Golden Gem Community Development District

Agenda September 11, 2024

Agenda

Golden Gem
Community Development District

219 E. Livingston Street, Orlando, Florida 32801 Phone: 407-841-5524 – Fax: 407-839-1526
September 4, 2024

Board of Supervisors Golden Gem Community Development District

Dear Board Members:

The meeting of the Board of Supervisors of the Golden Gem Community Development District will be held Wednesday, September 11, 2024 at 10:30 a.m. at the offices of GMS-CF, 219 E. Livingston Street, Orlando, Florida. Following is the advance agenda for the regular meeting:

Roll Call
Public Comment Period
Approval of Minutes of the June 12, 2024 Meeting
Consideration of Resolution 2024-41 Designating Regular Monthly Meeting Date, Time and Location for Fiscal Year 2025
Consideration of Resolution 2024-42 Ratifying, Confirming and Approving the Sale of the Series 2024 Bonds
Consideration of Disclosure of Public Finance (Series 2024 Bonds)
Ratification of Series 2024 Requisitions #1 - #10
Staff Reports
Attorney
Engineer
Consideration of Change Orders #2 & #4 with RCS Construction Company
District Manager’s Report
Balance Sheet and Income Statement
Ratification of Funding Requests #6 - #8
Other Business
Supervisor’s Requests
Adjournment

The balance of the agenda will be discussed at the meeting. In the meantime, if you should have any questions, please contact me.

Sincerely,
George S. Flint
George S. Flint District Manager

Cc:	Alyssa Willson, District Counsel Kevin Roberson, District Engineer

Enclosures

Minutes

MINUTES OF MEETING GOLDEN GEM
COMMUNITY DEVELOPMENT DISTRICT

The regular meeting of the Board of Supervisors of the Golden Gem Community Development District was held Wednesday, June 12, 2024 at 10:30 a.m. at the Offices of GMS- CF, 219 E. Livingston Street, Orlando, Florida.

Present and constituting a quorum were:

Craig Linton, Jr.	Chairman
H.M. Ridgely, III	Vice Chairman
Taylor Edwards	Assistant Secretary
Duane “Rocky” Owen	Assistant Secretary
George Hamner, Jr.	Assistant Secretary Also present were:
George Flint	District Manager
Alyssa Wilson by phone	District Counsel
Kevin Roberson by phone	District Engineer
Sete Zare by phone	Underwriter
Joe Beninati	Developer

FIRST ORDER OF BUSINESS	Roll Call
Mr. Flint called the meeting to order and called the roll. Five Board members were present constituting a quorum.
SECOND ORDER OF BUSINESS	Public Comment Period
Mr. Flint asked for any public comments. Hearing no comments, the next item followed.
THIRD ORDER OF BUSINESS	Approval of Minutes of the March 13,
2024 Board of Supervisors Meeting and Acceptance of Minutes of the March 13, 2024 Landowners’ Meeting
Mr. Flint presented the minutes of the March 13, 2024 Board of Supervisors meeting and the March 13, 2024 Landowners’ meeting. He asked if the Board had any comments or corrections to the minutes.

On MOTION by Mr. Ridgley, III, seconded by Mr. Linton, Jr., with all in favor, the Minutes of the March 13, 2024 Board of Supervisors Meeting were approved as presented, and the Minutes of the March 13, 2024 Landowners’ Meeting, were accepted.

FOURTH ORDER OF BUSINESS	Consideration of Professional Engineering
Agreement with Kimley-Horn & Associates, Inc.
Mr. Flint stated the Board designated Kimley-Horn & Associates, Inc. as the interim District Engineer at the Organizational meeting. Ms. Wilson added that they went through the statutorily required request for qualifications to ensure that they met the procurement requirements in order to designate them as their District Engineer in their on-going compacity. She explained that they circulated their typical form of agreement. She noted that Mr. Roberson worked with his in-house counsel with Kimley-Horn & Associates, Inc. to provide some comments back. She added that all of these were agreeable to her, and it was just further clarifications and interpretations of statutory items. She saw nothing problematic.

On MOTION by Mr. Ridgely, III., seconded by Mr. Edwards, with all in favor, the Professional Engineering Agreement with Kimley-Horn & Associates, Inc. and Authorization of Work Authorization 1, was approved in substantial form.

FIFTH ORDER OF BUSINESS	Financing Matters
A. Presentation of Engineer’s Report of Infrastructure & Improvements and Addendum
Mr. Flint stated the intent of this item is to finalize the assessments as a result of the fact that they have gone through the process of marketing and pricing the bonds now that they know what the final assessments are going to be. He explained that they originally went through a Master Assessment process where they established a lien through a public hearing. He stated that now that they know the actual pricing, this resolution brings those assessments down and finalizes them. He noted the first item is the Engineer’s Report from the District Engineer. He explained that there were no substantial changes to the report from what they have seen in the past. Ms. Wilson clarified that the note that the Engineer’s Report dated February 2024 is everything that is included within the Capital Improvement Program. She explained that it is what they validated bonds for, and it is what the Master Assessment lien is, which is for securing that entire portion of the project. However, she pointed out that what they issue bonds for is limited to the Phase 1 project, which is

what is further described in the addendum to the report just noting the scope of the project that the bonds are issued for as well as the overall Engineer’s completion obligation.
B. Presentation of Final First Supplemental Assessment Methodology for the Phase 1 Project
Mr. Flint stated they prepared an original Master Methodology when they went through the Master Assessment process. He noted that then once the bonds were actually priced, they prepared a Supplemental Assessment Methodology that was included in the preliminary limited offering memorandum when the bonds were marketed. He noted that now that the underwriter has priced the bonds, they know the final terms. They’ve updated that final Supplemental Assessment Methodology Report. He pointed out that in the agenda it stated May 30th, which was the date the bond purchase agreement was signed. He reviewed the tables, which started on page 68 of the PDF. Table 1 hasn’t changed. It is the development plan for the Phase 1 project, and it shows the product types and the number of units. Table 2 shows the construction costs, which have not changed. Table 3 reflects the actual terms now that the bonds have been priced. He pointed out that the par amount is $36,550,000 and of that $29,725,100 is in the construction account. He noted the average coupon is 5.92%, the amortization period is 30 years, and there is 17 months of capitalized interest. Table 4 demonstrates the improvement costs per unit. Table 5 shows the benefit based on the par debt. Table 6 shows what the net and gross annual assessments are by product type. He explained that the gross amount is what would actually be reflected on the annual tax bill that includes the 4% allowance for early payment and 2% collection costs from the county. He further explained that the net amount would be what would be without those. Table 7 is the preliminary assessment roll, which shows the various parcels, acres, etc. and the legal description is attached.
C. Consideration of Resolution 2024-36 Supplemental Assessment Resolution Series 2024
Ms. Wilson presented Resolution 2024-36 to the Board. She explained that this resolution essentially finalizes the assessment securing the Series 2024 bonds and it supplements their Resolution 2024-33, which declared the last assessments and levied the master lien on those bonds. She stated that it takes their engineer’s report up, which has not changed. She noted Mr. Flint’s supplemental report is attached as Exhibit B. She also noted that Exhibits C, D, and E are taken from their final numbers. She explained that this essentially just describes exactly what they issued

and the terms of the assessments that are securing that debt. She stated this was in substantially similar form to what they use in most of their deals. She pointed out that Section 1 deals with the authority for the resolution. Section 2 makes certain factual findings and approves those exhibits. Section 3 sets forth the terms of the bonds; confirming the maximum assessment lien securing these bonds. Section 4 levies and allocates the Series 2024 assessments and addresses the collection options regarding saying either on or off roll. Section 5 applies to the calculation and application of the true-up payments, which is governed by their Assessment Methodology and the True-Up Agreement and is essentially what allows them to ensure that there are appropriate units to pay back the bond but knowing that there needs to be flexibility in those things. Section 6 is application of proceeds of sale of impact fees. Section 7 is improvement lien book. Section 8 provides for the recording of an assessment notice. Section 9 deals with conflict. Section 10 is severability. Section 11 is today’s effective date.

On MOTION by Mr. Ridgely, III., seconded by Mr. Linton, Jr., with all in favor, Resolution 2024-36 Supplemental Assessment Resolution Series 2024, was approved.

SIXTH ORDER OF BUSINESS	Consideration	of	Resolution	2024-37
Approving Purchase of Property
Mr. Flint presented Resolution 2024-37 to the Board. This resolution approves the purchase of property. He stated a portion of the funds were going to be used to acquire property. They had an appraisal done that the Board previously approved. Ms. Wilson noted the appraisal came back higher from a tax perspective. She noted that this resolution authorizes, contingent upon the closing of the bonds, the acquisition of the Real Property in the not to exceed amount of $6,331,382.01, subject to receipt and finalization by District Counsel of the documents required for such acquisition under the Acquisition Agreement.

On MOTION by Mr. Edwards, seconded by Mr. Linton, Jr., with all in favor, Resolution 2024-37 Approving Purchase of Property, was approved.

SEVENTH ORDER OF BUSINESS	Consideration	of	Resolution	2024-38
Approving Assignment of Mass Grading Site Work Agreement and Acquisition of Partially Completed Improvements

Mr. Flint presented Resolution 2024-38 to the Board. Ms. Wilson explained that this resolution authorizes the assignment and acquisition of the partially completed improvements. She pointed out that this was for the mass grading site work contract with RCS that was entered into by the developer. But now that the District has bond funds, assuming once they get all of the executed assignment documents, this authorizes the District to take acceptance of that assignment and pay back the developer for those portions that were previously funded that are attributable to District work, the public improvements.

On MOTION by Mr. Edwards, seconded by Mr. Ridgely, III, with all in favor, Resolution 2024-38 Approving Assignment of Mass Grading Site Work Agreement and Acquisition of Partially Completed Improvements, was approved in substantial form.

EIGHTH ORDER OF BUSINESS	Consideration	of	Resolution	2024-39
Approving Assignment of Infrastructure Site Work Agreement
Mr. Flint presented Resolution 2024-39 to the Board. Ms. Wilson explained that this resolution is in the same form; however, this is just the assignment of the agreement because technically there has been no payment on this agreement yet. The District will take assignment of it before there has been any payment, so there is no acquisition of improvements associated. She stated they have slightly fewer exhibits. She also noted that her understanding, subject to District Engineer confirmation, was that 100% of the site infrastructure contract is public, so they don’t have the associated cost share. She pointed out that this was the one that has the Cadence’s paying in a portion of this contract, so they did not issue bonds for the total amount; however, their Engineer has advised that the overall scope is within the Phase 1 project. Therefore, as they have discussed, if there were any issues with Cadence’s contribution, they would look and if bond funds were exhausting, they would look to the developer under the Completion Agreement. There was a correction noted in the description of Change Order #1. Ms. Wilson responded that they would get that updated. She also noted that they were continuing to work with RCS to get all of these assignment documents executed as well as the District is going to need to be added to the bond associated with this agreement as well.

On MOTION by Mr. Hamner, Jr., seconded by Mr. Edwards, with all in favor, Resolution 2024-39 Approving Assignment of Infrastructure Site Work Agreement Subject to the Modifications to the Description of Change Order #1 as well as Any Updates Needed to those Assignment Documents the Assignment of this Contract, was approved in substantial form.

Ms. Wilson noted they did have some other items that they are working for reimbursement; they just didn’t get those finalized for approval today. She explained that these were the largest ones and what they wanted to make sure they got before the Board today. She will be requesting, to the extent that the Board is comfortable during her counsel report, an authorization to continue working with Mr. Edwards under their Acquisition Agreement to maybe get some additional soft cost to the extent that they want to go ahead and acquire those professional fees and permit related items in between Board meetings and authorize the Chair to sign those requisitions once the Chair and staff has reviewed, approved and ensures that it meets the requirements of the Acquisition Agreement. Then, those would be back before the Board for ratification at the next Board meeting.

NINTH ORDER OF BUSINESS	Public Hearing
A. Consideration of Resolution 2024-40 Adopting the Fiscal Year 2025 Budget and Relating to the Annual Appropriations
Mr. Flint stated the Board approved a proposed budget and set the public hearing for today at the Organizational meeting to consider the budget for FY 2025, which starts on October 1. This budget contemplates that they would continue to operate under a Developer Funding Agreement. He noted that it was primarily an administrative budget. He stated this was a developer contribution, so the developer would only actually be obligated for the actual costs under this. Mr. Flint asked to open the public hearing.

On MOTION by Mr. Hamner, Jr., seconded by Mr. Linton, Jr., with all in favor, Opening the Public Hearing, was approved.

Mr. Flint asked for public comments. Hearing no public comments, the public comment period was closed. Mr. Flint presented Resolution 2024-40 to the Board.

On MOTION by Mr. Ridgely, III, seconded by Mr. Edwards, with all in favor, Resolution 2024-40 Adopting the Fiscal Year 2025 Budget and Relating to the Annual Appropriations, was approved.

Mr. Flint asked to close the public hearing.

On MOTION by Mr. Hamner, Jr., seconded by Mr. Linton, Jr., with all in favor, Closing the Public Hearing, was approved.

TENTH ORDER OF BUSINESS	Consideration of Fiscal Year 2024/2025
Budget Funding Agreement
Mr. Flint stated this was an agreement between the District and Kelly Park VB Development, LLC. He explained that this was the same form of agreement that the Board approved for the current year. The budget is attached as an exhibit as well as the legal description.

On MOTION by Mr. Edwards, seconded by Mr. Hamner, Jr., with all in favor, the Fiscal Year 2024/2025 Budget Funding Agreement, was approved.

ELEVENTH ORDER OF BUSINESS	Adoption of District Goals and Objectives
– ADDED
Mr. Flint stated the legislature in the last session adopted a new law that requires special Districts to establish goals and objectives on an annual basis. The first set of goals and objectives have to be established by October 1, 2024 and the first time they need to be reported would be December of next year. They will get posted on the District’s website. He noted that it was a legal requirement that they were obligated to comply with. He pointed out that he put a memo in the agenda. He stated that they recommend three categories with the first being Community Communication and Engagement. The first goal under the Community Communication and Engagement is Public Meeting Compliance. The objective is to hold at least three regular Board of Supervisor meetings per year to conduct CDD related business and discuss community needs. The next goal in this category is Notice of Meetings Compliance. The objective for this would be to provide public notice of each meeting at least seven days in advance, as specified in Section 190.007(1), using at least two communication methods. The last goal in this category is Access to Records Compliance. The objective for this would be to ensure that meeting minutes and other public records are readily available and easily accessible to the public by completing monthly CDD website checks. The next category is Infrastructure and Facilities Maintenance. The goals for this category is District Infrastructure and Facilities Inspections. The objective for this goal is for the District Engineer to conduct an annual inspection of the District’s infrastructure and related systems. The next category is Financial Transparency and Accountability. The first goal for this is

Annual Budget Preparation. The objective for this goal is to prepare and approve the annual proposed budget by June 15th and final budget was adopted by September 30 each year. The next goal for this category is financial reports. This objective is to publish to the CDD website the most recent versions of the following documents: Annual audit, current fiscal year budget with any amendments, and most recent financials within the latest agenda package. The third and final goal is Annual Financial Audit. The objective for this goal is to conduct an annual independent financial audit per statutory requirements and publish the results to the CDD website for public inspection, and transmit to the State of Florida.

On MOTION by Mr. Hamner, Jr., seconded by Mr. Ridgely, III, with all in favor, the Adoption of District Goals and Objectives, was approved.

TWELFTH ORDER OF BUSINESS	Staff Reports
Attorney
Ms. Wilson stated that they would continue to work with the developer, the staff and Chair getting all these items finalized. She noted the anticipated timeline is hopefully having their real estate transaction completed on Friday and those funds wired on from the Trustee. She stated they will continue working with RCS on getting those two construction acquisitions assigned over. Then, as soon as that happens and all the paper work is done, their developer will be repaid for those items that they previously outlined and also requesting the authorization for staff to work with the developer and the Chair or the Vice Chair or the District Manager to continue working through these remaining acquisition items.

Engineer
Mr. Roberson provided a brief update on the construction.

District Manager’s Report
Approval of Check Register
Mr. Flint presented the check register from January 1 through April 26, check #1 through #10 totaling $30,448.60. The detailed register is behind the summary.

On MOTION by Mr. Hamner, Jr., seconded by Mr. Linton, Jr., with all in favor, the Check Register, was approved.

Balance Sheet and Income Statement
Mr. Flint reviewed the unaudited financial statements through April 30th. He asked for any questions. There was no action required.

Ratification of Funding Request #3 – #5
Mr. Flint reviewed Funding Request #3-#5, which has been sent to the developer under the Funding Agreement.

On MOTION by Mr. Hamner, Jr., seconded by Mr. Edwards, with all in favor, Funding Request #3-#5, was ratified.

Presentation of Number of Registered Voters – 1
Mr. Flint stated the Supervisor of Elections showed there was 1 registered voter.

Form 1 Filing Reminder – Due July 1st
Mr. Flint reminded the Board that the Form 1 is due by July 1st.

THIRTEENTH ORDER OF BUSINESS	Other Business
There being no comments, the next item followed.

FOURTEENTH ORDER OF BUSINESS	Supervisor’s Requests
There being no comments, the next item followed.

FIFTEENTH ORDER OF BUSINESS	Adjournment

On MOTION by Mr. Ridgely, III, seconded by Mr. Edwards, with all in favor, the meeting was adjourned.

Secretary/Assistant Secretary	Chairman/Vice Chairman

Section IV

RESOLUTION 2024-41
A RESOLUTION OF THE BOARD OF SUPERVISORS OF GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT ADOPTING THE ANNUAL MEETING SCHEDULE FOR THE FISCAL YEAR 2024/2025; AND PROVIDING FOR AN EFFECTIVE DATE.

Whereas, Golden Gem Community Development District (the “District”) is a local unit of special- purpose government created and existing pursuant to Chapter 190, Florida Statutes, being situated entirely within the City of Apopka, Orange County, Florida; and
Whereas, the District is required by Section 189.015, Florida Statutes, to file quarterly, semi-annually, or annually a schedule (including date, time, and location) of its regular meetings with local governing authorities; and

Whereas, further, in accordance with the above-referenced statute, the District shall also publish quarterly, semi-annually, or annually the District’s regular meeting schedule in a newspaper of general paid circulation in the county in which the District is located; and

WHEREAS, the Board desires to adopt the annual meeting schedule for the fiscal year beginning October 1, 2024, and ending September 30, 2025 (“Fiscal Year 2024/2025”), attached as Exhibit A.
NOW THEREFORE BE IT RESOLVED BY THE BOARD OF SUPERVISORS OF GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT:

SECTION 1.  The Fiscal Year 2024/2025 annual meeting schedule attached hereto and incorporated by reference herein as Exhibit A is hereby approved and shall be published in accordance with the requirements of Florida law and also provided to applicable governing authorities.

SECTION 2.   This Resolution shall become effective immediately upon its adoption.

Passed and adopted this 11th day of September, 2024.

ATTEST:	GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

Secretary / Assistant Secretary	Chairperson, Board of Supervisors
Exhibit A:	Fiscal Year 2024/2025 Annual Meeting Schedule

Exhibit A: Fiscal Year 2024/2025 Annual Meeting Schedule

BOARD OF SUPERVISORS MEETING DATES GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT
FISCAL YEAR 2024/2025
The Board of Supervisors of Golden Gem Community Development District will hold their regular meetings for the Fiscal Year 2024/2025 at 10:30 AM on the second Wednesday of each month at the Offices of GMS-CF, LLC, 219 E. Livingston Street, Orlando, FL 32801, unless otherwise indicated as follows:

October 9, 2024
November 13, 2024
December 11, 2024
January 8, 2025
February 12, 2025
March 12, 2025
April 9, 2025
May 14, 2025
June 11, 2025
July 9, 2025
August 13, 2025
September 10, 2025
The meetings are open to the public and will be conducted in accordance with the provision of Florida Law for Community Development Districts. The meetings may be continued to a date, time, and place to be specified on the record at the meeting. A copy of the agenda for these meetings may be obtained from Governmental Management Services – Central Florida LLC, 219 E. Livingston Street, Orlando, Florida 32801 or by calling (407) 841-5524.
There may be occasions when one or more Supervisors or staff will participate by telephone. Pursuant to provisions of the Americans with Disabilities Act, any person requiring special accommodations at this meeting because of a disability or physical impairment should contact the District Office at (407) 841-5524 at least 48 hours prior to the meeting. If you are hearing or speech impaired, please contact the Florida Relay Service by dialing 7-1-1, or 1-800-955-8771 (TTY) / 1-800-955-8770 (Voice), for aid in contacting the District Office.

A person who decides to appeal any decision made at the meeting with respect to any matter considered at the meeting is advised that person 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.
District Manager

Section V

RESOLUTION 2024-42

A RESOLUTION OF THE BOARD OF SUPERVISORS OF THE GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT RATIFYING, CONFIRMING, AND APPROVING THE SALE OF THE GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT REVENUE BONDS, SERIES 2024; RATIFYING, CONFIRMING, AND APPROVING THE ACTIONS OF THE CHAIRMAN, VICE CHAIRMAN, TREASURER, SECRETARY, ASSISTANT SECRETARIES, AND ALL DISTRICT STAFF REGARDING THE SALE AND CLOSING OF THE GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT REVENUE BONDS, SERIES 2024; DETERMINING SUCH ACTIONS AS BEING IN ACCORDANCE WITH THE AUTHORIZATION GRANTED BY THE BOARD; PROVIDING A SEVERABILITY CLAUSE; AND PROVIDING AN EFFECTIVE DATE.

WHEREAS, the Golden Gem Community Development District (“District”), is a local unit of special-purpose government created and existing pursuant to Chapter 190, Florida Statutes; and

WHEREAS, the District previously adopted resolutions authorizing the issuance and the negotiated sale of bonds within the scope of Chapter 190, Florida Statutes, including its Special Assessment Revenue Bonds, Series 2024, in the par amount of $36,550,000 (“Series 2024 Bonds”); and
WHEREAS, the District closed on the sale of the Series 2024 Bonds on June 14, 2024;
and

WHEREAS, as prerequisites to the issuance of the Series 2024 Bonds, the Chairman, Vice Chairman, Treasurer, Assistant Secretaries, and District Staff including the District Manager, District Financial Advisor, and District Counsel were required to execute and deliver various documents (“Closing Documents”); and
WHEREAS, the District desires to ratify, confirm, and approve all actions of the District Chairman, Vice Chairman, Treasurer, Assistant Secretaries, and District Staff in connection with closing the sale of the Series 2024 Bonds.

NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF SUPERVISORS OF THE GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT:

SECTION 1. The sale, issuance, and closing of the Series 2024 Bonds is in the best interests of the District.
SECTION 2. The issuance and sale of the Series 2024 Bonds, the adoption of resolutions relating to such bonds, the agreements entered into with respect to the issuance of such bonds, and

all actions taken in the furtherance of the closing on such bonds, are hereby declared and affirmed as being in the best interests of the District and are hereby ratified, approved, and confirmed.

SECTION 3. The actions of the Chairman, Vice Chairman, Treasurer, Secretary, Assistant Secretaries, and all District Staff in finalizing the closing and issuance of the Series 2024 Bonds, including the execution and delivery of the Closing Documents, and such other certifications or other documents required for the closing on the Series 2024 Bonds, are determined to be in accordance with the prior authorizations of the Board and are hereby ratified, approved, and confirmed in all respects.

SECTION 4. If any provision of this Resolution is held to be illegal or invalid, the other provisions shall remain in full force and effect.

SECTION 5. This Resolution shall become effective upon its passage and shall remain in effect unless rescinded or repealed.
PASSED AND ADOPTED this 11th day of September, 2024.

