA9E-6FFC-4FFF-9E05-7C9161253FF2
Created:	October 18, 2022 05:54:07 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
October 18, 2022 06:02:45 -8:00 [1C13321642B0] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Lisa M Hill (LMH)
October 18, 2022 06:02:45 -8:00 [907D9FDA8572] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

230

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$3,695.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 9/30/2022 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: 3EB5CA9E-6FFC-4FFF-9E05-7C9161253FF2
www.docverify.com

Page 1 of 1

17C9161253FF2

3EB5CA9E-6FFC-4FFF-9E05-7C9161253FF2 --- 2022/10/18 05:54:07 -8:00

KHA Project #:147641012	Invoice #: 147641012-0922

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		10/18/22	

KIMLEY-HORN AND ASSOCIATES, INC.

1C13321642B0

Heather Stone
Signed on 2022/10/18 06:02:45 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 18th day of October, 2022, by Heather Stone, Assistant Secretary of Kimley-Horn and

907D9FDA8572

Signed on 2022/10/18 06:02:45 -8:00

Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	as identification.
My commission expires:
	5/18/2023	
Notary Public

Lisa M. Hill
Commission # GG 310574
Notary Public - State of Florida
My Commission Expires May 18, 2023

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2022/10/18 06:02:45 PST	907D9FDA8572

231

6679/ JDE Line 9 Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0123
ATTN: TONY PALUMBO	Invoice Date:	Jan 31, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $7,390.00 
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Jan 31, 2023	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	11,085.00	7,390.00	18,475.00	25.00%	55,425.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	0.00	237.94	2.97%	7,762.06	
Subtotal	181,100.00	110,522.94	7,390.00	117,912.94	65.11%	63,187.06	
Total	7,390.00		

	

Total Invoice: $7,390.00

232

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: 1BEC088E-B082-4853-BEBF-124B0F9F6BE3
www.docverify.com

Generated Cover Page	124B0F9F6BE3

147641012 ROL 2023-01	.pdf

DocVerify ID:	1BEC088E-B082-4853-BEBF-124B0F9F6BE3
Created:	February 14, 2023 09:42:42 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
February 14, 2023 09:48:47 -8:00 [3FF517BF6395] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Lisa M Hill (LMH)
February 14, 2023 09:48:47 -8:00 [C36804D667C8] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

233

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$7,390.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 1/31/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: 1BEC088E-B082-4853-BEBF-124B0F9F6BE3
www.docverify.com

Page 1 of 1

1124B0F9F6BE3

1BEC088E-B082-4853-BEBF-124B0F9F6BE3 --- 2023/02/14 09:42:42 -8:00

KHA Project #:147641012	Invoice #: 147641012-0123

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		2/14/23	

KIMLEY-HORN AND ASSOCIATES, INC.

3FF517BF6395

Heather Stone
Signed on 2023/02/14 09:48:47 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 14th day of February, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.

C36804D667C8

Signed on 2023/02/14 09:48:47 -8:00

My commission expires:
5/18/2023

Notary Public

Lisa M. Hill
Commission # GG 310574
Notary Public - State of Florida
My Commission Expires May 18, 2023

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2023/02/14 10:48:47 PST	C36804D667C8

234

6679/ JDE Line 9: $7,390.00
Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0223
ATTN: TONY PALUMBO	Invoice Date:	Feb 28, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount: $7,390.00
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through Feb 28, 2023	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	18,475.00	7,390.00	25,865.00	35.00%	48,035.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	0.00	237.94	2.97%	7,762.06	
Subtotal	181,100.00	117,912.94	7,390.00	125,302.94	69.19%	55,797.06	
Total	7,390.00		

		

Total Invoice: $7,390.00

235

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: 5E3C2F52-1F3F-4A88-9A5D-9DD46F702D4C
www.docverify.com

Generated Cover Page	9DD46F702D4C

147641012 ROL 2023-02	.pdf

DocVerify ID:	5E3C2F52-1F3F-4A88-9A5D-9DD46F702D4C
Created:	March 14, 2023 06:54:53 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
March 14, 2023 07:00:10 -8:00 [34B06DC9504D] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)
E-Signature Notary: Tammy L Scarlott (TLS)
March 14, 2023 07:00:10 -8:00 [D6A287C06016] [134.238.172.9]

tammy.scarlott@kimley-horn.com

I, Tammy L Scarlott, did witness the participants named above electronically	 sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

236

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$7,390.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 2/28/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

KHA Project #:147641012	Invoice #: 147641012-0223

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		3/13/23	

KIMLEY-HORN AND ASSOCIATES, INC.

By:

34B06DC9504D

Heather Stone
Signed on 2023/03/14 07:00:10 -8:00

HEATHER STONE
Assistant Secretary

DocVerify ID: 5E3C2F52-1F3F-4A88-9A5D-9DD46F702D4C
www.docverify.com

Page 1 of 1

19DD46F702D4C

5E3C2F52-1F3F-4A88-9A5D-9DD46F702D4C --- 2023/03/14 06:54:53 -8:00

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 13th day of March, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.

D6A287C06016

Signed on 2023/03/14 07:00:10 -8:00

My commission expires:
12/03/2024

Notary Public

Tammy L. Scarlott Commission # HH 68903 Notary Public - State of Florida
My Commission Expires Dec 03, 2024

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2023/03/14 07:00:10 PST	D6A287C06016

237

6679/ Line 9 Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0523R
ATTN: TONY PALUMBO	Invoice Date:	May 31, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $11,085.00
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679 For Services Rendered through May 31, 2023
Southern Grove -Port St. Lucie	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	25,865.00	11,085.00	36,950.00	50.00%	36,950.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	0.00	237.94	2.97%	7,762.06	
Subtotal	181,100.00	125,302.94	11,085.00	136,387.94	75.31%	44,712.06	
Total	11,085.00		

		

Total Invoice: $11,085.00

238

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: 14275A6F-CE56-4D87-BA7C-B2996D3C097D
www.docverify.com

Generated Cover Page	B2996D3C097D

147641012 ROL 2023-05R	.pdf

DocVerify ID:	14275A6F-CE56-4D87-BA7C-B2996D3C097D Created:	 June 27, 2023 13:09:43 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

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E-Signature Summary

E-Signature 1: Heather Stone (HS)
June 27, 2023 13:13:35 -8:00 [D021F549F418] [130.41.174.195]

heather.stone@kimley-horn.com (Principal)

E-Signature Notary: Lisa M Hill (LMH)
June 27, 2023 13:13:35 -8:00 [2A18ED004B94] [130.41.174.195]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

239

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$11,085.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 5/31/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

KHA Project #:147641012	Invoice #: 147641012-0523R

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		6/27/23	

KIMLEY-HORN AND ASSOCIATES, INC.

D021F549F418

Heather Stone
Signed on 2023/06/27 13:13:35 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 27th day of June, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and
Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as

identification.

My commission expires:

Lisa M. Hill
Commission # HH 363807
Notary Public - State of Florida
My Commission Expires May 18, 2027

	5/18/2027	

Signed on 2023/06/27 13:13:35 -8:00
Notary Public

2A18ED004B94

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

DocVerify

Notary Stamp 2023/06/27 13:13:35 PST

2A18ED004B94

DocVerify ID: 14275A6F-CE56-4D87-BA7C-B2996D3C097D
www.docverify.com

Page 1 of 1

1B2996D3C097D

14275A6F-CE56-4D87-BA7C-B2996D3C097D --- 2023/06/27 13:09:43 -8:00

240

6679
JDE Line 9 Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0623
ATTN: TONY PALUMBO	Invoice Date:	Jun 30, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $3,695.00 
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE -CONTRACT 6679
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679
For Services Rendered through Jun 30, 2023	Southern Grove -Port St. Lucie	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	36,950.00	3,695.00	40,645.00	55.00%	33,255.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	0.00	237.94	2.97%	7,762.06	
Subtotal	181,100.00	136,387.94	3,695.00	140,082.94	77.35%	41,017.06	
Total	3,695.00		

		

Total Invoice: $3,695.00

241

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

DocVerify ID: B08AC5BF-2B8F-4BFB-BDA8-F9D0042F1CD4
www.docverify.com

Generated Cover Page	F9D0042F1CD4

147641012 ROL 2023-06	c.pdf

DocVerify ID:	B08AC5BF-2B8F-4BFB-BDA8-F9D0042F1CD4 Created:	 July 17, 2023 12:57:08 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
July 17, 2023 13:13:11 -8:00 [0D109010ED68] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)

E-Signature Notary: Lisa M Hill (LMH)
July 17, 2023 13:13:11 -8:00 [3B114208CBFE] [134.238.172.9]
lisa.hill@kimley-horn.com
I, Lisa M Hill, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

242

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$3,695.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 6/30/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: B08AC5BF-2B8F-4BFB-BDA8-F9D0042F1CD4
www.docverify.com

Page 1 of 1

1F9D0042F1CD4

B08AC5BF-2B8F-4BFB-BDA8-F9D0042F1CD4 --- 2023/07/17 12:57:08 -8:00

KHA Project #:147641012	Invoice #: 147641012-0623

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		7/17/23	

KIMLEY-HORN AND ASSOCIATES, INC.

0D109010ED68

Heather Stone
Signed on 2023/07/17 13:13:11 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 17th day of July, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and

3B114208CBFE

Signed on 2023/07/17 13:13:11 -8:00

Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.
My commission expires:
	5/18/2027	
Notary Public

Lisa M. Hill
Commission # HH 363807
Notary Public - State of Florida
My Commission Expires May 18, 2027

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2023/07/17 13:13:11 PST	3B114208CBFE

243

6679
JDE Line 9: $3,695.00 JDE CO #1: $89.08
Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0723
ATTN: TONY PALUMBO	Invoice Date:	Jul 31, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $3,784.08 
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE -CONTRACT 6679
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679
For Services Rendered through Jul 31, 2023	Southern Grove -Port St. Lucie	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	40,645.00	3,695.00	44,340.00	60.00%	29,560.00	
REIMBURSEMENT BUDGET	8,000.00	237.94	89.08	327.02	4.09%	7,672.98	
Subtotal	181,100.00	140,082.94	3,784.08	143,867.02	79.44%	37,232.98	
Total	3,784.08		

	

Total Invoice: $3,784.08

244

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	32CLB

MATTAMY PALM BEACH, LLC ATTN: TONY PALUMBO
2500 QUANTUM LAKES DRIVE SUITE 215
BOYNTON BEACH, FL 33426

COST PLUS MAX
KHA Ref # 147641012.3-25506388			

Invoice No Invoice Da
Project No Project Na Project Ma	

Task	
Description	
Hrs/Qty	
Rate	Current Amount Due	
REIMBURSEMENT BUDGET	VEHICLE MILEAGE	136.0	0.655	89.08	
TOTAL REIMBURSEMENT BUDGET	136.0		89.08	
TOTAL LABOR AND EXPENSE DETAIL			89.08	

:
te:
:
me: nager:

147641012-0723
Jul 31, 2023
147641012
PAAR DRIVE -CONTRACT 6679
KLEIER, ERIC

This page is for informational purposes only. Please pay amount shown on cover page.

245

32CLB

DocVerify ID: D3B5B3DB-C210-42A0-B704-269FE54FAB36
www.docverify.com

Generated Cover Page	269FE54FAB36

147641012 ROL 2023-07	c.pdf

DocVerify ID:	D3B5B3DB-C210-42A0-B704-269FE54FAB36
Created:	August 14, 2023 08:10:03 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
August 14, 2023 08:14:41 -8:00 [96D5BE45BAC3] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)

E-Signature Notary: Tammy L Scarlott (TLS)
August 14, 2023 08:14:41 -8:00 [EFDA7853BD97] [134.238.172.9]
tammy.scarlott@kimley-horn.com
I, Tammy L Scarlott, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

246

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$3,784.08	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 7/31/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

DocVerify ID: D3B5B3DB-C210-42A0-B704-269FE54FAB36
www.docverify.com

Page 1 of 1

1269FE54FAB36

D3B5B3DB-C210-42A0-B704-269FE54FAB36 --- 2023/08/14 08:10:03 -8:00

KHA Project #:147641012	Invoice #: 147641012-0723

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		8/14/23	

KIMLEY-HORN AND ASSOCIATES, INC.

96D5BE45BAC3

Heather Stone
Signed on 2023/08/14 08:14:41 -8:00

By:

HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 14th day of August, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and

EFDA7853BD97

Signed on 2023/08/14 08:14:41 -8:00

Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.
My commission expires:
12/03/2024
Notary Public

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Tammy L. Scarlott Commission # HH 68903 Notary Public - State of Florida
My Commission Expires Dec 03, 2024

DocVerify

Notary Stamp 2023/08/14 08:14:41 PST	EFDA7853BD97

247

6679/ JDE Line 9 Tyler

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-0823
ATTN: TONY PALUMBO	Invoice Date:	Aug 31, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $3,695.00 
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE -CONTRACT 6679
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679
For Services Rendered through Aug 31, 2023	Southern Grove -Port St. Lucie	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	44,340.00	3,695.00	48,035.00	65.00%	25,865.00	
REIMBURSEMENT BUDGET	8,000.00	327.02	0.00	327.02	4.09%	7,672.98	
Subtotal	181,100.00	143,867.02	3,695.00	147,562.02	81.48%	33,537.98	
Total	3,695.00		

		

Total Invoice: $3,695.00

248

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	31CLB

DocVerify ID: F0069F49-C369-4D50-89C2-3B5E5E2F0FA0
www.docverify.com

Generated Cover Page	3B5E5E2F0FA0

147641012 ROL 2023-08	c.pdf

DocVerify ID:	F0069F49-C369-4D50-89C2-3B5E5E2F0FA0
Created:	September 15, 2023 05:02:27 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

This document is a DocVerify VeriVaulted protected version of the document named above. It was created by a notary or on the behalf of a notary, and it is also a DocVerify E-Sign document, which means this document was created for the purposes of Electronic Signatures and/or Electronic Notary. Tampered or altered documents can be easily verified and validated with the DocVerify veriCheck system.

Go to www.docverify.com at any time to verify or validate the authenticity and integrity of this or any other DocVerify VeriVaulted document.

E-Signature Summary

E-Signature 1: Heather Stone (HS)
September 15, 2023 05:06:05 -8:00 [B818039758D1] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)

E-Signature Notary: Tammy L Scarlott (TLS)
September 15, 2023 05:06:05 -8:00 [C89A7B2D1D49] [134.238.172.9]
tammy.scarlott@kimley-horn.com
I, Tammy L Scarlott, did witness the participants named above electronically sign this document.

DocVerify documents cannot be altered or tampered with in any way once they are protected by the DocVerify VeriVault System. Best viewed with Adobe Reader or Adobe Acrobat.
All visible electronic signatures contained in this document are symbolic representations of the persons signature, and not intended to be an accurate depiction of the persons actual signature as defined by various Acts and/or Laws.

249

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of	$3,695.00	,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices

dated	8/31/2023	to

on the job of

MATTAMY PALM BEACH, LLC PAAR DRIVE

Description Of Property

DocVerify ID: F0069F49-C369-4D50-89C2-3B5E5E2F0FA0
www.docverify.com

Page 1 of 1

13B5E5E2F0FA0

F0069F49-C369-4D50-89C2-3B5E5E2F0FA0 --- 2023/09/15 05:02:27 -8:00

KHA Project #:147641012	Invoice #: 147641012-0823

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on	9/14/23

KIMLEY-HORN AND ASSOCIATES, INC.

B818039758D1

Heather Stone
Signed on 2023/09/15 05:06:05 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 14th day of September, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and

C89A7B2D1D49

Signed on 2023/09/15 05:06:05 -8:00

Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.
My commission expires:
12/03/2024
Notary Public

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Tammy L. Scarlott Commission # HH 68903 Notary Public - State of Florida
My Commission Expires Dec 03, 2024

DocVerify

Notary Stamp 2023/09/15 05:06:05 PST	C89A7B2D1D49

250

6679/ JDE Line 9 Frank

Please remit payment electronically to:	If paying by check, please remit to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.	KIMLEY-HORN AND ASSOCIATES, INC. Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94163	P.O. BOX 932520
Account Number:	2073089159554	ATLANTA, GA 31193-2520
ABA#:	121000248

Payment for this invoice is due within 25 days of receipt.
MATTAMY PALM BEACH, LLC	Invoice No:	147641012-1023
ATTN: TONY PALUMBO	Invoice Date:	Oct 31, 2023
2500 QUANTUM LAKES DRIVE	Invoice Amount:  $3,695.00 
SUITE 215	Project No:	147641012
BOYNTON BEACH, FL 33426	Project Name:	PAAR DRIVE -CONTRACT 6679
Project Manager: KLEIER, ERIC
Federal Tax Id: 56-0885615	Client Reference: 6679
For Services Rendered through Oct 31, 2023	Southern Grove -Port St. Lucie	

Description	Contract Value	Previous Amount Billed	Current Amount Due	Amount Earned to Date	%
Complete	Remaining Balance	
TASK 1 PROJECT MANAGEMENT	10,500.00	10,500.00	0.00	10,500.00	100.00%	0.00	
TASK 2 PRELIMINARY 30% PLANS	9,700.00	9,700.00	0.00	9,700.00	100.00%	0.00	
TASK 3 60% PLANS	20,800.00	20,800.00	0.00	20,800.00	100.00%	0.00	
TASK 4 90% CONSTRUCTABILITY PLANS	14,300.00	14,300.00	0.00	14,300.00	100.00%	0.00	
TASK 5 FINAL DESIGN PLANS	10,400.00	10,400.00	0.00	10,400.00	100.00%	0.00	
TASK 6 STREET LIGHTING	12,500.00	12,500.00	0.00	12,500.00	100.00%	0.00	
TASK 7 PERMITTING	17,500.00	17,500.00	0.00	17,500.00	100.00%	0.00	
TASK 8 BID COORDINATION	3,500.00	3,500.00	0.00	3,500.00	100.00%	0.00	
TASK 9 CONSTRUCTION PHASE SERVICES	73,900.00	48,035.00	3,695.00	51,730.00	70.00%	22,170.00	
REIMBURSEMENT BUDGET	8,000.00	327.02	0.00	327.02	4.09%	7,672.98	
Subtotal	181,100.00	147,562.02	3,695.00	151,257.02	83.52%	29,842.98	
Total	3,695.00		

		

Total Invoice: $3,695.00

251

If you have any questions, please contact Cheryl Barrett at 561-840-0839 or Cheryl.Barrett@kimley-horn.com.	31CLB

DocVerify ID: 44A8E1D1-C871-4C8F-9013-87D3DE61A686
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Generated Cover Page	87D3DE61A686

147641012 ROL 2023-10	c.pdf

DocVerify ID:	44A8E1D1-C871-4C8F-9013-87D3DE61A686
Created:	November 14, 2023 10:00:10 -8:00
Pages:	1
Electronic Notary:	Yes / State: FL

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E-Signature Summary

E-Signature 1: Heather Stone (HS)
November 14, 2023 10:03:13 -8:00 [824108FE0B99] [134.238.172.9]

heather.stone@kimley-horn.com (Principal)

E-Signature Notary: Tammy L Scarlott (TLS)
November 14, 2023 10:03:13 -8:00 [694B8F7AF09D] [134.238.172.9]
tammy.scarlott@kimley-horn.com
I, Tammy L Scarlott, did witness the participants named above electronically sign this document.

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252

PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of		$3,695.00	 ,
hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished for invoices
dated	 10/31/2023 	to		MATTAMY PALM BEACH, LLC	

on the job of

	PAAR DRIVE	

Description Of Property

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187D3DE61A686

44A8E1D1-C871-4C8F-9013-87D3DE61A686 --- 2023/11/14 10:00:10 -8:00

KHA Project #:147641012	Invoice #: 147641012-1023

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified above.

DATED on		11/14/23	

KIMLEY-HORN AND ASSOCIATES, INC.

824108FE0B99

Heather Stone
Signed on 2023/11/14 10:03:13 -8:00

By:
HEATHER STONE
Assistant Secretary

STATE OF FLORIDA COUNTY OF PALM BEACH

The foregoing instrument was acknowledged before me by means of	physical presence or	X	online notarization, this 14th day of November, 2023, by Heather Stone, Assistant Secretary of Kimley-Horn and

694B8F7AF09D

Signed on 2023/11/14 10:03:13 -8:00

Associates, Inc., a North Carolina corporation. He / She is personally known to me or has provided 	 as identification.
My commission expires:
12/03/2024
Notary Public

Tammy L. Scarlott Commission # HH 68903 Notary Public - State of Florida
My Commission Expires Dec 03, 2024

DocVerify

Note: This is a statutory form prescribed by Section 713.20, Florida Statutes. Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form.

Notary Stamp 2023/11/14 11:03:13 PST	694B8F7AF09D

253

64228384.1510.37580
Tyler

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4446663
Date	05/02/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through May 02, 2023

Professional Services
Hourly - Surveying Services

02/20/2023
Professional Land Surveyor

Hours	Rate

Billed Amount

Hourly	2.00	140.00	280.00
CALC PAAR ROAD SIDEWALKS NORTH SIDE PER TYLER
02/21/2023
Field Survey Crew-GPS
Hourly	3.00	165.00	495.00
STAKE 10 AND 12 FT WALKS NORTH SIDE OF PAAR. FROM POWERLINES WEST TO ROUNDABOUT. MATTAMY PORTION
Professional Services subtotal	5.00	775.00

775.00 

Invoice total

Aging Summary
Invoice Number	
Invoice Date	
Outstanding	
Current	
Over 30	
Over 60	
Over 90	
Over 120	
4446663	05/02/2023	775.00	775.00					
	Total	775.00	775.00	0.00	0.00	0.00	0.00	

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.

Office: 561-392-1991 Fax: 561-750-1452

64228384.1510.37580
Tyler

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4445391RA
Date	05/02/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through May 02, 2023

Professional Services
Hourly - Surveying Services

02/20/2023
Professional Land Surveyor

Hours	Rate

Billed Amount

Hourly	2.00	140.00	280.00
CALC PAAR ROAD SIDEWALKS NORTH SIDE PER TYLER
02/21/2023
Field Survey Crew-GPS
Hourly	3.00	165.00	495.00
STAKE 10 AND 12 FT WALKS NORTH SIDE OF PAAR. FROM POWERLINES WEST TO ROUNDABOUT. MATTAMY PORTION
Professional Services subtotal	5.00	775.00

775.00 

Invoice total

Aging Summary
Invoice Number	
Invoice Date	
Outstanding	
Current	
Over 30	
Over 60	
Over 90	
Over 120	
4445391R	05/02/2023	775.00	775.00					
	Total	775.00	775.00	0.00	0.00	0.00	0.00	

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.
Office: 561-392-1991 Fax: 561-750-1452

64228384.1510.37580
Tyler

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4450006
Date	08/25/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through July 30, 2023

Professional Services
Hourly - Surveying Services

07/05/2023
Field Survey Crew-GPS

Hours	Rate

Billed Amount

Hourly	2.00	165.00	330.00
STAKE NORTH RIGHT OF WAY
Professional Land Surveyor
Hourly	2.00	140.00	280.00
CALC NORTH ROW OF PAAR ROAD PER TYLER MATTAMY
07/17/2023
Field Survey Crew-GPS

Hourly
RESTAKE KNOCKED OUT STAKES FOR WALKS AND CHECK OTHERS 1000FT	5.00	165.00	825.00	
Professional Services subtotal	9.00		1,435.00	
				
		Invoice total	1,435.00	

Aging Summary
Invoice Number	

Invoice Date	

Outstanding	

Current	

Over 30	

Over 60	

Over 90	

Over 120	
4450006	08/25/2023	1,435.00	1,435.00					
	Total	1,435.00	1,435.00	0.00	0.00	0.00	0.00	

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.
Office: 561-392-1991 Fax: 561-750-1452

64228384.1510.37580
Tyler

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4450545
Date	09/18/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through September 03, 2023

Professional Services
Hourly - Surveying Services

08/08/2023
Professional Land Surveyor

Hours	Rate

Billed Amount

Hourly		4.00	140.00	560.00	
CALC DRIVEWAYS AND WALKS PAAR ROAD					
	Professional Services subtotal	4.00		560.00	
			Invoice total	560.00 	
Aging Summary
Invoice Number	Invoice Date	Outstanding	

Current	Over 30	

Over 60	

Over 90	

Over 120	
4450545	09/18/2023	560.00	560.00				
Total	560.00	560.00	0.00	0.00	0.00	0.00	

 

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.
Office: 561-392-1991 Fax: 561-750-1452

64228384.1510.37580
Frank

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4451852
Date	10/25/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through October 01, 2023

Professional Services
Hourly - Surveying Services

08/04/2023
Field Survey Crew-GPS

Hours	Rate

Billed Amount

Hourly	3.00	165.00	495.00
STAKE AND GRADE WALKS AND RAMPS
08/08/2023
Field Survey Crew-GPS
Hourly	5.00	165.00	825.00
STAKE DRIVEWAYS SIDEWALKS ON PARR
Professional Services subtotal	8.00	1,320.00

 1,320.00 

Invoice total

Aging Summary
Invoice Number	
Invoice Date	
Outstanding	
Current	
Over 30	
Over 60	
Over 90	
Over 120	
4450545	09/18/2023	560.00		560.00				
4451852	10/25/2023	1,320.00	1,320.00					
	Total	1,880.00	1,320.00	560.00	0.00	0.00	0.00	

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.
Office: 561-392-1991 Fax: 561-750-1452

64228384.1510.37580
Jonas

Caulfield & Wheeler 7900 Glades Road
Suite 100
Boca Raton, FL 33434

Mattamy Homes
2500 Quantum Lakes Dr, Suite 215
LD Email: SEFL.LandAP@mattamycorp.com HB Email: SEFL.AP@mattamycorp.com Boynton Beach, Fl 33426

Invoice number	4452691
Date	11/28/2023

Project 8993-1PAAR PAAR ROAD (SG4 OFFSITE)

For Professional Services Through October 29, 2023

Professional Services
Contract - Surveying Services

10/10/2023
Professional Land Surveyor

Hours	Rate

Billed Amount

Contract	3.00	140.00	420.00
CALC FENCING PAAR ROAD NORTH SIDE PER JONAS
Professional Services subtotal	3.00	420.00

420.00 

Invoice total

Aging Summary
Invoice Number	
Invoice Date	
Outstanding	
Current	
Over 30	
Over 60	
Over 90	
Over 120	
4451852	10/25/2023	1,320.00		1,320.00				
4452691	11/28/2023	420.00	420.00					
	Total	1,740.00	420.00	1,320.00	0.00	0.00	0.00	

Approved by:
Michael A. Vermeal Project Manager
FOR YOUR CONVENIENCE, WE NOW ACCEPT VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS. PLEASE USE OUR SECURE WEBSITE https://cwi-assoc.com TO MAKE YOUR CREDIT CARD PAYMENT.
Office: 561-392-1991 Fax: 561-750-1452

701 SE Ocean Boulevard Stuart, FL 34994
(772) 220-2100

6813
Tyler

MATTAMY HOMES - SOUTHEAST FLORIDA DIVISION ANTHONY PALUMBO
2500 QUANTUM LAKES BOULEVARD SUITE 215
BOYNTON BEACH, FL 33426

Invoice number	34416
Date	03/20/2023

Project 20-276.31 PAAR DRIVE EXTENSION - LANDSCAPE ARCHITECTURE

Professional Services for the period: 2/1/23 to 2/28/23

Contract
Description	Amount	Percent
Complete	Total
Billed	Prior Fee
Billings	Current
Billed	
PARTS A & B: DESIGN DEVELOPMENT (CONCEPT	21,500.00
DESIGN) & LANDSCAPE CONSTRUCTIONS DOCS	100.00	21,500.00	21,500.00	0.00	
PART C: SITE VISITS	5,500.00	25.00	1,375.00	0.00	1,375.00	
Total	27,000.00	84.72	22,875.00	21,500.00	1,375.00	

			Invoice total	1,375.00	
					
Aging Summary								
Invoice Number	Invoice Date	Outstanding	Current	Over 30	Over 60	Over 90	Over 120	
34416	03/20/2023	1,375.00	1,375.00					
	Total	1,375.00	1,375.00	0.00	0.00	0.00	0.00	

Project Manager

STEVEN GARRETT

701 SE Ocean Boulevard Stuart, FL 34994
(772) 220-2100

6813
Tyler

MATTAMY HOMES - SOUTHEAST FLORIDA DIVISION ANTHONY PALUMBO
2500 QUANTUM LAKES BOULEVARD SUITE 215
BOYNTON BEACH, FL 33426

Invoice number	34663
Date	07/19/2023

Project 20-276.31 PAAR DRIVE EXTENSION - LANDSCAPE ARCHITECTURE

Professional Services for the period: 6/1/23 to 6/30/23

Contract
Description	Amount	Percent
Complete	Total
Billed	Prior Fee
Billings	Current
Billed	
PARTS A & B: DESIGN DEVELOPMENT (CONCEPT	21,500.00
DESIGN) & LANDSCAPE CONSTRUCTIONS DOCS	100.00	21,500.00	21,500.00	0.00	
PART C: SITE VISITS	5,500.00	75.00	4,125.00	1,375.00	2,750.00	
Total	27,000.00	94.91	25,625.00	22,875.00	2,750.00	
					
			Invoice total	 2,750.00 	
Aging Summary								
Invoice Number	Invoice Date	Outstanding	Current	Over 30	Over 60	Over 90	Over 120	
34663	07/19/2023	2,750.00	2,750.00					
	Total	2,750.00	2,750.00	0.00	0.00	0.00	0.00	

Project Manager

STEVEN GARRETT

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Pag _1 of 2_

TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR):  GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

Inv #7657-1
10-11-2022
Tyler

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL
3310.2200200.0000

APP.	# 1

PERIOD TO; 09/30/2022

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below. in connection with the Contract Continuation Sheet, Documenl G703, must be attached.

1. ORIGINAL CONTRACT SUM	$17,160.00	
2. Net change by Change Orders	 $		
3. CONTRACT SUM TO DATE (Line 1 =/- 2)		$17,160.00		
4. TOTAL COMPLETED & STORED TO DATE	$5,310.00	

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

RETAlNAGE

(Column G on G703)

10% of Completed Work 	
(Column D + Eon G703
10% Stored Material	NIA

Total Retainage (Line Sa+ Sb] or
(Total in Column I of G703)		

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been completed In accordance with the Contract Documents, that all amounts have been
paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is
now due.

TOTAL EARNED
(line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from !!!l!ll Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

$5,310.00

$5.310.00	MS

$11,850.00

CONTRA	 ('j
BY	DATE

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on site observations and the data comprising the above application. the Architect certifies to the Owner that to the inclcated, the quallily of lhe Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

State of:	Florida	CountyA_	rai t-Luci1/
Subscribed d s rn .,?ti /	day of	,	2022
NotaryPublic_·	/	.	,.<(iflii,?-,. CandaceAzzopar9,
My Comm1s	n Expires: 08/28123	r�· A·t', Comm #GG908
t -	• E p1res A.ugus; 1 lt_
-:.U i- •	- - iaf\

AMOUNT CERTIFIED..............................................	$5,310:-/fo
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

 By:	Date:	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENTG703	PAGE OF PAGES2of2

AJA Document G702. APPLICATION AND CERTIFICATION FOR PAYMENT. contammg
Contractors signed cenificat1on 1s attached.
In tablllat1ons below, nmounts are stated to the nearest dollar
Use Column I on Contracts where variable retainage for line items may apply

APPLICATION NO:	1
APPLICATION DATE:	09/30/22
PERIOD TO:	09/30/22
GFA'S PROJECT NO: 3310. 2200200

A	B	Quan1ty	Umt	Uni1 Price	C	D	E	F	G	H	

ITEM	DESCRIPTION
OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO					VALUE	FROM PREVIOUS	TI	-asPERIOD	PRESENTLY	COMPLETED	(GTC)	TO FINlSH	
						APPLICATION		STORED	AND STORED		(C-G)	
						(D t-E)		(NOTIN	TO DATE			
								DORE)	(Dt-E+F)			
												
	Construction Material Testing				$17,160.00		$5,310.00		$5,310.00	30.94%	11,85000	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00					0.00%		
	Chanoe Orders:								,,	0.00%		
	GRAND TOTALS				$17,160.00	$0.00	$5,310.00	$0.00	$5,310.00	30.94%	11,850.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

September 30, 2022
Project: No:	3310.2200200.0000
Invoice No:	00650120

Terms: Net 30 days
We accept American Express, Visa, Master Card, Discover, and ACH

Project:	3310.2200200.0000	Parr Drive Improvements

Location:

Parr Drive
Port St Lucie, FL

Professional Services through October 31, 2022

Phase	3310
Unit Billing
Administration Fee

In-Place Density Test - Soils

CMT Parr Drive Improvements

0.5 Hours @ 50.00	25.00

8/17/2022	WO# 278404	11.0 Tests @ 25.00	275.00	
8/25/2022	WO # 278513	2.0 Tests @ 25.00	50.00	
8/29/2022	WO # 280636	2.0 Tests @ 25.00	50.00	
8/30/2022	WO # 280637	6.0 Tests @ 25.00	150.00	
8/31/2022	WO # 279222	1.0 Test @ 25.00	25.00	
9/1/2022	WO # 279223	7.0 Tests @ 25.00	175.00	
9/2/2022	WO # 279224	11.0 Tests @ 25.00	275.00	
9/6/2022	WO # 279871	12.0 Tests @ 25.00	300.00	
9/7/2022	WO # 279872	8.0 Tests @ 25.00	200.00	
9/8/2022	WO # 279873	3.0 Tests @ 25.00	75.00	
9/9/2022	WO # 279874	5.0 Tests @ 25.00	125.00	
9/12/2022	WO # 280615	2.0 Tests @ 25.00	50.00	
9/30/2022	Log Book - Force Main	18.0 Tests @ 25.00	450.00	

Laboratory Proctor Test (Each)
9/13/2022	5728
Log Book Creation Professional Engineer (Per Hr.)
Project Manager/Quality Control Technician Time (Per Hr.)

1.0 Test @ 105.00	105.00

1.0 Book @ 1,500.00	1,500.00

5.0 Hours @ 125.00	625.00

1.0 Hour @ 85.00	85.00

11.0 Hours @ 70.00	770.00

Total Units	5,310.00	5,310.00
Total this Phase	$5,310.00

264

Total this Invoice	$5,310.00

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	f>c1g 1_ of 2

TO:	Mattmay Homes
2401 Quantum lakes Drive Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

Inv #7657-2
11-2-2022
Tyler

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL
3310.2200200.0000

APP.	# 2

PERIOD TO: 10/31/2022

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

1. ORIGINAL CONTRACT SUM	$17,160.00	
2. Net change by Change Orders	$	
3. CONTRACT SUM TO DATE (Line 1 =/- 2)	$17,160.00	
4. TOTAL COMPLETED & STORED TO DATE		$8,100.00		

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

RETAINAGE

(Column G on G703)

10% of Completed Work 	
(Column D + Eon G703
10% Stored Material	N/A

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due

CONTRACTOR_		-

Total Retainage (Line Sa + Sb) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from Jl!!.Q! Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)
State of:	Flori•da Subscribed anzswbezfoome this

	$8,100.00	

	$5,310.00	

	$2,790.00	/vf S	
	$9,060.00	

Dv	'	arn

Sair! c	2022
Co""

BY		 		\Z

DATE

Notary Public·
<1J.J.IY Commiss•i	:	/281.!3

.\5-/aayof	/t AJTfJi?Af   ;��cit'c,��r}
[«	/., Expires August ?8 ,,_.

'----"..·.--·;·..it..'-'/ Bool'oo- Thn• --

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with lhe Contract Document, based on on-site observations and the data comprising lhe above application, the Architect certifies to lhe Owner Iha! !a lhe incicated, the qualilty of the Work is in accordance with the Contract Documents. and the Contractor ,s entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED .............	$2,790.00

(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

By:	Date:

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENTG703	PAGE OF' PAGES2ol2

AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT. containing
Contractor's signed cert1fication 1s attached
In tabularions below. amounts arc stated to the nearest dollar
Use Column I on Contracts where variable retamage for line items may apply.

APPLICATION NO:	2
APPUCATION DATE:	10/31/22 PERIOD TO:	 10/31/22
GFA'S PROJECT NO: 3310. 2200200

A	B	Quanny	Unit	Unit Price	C	D	E	F	G	H	

ffEM	DESCRIPTION
OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
8ALANCE	
NO.					VALUE	FROM PREVIOUS	THlS PERIOD	PRESENTLY	COMPLETED	(G+C)	TO FINISH	
						APPLICATION		STORED	AND STORED		{C-G)	
						(D+E)		(NOTIN	TO DATE			
								DORE)	(D+E+FJ			
												
	Construction Material Testing				S17.16000	$5,310.00	$2,790.00		sa.100.00	4720%	9,060.00	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00					0.00%		
	ChanAe Orders:									0.00%		
	GRAND TOTALS				$17,160.00	$5,310,00	$2.790,00	$0.00	$8.100.00	47.20%	9,060.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

October 31, 2022
Project: No:	3310.2200200.0000
Invoice No:	00655486

Terms: Net 30 days
We accept American Express, Visa, Master Card, Discover, and ACH

Project:	3310.2200200.0000	Parr Drive Improvements

Location:

Parr Drive
Port St Lucie, FL

Professional Services through October 31, 2022

Phase	3310
Unit Billing
Administration Fee

10/4/2022	WO # 282220	4.0 Tests @ 25.00	100.00	
10/5/2022	WO # 282221	7.0 Tests @ 25.00	175.00	
10/6/2022	WO # 282510	6.0 Tests @ 25.00	150.00	
10/7/2022	WO # 282512	7.0 Tests @ 25.00	175.00	
10/10/2022	WO # 282513	2.0 Tests @ 25.00	50.00	
10/21/2022	WO # 283971	4.0 Tests @ 25.00	100.00	
10/24/2022	WO # 284057	5.0 Tests @ 25.00	125.00	
10/25/2022	WO # 284147	5.0 Tests @ 25.00	125.00	
10/31/2022	Log Book - Force main	30.0 Tests @ 25.00	750.00	
aboratory Proctor Test (Each)
10/10/2022	5969	1.0 Test @ 105.00	105.00	

In-Place Density Test - Soils

CMT Parr Drive Improvements
0.25 Hours @ 50.00	12.50

L

267

Professional Engineer (Per Hr.) Project Manager/Quality Control Technician Time (Per Hr.)
Total Units

2.0 Hours @ 125.00	250.00
0.5 Hours @ 85.00	42.50

2,790.00	2,790.00	
Total this Phase	$2,790.00	
Total this Invoice	$2,790.00	

9.0 Hours @ 70.00	630.00

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of 2

TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

7657-3

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL

APP.	#3

PERIOD TO: 11/30/2022

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove
Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

12-1-2022
Tyler

3310.2200200.0000

APPLICATION FOR PAYMENT

Application Is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

1. ORIGINAL CONTRACT SUM		$17,160.00		
2. Net change by Change Orders	 $		
3. CONTRACT SUM TO DATE (Line 1 ;;/- 2)	$17,160.00	
4. TOTAL COMPLETED & STORED TO DATE	$9,820.00	

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

RETAINAGE

(Column G on G703)

10% of Completed Work 	
(Column D .. E on G703
10% Stored Material	NIA

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been
paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due.

Total Retainage (Line 5a + 5b) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from llliQ! Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

$9,820.00

$8,100.00

	$1,120.00MS	
	$7,340.00	

::NT	

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contracl Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the lncicated, the quallity of the Work is in accordance with the Contract Documents, and the Contractor 1s entitled to payment of the AMOUNT CERTIFIED.

DATE\

MyCommi  • n	xpires:	a  JO' )	J	tfll1\ Comm #GG908R,

Slate of:

Florida

Countyfl°1/	Saint Lucie

Subscribed ands omlo)"'	r•Yof/ V

Notary Public·

-9'(F	·

(}@I.bv.

,...;f¥1J'P, _;,,,. Candace AZZORara'

.2022

D	f>	:::>	\i i/ ExpiresAugt,S·?S !Ot
·•,, 0 r.. •  Rrvvfod ,.,no,">'fY' ili•
AMOUNT CERTIFIED..............................................	$1,720.00
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

 By:	Date:	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	A/A DOCUMENTG703	PAGE OF PAGES 2-of 2

AIA Docume111 G702, APPLICATION AND CERTIFICATION FOR PAYMENT. containing
Contrac1or1s signed certification is attached.
ln tabulations below, amounts are stated to the neares1 dollar.
Use Column I on Contracts where variable retainage for line items may apply.

APPLICATION NO:	3
APPLICATION DATE:	11/30/22
PERIOD TO:	11/30/22
GFA'S PROJECT NO: 3310. 2200200

A	B	Quanitv	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRJPTION
OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	THIS PERIOD	PRESENTLY	COMPLETED	(G-C)	TO FINISH	
						APPLICAT!ON		STORED	AND STORED		(C-0)	
						(D+E)		(NOTIN	TO DATE			
								DORE)	(D+E+F)			
												
	Construction Material Testing				$17,160.00	$8,100.00	$1,720.00		$9,820.00	57.23%	7,340.00	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00					000%		
	Change Orders:									0.00%		
	GRAND TOTALS				$17,160.00	$8,100.00	$1,720.00	$0.00	$9,820.00	57.23%	7,340.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document 0401 - Certification of Document's Authenticity

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

November 30, 2022
Project: No:	3310.2200200.0000
Invoice No:	00663178

Terms: Net 30 days
We accept American Express, Visa, Master Card, Discover, and ACH

Project:	3310.2200200.0000	Parr Drive Improvements

Location:

Parr Drive
Port St Lucie, FL

270

Professional Services through November 30, 2022
Phase	3310	CMT Parr Drive Improvements
Unit Billing
Administration Fee
11/30/2022	0.5 Hours @ 50.00	25.00
In-Place Density Test - Soils	
10/26/2022	WO#284148	3.0 Tests @ 25.00	75.00	
10/27/2022	WO#284149	13.0 Tests @ 25.00	325.00	
11/4/2022	WO#285232	4.0 Tests @ 25.00	100.00	
11/30/2022	Logbook - Force Main	24.0 Tests @ 25.00	600.00	
Professional Engineer (Per Hr.)	
11/30/2022	1.0 Hour @ 125.00	125.00		
Project Manager/Quality Control				
	1.0 Hour @ 85.00	85.00		
Technician Time (Per Hr.)				
	5.5 Hours @ 70.00	385.00		
Total Units		1,720.00	1,720.00	
Total this Phase	$1,720.00

Total this Invoice	$1,720.00

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR	PAYMENT			Page 1 of	
TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436	PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL	APP.

PERIOD	#4

TO: 2/28/2023	

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Mater als Testing, Inspections
APPLICATION FOR PAYMENT

7657-4
Tyler

3310.2200200.0000

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

1. ORIGINAL CONTRACT SUM		$17,160.00		
2. Net change by Change Orders	$	
3. CONTRACT SUM TO DATE (Line 1 =/- 2)		$17,160.00		
4. TOTAL COMPLETED & STORED TO DATE		$10,665.00		

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

RETAINAGE

(Column G on G703)

10% of Completed Work 	
(Column D + E on G703
10% Stored Material	N/A

Total Retainage (Line Sa + Sb) or
(Total in Column I of G703)		

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Worl< for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due.

TOTAL EARNED
(Line 4 less Line S Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from I!!!.!!! Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE

Slate of:

Florida

CONTRACTOR

Subscribed and sworn to before me this '?