ATTEST:	GOLDEN	GEM	COMMUNITY DEVELOPMENT DISTRICT

Secretary / Assistant Secretary	Chairperson, Board of Supervisors

Section VI

This instrument was prepared by:

Alyssa C. Willson, Esq. KUTAK ROCK LLP
107 West College Avenue Tallahassee, Florida 32301

GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

DISCLOSURE OF PUBLIC FINANCE (2024 BONDS)

The Golden Gem Community Development District (“District”) is a unit of special-purpose local government created pursuant to and existing under the provisions of Chapter 190, Florida Statutes. Under Florida law, community development districts are required to take affirmative steps to provide for the full disclosure of information relating to the public financing and maintenance of improvements to real property undertaken by such districts.

WHAT IS THE DISTRICT AND HOW IS IT GOVERNED?

The District is an independent special taxing district, created pursuant to and existing under the provisions of Chapter 190, Florida Statutes, and established by Ordinance No. 3041, which was enacted by the City Commission of the City of Apopka, Florida on January 3, 2024, and which became effective on January 3, 2024. The District currently encompasses approximately 199.869 acres of land located entirely within the City of Apopka, Orange County, Florida (“County”). The legal description of the lands encompassed within the District is attached hereto as Exhibit A. As a local unit of special-purpose government, the District provides an alternative means for planning, financing, constructing, operating and maintaining various public improvements and community facilities within its jurisdiction. The District is governed by a five-member Board of Supervisors (“Board”), the members of which must be residents of the State and citizens of the United States.

For more information about the District, please contact the District’s Manager, c/o Governmental Management Services, LLC, 219 East Livingston Street, Orlando, Florida 32801 (“District Office”).

DESCRIPTION OF PROJECTS, BONDS & ASSESSMENTS

The District is authorized by Chapter 190, Florida Statutes, to finance, fund, plan, establish, acquire, install, equip, operate, extend, construct, or reconstruct lake excavation, surface water management system, roadways, water distribution system, sanitary collection and transmission system, irrigation/reclaim water distribution system, offsite improvements, environmental improvements and other infrastructure projects, and services necessitated by the development of, and serving lands within, the District. To finance the construction of such projects, the District is authorized to issue bonds that are secured by special assessments levied against properties within the District that are benefitted by the projects.

2024 Bonds & Assessments

On June 14, 2024, the District issued its $36,550,000 Special Assessment Revenue Bonds, Series 2024 (“Bonds”) to finance a portion of its capital improvement plan known as the “Phase 1 Project” (“Project”). The Project includes, among other things, lake excavation, surface water management system, roadways, water distribution system, sanitary collection and transmission system, irrigation/reclaim water distribution system, offsite improvements, environmental improvements, and soft costs. The Project is estimated to cost approximately $32,210,100 and is described in more detail in the Engineer’s Report of Infrastructure Improvements, dated February 2024, and the Addendum – Engineer’s Report of Infrastructure Improvements, dated April 22, 2024 (“Engineer’s Report”).

The Bonds are secured by special assessments (“Assessments”) levied and imposed on certain benefitted lands within the District. The Assessments are further described in the Master Assessment Methodology, dated January 10, 2024, and as supplemented by the Final First Supplemental Assessment Methodology for the Phase 1 Project, dated May 30, 2024 (together, the “Assessment Report”).

Operation and Maintenance Assessments

In addition to debt service assessments, the District may also impose on an annual basis operations and maintenance assessments (“O&M Assessments”), which are determined and calculated annually by the Board in order to fund the District’s annual operations and maintenance budget. O&M Assessments are levied against all benefitted lands in the District, and may vary from year to year based on the amount of the District’s budget. O&M Assessments may also be affected by the total number of units that ultimately are constructed within the District. The allocation of O&M Assessments is set forth in the resolutions imposing the assessments. Please contact the District Office for more information regarding the allocation of O&M Assessments.

Collection Methods

For any given fiscal year, the District may elect to collect any special assessment for any lot or parcel by any lawful means. Generally speaking, the District may elect to place a special assessment on that portion of the annual real estate tax bill, entitled “non-ad valorem assessments,” which would then be collected by the County Tax Collector in the same manner as county ad valorem taxes. Alternatively, the District may elect to collect any special assessment by sending a direct bill to a given landowner. The District reserves the right to change collection methods from year to year.

A detailed description of all of the District’s assessments, fees and charges, as well as copies of the Engineer’s Report, Assessment Report, and other District records described herein, may be obtained from the registered agent of the District as designated to the Florida Department of Commerce in accordance with Section 189.014, Florida Statutes, or by contacting the District’s Manager, c/o Governmental Management Services, LLC, 219 East Livingston Street, Orlando, Florida 32801. Please note that changes to the District’s capital improvement plans and financing plans may affect the information contained herein and all such information is subject to change at any time and without further notice.

[THIS SPACE INTENTIONALLY LEFT BLANK]

IN WITNESS WHEREOF, the foregoing Disclosure of Public Finance has been executed to be effective as of the date of closing on the District’s 2024 Bonds.

WITNESS

By: 	 Name: 	 Address: 	 

GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

By: 	 Name: 	 Title: 	

		Address: 	

By: 	 Name: 	 Address: 	 

STATE OF FLORIDA
COUNTY OF 	

The foregoing instrument was acknowledged before me by means of  physical presence or 
online notarization, this 	 day of 	, 2024, by 	, as
	 of GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT, who appeared
before me this day in person, and who is either personally known to me, or produced
	 as identification.

(NOTARY SEAL)

NOTARY PUBLIC, STATE OF 	

Name: 	 (Name of Notary Public, Printed, Stamped or Typed as Commissioned)

EXHIBIT A: Legal Description

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¼

I

_l

11	I

NOT PLATTED

l3

,.

�	..

Q Qi�---7-80_CR_5_�	I!

LOT 2
l<El.l Y PARK CROSS:NGS
P8 111, PCS. 122 & 12,3

'iii

I'-'

lie �

l

44.	A
NOT PLATT£0

�

�

l.&J
�

NOT PLATIED

(n

,.. N	:,;

g'"'

I

�-,----,--.,,----,,.,.,,...,--,	!
S89'23'24"W	1325.16'
NOT PLATTED

Ill	�	NOR1H u"iio, ra.-,.,-,,,.,.,.�

I

PARK VIEW PR:€�� PHASE 1	L

PB 109, PCS. 109

3	i:�
3	avci:::!:I:.
iIc
-I--

KINGS CANYON		

DRIVE

r-

-	-

PARK VlEW PRESERVE PHASE 1
P8 109, PGS, 109

SHANNON SURVEYING, INC.
499 N�TH S,R, 434 - SUllE 2045
ALTAMONlE SPRINGS. FLORIDA, 32714
(407) 774-8372	LB # 6898

OATt or 9.JR\E��9!1<0/C,,l'ILG92!W?JL...... 	_
o,t,\""'1er. SP	SC.,.1.£ 19 - SOO'

IJ-�21 «LOE'N C8I ltt>-IIOT Pl.l,TlEl) S<[TCH
SHEET 2 OF 2

FflCU:CT NM£: VMD OAKS PURPOSE: REPLAT OF LOT 1

Tl-HS IS NOT A BOUNDARY SURVEY NOT VALID Wlll-lOUT SHEET 2

DESCRIPTION:
All ot lot 1, K�ly Perk Cros.,ln� OCC()t'dlng to the plat thereof OS recorded In Plot BoOk 11� Pages 122 Old 123, Public Records ot Oronge County. flotido ond that port of St:-etion 13, TO'fll'lship 20 ::,outh, Range 27 Eosl:, more porticulorly described os follows:
BeiQinning ot the Southeast corner of $Oid lot 1; thence the n,e.>ct 21 c°'nses and distonC$& run along the
perimeter of sold Lot 1: run S89"37'48'"W, o distance of 29t4.J6 fut: thence run N00"21'03Mw. o dl9tonee of
<t-6.69 feet; thence run H00"'29'36"� a dlstonee of 2603.70 feet: thence run N89"53'52"E. o dlst<J'\ee of 1324.32 feet: thence nm S001)4'14 E. a distance of 8S3.16 feet thenee run N89.34'17"E. o dlst<:tl.ee of
160.19 feet: thenoe run S00"'25'◄3"E, o distance of 30.00 feet: thence run H89"34'1?-E. a dlstan� of '176.16
h!et: thernce run N00"21'18•w, o di$tonce of 579.54 �;	thence run S89"53.52"'W, o di$tonce of 66.00 feet: ti')cl'!cc rul'i Noo·21·1e"w, a dist<mce of 256.00 feet; thence Nl'i N69'53'52"E, Q distal'!ce of 568.40: thcricc NI'\ S00"29'1Jt. a distaricc of 35,75 feel; ttiel'!ce NI'\ N89'1/56"E. a dislal'lce of 90.86 feet: tt,cnc;:c run 547.,5'37"E, Q di&imc:. of 44.44 fHt; th«1c:• run SOY35'05"E. a distance of 266.15 feet: theoc. run S00'49'55"E, Q distance of 485,06 f"1 to a point on a nol'!-tangel'lt cur..-. OOl'ica,... to the Northoost. haw'hg
a rgdius of 2003.86 feet; thence from a radial bearing of N74'50'57"E. Nl'i Southeasterlyglong the arc of sold curve ttirough Q central angle of 04'20'51", an crc distance of 152.05 feet. ha,.j'n9 a chord becring of S17"19'29.E and a chord distance of 152.02 feet: thenoe run s19•J0'0YE. o distance of J34.38 feet to a point on a non-tan�t curve concave to the We-,t, having a radius of 1815.86 feet: thence from o radial
bearing of s10·29·� W run So.Jt"casterly along t"c arc ot said airve tht'Otlg" a central angle of 19'08'.3'1�. on ore di:,tonce of 606.68 feet, hov·ng o chord bearing of S09'5�)'17"E and o chord disfonceeaf 603..67 feet: ti')cl'!cc run S00'21'30"E. Q distance of 721..34 feet to tl')c Point of 8cginnil'lg.
Col'itains 6.7�,674 square fHt or 1$5,089 gcre,;, rnont or Ina.

SUR'vEYORS NOTES
Searings based on the Sooth line of the
SOuthwest 1/4 of Section 13, Township 20 SQJth, Rongc 27 East. Orange County,
Florida QS bcil'lg S69"31'40""W,
I htreby «rtify that the ct>ove dw:ribed property is true gnd correct to the best of my knowledge ond belief as recently drawn tJnder my direction and that rt meets the Stoncfofds of Proetiee for Lond 5'.lrYCyjl'lg set forth in Florida Adminisi:ratiw, Code Rule 5<r17,05 reqJirem-ents.
Not valld ..1thout the 9f9nature and �  of o flOl'ido Licensed Sur\'eyor ond Mcppcr.
4,. The elec:tronk $ignahlre tier$0n is in compllanee with the Aorldo Aanlnf!ltratlve Code (FAC) SJ-17.062(3)

5 The seol oppeoring on this document' wos authorized by James R Shannon. PLS 4671
on 08/18/2023 per 5J17-062(2).

CUR'vE TABLE

CUR\IEI RADIUS I DELTA	LENGTHI CH. BEARINGI CHORD
Cl  12003.86'104"20'51'' 1152.05' I S1719'299E 1152.02'
C'2 11815.86' I 19'06'34" 1606.68' I S09"55'4rE 1603.8/ 

	UNE TABLE		
LINE	BEARING	LENGTH	
ll	N00'21"03"W	,t-6,69"	
L2	S00'04'14'"E	853.16'	
L3	N89"3'1°17"E	160.19'	
L4	S00-25' 43"E	30.00'	
L5	N69'-3'1'17"E	,t-76.16'	
L6	N00"21'18"W	579.54'	
L7	S89'53'52"W	66.00"	
LB	N00"21'18"W	256.00'	

	LINE TABLE		
LINE	BEARING	LENGTH	
L9	N89'53'52"E	58a.'10'	
LIO	S00"29'1YE	35.75'	
L11	N89, ?'-�6'"E	90.86'	
L12	S4715'37"E	44.44'	
L13	S03'3�)05"E	266.15"	
L1'	S00'49'$5"E	485.06'	
L15	S19'30'03"E	334-.38'	
L16	S00'21'30�E	721.34'	

SHANNON SURVEYING. INC.
499 NORTH S.R. 43-4 - SUITE 2045 ALTAMONTE SPRINGS, FLORIOA. 32714
(407) 774-8372	LB # 6898

Off"""" er. SP	SC.,,1.£ 1-'

SOO'

lJ-�21 «l.OE'N CEw ll�LOn-11&1.AT S<[T¢H
SHEET I OF 2

FflCU:CT N/>111£: VMJl OAKS
PURPOSE: REPLAT OF LOT 1

n-11s IS NOT A BOUNDARY SURVEY NOT VALID WITHOUT SHEET 1

�

KELLY PARK ROAD	j

i

r'5Y52"E

1324.32'

0

L7
� HOT Pl.ATIED
HOT INCLUDED

N

L3 �	LS

EASTUILY UIIE OF LOT 1

30.00'

LOT 1
KELLY PARK CROSSINGS PB 111, PG$. 122 & 123
155.089 ACRES±

r--

I  NOT

L 	

I PLAmD

j

:c;o

111€ SOOlHfflT t/4 CS:

-'""'"..,.."'

r--H�:::::=....;....J<>lll!��U<�E::"'::""'!..:Oi!l!!�"""'='='=''="'="�'"'�"'=":·•�P=:"��j;:j!f¥1Li...;29:::1:4:.36;;;,==t

S[C1Qt1r2lr27   I1

$89"37'48"W

I�

PART Of' LOT 2 KELLY PARK CROSSINGS PB 111, PCS. 122 & 123
15.024 ACRES±
---7

POINT OF BEOINNIN
SOU11£AST CORt;ER OF LOT I
KELLY PJ.RI( CROSSNCS

SHANNON SURVEYING, INC.
499 N�TH S,R, 434 - SUllE 2045
ALTAMONlE SPRINGS. FLORIDA, 32714
( 407) 774-8372	LB # 6898

o,t,\VIN er. SP

sc.,,1.£ r  -  SOO'

lJ-�21 «l..OE'N C8I �LOn-11&1.J,T S<[TCH
SHEET 2 OF 2

	
I�

I

Section VII

REQUISITION

The undersigned, an Authorized Officer of Golden Gem Community Development District (the '1Districtj hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture between the District and U.S. Bank Trust Company, National Association, Fort Lauderdale, Florida, as tru&iee (the "Trustee"), dated as of June 1, 2024 (the "Master Indenture"), <\S amended and supplemented by the First Supplemental Trust Indenture between the District and the Trustee, dated as of June 1, 2024 (the Master Indenture as amended and supplemented is hereinafter referred to as the "Indenture") (all capitalized terms used herein shall have the meaning ascribed tosuch term in the Indenture):
Requisition Number: 1
Name of Payee:	Lowndes, Drosdick, Doster, Kantor & Reed., P.A.
(see attached wire instructions)
Amount Payable:	$750
Purpose for which paid or incurred (refer alsoto specific contract if amount is due and payable pursuant to a contract involving progress payments, or, state Costs of Issuance, if applicable): Closing Fee associated with stormwater system land acquisition.
Fund, Account and/or subaccount from which disbursement is to be made:
Series 2024 Acquisitiun and Construction Account
The undersigned hereby certifies that obligations in the stated amount set forth above have been incurred by the District, that each disbursement set forth above is a proper charge against the Se.ries 2024 Acquisition and Construction Account and the subaccount, if any, referenced above, that each disbursement set forth above was incurred in connection with the acquisition and construction of the Phase 1 Project and each represents a Cost of the Phase 1 Project, and has not previously been paid.
Theundersigned hereby further certifies that there has notbeen filed withor served upon the District notice of any lien, right to lien, or attachment upon, or claim affecting the right to receive payment of, any of the moneys payable to the Payee set forth above, which has not been released or will not be released simultaneously with the payment hereof.
The undersigned hereby further certifies that such requisition contains no item representing payment on account of any retained percentage which the District is at the date of such certificate entitled to retain.

Originals or copies of the invoice(s) from the vendor of the property acquired or services rendered with respect to which disbursement is hereby requested are on file with the District.
GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

Authorized Officer

CONSULTING ENGINEER'S APPROVAL FOR NON-COST OF ISSUANCE REQUESTS ONLY
H this requisition is for a disbursement from other than the Costs of Issuance Account, the undersigned Consulting Engineer hereby certifies that thisdisbursement isfor a Cost of thePhase 1 Projectandis consistent with: (i) theapplicable acquisition or construction contract; (ii) theplans and specifications for the portion of the Phase 1 Project with respect towhich such disbursement is being made; and (iii) the report of the Consulting Engineer attached as an Exhibit to the First Supplemental Trust Indenture, as such report shall have been amended or modified on the date hereof.

Consulting Engineer
Kevin M. Roberson
Kimley-Horn and Associates, Inc.

Lowndes,Drosdlclr.DosUlr,Kantor & Reed,P.A. 215N.EdaDfflle• Orlando,Florltle 32801
0fllce Pl'lone:(�	OflbFax:1407)864444	
BUYER/SELURCJ.OSINGSTATEMBfT	
BUYER:	GOLDEN GEMCOMMUNITYIJEYB.OPMENTDISTRICT, a local unttof specialpurpose10'ffltlmentorpnlledunderthe laws oftheState ofFlorida	
SELLER;	KEU.Y PAIUCV8DEV£1.0PMEHT,UC,aDelaware llm!ted liabllltyccmpany	
CONTRACT:	Aalulsltlon Agreement datedJune14,202A	
O.OSlNGDAlE:	June14, 202A	
trm£COMPANY:	Fidelity Nat!onal lltle Insurance C.Ompany	
0..0SING&TITtf
AGENT:	Lowndes,0!'0$dlcil,Doster,Kintor& Rttd, P.A.	
PROP£R'TY:	TractCof ProposedPlat aflCelly Parle Crosslngs-App,olClmatelv31.021acres	
	
Buyer
o.ar-	Cledll	ChirpDesaiptJcn	Seller
Cllallll	cncllt	
		.flllllmll:			
$ 6,331,382.01		RealPropertyPurchase Prtce		$ 6,331,382.01	
					
		Pmnttlam:			
	s	3,7Q3.12	Creditto Buyerfor 2024 RealEstateTaxesfrom1.1.24to 6.13.24 basedon 21123 taxesIn theamount of $11,856.50(seeNot-e at
bot!Dmof p11e)	$	3,703.12		
					
		Tltle/&c:raw Olarl.el:			
		To;LoWllllet, OIWCl!dl, Dmer,Kmtor.Reed,P.A./fldellty NationalTIiieInsurance Company			
		Owner's�IcybasedonPurchase Price	$	18,070.65		
		Search Fee	s	200.00		
					
		8ectltdl1J8 , ••			
		To:0nqaCDuntyOerlr/Slmplllle			
		RecordingFeefor UCAffidavit• 6 pases(Includes e-recordtngfeecf $	57.25		
		$4.75)			
		Raa,rdlngFeefor Special Warranty Deed•7 pases (Includese- rec::onll,.feeof$4,7S)	$	65.75		
		Documentary stampTaxes onSpegal warranty Deed	s	44,319.80		
					
		MlllcellaneousR.1sbummen11:			
$	750.00		To: l.owlllles,Drosdie'- DOllitar,Kantor & Reed,P.A,
For.ClosingFee	$	750.0"		
		To:VcorpServlcel
For:Certified0111antmlon documents andc:ertlflc:ateSofgood	$	447.SO		
		To:LowndeJ, Drosclck.Doster,Kffltor•  Ried,P.A.
For:1..eialFees	fO(		
					
� 6,U2.1U.01	�	3.703.12	SU.Totals	�	67,614.07	�	
	
	I$ 6,328,GI89 Net Amount Due fROM Buyer		
		NetAmlluntduaT05e11111$ 6,263,767.IM		

Note:2023RETaxes:(0 Breney• $4,215.55:(ff)Hardy-liolt • $4,576.57: {Iii) Hedt • $1.49U2:and (IY)Hoffman•$1,573.23 e  $11,85650.
Sl1,8S6.5Qa,6928+386x 185a:$3.mJj.   69.28o/obasedonSWM3LandAc;quisitlonSl.immarycalalliltlon.

C1oHlgS111111Mnt
Kslly PlllkVB  OGvalDpmir\1;Goldaa Gem COO
0894184\203529\1388&7112

Lowndes,Drosdfck, Doster, Kantor & Reed, P.A. 215 N,Ecla Drive • Orlando, Florida 32801
Office Phone:(407)843-4600 OfficeFax:(4071843-4444	
BUYER/SEHER aDSING STATEMENT	
BUYER:	GOWEN GEMCOMMUNITY DEVELOPMENT DISTRICT.a localunitof special purpose government organized under the laws of the State of Rorlda	

SEUfR:	KELLY PARK VBDEVELOPMENT, LLC, a Delaware limlted liability company	
CONTRACT:	Acquisition Agreement dated June 14, 2024	
CLOSING DATE;	6/14/2024	
TIT!£ CDMPANY:	Fidelity Nationallltle Insurance Company	
CLOSING & TITLE AGENT:	Lowndes, Drosdick. Doster, Kantor & Reed, P.A.	
PROPERTY:	Tract Cof Proposed Plat ofKelly Park Crossings• Approximately 31.021acres	

Summarv of lncoml- Funds:	
From 5111,..rlEscrow Dennsltl:	$0.00	
FromBuverlfunds to close\:	$6 328 428.89	
		
Total Fu.nds Received By Oosin11Agent:	S6 328,418.89	

SUmmarv ofDisbursements bv aosl"" A.oent:	
To:seller(Proceeds of Salel	$	6,263,767.94	
To:Lowndes, Drosdlck, Doster, Kantor & Reed,P.A./Fioollly National Title Insurance
Company	$18,270.65	
To:Ora1111e Countv aerk/Slmi>llfile	$44,442.80	
To:Lowndes, Orosdick Doster, Kantor &Reed,P.A.	$1,500.00	
To: VcorP Services	$447.50	
To: Lowndes, Drosdlck, Doster, Kantor& Reed, P.A.	POC	
TotalD1$burse_mentsByCloslneAnnt:	$6,328---:iiS.89	

Closlng Stetemellt
KeUyPark VBOevetoiment; GOidenGemCOD
0894184\203528\13886702

Lowndes,Drosdldc, Dcster, ranter & Reed, P.A.
21SN.tolll Drive• Oltando, Florlda 32801
Office Phone:(401)8U-1600 Office Fu: (�-4444	
su-,SEUERaOStNGsr-ATEMENT	
BUYER:	GOlOEN GEM COMMUNITY OEVEl.OPMENT DISTRICT, a local unit ohpedal purp0$egovernment organlmd under the
laws of theStateof Rorida	
SEllER:	KELLY PARK VB DEVELOPMENT, U.C, aDelaware limited llability wmpany	
CONTAACT:	Acquisition Agreement dated June14, 2024	
Q.OSING DATE:	6/14/2024	
'lTll.ECOMPANY:	Adelity National Tltle Insurance Company	
ClOSJNG & TlnEAGENT:	Lowndes, Drosdldc, Doster, Kantor & Reed, PA	
PROPERTY:	Tratt Cof Proposed Plat of Kelly Park Crossings - Approximately 31.c>21acres	

II

APPROVAL OFa.o51NGSTATEMENT
6-andSellc ac!cnowled&undas,<tt that 6llheyhew neadth9forqolngCbln1Statementand�	anddlle<tllllltClosln&Acent disburse the moniesto tnapmons
and In the amounts desalbed herelri; (Ill that tloslncAlent!haft hivenol1al:llllly for IIIYlnccrmt infcrmalian provided brthlrd,pmjl$, nor foranymathtmatlcal er c,tt,er
.,,.... onthlJ Closhw State,nrm. md th. putlu INl1 look1ololy ...t,totheolller ror ony ld]umnents tmt may be l'Qq\llrtd •• a rUU!t ar any"""" •nan;ind (Ill) eny
PRQllons and/or -ificaliG!I of real pn,perty tua  have bun conl'llmed 91111�	try 11le unclenlgned ,artltts; and (Iv) CloslrW llnwlent may be aecull!d In
counwrparls, andthe c:ounlerl)arts tqillhersllallainst!llltt tM s1n£1eagreement ofIlleparties.

GOLDEN GEM COMMUNRY OfV!LOPMl!NT DISTRlcr,
alocalunitof specialpurpose government organized
under thelaws of theStab!of Florida
By:			 Name: Herbert M.RldgeJV, Ill lltle:ViceChairperson

�

KEU.Y PARK VBDEVELOPMENT, UC,
a Delaware limited liability company
By: KPVB Acquisition u.c.
a Delaware llmltedliabilitycompany, Its Member

By: WO Assignment, LLC,
aFloridaUmlted llabllltycompany,Its Member By:	
Name: KevinM.Barry
Title:Manager

UNDERTAKING OFa.o51NG AG£NT
Clcslng Aaer,t hereby 1,rees with Buyer ;,nd Seller to under1at:le Its dlltles as Ooslnc Apnt !'or tht subJect transaction, to comply with the within end fwegolng ln5tr\ltllons ofSuver andSeller,and to dlSburse the proceeds ofIfiesub,leet transaction In tilt manner, to tile persons, In tile amounts and at th.e times hen1inabow speclfted In the within andJgrecolllg(10$1118Sraument.
LOWNDES, DROSOICK, DOfflR,KANTOR &REED, PA

ev:.		 Name: 	_ Tltle: Vice President

Cloai!Q Slllk!meJ1I
KalyPark VBOM!opma�;GcilenGem COO
0894184\203!i2S\1981511)2

REQUISITION

The undersigned, an Authorized Officer of Golden Gem Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture between the District and U.S. Bank Trust Company, National Association, Fort Lauderdale, Florida, as trustee (the "Trustee"), dated as of June 1, 2024 (the "Master Indenture"), as amended and supplemented by the First Supplemental Trust Indenture between the District and the Trustee, dated as of June 1, 2024 (the Master Indenture as amended and supplemented is hereinafter referred to as the "Indenture") (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):
Requisition Number: 02

Name of Payee:	RCS Construction Co. Inc.

Amount Payable:	$481,893.59

Purpose for which paid or incurred (refer also to specific contract if amount is due and payable pursuant to a contract involving progress payments, or, state Costs of Issuance, if applicable):
Fund, Account and/or subaccount from which disbursement is to be made:
Series 2024 Acquisition and Construction Account

The undersigned hereby certifies that obligations in the stated amount set forth above have been incurred by the District, that each disbursement set forth above is a proper charge against the Series 2024 Acquisition and Construction Account and the subaccount, if any, referenced above, that each disbursement set forth above was incurred in connection with the acquisition and construction of the Phase 1 Project and each represents a Cost of the Phase 1 Project, and has not previously been paid.
The undersigned hereby further certifies that there has not been filed with or served upon the District notice of any lien, right to lien, or attachment upon, or claim affecting the right to receive payment of, any of the moneys payable to the Payee set forth above, which has not been released or will not be released simultaneously with the payment hereof.
The undersigned hereby further certifies that such requisition contains no item representing payment on account of any retained percentage which the District is at the date of such certificate entitled to retain.

A-1

Originals or copies of the invoice(s) from the vendor of the property acquired or services rendered with respect to which disbursement is hereby requested are on file with the District.
GOLDEN GEM COMMUNITY DEVELOPMENT
DISTRICT

Authorized Officer

CONSULTING ENGINEER'S APPROVAL FOR NON-COST OF ISSUANCE REQUESTS ONLY
If this requisition is for a disbursement from other than theCosts of Issuance Account, the undersigned Consulting Engineer hereby certifies that thisdisbursement is fora Cost of the Phase 1 Project andis consistent with: (i) the applicable acquisition or construction contract; (ii) theplans and specifications for the portion of the Phase 1 Project with respect to whichsuchdisbursement is being made; and (iii) the report of the Consulting Engineer attached as an Exhibit to the First Supplemental Trust Indenture, as such report shall have been amended or modified on the date hereof.

Consulting Engineer

A-2

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF	PAGES

TO OWNER:
Kelly Park VB Development. LLC
660 Beachland Blvd. Vero Beach, FL 32963 FROM CO TRACTOR:
RCS CONSTUCTION CO. INC. 295 E. HWY 50 SUITE I CLERMONT. FL3471I CONTRACT FOR:

PROJECT: Wyld Oaks

VIA ARCHITECT:

APPLICATIO NO:

PER.IODTO:

PROJECT NOS: CONTRACT DATE:

5

4/30/24

Distribution to:

§

OWNER ARCHITECT CONTRACTOR

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.

ORI ,I ·\I ( ONTR\CT SIJM

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.

ct change hv Change Orders
CO I RACl SlJ 110 DA 11 !Ltnc I  21
IOlAI COMPI I rrn&SfORFD 10
DATE	(Column G on G703)
5. RETAINAGE:

176.347.12

	69.787.00 
	n.589., 1507 

CONTRACTOR:	RCS CONSTRUCTION CO., INC.

	5_% of Completed Work		 (Column D + Eon G703)

5_ % of Stored Material
(Column Fon G703)		

Total Rctainage (Lines Sa+ Sb or

ENGINEER'S CERTIFICATE FOR PAYMENT

Jr,tal m ( olumn I ol (i703I
6 101 Al I ARNI I) 11SS RI TM  :\<JI
(Line 4 Le s Line 5 Total)
7. LESS PREVIOU CERTfFICATES FOR		
PAYMENT (Line 6 from prior Certificate)
CURRFt,,I I',\ Y IFNl DtJI
BALANCI 10 rlNISIL I (I.I/DING RI lAI  A(,I
(Linc 3 less Line 6)

Total Completed and Stored To Date - Eligible For CDD Payment Total Retainage At 5%
Total Earned Which Is Elib�ble For CDD Payment. Less Retainage Less Amount Previously Paid By CDD
Current Payment Due By COD

Total ompleted and Stored To Date - Eligible For KPVBD Payment Total Retainage At 5%
Total Earned Which Is Eli1,�ble For KPVBD Payment. Less Retainage Less Amount Previously Paid By KPVBD
Current Payment Due By KPVBD

	ll/S.472.22 
	Ul�.'ln.13

$	2,771,928.12 
	942,0-1-1.01  •••
2,875.842 9-1

	1,239,192.74 
	61,959.64 
	1,177,233.10 
	695.339.51 
481,893.59

	2,670,251.61 
	133,512.58 
	2,536.739.03 
	2,076,588.61 
460,150.42

In accordance with the Contract Documents, based on on-site observations and the data comprising the application, the Engineer certifies to the Owner that to the best of the Engineer'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.
$942,044.01
AMOUNT CERTIFIED	$

(A/Inch explanation ifa11101111t certified differsfrom the amount applied. Initial all Jig11res 011 this Applicmion and onthe Contimwtion Sheet that are changed to conform with the nmo11/J/ certified.)

By: K	• R b

ENGINEER:	r1J	_
/,1.	�	6/26/2024
8Vln	O 8rSOn {f,l/"l fV'i	Date:
K1mley-Horn	--------
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 oft he Owner or Contractor under this Contract.

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTION	
Total changes approved in previous months by Owner	$69,787.00	$0.00	
Total a  roved this Month	$0.00	$0.00	
IOTAI.	69.787.00	O.Oll	
I I CHAN<il•<;by C'han�c Order	69.787.00		

AIA DOCUMENT G702 APPLICATION ANO CERTIFICATION FOR PAYMENT 1992 EDITION AIA C1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE, NW, 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.
••• ,m11r<1c1or 11.�rl'es th{lt Owner ll'i/1 p{l1 ll'ith what /1111di11�1s am,lnble which 11wr nm eq11al the Currell/ Pm'lllent Due. 11111unpmd balance will remaiu 011 accoullf /or Owner to par 11•1th fu111re /1111ds.
ote: Items in RED FO Tare automatically calculated from the G703 form or from items within this G702 Form. Do  OT hand enter these items on this sheet.

AIA Dorument G702. APPLICATION AND CERTIFICATION FOR PAYMENT. containing
Conlractor'ssigned certification 1s attached.

A	ll	('	I)	E	F	G	II	I	J	I	K		M	I	N	()	I	
HEM
NO	
l>ESCRll'TION OF WORK	
SCJIEDUL.El>
VAI.IJE	WuKII.\.UM	'LC 'ED	MAll:tu/\l..S l'RESEN"ll�Y STORED (NOT IN
DORI:)	lurAL COMPl.l'.:TED ANnSTORED
l'O DA11� (D+E+F)	
(G•CJ	BALANCE TO FINISH (C-<;J	RETAINA(,E.
Cak111all-dat5%	CIJO lilig1nilit	K1•vno E IJU ,ht	
			FROM PREVIOUS
APl'Ll('A rl()N
(D + E)	1111$ PERIOD						•11 Eligible for
P3.)t1w=nl Uy(DD	Tola! [omplctcd And
Slortd To Date Eligible for l'a)111cn1 lh·CDD	fotalCDO
Retain.age 0 5'-•	•• Eligit>lc For l'aymcnt D:; KPVllD	ro,al C. C'>mplc1odAnd
Storor.l To Da1c
Eligible Fnr P,1)n1Cnt
fly KJ)VJlO	Toul KPVBIJ
Kc1.11n.1g<:(a s,o		
		Qu.1ntily	Unit	l'ncc	fol.ii															
	l\,l'nrna LOOOlltOnS, 1'10 I z:11100, �Un'l'\'																			
1.	MOBILIZATION	1	LS	$250,000.00	S250.000.00	S250,000.00	SO.DO		S250,000.00	100"/4	S0.00	Sl2,500.00	9.97%	S24,925.00	Sl.246.25	90.0'.\%	S225,075.00	Sl I,253.75		
2.	ATTORNEY FEE	1	LS	$95,000.00	S95,000.00	S95.000.00	S0.00		S95.000.00	100%	SO.DO	S4,750.00	9.97%	S9,471.50	S47J.58	90.03%	S85.528.50	S4.276.4)		
3.	GENERAL CONDITIONS	1	LS	$21457.44	S21,457.44	SI0,500.00	S6,500.00		SI 7.000.00	79%	S4.457.44	S850.00	9.97%	Sl,694.90	S84.75	90.0.1%	SIS.305.I0	5765.26		
4.	PERFORMANCE BOND	1	LS	$80,494.50	S80.494.50	580.494.50	SO.DO		580,494.50	100%	SO.DO	54,024.73	9.97%	SS.025.JO	5401.27	90.01%	572,469.20	SJ,62).46		
5.	LAYOUT/ASBUILTS	1	LS	$48,391.25	S48.l9l.25	Sl2,600.00	S12.6-00.00		S25,200.00	52%	S2J,I9l.25	Sl,260.00	9.97%	52,512.44	S125.62	90.0Jo/o	S22.687.56	Sl.1.14.38		
6.	SWWWP	1	LS	$10,003.75	SIO.OOJ.75	Sl.750.00	52,800.00		S6.550.00	65%	Sl.453.75	5327.50	9.97%	SMJ.04	SJ2.65	90.03%	S5,8%.97	5294.85		
7.	SILTFENCE	1	LS	$38,618.08	SJS.6I8.08	SJS.6I8.08	SO.DO		SJS.6I8.08	100%	SO.DO	Sl,930.90	9.97%	S.1,850.22	5192.51	90.0.3%	SJ4,767.86	Sl.718..19		
8.	TREE PROTECTION	1	LS	$19 718.90	Sl9,718.90	SO.DO	SO.DO		S0.00	Oo/.	SI9,7I8.90	SO.DO	9.9r/4	SO.DO	S0.00	90.03%	S0.00	SO.DO		
9.	CONSTRUCTION ENTRY	2	EA	$12 461.65	S24.92J.JO	Sl,000.00	S0.00		Sl,000.00	4%	S2l.92J.JO	S50.00	9.97%	599.70	S4.99	90.03%	S900.JO	S45.02		
10.	CLEAR SITE/WYLD OAKS	1	LS	$52 000.00	S52,000.00	536,000.00	S7,500.00		S4J,500.00	84%	58,500.00	S2,I75.00	9.97%	S4.JJ6.Y5	S2I6.85	90.03%	SJ9,l6J.05	Sl.958.15		
11.	DEMO STRUCTURES -WYLD OAKS	1	LS	$34,500.00	S.14,500.00	$8,500.00	S22,000.00		SJ0,500.00	88%	S4.000.00	$1,525.00	9.97%	SJ,040.85	Sl52.04	90.03%	527,459.15	SU72.96		
12.	DEMO PAVEMENT	3658	SY	$5.92	Sll .655..16	SO.DO	Sll,500.00		Sl2.500.00	58%	S9.l55.J6	S625.00	9.97%	Sl.246.25	S62.Jl	90.0)%	SI 1,25.l.75	5562.69		
13.	DEMO CONCRETE	960	SY	$9.56	S9.I77.60	S0.00	S4,000.00		S4,000.00	44%	S5.l77.60	S200.00	9.97%	S398.80	Sl9.94	90.0)%	SJ,601.20	5180.06		
14.	MASS GRADE	1273657	C'(	$2.42	SJ.082,249.94	Sl,928,808.00	SJ6.1,000.00		S2.29l.808.00	74%	S790,44I .94	SI 14,590.40	9.97%	S228.49J.26	SI 1,424.66	90.0)%	S2.06J,J 14.74	SIOJ,I65.74		
15.	DEMO GOLDEN GEM PROPERTY	1	LS	$55,333.23	sss.JJJ.23	SO.DO			SO.DO	0%	S55,JJJ.2.1	SO.DO	9.97%	SO.DO	SO.DO	90.0'.\%	SO.DO	SO.DO		
16.	DOUBLE SILT FENCE FOR STOCK PILE AREA	38DO	LF	$4.3S	Sl6,5JO.OO	SO.DO			S0.00	0%	Sl6,SJO.OO	S0.00	9.97%	SO.DO	SU.00	90.0�%	S0.00	S0.00		
17.	HYDRO SEED STOCK PILE AREA	S7000	SY	$1.00	S57,000.00	SO.DO			SO.DO	0%	S57.000.00	SU.DO	9.97%	SO.DO	SO.DO	90.03%	SO.DO	so.oo		
18.	OVER EXCAVATE SOILS AREAS 5' IN DEPTH	47682	CY	$S.52	S26J,204.M	SO.DO			S0.00	0%	S26J.204.64	SO.DO	9.97¾	S0.00	50.00	90.03%	SO.DO	S0.00		
19.	GRADE SITE	1	LS	$42 707.00	$42,707.00	S0.00			SO.DO	0%	542,707.00	SO.DO	9.97%	S0.00	S0.00	90.03%	SO.DO	so.oo		
20	EROSION BLANKET	1	LS	$258S1.20	S25.85l.20	SO.DO			S0.00	ll'/4	$25,851.20	SO.DO	9.97%	SO.DO	S0.00	90.03%	S0.00	SO.OD		
21.	WELL ABONOONMENT • WYLD/GOLOEN GEM	4	EA	$9,700.00	
SJS,800.00	
SO.DO			
SO.DO	
ll'/4	
SJ8.800.00	
S0.00	
9.97%	
SO.DO	
SO.DO	
90.03%	
SO.DO	
SO.DO		
22.	CLEAR SITE/GOLDEN GEM	1	LS	$S1 000.00	SSl,000.00	S0.00			SO.DO	0%	S5I.000.00	S0.00	9.97%	SO.DO	SO.DO	90.0J'Y.	SO.DO	SO.DO		
23.	SOD PONDS	67270	SY	$4.81	SJ2J,568.70	SO.DO			SO.DO	0%	S.123,568. 70	SU.DO	9.97%	SO.DO	S0.00	90.0)%	S0.00	S0.00		
24.	POND LINER 30 Mill	20645	SF	$3.57	S7J.702.65	SO.DO			SO.DO	ll'/4	S7),702.65	SU.DO	9.97%	SO.DO	S0.00	90.03%	SO.DO	S0.00		
25.	HYDRO SEED BOTTOM OF PONDS	72900	SY	$1.00	S72,900.00	S0.00			SO.DO	0%	572,900.00	SO.DO	9.97%	SO.DO	SO.DO	90.03%	SO.DO	S0.00		
26.	DEWATERING	1	LS	$30 000.00	SJ0,000.00	S0.00			SO.DO	0%	SJ0,000.00	S0.00	9.97%	SO.DO	SO.DO	90.03%	S0.00	S0.00		
27.	SEED/MULCH	1	LS	$354 813.60	SJ54.8 I J.60	S0.00			S0.00	0%	SJ54,8IJ.60	S0.00	9.97%	SO.DO	SO.DO	90.0J¾	SO.DO	S0.00		
28.	60" HOPE	1414	LF	$274.81	5388,581.34	S24J,J82. 72	SO.DO	SU.DO	S24l.l82.72	63%	Sl45,I98.62	512.169.14	100"/4	5243.382.72	Sl2,l69.14	0.00%	S0.00	SO.DO		

Use ColumnI on Contractswhere variable rctainafc for line items may apply.

APPLICATION NO: APPLICATION DATE:
PERIOD TO: ARCHITECT'S PROJECT NO·

5
4/3012024
4/30/2024
,.

AIAOOCUMENT0703 CONTNUATONSHEETFORG702 1992EOlllON Al/\ C11»2
THE AMERICAN INSTrruTE OF AACttfTECTS, 1735 NEW YORK AVENUE. N.W WASHNOTON, DC �5232	G703•1992

AJA DOCllmcnt G702, APPUCATION AND CERTIFICATION FOR PAYMENT. containing
Con1rae1or'ssigned cenification is a11ached.

A	II	C	I)	E	F		II	I	)	I	K	I	I,		I	

flH,1
NO	

OESCRIPTK)N OF WORK	
SCllEDUIJ:O
YALUF	WUK.K CUMl'Ll! I ED	MA rERIAI.S PRESL:N"ll�Y STORED (NOTIN
DORE)	l(HAL
C'OMPl.l;7liD ANOSTOREO TO DA11�
(O+E+F)	

(G+-q	
8AI.ANCE TO FINL5II (C-G)	RETAINAGI:
CAicuiated al 5°,	t,:l)I) Eli ibilitv	KJ>VBIJ J;lip:ib,hty	
			FllOM PKEVK)US APl'LICATION (D+ E)	
'lllL'i l'ERIOO						
• Eligihlc For PA)'T111..-Yll DyCDD	Tot:tl C(lruplcted And Sl\lrcd lo Date Eligible For P:iynk'fll
ByCDD	1'oL1ICIJDs,•
Rct.,1nagc @	
•• Eh�1blc: For i'a)incnl lly
KPVllU	fotal Completed And Ston:d To Date Elil!ibk: for P.'.l)mi.'Tlt
OvKPVBO	
Total KPYBD
Relilm,1gc 0 5°•	
		Quantily	Unit	Pnce	·fo1al														
29.	CONTROL STRUCTURE	1	LS	$7 331.82	S7.JJ 1.82	S0.00			S0.00	0%	S7.Jll.82	S0.00	100%	S0.00	S0.00	0.00%	S0.00	S0.00	
30.	MANHOLE	B	EA	SB 144.54	565.156..12	S0.00			S0.00	0%	S65. 156.32	so.oo	100%	S0.00	S0.00	0.00%	S0.00	S0.00	
31.	BUBBLE UP	3	EA	$6,067.44	Sl8,201.32	S0.00			50.00	0%	518,202.32	so.oo	100%	S0.00	S0.00	0.00%	S0.00	S0.00	
32.	BOX CULVERT	617	LF	$1,317.89	5813. I .18.13	S273,702.05	S43,900.00	S.182,502.00	S700,104.05	86%	SIIJ,034.08	Sl5.U05.20	JOO%	S700, I 04.05	5)5.005.20	0.00%	S0.00	S0.00	
33.	TV LINES	1	LS	$34,017.00	SJ4,017.00	S0.00			S0.00	0%	S34.017.00	S0.00	100%	S0.00	so.oo	0.00%	S0.00	S0.00	
																			
	Chanae Orders																		
1.	C0#1 Builder Risk Insurance	1	LS	$69,787.00	S69.787.00	S69,787.00	S0.00		S69,787.00	100"/4	S0.00	SJ,489.35	9.97%	56.957,76	5347.89	90.0.1%	562.829.24	53.141.46	

																			

																			

																			

																			

																			

																			

																			

	SUTHOTAL				S6,589,815.07	SJ.052.142.35	S474.800.00	5]82.502.00	Sl.909.444..15	59%	52.680.)70.72	SI 95.472.22		Sl,239,192.74	561,959.64		S2.670,251.61	5133.512,58	
	GRAND TOTALS				S6.589.815.07	SJ.052.142.35	5474.800.00	S382,502.00	S.l,909.444.35		52,680.)70.72	5195.472.22		Sl,239,192.74	S61.959.64		S2,670.251.61	SIJJ.512.58	

Use C0l UITlll I on Contracts where vanable retamage ro, r Ime 1terrr.,; mav annl .

APPLICATION NO: APPLICATION DATE:
PERJODTO: ARCHITECTS PROJECT NO
G

5
4/30/2024
4/3012024

Users may obtain validation of this document by requesting of the license a completed AIA Document 0401 - Certification of Document's Authenticity

""'OOCUMENT0703 COHT�U,\TIONSHEE1FOR0102 1992EDOOO A� Cl19Q1
THE AMER CAN NS mute OF �CHRECTS, 1735 NEW Y'OkK AVENU[. N w WAStllNGTON, 0 C 2000e·52'32	G703°1992

PROGRESS PAYMENT AFFIDAVIT

STATE OF FLORIDA COUNTY OF LAKE

BEFORE ME, the undersigned authority, duly qualified and authorized in the State and County aforesaid to administer oaths and take acknowledgements, this day, personally appeared	Everett Rozar	, who being by me first duly sworn, deposes and says:

The facts and matters contained and recited in the Affidavit are based upon personal knowledge of the Affiant.
Affiant is the Owner of	RCS Construction Company, Inc.	, a North Dakota Corporation company (hereinafter the "Contractor")
Contractor and	Kelly Park VB Development, LLC	(hereinafter the "Owner") have executed, delivered and entered into that certain CONTRACT AND AGREEMENT dated	December 4, 2023	(hereinafter the "contract").
Affiant now requests partial payment under the Contract. In Consideration of Owner providing such partial payment, Contractor hereby provides this Affidavit upon which Owner intends to rely.
Contractor is not aware of any Claims that would require an adjustment of the Contract Time or the Contract Price except for any Change Order Requests or Change Order Proposals previously submitted in writing to Owner prior to execution of this Affidavit.
Contractor releases any Claims for an adjustment to the Contract Time or the Contract Price except for those previously made in writing and delivered to Owner prior to execution of this Affidavit.
Affiant states that all bills for labor, services or materials furnished, delivered, installed or performed on the job site through the date of this Affidavit have been FULLY paid and that no lien for such may properly be filed, recorded or enforced. Waiver and Release of Lien upon Progress Payment forms for every such potential lienors are provided herewith through 04/30/2024
Affiant states that, except as provided herein, all bills for labor, services or materials furnished, delivered, installed or performed on the job site through the date of this Affidavit have been FULLY paid and that no lien for such may properly be filed, recorded or enforced. Waiver and Release of Lien Upon Progress Payment forms for every such potential lienor are provided herewith, except as provided below:

Name of Lienor Or Potential Lienor

Amount due for labor, services or materials furnished, delivered, Installed or performed

1.  Abatement & Demolition Services	$6,495.00	
2. Fortiline Inc.	$10,027.81	
3. Oldcastle Infrastructure	$377,950.95	
4.  Universal Engineering Sciences	$6,870.00	

FURTHER AFFIANT SAYETH NOT.

  RCS Construction Company, Inc.	

---.�----�	�· Affiant

Sworn to ak1  subscribed before me this	13th	day of  June	2024, by
f:¥t::rc1±oza✓	, who (check one): [ X] is personally known to me, [ ] produced

Pr n	ame:	Victoria	a	eria 	

a driver's license (issued by a state of the United States within the last five (5) years) as identification, or [ ] produced other identificat'		. Affiant did take an oath.