,, _f	( _ ..,

BY

 	

DATE

Notary Public:
My Commissionires:

•

J-ocf'

JENNIFERRB
MYCOMMISSION I HH323323
EXPIRES:February 18.2027

(Line 3 less Line 6)

	$10,665.00	

	$9,820.00,L,_	
	$845.oo Y!_MS	
	$6,495.00	

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the incicated, the qualiity of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED		$845.00	
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

By:	Date:

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE OF PAGES2of2

AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below. amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

APPLICATION NO:	4
APPLICATION DATE:	02/24/23
PERlOD TO:	02/28/23
GFA'SPROJECTNO: 3310.2200200

A	B	Ouanfr\.·	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	THISPERJOD	PRESENTLY	COMPLETED	IG+C)	TOFINJSH	
						APPLICATION		STORED	AND STORED		(C-GI	
						tD+E)		(NOT IN	TO DATE			
								DORE)	(D+E+FI			
												
	Construction Material Testing				$17,160.00	$9,820.00	$845.00		$10,665.00	62.15%	6,495.00	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00				$0.00	0.00%		
	Change Orders:								$0.00	0.00%		
	GRAND TOTALS				$17,160.00	$9,820.00	$845.00	$0.00	$10,665.00	62.15%	6,495.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

February 27, 2023
Project: No:	3310.2200200.0000
Invoice No:	00687201

Terms: Net 30 days
We accept American Express, Visa, Master Card, Discover, and ACH

Project:	3310.2200200.0000	Parr Drive Improvements

Location:

Parr Drive
Port St Lucie, FL

Professional Services through February 28, 2023
Phase	3310	CMT Parr Drive Improvements
Unit Billing
Administration Fee
2/28/2023	1.0 Hour @ 50.00	50.00
In-Place Density Test - Soils	
2/1/2023	WO# 291657	4.0 Tests @ 25.00	100.00	
2/9/2023	WO# 292400	7.0 Tests @ 25.00	175.00	
2/17/2023	WO# 292998	4.0 Tests @ 25.00	100.00	
Professional Engineer (Per Hr.)	
2/28/2023	1.0 Hour @ 125.00	125.00		
Project Manager/Quality Control				
	1.0 Hour @ 85.00	85.00		
Technician Time (Per Hr.)				
	3.0 Hours @ 70.00	210.00		
Total Units		845.00	845.00	
	Total this Phase		$845.00	
	Total this Invoice		$845.00	

273

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Pa_g_e 1 of 2

TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

7657-5
Tyler

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL
3310.2200200.0000

APP.	# 5

PERIOD TO: 04/30/2023

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE (Line 1 =/- 2)
TOTAL COMPLETED & STORED TO DATE
(Column G on G703)

	$17,160.00	
 $	
	$17,160.00;:l	
	$12,855.50	

RETAINAGE

10% of Completed Work 	
(Column D + E on G703
10% Stored Material	N/A

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been
paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due.

Total Retainage (Line 5a + 5b} or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from er!Qr Certificate}
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

s

State of:	Florida

	$12,855.50	

	$10,665.00	
	$2,190.50	MS
$4,304.50

Countx <}f r _  Saint Lucie

::NTRA

DATE.5

fore	is} /
MyCommi  i	)J-i tb_

day of / V \j\-'.(

.,. Candace ,c.,z.zoparai
\ comm.#GG9088' 1e,io2;

"

it)
'

ARCHITECT'S CERTIFICATE FOR PAYMENT

AMOUNT   CERTIFIED ..............................................

	$2,190.50	

In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the incicated, the qualiity of the Work is in accordance w h the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

 By:	Date:	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE OF PAGES 2 of 2

AJA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

APPLICATION NO:	5
APPLICATION DATE:	04/26/23
PERIOD TO:	04/30/23
GFA'S PROJECT NO: 3310. 2200200

A	B	Ouanitv	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION
OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	THIS PER1OD	PRESENTLY	COMPLETED	(G+C)	TOFINJSH	
						APPLICATION		STORED	AND STORED		(C-G)	
						(D+E)		(NOTJN	TO DATE			
								DORE)	(D+E+Fl			
												
	Construction Material Testing				$17,160.00	$10,665.00	$2,190.50		$12,855.50	74.92%	4,304.50	

												

												

												

												

												
												
									-			

												

												

												
												
	Subtotal				$17,160.00				$0.00	0.00%		
	Chanae Orders:								$0.00	0.00%		
	GRAND TOTALS				$17,160.00	$10,665.00	$2,190.50	$0.00	$12,855.50	74.92%	4,304.50	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

INVOICE	
Ptease Make Payable to: Universal Engineering Sciences
Remit to: P.O. Box 735401, Chicago, IL 60673-5401	
Billing questions contact: uesar@leamues.com	

607 NW Commodity Cove, Port St. Lucie, FL 34986 I p 772-924-35751 r 772-924-3580

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

April 26, 2023 Project: No: Invoice No:

3310.2200200.0000
00704651

TERMS: Net 30 Days
We accept American Express, Visa
Master Card, Discover, and ACH	

Project:
Location:

3310.2200200.0000
Parr Drive
Port St Lucie, FL

Parr Drive Improvements

Phase	3310	GMT Parr Drive Improvements
Unit Billing
Laboratory Proctor Test (Each)
12/8/2022	Lab ID 6462	1.0 TEST@ 95.00

95.00

In-Place Density Test - Soils	
12/8/2022	WO#287476	10.0 Tests@ 23.00	230.00	
12/29/2022	Log Book - Water Densities	56.0 Tests @ 23.00	1,288.00	
4/21/2023
Administration Fee	WO# 296308	6.0 Tesis @ 25.00

0.5 Hours@ 50.00	150.00

25.00	
Professional Engineer (Per Hr.)	
12/31/2022
Project Manager/Quality Control	0.5 Hours@ 125.00

0.5 Hours @ 85.00	62.50

42.50	
Technician Time (Per Hr.)			
4.25 Hours @ 70.00	297.50		
Total Units	2,190.50	2,190.50	

Total this Phase Total this Invoice

$2,190.50

$2,190.50

276

SUBCONTRACTOR/VENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of

TO:	Mattmay Homes
2401 Quantum Lakes Drive

PROJECT:	Paar Drive Improvements
Paar Drive

APP.	#6

Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove
Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

7657-6
Tyler

Port St Lucie, FL 3310.2200200.0000

PERIOD TO: 05/31/2023

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE (Line 1 =/- 2)
TOTAL COMPLETED & STORED TO DATE
(Column G on G703)

$17,160.00

$

	$17,160.00	
	$13,641.75	

RETAINAGE

10% of Completed Work 	
(Column D +Eon G703
10% Stored Material	N/A

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor. and the current payment shown here is now due.

Total Retainage (Line 5a + 5b) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from JWQ! Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE

�Y,o

(Line 3 less Line 6)
State of:
Subscn 'bedan swo[ t Florida

Countyr.

	$13,641.75	

	$12,855.50	

	$786.25 ,L MS	
$3,518.25

, 2023

CONTRACTOR

(.	Notary Public:	. o....

....reme t ilt\"7	day of C(\Y.{,, Saint Lucie

BY	DATE

My Comm;.,	/	/	'-( e

i

xp1res:	'{  b	�	fJ_

VY\{.	

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the incicated, the qualiity of the Work is in accordance wtth the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED		$786.25	
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

 By:	Date:	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE OF PAGES2of2

AJA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.

APPLICATION NO: APPLICATION DATE:
PERIOD TO:

6
05/31/23
05/31/23

Use Column I on Contracts where variable retainage for line items may apply.

GFA'S PROJECT NO: 3310.2200200

A	B	Ouanil'I	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	nns PERIOD	PRESENTLY	COMPLETED	(G+C)	TOFINISH	
						APPLICATION		STORED	AND STORED		(C-G)	
						(D+EI		(NOTIN	TO DATE			
								DORE)	(D+E+F)			
												
	Construction Materlal TestlnQ				$17,160.00	$12,855.50	$786.25		$13,641.75	79.50%	3,518.25	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00				$0.00	0.00%		
	Change Orders:								$0.00	0.00%		
	GRAND TOTALS				$17,160.00	$12,855.50	$786.25	$0.00	$13,641.75	79.50%	3,518.25	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

INVOICE	
Please Make Payable to: Universal Engineering Sciences	
Remit to: P.O. Box 735401, Chicago, IL 60673-5401	
Billing questions contact: uesar@teamues.com	

607 NW Commodity Cove, Port St. Lucie, FL 34986 | p 772-924-3575 | f 772-924-3580

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

Project:	3310.2200200.0000	Parr Drive Improvements

May 31, 2023
Project: No:	3310.2200200.0000
Invoice No:	00719046

TERMS: Net 30 Days
We accept American Express, Visa Master Card, Discover, and ACH	

Location:

Parr Drive
Port St Lucie, FL

Professional Services through June 30, 2023
Phase	3310	CMT Parr Drive Improvements
Unit Billing
Administration Fee
5/31/2023	0.25 Hours @ 50.00	12.50

5/19/2023	WO # 269439	6.0 Tests @ 25.00	150.00	
5/24/2023	WO # 300816	2.0 Tests @ 25.00	50.00	

In-Place Density Test - Soils
Professional Engineer (Per Hr.)
5/31/2023	0.5 Hours @ 125.00	62.50
Project Manager/Quality Control

Technician Time (Per Hr.)

0.25 Hours @ 85.00	21.25
7.0 Hours @ 70.00	490.00

Total Units	786.25	786.25
Total this Phase	$786.25
Total this Invoice	$786.25

279

	

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of 2

TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

7657-7
Tyler

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL
3310.2200200.0000

APP.	#7

PERIOD TO: 06/30/2023

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE (Line 1 =/- 2)
TOTAL COMPLETED & STORED TO DATE
(Column G on G703)

	$17,160.00	
 $	
$17,160.00 .-..-.;z_
	$13,766.75	

RETAINAGE

10% of Completed Work 	
(Column D + E on G703
10% Stored Material	N/A

The undersigned SubcontractorNendor certifies that to the best of his knowledge infonnation and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due.

CONTRACTOR

Total Retainage (Line 5a + 5b) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Tota
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from llli!1! Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

{_p

	$13,766.75	

	$13,641.75	
	$125.oo ._L MS	
$3,393.25

State of:	Florida			Coun		paint Lucie Subscribed nd swfrn to)'	m this	ay	of	U\.

2023

VJ

y	,

BY	DATE 7\ 1e\1.\ 

NotaryPubh	/
My Commission Expires:

.-,\ iYz•,,,_ Candace AZZORara:

.J	,.,	•·	Jfr'

&/7 2-	f A .,\. Comm.#GG9088'3.
'CJ-'	\¾,,.._.,.'<!/ E xP1resA	JA

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the incicated, the qualiity of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED-.............................................	'""$125.00
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

By:	Date:

 ugus;

,•,• :;

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE OF PAGES 2 of 2

AJA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

APPLTCATION NO:	7
APPLICATION DATE:	06/30/23
PER10D TO:	06/30/23
GFA'S PROJECT NO: 3310. 2200200

A	B	Quanitv	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	TIIISPERIOD	PRESENTLY	COMPLETED	(G•C)	TO FINISH	
						APPLICATION		STORED	AND STORED		(C-Gl	
						(D+E)		(NOTIN	TO DATE			
								DORE)	(D+E+F}			
												
	Construction Material Testlnq				$17,160.00	$13,641.75	$125.00		$13,766.75	80.23%	3,393.25	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00				$0.00	0.00%		
	ChanQe Orders:								$0.00	0.00%		
	GRAND TOTALS				$17,160.00	$13,641.75	$125.00	$0.00	$13,766.75	80.23%	3,393.25	
Users may obtain validation of this document by requesting of the license a completed AIA Document 0401 - Certification of Document's Authenticity

INVOICE	
Please Make Payable to: Universal Engineering Sciences	
Remit to: P.O. Box 735401, Chicago, IL 60673-5401	
Billing questions contact: uesar@teamues.com	

607 NW Commodity Cove, Port St. Lucie, FL 34986 | p 772-924-3575 | f 772-924-3580

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

Project:	3310.2200200.0000	Parr Drive Improvements

June 29, 2023
Project: No:	3310.2200200.0000
Invoice No:	00723860

TERMS: Net 30 Days
We accept American Express, Visa
Master Card, Discover, and ACH	

Location:

Parr Drive
Port St Lucie, FL

Professional Services through June 30, 2023
Phase	3310	CMT Parr Drive Improvements
Unit Billing
Administration Fee
0.25 Hours @ 50.00	12.50
In-Place Density Test - Soils
6/7/2023	WO# 301892	1.0 Test @ 25.00	25.00
Professional Engineer (Per Hr.)

Project Manager/Quality Control Technician Time (Per Hr.)

0.25 Hours @ 125.00	31.25
0.25 Hours @ 85.00	21.25
0.5 Hours @ 70.00	35.00

Total Units	125.00	125.00
Total this Phase	$125.00
Total this Invoice	$125.00

282

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of 2

TO:	Mattmay Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

FROM (SUBCONTRACTORNENDOR):  GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing, Inspections

7657-8
Tyler

PROJECT:	Paar Drive Improvements Paar Drive
Port St Lucie, FL
3310.2200200.0000

APP.	# 8

PERIOD TO: 08/30/2023

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE (Line 1 =/- 2)
TOTAL COMPLETED & STORED TO DATE
(Column G on G703)

$17,160.00

z

$

	$17,160.00	
$14,559.25

RETAINAGE

10% of Completed Work 	
(Column D + E on G703
10% Stored Material	NIA

The undersigned SubcontractorNendor certifies that to the best of his knowledge lnfom,a on and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due.

Total Retainage (line Sa• Sb) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from J!!lQ!: Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

	$14,559.25	

	$13,766.75	

	$792.so	MS	
$2,600.75

State of:

Florida

County of:	Sain.t. Lucie

CONTRACT

Subscribedsom to before me this Notary Public·	-:C
.  .	.
My Comm1ss10	xpIres:

fj, \ Notary Public· State of Flo a

··· • i,,'•,.	ROXANN TAYLOR

.	023
nd

BY

 	

DATE	1'.)

\-0...•.�l,..<-/ My Commission# HH 169275

Comm. Expires Aug 28, 2025

'•,.?,• f:'SQndedthrough National Notary A;sr..

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the lncicated, the qualiity of the Work is in accordance w h the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED......................... ..":':'.. :'?.. '.":':.. ':":..w  w-	-  -$792.50
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

By:	Date:

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENTG703	PAGE OF PAGES 2 of 2

AIA Docwnent G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.

APPLICATION NO:
APPLICATION DATE:
PERIOD TO:

8
08/30/23
08/30/23

Use Column I on Contracts where variable retainage for line items may apply.	GFA'S PROJECT NO: 3310. 2200200

A	B	Quanir:y	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION OF WORK				
SCHEDULED	
WORK COMPLETED	
MArnRIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	TinSPERJOD	PRESENTLY	COMPLETED	(G+C)	TOFINISH	
						APPLICATION		STORED	AND STORED		(C-Gi	
						(D+EI		(NOTIN	TO DATE			
								DORE]	(D+E+F)			
												
	Construetion Material Testing				$17,160.00	$13,766.75	$792.50		$14,559.25	84.84%	2,600.75	

												

												

												

												

												

												

												

												

												
	Subtotal				$17,160.00				$0.00	0.00%		
	ChallQe Orders:								$0.00	0.00%		
	GRAND TOTALS				$17,160.00	$13,766.75	$792.50	$0.00	$14,559.25	84.84%	2,600.75	
Users may obtain validation of this document by requesting of the license a completed AIA Document 0401 - Certification of Document's Authenticity

INVOICE	
Please Make Payable to: Universal Engineering Sciences	
Remit to: P.O. Box 735401, Chicago, IL 60673-5401	
Billing questions contact: uesar@teamues.com	

607 NW Commodity Cove, Port St. Lucie, FL 34986 | p 772-924-3575 | f 772-924-3580

Mr. Frank Covelli Mattamy Homes
2401 Quantum Lakes Drive Boynton Beach, FL 33436

Project:	3310.2200200.0000	Paar Drive Improvements

August 30, 2023
Project: No:	3310.2200200.0000
Invoice No:	00742579

TERMS: Net 30 Days
We accept American Express, Visa
Master Card, Discover, and ACH	

Location:

Parr Drive
Port St Lucie, FL

Professional Services through August 31, 2023
Phase	3310	Paar Drive Improvements
Unit Billing
Administration Fee

In-Place Density Test - Soils

1.0 Hour @ 50.00	50.00

8/8/2023	WO# 306391	5.0 Tests @ 25.00	125.00	
8/9/2023	WO# 306504	9.0 Tests @ 25.00	225.00	

Professional Engineer (Per Hr.) Project Manager/Quality Control Technician Time (Per Hr.)

0.5 Hours @ 125.00	62.50
1.0 Hour @ 85.00	85.00
3.5 Hours @ 70.00	245.00

Total Units	792.50	792.50
Total this Phase	$792.50
Total this Invoice	$792.50

285

Invoice # 2687855	Page 1 of 1	
ACCOUNT NUMBER	DATE	
MATTHOM-01	04/18/2022	
BALANCE DUE ON	AMOUNT DUE	
04/18/2022	$5,686.00	

Hub International Midwest West
Phone: 630-468-5600
Fax:

Pay My Bill Online
Visit our online portal to easily and securely pay your HUB invoice using your banking information (ACH)
www.hubinternational.com/paymybill

Darryl Dawe Mattamy Homes
66 Wellington Street West, Suite 5500 Toronto, ON M5K 1G8

Bond (Renewable)			PolicyNumber:	SUR0074053	Effective:	04/15/2022	to	04/15/2023	
									
Item #	Trans Eff Date	Due Date	Trans	Description				Amount	
30659456	04/15/2022	04/18/2022	NEWB	Mattamy Homes Palm Beach, LLC				$5,686.00	
Subd. City of Port St. Lucie, FL; Southern Grove 4C (Parr Drive) $1,263,467.40	Policy Invoice Balance:	$5,686.00	
	Total Invoice Balance:	$5,686.00	

*** PREMIUM FINANCING OPTIONS MAY BE AVAILABLE UPON REQUEST; PLEASE CONTACT YOUR HUB REPRESENTATIVE ***
*** PLEASE RETURN A COPY OF THIS INVOICE WITH YOUR CHECK, AND REFERENCE ON THE PAYMENT YOUR INVOICE #	2687855 ***

PAY BY CHECK
Please remit your payment to:
HUB International
55 East Jackson Boulevard Suite 14th Floor
Chicago, IL 60604

ADDITIONAL PAYMENT OPTIONS

More detailed information about how Hub International is compensated can be found at hubinternational.com behind the "How We Get Paid" tab.

286

HROBINSON

APPLICATION AND CERTIFICATE FOR PAYMENT

Invoice #:  120557

To Owner:

Mattamy Palm Beach LLC	Project:
2500 Quantum Lakes Drive, Suite 215

Boynton Beach, FL 33426

22-0017- CDD SG Parr Road

#8365-1
8-19-2022
Tyler

Application No. :

Period To:

1

06/30/2022

Distribution to :
Owner Architect/Engineer Contractor

From Contractor:

Contract For:

H and J Contracting Inc. 3160 Fairlane Farms Road
Wellington, FL 33414
64228384

Via Architect/Engineer:

Project Nos:

Contract Date:

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

1. Original Contract Sum . . . . . . . . . . . . . . . . . . . . . . . .	$1,034,777.00	
2. Net Change By Change Order . . . . . . . . . . . . . . . . . . . .	$0.00	
3. Contract Sum To Date . . . . . . . . . . . . . . . . . . . . . . . . . .	$1,034,777.00	
4. Total Completed and Stored To Date . . . . . . . . . . . . . . .	$86,595.00	
5. Retainage:		

CONTRACTOR:

SUZETTE ANDRIANO
H and J Contracting Inc.MY COMMISSION # HH 010148

EXPIRES: July 10, 2024
Bonded Thru Notary Public Underwriters

By:	Date: 7/7/22	
Jeremy Rury - Vice President

10.00%

of Completed Work

$8,659.50

State of: Florida

Subscribed and sworn to before me this

7th

County of:Palm Beach
day of July, 2022

b.	0.00% of Stored Material

Total Retainage . . . . . . . . . . . . . . . . . . . . . . . . . . .

$0.00

$8,659.50

Notary Public:
My Commission expires:

July 10, 2024

Total Earned Less Retainage . . . . . . . . . . . . . . . . . . .

Less Previous Certificates For Payments . . . . . . . . . .
Current Payment Due . . . . . . . . . . . . . . . . . . . . . . . . .

$77,935.50

$0.00
$77,935.50

ARCHITECT'S/ ENGINEER'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, and belief, the Work has progressed as indicated ,
the quality of the Work is in accordance with the Contract Documents , and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

Balance To Finish, Plus Retainage . . . . . . . . . . . . . . .	$956,841.50

AMOUNT CERTIFIED

$77,935.50

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total Approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
Net Changes By Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.)

ARCHITECT/ ENGINEER:

08/15/2022

___________________

By:			Date:	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

287

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

1
06/30/22
06/30/22

Invoice # :

120557

Contract : 22-0017- CDD SG Parr Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	0.00	1,770.00	0.00	1,770.00	10.00%	15,930.00	177.00	
	Survey									
110	Clear & Grub Site	28,290.00	0.00	28,290.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	0.00	2,760.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	0.00	47,025.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	0.00	6,750.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	0.00	0.00	0.00	0.00	0.00%	16,200.00	0.00	
300	12 Compacted Subgrade	21,840.00	0.00	0.00	0.00	0.00	0.00%	21,840.00	0.00	
305	16 FDOT Rock Base LBR100	216,580.00	0.00	0.00	0.00	0.00	0.00%	216,580.00	0.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	0.00	0.00	0.00	0.00%	115,200.00	0.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	0.00	0.00	0.00	0.00	0.00%	80,660.00	0.00	
335	Drop Curb	4,484.00	0.00	0.00	0.00	0.00	0.00%	4,484.00	0.00	
340	Type RA Curb	9,900.00	0.00	0.00	0.00	0.00	0.00%	9,900.00	0.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	0.00	86,595.00	0.00	86,595.00	8.37%	948,182.00	288	8,659.50	

APPLICATION AND CERTIFICATE FOR PAYMENT

Invoice #:  120957

To Owner:

Mattamy Palm Beach LLC	Project:
2500 Quantum Lakes Drive, Suite 215

Boynton Beach, FL 33426

22-0017- CDD SG Parr Road

#8365-2
10-25-2022

Application No. :

Period To:

2

10/31/2022

Distribution to :
Owner Architect/Engineer Contractor

From Contractor:

H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414

Via Architect/Engineer:

Tyler

Project Nos:

Contract For:	64228384

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

Contract Date:

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown

1. Original Contract Sum . . . . . . . . . . . . . . . . . . . . . . . .	$1,034,777.00	
2. Net Change By Change Order . . . . . . . . . . . . . . . . . . . .	$0.00	
3. Contract Sum To Date . . . . . . . . . . . . . . . . . . . . . . . . . .	$1,034,777.00	
4. Total Completed and Stored To Date . . . . . . . . . . . . . . .	$96,465.00	
5. Retainage:		

herein is now due. CONTRACTOR:

SUZETTE ANDRIANO
H and J Contracting Inc.MY COMMISSION # HH 010148
EXPIRES: July 10, 2024
Bonded Thru Notary Public Underwriters

By:	Date: 10/18/22	
Jeremy Rury - Vice President

a.	10.00%  of Completed Work

State of: Florida

County of: Palm Beach

b.	0.00% of Stored Material

$9,646.50
$0.00

Subscribed and sworn to before me this Notary Public:

18th

day of	October, 2022

Total Retainage . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Earned Less Retainage . . . . . . . . . . . . . . . . . . .

Less Previous Certificates For Payments . . . . . . . . . .
Current Payment Due . . . . . . . . . . . . . . . . . . . . . . . . .

$9,646.50

$86,818.50

$77,935.50
$8,883.00

My Commission expires: July 10, 2024

ARCHITECT'S/ ENGINEER'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, and belief, the Work has progressed as indicated ,
the quality of the Work is in accordance with the Contract Documents , and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

Balance To Finish, Plus Retainage . . . . . . . . . . . . . . .	$947,958.50

AMOUNT CERTIFIED

$8,883.00

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total Approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
Net Changes By Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.)

ARCHITECT/ ENGINEER:

10/24/2022

_____________________

By: 		Date:	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

289

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

2
10/31/22
10/31/22

Invoice # :

120957

Contract : 22-0017- CDD SG Parr Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	1,770.00	1,770.00	0.00	3,540.00	20.00%	14,160.00	354.00	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	0.00	8,100.00	0.00	8,100.00	50.00%	8,100.00	810.00	
300	12 Compacted Subgrade	21,840.00	0.00	0.00	0.00	0.00	0.00%	21,840.00	0.00	
305	16 FDOT Rock Base LBR100	216,580.00	0.00	0.00	0.00	0.00	0.00%	216,580.00	0.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	0.00	0.00	0.00	0.00%	115,200.00	0.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	0.00	0.00	0.00	0.00	0.00%	80,660.00	0.00	
335	Drop Curb	4,484.00	0.00	0.00	0.00	0.00	0.00%	4,484.00	0.00	
340	Type RA Curb	9,900.00	0.00	0.00	0.00	0.00	0.00%	9,900.00	0.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	86,595.00	9,870.00	0.00	96,465.00	9.32%	938,312.00	290	9,646.50	

APPUCATION AND CERTIFICATE FOR PAYMENT	Invoice#:  12J02l

To Owner.	Mall:amy Palm Beach LLC
2500 Quantum Lakes Driive, Suite 215

Boynton Beach, FL 33426
From Coniractor:	H and J Contracting lnr:.

Projecl.:  22-0017- COD SG Parr Road	Appllcalion No. :	3
Ple'rloclTo:	11/30/2022.
Via

Dislributi1m le :
CJ	Owner
C:J	Archi!ec1/Ehglnllilr
[==:J  Contractor
c:=i
c=J

3160 Fairtane Farms Road Wellington, FL 33414
Contract !For:	64228384

Alchifecl/Eg13jnur.	8365

FrojeclNos:

Contract Date:

CONTRACTOR'S APPLICATION FOR PAYMENT
Ap,plicalion is ma<le ror pa.ymenl. "<''i soown below, In connecoon with lhe ConlracL
COnlinualioo Slieel is attached.

Original Contract Sum
Net Chan.ge By Chal"lge Order .. , ................ .

$1,034,777.00
$0,00

The undersigned Contractor certifies tl7at to the best of the Contractor's knowledge, information, and belief, the work covered by this Application forl"a9ment ha,s been completed in accordance with the Contract Documents. That all amounts have,been paid by the Contractor for Work for which previous Certillcales for Payment were issued and payments received from the Owner, and that current payment shown

04

herein is now due.	SUZETTE ANDRIANO
CONTRACTOR:	Hand J Contracttng Inc. MY COMMISSION# HH 010148
EXP:IRES: July 10, 2024

Contract Sum To Date . , ................... ,....

$1,034,777.00		

Bo.nded Thru Notary Public Underwriters

Total Completed and Stornd To Date .............. .
Relainage:

$106.,335.00

By;	/ 	Date:  11/16/22
Jeremy 1Rury-\7ice President

Palm Beach

a.	10.00¼ of Completed Work

0.00¾ of Stored Material

$10,633.50
$0.00

Stale ot: Florida

S�3a:iz A�

Suoscribed and sworn to before me lhi 16th .
Notary Public:
My Commission expl'to/ July 10, 2024

County or: day of

November, 2022

Total Retainage .................... ,	,

Total Earned Less Retalnaga , . , ....... ,....... .

Less Previous Certificates For Payments ......... .
Current Payment Due ........................ .

Balance To Finish, Plus Retainage ... , ....... ,,..

$10,633.50

$95.701.50

$86,818,SJC
$8,883.00

$939,075.50

ARCHITECTS/ ENGINEER'S CERTllrlCATE FOR PAYMENT
In accordar-1ce with the Contract Documents, based on on-site observations and'Ule da1a cornpris·ing lhe above application, li:1e Architect certifies to the Owner that to the bes-tof the Architect's !cnowledg.e, inforrnalion, and belief, the Work has progressed as indicated,
lhe qualrty of the Work. is in accordance with the Co11lracl Documents, and lne Contractor is enliUed lo payment of the AMOUNT CERTIFIED,

AMOU.NT CERTIFIED	$8,883.00

(Attach explanation if amount cerfifierJ rJJffers·from /heamount applied. Initial all figures on thisAppf"ICBtron al'ld on the

iCHANGE ORDER SUMMARY	Addit1ons	Deductions	
1  Total change
1I' In pre\'ious	s a,p,Jll"o,,
,moolhs by	ed
·Owner	$0.00	$0.00	
Total Approved this Mon!.h	$0.00	$0.00	
i
TOTALS	so.co	$0.00	
Net Changes By Change Order	$0.00	

Corr!inuatlon Sheet thal ate changed to conform ,vtlh the amount certified.)
:

'	ARCHl NG	
By:---w--2-Date: fJ-Z.1-lvt.t
This Certific te fs not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment. and aoceptance of payment are without prejudice- to any rights of the Owner or Contractor under this Contract.

291

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

3
11/30/22
11/30/22

Invoice # :

121021

Contract : 22-0017- CDD SG Parr Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	3,540.00	1,770.00	0.00	5,310.00	30.00%	12,390.00	531.00	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	8,100.00	8,100.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	0.00	0.00	0.00	0.00	0.00%	21,840.00	0.00	
305	16 FDOT Rock Base LBR100	216,580.00	0.00	0.00	0.00	0.00	0.00%	216,580.00	0.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	0.00	0.00	0.00	0.00%	115,200.00	0.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	0.00	0.00	0.00	0.00	0.00%	80,660.00	0.00	
335	Drop Curb	4,484.00	0.00	0.00	0.00	0.00	0.00%	4,484.00	0.00	
340	Type RA Curb	9,900.00	0.00	0.00	0.00	0.00	0.00%	9,900.00	0.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	96,465.00	9,870.00	0.00	106,335.00	10.28%	928,442.00	292
10,633.50	

APPLICATION AND CERTIFICATE FOR PAYMENT	1nvoice#:  121111

To Owner:	Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215

Project: 22-0017- CDD SG Paar Road	Application No. :	4

Distribution to :

C:J

Owner
c:=I Architect/Engineer

Boynton Beach, FL 33426 From Contractor:	H and J Contracting Inc.
3160 Fairlane Farms Road Wellington, FL 33414

Via Architect/Engineer:

8365-4
Tyler

Period To:	12/31/2022

Project Nos:

[=:J  Contractor
[=:J
C:J

Contract For:

64228384

Contract Data:

CONTRACTOR'S APPLICATION FOR PAYMENT
AppllcaUon Is made for payment, as shown below, In connection with lhe ContracL ConUnuaUon Sheet is allached.

Original Contract Sum ........................ .

$1,034,777.00

The undersigned Contractor certifies that lo the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown
here1n Is now due.	SUZETTE ANDRIANO
.	MY COMMISSION# HH 010148

Net Cliange By Change Order ........... ,	,..
Contract Sum To Date .. _ ...................... .

$0.00
$1,034,777,00

CONTRACTOR:

HandJ Contracting Inc. EXPIRES: July 10, 2024

Bonded Thru Notary Public Underwriters

4T.otal Completed and Stored To Date .............. .

Retalnage:

$154,110.00

·----	1--,,L.- 		Date:_1_/4_/2_3_

ice President

a,	10.00%  of Completed Work

b.	0.00% of Stored Material

$15,411.00
$0.00

Stale of: Florida
Subscribed and sworn to before me this 4th
Notary Publlc:Su �	A
My Commission e	: July 10, 2024

County of: Palm Beach
day of	January, 2023

Total Retalnage , .......................... .

Total Earned Less Retainage .................. .

Less Previous Certificates For Payments	,.
Current Payment Due ........................ .

$15,411.00

$138,699.00

$95,701.50
$42,997.50

Engineer's Approval
The engineer, through periodic onsite observations. agrees with the requested payment amount based on onsite progress and the. eng1neer sees no reason why payment should not be made. This work has been completed, but has not been certified to the municipality or considered 100% complete until a final walk-lhfough, and approval by the municipality has occurred. It is the contractor's obli_gation to maintain the construoted Improvements until such time. The engineer does not warrant the completed work or perform dally observations
to make sure that the completed work is being maintained.

Balance To Finish, Plus Relainage .. _ ........... .	$896,078.00

AMOUNT CERTIFIED	$42,991.soMS
(Attach explanallon if amount certified differs from Iha amount applied. /nitlal al/ figures on this Application and on Iha Continua/ion Sheet that are changed lo conform with the amount certified,)

CHANGE ORDER SUMMARY
Total changes approved
in previous months by Owner
Total Approved lhis Month

Net Changes By Change Order

	Additions

$0.00	Deductions

$0.00	
	$0.00	$0.00	
TOTALS	$0.00	$0.00	
	$0.00		

ARCHITECT/ ENGINEER:
By:,	

Date: / -	Jb- lo  23

This Certificate is not negotiable. The AMOUNT CERTIFIED 1s payable only lo the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

293

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

4
12/31/22
12/31/22

Invoice # :

121111

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	5,310.00	0.00	0.00	5,310.00	30.00%	12,390.00	531.00	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	16,200.00	0.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	0.00	15,288.00	0.00	15,288.00	70.00%	6,552.00	1,528.80	
305	16 FDOT Rock Base LBR100	216,580.00	0.00	32,487.00	0.00	32,487.00	15.00%	184,093.00	3,248.70	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	0.00	0.00	0.00	0.00%	115,200.00	0.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	0.00	0.00	0.00	0.00	0.00%	80,660.00	0.00	
335	Drop Curb	4,484.00	0.00	0.00	0.00	0.00	0.00%	4,484.00	0.00	
340	Type RA Curb	9,900.00	0.00	0.00	0.00	0.00	0.00%	9,900.00	0.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	106,335.00	47,775.00	0.00	154,110.00	14.89%	880,667.00	294
15,411.00	

APPLICATION AND CERTIFICATE FOR PAYMENT	lavoice #:  12}) 60

To Owner:	Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215

PrQject: 22-0017- COD SG Paar Road	Application No.;	5
Inv #121160

Distribution lo :

c:::J

Owner
[:=I  Architect/Engineer

Boynton Beach, FL 33426

8365-5

Period To:	01/31/2023

[:=J Contractor
c::::::J

From Contractor:

Contract For:

H and J Contracting Inc. 3160 Fairlane Farms Road
Wellington, FL 33414
64228384

Via
Architect/Engineer:

Tyler

CJ
Project Nos:

Contract Date:

CONTRACTOR'S APPLICATION FOR PAYMENT
AppllcaUon Is made for payn,en1. as shown below, in connection with Iha Contract. Continuation Sheet is attached,

Original Contract Sum ....................... .

$1,034,777 .DO

The undersigned Contractor certifies that to the best of the Contractor's knowledge, fnformation, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. Thal all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were Issued and payments received from the Owner, and that current payment shown
herein is now due.	SUZETTE ANDRIANO
.	MY COMMISSION# HH 010148

Net Change By Change Order ........ ,.......... .
Contract Sum To Dale .............. _ .  ..  _ .... .

$0.00
$1.034,777.0o\/'

CONTRACTOR:

HandJ Contracting lnc'EXPIRES: July 10, 2024

Bonded Thru Notary Public Underwriters

Total Completed and Stored To Date ... 	........ .

Retainage:
10.00% of Completed Work
$41,266.60

$412,666.00

By:	 r		Date: 1/18/23
Jeremy Rury:JCePresident
State of: Florida
Subscribed and sworn to before me this t1h_

Coun\y of: Palm Beach
day of	January, 2023

0.00% of Stored Material

Total Retainage	,..

6T.otal Earned Less Retainage .................. .

Less Previous Certificates For Payments ......... .
Current Payment Due ........................ .

$0.00

$41,266.60

$371,399.40

$138,699.00
$232,700.40

Notary Publfc: Su,3 ,t(/�
MyCommissionexrc,s: July 10, 2024

Engineer's Approval
The engfneer, through periodic onsite obse111ations, agrees with the requested payment amount based on onsite progress and the engineer sees no reason why payment should not be made. This work has been completed, but has not been certified to the municipality or considered 100% complete until a fina,l walk-through, and approval by the municipality has occurred. Ills the contractor's obligation to maintain the constructed Improvements until such time. The engineer does not warrant the completed work or perform da,lly observations to make sure that the completed work is being maintained

Balance To Finish, Plus Retainage ..  _.   . _	_.

$663,377.60

AMOUNT CERTIFIED	$232.100.4M0	S

CHANGE ORDER SUMMARY
Total changes approved
in previous rnonlhs by Owner
Total Approved this Month

Additions

Deductlons

TOTALS

$0.00

$0.00

Net Changes By Change Order

$0.00

(Attaoh explanat./on if amount certified differs from the amount app/led, In/tis/ all figures on this Appl/cation and an the Continuation Shaet that are ohanged to conform with the amount certified.)

$0.00	$0.00	ARCHITECT/ ENGINEER:		
$0.00	$0.00	By:		rm(/_	Date: l. :1.3_- 2--'	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance. payment, and acceptance of payment are without prejudice to a;,y rights of the Owner or Contractor under this Contract.

295

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

5
01/31/23
01/31/23

Invoice # :

121160

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	5,310.00	4,425.00	0.00	9,735.00	55.00%	7,965.00	973.50	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	16,200.00	0.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	15,288.00	6,552.00	0.00	21,840.00	100.00%	0.00	2,184.00	
305	16 FDOT Rock Base LBR100	216,580.00	32,487.00	162,435.00	0.00	194,922.00	90.00%	21,658.00	19,492.20	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	0.00	0.00	0.00	0.00%	115,200.00	0.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	0.00	80,660.00	0.00	80,660.00	100.00%	0.00	8,066.00	
335	Drop Curb	4,484.00	0.00	4,484.00	0.00	4,484.00	100.00%	0.00	448.40	
340	Type RA Curb	9,900.00	0.00	0.00	0.00	0.00	0.00%	9,900.00	0.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	154,110.00	258,556.00	0.00	412,666.00	39.88%	622,111.00	296
41,266.60	

APPLICATION AND CERTIFICATE FOR PAYMENT	Invoice#:  121211

To Owner:		Mattamy Palm Beach LLC	Project: 22-0017- CDD SG Paar Road 2600 Quantum Lakes Drive, Suite 215

Application No_ :	6

Distribution to :

C=:J

Owner
C=:J Architect/Engineer

Boynton Beach, FL 33426
From Contractor:	H and J Contracting Inc.	Via

Inv 121211-6
8365
Tyler

Period To:	02/28/2023

c:J	Contractor
c:J
[:=I

Contract For:

3160 Fairlane Farms Road Wellington, FL 33414
64228384

Archltec Engineer:

Project Nos:

Contract Date:

**This Pay App does not included JDE CO #1

CONTRACTOR'S APPLICATION FOR PAYMENT
Application Is made for payment, as shown below, In connection with the ContracL Conllnuatton Sheet ls attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed In accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which prevlous Certificates for Payment were issued and payments received from the Owner, and that current pc1yment shown

Original Contract Sum ..	................... .

Net Change By Change Order ................... .

$1,034,777.00
$0.00

herein is now due. CONTRACTOR:

SUZETTE ANDRIANO

4

Hand J Contracting Inc. MY COMMISSION# HH 010148
EXPIRES: July 10, 2024

Contract Sum To Date ............. ,........ _ ..  .

$1,034,777.00		

Bonded Thru Notary Public Underwriters

Total Completed and Stored To Date	, ..
Relainage:
10.00% of Completed Work
$55,942.40

$559,424.00

By:	'J'7	,.	Date: 2/20/23
Jeremy Rury - e President
State of: Florida
Subscribed and sworn to before me this 20th

County of: Palm Beach
day of	Florida, 2023

-	0.00% of Stored Material

Total  Retalnage       ...........................

Tota'! Earned Less Relainage _ .............. _ ..  .

Less Previous Certificates For Payments	_.
Current Payment Due ...... _ .. _ ...... _ .. _ .... .

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous monlhs by Owner	$0.00	$0.00	
Total Approved this Month	$0.00	$0.00	

TOTALS	$0.00	$0.00	
Net Chang.es By Change Order	$0.00	

Balance To Finish, Plus Retainage ...... ,....... .

$0.00

$55,942.40

$503,481.60

$371,399.40
$132,082.20

$531,295.40

Notary Public: Su '0177L A,,,,	MA
My Commissfon ex '-July i()','	-

Engineer's Approval
The engineer, through periodic onsite observations, agrees with the requested payment amount based on onsite progress and the en_gineer sees no reason why payment should not be made. Thls work has been completed, but has not been certified to the munlcipality or considered 100% complete until a final
walk-through, all testing, and approval by the municipality has occurred. It is the contractor's obligation to maintain the constructed improvements until such time. The engineer does not warrant the completed work or perform daily observations to make sure that the completed work is being maintained.
AMOUNT CERTIFIED	$132,082.20 MS
(Attach e'l<fJ/anatfon If amounl certified differs from /he amount applied. tnltiel all figures- on this Application and on the Continuation Sheet that ere changed to conform with the amount cerlified.)

ARCHITECT/ ENGINEER:
By:	1%@1	�		Date: 1- 2_K - 2 3
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this.Contract.

297

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

6
02/28/23
02/28/23

Invoice # :

121211

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	9,735.00	0.00	0.00	9,735.00	55.00%	7,965.00	973.50	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	16,200.00	0.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	21,840.00	0.00	0.00	21,840.00	100.00%	0.00	2,184.00	
305	16 FDOT Rock Base LBR100	216,580.00	194,922.00	21,658.00	0.00	216,580.00	100.00%	0.00	21,658.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	0.00	115,200.00	0.00	115,200.00	100.00%	0.00	11,520.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	80,660.00	0.00	0.00	80,660.00	100.00%	0.00	8,066.00	
335	Drop Curb	4,484.00	4,484.00	0.00	0.00	4,484.00	100.00%	0.00	448.40	
340	Type RA Curb	9,900.00	0.00	9,900.00	0.00	9,900.00	100.00%	0.00	990.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
Grand Totals	1,034,777.00	412,666.00	146,758.00	0.00	559,424.00	54.06%	475,353.00	298
55,942.40	

APPLICATION AND CERTIFICATE FOR PAYMENT	Invoice#:  121273

To Owner:	Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215

Project:  22-0017- COD SG Paar Road	Application No. :	7
Inv #121273-7

Distribution to :
Owner
[:=J  Architect/Engineer

Boynton Beach, FL 33426

8365

Period To:	03/31/2023

c::::::J Contractor
r:::::J

From Contractor:

Contract For:

H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414
8365

Via Architect/Engineer:

Tyler

Project Nos: Contract Date:

CONTRACTOR'S APPLICATION FOR PAYMENT
Ai,plicalion is made for payment, as shown below, fn connection with the Contract
ConUnuation Sheet Is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the Work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were Issued and payments received from the Owner, and that current payment shown

Original Contract Sum .. _ .. _ ................. .
Net Change By Change Order ..... , .... , ........ .
Contract Sum To Date ......................... .

$1,034,777.00
$11,088.00
$1,045,865.00

herein is now due. CONTRACTOR:

SUZETTE ANDRIANO
Hand J Contracting Inc. MY COMMISSION # HH 010148
EXPIRES: July 10, 2024
Bonded Thru Notary Public Underwriters

Total Completed and Stored To Dale .............. .

5R. etainage:
10.00'll,  of Completed Work
$57,064.70

$570,647.00

By:	�<		Date:3115/23
Jeremy Ru	e President
State of: Florida
Subscribed ands to before me this 16tj, .