VICTORIA E. LAUTERIA
Notary Public State of Florida Comm# HH276625
Expires 6/19/2026

Notary Public, State of Florida
Commission No.:--H-H2-766-25-------
MyCommission Expires:	06/19/2026

JOINDER AND INDEMNIFY AGREEMENT

Contractor, joins in the execution of this Affidavit for the purpose of adopting all representations of fact contained therein. Contractor understands that this Affidavit will be relied upon by Owner for all purposes relating to the Contract. Contractor agrees to indemnify, hold harmless and defend the Owner from, against and with respect to any and all loss, cost, damage and expense, including reasonable attorneys' fees, arising out of any claims by laborers, subcontractors or materialmen who might claim that they have not been paid for labor, services or material.

A Florida Corporation Company

By:----,,,�'---�----	
Name: Everett Rozar Title:	President

(CORPORATE SEAL)[where applicable]

WAIYER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of$ 942,044.01	, hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished through 04/30/2024 to Double B Development and Kelly Park VB Development, LLC on the job of Wyld Oaks Mass Grading Improvements to the following property:
S of Kelly Park Rd & Effie Dr.
3620 W Kelly Park Rd.
Apopka, FL 32712, Orange County (description of property)

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

DATED on June 26, 2024.

Lienor RCS Construction Company, Inc. Address 295 E SR 50, Suite 1,

	Clermont FL 34711	

By:--r"i::-7�+"-l-"'�-b'--=--...c...._	­

Prin
Its:

State of Florida
County of �L=a=k=e'----
The foregoing instrument was acknowledged before me this 26th	day of June	, 20_1i_, by , as of said company, who has presented as identification or is personally known to me.

VICTORIA E. LAUTERIA
Notary Public State of Florida Comm# HH276625
Expires 6/19/2026
		Victoria E Lauteria	 Print, Type or Stamp Commission

DEVELOPER'S REPRESENTATIVE CERTIFICATE FOR PAYMENT

Wvld Oaks- Mass Site Grading Pay Application #5 Pay Application Dated 4/30/24

In accordance with the Contract Documents, based on on-site observations and the data comprising
this application, the Developer’s Representative certifies to the Owner that to the best of the Developer's Representative’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.

AMOUNT CERTIFIED

$942,044.01

(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.)

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.

REQUISITION

The undersigned, an Authorized Officer of Golden Gem Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture between the District and U.S. Bank Trust Company, National Association, Fort Lauderdale, Florida, as trustee (the "Trustee"), dated as of June 1, 2024 (the "Master Indenture"), as amended and supplemented by the First Supplemental Trust Indenture between the District and the Trustee, dated as of June 1, 2024 (the Master Indenture as amended and supplemented is hereinafter referred to as the "Indenture") (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):
Requisition Number: 03

Name of Payee:	RCS Construction Co. Inc.

Amount Payable:	$71,482.68

Purpose for which paid or incurred (refer also to specific contract if amount is due and payable pursuant to a contract involving progress payments, or, state Costs of Issuance, if applicable):
Fund, Account and/or subaccount from which disbursement is to be made:
Series 2024 Acquisition and Construction Account

The undersigned hereby certifies that obligations in the stated amount set forth above have been incurred by the District, that each disbursement set forth above is a proper charge against the Series 2024 Acquisition and Construction Account and the subaccount, if any, referenced above, that each disbursement set forth above was incurred in connection with the acquisition and construction of the Phase 1 Project and each represents a Cost of the Phase 1 Project, and has not previously been paid.
The undersigned hereby further certifies that there has not been filed with or served upon the District notice of any lien, right to lien, or attachment upon, or claim affecting the right to receive payment of, any of the moneys payable to the Payee set forth above, which has not been released or will not be released simultaneously with the payment hereof.
The undersigned hereby further certifies that such requisition contains no item representing payment on account of any retained percentage which the District is at the date of such certificate entitled to retain.

A-1

Originals or copies of the invoice(s) from the vendor of the property acquired or services rendered with respect to which disbursement is hereby requested are on file with the District.
GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

Authorized Officer

CONSULTING ENGINEER'S APPROVAL FOR NON-COST OF ISSUANCE REQUESTS ONLY
If this requisition is for a disbursement from other than the Costs of Issuance Account, the undersigned Consulting Engineer hereby certifies that thisdisbursement is for a Cost of the Phase 1 Project andis consistent with:(i) the applicable acquisition or construction contract; (ii) the plans and specificationsfor the portion of the Phase 1 Project with respect to which such disbursement is being made; and (iii) the report of the Consulting Engineer attached as an Exhibit to the First Supplemental Trust Indenture, as such report shall have been amended or modified on the date hereof.

Consulting Engineer

A-2

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF	PAGES	

TO OWNER:	PROJECT: Wyld Oaks
Kelly Park VB Development, LLC	
APPLICATION NO:	
6	Distribution to:
ow ER	
660 Beachland Blvd.			ARCHITECT	
Vero Beach, FL 32963	PERIOD TO:	5/31/	24	CONTRACTOR	
FROM CONTRACTOR:	VIA ARCHITECT:				
RCS CONSTUCTION CO. INC.				
295 E. HWY 50 SUITE I	PROJECT NOS:			
CLERMONT, FL 34711				
CONTRACT FOR:	CONTRACT DATE:			

§

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment. as shown below, in connection with the Contract. Continuation Sheet. AJA Documem G703, is attached.

The undersigned Contractor certifies that to the best of the Contractor's knowledge. informatfon 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

ORIG! Al CO IRA( 1 SlJI\I
ct change h} Change Order,
CON1R·\C I SlJ I 'H)  DA f[ (line I  21
4  IOIAI COMPLl rl D& SIORI D ro
DATE	(Column G on G703)
RETAINAGE:

22b.-l}5.32

�	o,52(J.02b.ll7
	69.7 700
$	h.5R9, '15 07
s 	4.528.706.35 

shown herein is now due. CONTRACTOR:

	5 % of Completed Work		 (Column D + Eon G703)
5 % of tored Matcria I	0.00

(Column Fon G703)		

Total Retainage (Lines Sa+ Sb or

ENGINEER'S CERTIFICATE FOR PAYMENT

Total in f'olumn I olG7ml
6  IOIAI IAR TDIISSRll\l Mir
(Line 4 Less Line 5 Total)
7. LESS PREVIOUS CERTIFICATES FOR		
PAYMENT (Line 6 from prior Certificate)
X CURRIN! l'AYMT l [)IIE	,
9 Bt,,1 t,, Cl 10 n ISi I. I 
(Line 3 less Linc 6)

Total Completed and Stored To Date TI1at is Elib,jble For CDD Paymen Total Retainage At 5%

	226.435.32 
	�.3112.271.0' 

$	3,713,972.13 
	S8X.298.90  •••
$	2.287.544.04 

	1,314,437.66 
	65,721.88 

In accordance with the Contract Documents, ba ed on on-site observations and the data comprising the application, the Engineer certifies to the Owner that to the best of the Engineer'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.

AMOUNT CERTIFIED ........... $	$588,298.90

(Artach expla11ario11if amount certified differsfrom Ihe 0111011111 applied. Initial allfigures 011 this Application a11d onthe Conlinuation Sheet thal are changed to conform with the amoum certified.)
ENGINEER:	,--./J	_

Total Earned Which Is Eligible For COD Payment. Less Retainage Less Amount Previously Paid By COD

	1,248.715.78 
	1,177,233.10 

By: K8V•ln R Ob

erSOn _I(f,//)J'.n fV\�

Total Completed and Stored To Date - Elib,jble For KPVBD Payment	71,482.68

3,214,268.69	This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance. payment and acceptance of payment are without	
Total Retainage At 5%		160.713.43 	prejudice to any rights of the Owner or Contractor under this Contract.	
Total Earned Which ls Elib,jble For KPVBD Payment, Less Retainage		3.053,555.25 		
Less Amount Previously Paid By KPVBD		2,536,739.03 		
Current Payment Due By KPVBD	516.816.22		

Date:

6!2612024

Current Payment Due By COD

K1mley-Horn	--------

CHANGE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous months by Owner	$69.787.00	$0.00	
Total a  roved this Month	$0.00	$0.00	
TOTAi	69.787 ()()	Cl.On	
I I CIIANGI S hv Chan •c Order	69.787.0()		

AIA DOCUMENT G702 APPLICATION ANO CERTIFICATION FOR PAYMENT 1992 EDITION AIA @1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE, NW, 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.
••• Co11trac1ar a>?,rees that 011'ner ll'i/1 pal' 11·1th ll'hat /1111du1,: 1s amilable which 111<11' 1101 equal the Curreut Pal'l11e11t Due. Am·1u1paul balance will rema111 011account /or Owner 10 pm·wah /11I11re funds.
l'lote: Items in RED FO Tare automatically calculated from the G703 form or from items within this G702 Form. Do  OT hand enter these items on this sheet.

CONTINUATION SHEET	A/A DOCUM£NTG703	
Pa,g•18')"-l!n	
AIA Docwncnl G702, APPI.JCA0llON AND CERTIFICATION FOR l'A YMEN'I, contaming	APPLICATION NO:	6	
('onIractor's s1gncd ccrtificaI1on Is auachcd	APPLICATION DATE:	1/0/1900	
	PERIOD TO:	S/,i/2024	

Use Column I on Coo1rac1s where ,eariahlc rctama c. ror hnc 11am ma		
A	ll		"	E		G				K	I	L	M	I	N	I	0	
rrr.M
NO	

1)1:;.�('RIPTK)N OF WORK	SCIIEDln�l:IJ VALUI'	WORK COMPLl�I l:D	MATERIALS PRESENTLY STORE.I>
!NOTIN DORE)	IOJ'AI. ('OMPLETFO i\NOS10MHl TO OATI�
(D<f..+1·)	%

CG t")	
UAI.ANC'E 1O1-lNISII IC-G)	RETAr..lAGE
C•kulll!C"d•l5.,.	CDDl:IJJl.ibihtv	KJ'Vlll)Eluubililv	
			FKOM l'K�VIOUS
APPIJC'ATION
(0 .. E)	·nusPFRIOD						
¾EliiibkF.ir
Payn'Cl1 Uy COD	l"o1alCorrc,ldcdAld S1orcd To l:►.Ui: Flis.ibk for 1'1ymrn
UvCDIJ	
Total ('DI) RctalrlljlC
�)5%	%El1giblcFor
1'1ymt1111ly
Kl'Vlll}	fo1al C:orrqdctcd A1tl
Stomi J'oD01c
Ehttihlcl'r,rl'■}'Tltm Dv Kl'Vlll>	
TM.11I KPVIJD
RC'laPUflC� 5•,•	
		Quan11y	\Ji-it	l'rkc	folal														
	I Genera  onmt ons, l\'lobilut1on.�un'" •																		
1.	MOBILIZATION		LS	$2S0 000.00	S:?50.000.00	S250.000.00	S0.00		S250.000.00	100%	sooo	Sl:?.50000	9.97'°.	S:?4.9:!5.00	Sl.:!46.25	90.03·•	S:?:?.S.075.00	SIJ.:!5375	
2.	ATTORNEY FEE		LS	$9S 000.00	S95.000.00	S95.000.00	S0.00		S9S.OOO.OO	IOODCI	S0.00	54,75000	9.9-r"•	59.471.SO	5473.58	900Jfl♦	SK5.5:?8.SO	S-1,276 43	
3.	GENERAL CONDITIONS		LS	$21 457.44	S21,4Sl44	Sl7,000.00	S2.SOO.OO		Sl9.500.00	91%	S!,957,44	S97S.00	997°.	Sl.944.15	S97.21	90.0J�.	Sl7.S5S.8S	S877 79	
4.	PERFORMANCE BONO		LS	$80 494.50	$80.494.SO	SM0.494.50			S80.494.50	100•1.	SOOO	S4.0:?4.73	9.97'.	SS.025 30	S40l.27	90.03'•	$72,469.20	SJ.6:?J 46	
5.	LAYOUT/ASBUILTS		LS	$48 391.25	S48,391 25	S25,200.00	$6,500.00		SJl,70000	661♦	Sl6,691.25	Sl.585.00	9.97'o	53,160.49	5158.02	90.03'··	S28.539.51	$1,426.98	
6.	SWWWP		LS	$10 003.7S	SI0.003.75	$6.550.00	Sl.100.00		$7,650.00	76•♦	S:?.353.75	$382.50	IJ9J-.	S762.71	SJIU-1	90.0J•.	S6.88730	S344 36	
7.	SILT FENCE		LS	538 618.08	S38.6l808	S38.6l8.08			$38.618.08	100,.	S0.00	Sl.930.90	IJ.97°.	SJ,850.22	Sl9:?.SI	IJ0.03°.	$34,767.86	S1.73839	
8.	TREE PROTECTION		LS	$19 718.90	S19,?IK 90	S0.00			sooo	o,.	S19.718.90	S0.00	9.9�♦	S0.00	S0.00	9003,.	sooo	SOOO	
9.	CONSTRUCTION ENTRY		EA	512 461.6S	$24,923.30	Sl,000.00	$4,000.00		SS.000.00	�o,..	Sl9,92J.JO	S250.00	9.9?-/4	S498 SO	S.24.93	90.0J•o	$4,501.50	S.22508	
10.	CLEAR SfTEIWVLD OAKS		LS	S52 000.00	S52,000.00	S43.50000	SS.500.00		$49.000.00	94%	SJ.000.00	S:?.450.00	9.97�.	S4,K85 JO	S24➔.27	9003•-.	S44.I 14.70	S.'.!,!05.74	
11.	DEMO STRUCTURES •WYLDOAKS		LS	$34 500.00	S34.500.00	SJ0.500.00	S4.000 00		SJ4,SOO.OO	IOO'Yo	S0.00	Sl.725.00	9.97�e	SJ.439.65	Sl7>.9S	91).03"0	SJl.060.35	Sl,553.0:?	
12.	DEMO PAVEMENT	3658	SY	$5.92	S2l.65S.36	$1.2.5CX>.OO	S3.300.00		$15,800.00	73%	SS,855.36	S790.00	9.97'•	Sl.575.26	$78.76	90.03'-•	Sl4.224 74	S711 24	
13.	DEMO CONCRETE	%0	SY	$9.56	S9,177.60	$4,000.00	$4,000.00		SR.000.00	g,-.	Sl.177.60	S400.00	9.97'.	$797.60	S39.88	90.0J�.	SJ.202.40	SJ60 I:!	
14.	MASS GRADE	1273657	CY	$2.42	S3.082.:?49.94	$2.291,808.00	S392,500.00		S2.684.308.00	87o/.	SJ97,941.94	$134,215.40	9_97•,.	S:!67.625.Sl	SIJ.J81.:?8	90.oJ,.,	52.416.682 49	Sl20.8J4.12	
15.	DEMO GOLDEN GEM PROPERTY	1	LS	$S5 333.23	S55.333.23	S0.00	SJJ.250.00		SJJ.250.00	60'"10	S:!:?,083.23	S\.662.50	9.9?-I.	S3.315.03	S165.75	90.0J•-..	$29,934.98	S1.496.75	
16.	DOUBU SILT FENCE FOR STOCK PILE AREA	3800	LF	$4.35	Sl6.S30.00	S0.00			SO.DO	o•'♦	Sl6.530.00	S0.00	9.97%	S0.00	S0.00	IJ0.03'•	SO(l()	S0.00	
17.	HYDRO SEED STOCK PILE AREA	57000	SY	$1.00	$57,000.00	S0.00			S0.00	o�.	$57.000.00	S0.00	9.97"I,	sooo	S0.00	90.03%,	S0.00	SO(l()	
18.	OVER EXCAVATE SOILS AREASS' IN DEPTH	47682	CY	$S.52	S263,2(H.64	S0.00	S105,112.00		SIOS,112.00	400,	$153.09:?.64	SS..255.60	9_9r,.	SI0.479.67	S523.98	90.o:w.	$94,632 33	S4,73162	
19.	GRADE SITE		LS	S42 707.00	S42,707.00	SO.DO			S0.00	o,.	S42,70700	S0.00	9.91•,:,	S0.00	S0.00	90.0J•··	SO.DO	S0.00	
20	EROSION BLANKET		LS	525 851.20	S2.5.851.20	S0.00			S0.00	o•,	525.851.!0	S0.00	9.97�♦	S0.00	S0.00	90.03.,,.	SQ(l()	S0.00	
21.	WELL ABONDONMENT • WYLO/GOLOEN GEM		EA	S9 100.00	538.800.00	S0.00	S18.SOO.OO		SIS.500.00	48%	S20,300.00	sns.oo	9.97�•	Sl.84-4.45	S92.�2	9003°'"	Sl6.6SS 55	S83::!.7R	
22.	CLEAR SITE/GOLDEN GEM		LS	$51000.00	SSl.000.00	S0.00	s2-1.ooo.oo		S:!4.000.00	4�.	$27,000.00	Sl.200.00	9_97•�	S2.J92.80	5119.64	90.0J'.	S.21.607.:!0	Sl.080 36	
23.	SOD PONDS	67270	SY	$4.81	S323,.568.70	S0.00			sooo	Oo/.,	5323.568.70	S0.00	9.9'79/4	S0.00	S0.00	90.03�.	5000	50.00	
24.	PONO LINER 30 MILL	20645	SF	$3.S7	SJJ.702.65	sooo			sooo	o••	573.702.65	S0.00	9.9-r'',	SO.OD	S0.00	90.03°'"	S0.00	SO.DO	
25.	HYDRO SEED BOTTOM OF PONDS	72900	SY	$1.00	$72,900.00	S0.00			S0.00	o,.	57.:!.900.00	S0.00	9.97"/,	S0.00	S0.00	90.0'.l"o	S0.00	sooo	
26.	DEWATERING	1	LS	$30 000.00	SJ0.000.00	SO.OD			S0.00	o•-•	S30.000.00	S0.00	9.9ro	so.oo	S0.00	90.0.3'•	S0.00	SO.DO	
27.	SEED/MULCH		LS	S3S4 813.60	SJ'.54.813.60	S0.00			S0.00	0%	SJS4.R I 3.60	S0.00	9.9?-/.	sooo	sooo	90.03'.	SO.DO	S0.00	
28.	60- HOPE	1414	LF	$274.81	S388.581.34	S.243.38:?.7.:!	SO.DO	S0.00	S:!4.3..3112.72	6)•'1,	S145.198.62	Sl.2.169 14	100'/4	5243,38212	Sl2.169.14	0.00�•	S0.00	S000	

aool,	ARCHITECT'S PROJECT NO:

NA00CVMENlG70l CONllNUAIIONSl1EETFOAG7W 19112EOITION M" o,m
TH£ AMERICMIINSllfUlEOF "-RCHITECTS ,73!>1'EW YOA!F;"-"1:HUE NW WASH!NOTON OC :lOOOS-�

CONTINUATION SHEET	A/A DOCUMENT G703
AIA Doc1u11cnt G70:?. Al'l'l,IC'A0l"ION AND C'ERTIFICA nON 1:oR JIA YMENT. l,."O!llai111nl!
Contractor's i.i>=ned cmificat1on i� auaclu.xl

APPLICATION NO, APPLICATION DATE,
PERIOD TO,

6
11011900
5/3112024

Pag•l-lPagH

Use Column I oo Contr.1c1s where vanahlc n111111a •c 11:,r ltnc 11crns ma •annlv	ARCHITECTS PROJECT NO

n	C	I)	11	G
\\'ORK COMl'Ll�ll:I>	MAl"l:RIAI...S	IOIAt

.,.

II	I	K	I	I	I
	CDDl:1,..ibili!V	Kl'VDIJ l:lia1bil11v	

ITFM	SC'IIEDlJLED
NO	Df,${."RJP'I ION 01· Yt'ORK	VAi UI:

""''

QU3111ty	u,..	Totol
CONTROL STRUCTURE	LS	�7 331.82	S7.331.82
MANHOLE	EA	�8 144.54	S65,IS6.J:?
BUBBLE UP	EA	C:6 067.44	SIR.:?0.'.!32
BOX CULVERT	617	LF	$1 317.89	5813.138.13
TV LINES	LS	$34017.00	S34,017 00
Chan□e Orders
1. C0#1 Builder Risk Insurance	LS  $ 69,787.00	$69,78700

FROM l'IU::VK>US
APPl.l(AllON
(0+1:)

5000
souu
SO.DO
5700.104 05
S0.00

569,787.00

l'Rl?SENTLY	COMPLETED
1111S1'1:IUOD	STORED	ANOSTOkELl  (G  C)
(NOTIN	TO DATE
DORE\	(l)�E•t-·1
SO.DO	u•,
SO.DO  o�•
SO.DO	o�•
515.000.00	SO.DO	S715,104.0$  RK,'li
S0.00	o�•

S0.00	S69.78700  100%

UAI.ANC'I·	RETAINAGI.	f-0,al con.,lclcd Ard	1ot1i (·ompktcd Ard
TO l·TNISII	C1lculatcdatS%		•". Eh1tihk for	S1orodTo Date  T1•tal ('01) Rclltllllg,c  ��Eliaiblel•l'f		Scc>red lo Date	 fotal Kl'VHI) (C-GI		1'1ymert OyCDD  Elii;!_ibltforl'1}TT1CT1	(a S!'-	P1)11rtllly	1::11@:ibk forP1yrne,1	Rctatt11Jtc(l1 s•.
U CUD	Kl'VDD	OvKPVRrJ
S7.331 8:!	S0.00	1()()%	S0.00	SO.DO	ooo•.	S0.00	5000
S65,156.J2	5000	100•.	5000	S0.00	o oo�.	5000	$0.00
$18.202.32		S0.00	100•.		SO.DO		S0.00	o.oo•.	S0.00	 5000 S98.0J4.08	S35.755.20	100''•	S71S.104.05	SJS.755.20	ooo•.	S0.00	S0.00
$34,017.00	50.00	100111	SO.DO	S0.00	000',	S0.00	5000

S0.00	SJ.489 JS	9.97",	56,957.76	$34789	90.03�'1,	S62.829 2.i	SJ.HI 46

SUIJIOT/\1

GRAND TOTALS

$6.589.815.07
S6.589.815.07

SJ,909,444 35 SJ.909.444 JS

S619.:!6:!.00	SO.OU S4.S:!8.706.35  69"�
5619.262.00	50.00  $4.5!8.706.35

52.061.108 72
S2.061.108.72

S226.435.32

SJ.314.437.66 Sl.314.437 66

S65.7:!I.R8 S65,721 88

SJ,:?14.268.69	$160.713 43
SJ.214,268.69	$160.713 4"\

Users may obtain valldatlon of this document by requesting of tho llconse a completed AlA Document 0401. Certification of Documont's Authenticity

1'JA.t>OCIJ�E,.,,.G103 CONTINU.-,TK)NSHE.E1FQffG702 11111:.>[0ITION /IJ.-, C>III02
THE .WEA:ICAJ\IINST1TUT( Of AACHlTECIS H'35NEW Y�KA\/ENIJ£ N.W W-'SttlNOTON O C :.>COOS·S:1'32	G703-Hl92

PROGRESS PAYMENT AFFIDAVIT

STATE OF FLORIDA COUNTY OF LAKE

BEFORE ME, the undersigned authority, duly qualified and authorized in the State and County aforesaid to administer oaths and take acknowledgements, this day, personally appeared	Everett Rozar	, who being by me first duly sworn, deposes and says:

The facts and matters contained and recited in the Affidavit are based upon personal knowledge of the Affiant.
Affiant is the Owner of	RCS Construction Company, Inc.	, a North Dakota Corporation company {hereinafter the "Contractor")
Contractor and	Kelly Park VB Development, LLC	{hereinafter the "Owner") have executed, delivered and entered into that certain CONTRACT AND AGREEMENT dated	December 4, 2023	{hereinafter the "contract").
Affiant now requests partial payment under the Contract. In Consideration of Owner providing such partial payment, Contractor hereby provides this Affidavit upon which Owner intends to rely.
Contractor is not aware of any Claims that would require an adjustment of the Contract Time or the Contract Price except for any Change Order Requests or Change Order Proposals previously submitted in writing to Owner prior to execution of this Affidavit.
Contractor releases any Claims for an adjustment to the Contract Time or the Contract Price except for those previously made in writing and delivered to Owner prior to execution of this Affidavit.
Affiant states that all bills for labor, services or materials furnished, delivered, installed or performed on the job site through the date of this Affidavit have been FULLY paid and that no lien for such may properly be filed, recorded or enforced. Waiver and Release of Lien upon Progress Payment forms for every such potential lienors are provided herewith through 05/31/2024
Affiant states that, except as provided herein, all bills for labor, services or materials furnished, delivered, installed or performed on the job site through the date of this Affidavit have been FULLY paid and that no lien for such may properly be filed, recorded or enforced. Waiver and Release of Lien Upon Progress Payment forms for every such potential lienor are provided herewith, except as provided below:

Name of Lienor	 Amount due for labor1 services or Or Potential Lienor	materials furnished, delivered1

Installed or performed

1. Florida Design Consultants, Inc.	$3,750.00	
2. Koncept Carma, Inc.	$605.00	
3.  Oldcastle Infrastructure	$1,272.00	
4.  Quality Petroleum Corporation	$47,070.90	

FURTHER AFFIANT SAYETH NOT.

RCS Construction Company1 Inc.

��==.._:_�-==	'' Affiant

Sworn to�  subscribed before me this	13th	day of June	2024, by
Ev::ecd:\:�7/1✓	, who (check one): [ X] is personally known to me, [ ] produced
a driver's license (issued by a state of the United States within the last five (5) years) as identification, or [ ] produced other identification, to wit: 	. Affiant did take an oath.

�
�

VICTORIA E. LAUTERIA

Print Name:	Victori	auteria ------
Notary Public, State of Florida

Notary Public

Commission No.:_ _;H-'-'H-'-'2=7. ;:6;..::6=2=5	

state of Florida
Comm# HH276625
Expires 6/19/2026

MCyommission Expires:	06/19/2026

JOINDER AND INDEMNIFY AGREEMENT

Contractor, joins in the execution of this Affidavit for the purpose of adopting all representations of fact contained therein. Contractor understands that this Affidavit will be relied upon by Owner for all purposes relating to the Contract. Contractor agrees to indemnify, hold harmless and defend the Owner from, against and with respect to any and all loss, cost, damage and expense, including reasonable attorneys' fees, arising out of any claims by laborers, subcontractors or materialmen who might claim that they have not been paid for labor, services or material.

A Florida Corporation Company

By:��  Name: Everett Rozar Title:  President

(CORPORATE SEAL)[where applicable]

WAIYER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of$ 588,298.80	, hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished through 05/31/2024 to Double B Development and Kelly Park VB Development, LLC on the job of Wyld Oaks Mass Grading Improvements to the following property:
S of Kelly Park Rd & Effie Dr.
3620 W Kelly Park Rd.
Apopka, FL 32712, Orange County (description of property)

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

DATED on June 13, 2024.

Lienor RCS Construction Company, Inc. Address 295 E SR 50, Suite 1,
	Clermont FL 34711	

By:�
Print Name: Everett Rozar Its: President

State of Florida
County of�L=a=k=e'-----
The foregoing instrument was acknowledged before me this 13th	day of  June	,
20	11_, by , as of said company, who has presented as identification or is personally known to me.

VlCTORIA E. LAUTERIA
!:I	Notarv Publl�
� State of Flonda
,.  .....,� eornm# HH276625
""·s,,,.c ,�""�	Expires 6/19/2026

Sig��o/1/f NotaryPubli�t	/)
(Seat /IJ�(7n<;,�
		Victoria E Lauteria	 Print, Type or Stamp Commission

DEVELOPER'S REPRESENTATIVE CERTIFICATE FOR PAYMENT

Wyld Oaks- Mass Site Grading Pay Application #6 Pay Application Dated 5/29/24

In accordance with the Contract Documents, based on on-site observations and the data comprising
this application, the Developer's Representative certifies to the Owner that to the best of the Developer's Representative'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.

AMOUNT CERTIFIED.	$588,298.90
(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.)

DEVELOPER'S REPRESENTATTVll':

e ...

Aee.sm:IM!�lllls"�

d80d4652-9128-4b76·-�=--,..,.,���"",_
By:	bfd1-907730c7793f	,:.::.:=t.�
	6/14/2024	

Date:

Name: 	 Timothy R. Dennard	 Title:'		President
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.

REQUISITION

The undersigned, an Authorized Officer of Golden Gem Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture between the District and U.S. Bank Trust Company, National Association, Fort Lauderdale, Florida, as trustee (the "Trustee"), dated as of June 1, 2024 (the "Master Indenture"), as amended and supplemented by the First Supplemental Trust Indenture between the District and the Trustee, dated as of June 1, 2024 (the Master Indenture as amended and supplemented is hereinafter referred to as the "Indenture") (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):
Requisition Number: 04

Name of Payee:	Kelly Park VB Development, LLC

Amount Payable:	$695,339.51

Purpose for which paid or incurred (refer also to specific contract if amount is due and payable pursuant to a contract involving progress payments, or, state Costs of Issuance, if applicable):
Fund, Account and/or subaccount from which disbursement is to be made:
Series 2024 Acquisition and Construction Account

The undersigned hereby certifies that obligations in the stated amount set forth above have been incurred by the District, that each disbursement set forth above is a proper charge against the Series 2024 Acquisition and Construction Account and the subaccount, if any, referenced above, that each disbursement set forth above was incurred in connection with the acquisition and construction of the Phase 1 Project and each represents a Cost of the Phase 1 Project, and has not previously been paid.
The undersigned hereby further certifies that there has not been filed with or served upon the District notice of any lien, right to lien, or attachment upon, or claim affecting the right to receive payment of, any of the moneys payable to the Payee set forth above, which has not been released or will not be released simultaneously with the payment hereof.
The undersigned hereby further certifies that such requisition contains no item representing payment on account of any retained percentage which the District is at the date of such certificate entitled to retain.

A-1

Originals or copies of the invoice(s) from the vendor of the property acquired or services rendered with respect to which disbursement is hereby requested are on file with the District.
GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

�L.,s	':,	

CONSULTING ENGINEER'S APPROVAL FOR NON-COST OF ISSUANCE REQUESTS ONLY
If this requisition is for a disbursement from other than the Costs of Issuance Account, the undersigned Consulting Engineer hereby certifies that this disbursement is for a Cost of the Phase 1 Project and is consistent with: (i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the Phase 1 Project with respect to which such disbursement is being made; and (iii) the report of the Consulting Engineer attached as an Exhibit to the First Supplemental Trust Indenture, as such report shall have been amended or modified on the date hereof.

Consulting Engineer
Kevin M Roberson Kimley-Horn and Assoc.

A-2

Total Estimated Reimbursement To Developer	$695,339.51

Mass Grading For Stormwater And Rights-Of-Way	

Total Contract Value	

% Eligible For CDD	

Mobilization Payment	

Mass Grading Payment Application #1	

Mass Grading Payment Application #2	

Mass Grading Payment Application #3	

Mass Grading Payment Application #4	

Total Paid To Date	

Total Eligible For CDD
Reimbursement	
			Check #1044	Check #2020	Check #2043	ACH 4/16/24	Check #2075			
General Conditions, Mobilization, Survey										
Change Order #1 - Builders Risk Insurance	69,787.00	9.97%			69,787.00			69,787.00	6,957.76	
Mobilization Payment	250,000.00	9.97%	250,000.00					250,000.00	24,925.00	
Attorney Fee	95,000.00	9.97%		95,000.00				95,000.00	9,471.50	
General Conditions	21,457.44	9.97%		3,000.00		3,000.00	4,500.00	10,500.00	1,046.85	
Performance Bond	80,494.50	9.97%		80,494.50				80,494.50	8,025.30	
Layout / Asbuilts	48,391.25	9.97%		4,500.00		4,600.00	3,500.00	12,600.00	1,256.22	
SWPPP Monitoring	10,003.75	9.97%		850.00		1,400.00	1,500.00	3,750.00	373.88	
Silt Fence	38,618.08	9.97%		31,000.00			7,618.08	38,618.08	3,850.22	
Tree Protection	19,718.90	9.97%						0.00	0.00	
Construction Entry	24,923.30	9.97%		1,000.00				1,000.00	99.70	
								0.00	0.00	
Clearing & Earthwork								0.00	0.00	
Disc / Clear Site - Wyld Oaks	52,000.00	9.97%				33,500.00	2,500.00	36,000.00	3,589.20	
Demo Structures	34,500.00	9.97%				8,500.00		8,500.00	847.45	
Demo Pavement	21,655.36	9.97%						0.00	0.00	
Demo Concrete	9,177.60	9.97%						0.00	0.00	
Mass Grade	3,082,249.94	9.97%				1,160,000.00	768,808.00	1,928,808.00	192,302.16	
Demo Golden Gem Property	55,333.23	9.97%						0.00	0.00	
Double Silt Fence For Stockpile Area	16,530.00	9.97%						0.00	0.00	
Hydro Seed Stockpile Area	57,000.00	9.97%						0.00	0.00	
Over Excavate Soft Soil Areas 5' In Depth	263,204.64	9.97%						0.00	0.00	
Grade Site & Sediment Basins	42,707.00	9.97%						0.00	0.00	
Erosion Control Blankets	25,851.20	9.97%						0.00	0.00	
Well Abandonment	38,800.00	9.97%						0.00	0.00	
Clear Site - Golden Gem	51,000.00	9.97%						0.00	0.00	
Sod Ponds	323,568.70	9.97%						0.00	0.00	
Pond Liner 30 Mill	73,702.65	9.97%						0.00	0.00	
Hydro Seed Bottom Of Ponds	72,900.00	9.97%						0.00	0.00	
Dewatering	30,000.00	9.97%						0.00	0.00	
Seed/Mulch	354,813.60	9.97%						0.00	0.00	

Total Mass Grading For Stormwater And Rights-Of-Way	
5,263,388.14	
9.97%	
250,000.00	
215,844.50	
69,787.00	
1,211,000.00	
788,426.08	
2,535,057.58	
252,745.24	
Retainage			0.00	-21,584.45	-6,978.70	-121,100.00	-78,842.61	-228,505.76	-22,782.02	
Total Amount Paid			250,000.00	194,260.05	62,808.30	1,089,900.00	709,583.47	2,306,551.82	229,963.22	

Mass Grading For Stormwater And Rights-Of-Way	

Total Contract Value	

% Eligible For CDD	

Mass Grading	Mass Grading  Mass Grading Mass Grading Mobilization	Payment		Payment	Payment	Payment
Payment	Application #1 Application #2 Application #3 Application #4	

Total Eligible For
Total Paid To	CDD
Date	Reimbursement	

Total Mass Grading For Stormwater And Rights-Of-Way	

Total $ Paid	Total $ Eligible For CDD Reimbursement		
	
2,306,551.82	
229,963.22		

Total Contract Value	

% Eligible For CDD	

Mobilization Payment	

Mass Grading Payment Application #1	

Mass Grading Payment Application #2	

Mass Grading Payment Application #3	

Mass Grading Payment Application #4	

Total Paid To Date	

Total Eligible For CDD
Reimbursement	
						ACH 4/16/24	Check #2075			
Stormwater Infrastructure										
60" HDPE	388,581.34	100.00%					243,382.72	243,382.72	243,382.72	
Control Structure	7,331.82	100.00%						0.00	0.00	
Manholes	65,156.32	100.00%						0.00	0.00	
Bubble Ups	18,202.32	100.00%						0.00	0.00	
Box Culvert 5'X10'	813,138.13	100.00%				105,550.00	168,152.05	273,702.05	273,702.05	
TV Lines	34,017.00	100.00%						0.00	0.00	
Total Stormwater Infrastructure	1,326,426.93	100.00%	0	0	0	105,550.00	411,534.77	517,084.77	517,084.77	
Retainage			0.00	0.00	0.00	-10,555.00	-41,153.48	-51,708.48	-51,708.48	
Total Amount Paid			0.00	0.00	0.00	94,995.00	370,381.29	465,376.29	465,376.29	

Total Stormwater Infrastructure	
Total $ Paid	Total $ Eligible For CDD
Reimbursement		
	465,376.29	465,376.29		

Grand Total Under Mass Grading Contract	
Total $ Paid	Total $ Eligible For CDD	
	2,771,928.12	695,339.51	

Image Details

---------	,I[	I ...I_		,I ......[_		,

Date
12/1112023

Sequence Number	/\ccounl Number
6904557473
Front Image

Amount
$250,000.00

Serial Number
1044

KELLYPARK VB DEVELOPMENT LLC
660BEACHUNE BLVDSlE301 VEROBEACH,FL32963

OAT! DeCenber 71 2023

PAY

ORDellOl'	 ��	1-1>

TOlliE

RCS Construction �Y

,a, 250,000.00

'l\.\J Hundred Fifty Trousand Dollars aril 00/100	DOl.UR$

truistHE!
FOR	
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Back Image

r
:1	PAY

KE�yL �ARK VB DEVELOPMENT LLC
660 BEACHLINE BLVD STE301
VERO BEACH, FL 32963

1044  il

a"!c.u11£0 av	t

�

1:ZSHIELO•	I j
I
DATE December  7,  2023	63-9138/2631 11

rl	ii��OF	 R_CS_C_o_ns_tru_c_t_i_on_c_o_m-=-�=--=Y'--- 	1$ 250,000.00

Two Hundred Fifty Thousand Dollars and 00/100	DOLLARS

TRUIST lffi
FOR	 _

0_Q_ U.o,Jh
�(ti)�[�

Derek Wells

From:
Sent:
To:
Subject: Attachments:

Taylor Edwards <tedwards@Doubleb-development.com> Thursday, December 7, 2023 2:49 PM
Bridgette Storch; Derek Wells Deposit Payment To RCS
Wyld Oaks Mass Grading Contract - Fully Executed.pdf

CAUTION: POTENTIAL SECURITY RISK--	This email originated from outside of Evans Properties. Do not click links or open attac�ments unless you recognize the sender and
know the content is safe.

Bridgette,

Can you please overnight a check from KPVBD to RCS Construction Company for $250,000? Their address is 295 E. Highway 50, Suite 1. Clermont, FL 34711

This is the mobilization payment authorized in section 5.1 of the attached mass grading contract (screenshot of that section below).

Thanks, Taylor

Contractor shall submit applications for payment in accordance with the Contract Documents. Contractor= s applications for payment will be submitted to Developer= Engineer and
Third Party Beneficiary�s Engineer. Applications for payment will be processed by Engineer as provided in the General Conditions. Contractor shall utilize the AIA G702 and G703 payment application forms for each of its applications for payment and shall allocate the Schedule of Values
reflected on such payment application forms between labor� matroals and equipment to be furnished on the northem parcel of the Site and labor, materials and equipment to be furnished on the southern parcel of the Site. Seven (7) days prior to Contractor= s mobilization to the Site to
begin the Work under this Agreement	Developer shall pay Contractor a mobilization sum of
$250,000.00 which shall be credited against the Contract Price and reflected in Contractor•s first application for payment.

1

Image Details
Date
02/15/2024

Sequence Number
6905825699

Account Number	Amount

$194,260.05
Front lll!�ge

Serial Number
2020

Truist.

KeUy Paik.VltDevdop�of, LLC
-oiO Seachland Blvd, Ste 301
'l<lro 8eAch, rL )2963

fAY'0.•0.11w>drod 11,net)'-fOll.r TIIO\U&Dd TV<> IIUl>dN<l Sixty a0405/lOO••••••-••••••••••-••-••·•••·•

T01'11£
-ORD11l01'"

&CS Can.$truct1on Co., Inc 295 f: .. Hwy so .suite 1 Cl_emont:', FL 3A10

63-9138/831

002020
02/12/2024

1

.	194,260.05

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I

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF	PAGES	
TO OWNFR	PROJFCT· Wyld O;iks	J\PPLICJ\TIO•	0:			Distrihution to:	
Kelly Park VB Development. LLC				CJOWNER	
660 Beachland Blvd.				CJ	ARCHITECT	
Vero Beach, FL 32963	PERIOD TO:	12'20,2.,		CJcoNTRACTOR	
FROM CO. TRACTOR:	VIA ARCHITECI;				CJ	
RCS CO STUCTION CO. INC
295 E HWY 50 SL1ITE I	
PROJECT OS:			CJ	
CL[RMONT. FL }4711 CONTRACT FOR:	
CONTRACT DA TE				
CONTRACTOR'S APPLICATION FOR PAYMENT	 The undcrs1gnLxl Conirnctor cc111li<:s that tc>the best ,,f the L<>nlractor's kno" ledge. Apphca11on ,s ma<ll." for payment. as shown hclow. in conncctll)n "ith the Contrncl.	 mfonnation and hcli.:fthc \\'ork co,cr,•d hy 1!11s Apphcation for Pa}mrn1ha� been Cnntinuatton Shccl. /\Ii\ Docum�nt G703. 1s attached.	completed in accordnncc wnh the Con1rac1 Document,. that all amounts have b,x•n paitl by
the Contrnc10r for Work for which previous Cenilicatcs for Payment w�re issued and payments received from the Owner. and that current payment shown herein is nnw due.
11111, ,I', \t < c 1, It{ H"l  <;t '-1
" '" 1 t li;111µ1.• h, < 'h.tn;,!r t >rd, ..	'	CONTRACTOR:	RCS CONSTRUC7"JON CO .. INC.
( 11\; IR •\I I <;1'M n l J) \ r I fl ,n,· I	'>		
-l  !Cll \I ( n\11'1 f·l I J1 S,.rORI ll ltl	-lll5.X44.5tl

DATE	{Column G on G70J)
RElt\lNAGE:	VICTORIA E, LAUTERIA
IO % of Completed Work	S
(ColumnD ➔ Eon G703)	--"--'--'-"'-'-'---=-'-'--
h.		IO •·• of Stonxl Matcnal	S (Cnlmnn Fon G703)

Tntal Rc1ainage (Lines 5a .,. 5b or
1111:1! Ill ( olumn I "I (,"1111	ARCHITECT'S CERTIFICATE FOR PAYMENT
<, 1<11 \I I ·\R'll D 11 S'-. RI I -\I'\ \l,I			111 accord:i11cc with the Contract D1>eu111cnts. basoo on on-site obscn a1ions and the data
(L111c 4 Less Linc 5 T1,1al)	compnsing the application. the Architect certiiic.�10th.: Owner that to the hcst of the
7. LESS PREVIOUS CERTIFICATES FOR						Architect'� knowkxlgc. mforrnation and belief the Work !ms progressed as 1nchca1cd. PAYMENT (Linc c, from prior Ccrtilic;II(')			-s 	2_so...:,_oo_o_.u_o_	the quality of the Work is 111 accorclancc with the Contract D1>eumc111s. and the Contrartor
X ( t RR,!  l P \ Y\11 '\l  f)I I	J  .,  ,	i, entitled to payment of the AMOUNT CERTIFIED.
'I  Ii\) \\;( I ro 1-1,1s1t I"(  It 1)1\;(, )(I I •\l\;,\(,I
(Linc J lc.ss Linc 6)	,\MOL; T CERTIFIED ........... S		
ADDITIONS	DEDUCTIONS	fA 1111c/1 expla11atio11 if amu11111 ccrr[/ied differs from 1he 0111011111 applied Initial all figure, on 1hi.,
Total change,; appro\'cd	S0.00	•lpplica11on and onthe Contimmtwn Sheri tluu are clumJ!ed w co,furm lt'ith flrl' wnuwll <·£•111/ied)
in prcv111u, months by Owner	ARCHITECT:
Total a ruvL,I 1)115 Month	�0.00		B_y. 		Date: 	 I tlf \I'-	 ,11.rn1	·1his C�rtificatc is not ncgcuiable. The AIV1OUNT CERTIFIED is payable only to the
l on1rac1or named herein. Issuance. payment and acceptance nl payment arc w1111nu1
,1 f < IIA'-<,l·S '" Chan�cO1uc1	\IUW1	prc1udicc to any rights of the Owner or Contractor under this Contract.

AIA DOCUMENT G702 • APPUCATIOIJ ANO CERTIFICATION FOR PAYtJE,iT 1992 EDITION AIA '->1992	THE AMERICANINSTITUTE OF ARCHITECTS. 1735 NEW YORK AVE.NW WASHINGTON. DC 20006-5292
Users may obtain validation of this document by requesting a completed AJA Document 0401 - Certification of Document's Authenticity from the Licensee.
••'  ( ,111111100, ,Jf!J"(•·.'i 1lu11 ( Jun,�, u ,II JUii inth ,du;f ftmdrnt: , ... '" mlahl,• "hu It mn\  110, ,�qu,1' 1/r,· ( ttrt\'nl l'<ll Wi'ltl /)11c  fll\ 11111�11,d /•111011,c � 1/! •c·1111w1 ,111 ,;u otm/ fm ( Ju1/r I' (fl /Ill\ ,, 11/1 /111111, Jr,nd,
'-otc; ltl•m�in HED FOVI nrr 11utom:i1icall� calculatc:<l from th<:G70J form or from items 11ilhi11 thi� c;70.2 l·orm. L>n '\O I hand enter these items on thi, \hl'l•t.	

CONTINUATION SHEET	AJA DOCUMENT G703	Pege 2 of 2 Pagn

AIA Document G702, APPU('ATION AND CER11FICATION FOR PAYMENT. containing
Contrc1ctor's sigm.-d ccrtificalion ii; attached.

,\	R	('	n	E	F	G	II	I	
ITEM NO.	