County ot Palm Beach
dayof	March, 2023

0.00% of Stored Material

Total Retainage ........................... .

Total Earned Less Retainage

Less Previous Certificates For Payments ......... .
o.irrent Payment Due ............... , ......... .

Balance To Finish, Plus Retainage .............. .

$0.00

$67,064.70

$513,582.30

$503,481.60
$10,100.70

$532,282.70

Notary Public:	0ugrd.:a,, A
My Commission expirt51 July 10, 2024

Engineer's Approval
The engineer, through periodic onsite observations, agrees with the requested payment amount based on onslle progress and the engineer sees no reason why payment should not be made. This work has been completed, but has not been certilied to the municipality or considered 1OOo/o complete until a flnal walk-through, all testing, and approval by the municipality has occurred. ll is the contractor's obligation to maintain the cons1ructed improvements until such time. The engineer does not warrant the compleled
work or perform daily observations to make sure that the completed work is being maintained.

AMOUNT CERTIFIED	$10,100.70MS

CHANGE ORDER SUMMARY
Total changes approved
In previous months by Owner
Total Approved this Month

Net Changes By Change Order	

TOTALS	Additions	Deductions	
		$0.00	$0.00	
		$11,088.00	$0.00	
		$11,088.00	$0.00	
		$11,088.00		

(Attach explanation if amount certified differs from the amount applied. Initial all figuras on this Application and on the Continuation Shea/ that are changed to oonform with the amount certified./

&	

ARCHITECT/ ENGINEER:
By: EoR Ber 	Date:  '	I3 - 2 3
This Certificate is not negotiable. The AMOUNT CERTIFIED Is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

299

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

7
03/31/23
03/31/23

Invoice # :

121273

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	9,735.00	2,655.00	0.00	12,390.00	70.00%	5,310.00	1,239.00	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	16,200.00	0.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	21,840.00	0.00	0.00	21,840.00	100.00%	0.00	2,184.00	
305	16 FDOT Rock Base LBR100	216,580.00	216,580.00	0.00	0.00	216,580.00	100.00%	0.00	21,658.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	115,200.00	0.00	0.00	115,200.00	100.00%	0.00	11,520.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	80,660.00	0.00	0.00	80,660.00	100.00%	0.00	8,066.00	
335	Drop Curb	4,484.00	4,484.00	0.00	0.00	4,484.00	100.00%	0.00	448.40	
340	Type RA Curb	9,900.00	9,900.00	0.00	0.00	9,900.00	100.00%	0.00	990.00	
345	Type D Curb	5,428.00	0.00	0.00	0.00	0.00	0.00%	5,428.00	0.00	
350	Concrete Sidewalk 6	224,400.00	0.00	0.00	0.00	0.00	0.00%	224,400.00	0.00	
355	ADA Ramp	41,850.00	0.00	0.00	0.00	0.00	0.00%	41,850.00	0.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
CO1.01	2" Asphalt Bottom Lift Type SP	14,112.00	0.00	14,112.00	0.00	14,112.00	100.00%	0.00	1,411.20	
CO1.02	1" Asphalt Top Lift Type SP	8,064.00	0.00	0.00	0.00	0.00	0.00%	8,064.00	0.00	
CO1.03	Customer Discount	-11,088.00	0.00	-5,544.00	0.00	-5,544.00	50.00%	-5,544.00	-554.40	
Grand Totals	1,045,865.00	559,424.00	11,223.00	0.00	570,647.00	54.56%	475,218.00	300
57,064.70	

64228384.1510.31045
Tyler

From :

Invoice
H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414 US

Bill to:

Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #

Disc Date

Customer Ref

Terms

Invoice Date

Due Date

Invoice #

334262

Ship to:

2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #	Customer Ref	Invoice #	Invoice Date	Due Date	Disc Date	Terms	
1534	Southern Grove Paar	220017-2	06/30/23	06/30/23		Due Upon Receipt	

Mth/Trans	Line	Description	Contract	Item		Unit Price	Quantity	Amount	
06/23 618	1	Replace & Repour RA Curb	22-0017-	1	0.000	20,160.00	
240 LF @ $84.00
06/23 618	

2	

Credit for RA Curb	

22-0017-	

1	

0.000	

-10,080.00	
120 LF @ ($84.00)	

Notes:
Southern Grove Paar Curb Repairs	Total Sales Tax		10,080.00	
	Less Retainage			
	Total Due		10,080.00	

From :

Invoice
H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414 US

64228384.1510.3xxxx
Tyler to Provide CC

Bill to:

Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #

Disc Date

Customer Ref

Terms

Invoice Date

Due Date

Invoice #

334262

Ship to:

2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #	Customer Ref	Invoice #	Invoice Date	Due Date	Disc Date	Terms	
1534	Southern Grove 4C	220017-3	08/22/23	08/22/23		Due Upon Receipt	

Mth/Trans	Line	Description	Contract	Item		Unit Price	Quantity	Amount	
08/23 162	1	Paar Rd Clean Up	22-0017-	1	0.000	840.00	

Notes:
Southern Grove 4C Paar Rd	Total Sales Tax		840.00	
	Less Retainage			
	Total Due		840.00	

64228357.1510.3xxxx
Tyler to provide CC

From :

Invoice
H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414 US

Bill to:

Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #

Disc Date

Customer Ref

Terms

Invoice Date

Due Date

Invoice #

334262

Ship to:

2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #	Customer Ref	Invoice #	Invoice Date	Due Date	Disc Date	Terms	
1534	Southern Grove 4C	220007-10	08/22/23	08/22/23		Due Upon Receipt	

Mth/Trans	Line	Description	Contract	Item		Unit Price	Quantity	Amount	
08/23 156	1	Sidewalk Grading	22-0007-	1	0.000	780.00	

Notes:
Southern Grove 4C	Total Sales Tax		780.00	
	Less Retainage			
	Total Due		780.00	

APPLICATION AND CERTIFICATE FOR PAYMENT

Invoice #:  121666

To Owner:

Mattamy Palm Beach LLC	Project:
2500 Quantum Lakes Drive, Suite 215

Boynton Beach, FL 33426

22-0017- CDD SG Paar Road

Inv #121666-8

Application No. :

Period To:

8

10/31/2023

Distribution to :
Owner Architect/Engineer Contractor

From Contractor:

H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414

Via Architect/Engineer:

8365
Frank

Project Nos:

Contract For:	8365

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

Contract Date:

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown

1. Original Contract Sum . . . . . . . . . . . . . . . . . . . . . . . .	$1,034,777.00	
2. Net Change By Change Order . . . . . . . . . . . . . . . . . . . .	$32,468.50	
3. Contract Sum To Date . . . . . . . . . . . . . . . . . . . . . . . . . .	$1,067,245.50	
4. Total Completed and Stored To Date . . . . . . . . . . . . . . .	$690,163.00	
5. Retainage:		

herein is now due. CONTRACTOR:

H and J Contracting Inc.

SUZETTE ANDRIANO
MY COMMISSION # HH 010148 EXPIRES: July 10, 2024
Bonded Thru Notary Public Underwriters

By:	Date: 10/19/23	

Jeremy Rury - Vice President

10.00%

of Completed Work

State of: Florida

County of:Palm Beach

b.	0.00% of Stored Material

$69,016.30
$0.00

Subscribed and sworn to before me this19th Notary Public:
My Commission expireJs:uly 10, 2024

day of

October, 2023

Total Retainage . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Earned Less Retainage . . . . . . . . . . . . . . . . . . .

Less Previous Certificates For Payments . . . . . . . . . .
Current Payment Due . . . . . . . . . . . . . . . . . . . . . . . . .

$69,016.30

$621,146.70

$513,582.30
$107,564.40

In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, and belief, the Work has progressed as indicated ,
the quality of the Work is in accordance with the Contract Documents , and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

ARCHITECT'S/ ENGINEER'S CERTIFICATE FOR PAYMENT
The engineer, through periodic onsite observations, agrees with the requested
payment amount based on onsite progress and the engineer sees no reason why payment should not be made. This work has been completed, but has not been certified to the municipality or considered 100% complete until a final
walk-through, all testing, and approval by the municipality has occurred. It is the contractor’s obligation to maintain the constructed improvements until such time. The engineer does not warrant the completed work or perform daily observations

Balance To Finish, Plus Retainage . . . . . . . . . . . . . . .	$446,098.80

AMOUNT CERTIFIED

$107,564.40

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous months by Owner	$11,088.00	$0.00	
Total Approved this Month	$21,380.50	$0.00	
TOTALS	$32,468.50	$0.00	
Net Changes By Change Order	$32,468.50	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.)

ARCHITECT/ ENGINEER:

__________

___________

By:			Date:_ 11/15/23 	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	Page 2 of 3

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

8
10/31/23
10/31/23

Invoice # :

121666

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Construction Layout And As-Built	17,700.00	12,390.00	1,770.00	0.00	14,160.00	80.00%	3,540.00	1,416.00	
	Survey									
110	Clear & Grub Site	28,290.00	28,290.00	0.00	0.00	28,290.00	100.00%	0.00	2,829.00	
115	Disk Site	2,760.00	2,760.00	0.00	0.00	2,760.00	100.00%	0.00	276.00	
120	Excavate Lake- Spread & Compact	47,025.00	47,025.00	0.00	0.00	47,025.00	100.00%	0.00	4,702.50	
	Or Stockpile Fill									
125	Machine Grade Rough	6,750.00	6,750.00	0.00	0.00	6,750.00	100.00%	0.00	675.00	
130	Machine Grade Fine	16,200.00	16,200.00	0.00	0.00	16,200.00	100.00%	0.00	1,620.00	
300	12 Compacted Subgrade	21,840.00	21,840.00	0.00	0.00	21,840.00	100.00%	0.00	2,184.00	
305	16 FDOT Rock Base LBR100	216,580.00	216,580.00	0.00	0.00	216,580.00	100.00%	0.00	21,658.00	
310	2 Asphalt Bottom Lift Type SP	115,200.00	115,200.00	0.00	0.00	115,200.00	100.00%	0.00	11,520.00	
315	1 Asphalt Top Lift Type SP	68,400.00	0.00	0.00	0.00	0.00	0.00%	68,400.00	0.00	
320	6 Stamped Concrete	52,650.00	0.00	0.00	0.00	0.00	0.00%	52,650.00	0.00	
325	6 Concrete Driveway	16,660.00	0.00	0.00	0.00	0.00	0.00%	16,660.00	0.00	
330	Type F Curb	80,660.00	80,660.00	0.00	0.00	80,660.00	100.00%	0.00	8,066.00	
335	Drop Curb	4,484.00	4,484.00	0.00	0.00	4,484.00	100.00%	0.00	448.40	
340	Type RA Curb	9,900.00	9,900.00	0.00	0.00	9,900.00	100.00%	0.00	990.00	
345	Type D Curb	5,428.00	0.00	5,428.00	0.00	5,428.00	100.00%	0.00	542.80	
350	Concrete Sidewalk 6	224,400.00	0.00	49,087.50	0.00	49,087.50	21.88%	175,312.50	4,908.75	
355	ADA Ramp	41,850.00	0.00	41,850.00	0.00	41,850.00	100.00%	0.00	4,185.00	
360	Striping And Signage	58,000.00	0.00	0.00	0.00	0.00	0.00%	58,000.00	0.00	
CO1.01	2" Asphalt Bottom Lift Type SP	14,112.00	14,112.00	0.00	0.00	14,112.00	100.00%	0.00	1,411.20	
CO1.02	1" Asphalt Top Lift Type SP	8,064.00	0.00	0.00	0.00	0.00	0.00%	8,064.00	0.00	
CO1.03	Customer Discount	-11,088.00	-5,544.00	0.00	0.00	-5,544.00	50.00%	-5,544.00	-554.40	
CO2.01	6" Temp Solid White & Yellow Line	4,180.50	0.00	4,180.50	0.00	4,180.50	100.00%	0.00	418.05	
	Paint									
CO2.02	8" White Line - Paint	192.00	0.00	192.00	0.00	192.00	100.00%	0.00	19.20	
CO2.03	12" Temp White Solid Paint	180.00	0.00	180.00	0.00	180.00	100.00%	0.00	18.00	
CO2.04	24" Temp White Solid Paint	828.00	0.00	828.00	0.00	828.00	100.00%	0.00	82.80	
CO2.05	18" Yellow Line - Paint	420.00	0.00	420.00	0.00	420.00	100.00%	0.00	42.00	
CO2.06	Temp Paint Yield Bars	360.00	0.00	360.00	0.00	360.00	100.00%	0.00	36.00	
CO2.07	Yield Street Message Temp Paint	240.00	0.00	240.00	0.00	240.00	100.00%	0.00	24.00	
CO2.08	FDOT R03-17/R03-17BP	635.00	0.00	635.00	0.00	635.00	100.00%	0.00	63.50	
CO2.09	FDOT R03-17/R03-17AP	635.00	0.00	635.00	0.00	635.00	100.00%	0.00	305	63.50	

CONTINUATION SHEET	Page 3 of 3

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

8
10/31/23
10/31/23

Invoice # :

121666

Contract : 22-0017- CDD SG Paar Road

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
CO2.10	FDOT R4-7 Keep Right Sign 24 X 30/	1,270.00	0.00	1,270.00	0.00	1,270.00	100.00%	0.00	127.00	
	OM1-1									
CO2.11	FDOT W11-2 - 30 X 30 Crosswalk	5,080.00	0.00	5,080.00	0.00	5,080.00	100.00%	0.00	508.00	
	Sign/W16-7pl									
CO2.12	FDOT R1-2 Yield Sign 36 X 36	2,540.00	0.00	2,540.00	0.00	2,540.00	100.00%	0.00	254.00	
CO2.13	FDOT R6-4a	2,420.00	0.00	2,420.00	0.00	2,420.00	100.00%	0.00	242.00	
CO2.14	FDOT R2-1 Speed Limit Sign - 24 X	635.00	0.00	635.00	0.00	635.00	100.00%	0.00	63.50	
	30									
CO2.15	FDOT Case 2 18 X18	1,125.00	0.00	1,125.00	0.00	1,125.00	100.00%	0.00	112.50	
CO2.16	R1-2 Yield Sign 18 X 18	640.00	0.00	640.00	0.00	640.00	100.00%	0.00	64.00	
Grand Totals	1,067,245.50	570,647.00	119,516.00	0.00	690,163.00	64.67%	377,082.50	306
69,016.30	

64228384.1510.3xxxx
Tyler to Provide CC

From :

Invoice
H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414 US

Bill to:

Mattamy Palm Beach LLC
2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #

Disc Date

Customer Ref

Terms

Invoice Date

Due Date

Invoice #

334262

Ship to:

2500 Quantum Lakes Drive, Suite 215 Boynton Beach, FL 33426

Cust #	Customer Ref	Invoice #	Invoice Date	Due Date	Disc Date	Terms	
1534	Southern Grove 4C	220017-6	08/22/23	08/22/23		Due Upon Receipt	

Mth/Trans	Line	Description	Contract	Item		Unit Price	Quantity	Amount	
08/23 165	1	Road Prepping ADA Ramps 2	22-0017-	1	0.000	4,200.00	

Notes:
Southern Grove 4C Paar Road	Total Sales Tax		4,200.00	
	Less Retainage			
	Total Due		4,200.00	

Page 1 of 1

307

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:
Mattamy Homes
2500 Quantum Lakes Blvd Ste 215 Attn: Frank Covelli
FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court Riviera Beach, FL 33404
CONTRACT FOR: Paar Road • 64228384

PROJECT:
Paar Road - Utilities

VIA ARCHITECT: Kimley Hom

APPLICATION NO: APPLICATION DATE:

PERlODTO:

PROJECT NO: CLIENT REFERENCE: CONTRACT DATE:

8/31/2022
2022-106
8/1/22-8/31/22

64228384
Paar Road - Pipeline Utilities

Distribution to: c=]oWNER c:::JARCHITECT c:::J CONTRACTOR
c:::J
c:::J

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

I. ORIGINAL CONTRACT SUM	$	906,517.45	
2. Net change by Change Orders	$	0.00	
3. CONTRACTSUMTODATE(Linel±2)	$	906,517.45	
4. TOTAL COMPLETED & STORED TO	$	227,031.10	

CONTRACTOr· ...	I l)k. .

y

, }._(	.  .	-

DATE	(Column G on G703)
5. RETAINAGE:
a		10 % of Completed Work	$ (Column D + E on G703)

	22,703.11 

f  ,\ '\,;·  ') I	I
By:	 ..,"-/ ',:::_..,,,,7\/	,'

State of:
Subscribed and sworn to before me this /') Qj

Date:
Coooty o.t ;:._-.D()llfitl)5t. IIIIM:DGG::•-.R.1t/E.Ql S
day of	. •	Notal'V Public
s,ate of Flonda

0 % of Stored Material	$		
(ColumnF on G703)
Total Retainage (Lines Sa+ Sb or

Notary Public:	i  [/	,

l

My Commission expires:	•	I

, -	•·

Commit 1-1tt169929 E.,(pires 8/26/2015

Total in Column I ofG703)	$ 	22,703.11	ARCHITECT'S CERTIFICATE.FOR PAYMENT	
6. TOTAL EARNED LESS RETAlNAGE	$ 	204,327.99	In accordance with the Contract Documents, based on on-site observations and the data	
(Line 4 Less Line S Total)		comprising the application, the Architect certifies to the Owner that to the best of the	
7. LESS PREVIOUS CERTIFICATES FOR		Architect's knowledge, information and belief the Work has progressed as indicated,	
PAYMENT (Line 6 from prior Certificate)	$ 	0.00	the quality of the Work is in accordance with the Contract Documents, and the Contractor	
8. CURRENTPAYMENTDUE	$ 	204.327.99	is entitled to payment of the AMOUNT CERTIFIED.	
9. BALANCE TO FINISH, INCLUDING RETAINAGE	$ 	702,189.46		
(Line 3 less Line 6)		AMOUNT CERTIFIED ........... $		204,327.99 	

CHANGE"'ORDER SUMMA.RY	ADDlTIONS	DEDUCTIONS	
Total changes approved
in previous months by Owner		
$0.00
$0.00
$0.00	
$0.00	
Total approved this Month			$0.00	
TOTALS			$0.00	
NET CHANGES by Change Order	$0.00	

(Attach e:,;planation if amount certified differs from the amount applied. Jnitial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.)
:CIDTECT·:	Date:  09/07/2022

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AIA DOCUME"1T G702 • APPLICATION AND CERTIFICATION FDR PAYMENT· 1992 EDITION· AIA • 101992	THE AMERICAN INSTITUTE OF ARCHrfECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292
Users may obtain validation of this docu·ment by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

308

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 1
APPLICATIO ON DATE: 8/31/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 8/1/22-8/31/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE
Phase - Cost Code	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00
$0.00	
-	
-	$0.00
$0.00	$0.00
$0.00	-
-	0%
0%	$51,500.00
$0.00	$0.00
$0.00	
	Subtotal			$51,500.00	$0.00	-	$0.00	$0.00	$0.00	0%	$51,500.00	$0.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	-	-	$0.00	$0.00	-	0%	$26,210.25	$0.00	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	-	$0.00	$0.00	-	0%	$2,060.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-	-	$0.00	$0.00	-	0%	$3,440.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	-	-	$0.00	$0.00	-	0%	$17,700.00	$0.00	
31020	Water Fittings	10	$	840.00	$8,400.00	-	-	$0.00	$0.00	-	0%	$8,400.00	$0.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	-	-	$0.00	$0.00	-	0%	$4,660.00	$0.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-	-	$0.00	$0.00	-	0%	$4,000.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-	-	$0.00	$0.00	-	0%	$555.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	-	-	$0.00	$0.00	-	0%	$25,090.00	$0.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-	-	$0.00	$0.00	-	0%	$2,200.00	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$94,315.25	-	-	$0.00	$0.00	-	0%	$94,315.25	$0.00	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	-	-	$0.00	$0.00	-	0%	$2,600.00	$0.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	-	920	$161,000.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	-	-	$0.00	$0.00	-	0%	$4,929.00	$0.00	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	-	-	$0.00	$0.00	-	0%	$6,460.00	$0.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	-	-	$0.00	$0.00	-	0%	$54,810.00	$0.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	-	-	$0.00	$0.00	-	0%	$24,750.00	$0.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	-	-	$0.00	$0.00	-	0%	$31,960.00	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$399,209.00	-		$161,000.00	$0.00	161,000.00	40%	$238,209.00	$16,100.00	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	-	63	$4,249.35	$0.00	4,249.35	33%	$8,498.70	$424.94	
31015	24" RCP	819	$	89.35	$73,177.65	-	305	$27,251.75	$0.00	27,251.75	37%	$45,925.90	$2,725.18	
31015	30" RCP	108	$	120.00	$12,960.00	-	45	$5,400.00	$0.00	5,400.00	42%	$7,560.00	$540.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	-	-	$0.00	$0.00	-	0%	$19,110.00	$0.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	-	1	$9,450.00	$0.00	9,450.00	33%	$18,900.00	$945.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	-	-	$0.00	$0.00	-	0%	$34,830.00	$0.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	-	2	$19,680.00	$0.00	19,680.00	33%	$39,360.00	$1,968.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	-	-	$0.00	$0.00	-	0%	$121,277.50	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$361,493.20	-		$66,031.10	$0.00	66,031.10	18%	$295,462.10	$6,603.11	
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	-		$0.00	$0.00	$0.00	0%	$51,500.00	$0.00	
	31020	Water	$94,315.25	$94,315.25	-		$0.00	$0.00	$0.00	0%	$94,315.25	$0.00	
	31620	Force Main	$399,209.00	$399,209.00	-		$161,000.00	$0.00	$161,000.00	40%	$238,209.00	$16,100.00	
	31015	Drainage	$361,493.20	$361,493.20	-		$66,031.10	$0.00	$66,031.10	18%	$295,462.10	$6,603.11	
	GRAND TOTALS			$906,517.45	$0.00		$227,031.10	$0.00	227,031.10	25%	$547,424.15	$22,703.11	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 1
APPLICATIO ON DATE: 8/31/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 8/1/22-8/31/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE
Phase - Cost Code	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						

Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT 0702	PAGE ONE OF TWO PAGES

TO OWNER:
Mattamy Homes
2500 Quantum Lakes Blvd Ste 215
Attn: Frank Covelli
FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court Riviera Beach, FL 33404
CONTRACT FOR: Paar Road - 64228384

PROJECT:
Paar Road - Utilities

VIA ARCHITECT: Kimley Hom

7757
10/15/22

APPLICATION NO: APPLICATION DATE:

PERIOD TO:

PROJECT NO: CLIENT REFERENCE: CONTRACT DATE:

2
9/30/2022
2022-122
9/]/22 - 9/30/22

64228384
Paar Road - Pipeline Utilities

Distribution to: C}OWNER C}ARCHITECT C]coNTRACTOR
CJ
CJ

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, A1A Document G703, is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amoWits have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that curre1;1t payment shown herein is now due.
n_,

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACTSUMTODATE(Line I ±2)
TOTAL CO!\1PLETED & STORED TO
DATE	(Column Gon G703)
RETAINAGE:

$	906,517.45

V

$ 	0.00 
$	906,s 11.4s
$ 		39_3"",0_85_._95_

CYO·N_T_RA ,,7_TO.-:::;.·_... ) B 

Date:	j/3v/zi,.
A	''	7

	IO % of Completed Work	$ (Column D +Eon 0703)

	39,308.60 

State of:fL	County of: f.:.I
Subscribed and sworn to before me this	day of Scp-N _.,.b .,	ZO"

	0 % of Stored Material	$		 (Column Fon 0703)
Total Retainage (Lines Sa+ Sb or

Notary Public:	 ""----- My Commission expires:

Total in Column I ofG703)
TOTAL EARNED LESS RETAINAGE
(Line 4 Less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificate)
CURRENTPAYMENTDUE
BALANCE TO FrNISH, lNCLUDING RETAINAGE

$	39,308.60
$	,-35=3-,1=1=1."0'"36.,...	

1/ 

$ ,	 204,327.99 v
149,449.37
$ 		55_2.:.,7_40_._I0_

ARCHITECT'S CERTIFICATE FOR P
In accordance with the Contract Documents, based on on-site obse comprising the application, the Architect certifies to the Owner that Architect's knowledge, information and belief the Work has progre the quality of the Work is in accordance with the Contract Docume is entitled to payment of the AMOUNT CERTIFIED.

KYLES KOPF
tiffilry Public-State of Florida
¼i\;ommission # H-H 132031
~ea My Commission Expires
'	May 21, 2025

(Line 3 less Line 6)

AMOUNT CERTIFIED	$

149,449.37

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTJONS	
Total changes approved
in previous months by Owner	
$0.00	
$0.00	
Total approved this Month	$0.00	$0,00	
TOTALS	$0.00	$0.00	
NET CHANGES by Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial al/figures on this Application and on/he Continuation Sheet that are changed to conform with the amotmt certified.)

------------

ARyB.·.CHITECT:	10/05/2022
-	Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herem. lssuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AIA DOCUMENT G702 • APPLICATION AND CERTIFICATION FOR PAYMENT· 1992 EDITION· AIA • <il1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE.. N.W., WASHINGTON, DC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document 0401 - Certification of Document's Authenticity from the Licensee.

311

CONTINUATION SHEET	AJA DOCUMENT G703
AlA Document 0702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is att1ched.
ln tabulations below, amounts are stated to the nearest dollar.
Use ColumnI on Contracts where variable retainage for Line itemsmay apply.

PAGETWO OFT'NO PAGES
APPLJCATION NO: 2 APPLICATIONONDATE: 9/30/22
PERIOD TO: 911/22 - 9/30/22
PROJECT NO: 64228384

G

CUENT REF: Paar Road - P11 ehne Uti]1"t1es

A
-:vo,

B
---·- lvNv,· Wvi."-£'1.

l,lU:mt1ty

PRJCE

D	E
V{l,,_RK

F
MAiCNJ\J..S

·~·~	,.

H
OA!.AN<.,o

I
K.1:.1,... ,,.A,u;t:.

CODE
P1wa.-c 1eo&

VALUE

fRuM Pl'I..C..- •...,.,.,.;, Al'PLICATION (D+EJ

OTYTHIS PERIOD

ltU;:i l,,;l\.lVV

PRESENTLY STORED (NOT IN DORE)

COMPLETED AND STORED TO DATE (D+E+F)

(G+C)

TO FINISH (C-G)

(IF VARJABLE
RATE)

10%

31245

General
Survey, Layout. & As-Buills

Subtotal Water

l	$51,500.00

$51.500.00
$0.00
$51,500.00

0
-
SO.DO	-

$12,875.00
$0.00
SI 2,875.00

$0.00
$0.00
$0.00

12.875.00

Sl2.875.00

25%
0%
25%

$38,625.00
S0.00
$38.625.00

$1,287.50
$0.00
SI ,287.50

31020
31020

31020
31020
31020
31020
31020
31020
31020
31020

31620
31620
31620
31620
31620
31620
31620

31015
31015
31015
31015
31015
31015
31015
31015

-

Water Main- 8" C-900
Water Pressure Test

Water Main Sample Points Water Main Fill & Flush Water Fittings
Water Main s Gnte Valve w/Box
Water Main 211 BlowoffTemporruy for Testing,
Adjust Valve Box
W!l.ter Main 16 x 8 Tapping Sleeve & Valve 211 Blowoff -Temprary for Testing

Subtotal
Force M!l.in
Force Main - 8" C-900 Force M!l.in - 16"C-900 Force Ma.in - Pr ure Test Connect to E::cisting FM Force Main Fittings
Force M:i.in 16'1 &.i.te Valve w/Box Foree Main ARV Assembly

Subtot:i.1 Drninage 18" RCP
24" RCP
30" RCP
Storm Se\.VerInspection
Inlet - Type P-5 Inlet -Type J-5 Inlet Type P-6 Edge Drain

Subtotal
SUMMARY BY COST CODE
31245
31020
31620
31015

GRANDTOTA!.S

297
1

4
2
10
2
2
l
2
1

26
1,564
1,590
1
14
2
z

189
819
108
l
3
2
6
3,490

General Water Force Main Drainage

$	88.25
s	2,060.00

$	860.00
s	8.850.00
$	840.00
s	2,330.00
s	2,000.00
s	555.00
$	12,545.00
$	2,200.00

s	100.00
s	175.00
$	3.10
$	6,460.00
$	3,915.00
s	12,375.00
s	15,980.00

$	67.45
$	89.35
$	120.00
$	19,110.00
$	9,450.00
$	17,415.00
s	9,840.00
$	34.75

$51,500,00
$94,315-25
S399,209.00
$361,493-20

$26,210.25
$2,060.00

$3,440.00
$17.700.00
$8.400.00
$4,660.00
$4,000.00
$555.00
S25,090.00
$2,200.00
SO.DO S94.315.25
SO.OD
$2,600.00
$273,700.00
$4,929.00
$6,460.00
$54,810.00
S24,750.00
$31,960.00
S0.00
$399,209.00

$12,748.05
$73,177.65
$12,960.00
$19.110.00
$28,350.00
$34,830.00
$59,040.00
$121,277.50
$0.00
$361,493.20

$51,500.00
$94,315.25
$399,209.00
$361,493.20

$906,517.45

-

,

161,000.00

-

161,000.00

4,249
27,252
5,400
-
9,450
-
19,680
-
-
66,031.10

-
-
161,000.00
66,031.10

$16 I,000.00

297
-
-
-
10
2

-
-

26

-

126
414
63

2

4

$26,210.25
$0.00

$0.00
$0.00
$8,400.00
$4,660.00
$0.00
$0.00
$0.00
$0.00
$0.00
$39,270.25

$2,600.00
S0.00 S0.00
So.oo
SO.OD SO.OD SO.DO S0.00
$2,600.00

$8,498.70
$36,990.90
$7,560.00
$0.00
Sl8,900.00
$0.00 539,360.00
$0.00
$0.00
$111,309.60

$12,875.00
$39,270-25
$2,600.00
SI 11,309.60

$166,054.85

$0.00
$0.00

S0.00 SO.DO SO.OD
$0.00
$0.00
$0,00
so.oo
SO.DO SO.OD SO.OD

$0.00
SO.OD
$0.00
SO.DO
$0.00
SD.00
$0.00
S0.00
$0.00

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00

$0.00
$0.00
$0.00
$0.00

$0.00

26,210.25

8.400.00
4,660.00
-
-
-
.
39.270.25

2,600.00
161,000.00
-
-
-
-
-
-
163,600.00

12,748.05
64,242.65
12,960.00
-
28,350.00

59,040.00

I77.340.70

$12,875.00
$39.270-25
$163,600.00
$177,340.70

393,085.95

100%
0%

0%
0%
100%
100%
0%
0%
0%
0%
0%
42%

100%
59%
0%
0%
0"/4
O"I,
O"/,
0%
41%

100"/4
88¾
100%
0%
100%
0%
100%
0%
0"/4
49%

25%
42%
41%
49%

43%

$0.00
$2,060,00

$3,440.00
$17,700.00
$0,00
$0.00
$4,000.00
$555.00
$25,090,00
$2,200.00
S0.00
$55,045 00

SD.OD S112,700.00
$4,929.00
$6,460.00
$54,810.00
$24,750.00
$31,960.00
SO.OD SlJS,609.00

SD.OD 58,935.00
$0.00 519,110.00
$0.00
$34,830.00
$0.00
$121.277.50
$0.00
$184.152.50

$38.625.00
$55,045.00
$235,609.00
$184,152.50

$513.43 I.SO

$2,621.03
$0.00

$0.00
SO.DO
$840.00
$466,00
$0.00
$0.00
$0.00
SO.OD SO.DO
$3.927.03

S260.00
SI 6,100.00
so.oo
S0.00 SO.OD SO.DO SO.OD SO.DO S16,360.00

Sl.274.81 S6.424.27
$1,296.00
$0.00
$2,835.00
$0.00
$5,904.00
$0.00
SO.OD S17.734.07

$1,287.50
$3,927.03
$16,360.00
$17,734.07

$39,308.60

AIA DOCUMENT G7m • CONTINUATION SHEET FOR G702-1992 EOmON • A!A ·<!'J'1992
THE AMERICAN INSTITUTE OF ARCHITECTS, 17'J5 NEW YORK AVENUE. N,W, WASHINGTON. D.C. 2COOS62J2

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE'tWO Ol=T"NO PAGES

AlA Document 0702, APPLICATION AND CERTIFICATION FOR PAYMENT, ccntainins
Contractor's sigoed certification is :mached.
ln tabulations below, amounts are sr:ued 101he nc3rest doUar.
Use Columnl on Contracts \Vhcre variable retainage for line items may apply,

APPLICATION NO: 2 APPLI CATl OMON DATE: 9/30122
PERIOD TO: 9/1/22 - 9/30122
PROJECT NO: 64228384
CLIENT REF· Paar Raad - Pineline Utilities

A	B				D	,.,	I	E	F	G	H	!	
u,i"
CODE
l'll•t•CJW.Clldc	DESCRll'flON OrWu,u,.	l.,lUMllty	PN t

..	..,..,,	ULED
VALUE	w,n	MA,-uAL
PRESENTLY STORED (NOTIN DORE]	T"",:ru.
COMPLETED AND STORED TO DATE IP+E+Fl	o/,
(G+C)	B~~-
TO FlNISH (C-GJ	=•=•A<,t (IF VAR.IABLE
RATE)
lOf	
					vM c=uvua
APPLlCATJON
(D +E)	QTYTHIS	•a •~vv
PERJOD	I						
					Authent.ic.ity							

Users may obtain valldaUon of llus document by requesting of the license a completed AIA Document D401 - Cert1f1cation of Documents

AIA OOCUMENT G703 • CCMTINUATION SH'EET FOR G70'2, 1992 eomoN • AlA • c:n992
THE AMERICAN !NSTTTUTE Of AACHrrECTS. 1735 NEW YORK AVENUE. N,w. WA-SHINGTON, a.c. :lOOJG-5232

EXHIBITD-1
CONTRACTOR'S CONDITIONAL RELEASE OF LIEN

OWNER: CONTRACTOR: PROPERTY:

Mattarny Hornes USA Pipeline Utilities, Inc.
Southern Grove 4C - Paar Rd.

CONTRACTDATED: 2.17.2022

FOR WORK AND MATERIALS FURNISHED THROUGH SEPTEMBER 30TH 2022

The undersigned, which provided services, materials or equipment for the above Property in accordance with a contract with the Owner identified above, conditioned upon receipt of payment in the amount of $149,449.37, hereby waives and releases all claims for, liens and rights of lien now existing represents full payment received by the undersigned (exclusive of contractual retainage) for work, services, materials and/or equipment fumished in connection with the above Property to the date of this release.

This Release of Lien may be relied upon by purchasers procuring improvements from Owner, by mortgagees making mortgage loans to said purchasers, and title insurance companies insuring titles for said purchasers and shall run to the benefit of any such persons/entities and their successors and assigns.

IN WITNESS WHEREOF, the undersigned has hereunto set his hand and seal [as the duly authorized officer/partner of the undersigned] this  day of    , 20_

NAME:  C:_V\. r-'"7_,	i) lt t_o K	_
TITLE:    v_/7	 _

STATE OF fl.-

CORPORATE/PARTNERSHIP ACKNOWLEDGMENT

COUNTY OF r IP\ c.h,
On this 7	day ofOc--\cbllr , ,	before me, personally appeared &o..,y Dv'-ot	, the VP	of	1= ,.	,who I am satisfied is the person w	•		the within Instrument and he/she did acknowledge that he/she signed and deliver		t as th		officer] partner] above stated, and that the
foregoing instrument is the act and deed of sa1	----...		artners  NOTARYPUBLIC	.
MY COMMISSIO IRES:

,,,:}V�ff,,,

KYLE S KOPF

	Notary Public-State of Florida

�/;>i ,,_,;:.	My Commission Expires

:.	;	Commission II HH 132031

11,,,, ..0,1,'	May 21, 2025

Owner Initials	
314

APPLICATION AND CERTIFICATION FOR PAYMENT	AIA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:

PROJECT:

APPLICATION NO:	3	Distribution to:

Mattamy Homes	Paar Road - Utilities	APPLICATION DATE:		10/31/2022	OWNER 2500 Quantum Lakes Blvd Ste 215			2022-138	ARCHITECT
Attn: Frank Covelli	PERIOD TO:	10/1/22 - 10/31/22	CONTRACTOR

FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court

VIA ARCHITECT: Kimley Horn
7757-3
Tyler

PROJECT NO:	64228384

Riviera Beach, FL 33404	CLIENT REFERENCE:	Paar Road - Pipeline Utilities
CONTRACT FOR: 7757	CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT	The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment, as shown below, in connection with the Contract.	information and belief the Work covered by this Application for Payment has been Continuation Sheet, AIA Document G703, is attached.	completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

ORIGINAL CONTRACT SUM	$	906,517.45
Net change by Change Orders	$	50,377.40	CONTRACTOR:
CONTRACT SUM TO DATE (Line 1 ± 2)	$	956,894.85
TOTAL COMPLETED & STORED TO	$	555,653.35
DATE	(Column G on G703)	By:	Date:
RETAINAGE:
	10 % of Completed Work	$	55,565.34	State of:	County of: (Column D + E on G703)			Subscribed and sworn to before me this	 day of
0 % of Stored Material	$	Notary Public:
(Column F on G703)	My Commission expires:
Total Retainage (Lines 5a + 5b or

500,088.02

Total in Column I of G703)	$	55,565.34	ARCHITECT'S CERTIFICATE FOR PAYMENT
TOTAL EARNED LESS RETAINAGE	$	In accordance with the Contract Documents, based on on-site observations and the data
(Line 4 Less Line 5 Total)	comprising the application, the Architect certifies to the Owner that to the best of the

353,777.36
146,310.66
456,806.84

LESS PREVIOUS CERTIFICATES FOR	Architect's knowledge, information and belief the Work has progressed as indicated,

PAYMENT (Line 6 from prior Certificate)	$
CURRENT PAYMENT DUE	$
BALANCE TO FINISH, INCLUDING RETAINAGE	$

the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Line 3 less Line 6)	AMOUNT CERTIFIED . . . . . . . . . . . $	146,310.66

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
NET CHANGES by Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.) ARCHITECT:
By:	Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AIA DOCUMENT G702 · APPLICATION AND CERTIFICATION FOR PAYMENT · 1992 EDITION · AIA · ©1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

315

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 3
APPLICATIO ON DATE: 10/31/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 10/1/22 - 10/31/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	12,875.00		0	$12,875.00	$0.00	25,750.00	50%	$25,750.00	$2,575.00	
				$0.00	-	-		$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$51,500.00	$12,875.00	-	$12,875.00	$0.00	$25,750.00	50%	$25,750.00	$2,575.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25			$0.00	$0.00	26,210.25	100%	$0.00	$2,621.03	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	-		$0.00	$0.00	-	0%	$2,060.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-	-		$0.00	$0.00	-	0%	$3,440.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	-		2	$17,700.00	$0.00	17,700.00	100%	$0.00	$1,770.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00			$0.00	$0.00	8,400.00	100%	$0.00	$840.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00			$0.00	$0.00	4,660.00	100%	$0.00	$466.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-	-		$0.00	$0.00	-	0%	$4,000.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-	-		$0.00	$0.00	-	0%	$555.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	-		2	$25,090.00	$0.00	25,090.00	100%	$0.00	$2,509.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-	-		$0.00	$0.00	-	0%	$2,200.00	$0.00	
				$0.00	-	-		$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$94,315.25	39,270.25	-	$42,790.00	$0.00	82,060.25	87%	$12,255.00	$8,206.03	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00		$0.00	$0.00	2,600.00	100%	$0.00	$260.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00		$0.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	-	-	$0.00	$0.00	-	0%	$4,929.00	$0.00	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	-	-	$0.00	$0.00	-	0%	$6,460.00	$0.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	-	14	$54,810.00	$0.00	54,810.00	100%	$0.00	$5,481.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	-	2	$24,750.00	$0.00	24,750.00	100%	$0.00	$2,475.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	-	-	$0.00	$0.00	-	0%	$31,960.00	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$399,209.00	163,600.00		$79,560.00	$0.00	243,160.00	61%	$156,049.00	$24,316.00	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$1,274.81	
31015	24" RCP	819	$	89.35	$73,177.65	64,243	100	$8,935.00	$0.00	73,177.65	100%	$0.00	$7,317.77	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$1,296.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	-		$0.00	$0.00	-	0%	$19,110.00	$0.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$2,835.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	-	2	$34,830.00	$0.00	34,830.00	100%	$0.00	$3,483.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$5,904.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	-		$0.00	$0.00	-	0%	$121,277.50	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$361,493.20	177,340.70		$43,765.00	$0.00	221,105.70	61%	$140,387.50	$22,110.57	
	Change Order 1			$0.00	-		$0.00	$0.00	$0.00	0%	$0.00	$0.00	
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	-	(675)	($118,125.00)	$0.00	($118,125.00)	100%	$0.00	($11,812.50)	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	-	(2)	($24,750.00)	$0.00	($24,750.00)	100%	$0.00	($2,475.00)	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	-	(14)	($54,810.00)	$0.00	($54,810.00)	100%	$0.00	($5,481.00)	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	-	1,564	$143,262.40	$0.00	$143,262.40	100%	$0.00	$14,326.24	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	-	2	$9,300.00	$0.00	$9,300.00	100%	$0.00	$930.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	-	14	$28,700.00	$0.00	$28,700.00	100%	$0.00	$2,870.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	-		$0.00	$0.00	$0.00	0%	$66,800.00	$0.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 3
APPLICATIO ON DATE: 10/31/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 10/1/22 - 10/31/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	12,875.00		$12,875.00	$0.00	$25,750.00	50%	$25,750.00	$2,575.00	
	31020	Water	$94,315.25	$94,315.25	39,270.25		$42,790.00	$0.00	$82,060.25	87%	$12,255.00	$8,206.03	
	31620	Force Main	$399,209.00	$399,209.00	163,600.00		$79,560.00	$0.00	$243,160.00	61%	$156,049.00	$24,316.00	
	31015	Drainage	$361,493.20	$361,493.20	177,340.70		$43,765.00	$0.00	$221,105.70	61%	$140,387.50	$22,110.57	
	CO1-31620		($16,422.60)	($16,422.60)	-		($16,422.60)	$0.00	($16,422.60)	100%	$0.00	($1,642.26)	
	CO1-31015		$66,800.00	$66,800.00	-		$0.00	$0.00	$0.00	0%	$66,800.00	$0.00	
	GRAND TOTALS			$956,894.85	393,085.95		$162,567.40	-	$555,653.35	58%	$401,241.50	$55,565.34	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AIA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:

PROJECT:

APPLICATION NO:	4	Distribution to:

Mattamy Homes	Paar Road - Utilities	APPLICATION DATE:		11/30/2022	OWNER 2500 Quantum Lakes Blvd Ste 215			2022-150	ARCHITECT
Attn: Frank Covelli	PERIOD TO:	11/1/22 - 11/30/22	CONTRACTOR

FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court Riviera Beach, FL 33404

VIA ARCHITECT: Kimley Horn

7757-4
Tyler

PROJECT NO:	64228384
CLIENT REFERENCE:	Paar Road - Pipeline Utilities

CONTRACT FOR: 7757	CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT	The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment, as shown below, in connection with the Contract.	information and belief the Work covered by this Application for Payment has been Continuation Sheet, AIA Document G703, is attached.	completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