DESCRIPTION 01' WORK	SCHEDULED VALUE	WORK \. vMl'LETED	MATERIALS
PRESENTLY STORED (NOTN
DORE}	TOTAL
COMPI.ETED AND STORED
lODATf (D..E•F)	¾
(G •Cl	BAI.AN('!, TOFINISlf (C• GI	RETAIN,\GI' (II' VARl·\BLE R,\TI')	
			!'ROM l'Kl:VIUI/:,
Al'PI.ICATION
◄D• El	THIS PERIOD						
		Quantiiy	Unit	Price	lot11I								
	\ICneral Lond1Uoas, Mobilzalton, �urvey					S250.000.00
SO.CJO SO.IX) S0.00 S0.00 SO.<lO S0.00 S0.00 S0.00 S0.00 S0.00
$0.00
$0.00
$0.00
S0.00
$0.00
S0.00
SO.OU
so.co
S0.00 S0.00
$0.00
S0.00 S0.00 S0.00 S0.00 S0.00
$0.00							
1.	MOBILIZATION	1	LS	$250,000.00	S250.000.00		S0.00		S250.000.00	IOO'lo	$0.00	SO.O<l	
2.	ATTORNEY FEE	1	LS	$95,000.00	S95,000.00		$95,000.00		$95,000.00	100%	S0.00	$9,500.00	
3.	GENERAL CONDITIONS	1	LS	$21,457.44	S:?1.457.44		$3,000.00		$3,000.00	14%	Sl8,457.44	$300.00	
4.	PERFORMANCE BOND	1	LS	$80,494.50	SS0.494.50		SS0.494.50		SS0,494.50	100%	S0.00	SS,049.45	
5.	LAYOUT/ASBUILTS	1	LS	$48,391.25	$48,391.25		$4,500.00		S4,500.00	9%	S43.891.25	$450.00	
6.	SWWWP	1	LS	$10,003.75	$10,003.75		S850.00		S850.00	8%	S9.l53.75	S85.00	
7.	SILTFENCE	1	LS	$38,618.08	$38,618.08		$31,000.00		$31,000.00	80%	Si,618.08	SJ.100.00	
8.	TREE PROTECTION	1	LS	$19,718.90	$19,718.90		S0.00		S0.00	0%	Sl9,718.90	S0.!XI	
9.	CONSTRUCTION ENTRY	2	EA	$12,461.65	$24,923.30		Sl.000.00		Sl.000.00	4%	S23,923.30	SI00.00	
10.	CLEAR SITE/WYLD OAKS	1	LS	$52,000.00	$52,000.00				S0.00	0%	S52,000.00	so.oo	
11.	DEMO STRUCTURES -WYLD OAKS	1	LS	$34,500.00	$34,500.00				S0.00	0%	S34.500.00	S0.00	
12.	DEMO PAVEMENT	3658	SY	$5.92	$21,655.36				S0.00	0%	S21.655.36	S0.00	
13.	DEMO CONCRETE	960	SY	$9.56	$9,177.60				$0.00	0%	$9,177.60	$0.00	
14.	MASS GRADE	1273657	CY	$2.42	$3,082,249.94				S0.00	0%	$3,082,249.94	S0.O<l	
15.	DEMO GOLDEN GEM PROPERTY	1	LS	$55,333.23	$55,333.23				$0.00	0%	$55,333.23	so.oo	
16.	DOUBLE SILT FENCE FOR STOCK PILE AREA	3800	LF	$4.35	$16.530.00				S0.00	0%	S16,530.00	S0.00	
17.	HYDRO SEED STOCK PILE AREA	57000	SY	$1.00	$57,000.00				S0.00	0%	S57,000.00	S0.O<l	
18.	OVER EXCAVATE SOILS AREAS 5' IN DEPTH	47682	CY	$5.52	$263,204.64				$0.00	0%	$263,204.64	$0.00	
19.	GRADE SITE	1	LS	$42,707.00	$42,707.00				S0.00	0%	S42,707.00	S0.00	
20	EROSION BLANKET	1	LS	$25,851.20	$25,851.20				S0.00	0%	S25,851.:?0	so.oo	
21.	WELL ABONOONMENT • WYLO/GOLOEN GEM	4	EA	$9,700.00	$38,800.00				$0.00	0%	S38,800.<l0	S0.00	
22.	CLEAR SITE/GOLDEN GEM	1	LS	$51,000.00	$51,000.00				S0.00	0%	S51,000.00	$0.00	
23.	SOD PONDS	67270	SY	$4.81	$323,568.70				S0.00	0%	$323.568.70	S0.00	
24.	PONO LINER 30 MILL	20645	SF	$3.57	S73.70:?.b5				S0.00	0%	$73.702.65	S0.00	
25.	HYDRO SEED BOTTOM OF PONDS	72900	SY	$1.00	S72.900.00				S0.00	0%	$72,900.00	S0.00	
26.	DEWATERING	1	LS	$30,000.00	SJ0,000.00				S0.00	0%	$30,000.00	S0.00	
27.	SEED/MULCH	1	LS	$354,813.60	$354,813.60				S0.00	0%	$354,813.60	S0.00	
28.	60" HOPE	1414	LF	$274.81	S388.581.34				S0.00	0%	$388,581.34	SO.O<l	

l!sc Column I on Contracts where variable rc1ama11.c for line items ma-v apply

APPLICATION NO:
APPLICATION DATE:
PERIOD TO:
ARCHITECT'S PROJECT NO·

I
1212012023
12/20/2023

CONTINUATION SHEET

AJA DOCUMENT G703

AJA Document G702, APPLIC"ATION AND CERTIRC ATION FOR PAYMENT, containing
Contractor's signed cenification is auachcd.

Use Column I on Contracts where \'Unable rctnilllll!c for line items may apply.

APPLICATION NO:
APPLICATION DATE:
PERIOD TO:
ARCHITECTS PROJECT NO·

I
12/2012023
12/20/2023

A	B	C	D	E	F	G	II	I	
ITF.M
NO.	
DESCRIPTION OF WORK	SCHEDLILED VALUE	Wvi,."v
l•KUM PREVIOUS APPI.ICATlO1'
(D • E)	"

TIIISPERIOD	MATERIAU>
PRESENTLY STORED (NOTIN
DOREI	fUTAL
COMPLETED AND STORED
ro DATE
(D•E•F)	,-;,
(G;  Ct	BALANCE TO FINISII (C-0)	REl'AINAGE (If VARIABLE RAT!:)	
		Quantity  I Unir I	Price	I	Total								

AIA OOCUUENT 0703 CONTINUATION SHEET FOR G702 19112 EOITlON AlA ll:)100,
THE AMERICAN NSTITUTE OF ARCIUTECTS. 173:'> NEW YORKAVENUf NW WASHINGTON. O.C 2000&-�237	G703-1992

29.	CONTROL STRUCTURE	l	LS	$7,331.82	S7,331.$2	$1).00
SOllO
$0.llO S0.00
SO.Oil
so00 sooo
$0.00
S0.00 S0.00
$0.00
Stl.00 S0.00
Sll.00
so.no
S0.00 S0.00
S0.00
so.no
S0.00
SO.Oil
$00\1
so.no
S0.00
soon so.oo
SO.Oil S0.00 S(l.00 S0.00			SU.Oil	

7t1,o	$7.331.S: S65.151d2 SIK.202.32 S�l3.138.13
$34,(117.00
SO.OU
soon
S0.00 SO.Oo
souo
so.oo
0.()()
50.00
S0.00 S0.00
$0.0IJ
so.oo
S0.00 SO.<)() S0.00
�() (){I
Stl.00
so.on
S0.00
so.on
so00
ll.00 S0.00 S0.00
snoo	S0.00
SO llO S0.00 S0.00
$0 (KJ
S0.00
SOI)()
S0ll()
S0.00
o.uo
su.oo
$0,(IO
SO.lll) S000 S0.00 SUIJO S0.00 SIJ.OIJ Sn 01) SO.l10
sono
S0.(tO
$0.0/J
SO.<>O S0.00 SO.(>()
S0.00
sooo
S000
so.oo	
30.	MANHOLE	8	EA	58,144.54	$65.156..12				',00(1
$(1(1/)
so.on
Sll.tltl
(I 0•)
Sil lhJ
$11.(l()
so.on
SO.OU
$()(11)
S0.IJO
so.no
SOCIO
so.no
Sil110
SO.li!l
so.oo
�tlll()
$(),(ij)
SU.00 S0.00 SO.OU
�o.on
S0.0<1
$000
'()(J(l
$0.lKI
$0.()(1
S0.00				
31.	BUBBLE UP	3	EA	$6,067.44	$18.102.32								
32.	BOX CULVERT	617	LF	$1,317.89	S813,138.13								
33.	TV LINES	1	LS	$34,017.00	534,017.00								
					50.00
so.on
�0.00
SO.(J(l
S0.00
$U.00 S0.00 S0.00
$0.00
$0.00
50.00
S0.00 S0.00
$0.00
so00
SO.CK>
S0.00
$0.00
SO.O<l SU.00 S0.00 S0.00
S0.llO S0.00 S0.00								

													

													

													

													

													

													

													

													
													
	SUUTOfAI				$6.520.028.0i	$250.000.00	��1�-:,;�.J �(I	S0.00	$465.844.5(1		$6,054.183.57	S21.584.45	
	GRAND TOTALS				S6.520.028.07	5250.000.00	'�l ".:-.:�� �•)	S0.00	S465.844 50		$6.054.183.57	S21.5S4A5	
Users may obtain validation of !his document by requesting of the license a completed AIA Document D401 • Certification of Document's Authenticity

A.t.-.OOCUM[tfl G70J CONl HUAllOfl SIii Lt roqG70'1 1001 comoN AlA u1m
lH�M,V-"RICAN IN$111Ull rn ARr.111lf C:fo;,. 1735 tffWV0RK A.VO,UE NW WASHt-lGl0N 0 C '0006-!i?:\1	G703·1992

Image Details
Date
04/09/2024

Sequence Number
6900426962

Account Number	Amount
$62,1108.30
Front Image

Serial Number
2043

Truisl

KellrPadtVBDevelopment, LLC
660 aoachland 81vd, Ste 301 Vero- 8eacll, FI. 3n-63

CKECK
DATE,

PAY Sixty-Two ?houaand Ei.9ht. Kundl:ed Ci.gilt and 30/lOO-------------------------

lOTBt,
_!!IIDEROP

!lC� Const:ruction. Co., Inc: 29'- 6. Rwy 50- Suite •I Cle:cmont, rL 34"H.l

63-9131f/831

I

04102/2024  I

002043

.	62,808.30
- Dollars

@

I

I

I

I

Back Image

APPLICATION AND CERTIFICATION FOR PAYMENT	A/A DOCUMENT G702	PAGE ONE OF	PAGES

TO OWNER:
Kelly Park VB Development. LLC
660 Beachland Blvd. Vero Beach, FL 32963 FROM CONTRACTOR:
rcs constuction co. i 1C.
295 E. HWY 50 SUITE I CLERMO  T. FL 34711

PROJECT: Wyld Oaks

VIA ARCHITECT:

APPLICATIO

PERIOD TO:

PROJECT NOS:

0:	2

1/20/24

Distribution to:
LJOWNER LJARCHITECT
CJCONTRACTOR
D
D

CONTRACT FOR:

CO TRACT DATE

CONTRACTOR'S APPLICATION FOR PAYMENT
Applicmion is made for payment. as shown below. in con1K'Ction with the Con1rnc1. Co111inuation Shc'CI. AIA Documt!nl G703. is anachcd.

1101,1, \ I l 1 )', 11< \(  I <.1 \I
,	h n	,, l h,1	• lr I ,,
!II	11''1  '1\llllll\111',11,·'	'1
1 11 11' I I 11 \	'"''' > l<l		
DATE	tCc,lumn G on G703)
5. RETAINAGE:

The undersigned C<1n1rnc1or certifies thal 1(' 1hc bcs1 or 1hc Co111ractor's kn<•wlcdgc, infonnation and belier 1hc Work covcm:.Iby 1his Appl1ca1ion for Payme11h1as been comple1ed in accordance with 1hc Con1rnc1Documcn1s. 1ha1all amounls have hccn paid by 1hc Con1rnctor for Work for which previous Ccrtifica1cs for Paymcn1were issued and payments received from 1he Owner. and thai current puymem shown herein is m,w due.

CONTRACTOR:	RCS CONSTRUCTION CO.. INC.

By: -l"-¼---"-'L-7�----!�l',jllll!:!!=:._-----Date: -----VI-C--:T:--::Oc::RIA:-:-a---=f,...6_.--J,.,g,.,.,.;�IA

a.		10 %<1rComple1cd Work (Column D + Eon G703 I
Ii.		IO 0'oor Stored Material (Column Fon G703J
Tomi Rc1ainagc (Lines 5a + 5h or
I 111m • l1lunm I ,,It 1 �,

S 		..;;.:!_S;;.;(_11_1_J...;;,	_
s
I (Ill

Stal Subs Noia
My Com

of: LAKE
a of Fcbuary. 20
�

RTIFICATE FOR PAYMENT

Notary Public State of Florida
Commll HH276625·
s 6 19 2026

I I	I(	" I  ...... '  I \I	\( ,I
( Linc 4 Less Linc 5 fo1al)
7. 1.ESS PREVIOUS CERTIFICATES FOR		
PAYMENT (Linc C, from prior Ccnilicatc)

I"'"''

l I<IIJ	I I  \ \11  I Pl I
,	1\1	I	'l'-1 I • 11 Ill'\""'
(Linc 3 k-s.s Lint!61

ADDITIONS

s 		-1_4_4.;...2_6_0._o_s
,,  \ll'.'< \ft  •••
It I  -1h ...

DEDUCTIONS

In accortlancc with the Comract Documents. based on on-site observations and thedata comprising the application, the Engmee, I certifies to th<:Owner 1ha110 1hc hcs1or 1hc Engineers  knowledge. infomiation and belief lhc W11rk has progressed as indicated.
me quality of the Work is in accortlancc with the Comrac1 Documc111s. and 1h<:Contractor
i�c111i1led 10 pnymcn1of 1hc AMOUNT CERTlr'IED.
$62,808.30
AMOUNT CERTIFIED ........... $ 	
( Auacl, <'Xp!m,mion if tmu111111c·er1ified differsfrom the a111011111applied. Initial a/1_/igures 0111/1i�

S0.00

Application and onrlw Co111i1111t1tio11SheC't thm arC'changed to cm!form with 1/,r m11011111cC'rt/fied)

-------------

Engineer	//J.	�

3/22/24

Tc,tal a roved 1his Month
I I  I
-..11111 ,,,,r:,

S69.787.00

By:  	�	«,IJ'tl_M	Da1c:
This Certilica1c is no1n.:go1iablc. The /\MOUNT CERTIFIED is payable only 10 1hc Comractor named herein. Issuance. payment an<Iacc.,-p1ancc ol payment arc w11hou1
preJudice 10 any rights of the Owner or Comrnc1or under this Con1rac1.

AIA DOCUMENT G702 APP\.ICATION AND CERTIFICATION FOR PAYMENT· 1992 EDITION· AIA 01992	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.
""  ( ri,11nu 1111 ct!.!I1 ,'"' ,1,,,, ( Ju 11c·1 1,,// pur hit/, "Ju,1 ltmdmc n a,  111/uhlc• 1t hu I, mt1\' ""' e,111a/ thl·wn•1,11 l't,rm,•111 /Jue  1,11  11111m1d hal,mc, "·ill r,·111"111 o'"nconul /or ( JH·m·, tu f"U- ,d1l1 fuun,· f11n.l,

"\uk: lh•111, in IU ll IO"\ I :irl' :111t11111a11c:1l1\ l':1kul:11l•d from lhl ( ;?OJ form ur from itl'lll' \\ithin lhi, c:702 1•01·111. 1)11"\() I hand l'llll'r thL'\l' itL'ITI\ 1111 1hi, ,hl'�t.

CONTINUATION SHEET	AJA DOCUMENT G703	Paga 2 of 2 Pagn

AIA Oocumcnl G702, APPLICATION AND CERTfflCATION FOR PAYMENT. conlaining
Contraclor's signed certification l!i attached.

UseColumn I on ConIracts where variable reiainage for line iIcms may ap11ly.

APPLICATION NO: APPLICATION DATE:
PERIOD TO: ARCHITECT'S PROJECT NO·

2
1/20/2024
1/20/2024

A	B	C	D	E	F	G	1-1	I	
ITEM
NO.	
DESCRIPTION OF WORK	SCIIEDULED VAi.VE	IVORK cm·IPLETEO	MAll:RIALS
l'RESENTLY STORED (NOl IN DOR El	TOTAL
COMPLETED AND STORED TO D,\TE
iD•f:H'l	%

(G • Ci	BALANCE ro FINISM IC-Gl	RETAINAGE (IF VARIABLE RATE)	
			FKOM l'R1;v10US
APPLICATION
ID· E)	nrrs PERIOD						
		Qu;mtity	U1111	Price	Tolnl								
	v�nera1\...0nmttons. �"1oon1.at1on, :,urvcv												
1.	MOBILIZATION	1	LS	$250,000.00	$250,000.00	5250,000.00	S0.00		5250.000.00	100%	S0.00	S0.00	
2.	ATTORNEY FEE	1	LS	$95,000.00	$95,000.00	$95,000.00	S0.00		S95,000.00	100%	$0.00	S9.500.00	
3.	GENERAL CONDITIONS	1	LS	$21,457.44	S:!I.457.44	53.000.00	S0.00		S3,000.00	14%	S18,457.44	$300.00	
4.	PERFORMANCE BOND	1	LS	$80,494.50	$80.494.50	$80,494.50	S0.00		SH0.49-1.50	100%	S0.00	$8,049.45	
5.	LAYOUT/ASBUILTS	1	LS	$48,391.25	$48.391.25	$4,500.00	S0.00		S4.500.00	9%	$43,891.25	$450.00	
6.	SWWWP	1	LS	$10,003.75	SI0.003.75	S850.00	S0.00		$850.00	8%	S9,153.75	$85.00	
7.	SILTFENCE	1	LS	$38,618.08	$38,618.08	S31.000.00	S0.00		$31,000.00	80%	S7.6I8.0R	SJ,I00.00	
8.	TREE PROTECTION	1	LS	$19,718.90	SI9,7I8.90	S0.00	S0.00		S0.00	0%	SI9,7I8.90	$0.00	
9.	CONSTRUCTION ENTRY	2	EA	$12,461.65	$24,923.30	SI,000.00	S0.00		Sl,000.00	4%	S23.'123.30	$100.00	
10.	CLEARSITE/WYLD OAKS	1	LS	$52,000.00	$52.000.00	S0.00			S0.00	0%	S52.000.00	SO.<IO	
11.	DEMO STRUCTURES -WYLD OAKS	1	LS	$34,500.00	$34.500.00	S0.00			S0.00	0%	S34.501J.OO	S0.00	
12.	DEMO PAVEMENT	3658	SY	$5.92	S2l.655.36	so.on			S0.00	0%	$21.655.36	S0.00	
13.	DEMO CONCRETE	960	SY	$9.56	$9,177.60	S0.00			S0.00	0%	$9,177.60	so.oo	
14.	MASSGRADE	1273657	CY	$2.42	$3,082.249.94	$0.00			S0.00	0%	$3,082,249.94	S0.0<)	
15.	DEMO GOLDEN GEM PROPERTY	1	LS	$55,333.23	S55,333.23	50.00			S0.00	0,o.,	$55,333.23	S0.00	
16.	DOUBLESILT FENCE FOR STOCK PILE AREA	3800	LF	$4.35	SI6.530.00	S0.00			S0.00	0.,,o	SI6,530.00	S0.00	
17.	HYDRO SEED STOCK PILE AREA	57000	SY	$1.00	S57.000.00	so.on			S0.00	0%	$57,000.00	S0.00	
18.	OVER EXCAVATE SOILSAREAS 5' IN DEPTH	47682	CY	$5.52	$263,204.64	S0.00			$0.00	0%	$263.20-l.64	S0.00	
19.	GRADESITE	1	LS	$42,707.00	S42.707.00	S0.00			S0.00	0%	$42,707.00	so.oo	
20	EROSION BLANKET	1	LS	$25,851.20	S25,851.20	S0.00			S0.00	0%	S25.X5l.20	S0.00	
21.	WELL ABONDONMENT • WYLD/GOLDEN GEM	4	EA	$9,700.00	$38.800.00	S0.00			S0.00	0%	$38,800.00	S0.00	
22.	CLEAR SITE/GOLDEN GEM	1	LS	$51,000.00	$51.000.00	S0.00			S0.00	0%	SSl,000.00	S0.00	
23.	SOD PONDS	67270	SY	$4.81	$323,568.70	S0.00			S0.00	0%	$323,568.70	so.on	
24.	POND LINER 30 MILL	20645	SF	$3.57	$73,70'.!.65	S0.00			:S0.00	0%	$73.702.65	S0.00	
25.	HYDRO SEED BOTTOM OF PONDS	72900	SY	$1.00	$72,900.00	SO.OU			S0.00	0%	$72.900.00	S0.00	
26.	DEWATERING	1	LS	$30,000.00	S30.000.00	S0.00			S0.00	0%	$30,000.00	S0.00	
27.	SEED/MULCH	1	LS	$354,813.60	$354.8I 3.60	50.00			S0.00	0%	5354.�I 3.60	S0.00	
28.	60" HOPE	1414	LF	$274.81	$388.581.34	S0.00			S0.00	0%	SJ88,58I .34	S0.00	

CONTINUATION SHEET	AJA DOCUMENT G703	Pa,g,aZof2Pagu

AIA Oocumenl G702. APPLICATION AND CElfllFICATION FOR PAYMENI'. conIaining
Contractor'�signt."(_I ,cr1Hica1ion isa1t3chct.l.

Use Column I on Con1racIs where variable rclainai:c for lineiIcmsmay apply.

APPLICATION NO: APPLICATION DATE:
PERIOD TO: ARCHITECT'S PROJECT NO·

2
1/20/2024
1/20/2024

A	n	C	D	E	F	G	II	I	
llE�I NO.	
DESCRIPTION OF WORK	SCIIEDULED VALUE	WORK,uMPU,IED	Mi\TERII\LS
PRESENTLY STORED (NOTIN
l>OR El	TO	"IAI,	%

IG+CI	BALANCE TO FINISM (C- Gl	RETI\INAGE (IF VARl,\ULE RATr-I	
			fROM PREvlOU�
APPLICATION
ID• El	TIIIS PERIOD		COMPLETED
/\ND STORED TO DATE (D•E•F)				
		Qu.,ntity  I Un,1 I	Price	I	Tolal								

AIA. OOCUMEHT G703 COOTNUATK>N SHEET FOR 0702 1m EDITION AIA. c,om
THE AUERICo\.N NSTITUTE Of ARCHllECTS, 1735NEW YORK AVENUE.NW WASHINGTON.DC  lOOOG-5232	G703-1992

29.	CONTROL STRUCTURE	1	LS	$7,331.82	$7,331.82	so.co			$0.00		$7,331.82	$0.00	
30.	MANHOLE	8	EA	$8,144.54	$65,156.32	S0.00			S0.00		$65,156.32	$0,00	
31.	BUBBLE UP	3	EA	$6067.44	$18,202.32	S0.00			S0.00		$18,202.32	S0.00	
32.	BOX CULVERT	617	LF	$1317.89	$813,138.13	$0.00			S0.00		$813,138.13	$0.00	
33.	TV LINES	1	LS	$34,017.00	S34,017.00	S0.00			S0.00		$34,017.00	$0.00	
					S0.00
S0.00
$69,787.00
$0.00
S0.00
$0.00
S0.00
$0.00
$0.00
S0.00 S0.00
$0.00
S0.00 S0.00 S0.00 S0.00 S0.00
$0.00
$0.00
S0.00 S0.00
$0.00
S0.00
$0.00
S0.00	S0.00			S0.00		S0.00	S0.00	
	Chanae Orders					S0.00			$0.00		S0.00	$0.00	
1.	C0#1 Builder Risk Insurance	1	LS	$	69,787.00		S0.00	$69,787.00		$69,787.00		S0.00	S6,978.70	
						S0.00			$0.00		S0.00	S0.00	
						$0.00			S0.00		S0.00	$0.00	
						S0.00			$0.00		$0.00	S0.00	
						$0.00			S0.00		$0.00	S0.00	
						$0.00			$0.00		$0.00	$0.00	
						S0.00			S0.00		S0.00	$0.00	
						S0.00			$0.00		$0.00	S0.00	
						S0.00			S0.00		$0.00	$0.00	
						S0.00			S0.00		$0.00	S0.00	
						$0.00			S0.00		S0.00	S0.00	
						$0.00			S0.00		S0.00	S0.00	
						S0.00			S0.00		S0.00	$0.00	
						$0.00			S0.00		S0.00	S0.00	
						S0.00			$0.00		$0.00	S0.00	
						S0.00			$0.00		$0.00	so.co	
						$0.00			$0.00		$0.00	$0.00	
						$0.00			$0.00		$0.00	S0.00	
						S0.00			$0.00		$0.00	$0.00	
						$0.00			$0.00		S0.00	S0.00	
						$0.00			$0.00		$0.00	S0.00	
						S0.00			$0.00		$0.00	$0.00	
						S0.00			$0.00		S0.00	$0.00	
													
	SUBTOTAL				$6,589,815.07	$465,844.50	$69,787.00	S0.00	$S35,631.50	8%	$6,054.183.57	$28,563.15	
	GRAND TOTALS				$6,589,81S.01	$465,844.50	$69,787.00	so.co	$S35,631.50		$6,054.183.57	$28,563.15	
Users may obtain validation of this document by mquesting of the license a completed AJA Document D401 - Certification of Document's Authenticity

AIAOOCUUENTG103 • CONTIHUATIONSHEETFORG102 • 111112EOITIOH • AIA 01002
THE AMERICAN INSTITIJTE OF ARCHITECTS. 11» NEW YOAKAVEHUE. NW WASHINGTON, 0.C. 20006-5232

G703-1992

Account• Stop Type

Required

KELLY PARK VB D�VELOPMENT _LC

V

(!)	Single O Range

Check Humber•  .  lo_o_2o_s_2
Date Written	104112/2024 J 1§1
Amount	11184895.00
Payee	!ResConstruction Co., Inc.
, For Stop Payment	'jN-S-F 	
Memo	!stop paymen<:and send wire
ffaj-j,j•rf  Cancel

SuccHsful Submit

You have successfully Qlaced the Stop (or Cancel Stop) Placement Request for Check Numberts) 002052. The confinnation number is 2282066.

iect to the Rules and Regulations for deposit accounts. Stop payments can be submitted up to 9:30 p.m. ET ar

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF	PAGES

TOO\\'  FR:
Kelly Park VO Development. I I C
660 Beachland Blvd.
Vero Beach, FL 32963
!=ROM CONTRACTOR
RCS CO 'STUCTIO\I CO I\JC.
295 F IIWY 50 SUITF I CLl:R�lO T. FL •4711 CONl RACT FOR

PROJl·C r: Wyld Oak,

Vii\ ARCIIITl·CT:

APPi ICA no ,o

PERIOD TO:	.'\ 10 24

PROJl·C I NOS.

CO ·1RACI Di\I L

D1,1rihutio1110: c=JowNFR LJARClllll•cr
LJCO\i  rRACTOR
D
D

CONTRACTOR'S APPLICATION FOR PAYMENT
Apphca1io,n�mode li,r payment. a�shn" n hd,,w. m cnnncc11c111w11h 1hc Commcl C,,n11nua1mn Sheet. AIA Documcn1G703. os ,lllachLxl.

I he undcr-1gm'(I Contmrtnr, cn,lic,. rhm 10 the hc,t ol the Contmc1or's knowit'tlgc. 1nlonna11nn ,,ml hd,c.:t 1hc \\'mI,,''" l'rcu h) th,, Appl1ci1l1011for Paymcn1ha, been u1mplctcd 1n ac,<irnm,cc"11h the Contr.wt Documents. 1h;o1 nil a,rn,u1ll', ha. c hccn pa1CI h) 1he (ommc111r l11r Work lnr"h1ch pre,""" Ccni licaics for Payment were issue.I and 11ay111cnb rc's.Cl\c-d fm111 lhl' 0\\ ncr. and 1ha1current pa�mcnt �h,,_, n hcrcm 1, nm, due

l>Rt<,INAI (11N1RM I -;I 1\1

,,

",',:t hmgc hv Ch in  • 1ln1
1 o  n,  r-T sl \I ri, O,\ 1 r, 1
\ I 1	)	1( I	0

CUN I R-\t I OR:

RCS CO'JS f RUCTIO'J CO.. INC.

DA I I:	(Column G ,111G703)
5. RETA! AGE.
J		10 °o nl (\1111ph:tcd \\'ork ({"nl11111n D t I· on G70J)
h.		10 %nfSIPrL-d \1alcnal (Column Fon G703)
TornI Rcrnmagc ( Lmc;. 5a • 'ih or

s ----------
10,t;sS.oD

lly: -¥--U:,,-l:..ll�,---1.L  .._;;-,,,,.c..x.	 Date:	�v=1CT�O�R=IA�.ll�IE�1:�t-l2��TERIA 

C univ nf· 1./\KE	 Notary Public rch. :!024	State of Florida
Commu HH276625
	E I	Expires 6 19 2026 

1111 ,,	1<

Engineer's

CERTIFICATE FOR PAYMENT

, Tnf	'  I	11	"t,1
(I.me .J Less I.me 5 Tomi)
7. LESS PREVIOUS CERTIFKA r1::s FOR		
PAYMENT (Lmc <, from p1111r Ccn1fa:11c)
r	ll
Ii  I	!I	Tl  I 11	I  tllOI l,MI I  INl\1,l
(I me 3 less Linc f,)

ADDI flONS
$69.787.00

DEDUCTIONS

1n accord,tnCL' "11h 111c \ 0111111c1 Dr-.cum�nls. hnS;c.."tl nn f'ln-�itt· ('Ibsen ,u1nn:'\and the d:ua Eng,nea<"s	thc npphca11nn. 1hc Eng·noe, ccnifics 10 1hc Owner thnr 10 the hc�r of 1hc '"�1111L-u, knmvlcdgc. mlnnna11<1n anelbchd. the W11rk ha, progrc,scd as mu1ca1ctl.
the quaht) 111 the Work ,, 1n accordance "11h the Contract Dornmcnts. and the Contmc1<1r
,, cn11tlcd to pavrncnt ul the /\MOUN f C'ER1IFIED.
$1,184,895.00
M,10UN I Cl-ll. I IFll:'D

(Allach t'xp/111111111m 1(111111111111,cm{i<'II tli/(i•,.,./ram tlw 111111m111 appl,ed /1111wl all /ii:111·n 0,1 1/11.<
1lfJ/IJ,rn110111111d011//,c C11111i1111111io11Shl'ct 1/,a1 art• cl111111!1'd to nm/i>rm 1111/i 1111• 11111011111 et•mfird.)

So.oo

Engineer

3/22/24

Ioinl a 1 n1, cu th" M,,nth
t,

(,-J.

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2.	ATTORNEY FEE	l	LS	$95,000.00	S95.000.00				s•1.s.oon.oo	100•.	S0.00		
3.	GENERAL CONDITIONS	l	LS	S21,4S7.44	S21.457.44				S6.000.00	1Rt10	515.�57 4-1		
4.	PERFORMANCE BOND	l	LS	$80,494.SO	SX0,49-1.50				SX0.494.50	100•.•	S0.00		
5.	LAYOUT/ASBUILTS	l	LS	$48,391.25	$48,391.25				S9.100.00	l99u	SJ9.2?1.25		
6.	SWWWP	l	LS	$10,003.75	SI0.003.75				S2.250.00	:!2°o	$7,753.75		
7.	SILT FENCE	1	LS	$38,618.08	S38.618.0X				S.11.000.00	80110	S7.1>18 08		
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9,	CONSTRUCTION ENTRY	2	CA	$12,461.65	524,92.l.30				Sl.000.00	4�11	ScJ.923.30		
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23.	SOD PONDS	67270	SY	$4.81	$323,568.70				S0.00	O"o	SJcJ,56X.70		
24.	POND LINER 30 MILL	20645	SF	$3.57	\73.702.65				so 00	0%	S7J,702.65		
25.	HYDRO SEED BOTTOM OF PONDS	72900	SY	$1.00	$72.900.00				S0.00	o·'o	S?::,?O<l.00		
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29.	CONTROL STRUCTURE	1	LS	$7,331.82	$7,331.82	SO.ClO	{c/10

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31.	BUBBLE UP	3	EA	$6,067.44	SIR.202.32								
32.	BOX CULVERT	617	LF	$1,317.89	5g1_;_138.13								
33.	TV LINES	1	LS	$34,017.00	Yl�.(117.(YJ								

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	Slll3TOl \L				S6,58q,H 15.07	$535,631.50	s,.211.1,no •lO	S105,550.00	SI.852.1X1.50		$4,737,633.57	)J/,O,:I� I<	
	GRAND TOTALS				S6.5K9,815.07	$535,631.50	Sl.211.000.00	$105,550.00	SI.RSc.lSl.50		S4.737.633.57	S160,cI K.15	
Users may obtain validation of th,s document by requesting of the license a completed AIA Document 0401 - Certaficahon of Document's Authentac,ty

IAOOC.t.Jt.,EN1G/OJ co•ntt,UATONSHEETrORG70? 19W[OfHON A'J. e,901
THE 4.f,,"E.RC.A►l t4SflfUTE or ARCHfTFCTS 1/� N[WYORH.AVENUE r,, W WA.StHNGTO!l O C 10006-5:>31	G703-1992

Account Number

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KellyParleVBDtvelopme11t, LLC
660 Boachlan<l Blvd., see 301 Vero Beach, rL 32t63

CHECK,-
0,\TE

OS/08/2024  I

Serial Number
2075

*"1,079,984.77

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Front Image

002076

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Image Details

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07678046

Amount
$1,079,964.77

Date	Se
05/15/2024	69

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APPLICATION AND CERTIFICATION FOR PAYMENT	A/A DOCUMENT G702	PAGE ONE OF	PAGES	2

·10 ()WI\ r.R.
Kell) l'�rl-. vn DC\Clopmcnt. I IC
660 Beachland Blvd. Vero Beach, FL 32963 I·IWM COi\ I Ri\CI OR
RCS C ONS1 UCTION CO INC.
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Al._ DOCUMENT C,702 APPLICATION ANO CERT1FICUION <OR PAYMENT 19<l2 EDITION AJA 1\11992	THE AMERICAN INSTITUTE OF ARCIUTECTS. 1715 NEW YORK AVE NW WASHiNGTON DC 2000fi.',n2

Users may obtain validation of this document by requesting a completed AJA Document 0401 • Certification of Document's Authenticity from the Licensee.
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CONTINUATION SHEET

A/A /JOCUMENTG703

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1	MOBILIZATION	I	LS	$250,000.00	\2'>0,(��) 1)1)	\1'itlJXXl IKI			�2:"(),ll(HJ.fXI		\[I 1)1)		
2.	ATTORNEY FEE	1	LS	$95,000.00	\'l'i.(1(1() I)()	S'1'i,000 IKJ			s••:-.1x111oo		q, 1111		
3.	GENER/IL CONDITIONS	l	LS	S21,457 44	'>c1_4<1 ,➔	�h.OIHJ !Kl			'>IU_<IHJ !H)		�l•l.Y<- 44		
4.	PERFORMANCE BONO	l	LS	S80,494.50	5,0.4•1➔ 'i(I	��llA11,I 'iO			��11.4'14 so		�11.IWJ		
5.	LAYOUT/ASBUILTS	I	LS	S48,391.25	',-18..14) �'	,9.10ll.Oll			�l�.MlOOll		�l,.-•n :'.�		
6.	SWWWP	J	LS	$10,003.75	SI0.0011,	\U50110			SJ.>5ll.00		\fi.2�1,..		
7.	SILTFENCE	l	LS	$38,618.08	\ 1S,61S IN	S1J.00ll.110			3�.hl�.II,		\IIIHI		
8.	TREE PROTECTION	1	LS	$19,718.90	Sl'l.718 IIIJ	SO.ll11			\II IHI		Sl'J,71X1HI		
9.	CONSTRUCTION ENTRY	2	EA	$12,461.65	�24,0::!J.10	51.(XHlllll			SI,!HIii Oil		,:!J.1/::!1 HI		
10.	CLEAR SITE/WVLO OAKS	1	LS	S52,000.00	S5�.1KHUKl	�3\�flll IHI			516.(HHl IHI		Sll>.llllll (HI		
11.	DEMO STRUCTURES WYLO 01\KS	l	LS	$34,500.00	)1.l_>(Hl.(I()	s�.5m1.no			,X.5(HI 110		S�h.111111llll		
12	DEMO PAVEMENT	3658	SY	$5.92	)2 l .655 16	\(1(10			Sll.110		\� 1,6)'\ _;h		
13.	DEMO CONCRETE	960	SY	S9.Sb	511, J'7.1,0	)ll.\111			�II.OIi		�<1.1-- ""		
14.	MASSGRADE	1273657	CY	S2.42	SJ,rn<2.�41>.94	51.llill.lHIO.llll			51.91•.�o� no		SI.I 53."1-ll <11		
15.	DEMO GOLDEN GEM PROPERTY	l	LS	$55,333.23	SS5.J.11.1J	so.on			soon		�,,.n123		
16	OOUOLESILT FENCE FOR STOCK PILE AREA	3800	LF	$4.35	Sl6.53ll.0(1	snoo			�11,(K>		516.510 llil		
17	HYDRO SEED STOCK PILE AREA	57000	SY	S1.00	S57.fl()(l no	Sll.<tll			SO.Oil		sq.non no		
18.	OVER EXCAVATE SOILS ABEAS S' IN DEPTH	47682	CY	55.52	5263.�04,M	snoo			5ll 110		'-�63..20-161		
19.	GRADESITE	l	LS	$42,707.00	$42.7(1- IKJ	SIJ U11			'\IJ,(I()		S lc.-0' (�l		
20	EROSION BLANKET	l	LS	$25,851.20	515.�:i1.10	5()1111			',0 1Hl		'\�'i.S:iI 10		
21.	WW ABONDONM�NT WVLD/GOLDEN G(M	4	EA	$9,700.00	l.JS.X00.00	'-ll OIi			'\I) ()[I		, 1�.sno1K1		
22.	CLEAR SITE/GOLDEN GEM	l	LS	$51,000.00	,;, l.(l(�J (,0	',{)(HI			SO IHI		\'\1.IIIKlIHI		
23.	SOD PONDS	67270	SY	S4.81	\.111.5�� 10	,1100			\ILIHI		\1c1.,�� 7!•		
24.	PONO LINER 30 MILL	20645	SF	$3.57	) 73.70�.65	so.on			,n.oo		�7�.-.(1� h.'\		
25.	HYDRO SEED BOTTOM OF PONDS	72900	SY	$1.00	s,2,<Joo.110	Slillll			\II Oll		�"1.'llKl 00		
26.	DEWATERING	l	LS	$30,000.00	S10.(l(K11K1	Sll.1111			,non		S1•1.IKH1IH1		
27.	SEED/MULCH	l	LS	$354,813.60	s.1,,1.sI J.i,o	W.110			SO.Oil		',l'\1,XJ1 t,(!		
28.	60" HOPE	1414	LF	$274.81	,Sq�.5�I 34	)U(l{l			'S14.\. l}Q.i:!		\l<l:i.l<l\.hl		

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31.	BUBBLE UP	3	El\	$6,067.44	,1 �.::oc 1::								
32	BOX CULVERT	617	LF	$1,317.89	S�l3.IJS 11								
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1	CO#1 Builder Risk Insurance	1	LS	$	69.787 00									

													

													

													

													

													

													

													

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Users may obtain validation of this document by requesting of the license a completed AIA Document D401 • Certification of Document's Authcnt1c1ty

41A fl(..CIIMt tlf t,1M , ()fl, .tlt/ATION ".II( rt J"(l'l,./o, !CQ?' 1 l•lfl{),/ A1A ,. •uo
rnr A1Afmr,..Atl1N�tl11JH Of A.RCllltfC'.'IS 11''1N[W'foRkA,V[WI( N'IJ '.'IA�IHNGTO.., UC 10000-..,�Jl	G703-1992

PAYMENT REQUEST

;:>OST ROAD
0  lit 0  U P

\,t'r,lf. r1111\+'.-
r,1 n, ,,  11 ,,,,1rt•<			

"u,t C'f'.',r-r•		

(), l ",1 6, t1:1 I	;.,,l', ('' \ ,"l!l111H11>,•nh 	

(,.,.,.,	

I ,,,t,t,,IIPt"fll\		

R,•�l\("(l tlt1!lf."I
l l 1°111, l • .J)		

,,,,.� '	

y ;,,,d		

,,1T1,",1ll,lfl'1\
P,,,,1,11,,1	
Blll"C• fp fle-,.:,m°"
[1,11·
j.lmtiHl\\o(,)	
Lowndt-s, Oroidid:, Oo\ter, K.antor & Reed, P.A 215 N
£ol, 01 Ort1ndo. FL 32801	le �I			s	s	
325,000.00	s		
U,07L81	s	)12Cl28.l.9	s	
		s	l2S,000.00  ;;.									
LawOffices or Jeffrey HeJLm,m, UC	195
Church St, Nl!W IDven, CT 06510	
LeHI	s	
75,000.00	s	s	s	
75,000.00	s	s	
75,000.00	s	
P.ouw�vSwan rie,ney Barry& Ohver, P.L	2101
lndi,;n Rr.-er 8tvd l200. Vero Beach. Fl32960	
ltr.al	s	
lU,315.00	s	s	s	

113.315.00	s	s	
lU 315.00	s	
Allen& Comp,rny	16[
Plant Strnet, Winter Garden. Florldil 34787	
SUN""inv	s	
28800.00	s	s	s	
28,800.00	s	s	
28,800.00	s	
Kimley-Horn	445 24th
St Suite 200.Vero Beach. FL 32960	
En11nttrln1:Consu!Un1:	s	
lU,617.00	s	s	s	
188,617.00	s	s	
118,617.00	s	
S&M[ Inc.	2724
Oiscoverv Dtive Suile 120, Ralela:h NC 27616	
Geotechnlol	s	
41,750.00	s	s	s	
41,750.00	s		s	
									s	42.750	.00		
Bauhou«'! StudlO LrO	20-22
WtnkK.\ �d, London.Nt 7GU	
Pro	
Coordinator	s	
28 225.00	s	s	s	
28.225.00	s	s	
21,225.00	s	
foundry Commt::rclal	CNl
Center 11.111City Comrnons, 420 S.Orangt Avenue Suite 400, Orlan�. fl 32801	

B<oktrue Servku	
s	

225,000.00	
s	
s	
s	

llS,000.00	
s	
s	

22S 000.00	
s	
You,Upltal Connect/On	417 E
Vir0inla St lfl,T111lahusee. FL32301	
Leaal	s	
462.50	s	s	s	
462.!,0	s		
237.50	s	
22S.OO	s	
Dollble BDevelopment. UC	660
BEACltlAUD BLVD. SUITE 301. VERO B£ACII. rt	32963	
Re,mbunement	s	
216.3G4.8J	s	s	s	
216,364.81	s	s	
216.364.81	s	
		s	s	s	s	s	s	s	
		s	s	s	s	s	s	s	
		s	s	s	s	s	s	s	

TOTAL	1,242.534.31  s	1,242.534.31  s	12,309.31  s	1,230,225.00  s

SOURCES	loon	1,,242,2'6.IL	1,242,296.81	12.071.81	1,230,22.S.00
Equity	231.50	237.50	237.50
Total	1,242,534.31	1,242,534.31	12,309.31	L,2J0,2Z.S.OO
Difference

DRAW REQUEST

CERTIFICATE FOR PAYMENT
DATED:	JUNE 20, 2022
TO:	POST ROAD REAL ESTATE FINANCE, LLC (LENDER) FROM:	KELLY PARK VB DEVELOPMENT, LLC (BORROWER)

In accordance with the Loan Agreement ("Loan Agreement") between Borrower and Lender dated June 15, 2022, Borrower does hereby request that $1,230,225.00 be advanced and credited to Borrower. The amount requested above is determined as follows:

[SEE ATTACHED PAYMENT REQUEST]

The undersigned Borrower does hereby certify that, as of the date hereof, all items for which previous certificates were issued and advances received have been paid; and that all labor and materials for which this advance will pay, and for which previous advances have been paid, have gone into the construction of or other approved expenses for the Work (as defined in the Loan Agreement); and that the warranties and representations of Borrower in the Loan Agreement are hereby ratified and confirmed, except as disclosed to Lender in writing; and that there is no Event of Default under the Loan Agreement; and that there are no offsets, counterclaims or defenses against the indebtedness which is the subject of the Loan Agreement or any instrument evidencing, securing or otherwise concerning such indebtedness; and that there are no liens of record against the Property and arising out of the supplying of labor, material and/or services in connection with the construction thereon, except as disclosed to Lender in writing; and that no party other than Borrower and Lender claims any interest in, or lien or encumbrance on, the Property (except for ad valorem taxes not due and payable and liens or rights to liens to be dissolved upon payment of the advance hereby requested), except as disclosed to Lender in writing.

[Signature page(s) to follow]

Signed, sealed and delivered in the presence of:

Unofficial Witness

BORROWER:

KELLY PARK VB DEVELOPMENT, LLC, a
Delaware limited liability company

By: KPVB ACQUISITION, LLC, a Delaware limited
liability company, its Member

NotaryPublic	'	By:
Name:

/<1rn�'I-�
f<cNALb	l  cl)WARDS

,,,,��•,,,	SHANNON SKINNER
-':�Notary Pub!ic-State of Florida
=•	•� Commission # GG 931626

�,.\,;	..�f	My Commission Expires

',,,,l','11',\�,,,	November 13, 2023

My commission expires:	Title:  Manager

(AFFIX NOTARIAL STAMP OR SEAL)

[Signature page(s) continue on next page]

NOT APPLICABLE*

The undersigned does hereby certify, to the best of his knowledge and belief, that the foregoing statements are true and correct, and that the attachments hereto correctly reflect any payments heretofore made to the undersigned.
IN WITNESS WHEREOF, the undersigned has set its hand and seal as ofthis		day of
---"20_.
TRADE CONTRACTOR:

	(SEAL) [NAME OF TRADE CONTRACTOR], a

By: 	

* Per the terms of the Loan Agreement, Trade Contracts exclude any agreements pertaining solely to professional services from professional service firms. Invoices for these services were previously provided to Lender.

REQUISITION

The undersigned, an Authorized Officer of Golden Gem Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture between the District and U.S. Bank Trust Company, National Association, Fort Lauderdale, Florida, as trustee (the "Trustee"), dated as of June 1, 2024 (the "Master Indenture"), as amended and supplemented by the First Supplemental Trust Indenture between the District and the Trustee, dated as of June 1, 2024 (the Master Indenture as amended and supplemented is hereinafter referred to as the "Indenture") (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):
Requisition Number: 05

Name of Payee:	RCS Construction Co. Inc.

Amount Payable:	$825,274.65

Purpose for which paid or incurred (refer also to specific contract if amount is due and payable pursuant to a contract involving progress payments, or, state Costs of Issuance, if applicable):
Fund, Account and/or subaccount from which disbursement is to be made:
Series 2024 Acquisition and Construction Account

The undersigned hereby certifies that obligations in the stated amount set forth above have been incurred by the District, that each disbursement set forth above is a proper charge against the Series 2024 Acquisition and Construction Account and the subaccount, if any, referenced above, that each disbursement set forth above was incurred in connection with the acquisition and construction of the Phase 1 Project and each represents a Cost of the Phase 1 Project, and has not previously been paid.
The undersigned hereby further certifies that there has not been filed with or served upon the District notice of any lien, right to lien, or attachment upon, or claim affecting the right to receive payment of, any of the moneys payable to the Payee set forth above, which has not been released or will not be released simultaneously with the payment hereof.
The undersigned hereby further certifies that such requisition contains no item representing payment on account of any retained percentage which the District is at the date of such certificate entitled to retain.

A-1

Originals or copies of the invoice(s) from the vendor of the property acquired or services rendered with respect to which disbursement is hereby requested are on file with the District
GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

Author�cer

CONSULTING ENGINEER'S APPROVAL FOR NON-COST OF ISSUANCE REQUESTS ONL\'
If this requisition is for a disbursement from other than theCosts of Issuance Account, the undersigned Consulting Engineer hereby certifies that thisdisbursement is for a Cost of thePhase 1 Project and is consistent with: (i) theapplicable acquisition or construction contract; (ii) theplans and specificationsfor the portion of the Phase 1 Project with respect to which such disbursement is being made; and (iii) the report of the Consulting Engineer attached as an Exhibit to the First Supplemental Trust Indenture, as such report shall have been amended or modified on the date hereof.

Consulting Engineer
Kevin M. Roberson
Kimley Horn and Associates, Inc.

A-2

Incoming Domestic Wire Instructions
Please forward the funds utilizing the following instructions:
Send the funds to: Beneficiary Bank Information:
ABA/Routing
First Horizon Bank 165 Madison Ave.
Memphis, TN 38103

Client Name

Providing credit to: Beneficiary Information

Client Account Number

Client Address:
Additional information:

Wires received with missing or incorrect information are returned to the originating bank. To ensure delays are avoided in wire processing, please provide all necessary information.