ORIGINAL CONTRACT SUM	$	906,517.45
Net change by Change Orders	$	50,377.40	CONTRACTOR:
CONTRACT SUM TO DATE (Line 1 ± 2)	$	956,894.85
TOTAL COMPLETED & STORED TO	$	667,288.35

DATE	(Column G on G703)	By:	Date:
RETAINAGE:
	10 % of Completed Work	$	66,728.84	State of:	County of: (Column D + E on G703)			Subscribed and sworn to before me this	 day of
0 % of Stored Material	$	Notary Public:
	
(Column F on G703)	My Commission expires:
Total Retainage (Lines 5a + 5b or

600,559.52

Total in Column I of G703)	$	66,728.84	ARCHITECT'S CERTIFICATE FOR PAYMENT
TOTAL EARNED LESS RETAINAGE	$	In accordance with the Contract Documents, based on on-site observations and the data
(Line 4 Less Line 5 Total)	comprising the application, the Architect certifies to the Owner that to the best of the

500,088.02
100,471.50
356,335.34

LESS PREVIOUS CERTIFICATES FOR	Architect's knowledge, information and belief the Work has progressed as indicated,

PAYMENT (Line 6 from prior Certificate)	$
CURRENT PAYMENT DUE	$
BALANCE TO FINISH, INCLUDING RETAINAGE	$

the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Line 3 less Line 6)	AMOUNT CERTIFIED . . . . . . . . . . . $	100,471.50

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
NET CHANGES by Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.) ARCHITECT:
By:	Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AIA DOCUMENT G702 · APPLICATION AND CERTIFICATION FOR PAYMENT · 1992 EDITION · AIA · ©1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

318

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 4
APPLICATIO ON DATE: 11/30/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 11/1/22 - 11/30/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	25,750.00		0	$12,875.00	$0.00	38,625.00	75%	$12,875.00	$3,862.50	
				$0.00	-	-		$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$51,500.00	$25,750.00	-	$12,875.00	$0.00	$38,625.00	75%	$12,875.00	$3,862.50	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25		$0.00	$0.00	26,210.25	100%	$0.00	$2,621.03	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	-	$0.00	$0.00	-	0%	$2,060.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-	-	$0.00	$0.00	-	0%	$3,440.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	17,700.00		$0.00	$0.00	17,700.00	100%	$0.00	$1,770.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00		$0.00	$0.00	8,400.00	100%	$0.00	$840.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00		$0.00	$0.00	4,660.00	100%	$0.00	$466.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-	-	$0.00	$0.00	-	0%	$4,000.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-	-	$0.00	$0.00	-	0%	$555.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	25,090.00		$0.00	$0.00	25,090.00	100%	$0.00	$2,509.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-	-	$0.00	$0.00	-	0%	$2,200.00	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$94,315.25	82,060.25	-	$0.00	$0.00	82,060.25	87%	$12,255.00	$8,206.03	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00			$0.00	$0.00	2,600.00	100%	$0.00	$260.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00			$0.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	-	-		$0.00	$0.00	-	0%	$4,929.00	$0.00	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	-	-		$0.00	$0.00	-	0%	$6,460.00	$0.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	54,810.00			$0.00	$0.00	54,810.00	100%	$0.00	$5,481.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	24,750.00			$0.00	$0.00	24,750.00	100%	$0.00	$2,475.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	-		2	$31,960.00	$0.00	31,960.00	100%	$0.00	$3,196.00	
				$0.00	-	-		$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$399,209.00	243,160.00		$31,960.00	$0.00	275,120.00	69%	$124,089.00	$27,512.00	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$1,274.81	
31015	24" RCP	819	$	89.35	$73,177.65	73,178		$0.00	$0.00	73,177.65	100%	$0.00	$7,317.77	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$1,296.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	-		$0.00	$0.00	-	0%	$19,110.00	$0.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$2,835.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	34,830		$0.00	$0.00	34,830.00	100%	$0.00	$3,483.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$5,904.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	-		$0.00	$0.00	-	0%	$121,277.50	$0.00	
				$0.00	-	-	$0.00	$0.00	-	0%	$0.00	$0.00	
	Subtotal			$361,493.20	221,105.70		$0.00	$0.00	221,105.70	61%	$140,387.50	$22,110.57	
	Change Order 1			$0.00	-		$0.00	$0.00	$0.00	0%	$0.00	$0.00	
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	(118,125.00)		$0.00	$0.00	($118,125.00)	100%	$0.00	($11,812.50)	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	(24,750.00)		$0.00	$0.00	($24,750.00)	100%	$0.00	($2,475.00)	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	(54,810.00)		$0.00	$0.00	($54,810.00)	100%	$0.00	($5,481.00)	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	143,262.40		$0.00	$0.00	$143,262.40	100%	$0.00	$14,326.24	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	9,300.00		$0.00	$0.00	$9,300.00	100%	$0.00	$930.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	28,700.00		$0.00	$0.00	$28,700.00	100%	$0.00	$2,870.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	-	167	$66,800.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 4
APPLICATIO ON DATE: 11/30/22	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 11/1/22 - 11/30/22	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
									$0.00				
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	25,750.00		$12,875.00	$0.00	$38,625.00	75%	$12,875.00	$3,862.50	
	31020	Water	$94,315.25	$94,315.25	82,060.25		$0.00	$0.00	$82,060.25	87%	$12,255.00	$8,206.03	
	31620	Force Main	$399,209.00	$399,209.00	243,160.00		$31,960.00	$0.00	$275,120.00	69%	$124,089.00	$27,512.00	
	31015	Drainage	$361,493.20	$361,493.20	221,105.70		$0.00	$0.00	$221,105.70	61%	$140,387.50	$22,110.57	
	CO1-31620		($16,422.60)	($16,422.60)	(16,422.60)		$0.00	$0.00	($16,422.60)	100%	$0.00	($1,642.26)	
	CO1-31015		$66,800.00	$66,800.00	-		$66,800.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	
	GRAND TOTALS			$956,894.85	555,653.35		$111,635.00	-	$667,288.35	70%	$289,606.50	$66,728.84	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AIA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:

PROJECT:

7757-5

APPLICATION NO:	5	Distribution to:

Mattamy Homes	Paar Road - Utilities

Tyler

APPLICATION DATE:	3/31/2023	OWNER

2500 Quantum Lakes Blvd Ste 215	2023-034	ARCHITECT
Attn: Frank Covelli	PERIOD TO:	3/1/23 - 3/31/23	CONTRACTOR

FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court

VIA ARCHITECT: Kimley Horn

**This Pay App does not include JDE CO #5 for $18,886.00

PROJECT NO:	64228384

Riviera Beach, FL 33404	CLIENT REFERENCE:	Paar Road - Pipeline Utilities
CONTRACT FOR: 7757	CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT	The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment, as shown below, in connection with the Contract.	information and belief the Work covered by this Application for Payment has been Continuation Sheet, AIA Document G703, is attached.	completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

ORIGINAL CONTRACT SUM	$	906,517.45
Net change by Change Orders	$	253,426.65	CONTRACTOR:
CONTRACT SUM TO DATE (Line 1 ± 2)	$	1,159,944.10
TOTAL COMPLETED & STORED TO	$	825,991.35

DATE	(Column G on G703)	By:	Date:
RETAINAGE:
	10 % of Completed Work	$	82,599.14	State of:	County of: (Column D + E on G703)			Subscribed and sworn to before me this	 day of
0 % of Stored Material	$	Notary Public:
	
(Column F on G703)	My Commission expires:
Total Retainage (Lines 5a + 5b or
Total in Column I of G703)	$	82,599.14	ARCHITECT'S CERTIFICATE FOR PAYMENT
TOTAL EARNED LESS RETAINAGE	$	743,392.22	In accordance with the Contract Documents, based on on-site observations and the data (Line 4 Less Line 5 Total)			comprising the application, the Architect certifies to the Owner that to the best of the
LESS PREVIOUS CERTIFICATES FOR				Architect's knowledge, information and belief the Work has progressed as indicated, PAYMENT (Line 6 from prior Certificate)	$	600,559.52	the quality of the Work is in accordance with the Contract Documents, and the Contractor
CURRENT PAYMENT DUE	$	142,832.70	is entitled to payment of the AMOUNT CERTIFIED.
BALANCE TO FINISH, INCLUDING RETAINAGE	$	416,551.89
(Line 3 less Line 6)	AMOUNT CERTIFIED . . . . . . . . . . . $	142,832.70

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
NET CHANGES by Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.) ARCHITECT:
By:	Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AIA DOCUMENT G702 · APPLICATION AND CERTIFICATION FOR PAYMENT · 1992 EDITION · AIA · ©1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

321

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 5
APPLICATIO ON DATE: 3/31/223	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 3/1/23 - 3/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	38,625.00	0.25	$12,875.00	$0.00	51,500.00	100%	$0.00	$5,150.00	
	Subtotal			$51,500.00	$38,625.00	-	$12,875.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25		$0.00	$0.00	26,210.25	100%	$0.00	$2,621.03	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	-	$0.00	$0.00	-	0%	$2,060.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-		$0.00	$0.00	-	0%	$3,440.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	17,700.00		$0.00	$0.00	17,700.00	100%	$0.00	$1,770.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00		$0.00	$0.00	8,400.00	100%	$0.00	$840.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00		$0.00	$0.00	4,660.00	100%	$0.00	$466.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-		$0.00	$0.00	-	0%	$4,000.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-		$0.00	$0.00	-	0%	$555.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	25,090.00		$0.00	$0.00	25,090.00	100%	$0.00	$2,509.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-		$0.00	$0.00	-	0%	$2,200.00	$0.00	
	Subtotal			$94,315.25	82,060.25	-	$0.00	$0.00	82,060.25	87%	$12,255.00	$8,206.03	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00	

-

-	

1	$0.00	$0.00	2,600.00	100%	$0.00	$260.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00			$0.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	-			$0.00	$0.00	-	0%	$4,929.00	$0.00	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	-			$6,460.00	$0.00	6,460.00	100%	$0.00	$646.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	54,810.00			$0.00	$0.00	54,810.00	100%	$0.00	$5,481.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	24,750.00			$0.00	$0.00	24,750.00	100%	$0.00	$2,475.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	31,960.00			$0.00	$0.00	31,960.00	100%	$0.00	$3,196.00	
					-									
	Subtotal			$399,209.00	275,120.00		$6,460.00	$0.00	281,580.00	71%	$117,629.00	$28,158.00	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$1,274.81	
31015	24" RCP	819	$	89.35	$73,177.65	73,178		$0.00	$0.00	73,177.65	100%	$0.00	$7,317.77	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$1,296.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	-		$0.00	$0.00	-	0%	$19,110.00	$0.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$2,835.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	34,830		$0.00	$0.00	34,830.00	100%	$0.00	$3,483.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$5,904.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	-	3,025	$105,118.75	$0.00	105,118.75	87%	$16,158.75	$10,511.88	
				$0.00	-	-							
	Subtotal			$361,493.20	221,105.70		$105,118.75	$0.00	326,224.45	90%	$35,268.75	$32,622.45	
	Change Order 1												
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	(118,125.00)		$0.00	$0.00	($118,125.00)	100%	$0.00	($11,812.50)	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	(24,750.00)		$0.00	$0.00	($24,750.00)	100%	$0.00	($2,475.00)	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	(54,810.00)		$0.00	$0.00	($54,810.00)	100%	$0.00	($5,481.00)	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	143,262.40		$0.00	$0.00	$143,262.40	100%	$0.00	$14,326.24	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	9,300.00		$0.00	$0.00	$9,300.00	100%	$0.00	$930.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	28,700.00		$0.00	$0.00	$28,700.00	100%	$0.00	$2,870.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 5
APPLICATIO ON DATE: 3/31/223	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 3/1/23 - 3/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
	Subtotal			$50,377.40	50,377.40		$0.00	$0.00	50,377.40	100%	$0.00	$5,037.74	
	Change Order 2												
C02-31620	CONDUIT - F&I open trench 2" PVC	3,200	$52.75	$168,800.00			$0.00	$0.00	$0.00	0%	$168,800.00	$0.00	
	Subtotal			$168,800.00	-	-	-	-	-	0%	$168,800.00	-	
	Change Order 3												
CO3-34010	2" CONDUIT INSTALLATION	1,120	$13.75	$15,400.00		1,120	$15,400.00	$0.00	$15,400.00	100%	$0.00	$1,540.00	
CO3-34010	4" CONDUIT INSTALLATION	65	$32.05	$2,083.25		65	$2,083.25	$0.00	$2,083.25	100%	$0.00	$208.33	
CO3-34010	6" CONDUIT INSTALLATION	230	$40.20	$9,246.00		230	$9,246.00	$0.00	$9,246.00	100%	$0.00	$924.60	
CO3-31245	Survey, Layout, & As-Builts	1	$2,600.00	$2,600.00		1	$2,600.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	Subtotal			$29,329.25	-	1,416.00	$29,329.25	$0.00	$29,329.25	100%	$0.00	$2,932.93	
	Change Order 4												
CO4-31015	Raise Existing Drainage Tops	2	$2,460.00	$4,920.00		2	$4,920.00	$0.00	$4,920.00	100%	$0.00	$492.00	
	Subtotal			$4,920.00	-	2.00	4,920.00	-	4,920.00	100%	$0.00	492.00	
									-				
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	38,625.00		$12,875.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	31020	Water	$94,315.25	$94,315.25	82,060.25		$0.00	$0.00	$82,060.25	87%	$12,255.00	$8,206.03	
	31620	Force Main	$399,209.00	$399,209.00	275,120.00		$6,460.00	$0.00	$281,580.00	71%	$117,629.00	$28,158.00	
	31015	Drainage	$361,493.20	$361,493.20	221,105.70		$105,118.75	$0.00	$326,224.45	90%	$35,268.75	$32,622.45	
	CO1-31620		($16,422.60)	($16,422.60)	(16,422.60)		$0.00	$0.00	($16,422.60)	100%	$0.00	($1,642.26)	
	CO1-31015		$66,800.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	
	CO2-31620	Fiber Optic	$168,800.00	$168,800.00	-		-	-	-	0%	$168,800.00	-	
	CO3-34010	Conduit	$26,729.25	$26,729.25	-		$26,729.25	$0.00	$26,729.25	100%	$0.00	2,672.93	
	CO3-31245	General	$2,600.00	$2,600.00			$2,600.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	CO4-31010	Drainage	$4,920.00	$4,920.00	-		$4,920.00	$0.00	4,920.00	100%	$0.00	$492.00	
	GRAND TOTALS			$1,159,944.10	667,288.35		$158,703.00	$0.00	$825,991.35	71%	$333,952.75	$82,599.14	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AL4. DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:
Mattarny Homes

PROJECT:
Paar Road - Utilities

7757-6
Tyler

APPLICATION NO: APPLICATION DATE:

6
6/30/2023

Distribution to: [:=]OWNER

2500 Quantum Lakes Blvd Ste 215
Attn: Frank Covelli
FROM CONTRACTOR:

VIA ARCHITECT: Kimley Hom

PERIOD TO:

2023-068
6/1/23 - 6/30/23

[:=]ARCHITECT [:=]CONTRACTOR
[:=J

Pipeline Vtilitics Inc 3610 Fiscal Court Riviera Beach. FL 33404
CONTRACT FOR: 7757

**This Pay App excludes JDE CO's #5 & #6 ($33,884.45 total)

PROJECT NO: CLIENT REFERENCE: CONTRACT DATE:

64228384
Paar Road - Pipeline Utilities

[:=J

CONTRACTOR'S APPLICATION FOR PAYMENT

Application is made for payment, as shown below, in connection with the Contract Continuation Sheet, AlA Document G703, is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

I. ORlGINAL CONTRACT $UM
Net change by Change Orders
CONfRACT SUM TO DATE (Line l ± 2)
TOTAL COMPLETED & STORED TO
DATE	(Column G on G703)

0

RETAINAGE:

$	906.517.45
$	253.426.65 
S	1.159.944.10

_·	!)"\IIRY �- 	C

$	l.034.989.10

Bsyw: , ,If.-·	Th. ,  7/1,.

10 % of Completed Work	$
(Column D +Eon G703)

	103.498.91 

Subscnbed and sworn tl;J)mbe . r:,� "· £\  .. ounty offl)-

Notary Public
State of Flo• riJdOa NES

0 % of Stored Material	$		
(Column Fon G703)
Total Retainage (Lines 5a + 5b or

NotaryPublic:	IS	y of  S  •	,.
MyCommission expire.s·	.",",-...-£..:	o-
r.,i,CE , 1'o

Comm# HH169929
Expires 8/26/20"25

Total in Column I ofG703)

$	103,498.91	

ARCHfT.ECT'S CERTIFICATE FOR PAYMENT

AMOUNT CERTIFIED ........... $	188.097.97MS
CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	(Attach explanation if amormr certified differs from the amount applied. fnirial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.)
:CHITEC"!  f[	07/06/2023
Date:	
Total changes approved
in previous months by Owner	$0.00	$0.00		
Total approved this Month	$0.00	$0.00		
TOTALS	$0.00	$0.00	This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.	
NET CHANGES by Change Order	$0.00		

6. TOTAL EARNED LESS RETAINAGE	$	931.490.19		In accordance with the Contract Documents, based on on-site observations and the data	
(Line 4 Less Line 5 Total)
7. LESSPREVIOUSCERTIFICATESFOR
PAYMENT (Line 6 from prior Certificate)	

$	743.392.22		comprising the application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated,
the quality of the Work is in accordance with the Contract Documents, and the Contractor	
8. CURRENTPAYMENTDUE	$	188,097.97	is entitled to payment of the AMOUNT CERTIFIED.	
9. BALANCE TO FINISH, INCLUDING RETAINAGE	$	228.453.91		
(Line 3 less Line 6)			

All\ DOCUMENT G702 • APPLICATION AND CERTIFICATION FOR PAYMENT· 1992 EDITION· AIA • 11)1992.	THE AMERICAN INSTmJTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W.. WASHINGTON, DC 2000&-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

324

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 6
APPLICATIO ON DATE: 6/30/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 6/1/23 - 6/30/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	51,500.00	100%	$0.00	$5,150.00	
	Subtotal			$51,500.00	$51,500.00	-	$0.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25		$0.00	$0.00	26,210.25	100%	$0.00	$2,621.03	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	-	$0.00	$0.00	-	0%	$2,060.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-		$0.00	$0.00	-	0%	$3,440.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	17,700.00		$0.00	$0.00	17,700.00	100%	$0.00	$1,770.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00		$0.00	$0.00	8,400.00	100%	$0.00	$840.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00		$0.00	$0.00	4,660.00	100%	$0.00	$466.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-		$0.00	$0.00	-	0%	$4,000.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-		$0.00	$0.00	-	0%	$555.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	25,090.00		$0.00	$0.00	25,090.00	100%	$0.00	$2,509.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-		$0.00	$0.00	-	0%	$2,200.00	$0.00	
	Subtotal			$94,315.25	82,060.25	-	$0.00	$0.00	82,060.25	87%	$12,255.00	$8,206.03	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00		$0.00	$0.00	2,600.00	100%	$0.00	$260.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00		$0.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	-	1,590	$4,929.00	$0.00	4,929.00	100%	$0.00	$492.90	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	6,460.00		$0.00	$0.00	6,460.00	100%	$0.00	$646.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	54,810.00		$0.00	$0.00	54,810.00	100%	$0.00	$5,481.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	24,750.00		$0.00	$0.00	24,750.00	100%	$0.00	$2,475.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	31,960.00		$0.00	$0.00	31,960.00	100%	$0.00	$3,196.00	
					-	-							
	Subtotal			$399,209.00	281,580.00		$4,929.00	$0.00	286,509.00	72%	$112,700.00	$28,650.90	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$1,274.81	
31015	24" RCP	819	$	89.35	$73,177.65	73,178		$0.00	$0.00	73,177.65	100%	$0.00	$7,317.77	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$1,296.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	-	1	$19,110.00	$0.00	19,110.00	100%	$0.00	$1,911.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$2,835.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	34,830		$0.00	$0.00	34,830.00	100%	$0.00	$3,483.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$5,904.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	105,119	465	$16,158.75	$0.00	121,277.50	100%	$0.00	$12,127.75	
				$0.00	-	-							
	Subtotal			$361,493.20	326,224.45		$35,268.75	$0.00	361,493.20	100%	$0.00	$36,149.32	
	Change Order 1												
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	(118,125.00)		$0.00	$0.00	($118,125.00)	100%	$0.00	($11,812.50)	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	(24,750.00)		$0.00	$0.00	($24,750.00)	100%	$0.00	($2,475.00)	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	(54,810.00)		$0.00	$0.00	($54,810.00)	100%	$0.00	($5,481.00)	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	143,262.40		$0.00	$0.00	$143,262.40	100%	$0.00	$14,326.24	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	9,300.00		$0.00	$0.00	$9,300.00	100%	$0.00	$930.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	28,700.00		$0.00	$0.00	$28,700.00	100%	$0.00	$2,870.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 6
APPLICATIO ON DATE: 6/30/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 6/1/23 - 6/30/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
	Subtotal			$50,377.40	50,377.40		$0.00	$0.00	50,377.40	100%	$0.00	$5,037.74	
	Change Order 2												
C02-31620	CONDUIT - F&I open trench 2" PVC	3,200	$52.75	$168,800.00		3,200	$168,800.00	$0.00	$168,800.00	100%	$0.00	$16,880.00	
	Subtotal			$168,800.00	-	3,200.00	168,800.00	-	168,800.00	100%	$0.00	16,880.00	
	Change Order 3												
CO3-34010	2" CONDUIT INSTALLATION	1,120	$13.75	$15,400.00	15,400.00		$0.00	$0.00	$15,400.00	100%	$0.00	$1,540.00	
CO3-34010	4" CONDUIT INSTALLATION	65	$32.05	$2,083.25	2,083.25		$0.00	$0.00	$2,083.25	100%	$0.00	$208.33	
CO3-34010	6" CONDUIT INSTALLATION	230	$40.20	$9,246.00	9,246.00		$0.00	$0.00	$9,246.00	100%	$0.00	$924.60	
CO3-31245	Survey, Layout, & As-Builts	1	$2,600.00	$2,600.00	2,600.00		$0.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	Subtotal			$29,329.25	29,329.25	-	$0.00	$0.00	$29,329.25	100%	$0.00	$2,932.93	
	Change Order 4												
CO4-31015	Raise Existing Drainage Tops	2	$2,460.00	$4,920.00	4,920.00		$0.00	$0.00	$4,920.00	100%	$0.00	$492.00	
	Subtotal			$4,920.00	4,920.00	-	-	-	4,920.00	100%	$0.00	492.00	
									-				
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	31020	Water	$94,315.25	$94,315.25	82,060.25		$0.00	$0.00	$82,060.25	87%	$12,255.00	$8,206.03	
	31620	Force Main	$399,209.00	$399,209.00	281,580.00		$4,929.00	$0.00	$286,509.00	72%	$112,700.00	$28,650.90	
	31015	Drainage	$361,493.20	$361,493.20	326,224.45		$35,268.75	$0.00	$361,493.20	100%	$0.00	$36,149.32	
	CO1-31620		($16,422.60)	($16,422.60)	(16,422.60)		$0.00	$0.00	($16,422.60)	100%	$0.00	($1,642.26)	
	CO1-31015		$66,800.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	
	CO2-31620	Fiber Optic	$168,800.00	$168,800.00	-		168,800.00	-	168,800.00	100%	$0.00	16,880.00	
	CO3-34010	Conduit	$26,729.25	$26,729.25	26,729.25		$0.00	$0.00	$26,729.25	100%	$0.00	2,672.93	
	CO3-31245	General	$2,600.00	$2,600.00			$0.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	CO4-31010	Drainage	$4,920.00	$4,920.00	4,920.00		$0.00	$0.00	4,920.00	100%	$0.00	$492.00	
	GRAND TOTALS			$1,159,944.10	823,391.35		$208,997.75	$0.00	$1,034,989.10	89%	$124,955.00	$103,498.91	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:
Mattamy Homes
2500 Quantum Lakes Blvd Ste 215 Attn: Frank Covelli

PROJECT:
Paar Road - Utilities

7757-7
Tyler

APPLICATION NO:	7
APPLICATION DATE:	8/31/2023
2023-099
PERIOD TO:	7/1/23 - 8/31/23

Distribution to:
C]OWNER C]ARCHITECT
CJCONTRACTOR

FROM CONTRACTOR:
Pipeline Utilities Inc 3610 Fiscal Court Riviera Beach, FL 33404
CONTRACT FOR: 7757

VIA ARCHITECT: Kimley Hom
**This Pay App excludes JDE CO's #5 & #6 (Total: $33,884.45)

Cl
CJ
PROJECT NO:	64228384
CLIENT REFERENCE:	Paar Road - Pipeline Utilities
CONTRACT DATE:

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AlA Document G703, is attached.

By:

I	{Jfa1;r:: -;_	

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

,	,

,

1. ORIGINAL CONTRACT SUM	$	906,517.45	
2. Net change by Change Orders	$	253,426.65	
3. CONTRACT SUM TO DATE (Line 1 ± 2)	$	1,159,944.10	
4. TOTAL CO"MPLETED & STORED TO	$	1,047,244.10	

DATE	(Column G on G703)

Date:

9/t./Z

RETAINAGE:
	10 % of Completed Work	$ (Column D +Eon G703)

	104,724.41 

State of: Subscribed and sw

v	OQNAt.Oeb ._JoNES
Notary Pu I 1c
State of Florida

	0 % of Stored Material	$		 (Column F on G703)
Total Retainage (Lines Sa+ Sb or

Notary Public:
My Commission expires:

0	comm# HH169929
......r,,,,.ce , ...,..,,· • Expires 8/26/2025

(Line 3 less Line 6)

AMOUNT CERTIFIED ........... $	11,029.so	MS

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved
in nrevious months by Owner	
$0.00	
$0.00	
Total approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
NET CHANGES by Change Order	$0.00	

Total in Column I of G703)	$	104,724.41		ARCHITECT'S CERTIFICATE FOR PAYMENT	
6. TOTAL EARNED LESS RETAINAGE	$	942,519.69		In accordance with the Contract Documents, based on on-site observations and the data	
(Line 4 Less Line 5 Total)			comprising the application, the Architect certifies to the Owner that to the best of the	
7. LESS PREVIOUS CERTIFICATES FOR			Architect's knowledge, information and belief the Work has progressed as indicated,	
PAYMENT (Line 6 from prior Certificate)	$	931,490.19			the quality of the Work is in accordance with the Contract Documents, and the Contractor	
8. CURRENT PAYMENT DUE	$	11,029.50			is entitled to payment of the AMOUNT CERTIFIED.	
9. BALANCE TO FINISH, INCLUDING RETAINAGE	$	217,424.41			

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.) ARCIDTECT:
By: 	 Date: 	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herem. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

AJA DOCUMENT G702 • APPLICATION AND CERTIFICATION FOR PAYMENT· 1992 EDITION· AJA • ©1992	Tl-IE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 2000&-5292
Users may obtain validation of this document by requesting a completed AIA Document 0401 - Certification of Document's Authenticity from the Licensee.

327

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 7
APPLICATIO ON DATE: 8/31/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 7/1/23 - 8/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	51,500.00	100%	$0.00	$5,150.00	
	Subtotal			$51,500.00	$51,500.00	-	$0.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25		$0.00	$0.00	26,210.25	100%	$0.00	$2,621.03	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	-	1	$2,060.00	$0.00	2,060.00	100%	$0.00	$206.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	-	4	$3,440.00	$0.00	3,440.00	100%	$0.00	$344.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	17,700.00		$0.00	$0.00	17,700.00	100%	$0.00	$1,770.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00		$0.00	$0.00	8,400.00	100%	$0.00	$840.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00		$0.00	$0.00	4,660.00	100%	$0.00	$466.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	-	2	$4,000.00	$0.00	4,000.00	100%	$0.00	$400.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	-	1	$555.00	$0.00	555.00	100%	$0.00	$55.50	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	25,090.00		$0.00	$0.00	25,090.00	100%	$0.00	$2,509.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	-	1	$2,200.00	$0.00	2,200.00	100%	$0.00	$220.00	
	Subtotal			$94,315.25	82,060.25	-	$12,255.00	$0.00	94,315.25	100%	$0.00	$9,431.53	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00		$0.00	$0.00	2,600.00	100%	$0.00	$260.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00		$0.00	$0.00	161,000.00	59%	$112,700.00	$16,100.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	4,929.00		$0.00	$0.00	4,929.00	100%	$0.00	$492.90	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	6,460.00		$0.00	$0.00	6,460.00	100%	$0.00	$646.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	54,810.00		$0.00	$0.00	54,810.00	100%	$0.00	$5,481.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	24,750.00		$0.00	$0.00	24,750.00	100%	$0.00	$2,475.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	31,960.00		$0.00	$0.00	31,960.00	100%	$0.00	$3,196.00	
					-	-							
	Subtotal			$399,209.00	286,509.00		$0.00	$0.00	286,509.00	72%	$112,700.00	$28,650.90	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$1,274.81	
31015	24" RCP	819	$	89.35	$73,177.65	73,178		$0.00	$0.00	73,177.65	100%	$0.00	$7,317.77	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$1,296.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	19,110		$0.00	$0.00	19,110.00	100%	$0.00	$1,911.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$2,835.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	34,830		$0.00	$0.00	34,830.00	100%	$0.00	$3,483.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$5,904.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	121,278		$0.00	$0.00	121,277.50	100%	$0.00	$12,127.75	
				$0.00	-	-							
	Subtotal			$361,493.20	361,493.20		$0.00	$0.00	361,493.20	100%	$0.00	$36,149.32	
	Change Order 1												
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	(118,125.00)		$0.00	$0.00	($118,125.00)	100%	$0.00	($11,812.50)	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	(24,750.00)		$0.00	$0.00	($24,750.00)	100%	$0.00	($2,475.00)	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	(54,810.00)		$0.00	$0.00	($54,810.00)	100%	$0.00	($5,481.00)	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	143,262.40		$0.00	$0.00	$143,262.40	100%	$0.00	$14,326.24	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	9,300.00		$0.00	$0.00	$9,300.00	100%	$0.00	$930.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	28,700.00		$0.00	$0.00	$28,700.00	100%	$0.00	$2,870.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 7
APPLICATIO ON DATE: 8/31/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 7/1/23 - 8/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
	Subtotal			$50,377.40	50,377.40		$0.00	$0.00	50,377.40	100%	$0.00	$5,037.74	
	Change Order 2												
C02-31620	CONDUIT - F&I open trench 2" PVC	3,200	$52.75	$168,800.00	168,800.00		$0.00	$0.00	$168,800.00	100%	$0.00	$16,880.00	
	Subtotal			$168,800.00	168,800.00	-	-	-	168,800.00	100%	$0.00	16,880.00	
	Change Order 3												
CO3-34010	2" CONDUIT INSTALLATION	1,120	$13.75	$15,400.00	15,400.00		$0.00	$0.00	$15,400.00	100%	$0.00	$1,540.00	
CO3-34010	4" CONDUIT INSTALLATION	65	$32.05	$2,083.25	2,083.25		$0.00	$0.00	$2,083.25	100%	$0.00	$208.33	
CO3-34010	6" CONDUIT INSTALLATION	230	$40.20	$9,246.00	9,246.00		$0.00	$0.00	$9,246.00	100%	$0.00	$924.60	
CO3-31245	Survey, Layout, & As-Builts	1	$2,600.00	$2,600.00	2,600.00		$0.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	Subtotal			$29,329.25	29,329.25	-	$0.00	$0.00	$29,329.25	100%	$0.00	$2,932.93	
	Change Order 4												
CO4-31015	Raise Existing Drainage Tops	2	$2,460.00	$4,920.00	4,920.00		$0.00	$0.00	$4,920.00	100%	$0.00	$492.00	
	Subtotal			$4,920.00	4,920.00	-	-	-	4,920.00	100%	$0.00	492.00	
									-				
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	$51,500.00	100%	$0.00	$5,150.00	
	31020	Water	$94,315.25	$94,315.25	82,060.25		$12,255.00	$0.00	$94,315.25	100%	$0.00	$9,431.53	
	31620	Force Main	$399,209.00	$399,209.00	286,509.00		$0.00	$0.00	$286,509.00	72%	$112,700.00	$28,650.90	
	31015	Drainage	$361,493.20	$361,493.20	361,493.20		$0.00	$0.00	$361,493.20	100%	$0.00	$36,149.32	
	CO1-31620		($16,422.60)	($16,422.60)	(16,422.60)		$0.00	$0.00	($16,422.60)	100%	$0.00	($1,642.26)	
	CO1-31015		$66,800.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$6,680.00	
	CO2-31620	Fiber Optic	$168,800.00	$168,800.00	168,800.00		-	-	168,800.00	100%	$0.00	16,880.00	
	CO3-34010	Conduit	$26,729.25	$26,729.25	26,729.25		$0.00	$0.00	$26,729.25	100%	$0.00	2,672.93	
	CO3-31245	General	$2,600.00	$2,600.00			$0.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	CO4-31010	Drainage	$4,920.00	$4,920.00	4,920.00		$0.00	$0.00	4,920.00	100%	$0.00	$492.00	
	GRAND TOTALS			$1,159,944.10	1,032,389.10		$12,255.00	$0.00	$1,047,244.10	90%	$112,700.00	$104,724.41	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF TWO PAGES

TO OWNER:
Mattamy Homes
2500 Quantum Lakes Blvd Ste 215

PROJECT:
Paar Road - Utilities 7757-8
Frank

APPLICATION NO:	8
APPLICATION DATE:	8/31/2023
2023-100

Distribution to:
OWNER ARCHITECT

Attn: Frank Covelli
FROM CONTRACTOR:
Pipeline Utilities Inc

 RETAINAGE RELEASE  PERIOD TO:	7/1/23 - 8/31/23
VIA ARCHITECT: Kimley Hom
**This Pay App excludes JDE CO's #5 & #6

CONTRACTOR

3610 Fiscal Court Riviera Beach, FL 33404 CONTRACT FOR: 7757

(Total: $33,884.45)

PROJECT NO:	64228384
CLIENT REFERENCE:	Paar Road - Pipeline Utilities
CONTRACT DATE:

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AlA Document G703, is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

DATE	(Column G on G703)
5. RETAINAGE:

Date:

"

I. ORIGINAL CONTRACT SUM	$	906,517.45		
2. Net change by Change Orders	$	253,426.65	CONTRACTOR:	
3. CONTRACT SUM TO DATE (Line 1 ± 2)	$ 	1,159,944.10 		
4. TOTAL COMPLETED & STORED TO	$	1,047,244.10		

"\A....-::2_ Jv.1 ):::	m;\ Y  Notary Public

0 % of Completed Work	$

SBtya,te of:	•I	-,	

Sta<e of Flo"·••

(Column D +Eon G703)
	0 % of Stored Material	$		 (Column Fon G703)
Total Retainage (Lines 5a + 5b or

Subscribed and sworn t51l:le:t'6re me this Notary Public:	_,/ 1

My Commission e;qiires:

o	.,_	$g Comm# HH169929
.•.,,"""tee ,9"•'b	Expires 8/26/2025

Total in Column I of G703)

$	0.00

ARCHITECT'S CERTIFICATE FOR PAYMENT

TOTAL EARNED LESS RETAINAGE
(Line 4 Less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificate)	$	1,047,244.10

$	942,519.69	In accordance with the Contract Documents, based on on-site observations and the data comprising the application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated,
the quality of the Work is in accordance with the Contract Documents, and the Contractor	
8. CURRENTPAYMENTDUE	$	104,724.41	is entitled to payment of the AMOUNT CERTIFIED.	
9. BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6)	$ 	112,700.00 	
AMOUNT CERTIFIED ........... $	104,724.41	

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	(Attach explanation if amount certified differs from the amount applied. Initial all figures on this
Application and onthe Continuation Sheet that are changed to conform with the amount certified.)
ARCHITECT:
By:	Date:
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herem. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.	
Total changes approved
in previous months by Owner	$0.00	
$0.00		
Total approved this Month	$0.00	$0.00		
TOTALS	$0.00	$0.00		
NET CHANGES by Change Order	$0.00		
AJA DOCUMENT G702 • APPLICATION AND CERTIFICATION FOR PAYMENT· 1992 EDITION· AJA • ©1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 2000&-5292
Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

330

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 8
APPLICATIO ON DATE: 8/31/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 7/1/23 - 8/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
													
	General												
31245	Survey, Layout, & As-Builts	1	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	51,500.00	100%	$0.00	$0.00	
	Subtotal			$51,500.00	$51,500.00	-	$0.00	$0.00	$51,500.00	100%	$0.00	$0.00	
	Water												
31020	Water Main - 8" C-900	297	$	88.25	$26,210.25	26,210.25		$0.00	$0.00	26,210.25	100%	$0.00	$0.00	
31020	Water Pressure Test	1	$	2,060.00	$2,060.00	2,060.00		$0.00	$0.00	2,060.00	100%	$0.00	$0.00	
31020	Water Main Sample Points	4	$	860.00	$3,440.00	3,440.00		$0.00	$0.00	3,440.00	100%	$0.00	$0.00	
31020	Water Main Fill & Flush	2	$	8,850.00	$17,700.00	17,700.00		$0.00	$0.00	17,700.00	100%	$0.00	$0.00	
31020	Water Fittings	10	$	840.00	$8,400.00	8,400.00		$0.00	$0.00	8,400.00	100%	$0.00	$0.00	
31020	Water Main 8" Gate Valve w/Box	2	$	2,330.00	$4,660.00	4,660.00		$0.00	$0.00	4,660.00	100%	$0.00	$0.00	
31020	Water Main 2" Blowoff Temporary for Testing	2	$	2,000.00	$4,000.00	4,000.00		$0.00	$0.00	4,000.00	100%	$0.00	$0.00	
31020	Adjust Valve Box	1	$	555.00	$555.00	555.00		$0.00	$0.00	555.00	100%	$0.00	$0.00	
31020	Water Main 16 x 8 Tapping Sleeve & Valve	2	$	12,545.00	$25,090.00	25,090.00		$0.00	$0.00	25,090.00	100%	$0.00	$0.00	
31020	2" Blowoff - Temprary for Testing	1	$	2,200.00	$2,200.00	2,200.00		$0.00	$0.00	2,200.00	100%	$0.00	$0.00	
	Subtotal			$94,315.25	94,315.25	-	$0.00	$0.00	94,315.25	100%	$0.00	$0.00	
	Force Main			$0.00									
31620	Force Main - 8" C-900	26	$	100.00	$2,600.00	2,600.00		$0.00	$0.00	2,600.00	100%	$0.00	$0.00	
31620	Force Main - 16" C-900	1,564	$	175.00	$273,700.00	161,000.00		$0.00	$0.00	161,000.00	59%	$112,700.00	$0.00	
31620	Force Main - Pressure Test	1,590	$	3.10	$4,929.00	4,929.00		$0.00	$0.00	4,929.00	100%	$0.00	$0.00	
31620	Connect to Existing FM	1	$	6,460.00	$6,460.00	6,460.00		$0.00	$0.00	6,460.00	100%	$0.00	$0.00	
31620	Force Main Fittings	14	$	3,915.00	$54,810.00	54,810.00		$0.00	$0.00	54,810.00	100%	$0.00	$0.00	
31620	Force Main 16" Gate Valve w/Box	2	$	12,375.00	$24,750.00	24,750.00		$0.00	$0.00	24,750.00	100%	$0.00	$0.00	
31620	Force Main ARV Assembly	2	$	15,980.00	$31,960.00	31,960.00		$0.00	$0.00	31,960.00	100%	$0.00	$0.00	
					-	-							
	Subtotal			$399,209.00	286,509.00		$0.00	$0.00	286,509.00	72%	$112,700.00	$0.00	
	Drainage												
31015	18" RCP	189	$	67.45	$12,748.05	12,748		$0.00	$0.00	12,748.05	100%	$0.00	$0.00	
31015	24" RCP	819	$	89.35	$73,177.65	73,178		$0.00	$0.00	73,177.65	100%	$0.00	$0.00	
31015	30" RCP	108	$	120.00	$12,960.00	12,960		$0.00	$0.00	12,960.00	100%	$0.00	$0.00	
31015	Storm Sewer Inspection	1	$	19,110.00	$19,110.00	19,110		$0.00	$0.00	19,110.00	100%	$0.00	$0.00	
31015	Inlet - Type P-5	3	$	9,450.00	$28,350.00	28,350		$0.00	$0.00	28,350.00	100%	$0.00	$0.00	
31015	Inlet - Type J-5	2	$	17,415.00	$34,830.00	34,830		$0.00	$0.00	34,830.00	100%	$0.00	$0.00	
31015	Inlet Type P-6	6	$	9,840.00	$59,040.00	59,040		$0.00	$0.00	59,040.00	100%	$0.00	$0.00	
31015	Edge Drain	3,490	$	34.75	$121,277.50	121,278		$0.00	$0.00	121,277.50	100%	$0.00	$0.00	
				$0.00	-	-							
	Subtotal			$361,493.20	361,493.20		$0.00	$0.00	361,493.20	100%	$0.00	$0.00	
	Change Order 1												
CO1-31620	16" FORCE MAIN PVC C900	(675)	$175.00	($118,125.00)	(118,125.00)		$0.00	$0.00	($118,125.00)	100%	$0.00	$0.00	
CO1-31620	16" FORCE MAIN GATE VALVE	(2)	$12,375.00	($24,750.00)	(24,750.00)		$0.00	$0.00	($24,750.00)	100%	$0.00	$0.00	
CO1-31620	FORCE MAIN FITTINGS	(14)	$3,915.00	($54,810.00)	(54,810.00)		$0.00	$0.00	($54,810.00)	100%	$0.00	$0.00	
CO1-31620	8" FORCE MAIN PVC C900	1,564	$91.60	$143,262.40	143,262.40		$0.00	$0.00	$143,262.40	100%	$0.00	$0.00	
CO1-31620	8" FORCE MAIN GATE VALVE	2	$4,650.00	$9,300.00	9,300.00		$0.00	$0.00	$9,300.00	100%	$0.00	$0.00	
CO1-31620	FORCE MAIN FITTINGS	14	$2,050.00	$28,700.00	28,700.00		$0.00	$0.00	$28,700.00	100%	$0.00	$0.00	
CO1-31015	CRITTER CROSSING	167	$400.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$0.00	

CONTINUATION SHEET	AIA DOCUMENT G703	
PAGE TWO OF TWO PAGES	
AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.		APPLICATION NO: 8
APPLICATIO ON DATE: 8/31/23	
In tabulations below, amounts are stated to the nearest dollar.		PERIOD TO: 7/1/23 - 8/31/23	
Use Column I on Contracts where variable retainage for line items may apply.		PROJECT NO: 64228384	
		CLIENT REF: Paar Road - Pipeline Utilities	

A	B				D		E	F	G	H	I	
COST
CODE	DESCRIPTION OF WORK	Quantity	PRICE	SCHEDULED
VALUE	WORK COMPLETED	MATERIALS
PRESENTLY STORED (NOT IN
D OR E)	TOTAL
COMPLETED AND STORED TO DATE (D+E+F)	%
(G ÷ C)	BALANCE
TO FINISH (C - G)	RETAINAGE
(IF VARIABLE RATE)
10%	
					FROM PREVIOUS
APPLICATION (D + E)	QTY THIS PERIOD	THIS PERIOD						
	Subtotal			$50,377.40	50,377.40		$0.00	$0.00	50,377.40	100%	$0.00	$0.00	
	Change Order 2												
C02-31620	CONDUIT - F&I open trench 2" PVC	3,200	$52.75	$168,800.00	168,800.00		$0.00	$0.00	$168,800.00	100%	$0.00	$0.00	
	Subtotal			$168,800.00	168,800.00	-	-	-	168,800.00	100%	$0.00	-	
	Change Order 3												
CO3-34010	2" CONDUIT INSTALLATION	1,120	$13.75	$15,400.00	15,400.00		$0.00	$0.00	$15,400.00	100%	$0.00	$0.00	
CO3-34010	4" CONDUIT INSTALLATION	65	$32.05	$2,083.25	2,083.25		$0.00	$0.00	$2,083.25	100%	$0.00	$0.00	
CO3-34010	6" CONDUIT INSTALLATION	230	$40.20	$9,246.00	9,246.00		$0.00	$0.00	$9,246.00	100%	$0.00	$0.00	
CO3-31245	Survey, Layout, & As-Builts	1	$2,600.00	$2,600.00	2,600.00		$0.00	$0.00	$2,600.00	100%	$0.00	$0.00	
	Subtotal			$29,329.25	29,329.25	-	$0.00	$0.00	$29,329.25	100%	$0.00	$0.00	
	Change Order 4												
CO4-31015	Raise Existing Drainage Tops	2	$2,460.00	$4,920.00	4,920.00		$0.00	$0.00	$4,920.00	100%	$0.00	$0.00	
	Subtotal			$4,920.00	4,920.00	-	-	-	4,920.00	100%	$0.00	-	
									-				
	SUMMARY BY COST CODE												
	31245	General	$51,500.00	$51,500.00	51,500.00		$0.00	$0.00	$51,500.00	100%	$0.00	$0.00	
	31020	Water	$94,315.25	$94,315.25	94,315.25		$0.00	$0.00	$94,315.25	100%	$0.00	$0.00	
	31620	Force Main	$399,209.00	$399,209.00	286,509.00		$0.00	$0.00	$286,509.00	72%	$112,700.00	$0.00	
	31015	Drainage	$361,493.20	$361,493.20	361,493.20		$0.00	$0.00	$361,493.20	100%	$0.00	$0.00	
	CO1-31620		($16,422.60)	($16,422.60)	(16,422.60)		$0.00	$0.00	($16,422.60)	100%	$0.00	$0.00	
	CO1-31015		$66,800.00	$66,800.00	66,800.00		$0.00	$0.00	$66,800.00	100%	$0.00	$0.00	
	CO2-31620	Fiber Optic	$168,800.00	$168,800.00	168,800.00		-	-	168,800.00	100%	$0.00	16,880.00	
	CO3-34010	Conduit	$26,729.25	$26,729.25	26,729.25		$0.00	$0.00	$26,729.25	100%	$0.00	2,672.93	
	CO3-31245	General	$2,600.00	$2,600.00			$0.00	$0.00	$2,600.00	100%	$0.00	$260.00	
	CO4-31010	Drainage	$4,920.00	$4,920.00	4,920.00		$0.00	$0.00	4,920.00	100%	$0.00	$492.00	
	GRAND TOTALS			$1,159,944.10	1,044,644.10		$0.00	$0.00	$1,047,244.10	90%	$112,700.00	$20,304.93	
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF 2 PAGES

TO OWNER:
Mattany Palm Beach, LLC

PROJECT:	PRM
Tradition COD SG PAAR ROAD

APPLICATION#: PERIOD TO:

1
05/05/23

Distribution to:

2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426
FROM CONTRACTOR:
Richard and Rice Construction
1219 W Newport Center Dr. Deerfield Beach, FL 33442

8950 SW PAAR DR
Port Saint Lucie, FL 34987
PROPOSAL#
1119652

8838-1
Tyler

PROJECT NOS: CONTRACT DATE:

04/18/23

Owner
Const. Mgr Architect Contractor

 CONTRACT FOR:	PARR ROAD	

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment. as shown below, in connection with the Contract. Continuation Sheet is attached.

ORIGINAL CONTRACT SUM------	$	288,582.00
Net change by Change Orders	$

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner. and that current payment shown therein is now due.

CONTRACT SUM TO DATE (Line 1 +/- 2)	$1	2-88-,S-8-2-.0--10
TOTAL COMPLETED & STORED TO DATE-$	22,018.70

By:
&o 

Date: <,,�.���--,o,1,,,,.

=

l Ti	,-I..,	--	/ MIS.S/o'•	'-:.

(Column G on Continuation Sheet)

sl

RETAINAGE:
	10.0% of Completed Work		2,201.871 (Columns D+E on Continuation Sheet)			

State of:		 t 10/i	f ,-·cPNuMBER lj,\ -=:_

:-'g

County of:	_	:: If-:	HH 109652	: •

.	: z·	EXPIRES,. m -

X..

/ f

Subs nbed and sworn to bef		.	--.,March2B,2025

meth1s	dayof	_,')O		-:. ·-,

  	ofStored Material	sl	I

£.---"	

,.... ;".-:'..••r,n,l_1lJ,	•• - '< ,._,

(Column F on Continuation Sheet)
Total Retainage (Line Sa+ Sb or

(Line4 less Line5 Total)

Notary Public:	<::::\	,,,,,,Au/'/•c••5•\•3·\,b. ,,,''

Total in Column 1 of Continuation Sheet--	$1	2,201.871	CERTIFICATE FOR PAYMENT	
6. TOTAL EARNED LESS RETAINAGE·---	$	19,816.83	In a  ance with Contract  uments. based on on-site observations and the data comprising	

My Commission expires:{	µ11n�	,,,,,, 11,,,,,,,

7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ,-----------	and behef the Work has progressed as indicated, the quality of the Work is in accordance with the

I	I  apphca 1on, the Architect certifies to the OWner that to the best or the Arehttect's knOWledge, information

(Line 6 from prior Certificatei-----
CURRENT PAYMENT DUE------

$	Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

$_	19,816.83.  MJ

---,----------

BALANCE TO FINISH, INCLUDING RETAINAGE		
(Line 3 less Line 6)	$	268,765.17

AMOUNT CERTIFIED	$
(AItach explanation if amount certified differs from the amount applied for. Initial all figures on this application and on the Continuation Sheet that are changed to conform to the amount certified.)

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous months by Owner			
Total aooroved this Month			
TOTALS			
NET CHANGES bv ChanQe Order		

By:	Date: 	
This Certificate is not negoUable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance or payment are without prejudice to any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET	Page2of	2 Pa es

ATTACHMENT TO PAY APPLICATION
PROJECT:
Tradition CDD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie, FL 34987

APPLICATION NUMBER:	1
APPLICATION DATE:	05/05/23
PERIOD TO:	5-May-23
Project CODE:

A	B	C	D	E	F	G	H	I	
Item No.	Description of Work	Scheduled Value	Work Completed	Materials Presently Stored (Not In
DorE)	Total Completed And Stored To Date
(D + E + F)	%
(G/C)	Balance To Finish (C-G)	Retainage	
			From Previous Application (D+ E)	This Period						
1	Flatwork - 4,070sf Poured - L&M	288,582.00		22,018.70		22,018.70	8%	266,563.30	2,201.87	
2										
3										
4										
5										
6										
7										
8										
9										
10										
11										
12										
13										
14										
15										
16										
17										
18										
19										
20										
21										
22										
23										
24										
25										
26										
27										
28										
	SUBTOTALS PAGE 2	288,582.00		22,018.70		22,018.70	8%	266,563.30	2,201.87	

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF  2 PAGES

TO OWNER:
Mattany Palm Beach, LLC
2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426
FROM CONTRACTOR:

PROJECT:	PRM
Tradition COD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie, FL 34987
PROPOSAL#

APPLICATION#: 2
PERIOD TO:	05/12/22
PROJECT NOS:

CONTRACT DATE:	04/18/23

Distribution to:

Owner Const. Mgr Architect

Richard and Rice Construction 1219 W Newport Center Dr.
Deerfield Beach, FL 33442
CONTRACT FOR:	PARR ROAD

1119652

8838-2
Tyler

Contractor

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

ORIGINAL CONTRACT SUM-----	$1--	2_8_8,,_5_82_._00--1
Net change by Change Orders-------	$
1	1
CONTRACT SUM TO DATE (Line 1 +/- 2)	$	288,582.00
TOTAL COMPLETED & STORED TO DATE-$	S6, 750.90 
(Column G on Continuation Sheet)
RETAINAGE:
10.0% of Completed Work	$I	5,67S.o9I
(Columns D+E on Continuation Sheet)	-------
			of Stored Material	$.	.... (Column F on Continuation Sheet)
Total Retainage (Line Sa+ Sb or
Total in Column 1 of Continuation Sheet--
TOTAL EARNED LESS RETAINAGE---

The undersigned Contractor certlfies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due.
CONTRACTOR: Richard and Rice Construction Co. Inc

By:

tate of: County of:

(Line 6 from prior Certificate)-----
8. CURRENT PAYMENT DUE------
9B.ALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6)	$ -----23-7,'S-06-.1-9 ----

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous
months by Owner			
Total aooroved this Month			
TOTALS			
NET CHANGES by Change Order		

By:	-------------------	Date:------
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET	Page 2 of	2	Pages

ATTACHMENT TO PAY APPLICATION
PROJECT:
Tradition COD SG PAAR ROAD 8950 SW PAAR DR

A	B	C	D	E	F	G	H	I	
Item No.	Description of Work	Scheduled Value	Work Completed	Materials Presently Stored (Not In
D orE)	Total Completed And Stored To Date
(D+ E +F)	%
(G/C)	Balance To Finish (C-G)	Retainage	
			From Previous Application (D+E)	This Period						
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28	Flatwork - 4,070sf Poured - L&M Flatwork - 6,420sf Poured - L&M	288,582.00		22,018.70
34,732.20		22,018.70
34,732.20	8%	266,563.30
(34,732.20}	2,201.87
3,473.22	
	SUBTOTALS PAGE 2	288,582.00		56,750.90		56,750.90	20%	231,831.10	5,675.09	

Port Saint Lucie, FL 34987

APPLICATION NUMBER: 2 APPLICATION DATE:	S-/t812023-
PERIOD TO:	51f272023
Project CODE:

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF 2 PAGES

TO OWNER:
Mattany Palm Beach, LLC

PROJECT:	PRM
Tradition CDD SG PAAR ROAD

APPLICATION#: PERIOD TO:

Distribution to:

06/09/23

2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426
FROM CONTRACTOR:
Richard and Rice Construction 1219 W Newport Center Dr.
Deerfield Beach, FL 33442
CONTRACT FOR:	PARR ROAD

8950 SW PAAR DR
Port Saint Lucie, FL 34987
PROPOSAL#
1119652

8838-3
Tyler

PROJECT NOS: CONTRACT DATE:

PRM

04/18/23

Owner Const. Mgr Architect Contractor

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

ORIGINAL CONTRACT SUM---	$	288,582.00
1	1
Net change by Change Orders-----	$,	,
CONTRACT SUM TO DATE (Line 1 +/- 2)	$	288,582.00 V
TOTAL COMPLETED & STORED TO DATE-$	66,813.50 

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due.

(Column G on Continuation Sheet)
RETAINAGE:

S

By:

,,,,,,,,,,,,,,,,,

C  tyof f: Broward

,,,':11.. , -�-���
..,.'

100'',,,

	10.0% of Completed Work	$I.	6"'"'",6_8_1_.3 .SI (Columns D+E on Continuation Sheet)				

\it1i1ss, --	......

:: :	=

Subscribed aA, sworn to bef		{	:·oO NUMBER ,i.,-.._
me this	l	 day of 		202--3	...,	HH 109652	•.•

....,.,,..-,---of Stored Material	$I.... ------

\	=  z:	EXPIRES ;:{g

.	:. 0 :	Maftl\ 2.8,2025	: -.:: ::

(Column F on Continuation Sheet) Total Retainage (Line Sa+ 5b or
Total in Column 1 of Continuation Sheet------
TOTAL EARNED LESS RETAINAGE---

Notary Public:	,,.......-	-:.	-  "'	:s
MyCommissione 	\:l-·:	/�./
$$1--1-----6_,6_8_1_.3--151	CERTIFICATE FOR PAYMENT	',,,,	//c"5ta'li j•'
_	60,132.15	In a=rdance with Contract Documents, based on on-site observations and the' <ff.H lA'1!1n g

(Line4 less Line5 Total)	application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information

7

. LESS PREVIOUS CERTIFICATES FOR PAYMENT		andbelief the Work has progressed as indicated, thequality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Line 6 from prior Certificate)-----
CURRENT PAYMENT DUE------
BALANCE TO FINISH, INCLUDING RETAINAGE

$$1	51,075.811

MS

--_----9 ,o-ss-.3-4_
AMOUNT CERTIFIED	$	_

(Line 3 less Line 6)	$ ----228,-44-9.8-5 ---

(Attach explanation if amount certified differs from the amount applied for. Initial all figures on this application and on the Continuation Sheet that are changed to conform to the amount certified.)

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous
months by Owner			
Total approved this Month			
TOTALS			
NET CHANGES by Change Order		

By:	------------------- Date: -------
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice lo any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET

Page 2 of	2

Pages

ATTACHMENT TO PAY APPLICATION	APPLICATION NUMBER:	3

PROJECT:
Tradition CDD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie, FL 34987

APPLICATION DATE:
PERIOD TO:
Project CODE:

06/09/23
9-Jun-23 PRM

A	B	C	D	E	F	G	H	I	
Item No.	Description of Work	Scheduled Value	Work Completed	Materials Presently Stored (Not In
D or E)	Total Completed And Stored To Date
(D + E + F)	% (G/C)	Balance To Finish (C - G)	Retainage	
			From Previous Application
(D + E)	This Period						
1	Flatwork - 4,070sf Poured - L&M - (1-2)	288,582.00	22,018.70			22,018.70	8%	266,563.30	2,201.87	
2	Flatwork - 6,420sf Poured - L&M - (3-4)		34,732.20			34,732.20		(34,732.20)	3,473.22	
3	Flatwork - 1,860sf Poured - L&M - (5)			10,062.60		10,062.60		(10,062.60)	1,006.26	
4										
5										
6										
7										
8										
9										
10										
11										
12										
13										
14										
15										
16										
17										
18										
19										
20										
21										
22										
23										
24										
25										
26										
27										
28										
	SUBTOTALS PAGE 2	288,582.00	56,750.90	10,062.60		66,813.50	23%	221,768.50	6,681.35	

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF 2. PAGES

TO OWNER:
Mattamy Palm Beach, LLC
2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426

PROJECT:	PRM
Tradition COD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie, FL 34987

APPLICATION #: PERIOD TO: PROJECT NOS:

4
08/22/23
PRM

Distribution to:

Owner Const. Mgr

FROM CONTRACTOR:
Richard and Rice Construction 1219 W Newport Center Or.
Deerfield Beach, FL 33442
CONTRACT FOR:	PARR ROAD

PROPOSAL#
1119652

8838-4 Revised Tyler

CONTRACT DATE:

04/18/23

Architect Contractor

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract Continuation Sheet is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due

ORIGINAL CONTRACT SUM----------------------	$ t-- 	2_8_8..c,,_58_2_._0--i0	CONTRACTOR:  Richard and Rice Construction Co. Inc
Net change by Change Orders------------------	$	-21,893.00			j 	, 	
CONTRACT SUM TO DATE (Line 1 +/-2)	$:==========2=6=6=,6=89=·=oo:
TOTAL COMPLETED & STORED TO DATE-$	144,237.28 
(Column G on Continuation Sheet)
RETAINAGE:
10.0% of Completed Work	$ 1	1_4, 4_23_._73 1
(Columns D+E on Continuation Sheet)		
			of Stored Material	$	------ (Column F on Continuation Sheet)
Total Retainage (Line Sa+ Sb or

Total in Column 1 of Continuation Sheet-------
TOTAL EARNED LESS RETAINAGE-----------
(line 4 less Line 5 Total)

 $-$	4_,4_2_3_.7_3  I
.	129,813.55

In accordance with Contract Documents, based on on-site observations and the data comprising application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information

LESS PREVIOUS CERTIFICATES FOR PAYMENT

and belief the Work has progressed as indicated, the quality of the Work is in accordance with the
Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(line 6 from prior Certificate)------------------
CURRENT PAYMENT DUE--------·-··········--···
BALANCE TO FINISH, INCLUDING RETAINAGE

$$1	,-13-2-,1--,5I
.	69,681.40.	
MS

AMOUNT CERTIFIED -------------·-·············-----$------------

(Line 3 less Line 6)	$ 	13_6..c,,8_7_5_.4 5	_

(Attach explanation if amount certified differs from /he amount applied for. Initial alt figures on this appfication and on the Continuation Sheet that are changed to conform to the amount certified.)

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous
months by Owner		
-$21,893.00	
Total approved this Month			
TOTALS		-$21,893.00	
NET CHANGES by Change Order	-$21,893.00	

By:		 Date: 	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner of Contractor under this Contract.

By:-  t/k'l.rV-:	 C(/-----.. (t=t't1

Date:

CERTIFICATE FOR PAYMENT

,,,,,,111111\'

CONTINUATION SHEET	Page 2 of	2	Pages

ATTACHMENT TO PAY APPLICATION
PROJECT:
Tradition COD SG PAAR ROAD
8950 SW PAAR DR

A	B				D	E	F	G	H	I	
Item
No.	Description of Work	QUANTITY (SQF)	PRICE	Scheduled Value	Work Completed	Materlals Presently Stored (Not In
DorEJ	Total Completed And Stored To Date
(D+ E+ Fl	%
(G/CJ	Balance To Finish (C ·GI	Retalnage	
					From Previous Application (D+EJ	This Period						
1	4" Flatwork 3000PSI	4070	$	5.41
$	5.41
$	5.41
$	5.41

$	5.41
$	6.12
$	12.50
$	285.00	$  22,018.70
$  34,732.20
$  10,062.60
$  99,316.78
$ (21,893.00)
$  96,563.09
$  12,515.40
$	3,112.50
$  10,260.00	$	22,018.70
$	34,732.20
$	10,062.60			$	22,018.70
$	34,732.20
$	10,062.60
$	99,316.78
$  (21,893.00)
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	.
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	100%
100%
100%
100%	$	.
$	.
$	.
$	.
$	.
$	96,563.09
$	12,515.40
$	3,112.50
$	10,260.00
$	.
$	.
$	.
$	.
$	.
s	.
$	.
$	.
$	-
$	.-
$
$	-
$	-
$	-
$	-
$	-
$	-
$	-	2,201.87	
	4" Flatwork 3000PSI											
2		6420									3,473.22	
	4" Flatwork 3000PSI											
3		1860									1,006.26	
												
4	4" Flatwork 3000PSI	18358				$	99,316.78					9,931.68	
6	CHANGE ORDER #1 • Prop# 1119778					$  (21,893.00)					(2,189.30)	
7	4" Flatwork 3000PSI	17849										
8	6" Flatwork 3000PSI	2045										
9	Flatwork Curb • 249 LF	249										
10	Trucated Domes	36										
11												
12												
13												
14												
15												
16												
17												
18												
19												
20												
21												
22												
23												
24												
25												
26												
27												
28												
	SUBTOTALS PAGE 2	50,887.00		$ 266,688.27	$	66,813.50	$	77,423.78		$ 144,237.28	54%	$ 122,450.99	14,423.73	

Port Saint Lucie, FL 34987

APPLICATION NUMBER:	4
APPLICATION DATE:	8122/2023
PERIOD TO:	8122/2023
Project CODE:	PRM

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF  2 PAGES

TO OWNER:
Mattamy Palm Beach, LLC
2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426
FROM CONTRACTOR:
Richard and Rice Construction 1219 W Newport Center Dr.

PROJECT:	PRM
Tradition COD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie, FL 34987
PROPOSAL#
1119652

8838-5
Frank

APPLICATION#: PERIOD TO: PROJECT NOS:

CONTRACT DATE:

5
09/13/23
PRM

04/18/23

Distribution to:

Owner Const. Mgr Architect Contractor

Deerfield Beach, FL 33442
CONTRACT FOR:	PARR ROAD

**This Pay App does not include JDE CO #3 for $28,937.00

CONTRACTOR'S APPLICATION FOR PAYMENT
Application 1s made for payment, as shown below, in connection with the Contract Continuation Sheet is attached

ORIGINAL CONTRACT SUM-------------------	$.	2_8_8"-,5_8_2._0_,0
Net change by Change Orders------------------	$,	-_1_5	,6_8_9_.0_,0
CONTRACT SUM TO DATE (Line 1 +/- 2)	$	272,893.00

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Cert1f1cates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due.

TOTAL COMPLETED & STORED TO DATE-$
(Column G on Continuation Sheet)
RETAINAGE:

	193,462.78 

\\I  I II It I/I
,,,,'' - - ! i''',,,.,

County of: Broward	,,' :-;..v,,ss10A·,·.	"-:.
'	• 0'11!'.	El'- ·v  •	'

	10.0% of Completed Work	sl.	1_9,'-3_46,;_;.._29_,I (Columns D+E on Continuation Sheet)				
		of Stored Material	$,	. (Column F on Continuation Sheet)
Total Retainage (Line 5a + 5b or

Subscribed '1nd sworn to before	,..,,,	2 .-·CJ \l 'L	\
me this	d yof	o1l.Q..e/: d	:	"- \ Ei i::g

·\%·,	--"t-/

£/'	:: -z.:	-	--s=
Notary Pu li :	..	::::...--c	--
My Comm1ss1on expires:28125	",,. t>.·•. ·,j,½0,,,'
1

Total in Column 1 of Continuation Sheet---···--

$1_.	1_9,_3_4_6._2--191	CERTIFICATE FOR PAYMENT

',	1,111;,,,,"

TOTAL EARNED LESS RETAINAGE-----------	.$

174,116.49	In accordance with Contract Documents, based on on-site observations and the data comprising

(Line4 less Line5 Total)	application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information

M

S

LESS PREVIOUS CERTIFICATES FOR PAYMENT	and beliefthe Work has progressed as indicated, thequality of the Work is 1n accordance with the Contract Documents, and the Contractor 1s entitled to payment of the AMOUNT CERTIFIED.

(Line 6 from prior Certificate)--------------
CURRENT PAYMENT DUE-------·-···-··--·--·---·

$$1	129,813.551

1--.	44 :..,3;.._o3-.o;,.;;.J3

BALANCE TO FINISH, INCLUDING RETAINAGE
(Line 3 less Line 6)	$ 	9_8.:....,7_7_6_.5_1_

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous months by Owner	
$6,204.00	
-$21,893.00	
Total approved this Month			
TOTALS	$6,204.00	-$21,893.00	
NET CHANGES by Change Order	-$15,689.00	

AMOUNT CERTIFIED ---------·--·	$	 _
(Attach explanation if amount certified differs from the amount applied for /n,t,al all figures on this application and on the Continuation Sheet that are changed to conform to the amountcertified.)

By:		 Date: -------
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein Issuance. payment and acceptance of payment are without pre1udice to any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET	Page 2 of	2	Pages

ATTACHMENT TO PAY APPLICATION
PROJECT:

.

Tradition COD SG PAAR ROAD 8950 SW PAAR DR
Port Saint Lucie FL 34987

APPLICATION NUMBER: APPLICATION DATE:
PERIOD TO:
Projecl CODE:

5
9/13/2023
9/13/2023
PRM

A	B				D	E	F	G	H	I	
Item
No.	Description of Work	QUANTITY (SQF)	PRICE	Scheduled Value	Work Comoleted	Materials Presently Stored (Not In
Dor El	Total Completed And Stored To Date
ID+ E+ Fl	%
(G/C)	Balance To Finish (C-G)	Retalnage	
					From Previous
Application
(D+E)	This Period						
	4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
CHANGE ORDER #1 - Prop# 1119778
4" Flatwork 3000PSI
CHANGE ORDER #2 - Prop# 304905 (Pump
4" Flatwork 3000PSI
6" Flatwork 3000PSI Flatwork Curb - 249 LF Trucated Domes	4070
6420
1860
18358
1
9099
1
8750
2045
249
36	$	5.41
$	5.41
$	5.41
$	5.41
$	1.00
$	5.41
$	6,204.00
$	5.41
$	6.12
$	12.50
$	285.00	$  22,016.70
$  34,732.20
$  10,062.60
$  99,316.78
$ (21,893.00)
$  49,225.59
$	6,204.00
$  47,337.50
$  12,515.40
$	3,112.50
$  10,260.00	$	22,016.70
$	34,732.20
$	10,062.60
$	99,316.78
$  (21,893.00)	

$	49,225.59		$	22,016.70
$	34,732.20
$	10.062.60
$	99,316.76
$  (21,893.00)
$	49,225.50
$	-
$	-
$	-
$	-
$	-
$	.
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	100%
100%
100%
100%
100%
100%	$	-
$	-
$	-
$	-
$	-
$	-
$	6,204.00
$	47,337.50
$	12,515.40
$	3,112.50
$	10,260.00
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	2,201.67
3,473.22
1,006.26
9,931.68
(2,189.30)
4,922.56	
	SUBTOTALS PAGE 2	50,869.00		$  272,892.27	$ 144,237.26	$	49,225.59		$ 193,462.78	71%	$	79,429.40	19,346.29	

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF 2 PAGES

TO OWNER:
Mattamy Palm Beach, LLC
2500 Quantum Lakes Dr., Suite 215 Boynton Beach, FL 33426
FROM CONTRACTOR:

PROJECT:	PRM
Tradition CDD SG PAAR ROAD
8950 SW PAAR DR
Port Saint Lucie, FL 34987
PROPOSAL#

APPLICATION #: PERIOD TO: PROJECT NOS:

CONTRACT DATE:

6
11/14/24
PRM

04/18/23

Distribution to:

Owner
Const. Mgr Architect

Richard and Rice Construction 1219 W Newport Center Dr.
Deerfield Beach, FL 33442

1119652

8838-6
Frank

Contractor

 CONTRACT FOR:	PARR ROAD	

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

ORIGINAL CONTRACT SUM---------------------	$1--	2_8_8:_,5_82_._oo-l
Net change by Change Orders-----------------	$	13,248.00
CONTRACT SUM TO DATE (Line1 +/- 2)	$1	3-0_1.,.8.._30 00-l	
TOTAL COMPLETED & STORED TO DATE-$	301,830.00 
(Column G on Continuation Sheet)
RETAINAGE:
	10.0% of Completed Work	$._I 	3-'0,'--1_83_.o_o_.l (Columns D+E on Continuation Sheet)				
	-,--_of Stored Material	$I....	. (Column F on Continuation Sheet)
Total Retainage (Line 5a + 5b or		

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown therein is now due.

Total in Column 1 of Continuation Sheet--------
TOTAL EARNED LESS RETAINAGE-----------
(Line 4 less Line 5 Total)

$1--	3_0;_1,_83_._oo-l

$.	2_1_1'-,6_47_._oo-'

LESS PREVIOUS CERTIFICATES FOR PAYMENT

(Line 6 from prior Certificate)---------

$===========1=7=4=,1=16=-=58=

CURRENT PAYMENT DUE	--·
BALANCE TO FINISH, INCLUDING RETAINAGE

$		91_.

,s_Jo_.4M.2

S
AMOUNT CERTIFIED -----

-----,	$	 _

(Line 3 less Line 6)	$	3_0-'-1,_8_3_.0_0

_	(Attach explanation if amount certified differs from the amount applied for. Initial all figures on this application and on the Continuation Sheet that are changed to conform to the amount certified.)

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous months by Owner	
$35,141.00	
-$21,893.00	
Total approved this Month			
TOTALS	$35,141.00	-$21,893.00	
NET CHANGES by Change Order	$13,248.00	

By:		 Date: -------
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET	Page 2 of	2	Pages

ATTACHMENT TO PAY APPLICATION
PROJECT:
Tradition COD SG PAAR ROAD

..

8950 SW PAAR DR
Port Saint Lucie FL 34987

APPLICATION NUMBER: APPLICATION DATE:
PERIOD TO:
Projoc:ICOOE:

6
911312023
9/1312023
PRM

A	B				D	E	F	G		H	I	
Item
No.	Description of Work	QUANTITY (SQF)	PRICE	Scheduled Value	Work ComDleted	Materials
Presently Stored (Not In
DorE>	Total
Completed And Stored To Date
(D+E+F)	%
(GIC)	Balance To Finish (C-G)	Retalnage	
					From Previous
Application
(D+E)	This Period						
	4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
CHANGE ORDER #1 • Prop# 1119778
4" Flatwork 3000PSI
CHANGE ORDER #2 - Prop# 304905 (Pump CHANGE ORDER #3 - Prop# 1119909 (6")
4" Flatwork 3000PSI
6" Flatwork 3000PSI Flatwork Curb • 249 LF Trucated Domes	4070
6420
1860
18358
1
9099
1
1
8750
2045
249
36	$	5.41
$	5.41
$	5.41
$	5.41
$	1.00
$	5.41
$	6,204.00
$	28,937.00
$	5.41
$	6.12
$	12.50
$	285.00	$  22,018.70
$  34,732.20
$  10,062.60
$  99,316.78
$ (21,893.00)
$  49,225.59
$	6,204.00
$  28,937.00
$  47,337.50
$  12,515.40
$	3,112.23
$  10,261.00	$	22,018.70
$	34,732.20
$	10,062.60
$	99,316.78
$  (21,893.00)
$	49,225.59	

$	6,204.00
$	28,937.00
$	47,337.50
$	12,515.40
$	3,112.23
$	10,261.00		$	22,018.70
$	34,732.20
$	10,062.60
$	99,316.78
$  (21,893.00)
$	49,225.59
$	6,204.00
$	28,937.00
$	47,337.50
$	12,515.40
$	3,112.23
$	10,261.00
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	.-
$	100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%
100%	$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	.-
$	.
$
$	.-
$
$	-	2,201.87
3,473.22
1,006.26
9,931.68
(2,189.30)
4,922.56
620.40
2,893.70
4,733.75
1,251.54
311.22
1,026.10	
	SUBTOTALS PAGE 2	50,890.00		$ 301,830.00	$ 193,462.87	$ 108,367.13		$ 301,830.00	100%	$	-	30,183.00	

APPLICATION AND CERTIFICATE FOR PAYMENT	PAGE ONE OF  2 PAGES

TO OWNER:
Mattamy Palm Beach, LLC
2500 Quantum Lakes Dr., Suite 215

PROJECT:	PRM
Tradition COO SG PAAR ROAD 8950 SW PAAR OR

APPLICATION#: PERIOD TO: PROJECT NOS:

7
11/21/23
PRM

Distribution to:

Owner

Boynton Beach, FL 33426
FROM CONTRACTOR:
Richard and Rice Construction

Port Saint Lucie, FL 34987 PROPOSAL#
1119652

8838-7
Jonas

CONTRACT DATE:

04/18/23

Const. Mgr Architect
Contractor

1219 W Newport Center Dr.
Deerfield Beach, FL 33442
CONTRACT FOR:	PARR ROAD
CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

ORIGINAL CONTRACT  SUM--------------------	$ .	2_8-'8,'--5_82_._oo_,
Net change by Change Orders-----------------	$	'-1.;..3•:..;2_4.;..8. 0 0
CONTRACT SUM TO DATE (Line 1 +/- 2)	$	301,830.00
TOTAL COMPLETED & STORED TO DATE-$	301,830.00
(Column G on Continuation Sheet)
RETAINAGE:
	10.0% of Completed Work	$l.		3_0-'-,1_8_3._0 ,0I (Columns D+E on Continuation Sheet)					
	-,-_ of Stored Material	$.._ 	, (Column F on Continuation Sheet)
Total Retainage (Line 5a + 5b or
Total in Column 1 of Continuation Sheet-----	$	30,183.00
1------------'	I
TOTAL EARNED LESS RETAINAGE--------	$	271,647.00

RETAINAGE RELEASE

Subscribed and sworn to bei e me this	_6_	day of

Notary Public:
My Commission expires:	03
CERTIFICATE FOR PAYMENT

,,,,	C,	\,,

/;(IJ,t:h'\

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner. and that current payment shown therein is now due.

Inaccordance with Contract Documents, based on on-site observations and the data comprising

(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR PAYMENT

L---------'	'

application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated. the quality of the Work is in accordance with the
Contract Documents. and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Line6 from prior Certificate)-----	$-----2-7-1-,6-4	7_0_0
CURRENT PAYMENT DUE ----·	$===========3=0:,1=8=3=.o:oM0i
BALANCE TO FINISH, INCLUDING RETAINAGE	AMOUNT CERTIFIED--------.$	 _

(Line 3 less Line 6)	$ 		....:.3..:..0:....c1,..:..8.:...3.....:.0..:..0	_

(Attach explanation if amount certified differs from the amount applied for. Initial all figures on this application and on the Continuation Sheet that are changed to confonn to tile amount certified.)

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous months by Owner	
$35,141.00	
-$21,893.00	
Total approved this Month			
TOTALS	$35,141.00	-$21,893.00	
NET CHANGES by Chanoe Order	$13,248.00	

By:			Date: 	 _
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner of Contractor under this Contract.

CONTINUATION SHEET	Page 2 of	2	Pages

ATTACHMENT TO PAY APPLICATION
PROJECT:
Tradition CDD SG PAAR ROAD 8950 SW PAAR DR

A	B				D	I	E	F	G	H	I	
Item
No.	Description of Work	QUANTITY (SQF)	PRICE	Scheduled
Value	Work Comnleted	Materials Presently Stored (Notln DorE)	Total Completed And Stored To Data (D+E+F)	%
(G/C)	Balance To Finish (C-G)	Retalnage	
					From Previous
Appllc:atlon (D+E)	This Period						
	4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
4" Flatwork 3000PSI
CHANGE ORDER #1 - Prop# 1119778
4" Flatwork 3000PSI
CHANGE ORDER #2 - Prop# 304905 (Pump CHANGE ORDER #3 - Prop# 1119909 (6")
4" Flatwork 3000PSI
6" Flatwork 3000PSI Flatwork Curb - 249 LF Trucated Domes	4070
6420
1860
18358
1
9099
1
1
8750
2045
249
36	$	5.41
$	5.41
s	5.41
$	5.41
s	1.00
$	5.41
$	6,204.00
$	28,937.00
$	5.41
$	6.12
$	12.50
$	285.00	$  22,018.70
$  34,732.20
$  10,062.60
$  99,316.78
$ (21,893.00)
$  49,225.59
$	6,204.00
$  28,937.00
$  47,337.50
$  12,515.40
$	3,113.23
$  10,260.00	$	22,018.70
$	34,732.20
$  10,062.60
$	99,316.78
$  (21,893.00
$	49.225.59
$	6,204.00
$	28,937.00
$	47,337.50
$  12,515.40
$	3,113.23
$	10,260.00	

)		$	22,018.70
$	34,732.20
$	10,062.60
$	99,316.78
$  (21,893.00)
$	49.225.59
$	6,204.00
$	28.937.00
$	47,337.50
$  12,515.40
$	3,113.23
$	10,260.00
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	100%
100%
100%
100%
100%
100°.<.
100%
100%
100%
100%
100%
100%	$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	.-
$
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	2,201.87
3,473.22
1,006.26
9,931.68
(2,189.30)
4,922.56
620.40
2,893.70
4,733.75
1,251.54
311.32
1,026.00	
	SUBTOTALS PAGE 2	50,890.00		$ 301,830.00	$ 301,830.00	$	-		$ 301,830.00	100%	$	-	30,183.00	

Port Saint Lucie FL 34987

APPLICATION NUMBER: APPLICATION DATE:
PERIOD TO:
P,ojedCODE:

7
1112112023
1112112023
PRM

8959-1
Tyler

PAGE 10F 2 PAGES

FROM: COBRA CONSTRUCTION
151 NW 18th Ave Delray Beach, FL 33444

TEL: 561-276-3820
FAX:

CONTRACTOR: Mattamy Homes
2500 Quantum Lakes Dr. Ste 215 Boynton Beach, FL 34986

TEL: 561-914-8725 FAX:

PROJECT: PAAR DRIVE - ROUND ABOUT CONTRACT:

APPLICATION NO: 001 APPLICATION DATE: 07/19/23
PERIOD FROM: 7/1/23-7/31/23

APPLICATION FOR PAYMENT

Analysis of adjusted contract amount to date:

Original contract sum
Net change by change orders

$ 		$=5..;;;.i3,.,;;..;00:;.;:;3.9.,;;..;0 
$ 	$:,;...;;.0.0...:: 0

3. Adjusted contract amount		$	$53,003.90	
Analysis of work performed:

4. Cost of original contract work to date:		

$	$53,003.90	
5. Extra work performed to date:		$	$0.00	
6. Total cost of work performed to date:		$	$53,003.90	
7. Less Retainage: 10.0%		$	$5,300.39	
8. Net amount earned to date		$	$47,703.51	
9. Billed on previous estimates		$	$0.00	
10. Net amount payable this period	1	$	$41,103.s1MS	

The undersigned Contractor certifies that to the best of the Contractor's knowledge. information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents. that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein Is now due.

CONTRACTOR: COBRA CONSTRUCTION
fl	
,_c£o:;;.....:;	 Date: 7/l	/'Z.3
RON SPADA PRESIDENT
State of: Florida	County of: Palm Beach

My Commission expires: 	

LOR.ITHERESE GULOTTA MY COMMISSION# HH 318866
EXPIRES: November 14, 2023

347

-

r:-,r.-r

Cc ,(	,-J/�.
-·  -,  L--··LJL  : . =, -,
CONSTRUCTION,INC

Cobra Construction, Inc.
151 NW 18th Ave Delray Beach, FL 33444
TREVOR@COBRAPAVERS.COM

1•{ c·)·,)r <r-T·,_;,,/ \.
., ---  !_  - L-\.-  ,.,_, ...
CONSTRUCTION, IN(.
i--

JOB NAME:	PAAR DRIVE - ROUND ABOUT

FROM: COBRA CONSTRUCTION
151 NW 18th Ave Delray Beach, FL
ZIP: 33444
TEL: 561-276-3820 FAX:

TO: Mattamy Homes
2500 Quantum Lakes Dr. Ste 215 Boynton Beach, FL 34986

TEL: 561-914-8725
FAX:

APPLICATION NUMBER: 1 APPLICATION DATE: 7/19/2023
PERIOD FROM: 7/1/23-7/31/23 CONTRACT NUMBER:

ITEM	DESCRIPTION OF WORK	QUANTITY

CONTRACT

UNIT UNIT PRJCE

TOTAL AMOUNT

PREVIOUS

QUANTITIES

CURRENT

TOTAL

PREVIOUS

AMOUNT$

PERIOD

TO DATE

%COMP TO DATE

6" STAMPED CONCRETE

2,518	SF

$21.05

$53,003.90

2518.00

2518.00

$0.00

$53,003.90

$53,003.90

100.0%

TOTALS:

$53,003.90

0.00

2518.00

2518.00

$0.00

$53,003.90

$53,003.90

100.0%

348

FROM: COBRA CONSTRUCTION
151 NW 18th Ave Delray Beach, FL 33444

8959-2
Frank
RETAINAGE RELEASE

PAGE 1OF 2 PAGES

TEL: 561-276-3820 FAX:

CONTRACTOR: Mattamy Homes
2500 Quantum Lakes Dr. Ste 215 Boynton Beach, FL 34986

TEL: 561-914-8725 FAX:

PROJECT: PAAR DRIVE - ROUND ABOUT CONTRACT:

APPLICATION NO: 2R APPLICATION DATE: 10/17/23
PERIOD FROM: RETAINAGE

APPLICATION FOR PAYMENT

Analysis of adjusted contract amount to date:

Original contract sum
Net change by change orders
Adjusted contract amount Analysis of work performed:
Cost of original contract work to date:
Extra work performed to date:
Total cost of work performed to date:
Less Retainage:  0.0%
Net amount earned to date
Billed on previous estimates

$ 		$53,_00_3_.9_0
$	$0.00
$ --$-5-3,-00-3-.9-0

$	-- $53-,00-3.-90
$	$0.00

$ 		$---5 .3,'--00_3_.9_0
$	$0.00
$	--$-5-3,-00-3-.9-0
$	$47,703.51	

Net amount payable this period	2R

$	ss,aoo.agMS

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents. that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein Is now due.

CONTRACTOR: COBRA CONSTRUCTION
_......,,,...­
i#:7 ¢* === -==a:a--:.._===-====-=-

Date: lD l \71a:>

State ot Florida

RON SPADA PRESIDENT

County of: Palm Beach

Subscribed and sworn to before me this \ 1 	day of	OC:tolo tr \	;)..0  ;>...3 Notary Publi	1'11A_ Jlw>M./ RJ:itl/J
My Commission expires:	//-/1/'-cJ.7 

LORI THERESE GULOTTA MY COMMISSION# HH 446960
EXPIRES: November 14, 2027

349

-

( (_<2ii}:-\ _;, ;;_; ,:>
( 0 N,ST RUCTION, IN(;

Cobra Construction, Inc.

151 NW 18th Ave Delray Beach, FL 33444
TREVOR@COBRAPAVERS.COM

JOB NAME:	PAAR DRIVE - ROUND ABOUT

FROM: COBRA CONSTRUCTION
151 NW 18th Ave Delray Beach, FL
ZIP: 33444
TEL: 561-276-3820 FAX:

TO: Mattamy Homes
2500 Quantum Lakes Dr. Ste 215 Boynton Beach, FL 34986

TEL: 561-914-8725 FAX:

APPLICATION NUMBER: 2R APPLICATION DATE: 10/17/2023
PERIOD FROM: RETAINAGE CONTRACT NUMBER:

	CONTRACT	QUANTITIES	AMOUNT$		

ITEM	
DESCRIPTION OF WORK	
QUANTITY	
UNIT	
UNIT PRICE	TOTAL AMOUNT	
PREVIOUS	
CURRENT	
TOTAL	
PREVIOUS	
PERIOD	
TO DATE	
%COMP TO DATE	
											
	6" STAMPED CONCRETE	2,518	SF	$21.05	$53,003.90	2518.00		2518.00	$53,003.90	$0.00	$53,003.90	100.0%	

													

													

													

													

													

													

													

													
													
	TOTALS:				$53,003.90	2518.00	0.00	2518.00	$53,003.90	$0.00	$53 003.90	100.0%	

350

APPLICATION AND CERTIFICATE FOR PAYMENT	AIA DOCUMENT G702	PAGE ONE OF	PAGES

□ ARCHITECT

TO:	Mattamy (Jacksonville) Partnership, PROJECT: Paar Dr.

APPLICATION NO:

1	Distribution to:

1000 Summit Tower Blvd. Ste. 500
Orlando, FL 32810
Phone: Fax:
FROM (SubcontractoiLSP Nursery, Inc
521 Thor Ave. Palm Bay, Fl 32909 FEIN: 59-3-134924
Phone: 321-72-1-6176 Fax: 321-728-1053
CONTRACT FOR:

Port Si. Lucie, FL

VIA (Engineer):

8369-1
Tyler

PERIOD TO: 5/3012023
ARCHITECT'S PROJECT NO:
Project Manager:

CONTRACT DATE:

□OWNER CONTRACTOR

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Owner
TOTAL	ADDITIONS	DEDUCTIONS	

0.00	
Approved this Month			
Number	Date Approved			

1				
2				
3			-	
4			-	
5		-	-
-	
TOTALS	-	-	
Net change by Change Orders	-	-	

CONTRACTOR'S APPLICATION FOR PAYMENT

Application is made for Payment, as shown below. in connection with the Contract, Continuation Sheet,
AJA Document G703, is attached.

I. ORJGlNAL CONTRACT SUM	$	368,992.00	
2. Net change by Change Orders	$	-	
3. CONTRACT SUM TO DATE	$	368,992.00	
4. TOTAL COMPLETED & STORED TO DATE	$	109,519.50	

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor

(Column G on G703)
RETAINAGE
	lQ¾ of Completed Work (Column D +Eon 0703)
 	% of Stored Material
(Column Fon G703)
Total Retainage (Line SA+ Sb or Total in Column I ofG703)
TOTAL EARNED LESS RETAINAGE
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificates)

$	10,951.95

$ ------
$	10,951.95
$	98,567.55

$	-

r----

for work which previous Certificates for Payment were issued and payments received from the Owner. and that current payment shown herein is now due.

CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)
State of:	Florida

$
$

County of:	Brevard

9s,s67ss

MS

270.424.45

By:		

Date: 	5/25/2023	

25th,i-.?,YPijf!-Y of MtAf,1.ANDASElB	2023

Notary Public:

·;J"

*	Commission# HH 177078

ARCHITECTS CERTIFICATE FOR PAYMENT

My Commission exp_ires: AMOUNT CERTIFIED

* .,.,, -'·

Exp·iresN ovem1'Jer 21, 2025
aor,ded ThrJ 3 •\No!e.rySensces

$

In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality
of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

(Attach explanation if amount certified differs from the amount applied for.) ARCI-IlTECT:

By:	Date: 	 _
This Certificate is not negotiable.	The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or

	Contractor under this Contract.	

Schedule of Values	AIA DOCUMENT G703	PAGE 2	OF  2	PAGES

AIA Document G702
Subcontractor: L.S.P. Nursery, Inc. 521 Thor Ave Palm Bay, Fl 32909 (EIN 59-3434924) Project: Paar Dr.
Project Estimate No.:12067

APPLICATION NUMBER: APPLICATION DATE:
PERIOD TO: AROiITECT'S PROJECT NO:

1
5/25/2023
5/30/2023

A	B	C	D	E	G	H	I	
ITEM NO.	DESCRIPTION OF WORK	SCHEDULED VALUE	FROM PREVIOUS APPLICATION	THIS PERIOD	COMPLETED TO
DATE	¾(G+C)	BALANCE TO FINISH (C-G)	RETAINAGE (10%)	
		
QUANTITY	
AMOUNT	
AMOUNT	
AMOUNT	
QUANTITY	
%			
1	Irrigation mainline	I	109,519.50	-	$	109,519.50
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-	109,519.50
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-	100%	-	$10,951.95	
2	Irrigation Lateral lines, heads, etc.	1	150,000.00	-			0%	150,000.00	$0.00	
3	Landscaping - Trees	J	31,825.00	-			0%	31,825.00	$0.00	
4	Landscaping - Palms	J	13,200.00	-			0%	13,200.00	$0.00	
5	Landscaping - 3 gallon Plants	I	2,522.00	-			0%	2,522.00	$0.00	
6	Landscaping - 1 gallon Plants	I	346.50	-			0%	346.50	$0.00	
7	Mulch	1•5	1,935.00	-			0%	1,935.00	$0.00	
8	Floratarn Sou	126,1-00	58,144.00	-			0%	58,144.00	$0.00	
9	Root Barrier	100	1,500.00	-			0%	1,500.00	$0.00	
10							#DIV/0!	-	$0.00	
11							#DIV/Of	-	$0.00	
12							#DIV/0!	-	$0.00	
13							#DIV/0!	-	$0.00	
14							#DIV/0!	-	$0.00	
15							#DIV/0!	-	$0.00	
16							#DIV/0!	-	$0.00	
17							#DIV/Of	-	$0.00	
18							#DIV/0!	-	$0.00	
19							#DIV/Of	-	$0.00	
20							#DIV/0!	-	$0.llO	
21							#DIVJO!	-	$0.00	
22							#DIV/0!	-	$0.00	
23							#DIV/0!	-	$0.00	
24							#DIV/0!	-	$0.00	
25							#DIV/0!	-	$0.00	
26							#DIV/0!	-	$0.00	
27							#DIV/0!	-	$0.00	
28							#DIV/0!	-	$0.00	
	Total	368,992.00	-	109,519.50	109,519.50		259,472.50	35Z$10,951.95	

APPLICATION AND CERTIFICATE FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF	PAGES

TO:	Mattamy (Jacksonville) Partnership, PROJECT: Paar Dr.

APPLICATrON NO:

Distribution to:

1000 Summit Tower Blvd. Ste. 500
Orla11do, FL 32810
Pfwue: Fax:
FROM (Subcontracto LSP Nursery, Inc
521 71wr Ave. Palm Bay, Fi 32909 1·1"/N: 5'J-3./3.JY2-I
Phone: 321-72./-6/76 Fax: 3}/.72X-W53
CONTRACT FOR:

Port St. Lucie, FL

VIA (Engineer):

8369-2
Tyler

PERIOD TO: 7/31I202.'I
ARCHITECT'S PROJECT NO:
Project Manager:

CONTRACT DATE:

□OWNER
0 ARCHITECT
0 CONTRACTOR

CHANGE ORDER SUMMARY	
Change Orders approved in previous 111u11lhs by Owner
TOTAL	ADDITIONS	DEDUCTIONS	

0.00	
Approved this Month			
Number	Date Approved			

I				
2				
3			-	
4			-	
5		-	-
-	
TOTALS	-	-	
Net change by Change Orders	-	-	

CONTRACTOR'S APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract, Continuation Sheet,
AJA Document G703, is attached.

The undersigned Contractor certifies that to the hest of the Contractor's knowledge, infonnation and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for work which previous Certificates for Payment were issued and payments rec ived from the

I. ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE
TOTAL COMPLETED & STORED TO DATE
(Column G on 0703)
RETAINAGE
	l0% of Completed Work (Column D +Eon G703)
	 %ofStored Material
(Column Fon 0703)
Total Retainage (Line 5A + 5b or Total in Column I of G703)
TOTAL EARNED LESS RETAINAGE
(Linc 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificates)
CURRENT PAYMENT DUE

$	368,992.00
$
$	3-68-,9-9-2.-0-0
S	143,019.50

$	1-U-l!f.i-)j
$ ------
$	14,301.95
$	128,717.55

$	98,567-55	
$	10,Ho.oo 'vf,,

Owner, and that current payment shown herein is now due.

BALANCE TO FINISH, PLUS RETAIN AGE

$	240,274.45	/V/ \

CONTRACTOR: LSP Nursery, Inc.

./.
/

(Linc 3 less Line 6)
State of:	Florida
Subscribed and sworn to before me this
·1  1· .

County of:	Brevard
25th	day of July
fi',1 Pv.,<,

2023
AMANDA SEIB

By:			Date: 	7/1512023	

Notary Public: ( <, ,,}_ -
"aA(;  l...,,-
My Commission_expires:

.;:o_.......¥. c,
*

Commission# MH 177078 Expkts Novemi,er 21, 2025
E>:.A, ...!llunBco.i e -!ak•) Se, x&

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, infom1ation and belief the Work has progressed as indicated, the quality
of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the /\MOUNT CERTIFIED.

AMOUNT CERTIFIED	$

(Attach explanation if amount certified differs from the amount applied for.) ARCHITECT:

By:	Date: 	.,...._
This Certificate is not negotiable.	The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or

	Contractor under this Contract.	

Schedule of Values	AIA DOCUMENT G703	PAGE 2	OF  2	PAGES
AIA Document G702				APPLICATION NUMBER:	2	
Subcontractor: L.S.P. Nursery, Inc.	521 Thor Ave Palm Bay, Fl	32909	(EIN 59-3434924)	APPLICATION DATE:	7/25/2023	
Project: Paar Dr.				PERIOD TO:	7/31/2023	
Project Estimate No.: 12067				ARCHITECT'S PROJECT NO:		

A	B	C	D	E	G	H	I	
ITEM NO.	DESCRIPTION OF WORK	SCHEDULED VALUE	FROM PREVIOUS APPLICATION	THIS PERIOD	COMPLETED TO
DATE	% (G+C)	BALANCE TO FINISH (C-G)	RETAINAGE (10%)	
		
QUANTITY	
AMOUNT	
AMOUNT	
AMOUNT	
QUANTITY	
%			
1	33055: Irrigation mainline	1	109,519.50	109,519.50	$	-	109,519.50	100%	-	$10,951.95	
2	33055: Irrigation Lateral lines, heads, etc.	1	150,000.00	-	$	25,000.00	25,000.00	17%	125,000.00	$2,500.00	
3	33210: Landscaping - Trees	1	31,825.00	-	$	8,500.00	8,500.00	27%	23,325.00	$850.00	
4	33210: Landscaping - Palms	1	13,200.00	-	$	-	-	0%	13,200.00	$0.00	
5	33210: Landscaping - 3 gallon Plants	1	2,522.00	-	$	-	-	0%	2,522.00	$0.00	
6	33210: Landscaping - 1 gallon Plants	1	346.50	-	$	-	-	0%	346.50	$0.00	
7	33210: Mulch	45	1,935.00	-	$	-	-	0%	1,935.00	$0.00	
8	33210: Floratam Sod	126,400	58,144.00	-	$	-	-	0%	58,144.00	$0.00	
9	33210: Root Barrier	100	1,500.00	-	$	-	-	0%	1,500.00	$0.00	
10					$	-	-	#DIV/0!	-	$0.00	
11					$	-	-	#DIV/0!	-	$0.00	
12					$	-	-	#DIV/0!	-	$0.00	
13					$	-	-	#DIV/0!	-	$0.00	
14					$	-	-	#DIV/0!	-	$0.00	
15					$	-	-	#DIV/0!	-	$0.00	
16					$	-	-	#DIV/0!	-	$0.00	
17					$	-	-	#DIV/0!	-	$0.00	
18					$	-	-	#DIV/0!	-	$0.00	
19					$	-	-	#DIV/0!	-	$0.00	
20					$	-	-	#DIV/0!	-	$0.00	
21					$	-	-	#DIV/0!	-	$0.00	
22					$	-	-	#DIV/0!	-	$0.00	
23					$	-	-	#DIV/0!	-	$0.00	
24					$	-	-	#DIV/0!	-	$0.00	
25					$	-	-	#DIV/0!	-	$0.00	
26					$	-	-	#DIV/0!	-	$0.00	
27					$	-	-	#DIV/0!	-	$0.00	
28					$	-	-	#DIV/0!	-	$0.00	
	Total	368,992.00	109,519.50	33,500.00	143,019.50		225,972.50	354 $14,301.95	

Southeast Sod LLC
6054 SW 52ND TER
Palm City, FL 34990 US
+1 7722605907

64228384.1510.30510
Tyler

southeastsodllc@gmail.com		

INVOICE				
BILL TO	INVOICE	1457		
Mattamy Homes	DATE	07/27/2023		
	TERMS	Due on receipt		
	DUE DATE	07/27/2023		
JOB NAME
South Side of parr				
QTY  DESCRIPTION		RATE	AMOUNT	
38,700  Sq Ft of Floratam Sod Deliver & Installed		0.45	17,415.00	

Attn: Tyler	

SUBTOTAL	

17,415.00	
	TAX	0.00	
	TOTAL	17,415.00	
	
BALANCE DUE	 $17,415.00 	

Southeast Sod LLC
6054 SW 52ND TER
Palm City, FL 34990 US
+1 7722605907
southeastsodllc@gmail.com

INVOICE
BILL TO
Mattamy Homes

Tyler to Code, please

INVOICE	1490
DATE	08/21/2023
TERMS	Due on receipt
DUE DATE	08/21/2023

JOB NAME
 Kenley-Open Space/Paar/Berm/Mdl

QTY  DESCRIPTION	RATE	AMOUNT

34,650  Sq Ft of Floratam Sod Deliver & Installed	0.42	14,553.00

Attn: Tyler	SUBTOTAL	14,553.00 TAX		0.00
TOTAL	14,553.00

BALANCE DUE	$14,553.00

Southeast Sod LLC
6054 SW 52ND TER
Palm City, FL 34990 US
+1 7722605907

64228384.1510.33210
Tyler

southeastsodllc@gmail.com		

INVOICE		
BILL TO		INVOICE	1521	
Mattamy Homes		DATE	09/08/2023	
		TERMS	Due on receipt	
		DUE DATE	09/08/2023	
JOB NAME
Parr Water Line				
QTY  DESCRIPTION			RATE	AMOUNT	
18,000  Sq Ft of Bahia Sod Deliver & Installed			0.26	4,680.00	

Attn: Tyler	
SUBTOTAL		
4,680.00	
	TAX		0.00	
	TOTAL		4,680.00	
				
	BALANCE DUE		$4,680.00	

2022 ACQUISITION AND CONSTRUCTION ACCOUNT REQUISITION REQUISITION NO. 19	
SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO. 5

SPECIAL ASSESSMENT BONDS, SERIES 2022-1 (COMMUNITY INFRASTRUCTURE)
and
SPECIAL ASSESSMENT BONDS, SERIES 2022-2 (COMMUNITY INFRASTRUCTURE) (FEDERALLY TAXABLE)

The undersigned, a Responsible Officer of Southern Grove Community Development District No. 5 (the “Issuer”) hereby submits the following requisition for disbursement from the 2022 Acquisition and Construction Account created under and pursuant to the terms of the Master Trust Indenture from the Issuer to U.S. Bank Trust Company, National Association, as trustee (the “Trustee”), dated December 17, 2014, as supplemented by that certain Eighth Supplemental Indenture, dated as of December 1, 2022 (collectively, the “Indenture”), (all capitalized terms used herein shall have the meaning ascribed to such terms in this Indenture);

Requisition Number: 19

Name of Payee: Mattamy Palm Beach LLC

Amount Payable: $890,410.78

The undersigned hereby certifies that (check the applicable box in 1. below):
This requisition is for a Cost of the 2022-1 CI Project payable from the 2022-1 Acquisition and Construction Subaccount and does not include any Cost related to the TIM Project   X   

AND/OR

This requisition is for a Cost of the 2022-2 CI Project payable from the 2022-2 Acquisition and Construction Subaccount 	

AND

Each disbursement set forth above is a proper charge against the 2022-1 Acquisition and Construction Subaccount or the 2022-2 Acquisition and Construction Subaccount, as applicable.

[Include if applicable]

1

Each disbursement set forth above is made as payment of a portion of the purchase price for the 2022-1 CI Project or 2022-2 CI Project, as applicable, or repayment of advances for 2022- 2 CI Project, in either case, pursuant to a written agreement between the District and the other party named therein receiving payment and the undersigned represents that such agreement has not been modified or amended and is in full force and effect on the date hereof.

Lk

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO. 5

By: 	
Responsible Officer
Date-:-'------/-l-f-°-,-e..,.L...,.:....-I1f-,,	Zu2-.f.,	 _
The undersigned, an authorized representative of the Consulting Engineer to the Issuer, hereby certifies that this disbursement is for a Cost of the 2022-1 CI Project and/or 2022-2 CI Project, as applicable, and is consistent with: (i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the 2022-1 CI Project and/or 2022-2 CI Project, as applicable, with respect to which such disbursement is being made; and (iii) the Engineer's Report as supplemented and amended through the date hereof.

The undersigned further certifies that (a) the improvements to be acquired with this disbursement will be (1) owned by the Issuer or another governmental entity and located on public property or within public rights of way or easements and (2) accessible by the general public and/or part of a public water management system; (b) the purchase price to be paid by the Issuer for the improvements to be acquired with this disbursement is no more than the lesser of (i) the fair market value of such improvements and (ii) the actual cost of construction of such improvements; (c) the plans and specifications for the improvements have been approved by all regulatory bodies required to approve them or such approval can reasonably be expected to be obtained; (d) all currently required approvals and permits for the acquisition, construction, reconstruction, installation and equipping of the portion of the 2022-1 CI Project and/or 2022-2 CI Project for which disbursement is made have been obtained from all applicable regulatory bodies; and (e) subject to permitted retainage under the applicable contracts, the seller has paid all contractors, subcontractors, and materialmen that have provided services or materials in connection with the portions of the 2022-1 CI Project and/or 2022-2 CI Project for which disbursement is made hereby, if acquisition or reimbursement is being made pursuant to an agreement.

[CONSULTING ENGINEER]

By:	0/ 
Name:	J.P. "Butch" Terpening
Title:	District Engineer
Date:  April 18, 2024

2

MATTAMY HOMES' CERTIFICATE OF COSTS
SG Becker Road Ext (64228356)
FOR GOOD AND VALUABLE CONSIDERATION, the receipt and sufficiency of which are hereby acknowledged, Mattamy Palm Beach LLC ("Mattamy"), to the best of its knowledge, information, and belief, certifies to the Southern Grove Community Development District No. 5 ("District No. 5"), that the costs of the Work Product as defined and described as the MXD 2 Lift Station, and as more particularly described in the attached Schedule 1 (the "Improvements"), are as follows:

A. Consultants	$375,703.60	See Exhibit A	
B. Permit Fees	$91,235.26	See Exhibit B	
C. Site Work (net of Cost-Share)	$423,471.92	See Exhibit C	
D. Landscape & Irrigation	$0.00

Total: $890,410.78		

IN WITNESS WHEREOF, Mattamy has caused this instrument to be executed by its duly authorized agents, and its corporate seal affixed hereto, this lt:y- day of February, 2024.

limited li .
.,,

MATTAMY PALM BEACH LLC, a Delaware
Print Name: Karl Albertson Title: Vice President

Schedule 1	
Cost
Classification	
Cost Description	
Invoice Date	Contract
#	
Invoice #	
Vendor	
Amount	
A	Consultants	6/21/2022	N/A	94912A	Culpepper and Turpening	$	57.09	
A	Consultants	7/22/2022	N/A	95022	Culpepper and Turpening	$ 16,128.47	
A	Consultants	8/25/2022	N/A	95560	Culpepper and Turpening	$ 19,716.70	
A	Consultants	9/27/2022	N/A	95726 A/B	Culpepper and Turpening	$ 10,443.50	
A	Consultants	10/21/2022	N/A	95982	Culpepper and Turpening	$	8,999.79	
A	Consultants	12/22/2022	7885	96610A	Culpepper and Turpening	$	6,183.75	
A	Consultants	1/24/2023	8524	96739	Culpepper and Turpening	$	3,445.13	
A	Consultants	1/25/2023	N/A	96769	Culpepper and Turpening	$	1,960.00	
A	Consultants	2/22/2023	8524	96828	Culpepper and Turpening	$	4,962.50	
A	Consultants	2/23/2023	N/A	96849	Culpepper and Turpening	$	1,960.00	
A	Consultants	3/24/2023	N/A	97129	Culpepper and Turpening	$	2,621.50	
A	Consultants	3/28/2023	8524	97153	Culpepper and Turpening	$ 21,662.00	
A	Consultants	4/24/2023	8524	97236	Culpepper and Turpening	$ 24,135.00	
A	Consultants	4/26/2023	N/A	97266	Culpepper and Turpening	$	3,208.00	
A	Consultants	5/12/2023	8524	97349	Culpepper and Turpening	$ 21,135.21	
A	Consultants	5/16/2023	N/A	97372	Culpepper and Turpening	$	1,248.00	
A	Consultants	6/16/2023	N/A	97596	Culpepper and Turpening	$ 29,002.77	
A	Consultants	7/17/2023	8524	97726	Culpepper and Turpening	$ 20,366.25	
A	Consultants	8/17/2023	8524	97834	Culpepper and Turpening	$ 16,028.13	
A	Consultants	9/22/2023	8524	97993	Culpepper and Turpening	$ 20,041.13	
A	Consultants	10/12/2023	8524	98043	Culpepper and Turpening	$ 12,645.52	
A	Consultants	11/21/2023	8524	98182	Culpepper and Turpening	$ 23,422.66	
A	Consultants	11/21/2023	7885	98219	Culpepper and Turpening	$	960.00	
A	Consultants	12/18/2023	8524	98404	Culpepper and Turpening	$ 14,347.50	
A	Consultants	12/31/2023	8524	98488	Culpepper and Turpening	$	9,570.00	
A	Consultants	7/18/2022	N/A	26927	EW Consultants	$	7,875.00	
A	Consultants	12/15/2022	8523	34240	Lucido & Associates	$ 11,375.00	
A	Consultants	1/16/2023	8523	34315	Lucido & Associates	$ 11,375.00	
A	Consultants	2/15/2023	8523	34367	Lucido & Associates	$ 11,375.00	
A	Consultants	3/20/2023	8523	34423	Lucido & Associates	$	6,825.00	
A	Consultants	6/18/2023	8523	34602	Lucido & Associates	$	4,550.00	
A	Consultants	1/31/2023	8540	682363	GFA International, Inc.	$	1,800.00	
A	Consultants	2/24/2023	8540	686888	GFA International, Inc.	$	3,130.00	
A	Consultants	3/24/2023	8540	695124	GFA International, Inc.	$	4,650.00	
A	Consultants	4/27/2023	8540	705178	GFA International, Inc.	$ 13,498.00	
A	Consultants	5/5/2023	8950	05.05.23	Kenneth DiDonato Inc.	$	5,000.00	
B	Permit Fees	11/4/2022	N/A	N/A	City of Port St. Lucie	$ 63,094.33	
B	Permit Fees	11/30/2022	N/A	112822CKRQ-CP	City of Port St. Lucie	$ 12,892.85	
B	Permit Fees	4/6/2023	N/A	3022	City of Port St. Lucie	$	2,477.08	
B	Permit Fees	1/25/2021	N/A	2147667	Hub International Midwest West	$ 10,493.00	
B	Permit Fees	03/25/223	N/A	3080044	Hub International Midwest West	$ 10,493.00	
B	Permit Fees	11/14/2023	N/A	3409085	Hub International Midwest West	$  (8,215.00)	
C	Site Work	7/31/2023	N/A	1800431503	Florida Power and Light	$ 11,437.36	
C	Site Work	10/25/2023	N/A	1800440437	Florida Power and Light	$	6,233.56	
C	Site Work	1/31/2023	8537	8537-1	H and J Contracting Inc.	$ 226,800.00	
C	Site Work	2/28/2023	8537	8537-2	H and J Contracting Inc.	$ 56,700.00	
C	Site Work	6/30/2023	8537	8537-3	H and J Contracting Inc.	$ 31,500.00	
C	Site Work	10/31/2023	8537	8537-4	H and J Contracting Inc.	$ 90,801.00	

Total Due	$ 890,410.78

64228356.1510.37430
10-3-2022
Eric

**Partial inv balance due. Only $16,087.00 previously paid in July as uploaded inv did not include the 2nd page
TOTAL NOW DUE: $57.09

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Julie Hurst

This invoice was previously part of the August '22 requisition, but failed to include the $57.09 as depicted below.

Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

June 21, 2022
Project No:	21-063
Invoice No:	 94912A

Unit Billing

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design

Fee

Fee

Percent Complete

Previous Current Fee

Billing Phase

Fee Billing

Billing

Total Fee

16,087.00

Previously requisitioned

Professional Services through May 31, 2022
Phase	0	Billing Phase

20.01 Route Design Survey	21,480.00	50.00	10,740.00	0.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	80.00	19,272.00	6,424.00	
30.04 100% Construction Plan	34,955.00	20.00	0.00	6,991.00	
30.10 CO.01 Final Plat Preparation	9,600.00	0.00	0.00	0.00	
40.01 Bid Coordination	7,660.00	0.00	0.00	0.00	
70.01 Project Representation	13,360.00	20.00	0.00	2,672.00	
70.02 Street Lighting Coordination	6,240.00	0.00	0.00	0.00	
Total Fee	287,565.00		192,162.00	16,087.00	

Phase	8	Reimbursable Expense

5/18/2022	Blueprint Color	5.0 BLUE-COLOR @ 1.50	7.50	
5/18/2022	Blueprint Color	23.0 BLUE-COLOR @ 1.50	34.50	
5/19/2022	Large Copy	1.0 Copy @ 0.35	.35	

Project	21-063	Becker Road West Phase 2 Design	Invoice	94912	
5/30/2022	Large Copy	2.0 Copies @ 0.35	.70		
MILEAGE	
5/20/2022	city meeting	24.0 Miles @ 0.585	14.04		
	Total Units		57.09	57.09	

$57.09

Total this Invoice	$16,144.09

Outstanding Invoices

Number	Date	Balance	
94865	5/26/2022	19,013.70	
Total		19,013.70	

Page 2

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Julie Hurst
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

July 22, 2022
Project No:	21-063
Invoice No:	95022

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

Per Tony
Please pay as invoice 64228356.1510.37430
6/22/22

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through June 30, 2022
Phase	0	Billing Phase
Fee

Percent

Previous

Current Fee

Billing Phase	Fee	Complete	Fee Billing	Billing	
20.01 Route Design Survey	21,480.00	50.00	10,740.00	0.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	80.00	25,696.00	0.00	
30.04 100% Construction Plan	34,955.00	50.00	6,991.00	10,486.50	
30.10 CO.01 Final Plat Preparation	9,600.00	50.00	0.00	4,800.00	
40.01 Bid Coordination	7,660.00	0.00	0.00	0.00	
70.01 Project Representation	13,360.00	26.00	2,672.00	801.60	
70.02 Street Lighting Coordination	6,240.00	0.00	0.00	0.00	
Total Fee	287,565.00		208,249.00	16,088.10	
Total Fee	16,088.10

Phase	8	Reimbursable Expense

Project	21-063	Becker Road West Phase 2 Design	Invoice	95022		
Unit Billing						
MILEAGE
6/8/2022		
14.0 Miles @ 0.585	
8.19			
6/13/2022		25.0 Miles @ 0.585	14.63			
6/22/2022		30.0 Miles @ 0.585	17.55			
	Total Units		40.37		40.37	
Total this Invoice	$16,128.47

Outstanding Invoices
Number	Date	Balance
94912	6/21/2022	57.09
Total	57.09

Page 2

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Julie Hurst
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

August 25, 2022
Project No:	21-063
Invoice No:	95560

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

64228356.1510.37430

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through July 31, 2022
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee

Current Fee
Billing

	Billing		
20.01 Route Design Survey	21,480.00	80.00	10,740.00	6,444.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	80.00	25,696.00	0.00	
30.04 100% Construction Plan	34,955.00	80.00	17,477.50	10,486.50	
30.10 CO.01 Final Plat Preparation	9,600.00	50.00	4,800.00	0.00	
40.01 Bid Coordination	7,660.00	10.00	0.00	766.00	
70.01 Project Representation	13,360.00	40.00	3,473.60	1,870.40	
70.02 Street Lighting Coordination	6,240.00	0.00	0.00	0.00	
Total Fee	287,565.00		224,337.10	19,566.90	
Total Fee	19,566.90	
Phase	8		Reimbursable Expense			
Unit Billing						
6/15/2022		Large Copy		8.0 Copies @ 0.35	2.80	
6/20/2022		Large Copy		1.0 Copy @ 0.35	.35	
6/20/2022		Large Copy		1.0 Copy @ 0.35	.35	

Project	21-063	Becker Road West Phase 2 Design	Invoice	95560		
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/20/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/29/2022	Large Copy	1.0 Copy @ 0.35	.35			
6/29/2022	Large Copy	1.0 Copy @ 0.35	.35			
7/27/2022	Large Copy	4.0 Copies @ 0.35	1.40			
7/27/2022	Large Copy	5.0 Copies @ 0.35	1.75			
7/27/2022	Large Copy	5.0 Copies @ 0.35	1.75			
7/27/2022	Large Copy	3.0 Copies @ 0.35	1.05			
7/27/2022	Large Copy	2.0 Copies @ 0.35	.70			
7/27/2022	Large Copy	7.0 Copies @ 0.35	2.45			
7/27/2022	Large Copy	3.0 Copies @ 0.35	1.05			
7/27/2022	Large Copy	3.0 Copies @ 0.35	1.05			
7/27/2022	Large Copy	10.0 Copies @ 0.35	3.50			
7/27/2022	Large Copy	3.0 Copies @ 0.35	1.05			
7/27/2022	Large Copy	1.0 Copy @ 0.35	.35			
7/27/2022	Large Copy	1.0 Copy @ 0.35	.35			
7/27/2022	Large Copy	9.0 Copies @ 0.35	3.15			
7/27/2022	Large Copy	2.0 Copies @ 0.35	.70			
7/27/2022	Large Copy	3.0 Copies @ 0.35	1.05			
7/27/2022	Large Copy	3.0 Copies @ 0.35	1.05			
6/16/2022	Blueprint Color	5.0 BLUE-COLOR @ 1.50	7.50			
6/27/2022	Blueprint Color	23.0 BLUE-COLOR @ 1.50	34.50			
6/30/2022	Blueprint Color	23.0 BLUE-COLOR @ 1.50	34.50			
7/27/2022	Blueprint Color	1.0 BLUE-COLOR @ 1.50	1.50			
7/27/2022	Blueprint Color	1.0 BLUE-COLOR @ 1.50	1.50			
7/27/2022	Blueprint Color	23.0 BLUE-COLOR @ 1.50	34.50			
7/27/2022	Blueprint	1.0 Blueprint @ 1.50	1.50			
	Total Units		149.80		149.80	

Page 2

Project

21-063	Becker Road West Phase 2 Design	Invoice
Total this Invoice

95560
$19,716.70

Outstanding Invoices

Number	Date	Balance	
94912	6/21/2022	57.09	
95022	7/22/2022	16,128.47	
Total		16,185.56	

Page 3

#7885
10-3-2 022
Eric

Invoice

$2,400.00
Culpepper & Terpening, Inc.

**Inv includes both contracted & non- contracted service items. Total inv. balance to be processed as two separate inv's (Inv. #A & B). One inv. billed to contract & one inv. billed as a stand alone inv.

Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Julie Hurst

September 27, 2022

Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

Project No: Invoice No:

21-063
 95726A

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through August 31, 2022
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee Billing

Current Fee
Billing

20.01 Route Design Survey	21,480.00	80.00	17,184.00	0.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	90.00	25,696.00	3,212.00	
30.04 100% Construction Plan	34,955.00	90.00	27,964.00	3,495.50	
30.10 CO.01  Final Plat 
 Preparation 	9,600.00	75.00	4,800.00	 2,400.00 	
40.01 Bid Coordination	7,660.00	10.00	766.00	0.00	
70.01 Project Representation	13,360.00	50.00	5,344.00	1,336.00	
70.02 Street Lighting Coordination	6,240.00	0.00	0.00	0.00	
Total Fee	287,565.00		243,904.00	10,443.50	
Total Fee	10,443.50
Total this Invoice	$10,443.50

Project

21-063	Becker Road West Phase 2 Design	Invoice

95726

Outstanding Invoices

Number	Date	Balance	
94912	6/21/2022	57.09	
Total		57.09	

Page 2

64228356.1510.37430
10-24-2022

Invoice

Eric
Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Frank Covelli
Director of Community Development and Planning Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

October 21, 2022
Project No:	21-063
Invoice No:	95982

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through September 30, 2022
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee Billing

Current Fee
Billing

20.01 Route Design Survey	21,480.00	100.00	17,184.00	4,296.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	95.00	28,908.00	1,606.00	
30.04 100% Construction Plan	34,955.00	95.00	31,459.50	1,747.75	
30.10 CO.01 Final Plat Preparation	9,600.00	75.00	7,200.00	0.00	
40.01 Bid Coordination	7,660.00	10.00	766.00	0.00	
70.01 Project Representation	13,360.00	60.00	6,680.00	1,336.00	
70.02 Street Lighting Coordination	6,240.00	0.00	0.00	0.00	
Total Fee	287,565.00		254,347.50	8,985.75	
Total Fee	8,985.75

Phase	8	Reimbursable Expense

Project Unit Billing MILEAGE

21-063	Becker Road West Phase 2 Design	Invoice

95982

9/20/2022	comment review meeting	24.0 Miles @ 0.585	14.04
Total Units	14.04	14.04

$8,999.79

Total this Invoice

Outstanding Invoices
Number	Date	Balance
94912	6/21/2022	57.09
95726	9/27/2022	10,443.50
Total	10,500.59

Page 2

7885
Eric

Invoice

Culpepper & Terpening, Inc.

**Inv includes both contracted & noncontracted service items. Total inv. balance to be processed as two separate inv's (Inv. #A & B). One inv.

Consulting Engineers and Land Surveyors billed to contract & one inv. billed as

2980 South 25th Street Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

a stand alone inv.

Mr. Frank Covelli
Director of Community Development and Planning Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

December 22, 2022
Project No:	21-063
Invoice No:	 96610 A

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through November 30, 2022
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee Billing

Current Fee
Billing

20.01 Route Design Survey	21,480.00	100.00	21,480.00	0.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	100.00	30,514.00	1,606.00	
30.04 100% Construction Plan	34,955.00	100.00	33,207.25	1,747.75	
30.10 CO.01 Final Plat Preparation	9,600.00	90.00	7,200.00	1,440.00	
40.01 Bid Coordination	7,660.00	20.00	766.00	766.00	
70.01 Project Representation	13,360.00	60.00	8,016.00	0.00	
70.02 Street Lighting Coordination	6,240.00	10.00	0.00	624.00	
Total Fee	287,565.00		263,333.25	6,183.75	

 

Phase

8

Reimbursable Expense

Total Paid

Total Fee	6,183.75

Project
Consultants

21-063	Becker Road West Phase 2 Design	Invoice

96610

Reimbursable Consultant
11/17/2022	EW Consultants, Inc.	Environmental Permitting	3,150.00		
	Total Consultants		3,150.00	3,150.00	

$9,333.75

Amount not paid

Total this Invoice

Page 2

64228356.1510.37430
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

**Inv includes both contracted & noncontracted service items. Total inv. balance to be processed as two separate inv's (Inv. #A & B).
One inv. billed to contract & one inv. billed as a stand alone inv.

Mr. Frank Covelli
Director of Community Development and Planning Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

December 22, 2022
Project No:	21-063
Invoice No:	 96610 B

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through November 30, 2022
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee Billing

Current Fee
Billing

20.01 Route Design Survey	21,480.00	100.00	21,480.00	0.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	100.00	30,514.00	1,606.00 	
30.04 100% Construction Plan	34,955.00	100.00	33,207.25	 1,747.75 	
30.10 CO.01 Final Plat Preparation	9,600.00	90.00	7,200.00	1,440.00	
40.01 Bid Coordination	7,660.00	20.00	766.00	766.00 	
70.01 Project Representation	13,360.00	60.00	8,016.00	0.00	
70.02 Street Lighting Coordination	6,240.00	10.00	0.00	624.00 	
Total Fee	287,565.00		263,333.25	6,183.75	

	
Total: $4,743.75

Total Fee	6,183.75

Phase	8	Reimbursable Expense

Project
Consultants

21-063	Becker Road West Phase 2 Design	Invoice

96610

Reimbursable Consultant
11/17/2022	EW Consultants, Inc.	Environmental Permitting	3,150.00		
	Total Consultants		3,150.00	3,150.00	
Total this Invoice	$9,333.75

Page 2

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

January 24, 2023
Project No:	21-063.001
Invoice No:	96739

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through December 31, 2022	
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel					
	Hours	Rate	Amount		
Principal Engineer, PE	8.50	210.00	1,785.00		
Project Engineer, PE	1.25	165.00	206.25		
Sr. Construction Inspector	5.00	125.00	625.00		
Totals
Total Labor	14.75		2,616.25	
2,616.25	
Tasks	50.02	Construction Inspection				
Professional Personnel				

Sr. Construction Inspector	Hours
6.50	Rate
125.00	Amount
812.50	
Totals	6.50		812.50	
Total Labor			812.50	
Phase	8	Reimbursable Expense
Unit Billing
MILEAGE
12/21/2022	28.0 Miles @ 0.585	16.38
Total Units	16.38	16.38

Total this Invoice

 $3,445.13 

Project

21-063.001	Becker Road West Phase 2 CEI	Invoice

96739

Page 2

64228356.1510.37430
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

**Billed items are NOT part of contract #7885; #7885 only includes item 30.10 CO.01

Mr. Frank Covelli
Director of Community Development and Planning Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

January 25, 2023
Project No:	21-063
Invoice No:	96769

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through December 31, 2022
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee Billing

Current Fee
Billing

20.01 Route Design Survey	21,480.00	100.00	21,480.00	0.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	100.00	32,120.00	0.00	
30.04 100% Construction Plan	34,955.00	100.00	34,955.00	0.00	
30.10 CO.01 Final Plat Preparation	9,600.00	90.00	8,640.00	0.00	
40.01 Bid Coordination	7,660.00	20.00	1,532.00	0.00	
70.01 Project Representation	13,360.00	70.00	8,016.00	1,336.00	
70.02 Street Lighting Coordination	6,240.00	20.00	624.00	624.00	
Total Fee	287,565.00		269,517.00	1,960.00	
Total Fee	1,960.00
Total this Invoice	 $1,960.00 

Project

21-063	Becker Road West Phase 2 Design	Invoice

96769

Outstanding Invoices

Number	Date	Balance	
96610	12/22/2022	9,333.75	
Total		9,333.75	

Page 2

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

February 22, 2023
Project No:	21-063.001
Invoice No:	96828

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through January 31, 2023
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
8.75	Rate
210.00	Amount
1,837.50	
Totals	8.75		1,837.50	
Total Labor			1,837.50	
Tasks	50.02	Construction Inspection
Professional Personnel

Hours	Rate	Amount	
Sr. Construction Inspector	25.00	125.00	3,125.00	
Totals
Total Labor		25.00	3,125.00	
3,125.00	
			Total this Invoice	$4,962.50	

Outstanding Invoices				
Number
96739	Date
1/24/2023	Balance
3,445.13		
Total		3,445.13		

64228356.1510.37430
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Frank Covelli
Director of Community Development and Planning Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

February 23, 2023
Project No:	21-063
Invoice No:	96849

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through January 31, 2023
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee Billing

Current Fee
Billing

20.01 Route Design Survey	21,480.00	100.00	21,480.00	0.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	100.00	32,120.00	0.00	
30.04 100% Construction Plan	34,955.00	100.00	34,955.00	0.00	
30.10 CO.01 Final Plat Preparation	9,600.00	90.00	8,640.00	0.00	
40.01 Bid Coordination	7,660.00	20.00	1,532.00	0.00	
70.01 Project Representation	13,360.00	80.00	9,352.00	1,336.00	
70.02 Street Lighting Coordination	6,240.00	30.00	1,248.00	624.00	
Total Fee	287,565.00		271,477.00	1,960.00	

$1,960.00

Total Fee	1,960.00
Total this Invoice

Outstanding Invoices
Number	Date	Balance
96610	12/22/2022	3,150.00

Project

21-063	Becker Road West Phase 2 Design	Invoice 96769		1/25/2023	1,960.00
Total	5,110.00

96849

Page 2

64228356.1510.37430
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Frank Covelli
Director of Community Development and Planning Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

March 24, 2023
Project No:	21-063
Invoice No:	97129

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through February 28, 2023
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee Billing

Current Fee
Billing

20.01 Route Design Survey	21,480.00	100.00	21,480.00	0.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	100.00	32,120.00	0.00	
30.04 100% Construction Plan	34,955.00	100.00	34,955.00	0.00	
30.10 CO.01 Final Plat Preparation	9,600.00	90.00	8,640.00	0.00	
40.01 Bid Coordination	7,660.00	20.00	1,532.00	0.00	
70.01 Project Representation	13,360.00	90.00	10,688.00	1,336.00	
70.02 Street Lighting Coordination	6,240.00	50.00	1,872.00	1,248.00	
Total Fee	287,565.00		273,437.00	2,584.00	
Total Fee	2,584.00

Phase	8	Reimbursable Expense
Unit Billing
1/11/2023	Blueprint Color	3.0 BLUE-COLOR @ 1.50	4.50

Project

21-063	Becker Road West Phase 2 Design	Invoice

97129

1/11/2023	Blueprint Color	20.0 BLUE-COLOR @ 1.50	30.00
1/11/2023	Blueprint Color	1.0 BLUE-COLOR @ 1.50	1.50
1/11/2023	Blueprint Color	1.0 BLUE-COLOR @ 1.50	1.50
Total Units	37.50	37.50
Total this Invoice	 $2,621.50 

Outstanding Invoices

Number	Date	Balance	
96610	12/22/2022	3,150.00	
96849	2/23/2023	1,960.00	
Total		5,110.00	

Page 2

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

March 28, 2023
Project No:	21-063.001
Invoice No:	97153

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through February 28, 2023	
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel					
	Hours	Rate	Amount		
Principal Engineer, PE	16.75	210.00	3,517.50		
Project Engineer, PE	.75	165.00	123.75		
Sr. Construction Inspector	2.00	125.00	250.00		
Totals
Total Labor	19.50		3,891.25	
3,891.25	
Tasks	50.02	Construction Inspection				
Professional Personnel					
	Hours	Rate	Amount		
Principal Engineer, PE	14.25	210.00	2,992.50		
Project Engineer, PE	.50	165.00	82.50		
Sr. Construction Inspector	117.00	125.00	14,625.00		
Totals
Total Labor	131.75		17,700.00	
17,700.00	
Phase	8		Reimbursable Expense			
Unit Billing						
1/11/2023		Large Copy		1.0 Copy @ 0.35	.35	
1/23/2023		Large Copy		4.0 Copies @ 0.35	1.40	

Project

21-063.001	Becker Road West Phase 2 CEI	Invoice

97153

1/16/2023	Blueprint Color	46.0 BLUE-COLOR @ 1.50	69.00
Total Units	70.75	70.75

$21,662.00

Total this Invoice

Outstanding Invoices

Number	Date	Balance	
96828	2/22/2023	4,962.50	
Total		4,962.50	

Page 2

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

April 24, 2023
Project No:	21-063.001
Invoice No:	97236

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through March 31, 2023
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
24.75	Rate
210.00	Amount
5,197.50	
Totals	24.75		5,197.50	
Total Labor			5,197.50	
Tasks	50.02	Construction Inspection
Professional Personnel
Hours	Rate	Amount
Sr. Construction Inspector	151.50	125.00	18,937.50
Totals
Total Labor		151.50	18,937.50	
18,937.50	
			Total this Invoice	$24,135.00	

Outstanding Invoices					
Number
97153	Date
3/28/2023	Balance
21,662.00			
Total		21,662.00			

64228356.1510.37430
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Frank Covelli
Director of Community Development and Planning Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

April 26, 2023
Project No:	21-063
Invoice No:	97266

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through March 31, 2023
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee Billing

Current Fee
Billing

20.01 Route Design Survey	21,480.00	100.00	21,480.00	0.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	100.00	32,120.00	0.00	
30.04 100% Construction Plan	34,955.00	100.00	34,955.00	0.00	
30.10 CO.01 Final Plat Preparation	9,600.00	90.00	8,640.00	0.00	
40.01 Bid Coordination	7,660.00	20.00	1,532.00	0.00	
70.01 Project Representation	13,360.00	100.00	12,024.00	1,336.00	
70.02 Street Lighting Coordination	6,240.00	80.00	3,120.00	1,872.00	
Total Fee	287,565.00		276,021.00	3,208.00	

$3,208.00

Total Fee	3,208.00
Total this Invoice

Outstanding Invoices
Number	Date	Balance
96610	12/22/2022	3,150.00

Project

21-063	Becker Road West Phase 2 Design	Invoice 97129		3/24/2023	2,621.50
Total	5,771.50

97266

Page 2

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

May 12, 2023
Project No:	21-063.001
Invoice No:	97349

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through April 30, 2023
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
22.00	Rate
210.00	Amount
4,620.00	
Totals	22.00		4,620.00	
Total Labor			4,620.00	
Tasks	50.02	Construction Inspection
Professional Personnel
Hours	Rate	Amount
Sr. Construction Inspector	132.00	125.00	16,500.00
Totals	132.00	16,500.00
Total Labor	16,500.00

Phase	8	Reimbursable Expense
Unit Billing
MILEAGE
4/4/2023	26.0 Miles @ 0.585	15.21

$21,135.21

Total Units	15.21	15.21
Total this Invoice

Project

21-063.001	Becker Road West Phase 2 CEI	Invoice

97349

Outstanding Invoices

Number	Date	Balance	
97236	4/24/2023	24,135.00	
Total		24,135.00	

Page 2

64228356.1510.37430
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Frank Covelli
Director of Community Development and Planning Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

May 16, 2023
Project No:	21-063
Invoice No:	97372

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through April 30, 2023
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee Billing

Current Fee
Billing

20.01 Route Design Survey	21,480.00	100.00	21,480.00	0.00	
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00	
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00	
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00	
30.03 Permitting	32,120.00	100.00	32,120.00	0.00	
30.04 100% Construction Plan	34,955.00	100.00	34,955.00	0.00	
30.10 CO.01 Final Plat Preparation	9,600.00	90.00	8,640.00	0.00	
40.01 Bid Coordination	7,660.00	20.00	1,532.00	0.00	
70.01 Project Representation	13,360.00	100.00	13,360.00	0.00	
70.02 Street Lighting Coordination	6,240.00	100.00	4,992.00	1,248.00	
Total Fee	287,565.00		279,229.00	1,248.00	

$1,248.00

Total Fee	1,248.00
Total this Invoice

Outstanding Invoices
Number	Date	Balance
96610	12/22/2022	3,150.00

Project

21-063	Becker Road West Phase 2 Design	Invoice 97266		4/26/2023	3,208.00
Total	6,358.00

97372

Page 2

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

June 16, 2023
Project No:	21-063.001
Invoice No:	97596

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through May 31, 2023
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
28.00	Rate
210.00	Amount
5,880.00	
Totals	28.00		5,880.00	
Total Labor			5,880.00	
Tasks	50.02	Construction Inspection
Professional Personnel
Hours	Rate	Amount
Sr. Construction Inspector	184.00	125.00	23,000.00
Totals	184.00	23,000.00
Total Labor	23,000.00

Phase	8	Reimbursable Expense
Reimbursable Expenses
Reimbursable Expense
5/30/2023	Terpening, Thomas	To and From Site	23.74		
5/31/2023	Terpening, Thomas	To and From Site	28.76		
6/1/2023	Terpening, Thomas	To and From Site	31.68		
6/2/2023	Terpening, Thomas	To and From Site	38.59		
	Total Reimbursables		122.77	122.77	

Project

21-063.001

Becker Road West Phase 2 CEI	Invoice
Total this Invoice

97596
 $29,002.77 

Outstanding Invoices

Number	Date	Balance	
97349	5/12/2023	21,135.21	
Total		21,135.21	

Page 2

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

8524
Eric

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

December 31, 2023
Project No:	21-063.001
Invoice No:	98488

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through December 31, 2023	
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
19.00	Rate
210.00	Amount
3,990.00	
Totals	19.00		3,990.00	
Total Labor			3,990.00	
Tasks	50.02	Construction Inspection			
Professional Personnel						
		Hours	Rate	Amount		
Sr. Engineering Designer		25.25	100.00	2,525.00		
Sr. Construction Inspector		19.00	125.00	2,375.00		
Construction Inspector		8.50	80.00	680.00		
Totals
Total Labor		52.75		5,580.00	
5,580.00	
			Total this	Invoice	 $9,570.00 	
Outstanding Invoices						
Number
98404	Date
12/18/2023	Balance
14,347.50				
Total		14,347.50				

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

July 17, 2023
Project No:	21-063.001
Invoice No:	97726

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through June 30, 2023
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
19.75	Rate
210.00	Amount
4,147.50	
Totals	19.75		4,147.50	
Total Labor			4,147.50	
Tasks	50.02	Construction Inspection
Professional Personnel
Hours	Rate	Amount
Sr. Construction Inspector	129.75	125.00	16,218.75
Totals
Total Labor		129.75	16,218.75	
16,218.75	
			Total this Invoice	 $20,366.25 	
Outstanding Invoices					
Number
97596	Date
6/16/2023	Balance
29,002.77			
Total		29,002.77			

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

August 17, 2023
Project No:	21-063.001
Invoice No:	97834

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through July 31, 2023	
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
15.25	Rate
210.00	Amount
3,202.50	
Totals	15.25		3,202.50	
Total Labor			3,202.50	
Tasks	50.02	Construction Inspection			
Professional Personnel					
	Hours	Rate	Amount		
Sr. Construction Inspector	77.50	125.00	9,687.50		
Construction Inspector	34.00	90.00	3,060.00		
Totals
Total Labor	111.50		12,747.50	
12,747.50	
Phase	8	Reimbursable Expense
Reimbursable Expenses
Reimbursable Expense
5/26/2023	Terpening, Thomas	To and From Site	17.60		
6/8/2023	Terpening, Thomas	To and From Site	35.29		
7/10/2023	Terpening, Thomas	To & From Site	25.24		
	Total Reimbursables		78.13	78.13	

Project

21-063.001

Becker Road West Phase 2 CEI	Invoice
Total this Invoice

97834
$16,028.13

Outstanding Invoices

Number	Date	Balance	
97726	7/17/2023	20,366.25	
Total		20,366.25	

Page 2

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

September 22, 2023
Project No:	21-063.001
Invoice No:	97993

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through August 31, 2023
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
21.50	Rate
210.00	Amount
4,515.00	
Totals	21.50		4,515.00	
Total Labor			4,515.00	
Tasks	50.02	Construction Inspection
Professional Personnel
Hours	Rate	Amount
Sr. Construction Inspector	124.00	125.00	15,500.00
Totals	124.00	15,500.00
Total Labor	15,500.00

Phase	8	Reimbursable Expense
Reimbursable Expenses
Reimbursable Expense
8/3/2023	Terpening, Thomas	To and From Site	9.70
8/10/2023	Terpening, Thomas	To and From Site	16.43

$20,041.13

Total Reimbursables	26.13	26.13
Total this Invoice

Project

21-063.001	Becker Road West Phase 2 CEI	Invoice

97993

Outstanding Invoices

Number	Date	Balance	
97834	8/17/2023	16,028.13	
Total		16,028.13	

Page 2

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

October 12, 2023
Project No:	21-063.001
Invoice No:	98043

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through September 30, 2023
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
18.75	Rate
210.00	Amount
3,937.50	
Totals	18.75		3,937.50	
Total Labor			3,937.50	
Tasks	50.02	Construction Inspection

Hours	Rate	Amount	
69.50	125.00	8,687.50	
69.50		8,687.50	

Professional Personnel

Sr. Construction Inspector
Totals
Total Labor	8,687.50

Phase	8	Reimbursable Expense
Reimbursable Expenses
Reimbursable Expense

$12,645.52

9/20/2023	Terpening, Thomas	To and From Site	20.52
Total Reimbursables	20.52	20.52
Total this Invoice

Project

21-063.001	Becker Road West Phase 2 CEI	Invoice

98043

Outstanding Invoices

Number	Date	Balance	
97993	9/22/2023	20,041.13	
Total		20,041.13	

Page 2

8524
Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

November 21, 2023
Project No:	21-063.001
Invoice No:	98182

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through October 31, 2023	
Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
22.25	Rate
210.00	Amount
4,672.50	
Totals	22.25		4,672.50	
Total Labor			4,672.50	
Unit Billing				
MILEAGE
10/25/2023	
34.0 Miles @ 0.655	
22.27		
Total Units		22.27	22.27	
Tasks	50.02	Construction Inspection				
Professional Personnel					
	Hours	Rate	Amount		
Principal Engineer, PE	4.00	210.00	840.00		
Sr. Project Manager	.50	135.00	67.50		
Sr. Engineering Designer	3.50	100.00	350.00		
Sr. Construction Inspector	137.00	125.00	17,125.00		
Sr. Engineering Technician	4.00	80.00	320.00		
Totals
Total Labor	149.00		18,702.50	
18,702.50	

Project

21-063.001	Becker Road West Phase 2 CEI	Invoice

98182

Phase	8	Reimbursable Expense
Reimbursable Expenses
Reimbursable Expense
9/7/2023	Terpening, Thomas	To and From Site		13.31		
9/13/2023	Terpening, Thomas	To and From Site		12.08		
Total Reimbursables			25.39	25.39	
		Total this Invoice		 $23,422.66 	
Outstanding Invoices			
Number	Date	Balance		
98043	10/12/2023	12,645.52		
Total	12,645.52		

Page 2

7885
JDE Line 1 Eric

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Frank Covelli
Director of Community Development and Planning Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

November 21, 2023
Project No:	21-063
Invoice No:	98219

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Stefan Matthes, P.E.

PO No:
Contract No:
WA No:
Client Project No.
Client Project Name
Project	21-063	Becker Road West Phase 2 Design
Professional Services through October 31, 2023
Phase	0	Billing Phase
Fee

Billing Phase	Fee

Percent Complete

Previous
Fee Billing

Current Fee
Billing

20.01 Route Design Survey	21,480.00	100.00	21,480.00	0.00		
20.02 Geotechnical Exploration	9,000.00	100.00	9,000.00	0.00		
30.01 30% Design Plans	58,395.00	100.00	58,395.00	0.00		
30.02 80% Design Plans	94,755.00	100.00	94,755.00	0.00		
30.03 Permitting	32,120.00	100.00	32,120.00	0.00		
30.04 100% Construction Plan	34,955.00	100.00	34,955.00	0.00		
30.10 CO.01 Final Plat Preparation	9,600.00	100.00	8,640.00	960.00		
40.01 Bid Coordination	7,660.00	20.00	1,532.00	0.00		
70.01 Project Representation	13,360.00	100.00	13,360.00	0.00		
70.02 Street Lighting Coordination	6,240.00	100.00	6,240.00	0.00		
Total Fee	287,565.00		280,477.00	960.00		
	Total Fee				960.00	
			Total this Invoice		 $960.00 	

Project

21-063	Becker Road West Phase 2 Design	Invoice

98219

Outstanding Invoices

Number	Date	Balance	
96610	12/22/2022	3,150.00	
Total		3,150.00	

Page 2

Invoice

Culpepper & Terpening, Inc.
Consulting Engineers and Land Surveyors 2980 South 25th Street
Fort Pierce, Florida 34981
Phone (772)464-3537 /Fax (772)464-9497
accounting@ct-eng.com

Mr. Tony Palumbo
Mattamy Homes, Southeast Florida Division SEFL.LandAP@mattamycorp.com

December 18, 2023
Project No:	21-063.001
Invoice No:	98404

Principal:	James 'Butch' Terpening, Jr., P.E. Project Manager:	Marcelo Dimitriou, P.E.

PO No:
Contract No:
WA No:
Client Project No. Client Project Name
Project	21-063.001	Becker Road West Phase 2 CEI
Professional Services through November 30, 2023

8524
Eric

Phase	5	Construction Services	
Tasks	50.01	Pre-Construction Start-up	
Professional Personnel				

Principal Engineer, PE	Hours
14.75	Rate
210.00	Amount
3,097.50	
Totals	14.75		3,097.50	
Total Labor			3,097.50	
Tasks	50.02	Construction Inspection
Professional Personnel

Hours	Rate	Amount	
Sr. Construction Inspector	90.00	125.00	11,250.00	
Totals
Total Labor		90.00	11,250.00	
11,250.00	
			 Total this Invoice 	 $14,347.50 	
Outstanding Invoices				
Number	Date	Balance		
98043	10/12/2023	12,645.52		
98182	11/21/2023	23,422.66		
Total		36,068.18		

EW Consultants, Inc.
1000 SE Monterey Commons Blvd., Suite 208 Stuart, FL 34996
Tel: (772) 287-8771 Fax: (772) 287-2988

Mr. Stef Matthes

64228356.1510.37230
Received 9/5/23 Eric/ Tony

Project ID:

Invoice Date	
Jul 18, 2022	
Billing From	
Jun 01, 2022	

1224.37:MAIN

Page 1 of 1

Invoice Num	
26927	
Billing To	
Jun 30, 2022	

Culpepper & Terpening

Project Name:	Becker / Mattamy

2980 South 25th Street Fort Pierce FL 34981

Manager:
P O Number:

INVOICE

E. Weinberg

Project ID

Phase Description	Contract

Amount

%
Complete

Previously
Billed

Amount
Due

1224.37:Lump 1

Environmental Permitting & Compliance

$10,500.00

75.00

$0.00

$7,875.00

$7,875.00

Amount Due This Invoice:
This invoice is due upon receipt

Conduct field reconnaissance and resource mapping
Conduct 100% gopher tortoise survey
Conduct permit research
Prepare and transmit environmental assessment report

701 SE Ocean Boulevard Stuart, FL 34994
(772) 220-2100

8523
Eric

MATTAMY HOMES - SOUTHEAST FLORIDA DIVISION ANTHONY PALUMBO
2500 QUANTUM LAKES BOULEVARD SUITE 215
BOYNTON BEACH, FL 33426

Invoice number	34240
Date	12/15/2022

Project 20-276.49 MATTAMY HOMES - BECKER ROAD EXTENSION - LANDSCAPE ARCHITECTURE

Professional Services for the period: 11/1/22 to 11/30/22

Description

Contract Amount

Percent Complete

Total Billed

Prior Fee Billings

Current Billed

001	45,500.00	25.00	11,375.00	0.00	11,375.00
	Total	45,500.00	25.00	11,375.00	0.00	11,375.00	
								
						Invoice total	 11,375.00 	
Aging Summary
Invoice Number	

Invoice Date	

Outstanding	

Current	

Over 30	

Over 60	

Over 90	

Over 120	
34240	12/15/2022	11,375.00	11,375.00					
	Total	11,375.00	11,375.00	0.00	0.00	0.00	0.00	

Project Manager

STEVEN GARRETT

701 SE Ocean Boulevard Stuart, FL 34994
(772) 220-2100

8523
Eric

MATTAMY HOMES - SOUTHEAST FLORIDA DIVISION ANTHONY PALUMBO
2500 QUANTUM LAKES BOULEVARD SUITE 215
BOYNTON BEACH, FL 33426

Invoice number	34315
Date	01/16/2023

Project 20-276.49 MATTAMY HOMES - BECKER ROAD EXTENSION - LANDSCAPE ARCHITECTURE

Professional Services for the period: 12/1/22 to 12/31/22

Description

Contract Amount

Percent Complete

Total Billed

Prior Fee Billings

Current Billed

001	45,500.00	50.00	22,750.00	11,375.00	11,375.00
		Total	45,500.00	50.00	22,750.00	11,375.00	11,375.00	

						Invoice total	11,375.00	
								
Aging Summary
Invoice Number	

Invoice Date	

Outstanding	

Current	

Over 30	

Over 60	

Over 90	

Over 120	
34240	12/15/2022	11,375.00		11,375.00				
34315	01/16/2023	11,375.00	11,375.00					
	Total	22,750.00	11,375.00	11,375.00	0.00	0.00	0.00	

Project Manager

STEVEN GARRETT

701 SE Ocean Boulevard Stuart, FL 34994
(772) 220-2100

8523
Eric

MATTAMY HOMES - SOUTHEAST FLORIDA DIVISION ANTHONY PALUMBO
2500 QUANTUM LAKES BOULEVARD SUITE 215
BOYNTON BEACH, FL 33426

Invoice number	34367
Date	02/15/2023

Project 20-276.49 MATTAMY HOMES - BECKER ROAD EXTENSION - LANDSCAPE ARCHITECTURE

Professional Services for the period: 1/1/23 to 1/31/23

Description

Contract Amount

Percent Complete

Total Billed

Prior Fee Billings

Current Billed

001	45,500.00	75.00	34,125.00	22,750.00	11,375.00
		Total	45,500.00	75.00	34,125.00	22,750.00	11,375.00	
								
						Invoice total	 11,375.00 	
Aging Summary
Invoice Number	

Invoice Date	

Outstanding	

Current	

Over 30	

Over 60	

Over 90	

Over 120	
34315	01/16/2023	11,375.00		11,375.00				
34367	02/15/2023	11,375.00	11,375.00					
	Total	22,750.00	11,375.00	11,375.00	0.00	0.00	0.00	

Project Manager

STEVEN GARRETT

701 SE Ocean Boulevard Stuart, FL 34994
(772) 220-2100

8523
Eric

MATTAMY HOMES - SOUTHEAST FLORIDA DIVISION ANTHONY PALUMBO
2500 QUANTUM LAKES BOULEVARD SUITE 215
BOYNTON BEACH, FL 33426

Invoice number	34423
Date	03/20/2023

Project 20-276.49 MATTAMY HOMES - BECKER ROAD EXTENSION - LANDSCAPE ARCHITECTURE

Professional Services for the period: 2/1/23 to 2/28/23

Description

Contract Amount

Percent Complete

Total Billed

Prior Fee Billings

Current Billed

001	45,500.00	90.00	40,950.00	34,125.00	6,825.00
	Total	45,500.00	90.00	40,950.00	34,125.00	6,825.00	

						Invoice total	6,825.00	
								
Aging Summary
Invoice Number	

Invoice Date	

Outstanding	

Current	

Over 30	

Over 60	

Over 90	

Over 120	
34367	02/15/2023	11,375.00		11,375.00				
34423	03/20/2023	6,825.00	6,825.00					
	Total	18,200.00	6,825.00	11,375.00	0.00	0.00	0.00	

Project Manager

STEVEN GARRETT

701 SE Ocean Boulevard Stuart, FL 34994
(772) 220-2100

8523
Eric

MATTAMY HOMES - SOUTHEAST FLORIDA DIVISION ANTHONY PALUMBO
2500 QUANTUM LAKES BOULEVARD SUITE 215
BOYNTON BEACH, FL 33426

Invoice number	34602
Date	06/18/2023

Project 20-276.49 MATTAMY HOMES - BECKER ROAD EXTENSION - LANDSCAPE ARCHITECTURE

Professional Services for the period: 5/1/23 to 5/31/23

Description

Contract Amount

Percent Complete

Total Billed

Prior Fee Billings

Current Billed

001	45,500.00	100.00	45,500.00	40,950.00	4,550.00
	Total	45,500.00	100.00	45,500.00	40,950.00	4,550.00	
								
						Invoice total	 4,550.00 	
Aging Summary
Invoice Number	

Invoice Date	

Outstanding	

Current	

Over 30	

Over 60	

Over 90	

Over 120	
34602	06/18/2023	4,550.00	4,550.00					
	Total	4,550.00	4,550.00	0.00	0.00	0.00	0.00	

Project Manager

STEVEN GARRETT

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of 2

TO:	Mattamy Homes
1500 Gateway Blvd, Suite 212 Boynton Beach, FL 33426

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing

8540-1
Eric

PROJECT:	Becker Road West Phase 2 Becker Road
Port St Lucie, FL
3310.2200542.0000

APP.	# 1

PERIOD TO: 01/31/2023

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

ORIGINAL CONTRACT SUM
Net change by Change Orders
CONTRACT SUM TO DATE (Line 1 =/- 2)
TOTAL COMPLETED & STORED TO DATE
(Column G on G703)

	$29,300.00	
$

	$29,300.00	
	$1,800.00	

RETAINAGE

10% of Completed Work 	
(Column D + E on G703
10% Stored Material	NIA

Total Retainage (Line Sa+ Sb} or
(Total in Column I of G703}		

The undersigned SubcontractorNendor certifies that to the best of his knowledge

TOTAL EARNED
(Line 4 less Line S Total}

	$1,800.00	

information and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been

LESS PREVIOUS CERTIFICATES FOR		
PAYMENT (Line 6 from fil!Q.!: Certificate}

paid by them for Work for which previous Certificates for Payment were Issued and payments received from the Contractor, and the current payment shown here is now due.

CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

	$1,800.00 y MS	
	$27,500.00	

CONTRACTOR

State of:	Florida	Coun f:	Saint Lucie
Subscribedan sworn tob tore methisL,-; ay of v�b( V:./)£:l-tf?:tandaceAzz.opar
Notary Public:	,,,,,..,., A7'	t T!A:df Comm#G 08B .,

· ·	·	:.....,..f	I

l'"..	: , Exo1res Augus, ?P. >.Q,.,

BY			DATE <hb.s 

My Comm1ss1	p1 s:	o· f.I)-,O' 1	"J	<- '!i;ii,;. / B<nJec 111\.J.Aar-.:'r-IO@f'i

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the incicated, the qualiity of the Work is In accordance with the Contract Documents, and the Contractor Is entitled to payment of the AMOUNT CERTIFIED.

t)	_,/ "-	1•1111,n\ll
-				
AMOUNT CERTIFIED ............................:.................	$1,800.00
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

 By:	Date:	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENTG703	PAGE Of: PAGES 2 of 2

AJA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dol1ar.

APPLICATION NO: APPLICATION DATE:
PERIOD TO:

1
01/31/23
01/31/23

Use Column I on Contracts where variable retainage for line items may apply.

GFA'S PROJECT NO: 3310.2200542

A	B	Quaniiy	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION
OF WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	THIS PERIOD	PRESENT!.,Y	COMPLETED	<G+C)	TO FINISH	
						APPLICATION		STORED	AND STORED		(C-G)	
						(D+E)		(NOT!N	TO DATE			
								DOREI	(D+E+Fl			
												
	Construction Material Testing				$29,300.00		$1,800.00		$1,800.00	6.14%	27,500.00	

												

												

												

												

												

	Subtotal				$29,300.00				-	0.00%		
	Chanae Orders:									0.00%		
	GRAND TOTALS				$29,300.00	$0.00	$1,800.00	$0.00	$1,800.00	6.14%	27,500.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document 0401 • Certification of Document's Authenticity

Mattamy Palm Beach, LLC 1500 Gateway Blvd, Suite 212 Boynton Beach, FL 33426

January 31, 2023
Project: No:	3310.2200542.0000
Invoice No:	00682363

Terms: Net 30 days
We accept American Express, Visa, Master Card, Discover, and ACH

Project:	3310.2200542.0000	Becker Road West Phase 2

Location:

Becker Road
Port Saint Lucie, FL

Professional Services through February 28, 2023

Phase	3310
Unit Billing
Administration Fee

In-Place Density Test - Soils

Becker Road West Phase 2

1.0 Hour @ 50.00	50.00

1/11/2023	WO # 289937	6.0 Tests @ 25.00	150.00	
1/12/2023	WO # 289935	24.0 Tests @ 25.00	600.00	
Laboratory Proctor Test (Each)
12/22/2022	6544, 1072, 1087	3.0 Tests @ 105.00	315.00
Professional Engineer (Per Hr.)

Project Manager/Quality Control Technician Time (Per Hr.)

2.0 Hours @ 125.00	250.00

1.0 Hour @ 85.00	85.00

5.0 Hours @ 70.00	350.00

Total Units	1,800.00	1,800.00
Total this Phase	$1,800.00

Total this Invoice	$1,800.00

418

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of 2

TO:	Mattamy Homes
1500 Gateway Blvd, Suite 212 Boynton Beach, FL 33426

PROJECT:	Becker Road West Phase 2 Becker Road
Port St Lucie, FL

APP.	#2

PERIOD TO: 02/28/2023

FROM (SUBCONTRACTORNENDOR): GFA International, Inc.
607 NW Commodity Cove Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing

8540-2
Eric

3310.2200542.0000

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

1. ORIGINAL CONTRACT SUM		$29,300.00		
2. Net change by Change Orders	$	
3. CONTRACT SUM TO DATE (Line 1 =/- 2)		$29,300.022		
4. TOTAL COMPLETED & STORED TO DATE	$4,930.00	

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

RETAINAGE

(Column G on G703)

10% of Completed Work 	
(Column D + E on G703
10% Stored Material	N/A

The undersigned SubcontractorNendor certifies that to the best of his knowledge information and belief the Wor1< covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor, and the current payment shown here is now due

Total Retainage (Line 5a + 5b) or (Total in Column I of G703)
TOTAL EARNED
(Line 4 less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from E![Qr Certificate)
CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(Line 3 less Line 6)

	$4,930.00	

	$1,800.00L.	

	$3,130.ooL:11 S	
$24,370.00

CONTRACTOR

State o :	Flori da	_	Counl)' :	Saip\t .'.: Candace ·orar :t

\_ :ft nt

Subscnbed and sworno_),efo!e	h!S. , . ay of /V \ /V{ t l: --P t-;2gai31111\1

?

Net ,i.	 J

Notary Publi,../'	/	"-	: _: b.01res. Aug ' ••o• l'I
"l--Y •	(	(	\'4!··-··Z'  ea TuuLl..arrf ' "'·

BY	DATE 2/.k-/,.,l::::>My Commission Expires:	-  J	));>	••,,f,,Cf.,%··

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on-site observations and the data comprising the above application, the Architect certifies to the owner that to the incicated, the qualiity of the Woll< is in accordance wijh the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED		$3,130.00	
(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

 By:	Date:	 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AJA DOCUMENT G703	PAGE OF PAGES 2 of 2

AlA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing
Contractor's signed certification is attached.
Tn tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

APPLICATION NO:	2
APPLICATION DATE:	02/28/23
PERJOD TO:	02/28/23
GFA'S PROJECT NO: 3310. 2200542

A	B	Quaniry	Unit	Unit Price	C	D	E	F	G	H	

ITEM	DESCRIPTION OFWORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO.					VALUE	FROM PREVIOUS	TIIIS PERIOD	PRESENTLY	COMPLETED	(G+C)	TO FINISH	
						APPUCATION		STORED	AND STORED		(C-G)	
						(D+EJ		(NOTIN	TO DATE			
								DORE)	(D+E+Fl			
												
	Construction Materlal TestinQ				$29,300.00	$1,800.00	$3,130.00		$4,930.00	16.83%	24,370.00	

												

												

												

												

												

	Subtotal				$29,300.00				$0.00	0.00%		
	Chance Orders:								$0.00	0.00%		
	GRAND TOTALS				$29,300.00	$1,800.00	$3,130.00	$0.00	$4,930.00	16.83%	24,370.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document 0401 - Certification of Document's Authenticity

Mattamy Homes
2450 Maitland Center Pkwy Suite 300
Maitland, FL 32751

February 24, 2023
Project: No:	3310.2200542.0000
Invoice No:	00686888

Terms: Net 30 days
We accept American Express, Visa, Master Card, Discover, and ACH

Project:	3310.2200542.0000	Becker Road West Phase 2

Location:

Becker Road
Port Saint Lucie, FL

Professional Services through February 28, 2023
Phase	3310	Becker Road West Phase 2
Unit Billing
Administration Fee

In-Place Density Test - Soils

1.0 Hour @ 50.00	50.00

2/9/2023	WO# 292234	8.0 Tests @ 25.00	200.00	
2/10/2023	WO# 292233	10.0 Tests @ 25.00	250.00	
2/14/2023	WO# 292235	6.0 Tests @ 25.00	150.00	
2/16/2023	WO# 292585	12.0 Tests @ 25.00	300.00	
2/20/2023	WO# 292586	5.0 Tests @ 25.00	125.00	
2/20/2023	WO# 292587	8.0 Tests @ 25.00	200.00	
2/23/2023	WO# 292588	28.0 Tests @ 25.00	700.00	
boratory Proctor Test (Each)
1/11/2023	Lab ID 1088	1.0 Test @ 105.00	105.00	

La

Professional Engineer (Per Hr.) Project Manager/Quality Control Technician Time (Per Hr.)

1.0 Hour @ 125.00	125.00

1.0 Hour @ 85.00	85.00

12.0 Hours @ 70.00	840.00

Total Units	3,130.00	3,130.00
Total this Phase	$3,130.00

Total this Invoice	$3,130.00

421

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of 2

TO:	Mattamy Homes
1500 Gateway Blvd, Suite 212 Boynton Beach, FL 33426

FROM (SUBCONTRACTORNENDOR):  GFA International, Inc.
607 NW Commodity Cove
Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing

8540-3
Eric

PROJECT:	Becker Road West Phase 2 Becker Road
Port St Lucie, FL
3310.2200542.0000

APP.	# 3

PERIOD TO: 03/31/2023

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below. in connection with the Contract Continuation Sheet, Document G703. must be attached.

paid by them for Work for which previous Certificates for Payment were issued and payments received from the Contractor. and the current paymenl shown here is now due

CURRENT PAYMENT DUE
BALANCE TO FINISH, PLUS RETAINAGE
(line 3 less Line 6)
State of:	Florida

$4,650.00	/vl.S

	
ORIGINAL CONTRACT SUM	$29,300.00
Net change by Change Orders	$
CONTRACT SUM TO DATE (Line 1 =/- 2)		$29.300.oov	
TOTAL COMPLETED & STORED TO DATE	$9,580.00
(Column G on G703)
RETAINAGE
10% of Completed Work 	
(Column D + E on G703
10% Stored Material	N/A
Total Reta,nage (Line 5a + Sb) or (Total in Column I of G703)	
	6. TOTAL EARNED	$9,580.00	
The undersigned SubcontractorNendor certifies that to the besl of his knowledge information and belief lhe Work covered by lh1s Application for Paymenl has been	(Line 4 less Line 5 Total)
7. LESS PREVIOUS CERTIFICATES FOR	
	$4,930.00		
completed in accordance with the Conlracl Documents. lhal all amounts have been	PAYMENT (. 1M 6 from l!W!.! c..n,foe••• )		

$19,720.00

County of:	Saint Lucie

CONTRACTOR

BY			DATE  ?.?

Subscribed and s orn1-ore me this Notary Public:	,k.	-
My Commissiln' xpires. ;J--jJ "i}dl)°o3

dafy'0--=·A{J0'\"'·'"-'"--== ·202ir-'
\->·· ·-.,;, ,.1.ci:::i· ·,;· ,,,13
-:.')."<.. /	t:XPIRE:S: t=tibr....-J' 18, 2Crl7
'-.,{ · :f.: /

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Document, based on on•site observat10ns and the data compnsing the above application. the Architect certifies to the Owner lhal to the incicated, the Qual11ty of the Work is 1n accordance with lhe Contract Documents, and the Contractor IS entitled to payment of the AMOUNT CERTIFIED

AMOUNT CERTIFIED ..............................................	$4,650.00

(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

By:	Dale:

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	A/A DOCUMENTG703	PAGE OF PAGES '2 at 2

AIA Document G702. APPLICATION AND CERTIFICATION FOR PAYMENT, contamms
Conrrnc1or's s1w,cd ceruficauon ,s attached
In tabulilllonsbelo,,. amounts arc stated to the nearest dollar
Use Column I on Contracts 1.,•hcrc variable reta,nag(' for hne Items mav applv

APPLICATION NO	3
APPLICATION DATE:	03/31/23
PERIOD TO·	03/31/23
GFA'S PROJECT NO: 3310.2200542

A	ll	Quamly	Uml	Unu Pncc	C	D	E.	F	G	II	

ITEM	DESCRIP-llON
Of WORK				
SCHEDULED	
WORK COMPLETED	
MATERIALS	
TOTAL	
%	
BALANCE	
NO					VALUE	FROM PREVIOUS	nus PERIOD	PRESENTLY	CO ll'LETED	(G C)	TO FINISl1	
						,ll'PLICATION		STORED	AND STORED		(C-G)	
						ID •El		(NOTIN	TO DATE			
								DORE)	(D+E•F)			
												
	Construction Material TestlnQ				$29,30000	$4,930.00	$4,650.00		$9.580.00	32 70%	19.72000	

												

												

												

												

												

	Subtotal				$29,300.00				'	0.00%		
	ChanQe Orders.								\	I	0.00%		
	GRAND TOTALS				$29,300 00	$4.930.00	$4,650.00	$0,00	$9,580.00	32,70%	19,720.00	
Use!'$ may obtain validation of this document by requesting of the license a completed AIA Document 0401 • Certification of Document's Authenticity

Remit to: P.O.Box 628749; Orlando, FL 32862-8749

INVOICE

-'-I,	'I-"
1-f'_qNATIO

A Universal Engineering Sciences Company

607 Northwest Commodity Cove, Port St. Lucie, FL 34986 Ip 772.924.3575 If 772.924.3580

Mattamy Homes
2450 Maitland Center Pkwy Suite 300
Maitland, FL 32751

March 24, 2023 Project: No: Invoice No:

3310.2200542.0000
00695124

Terms: Net 30 days
We accept American Express. Visa, Master Card, Discover, and ACH

Project:
Location:

3310.2200542.0000
Becker Road
Port Saint Lucie, FL

Becker Road West Phase 2

Phase
Unit Billing
Administration Fee

3310	Becker Road West Phase 2

1.0 Hour@ 50.00	50.00

In-Place Density Test - Soils
2/24/2023	WO# 293125	20.0 Tests@ 25.00	500.00	
2/25/2023	WO# 293126	24.0 Tests @ 25.00	600.00	
2/27/2023	WO# 293127	18.0 Tests@ 25.00	450.00	
2/27/2023	WO# 293128	10.0 Tests@ 25.00	250.00	
3/1/2023	WO#293129	6.0 Tests@ 25.00	150.00	
3/3/2023	WO# 293796	6.0 Tests@ 25.00	150.00	
3/3/2023	WO# 293797	9.0 Tests@ 25.00	225.00	
3/8/2023	WO# 294329	10.0 Tests@ 25.00	250.00	
3/10/2023	WO# 294332	8.0 Tests@ 25.00	200.00	
3/13/2023	WO# 294328	12.0 Tests@ 25.00	300.00	
3/17/2023	WO# 294330	5.0 Tests@ 25.00	125.00	

Professional Engineer (Per Hr.) Project Manager/Quality Control Technician Time (Per Hr.)
Total Units

1.0 Hour@ 125.00	125.00

1,0 Hour@ 85.00	85.00

17.0 Hours@ 70.00	1,190.00

4,650.00	4,650.00	
Total this Phase	$4,650.00	
Total this Invoice	$4,650.00	

424

SUBCONTRACTORNENDOR APPLICATION AND CERTIFICATE FOR PAYMENT	Page 1 of 2

TO:	Mattamy Homes
1500 Gateway Blvd, Suite 212 Boynton Beach, FL 33426

FROM (SUBCONTRACTORNENDOR):  GFA International, Inc.
607 NW Commodity Cove
Port St Lucie, FL 34986
CONTRACT FOR:	Materials Testing

8540-4
Eric

PROJECT:	Becker Road West Phase 2 Becker Road
Port St Lucie, FL
3310.2200542.0000

APP.	#4

PERIOD TO: 04130/2023

CHANGE ORDER SUMMARY	
Change Orders approved in previous months by Contractor
TOTAL	ADDITIONS	DEDUCTIONS	
Approved this Month			
Number	Date Approved			
				
	TOTALS	$	-	$	-	
Net change by Change Orders	$	-	

APPLICATION FOR PAYMENT

Application is made for Payment, as shown below, in connection with the Contract Continuation Sheet, Document G703, must be attached.

2. Net change by Change Orders	$	z

CONTRACTOR '	\.
BY	DATE  h rs

State of:	Flori

_;'-f�-{' day oJEN EAA
;•:	:•,  MY COMMISSION # HH 323323

, ::f. - ! l:. EXPIRES: Febrwuy 18, 2027

'I 

	
1. ORIGINAL CONTRACT SUM	$29,300.00

CONTRACT SUM TO DATE (Line 1 =/- 2)	$29,300.00
TOTAL COMPLETED & STORED TO DATE	$23,078.00
(Column G on G703)
RETAINAGE
10% of Completed Work 	
(Column D + E on G703
10% Stored Material	NIA
Total Retalnage (Line Sa+ Sb) or (Total In Column I of G703)		
	6. TOTAL EARNED	$23,078.00		
The undersigned SubcontraclorNendor certifies that to the best ot his knowledge 1nformat10n and bet,ef the Work covered by this Application for Payment has been	(Line 4 less Lme 5 Total)
7. LESS PREVIOUS CERTIFICATES FOR	
	$9,580.00			
completed in accordance will) the Contract Documents. that all amounts have been	PAYMENT (L,ne 6 lrom	Cer11flcate)			
paid by them tor Work for which previous Certificates for Payment were issued and	8. CURRENT PAYMENT DUE	$13,498.00	MS		
payments received from the Contractor, and the current payment shown here is	9. BALANCE TO FINISH, PLUS RETAINAGE	$6,222.00		
now due	(Line 3 less Line 6)			

Subscribe_dand sworn to bef	23
Notary Public:

ARCHITECT'S CERTIFICATE FOR PAYMENT
In accordance With the Contract Document, based on on·Stle observations and the data comprising the above application, the Architect cer1ifies to the Owner that to the 1ncicateo, the qualiity or the Work. 1s 1n accordance with the Contract Documents, and the Contractor 1s entitled lo payment of the AMOUNT CERTIFIED.

AMOUNT CERTIFIED..................... 	$13,498.00

(Attached explanation if amount cerfitied differs from the amount applied for.) ARCHITECT:

By:	Date:

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	AIA DOCUMENTC703	PAGE OF PI\GE.S 2of 2

AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, contammg
ContrrtCl01's signed c.crt1flc:a1mn 1s attached
l.n tabul;,,1t1ons bek1\\', amounts are stated 10 the nearest dollar
Use Column I on Contrae1s where vanabh:retamagc ror hnt: itemsmay apply

APPLICATION NO	4
APPLICATION DATE.	04/01/23
PERIOD TO.	04/30/23
GFA'S PROJECT NO: 3310, 2200542

•\	ii	Qu301ty	Umt	Uml Pnce-	C	0	E	F	G	H	

ITcM	DFSCRIPTION
OF WORK				
SCHEDULED	
WORK COMrUTED	
M,\TERIALS	
TOTAL	·	
BALANCE	
NO					VALUE	FRO I rRE\IJOUS	TiflS l'ERIOD	PKJ;SENTJ.Y	COMl•LETED	\G• C)	TO Fll\ Sll	
						ArPLICATION		STORED	AND STORED		(C-G)	
						fD + E)		(NOTIN	TO OATE			
								DORE)	(D+E+fl			
												
	Construction Material Testing				$29,300.00	S9,580.00	$13,498.00		$23,078.00	78.76%	6,222.00	

												

												

												

												

												

	Subtotal				$29,300 00					0.00%		
	Chani:ie Orders:								-  ,n	0.00%		
	GRANO TOTALS				$29,300.00	$9,580.00	$13,498.00	$0.00	$23,078.00	78.76%	6,222.00	
Users may obtain validation of this document by requesting of the license a completed AIA Document 0401 • Certification of Document's Authenticity

INVOICE	
Please Make Payable to: Universal Engineering Sciences
Remit to: P.O. Box 735401, Chicago, IL 60673-5401	
Billing questions contact: uesar@teamues.com	

,,ues..
607 NW Commodity Cove, Pon St. Lucie, FL 349861 p 772-924-35751I 772-924-3580

Mattamy Homes
2450 Maitland Center Pkwy Suite 300
Maitland, FL 32751

April 27, 2023 Project: No: Invoice No:

3310.2200542.0000
00705178

TERMS: Net 30 Days
We accept American Express, Visa
Master Card, Discover, and ACH	

Project:
Location:

3310.2200542.0000
Becker Road
Port Saint Lucie, FL

Becker Road West Phase 2

Phase	3310	Becker Road West Phase 2
Unit Billing
In-Place Density Test - Soils
3/26/2023	WO# 295444	11.0 Tests@ 23.00	253.00	
3/18/2023	WO# 294331	39.0 Tests@ 25.00	975,00	
3/19/2023	WO# 294942	16.0 Tests@ 25.00	400.00	
3/19/2023	WO# 294944	4.0 Tests@ 25.00	100.00	
3/22/2023	WO#294946	28.0 Tests@ 25.00	700.00	
3/24/2023	WO# 295926	6.0 Tests@25.00	150.00	
3/28/2023	WO# 296185	10.0 Tests@ 25.00	250.00	
3/30/2023	WO# 295445	15.0 Tests@ 25.00	375.00	
3/30/2023	WO# 296011	24.0 Tests @ 25.00	600.00	
3/31/2023	WO#296012	13.0 Tests @ 25.00	325.00	
4/3/2023	WO#295447	3,0 Tests@ 25.00	75.00	
4/3/2023	WO# 296456	14.0 Tests@ 25.00	350.00	
4/3/2023	WO#296643	13.0 Tests@ 25.00	325.00	
4/4/2023	WO# 296008	4.0 Tests@ 25.00	100.00	
4/4/2023	WO# 296118	8.0 Tests @ 25.00	200.00	
4/4/2023	WO# 296644	23.0 Tests@ 25.00	575.00	
4/4/2023	WO# 296895	14.0 Tests@ 25.00	350.00	
4/4/2023	WO# 296896	8.0 Tests@ 25.00	200.00	
4/5/2023	WO#296009	6.0 Tests@ 25.00	150.00	
4/5/2023	WO# 296010	1o.oTests @ 25.00	250.00	
4/5/2023	WO# 296645	17.0 Tests@ 25.00	425.00	
4/5/2023	WO# 297080	3.0 Tests@ 25.00	75.00	
4/13/2023	WO# 296651	8.0 Tests@ 25.00	200.00	
4/14/2023	WO# 296652	12.0 Tests@ 25.00	300.00	
4/19/2023	WO# 296655	23.0 Tests @ 25.00	575.00	
4/19/2023	WO# 297154	9.0 Tests@ 25.00	225.00	
4/20/2023	WO# 296646	6.0 Tests@ 25.00	150.00	
4/24/2023	WO# 296647	6.0 Tests@ 25.00	150.00	
4/25/2023	WO# 296649	6.0 Tests @ 25.00	150.00	
Administration Fee				
		1.0 Hour@ 50.00	50.00	

Project	3310.2200542.0000	Becker Road West Phase 2	Invoice	00705178
Cylinder - Concrete Compressive

WO# 296116
Limerock Bearing Ratio (LBR)
4/4/2023	Lab ID 1885, 1886, 1887, 1888
Professional Engineer (Per Hr.) Project Manager/Quality Control Technician Time (Per Hr.)
Total Units

1.0 Hour@ 60.00

4.0 Tests@ 260.00

1.0 Hour@ 125.00

1.0 Hour@ 85.00

13,498.00	13,498.00	
Total this Phase	$13,498.00	
Total this Invoice	$13,498.00	

45.5 Hours @ 70.00

60.00

1,040.00

125.00

85.00

3,185.00

Page 2

8950
Eric

Kenneth DiDonato Inc.
IRRIGATION CONSULTANT
2210 Hollywood Blvd.
Hollywood, Florida 33020

(954)-923-2555

Inv #05.05.23

May 5, 2023

Mattamy Homes USA
2500 Quantum Lakes Dr. #215 Boynton Beach, Fl 33426

Attn: Eric Sexauer

INVOICE

DESCRIPTION	FEE

Irrigation design for Becker Road Extension – Stations 125+35 to 184+50	$5,000.00

Total	$5,000.00

Specializing in Golf Course and Commercial Irrigation Design

DocuSign Envelope ID: 32D3702D-8B54-4C97-9F09-C9A0D12E5C2D

CHECK REQUEST

Request Date:	11/1/2022

Requestor Name:	Tara Toto

Date Check Needed:	11/4/2022 FEDEX

X	Return check to Requestor Other

PAY TO THE ORDER OF:	City of Port St. Lucie

Address:

Amount of Check:	$63,094.33	

Purpose of Check:	

Tradition: Becker Road Western Extension (P22-251). PW Permit Fee	

Vendor #:	

427940	

Account #:	

64228356.1510.35010	

Approved by:	

	

Date

** RECEIPT OR OTHER DOCUMENTATION MUST BE ATTACHED TO THIS REQUEST

DocuSign Envelope ID: 32D3702D-8B54-4C97-9F09-C9A0D12E5C2D

Laura Meyer
From:	Tara Toto
Sent:	Tuesday, November 1, 2022 2:14 PM
To:	Laura Meyer
Subject:	Check Request - Becker Road
Attachments:	P22-251_221027_Becker Rd West Extension_Construction Permit Fee Calculation.pdf
Follow Up Flag:	Follow up
Flag Status:	Flagged

Hi Laura,

Please process a check for the following:
Payable to: City of Port St. Lucie

Check Amount $63,094.33
Purpose: Tradition: Becker Road Western Extension (P22-251). PW Permit Fee. Vendor: 427940
Cost Code: 64228356.1510.35010

Please provide the check by EOD Thursday November 3, 2022. Thanks.

Sincerely,

Tara Toto
Land Planning & Entitlement Manager | Southeast Florida Division C (561) 592-9520
Tara.Toto@mattamycorp.com

Mattamy Homes USA
Division Office: 2500 Quantum Lakes Drive, Suite 215, Boynton Beach, FL 33426 Connect with us: 
Notice: This email is intended for use of the party to whom it is addressed and may contain confidential information. If you have received this email in error, please inform me and delete it. Thank you.

DocuSign Envelope ID: 32D3702D-8B54-4C97-9F09-C9A0D12E5C2D

Revised: July, 2017		CITY OF PORT ST LUCIE PUBLIC WORKS DEPARTMENT
Construction Permit Fee Calculation
(Fees Effective August 23, 2012 per Ordinance 12-37)	
PROJECT NO. & NAME :	P22-251 Becker Road Western Extension - Mattamy Portion	
Inspection and Fee Rate
(Check Off Indicates Required Inspection)	Fee	Contact	
NPDES
  City Sediment and Erosion Control Inspection		NPDES Program Manager Bret Kaiser
772/ 344-4128	
Survey
Culvert Design and Inspection
0	First Culvert @	$	370.00
0	Additional Culverts @	$	105.00

Driveway Modification
0	With Culvert @	$	215.00
0	With Curb and Gutter @	$	125.00
Swale / Culvert Design & Stakeout
  Swale & Culvert Final Inspection		
772/ 871-5177	
	$	-	772/ 344-4222 TDD (for deaf and hearing impaired)	
	$	-	A minimum 24-hour notification is required.	
		Culvert Reinspection Fee will apply as follows	
	$	-	First	$95.00	
	$	-	Second	$120.00	
	Fund 343.923	$	-	Third and Subsequent	$145.00	
			
Traffic
0	(Fund 344.902) New Signal (s) @	$	1,860.00
0	(Fund 344.907) Signal Modification (s) @	$	600.00
Signal Inspection

0	First Street/Ped Light @	$	1,270.00
0	Additional Street/Ped Light @	$	80.00
Street /Pedestrian Light Inspection
	Traffic Division Acceptance of Signals and Lights Design	
$	-
$	-	
Traffic Division Jack Beever 772/ 370-8203

Traffic Signal, Street/Pedestrian Light Reinspection First	$300.00
Second	$325.00
Third and Subsequent	$350.00	
		$	-		
	
$	-
$	-		
		$	-		
			
	Fund 344.903	$	-		
Site
Engineer of Record or Representative Must be Present for Site Inspections
$	6,252,432.68	Site Work Cost
Base Fee @ $	570.00
Site Work Cost Rate @	0.01	

$	570.00
$	62,524.33	772/ 871-5177
772/ 344-4222 TDD (for deaf and hearing impaired) A minimum 24-hour notification is required.

Public Works Site Reinspection
First	$135.00
Second	$160.00
Third and Subsequent	$185.00
432	
	Fund 343.924	$	63,094.33		
Total Fee	$	63,094.33		

1

DocuSign Envelope ID: CCDC033B-2657-41EC-8BED-134CBF1F3E98

CHECK REQUEST

Request Date:	11/28/2022

Requestor Name:	Tara Toto

Date Check Needed:	11/30/2022

Mail check directly to the address provided

X	Return check to Requestor Other

PAY TO THE ORDER OF:	City of Port St. Lucie

Address:

Amount of Check:	$12,892.85	

Purpose of Check:	

Tradition: Becker Road Western Extension (P22-251). Utility Connection Fee.	

Vendor #:	
427940	

Cost Code:	

64228356.1510.35010	

11/29/2022

Approved by:

** RECEIPT OR OTHER DOCUMENTATION MUST BE ATTACHED TO THIS REQUEST

DocuSign Envelope ID: CCDC033B-2657-41EC-8BED-134CBF1F3E98

Check Request -$12,892.85 (P22-251)
Tara Toto <Tara.Toto@mattamycorp.com>
Mon 11/28/2022 12:42 PM
To: Laura Meyer <Laura.Meyer@mattamycorp.com>

 1 attachments (223 KB)
5346B_112122-Drft-Frst-Amnd-Infrst-Agmt-PKG.pdf;

Hi Laura,

Please process a check for the following:

Payable to: City of Port St. Lucie

Check Amount $12,892.85
Purpose: Tradition: Becker Road Western Extension (P22-251). Utility Connection Fee. Vendor: 427940
Cost Code: 64228356.1510.35010

Thanks. Sincerely,

Tara Toto
Land Planning & Entitlement Manager | Southeast Florida Division C (561) 592-9520
Tara.Toto@mattamy corp.com

Mattamy Homes USA
Division Oﬃce: 2500 Quantum Lakes Drive, Suite 215, Boynton Beach, FL 33426 Connect with us: 

Notice: This email is intended for use of the party to whom it is addressed and may contain conﬁdential information. If you have received this email in error, please inform me and delete it. Thank you.

DocuSign Envelope ID: CCDC033B-2657-41EC-8BED-134CBF1F3E98

Port St. Lucie Utility Systems Department Connection Fee Worksheet
121 S.W. Port St. Lucie Boulevard, Building B 2nd Floor Port St. Lucie, FL 34984
utileng@cityofpsl.com

Project Name:  Becker Road West- Phase 3			 Plaza Name:  0	 Billing Customer:  Mattamy Palm Beach, LLC			 Mailing Address:  1500 Gateway Blvd, Ste 212		
 Boynton Beach, FL 33426	 Action(s) Requested:  Utility Infrastructure Agreement Fees	

Utility File No.:  5346B		 Owner's Contact Person:  Anthony Palumbo		 Contact Phone No.:  561-413-6128	
Contact E-Mail Address: tony.palumbo@mattamycorp.com
Potable Water ERC's / Line Charges Reserved:  0	 Wastewater ERC's / Line Charges Reserved:  0	

Item

Description

Unit Price	Quantity	Definer	Amount

  No.	

1	Backbone Water Main	$1.06	x	3930.0	Linear Feet	$4,165.80	
2	Backbone Wastewater Main	$1.06	x	3585.0	Linear Feet	$3,800.10	
3	Backbone Wastewater Fiber Optic line	$1.06	x	3470.0	Linear Feet	$3,678.20	
4	Agreement Recording Fees:	$14.75 first page, $8.50 thereafter	x	5.0	Pages	$48.75	
5	Agreement Cancelation/Amendment Fee:	$300.00	x	1.0	Each	$300.00	
6	PSLUSD Potable Water Construction Permit Fee:	$450.00	x	1.0	Each	$450.00	
7	PSLUSD Wastewater Construction Permit Fee:	$450.00	x	1.0	Each	$450.00	

$12,892.85

Total

Fees are effective until September 30, 2023

	

	

**
For Office Use Only:	
Receipt#:	Date Paid:	Amount Paid:$		
	
WWTF:	Received By:		
	
25% Surcharge Out of City Limits	N/A	

Customer Information:		Name: Address:

Phone:
10/01/22-Revs	PSLUSD Doc. No. 148B	

City of Port St

Payment Receipt

Lucie Planning and Zoning
121 SW Port St Lucie Blvd.

Receipt # Date Paid:

Clerk:

3022
04/06/2023

Bldg B
Port St Lucie, Florida 34984 (772) 871-5213

laura.meyer@mattamycorp.com

Paid By: Tony Palumbo
Project/Item: P23-072 - Southern Grove-Plat No. 44 - Final

	Fee Line Items		
Department	Description	Rev. Code	Fee	
P&Z	Subdivision - Minor - <5 lots units or tracts	(001) 341.901	$945.00	
Engineering Review	Subdivision - Minor - <5 lots units or tracts	(104) 367.705	$622.04	
Engineering Plat	Subdivision - Minor - <5 lots units or tracts	(104) 367.705	$330.00	
Engineering NPDES	Subdivision - Minor - <5 lots units or tracts	(112) 343.936	$312.04	
Utility Systems	Subdivision - Minor - <5 lots units or tracts	(431) 341.904	$268.00	
		Total Due:	$2477.08	
	Payments			
Payment Type	Card/Check #		Amount	
Visa	############7202		$2,477.08	
		Total Paid:	$2477.08	
		Balance:	$0.00	

Invoice # 3080044	Page 1 of 1	
ACCOUNT NUMBER	DATE	
MATTHOM-01	02/24/2023	
BALANCE DUE ON	AMOUNT DUE	
03/25/2023	$10,493.00	

Hub International Midwest West
Phone: 630-468-5600
Fax:

Pay My Bill Online
Visit our online portal to easily and securely pay your HUB invoice using your banking information (ACH)
www.hubinternational.com/paymybill

Mattamy Homes
66 Wellington Street West, Suite 5500

Toronto, ON M5K 1G8

Bond (Renewable)			PolicyNumber:	0230506	Effective:	03/25/2023	to	03/25/2024	
									
Item #	Trans Eff Date	Due Date	Trans	Description				Amount	
35883881	03/25/2023	03/25/2023	RENB	Mattamy Palm Beach, LLC				$10,493.00	
Subd. City of Port St. Lucie, FL; Becker Rd Extension; $2,331,800.00	Policy Invoice Balance:	$10,493.00	
	Total Invoice Balance:	$10,493.00	

*** PREMIUM FINANCING OPTIONS MAY BE AVAILABLE UPON REQUEST; PLEASE CONTACT YOUR HUB REPRESENTATIVE ***
*** PLEASE RETURN A COPY OF THIS INVOICE WITH YOUR CHECK, AND REFERENCE ON THE PAYMENT YOUR INVOICE # 3080044 ***

PAY BY CHECK
Please remit your payment to:
HUB International
55 East Jackson Boulevard Suite 14th Floor
Chicago, IL 60604

ADDITIONAL PAYMENT OPTIONS

Invoice # 3409085	Page 1 of 1	
ACCOUNT NUMBER	DATE	
MATTHOM-01	11/14/2023	
BALANCE DUE ON	AMOUNT DUE	
11/14/2023	-$8,215.00	

Hub International Midwest West
Phone: 630-468-5600
Fax:

Pay My Bill Online
Visit our online portal to easily and securely pay your HUB invoice using your banking information (ACH)
www.hubinternational.com/paymybill

Mattamy Homes
66 Wellington Street West, Suite 5500

Toronto, ON M5K 1G8

Bond (Renewable)			PolicyNumber:	0230506	Effective:	03/25/2023	to	03/25/2024	
									
Item #	Trans Eff Date	Due Date	Trans	Description				Amount	
40368250	03/25/2023	11/14/2023	ENDT	Mattamy Palm Beach, LLC				($8,215.00)	

Subd. City of Port St. Lucie, FL; Becker Rd Extension; $2,331,800.00 red. $154,150.00	Policy Invoice Balance:	($8,215.00)	
Bond reduced eff. 5/23/23, r/p issued	
Total Invoice Balance:	
($8,215.00)	

*** PREMIUM FINANCING OPTIONS MAY BE AVAILABLE UPON REQUEST; PLEASE CONTACT YOUR HUB REPRESENTATIVE ***
*** PLEASE RETURN A COPY OF THIS INVOICE WITH YOUR CHECK, AND REFERENCE ON THE PAYMENT YOUR INVOICE # 3409085 ***

PAY BY CHECK
Please remit your payment to:
HUB International
55 East Jackson Boulevard Suite 14th Floor
Chicago, IL 60604

ADDITIONAL PAYMENT OPTIONS

Invoice #	2147667	Page	1 of 1	
ACCOUNT NUMBER	DATE	
MATTHOM-01	01/25/2021	
BALANCE DUE ON	AMOUNT DUE	
03/25/2021	$10,493.00	

Hub International Midwest West
Phone: 630-468-5600
Fax:

Pay My Bill Online
Visit our online portal to easily and securely pay your HUB invoice using your banking information (ACH)
www.hubinternational.com/paymybill

Mattamy Homes
66 Wellington Street West, Suite 5500 Toronto, ON M5K 1G8

	Bond (Renewable)			PolicyNumber:	0230506	Effective:	03/25/2021	to	03/25/2022	
										
	Item #	Trans Eff Date	Due Date	Trans	Description				Amount	
	23539619	03/25/2021	03/25/2021	RENB	Renewal Business Premium				$10,493.00	
Subd. City of Port St. Lucie, FL; Becker Rd Extension; $2,331,800.00	Policy Invoice Balance:	$10,493.00	
	Total Invoice Balance:	$10,493.00	

ADDITIONAL PAYMENT OPTIONS

*** PREMIUM FINANCING OPTIONS MAY BE AVAILABLE UPON REQUEST; PLEASE CONTACT YOUR HUB REPRESENTATIVE ***
*** PLEASE RETURN A COPY OF THIS INVOICE WITH YOUR CHECK, AND REFERENCE ON THE PAYMENT YOUR INVOICE # 2147667 ***

PAY BY CHECK
Please remit your payment to:
HUB International
55 East Jackson Boulevard Suite 14th Floor
Chicago, IL 60604

DocuSign Envelope ID: E8D03227-6026-42A7-9021-B1A7B2BD3FED

CHECK REQUEST

Request Date:	8/28/2023

Requestor Name:	Eric Sexauer Date Check Needed:	8/28/2023
X	FEDEX
Return check to Requestor Other

PAY TO THE ORDER OF:	Forida Power and Light

Need to include the Bill Number: 1800431503 and Reference Number 1J.D00012556786 on the remittance advice.

Address:

Amount of Check:	$11,437.36

Purpose of Check: power pole relocation

Vendor #:	427929

Tony Palumbo

8/28/2023

Date

Account #:	64228356.1510.34080

Approved by:

** RECEIPT OR OTHER DOCUMENTATION MUST BE ATTACHED TO THIS REQUEST

DocuSign Envelope ID: E8D03227-6026-42A7-9021-B1A7B2BD3FED

FW: [EXTERNAL] RE: New Person - FPL
Eric Sexauer <Eric.Sexauer@mattamycorp.com>
Mon 8/28/2023 10:14 AM
To:Laura Meyer <Laura.Meyer@mattamycorp.com>
Cc:Eric Sexauer <Eric.Sexauer@mattamycorp.com>;Tony Palumbo <Tony.Palumbo@mattamycorp.com>

 1 attachments (428 KB) WR_12556786_INV_1800431503_31_July_2023.pdf;
Laura,

Can you please set up the attached invoice for a check request to pay Florida Power & Light (I believe it is JDE 427929) and then overnight to them.

This is for a Power Pole relocation. Need to include the Bill Number: 1800431503 and Reference Number 1J.D00012556786 on the remittance advice.

Code to 64228356.1510.34080

Tony will be the approver once you create the check request form. Thanks
Eric

Eric Sexauer
Land Project Manager | Southeast Florida Division C (404) 435-1347

Eric.Sexauer@mattamycorp.com

Mattamy Homes USA
Division Oﬃce: 2500 Quantum Lakes Drive, Suite 215, Boynton Beach, FL 33426 Connect with us: 

Notice: This email is intended for use of the party to whom it is addressed and may contain conﬁdential information. If you have received this email in error, please inform me and delete it. Thank you.

From: Williams, Lexington <Lexington.Williams@fpl.com>
Sent: Thursday, August 24, 2023 12:59 PM
To: Eric Sexauer <Eric.Sexauer@mattamycorp.com>; Richardson, Ben <Ben.Richardson@fpl.com>; Goez, Laura
<Laura.Goez@fpl.com>
Cc: Tod Batson <Tod.Batson@mattamycorp.com>; Tyler Gaﬀney <Tyler.Gaﬀney@mattamycorp.com>; Frank Covelli
<Frank.Covelli@mattamycorp.com>
Subject: RE: [EXTERNAL] RE: New Person - FPL

DocuSign Envelope ID: E8D03227-6026-42A7-9021-B1A7B2BD3FED

Hello,

Your relocation invoice is available for online payment through FPL’s Project Portal (FPL.com/construction).

To pay online, simply login to the portal, select the “Pay Bill” option, then click “How to Pay,” as shown below. Finally, select “Speedpay” to execute the transaction. Please include the bill number and reference number located on your invoice. Credit cards are not accepted, and a $1 service charge will be applied from Speedpay.

Thank you for your continued partnership with FPL. We value your business, and if there is anything we can do to better serve your needs, please let us know.

Best regards,

Lexington Williams
Engineer II
Walton Service Center - FPL Cell: 772-251-8522
Email: Lexington.Williams@fpl.com

Link to FPL's Electrical Service Standards; https://www.fpl.com/partner/builders/service-standards.html

Please contact me with any questions or concerns. If you cannot reach me, feel free to contact my Engineering Leader Ben Richardson at, (c) (561) 374-4288 or Ben.Richardson@ fpl.com.

From: Eric Sexauer <Eric.Sexauer@mattamycorp.com>
Sent: Wednesday, June 28, 2023 5:07 PM
To: Richardson, Ben <Ben.Richardson@fpl.com>; Goez, Laura <Laura.Goez@fpl.com>; Williams, Lexington
<Lexington.Williams@fpl.com>
Cc: Tod Batson <Tod.Batson@mattamycorp.com>; Tyler Gaﬀney <Tyler.Gaﬀney@mattamycorp.com>; Frank Covelli
<Frank.Covelli@mattamycorp.com>; Eric Sexauer <Eric.Sexauer@mattamycorp.com>
Subject: RE: [EXTERNAL] RE: New Person - FPL

DocuSign Envelope ID: E8D03227-6026-42A7-9021-B1A7B2BD3FED

Thanks
We have Lexington’s contact info.

Laura,
Can you provide you phone contact info? Eric

Eric Sexauer
Land Project Manager | Southeast Florida Division C (404) 435-1347

Eric.Sexauer@mattamycorp.com

Mattamy Homes USA
Division Oﬃce: 2500 Quantum Lakes Drive, Suite 215, Boynton Beach, FL 33426 Connect with us: 

Notice: This email is intended for use of the party to whom it is addressed and may contain conﬁdential information. If you have received this email in error, please inform me and delete it. Thank you.

From: Richardson, Ben <Ben.Richardson@fpl.com>
Sent: Wednesday, June 28, 2023 3:04 PM
To: Eric Sexauer <Eric.Sexauer@mattamycorp.com>; Goez, Laura <Laura.Goez@fpl.com>; Williams, Lexington
<Lexington.Williams@fpl.com>
Cc: Tod Batson <Tod.Batson@mattamycorp.com>; Tyler Gaﬀney <Tyler.Gaﬀney@mattamycorp.com>; Frank Covelli
<Frank.Covelli@mattamycorp.com>
Subject: [EXTERNAL] RE: New Person - FPL Laura Goez and Lexington Williams.
Best regards,

BenRichardson
Engineering Lead | Treasure Coast | Cell: (561) 374-4288

Visit the new FPL Project Portal to manage your FPL residential and commercial construction projects including milestones.

From: Eric Sexauer <Eric.Sexauer@mattamycorp.com>
Sent: Wednesday, June 28, 2023 2:15 PM
To: Richardson, Ben <Ben.Richardson@fpl.com>

DocuSign Envelope ID: E8D03227-6026-42A7-9021-B1A7B2BD3FED
Cc: Eric Sexauer <Eric.Sexauer@mattamycorp.com>; Tod Batson <Tod.Batson@mattamycorp.com>; Tyler Gaﬀney
<Tyler.Gaﬀney@mattamycorp.com>; Frank Covelli <Frank.Covelli@mattamycorp.com>
Subject: New Person - FPL

Ben

You mentioned getting another person involved on the calls and that some of the projects might be migrating to her. Can you send us her name and contact info (Email and Cell)?
Eric

Eric Sexauer
Land Project Manager | Southeast Florida Division C (404) 435-1347

Eric.Sexauer@mattamycorp.com

Mattamy Homes USA
Division Oﬃce: 2500 Quantum Lakes Drive, Suite 215, Boynton Beach, FL 33426 Connect with us: 

Notice: This email is intended for use of the party to whom it is addressed and may contain conﬁdential information. If you have received this email in error, please inform me and delete it. Thank you.

DocuSign Envelope ID: E8D03227-6026-42A7-9021-B1A7B2BD3FED

PAYMENT COUPON

/4115006400423000194582180043150360001143736

Cust. No.:3000194582 Bill No.:1800431503	
Payment Due Upon Receipt	Amount Due This Bill
$ 11,437.36	
Reference# 1J.D00012556786	

MATTAMY HOMES
2500 QUANTUM LAKES DRIVE SUITE 215 BOYTON BEACH FL 33426

Your payment may be eligible to be paid online. Visit www.fpl.com/construction to learn more. You can also mail a check payable to FPL in USD to the FPL address listed below right. Please mail the top portion of the coupon with your check.

FPL
General Mail Facility Miami FL 33188-0001

Florida Power & Light Company Federal Tax Id.#: 59-0247775 Customer Name and Address

MATTAMY HOMES

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Please retain this portion for your records.

Customer Number:	3000194582
Reference Number:	1J.D00012556786 Bill Number:	1800431503

2500 QUANTUM LAKES DRIVE SUITE 215 BOYTON BEACH FL 33426

Bill Date:	07/31/2023

CURRENT CHARGES AND CREDITS
Customer No: 3000194582 Bill No: 1800431503
Description	Amount	
RMV/RELO- FPL FAC/0 SW COMMUNITY BLVD
Reference# 1J.D00012556786	11,437.36	

For Inquiries Contact:
Walton Svc Ctr 772-337-7051	
Total Amount Due	$11,437.36
Payment Due Upon Receipt	

DocuSign Envelope ID: B1F521CA-AAF9-44A6-942A-5A89CA931605

CHECK REQUEST

Requestor Name:

Eric Sexauer

Date Check Needed:

asap

FEDEX
X	Return check to Requestor Other

PAY TO THE ORDER OF:	Florida Power and Light

Address:

Amount of Check:	$6,233.56

Purpose of Check: Becker Rd. Power Pole Transformers

Vendor #:

427929

Account #:

64228356.1510.34080

Approved by:

10/27/2023

Date

AND Reference Number 1J.D00012718183

PLEASE INCLUDE ON CHECK: Bill Number: 1800440437

Request Date:	10/25/2023

** RECEIPT OR OTHER DOCUMENTATION MUST BE ATTACHED TO THIS REQUEST

DocuSign Envelope ID: B1F521CA-AAF9-44A6-942A-5A89CA931605

Check Request - Becker Rd - FPL Pole Transformers
Eric Sexauer <Eric.Sexauer@mattamycorp.com>
Wed 10/25/2023 4:42 PM
To:Laura Meyer <Laura.Meyer@mattamycorp.com>
Cc:Frank Covelli <Frank.Covelli@mattamycorp.com>;Karl Albertson <Karl.Albertson@mattamycorp.com>;Eric Sexauer
<Eric.Sexauer@mattamycorp.com>;Carolyn Desanti <Carolyn.DeSanti@mattamycorp.com>

 1 attachments (431 KB)
Ref 1J.D00012718183 INV 1800440437 10..25.2023.pdf;

Laura,

Can you please set up the attached invoice for a check request to pay Florida Power & Light (I believe it is JDE 427929) and then overnight to them.

This is for a Power Pole Transformers.

Need to include the Bill Number: 1800440437 and Reference Number 1J.D00012718183 on the remittance advice. Code to 64228356.1510.34080
Frank will be the approver once you create the check request form. Thanks
Eric

Eric Sexauer
Land Project Manager | Southeast Florida Division C (404) 435-1347

Eric.Sexauer@mattamycorp.com

Mattamy Homes USA
Division Oﬃce: 2500 Quantum Lakes Drive, Suite 215, Boynton Beach, FL 33426 Connect with us: 

Notice: This email is intended for use of the party to whom it is addressed and may contain conﬁdential information. If you have received this email in error, please inform me and delete it. Thank you.

DocuSign Envelope ID: B1F521CA-AAF9-44A6-942A-5A89CA931605

PAYMENT COUPON

MATTAMY HOMES
1500 GATEWAY BLVD #220 BOYNTON BEACH FL 33426

/4115006400423000173585180044043730000623356

Cust. No.:3000173585 Bill No.:1800440437	
Payment Due Upon Receipt	Amount Due This Bill
$ 6,233.56	
Reference# 1J.D00012718183	

Your payment may be eligible to be paid online. Visit www.fpl.com/construction to learn more. You can also mail a check payable to FPL in USD to the FPL address listed below right. Please mail the top portion of the coupon with your check.

FPL
General Mail Facility Miami FL 33188-0001

Florida Power & Light Company Federal Tax Id.#: 59-0247775 Customer Name and Address

MATTAMY HOMES
1500 GATEWAY BLVD #220 BOYNTON BEACH FL 33426

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Please retain this portion for your records.

Customer Number:	3000173585

Reference Number:	1J.D00012718183 Bill Number:	1800440437
Bill Date:	10/25/2023

CURRENT CHARGES AND CREDITS
Customer No: 3000173585 Bill No: 1800440437
Description	Amount	
SW COMMUNITY BLVD, PORT ST LUCIE
Reference# 1J.D00012718183	6,233.56	

For Inquiries Contact:
LEXINGTON WILLIAMS 772-251-8522	
Total Amount Due	$6,233.56
Payment Due Upon Receipt	

APPLICATION AND CERTIFICATE FOR PAYMENT

Invoice #:	121187

To Owner:

Mattamy Palm Beach LLC	Project:
2500 Quantum Lakes Drive, Suite 215

Boynton Beach, FL 33426

23-0001- Becker Road West Ph 2 Haul Fill

8537-1
Eric

Application No. :

Period To:

1

1/31/2023

Distribution to :
Owner Architect/Engineer Contractor

From Contractor:

Contract For:

H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414

Via Architect/Engineer:

Project Nos:

Contract Date:

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown

Original Contract Sum . . . . . . . . . . . . . . . . . . . . . . . .
Net Change By Change Order . . . . . . . . . . . . . . . . . . . .
Contract Sum To Date . . . . . . . . . . . . . . . . . . . . . . . . . .

$315,000.00
$0.00
$315,000.00

herein is now due. CONTRACTOR:

SUZETTE ANDRIANO
H and J Contracting Inc. MY COMMISSION # HH 010148
EXPIRES: July 10, 2024

Bonded Thru Notary Public Underwriters

Total Completed and Stored To Date . . . . . . . . . . . . . . .
Retainage:

$252,000.00

By:	Date: 1/23/23	
Jeremy Rury - Vice President

a.	10.00%  of Completed Work

b.	0.00% of Stored Material

$25,200.00
$0.00

State of: Florida

Subscribed and sworn to before me this 23rd
Notary Public:

County of: day of

Palm Beach January, 2023

Total Retainage . . . . . . . . . . . . . . . . . . . . . . . . . . .

$25,200.00

My Commission expires:

July 10, 2024

Total Earned Less Retainage . . . . . . . . . . . . . . . . . . .

Less Previous Certificates For Payments . . . . . . . . . .
Current Payment Due . . . . . . . . . . . . . . . . . . . . . . . . .

$226,800.00

$0.00
$226,800.00

ARCHITECT'S/ ENGINEER'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, and belief, the Work has progressed as indicated ,
the quality of the Work is in accordance with the Contract Documents , and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

Balance To Finish, Plus Retainage . . . . . . . . . . . . . . .	$88,200.00

AMOUNT CERTIFIED

$226,800.00

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total Approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
Net Changes By Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.)

ARCHITECT/ ENGINEER:
By:	Date:	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

1
01/31/23
01/31/23

Invoice # :

121187

Contract : 23-0001- Becker Road West Ph 2 Haul Fill

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Haul Excess Material To Becker Road	315,000.00	0.00	252,000.00	0.00	252,000.00	80.00%	63,000.00	25,200.00	
Grand Totals	315,000.00	0.00	252,000.00	0.00	252,000.00	80.00%	63,000.00	450
25,200.00	

APPLICATION AND CERTIFICATE FOR PAYMENT

Invoice #:  121252

To Owner:

Mattamy Palm Beach LLC	Project:
2500 Quantum Lakes Drive, Suite 215

Boynton Beach, FL 33426

23-0001- Becker Road West Ph 2 Haul Fill

8537-2

Application No. :

Period To:

2

02/28/2023

Distribution to :
Owner Architect/Engineer Contractor

From Contractor:

H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414

Via Architect/Engineer:

Eric

Project Nos:

Contract For:	8537

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

Contract Date:

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown

Original Contract Sum . . . . . . . . . . . . . . . . . . . . . . . .
Net Change By Change Order . . . . . . . . . . . . . . . . . . . .
Contract Sum To Date . . . . . . . . . . . . . . . . . . . . . . . . . .

$315,000.00
$0.00
$315,000.00

herein is now due. CONTRACTOR:

H and J Contracting Inc.

SUZETTE ANDRIANO
MY COMMISSION # HH 010148 EXPIRES: July 10, 2024
Bonded Thru Notary Public Underwriters

Total Completed and Stored To Date . . . . . . . . . . . . . . .
Retainage:

$315,000.00

By:	Date: 2/20/23	
Jeremy Rury - Vice President

a.	10.00%

of Completed Work

$31,500.00

State of: Florida
Subscribed and sworn to before me this 20th

County of: day of

Palm Beach February, 2023

b.	0.00% of Stored Material

Total Retainage . . . . . . . . . . . . . . . . . . . . . . . . . . .

$0.00

$31,500.00

Notary Public:
My Commission expires:

July 10, 2024

Total Earned Less Retainage . . . . . . . . . . . . . . . . . . .

Less Previous Certificates For Payments . . . . . . . . . .
Current Payment Due . . . . . . . . . . . . . . . . . . . . . . . . .

$283,500.00

$226,800.00
$56,700.00

ARCHITECT'S/ ENGINEER'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, and belief, the Work has progressed as indicated ,
the quality of the Work is in accordance with the Contract Documents , and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

Balance To Finish, Plus Retainage . . . . . . . . . . . . . . .	$31,500.00

AMOUNT CERTIFIED

$56,700.00

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total Approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
Net Changes By Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.)

ARCHITECT/ ENGINEER:
By:	Date:	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

451

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

2
02/28/23
02/28/23

Invoice # :

121252

Contract : 23-0001- Becker Road West Ph 2 Haul Fill

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Haul Excess Material To Becker Road	315,000.00	252,000.00	63,000.00	0.00	315,000.00	100.00%	0.00	31,500.00	
Grand Totals	315,000.00	252,000.00	63,000.00	0.00	315,000.00	100.00%	0.00	452
31,500.00	

APPLICATION AND CERTIFICATE FOR PAYMENT

Invoice #:  121474

To Owner:

Mattamy Palm Beach LLC	Project:
2500 Quantum Lakes Drive, Suite 215

Boynton Beach, FL 33426

23-0001- Becker Road West Ph 2 Haul Fill

Inv #121474
8537-3/ Retainage

Application No. :

Period To:

3

06/30/2023

Distribution to :
Owner Architect/Engineer Contractor

From Contractor:

H and J Contracting Inc.
3160 Fairlane Farms Road

Via Architect/Engineer:

Eric

Project Nos:

Wellington, FL 33414
Contract For:	8537

**This Pay App excludes CO #1 for $47,250.00

Contract Date:

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown

Original Contract Sum . . . . . . . . . . . . . . . . . . . . . . . .
Net Change By Change Order . . . . . . . . . . . . . . . . . . . .
Contract Sum To Date . . . . . . . . . . . . . . . . . . . . . . . . . .

$315,000.00
$0.00
$315,000.00

herein is now due. CONTRACTOR:

SUZETTE ANDRIANO
MY COMMISSION # HH 010148
H and J Contracting Inc. EXPIRES: July 10, 2024

Bonded Thru Notary Public Underwriters

Total Completed and Stored To Date . . . . . . . . . . . . . . .
Retainage:

$315,000.00

By:	Date: 6/28/23	
Jeremy Rury - Vice President

a.	0.00%

of Completed Work

$0.00

State of: Florida

Subscribed and sworn to before me this

28th

County of: Palm Beach
day of June, 2023

b.	0.00% of Stored Material

Total Retainage . . . . . . . . . . . . . . . . . . . . . . . . . . .

$0.00

$0.00

Notary Public:
My Commission expires:

July 10, 2024

Total Earned Less Retainage . . . . . . . . . . . . . . . . . . .

Less Previous Certificates For Payments . . . . . . . . . .
Current Payment Due . . . . . . . . . . . . . . . . . . . . . . . . .

$315,000.00

$283,500.00
$31,500.00

ARCHITECT'S/ ENGINEER'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, and belief, the Work has progressed as indicated ,
the quality of the Work is in accordance with the Contract Documents , and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

Balance To Finish, Plus Retainage . . . . . . . . . . . . . . .	$0.00

AMOUNT CERTIFIED

$31,500.00

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total Approved this Month	$0.00	$0.00	
TOTALS	$0.00	$0.00	
Net Changes By Change Order	$0.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.)

ARCHITECT/ ENGINEER:
By:	Date:	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

453

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

3
06/30/23
06/30/23

Invoice # :

121474

Contract : 23-0001- Becker Road West Ph 2 Haul Fill

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Haul Excess Material To Becker Road	315,000.00	315,000.00	0.00	0.00	315,000.00	100.00%	0.00	0.00	
Grand Totals	315,000.00	315,000.00	0.00	0.00	315,000.00	100.00%	0.00	454	0.00	

APPLICATION AND CERTIFICATE FOR PAYMENT

Invoice #:  121694

To Owner:

Mattamy Palm Beach LLC	Project:
2500 Quantum Lakes Drive, Suite 215

Boynton Beach, FL 33426

23-0001- Becker Road West Ph 2 Haul Fill

Inv #121694
8357-4

Application No. :

Period To:

4

10/31/2023

Distribution to :
Owner Architect/Engineer Contractor

From Contractor:

H and J Contracting Inc. 3160 Fairlane Farms Road Wellington, FL 33414

Via Architect/Engineer:

Eric

Project Nos:

Contract For:	8537

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached.

Original Contract Sum . . . . . . . . . . . . . . . . . . . . . . . .

$315,000.00

Contract Date:

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information, and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents. That all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.
SUZETTE ANDRIANO

Net Change By Change Order . . . . . . . . . . . . . . . . . . . .
Contract Sum To Date . . . . . . . . . . . . . . . . . . . . . . . . . .

$100,890.00
$415,890.00

CONTRACTOR:

H and J Contracting Inc.

MY COMMISSION # HH 010148 EXPIRES: July 10, 2024
Bonded Thru Notary Public Underwriters

Total Completed and Stored To Date . . . . . . . . . . . . . . .
Retainage:

$415,890.00

By:	Date:11/6/23	

Jeremy Rury - Vice President

a.	2.43%

of Completed Work

State of:Florida

County of:Palm Beach

b.	0.00% of Stored Material

$10,089.00
$0.00

Subscribed and sworn to before me this 6th
Notary Public:
My Commission expires:

day of

November, 2023

Total Retainage . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Earned Less Retainage . . . . . . . . . . . . . . . . . . .

Less Previous Certificates For Payments . . . . . . . . . .
Current Payment Due . . . . . . . . . . . . . . . . . . . . . . . . .

$10,089.00

$405,801.00

$315,000.00
$90,801.00

July 10, 2024

ARCHITECT'S/ ENGINEER'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the above application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information, and belief, the Work has progressed as indicated ,
the quality of the Work is in accordance with the Contract Documents , and the Contractor is entitled to payment of the AMOUNT CERTIFIED.

Balance To Finish, Plus Retainage . . . . . . . . . . . . . . .	$10,089.00

AMOUNT CERTIFIED

$90,801.00

CHANGE ORDER SUMMARY	Additions	Deductions	
Total changes approved
in previous months by Owner	$0.00	$0.00	
Total Approved this Month	$100,890.00	$0.00	
TOTALS	$100,890.00	$0.00	
Net Changes By Change Order	$100,890.00	

(Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.)

ARCHITECT/ ENGINEER:
By:	Date:	
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment, and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract.

455

CONTINUATION SHEET	Page 2 of 2

Application and Certification for Payment, containing Contractor's signed certification is attached.
In tabulations below, amounts are stated to the nearest dollar.
Use Column I on Contracts where variable retainage for line items may apply.

Application No. :
Application Date :
To: Architect's Project No.:

4
10/31/23
10/31/23

Invoice # :

121694

Contract : 23-0001- Becker Road West Ph 2 Haul Fill

A	B	C	D	E	F	G		H	I	
Item	Description of Work	Scheduled	Work Completed	Materials	Total	%	Balance	Retainage	
No.		Value	From Previous	This Period	Presently	Completed	(G / C)	To Finish		
			Application (D+E)	In Place	Stored	and Stored To Date		(C-G)		
					(Not in D or E)	(D+E+F)				
100	Haul Excess Material To Becker Road	315,000.00	315,000.00	0.00	0.00	315,000.00	100.00%	0.00	0.00	
CO1.01	Haul Excess Material To Becker Road	47,250.00	0.00	47,250.00	0.00	47,250.00	100.00%	0.00	4,725.00	
CO2.01	336 Backhoe 06/10/23	1,680.00	0.00	1,680.00	0.00	1,680.00	100.00%	0.00	168.00	
CO2.02	Broom 06/10/23	600.00	0.00	600.00	0.00	600.00	100.00%	0.00	60.00	
CO2.03	336 Backhoe 06/12/23	2,800.00	0.00	2,800.00	0.00	2,800.00	100.00%	0.00	280.00	
CO2.04	Broom 06/12/23	800.00	0.00	800.00	0.00	800.00	100.00%	0.00	80.00	
CO2.05	(2) 336 Backhoes 06/13/23	2,800.00	0.00	2,800.00	0.00	2,800.00	100.00%	0.00	280.00	
CO2.06	950 Loader 06/13/23	220.00	0.00	220.00	0.00	220.00	100.00%	0.00	22.00	
CO2.07	Broom 06/13/23	500.00	0.00	500.00	0.00	500.00	100.00%	0.00	50.00	
CO2.08	336 Backhoe 06/14/23	2,520.00	0.00	2,520.00	0.00	2,520.00	100.00%	0.00	252.00	
CO2.09	Broom 06/14/23	900.00	0.00	900.00	0.00	900.00	100.00%	0.00	90.00	
CO2.10	336 Backhoe 06/15/23	2,800.00	0.00	2,800.00	0.00	2,800.00	100.00%	0.00	280.00	
CO2.11	Broom 06/15/23	800.00	0.00	800.00	0.00	800.00	100.00%	0.00	80.00	
CO2.12	(2) 336 Backhoes 06/17/23	3,360.00	0.00	3,360.00	0.00	3,360.00	100.00%	0.00	336.00	
CO2.13	Broom 06/17/23	600.00	0.00	600.00	0.00	600.00	100.00%	0.00	60.00	
CO2.14	(2) 336 Backhoes 06/22/23	4,480.00	0.00	4,480.00	0.00	4,480.00	100.00%	0.00	448.00	
CO2.15	Broom 06/22/23	700.00	0.00	700.00	0.00	700.00	100.00%	0.00	70.00	
CO2.16	(2) 336 Backhoes 06/23/23	5,600.00	0.00	5,600.00	0.00	5,600.00	100.00%	0.00	560.00	
CO2.17	Broom 06/23/23	800.00	0.00	800.00	0.00	800.00	100.00%	0.00	80.00	
CO2.18	(2) 336 Backhoes 06/24/23	4,480.00	0.00	4,480.00	0.00	4,480.00	100.00%	0.00	448.00	
CO2.19	Broom 06/24/23	600.00	0.00	600.00	0.00	600.00	100.00%	0.00	60.00	
CO2.20	336 Backhoe 07/12/23	2,800.00	0.00	2,800.00	0.00	2,800.00	100.00%	0.00	280.00	
CO2.21	Broom 07/12/23	700.00	0.00	700.00	0.00	700.00	100.00%	0.00	70.00	
CO2.22	(2) 336 Backhoes 07/13/23	5,600.00	0.00	5,600.00	0.00	5,600.00	100.00%	0.00	560.00	
CO2.23	Broom 07/13/23	700.00	0.00	700.00	0.00	700.00	100.00%	0.00	70.00	
CO2.24	336 Backhoe 07/18/23	2,800.00	0.00	2,800.00	0.00	2,800.00	100.00%	0.00	280.00	
CO2.25	Broom 07/18/23	700.00	0.00	700.00	0.00	700.00	100.00%	0.00	70.00	
CO2.26	336 Backhoe 07/19/23	2,800.00	0.00	2,800.00	0.00	2,800.00	100.00%	0.00	280.00	
CO2.27	Broom 07/19/23	500.00	0.00	500.00	0.00	500.00	100.00%	0.00	50.00	
	CO1.01 Cost Code 30510									
	CO2.01-CO2.27 Cost Code 30510									
Grand Totals	415,890.00	315,000.00	100,890.00	0.00	415,890.00	100.00%	0.00	456
10,089.00	

RESOLUTION 2024-11
A RESOLUTION OF THE BOARD OF SUPERVISORS OF THE SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO.’S 1-10 APPROVING THE DISTRICT'S PROPOSED BUDGET FOR FISCAL YEAR 2024/2025; SETTING A PUBLIC HEARING THERE ON PURSUANT TO FLORIDA LAW; DIRECTING STAFF TO PROVIDE A COPY OF THE PROPOSED BUDGET TO THE LOCAL GENERAL-PURPOSE GOVERNMENT AND PROVIDING FOR NOTICE OF SAID HEARING PUSUANT TO LAW.

WHEREAS, the District Manager has heretofore prepared and submitted to the Board a proposed budget for fiscal year 2024/2025 attached hereto as Exhibit A; and

WHEREAS, the Board of Supervisors has considered said proposed budget and desires to set the required public hearing thereon.

NOW, THEREFORE BE IT RESOLVED BY THE BOARD OF SUPERVISORS OF SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO. 1:

The budget proposed by the District Manager for fiscal year 2024/2025, attached hereto as Exhibit A, is hereby approved as the basis for conducting a public hearing to adopt said budget.

A public hearing on said approved budget is hereby declared and set for the following date, hour and place:

Date: 	

Hour: 	

Place: 	

The District Manager shall send a copy of the proposed budget to the City of Port St. Lucie at least 60 days prior to the date of the public hearing.

The District Manager shall cause notice of the public hearing to be provided by publication in a newspaper of general circulation in St. Lucie County once a week for two consecutive weeks with the first publication not less than 15 days prior to the date of the publichearing.

PASSED AND ADOPTED THIS 1st DAY OF May, 2024.

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO.’S 1, 2, 3, 5, 9

Chairman / Vice Chairman

Print Name

ATTEST:

Secretary / Assistant Secretary

Print Name

SOUTHERN GROVE COMMUNITY DEVELOPMENT DISTRICT NO.’S 4, 6, 7, 8, 10

Chairman / Vice Chairman

Print Name

ATTEST:

Secretary / Assistant Secretary

EXHIBIT II AII

Proposed Budget
Fiscal Year 2024-2025 (Under Separate Cover)

Financial Report:
Under Separate Cover