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF	PAGES	4		

TO OWNER:	PROJECT: Infrastructure - Wyld Oaks	APPLICATION NO:	§Distribution to: Kelly Park VB Development, LLC				OWNER
660 Beachland Blvd.	ARCHITECT
Vero Beach, FL 32963		PERIOD TO:	6/7/24	CONTRACTOR FROM CONTRACTOR:	VIA ARCHITECT:
RCS CONSTUCTION CO. INC.
295 E. HWY 50 SUITE I	PROJECT NOS:
CLERMONT, FL 3471 I
CONTRACT FOR:	CO TRACT DATE

CONTRACTOR'S APPLICATION FOR PAYMENT	 The undersigned Contractor certifies that to the best of the Contractor's knowledge, infonnation and belief the Application is made for payment, as shown below, in connection with the Contract.	Work covered by this Application for Payment has been completed in accordance with the Contract Documents,
Continuation Sheet, AIA Document G703, is attached.	that all amounts have been paid by the  ontractor 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.
ORIG! Al ( U l R \( 1 Sl 1\1		14.205,206 49 
2 N�t change bv ( hanj!c Order,		:!15,176 20 	ONTRACTOR:	RCS CONSTRUCTION CO., INC.	

l ONTR \CT  l M TO DA 11 (I me I ± :!)
TOTAi CO\1PI rn D& 'TORI!) IO
DATE	(Column G on G703)
5. RETAINAGE:

	l 4.420.382 6'1 
s	1,042,<>52 00 

    5_%ofCompleted Work	21.060.85
(Column D +Eon G703)

	5 % of Stored Material (Column Fon G703)
Total Retainage (Lines 5a + 5b or
I otal 111 ( olumn I ot(i703)
r,  IOT\L1\R. ID If<;  RI I  I  \Gr
(Line 4 Less Line 5 Total)

3 l ,0H6.75

�2.147 60

	990.804.40 

ENGINEER'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on-site observations and the data comprising the application, the Engineer certifies to the Owner that to the best of the

7. LESS PREVIOUS CERTIFICATES FOR		
PAYMENT (Line 6 from prior Certificate)
Cl IRRF l P \ Yl\11 f DLF	�
9n\I'\ Cl·IO[l !SIi.i CllOI C,RrT\l AC,r (Line 3 less Linc 6)

Total Completed and Stored To Date Allocated To Cadence
!Total Rctainage At 5%
Total Allocated To Cadence. Less Retainage

$ 	0.00 
	<J<l0,804 40  ***
	13.429 57X 29 

	$174,241.84
$8,712.09

	$165,529.75

Engineer'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 AMOU T CERTIFIED.
AMOUNT CERTlFIED ........... $	$990,804.40

(A1/ach explanation if amount cenifled differs fiwn the amo11111 applied. Initial all figures 011 this Application and 0111/te Co11ti11uation Sheet that are changed to conform with the amount certified.)
ENGINEER:	rlJ	_

Less Amount Previously Paid By Cadence		$0.00	
urrent Payment Due By Cadence	$165,529.75	
Remaining Balance Due From COD	$825,274.65	

/ffei 

6111124

By: Kevin Roberson KimIey-Horn

M �	Date:------------

ADDITIONS
$215,176.20

DEDUCTIONS

Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.

215.176.20
215,176 20

$000

AIA OOCUMENT G702 • APPLICATION ANO CERTIFICATION FOR PAYMENT 1992 EDITION AIA C>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 0401 - Certification of Document's Authenticity from the Licensee.
•** Contractor agree.�that O,rner will pm· ,nth 11·ha1/i111d111g 1s available ,,.hie/, mar nor equal the Current Pm ment Due Am•unpmd balance will remain 011account for Owner to par 11·i!l1 (,,111re (,111ds.
  ote: Items in RED FONT arc automatically calculated from the G703 form or from items within this G702 Form. Do  OT hand enter the·e item on thi	beet.	

NLI Cll/\ GI : llV Chan e Order

TOTAL�

Total changes approved in previous months by Owner
Total a  roved this Month

CHANGE ORDER SUMMARY

This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the

DEVELOPER'S REPRESENTATIVE CERTIFICATE FOR PAYMENT

Wyld Oaks- Infrastructure Pay Application #1 Pay Application Dated 6/7/24

In accordance with the Contract Documents, based on on-site observations and the data comprising
this application, the Developer’s Representative certifies to the Owner that to the best of the Developer's Representative’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.
AMOUNT CERTIFIED	 $990,804.40	
(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.)

DEVELOPER'S REPRESENTATIVE:

By:			Date:
	6/14/2024	
Name: 	Timothy R. Dennard		 Title:` 		President	

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.

THIRD PARTY BENEFICIARY'S ENGINEER CERTIFICATE FOR PAYMENT

In accordance with the Contract Documents, based on on-site observations and the data comprising this application, the Third Party Beneficiary's Engineer certifies to the Owner to the best of the Third Party Beneficiary Engineer'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.

AMOUNT CERTIFIED........................................................................	$	
(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.)

THIRD PARTY BENEFICIARY'S ENGINEER:

By:		Date:			 Name:				
Title:`		

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. Al�PLICATION AND CERTIFICATION FOR PAYMENT. containing
Con1ractor's signedcertification is anachod.

Use Column I on Contracts where variable rctainal'.?.e for line items ma, ao1,lv.

APPLICATION NO: APPLICATION DATE:
PERIOD TO: ARCHITECTS PROJECT NO :

I
6/6/2024
6/7/2024

A	8	C	D	E	F	G	H	I	J	K	L	M	
ITEM NO.	

DESCRIPTION OF WORK	SCHEDUl£0
VALUE	WORK COMPU.ffED	MATERJAI.S
PRESENTLY STORED (NOTIN DORE)	TOTAL
COMPLETED AND STORED TO DATE (D+E+f)	%

(G+C)	BALANCE TO FINISH (C-0)	RETAINAGE (IF VARIABI£ RATE)	CnJmdacd
·srumd
lmrr<w<.,1KTit•	Pu-cmt Eligihh: For Po\)111Ull SyCatlcnce	Tr>tal C'omph.'Cld And Slort'<ITo Date Ehgiblc For Pa}1nau
By Cadence	
Total Cadence Rctain.igc@s•;.	
			FROM PREVIOUS
APPLICATION
(D+E)	THIS PERIOD										
		Qua111i1y	Um•	Price	Tot.ii												
	1v�nera. \...onditions, l\1obilzaUon, Survt.y																
1.	MOBILIZATION	1	L.5	$13,750.00	$13,750.00		$5.000.00		$5,000.00	36%	$8.750.00	$250.00	Yc:s	17.00%	$850.00	$42.50	
2.	GENERAL CONDITIONS	1	LS	$221,250.00	$221.250.00		$23,000.00		$23,000.00	10%	$198.250.00	$1.150.00	Yc:s	17.00%	S3.910.00	$195.50	
3.	PERFORMANCE BOND	1	L.5	$103 750.00	$103.750.00		$103.750.00		$103.750.00	100%	S0.00	SS.187.50	Yc:s	17.00%	$17,637.50	S881.88	
4.	LAYOUT/ASBUILTS	1	L.5	$96,518.75	$96.518.75		$4,420.00		$4,420.00	5%	$92,098.75	$221.00	Yes	17.00%	$751.40	$37.57	
5.	SWWWP	1	L.5	$28,750.00	$28.750.00		$1,500.00		$1.500.00	5%	$27.250.00	$75.00	Yc:s	17.00%	$255.00	$12.75	
6.	SILT FENCE	21B18	LF	$1.81	$39,490.58		$7.200.00		$7,200.00	18%	$32,290.58	$360.00	Yc:s	17.00%	Sl.224.00	$61.20	
7.	TREE PROTECTION	2930	Lf	$6.73	$19.718.90				$(1.00	0%	$19,718.90	$0.00	Yc:s	17.00%	S0.00	$0.00	
8.	CONSTRUCTION ENTRY	2	EA	$12,647.28	$25.294.56				S0.00	0%	$25,294.56	S0.00	Yc:s	17.00%	$0.00	$0.00	
9.	MASS GRADING	31971	CY	$2.81	$89,838.51		$33,250.00		$33,250.00	37%	$56.588.51	Sl,662.50	Yes	17.00'}•	$5.652.50	$282.63	
10.	ROADWAY GRADING	1	LS	$97,182.84	$97,IRH4				SO.OD	0%	$97.182.84	so.oo	Yes	17.00%	S0.00	$0.00	
11.	SOD BEHIND CURB	10613	SY	$3.69	$39,161.97				$0.00	0%	$39,161.97	S0.00	Yes	17.00%	SO.oO	$0.00	
12.	10" FORCE MAIN	5244	LF	$70,72	$370,855.68			$92,160.00	$92.160.00	25%	$278,695.68	S4.608.00	Yes	17.00%	$15,667.20	$783.36	
13.	10" PLUG VALVE	14	EA	$5,619.75	$78,676.50			$6.250.00	$6,250.00	8%	$72,426.50	$312.50	Yes	17.00o/D	Sl.062.50	$53.13	
14.	12"Xl0" WET TAP	2	EA	$16,066.lB	$32.132.36				$0.00	0%	$32.132.36	S0.00	Ye,	17.00°/.	$0.00	$0.00	
15.	6" FORCE MAIN	648	LF	$50.13	$32,484.24				$0.00	0%	$32,484.24	so.oo	Yes	17.00%	SU.00	$0.00	
16.	6" PLUG VALVE	12	EA	$3,905.17	$46,862.04				so.oo	0%	$46.862.04	$0.00	Yes	17.00%	S0.00	$0.00	
17.	4" FORCE MAIN	20	LF	$36.17	S723.40				S0.00	0%	$723.40	SU.00	Yc:s	17.00¾	$0.00	SO.OU	
18.	4" PLUG VALVE	1	EA	$2,366.34	$2.366.34				$0.00	0%	$2,366.34	S0.00	Yc:s	17.00%	S0.00	S0.00	
19	FORCE MAIN FITTINGS	1	L.5	$78,1B4.45	$78.184.45				S0.00	0%	$78,184.45	so.oo	Yes	17.00%	$0.00	$0.00	
20.	TESTING	1	L.5	$12 278.25	$12,278.25				$0.00	0%	$12.278.25	S0.00	Yc:s	17.00%	S0.00	S0.00	
21.	18" HOPE	931	LF	$50.28	$46,810.68		SIO.OS6.00		SI0,056.00	21%	$36.754.68	$502.80	Yc:s	17.00%	Sl.709.52	$�5.4�	
22.	24" HOPE	1279	LF	$73.70	$94,262.30	S0.00	$40,180.00		$40.180.00	43%	$54,0S2.JO	$2.009.00	Yc:s	17.00%	$6,830.60	$.l41.5J	
23.	42" HOPE	106	LF	$246.26	$26.103.56				S0.00	0%	$26.103.56	S0.00	Yc:s	17.00%	$0.00	S0.00	
24.	48" HOPE	691	LF	$320.16	$221,230.56				SU.00	0%	$221,230.56	$0.00	Yc:s	17.00%	S0.00	$0.00	
25.	54"/60" HOPE	1462	LF	$360.14	$526,524.68				S0.00	0%	$526.524.68	$0.00	Yes	17.00%	$0.00	$0.00	
26.	60" HOPE	64	LF	$480.83	$30.773.12				S0.00	0%	$30,773.12	S0.00	Yc:s	17.00%	S0.00	$0.00	
27.	36" HOPE	1394	LF	$114.98	S160,282.12		$48.000.00	S0.00	$48,000.00	JO%	SI 12.282.12	S2.4(l0.00	Yc:s	17.00%	$8,160.00	$408.00	

AIA DOCUMENT 0103 CONT"'UATION SHEET rOA 0102 1'1112 EDITION II.IA Cll�7
11--\EAMERICAN NSTrlUTE Of ARCHITECTS. 1735MEW VOAK AVENUE:, NW W...SHNGTON. DC :;,oooe.573;,	0703-1992

AIA Document G702. APPLICATION A DCERTIFICATION FOR PAYMENT. containing
Contractor's signedcer1ifica1ion is attached.

APPLICATION NO: APPLICATION DATE:
PERJODTO:

I
6/6/2024
6/7/2024

Use Column I on Contracts where variable rctainai!e for line items ma) apply.	ARCHITECTS PROJECT NO:
A	ll	C	D	E	F	G	II	I	J	K	L	M	

ITEM
NO.	

DESCRIPTION OF WORK	
SCHEDULED
VAWE	WORK COMPL.E'fED	MATERIALS
PRESENTLY
STORED
(N◊TlN
DORE)	TOTAL
COMP1.ET6D
AND STORED
TO DATE tD+E+F)	o/,
1o�c,	BALANCE TO ANISH (C-G)	
RETAINAGE (IF VARIABLE RATE)	
Cc11��idt.r('(I
�Shared
lmprOVU11L1ll�	
Pc.YCClll Ehg.1blc
For Pa)1HL'fll
By Cadence	To1al Comrk'h:d Arlll Stored To Date Eligible for Pilyn1t.111
B Cad1.n:e	
Ttital CaduK:c
Rc..1:111i.1gt•(a 5'/4	
			FROM PREVIOUS
APPLICATION (D+E)	
THIS PERIOD										
		Quantily	Unit	Pncc	T°"'I												
28.	72" HOPE	1381	LF	$747.54	St.032.352.74	S0.00			S0.00		S1.032.352.74	S0.00	Yes	17.00%	S0.00	so.no	
29.	TYPE "P" MANHOLE	4	EA	$15,330.53	$61,322.12	$0.00	$4,600.00	$0.00	$4.600.00		$56,722.)2	5230.00	Yrs	17.00%	$7�2.00	$39.10	
31.	TYPE P-5 WITH "J" BOTTOMS	11	EA	$12,400.26	SI36,402.86	$0.00			S0.00		$)36.402.86	$0.00	Yes	17.00%	$0.00	S0.00	
32.	TYPE P-5 INLETS	25	EA	$6,492.88	$162,322.00	S0.00	S33,000.00	$0.00	$33,000.00		$)29.322.00	Sl.650.00	Yes	17.00%	$5.610.00	$280.50	
33.	TYPE P-6 WITH "J" BOTTOMS	8	EA	$14,844.13	$118.753.04	$0.00			S0.00		$118,753.04	S0.00	Yrs	17.00%	$0.00	S0.00	
34.	TYPE P-6 INLETS	4	EA	$7 220.65	$28.882.60	S0.00			SO.OU		$28.882.60	$0.00	Yes	17.00%	S0.00	S0.00	
35.	TYPE "J" BOTTOM WITH TYPE "A" MANHOLE	1	EA	$33,164.S9	$33,164.59	$0.00			S0.00		$33,164.59	$0.00	Yes	17.00%	$0.00	S0.00	
36.	BOX CULVERT S'XlO'	280	LF	$1,319.81	$369,546.80	S0.00		$228,005.00	$228,005.00		$141.541.80	SI 1,400.25	Yrs	17.00%	$38,760.85	Sl.938.04	
37.	TV LINES	1	LS	$31,524.38	$31,524.38	$0.00			S0.00		$31,524.38	S0.00	Yrs	17.00%	S0.00	S0.00	
38.	8" C-900	487	LF	$50.94	$24,807.78	S0.00			$0.00		$24,807.78	S0.00	Yrs	17.00%	S0.00	$0.00	
39.	16" DIP	2,581	LF	$131.18	$338.575.58	S0.00			S0.00		$338.575.58	S0.00	Yrs	17.00%	S0.00	$0.00	
40.	12" C-900	2,7S2	LF	$87.96	$242.065. 92	$0.00		$124,960.00	$124.960.00		$117,105.92	$6,248.00	Yrs	17.00%	$21,243.20	Sl.062.16	
41.	6"C·900	816	LF	$37.07	$30.249.12	SO.OD		$4,680.00	$4,680.00		$25,569.12	$234.00	Yes	17.00%	$795.60	S39.78	
42.	12" GATE VALVE	13	EA	$4,796.85	$62.359.05	$0.00		$56.000.00	$56.000.00		$6,359.05	$2,800.00	Yrs	17.00%	$9,520.00	$47(,.()()	
43.	6" GATE VALVE	13	EA	$1,903.55	$24,746.15	$0.00			so.oo		$24.746.15	S0.00	Yes	17.00%	$0.00	S0.00	
44.	16" GATE VALVE	18	EA	$8,950.47	$)61.108.46	S0.00			$0.00		$161.108.46	$0.00	Yrs	17.00%	S0.00	S0.00	
45.	8" GATE VALVE	17	EA	$2,648.89	$45.031.13	$0.00			S0.00		$45.031.13	S0.00	Yrs	17.00%	S0.00	SO.oo	
46.	RELOCATE FHA	1	EA	$3,474.50	$3.474.50	S0.00			S0.00		$3.474.50	S0.00	Yes	17.00%	so.oo	$0.00	
47.	FIRE HYDRANT ASSEMBLY	18	EA	$6 239.51	$112,311.18	$0.00			S0.00		SI 12.311.18	$0.00	Yrs	17.00%	S0.00	$0.00	
48.	ARV	1	EA	$7 426.58	$7.426.58	S0.00			S0.00		$7,426.58	S0.00	Yrs	17.00%	S0.00	S0.00	
49.	16"X12" WET TAP	1	EA	$15,160.96	$15.160.96	SO.OD	$5,800.00		SS.800.00		$9,360.96	$290.00	Yrs	17.00%	S9S6.00	$49.30	
50.	16"X16" WET TAP	l	EA	$33 555.01	$33,555.01	SO.DO			$0.00		$33.555.01	$0.00	Yrs	17.00%	S0.00	S0.00	
51.	14"0IRECTIONAL DRILL	80	LF	$173.41	$13,872.80	S0.00		$3,200.00	$3,200.00		$10,672.80	$160.00	Yrs	17.00%	$544.00	$27.20	
52.	JUMPER	2	EA	$2,787.30	$5,574.60	$0.00			S0.00		$5,574.60	$0.00	Yes	17.00%	SO.DO	S0.00	
53.	RESTORATION/MOT FOR OFFSITE WORK	1	LS	$33,392.21	$33,392.21	$0.00			S0.00		$33,392.21	$0.00	Yes	17.00%	S0.00	$0.00	
54.	WATER FITTING	1	LS	$122,471.75	$122,471.75	S0.00		$46,000.00	$46.000.00		$76.471.75	$2.300.00	Yes	17.00%	$7,820.00	$391.00	
55.	TESTING	1	LS	$11,475.00	SI 1,475.00	$0.00			$0.00		SI 1,475.00	S0.00	Yes	17.00%	$0.00	S0.00	
56.	8" REUSE	5,392	LF	$49.11	$264,801.12	S0.00		$60,480.00	$60.480.00		$204.321.12	S3.024.00	Yrs	17.00%	SI0.281.60	$5 )4.08	
57.	8" GATE VALVE	17	EA	$2,738.50	$46,554.50	S0.00			S0.00		$46,554.50	S0.00	Yes	17.00%	S0.00	S0.00	
58.	4" REUSE C-900	590	LF	$30,67	SIS.095.30	S0.00			$0.00		$18,095.30	S0.00	Yrs	17.00%	$0.00	S0.00	
59.	4" GATE VALVE	14	EA	$2,295.78	$32,)40.92	$0.00			$0.00		$32,)40.92	$0.00	Yes	17.00%	S0.00	S0.00	
60.	30"X8" WET TAP	2	EA	$12,237.97	$24.475.94	S0.00			$0.00		$24,475.94	S0.00	Yrs	17.00%	S0.00	S0.00	
61.	10" DIRECTIONAL DRILL	80	LF	$136.25	$10,900.00	S0.00			$0.00		$10,900.00	S0.00	Yrs	17.00%	S0.00	S0.00	
62.	REUSE JUMPER	2	EA	$2,737.14	$5,474.28	S0.00			S0.00		$5,474.28	S0.00	Yrs	17.00%	S0.00	S0.00	
63.	REUSE FITTINGS	1	LS	$41,221.83	S4I,22U3	$0.00			$0.00		$41.221.83	S0.00	Yrs	17.00%	S0.00	S0.00	
64.	REUSE TESTING	1	LS	$9,750.38	$9,750.38	S0.00			S0.00		$9,750.38	S0.00	Yrs	17.00%	S0.00	so.oo	
65.	TYPE "O" INLET	1,487	LF	$21.25	$31,598.75	$0.00			$0.00		$3 ).598.75	S0.00	Yrs	17.00'/4	S0.00	$0.00	
66.	TYPE "F" CURB	17,785	LF	$28.13	$500,292.05	$0.00			$0.00		$500.292.05	S0.00	Yrs	17.00%	S0.00	S0.00	
67.	10' CONCRETE SIDEWALK	3,647	LF	$61.44	S224,07l.68	S0.00			S0.00		$224.071.68	S0.00	Yrs	I7.00·/4	SO.oO	$0.00	
68.	10' HCR	11	EA	$2,750.00	S30.250.00	$0.00			$0.00		$30,250.00	$0.00	Yrs	17.00%	S0.00	$0.00	
69.	S' SIDEWALK	6,562	LF	$29.94	$196,466.28	S0.00			$0.00		$196.466.28	$0.00	Yes	17.00%	S0.00	$0.00	
70.	5' HCR	14	EA	$1,481.25	$20,737.50	S0.00			$0.00		$20.737.50	S0.00	Yes	17.00%	S0.00	S0.00	
71.	12" STABILIZATION	25,301	SY	$5.42	$137.131.42	S0.00			$0.00		$137,131.42	$0.00	Yrs	17.00%	S0.00	S0.00	
72.	1" SP 12.5 1ST LIFT	21,349	SY	$13.81	$294,829.69	$0.00			S0.00		$294,829.69	$0.00	Yrs	17.00%	$0.00	.$0.00	

MI\OOCUMENTG703 CONTINUA1IONSHEETrORG702 1"91EOITON A� Clll>D2
THEAMEHCAN INSTRUlE Of ARCttrlECTS, 11J5NEW YORK AVENUE.NW WASH"IOTON, O C 2000e-52J2	G703-1992

AIA DOCUMENTG703	Pag,t3ofif P19H

AIA Documcm G702. APPLICATION ANO CERTIFICATION FOR PAYMENT. containing
Contractor's signedccrcification is attached.

APPLICATION NO: APPLICATION DATE:
PERIOD TO:

I
6/6/2024
6/712024

A	B	C	D	I	E	F		H	I	J	K	L	M	

ITEM
NO.	
DESCRIPTION OF WORK	
SCHEDULED
VALUE	WORK COMPLETED	MATERIALS PRESENTLY STORED (NOTIN DORE\	TOTAL COMPLETED AND STORED TO DATE (D+E+Fl	

(G•C)	
BALANCE TOF1NISH (C-GJ	RETAINAGE (IF VARIABLE RATE)	Con.s1cknxl "Sh:1rcd lmprovum:nr	
Pi.Ycull Ehgiblc R'>l'Paymcnl ByCadcn1.x•	
T('!l!ll Cl'1mplelt'CI And S1oru.lTt1 D;itc Eligihlc For Paymc,11
BvCadcnoc	
Tolal Cadmcc
Re1.1iM{!C (d 5%	
			FROM PREVIOUS APPUCATION (D➔ E)	
THIS PERIOD										
		
Qu,111111)'	U1111	Pncc	Too,I												
73.	l" SP 9.S ASPHALT WITHIN 6 MONTHS OF CFC	21,349	SY	$17.63	S376.382.R7	S0.00			S0.00		$376,382.87	$0.00	y,.	17.00%	S0.00	S0.00	
74.	l" SP 9.S ASPHALT	21,349	SY	$13.71	$292,694.79	S0.00			S0.00		$292,694.79	S0.00	Yes	17.00%	$0.00	S0.00	
75.	10" LIME ROCK	21,349	SY	$24.71	S527,533.79	S0.00			S0.00		$527,533.79	S0.00	Yes	17.00%	$0.00	S0.00	
76.	STAMPED ASPHALT	1,680	SF	$13.7S	$23.100.00	$0.00			S0.00		$23,100.00	SO.OU	Yes	17.00%	so.oo	S0.00	
78.	TEMP MARKING	1	LS	$18,402.50	SIH.402.50	$0.00			S0.00		SIK.402.50	S0.00	Yes	17.00%	S0.00	S0.00	
79.	PERMENATE MARKINGS	1	LS	$72125.00	$72.125.00	S0.00			S0.00		S72.I25.00	$0.00	Yes	17.00%	S0.00	S0.00	
																	
80.	DRY UTILITIES																
81.	MOBILIZATION/GENERAL CONDITIONS	1	LS	$45,120.00	$45,120.00	S0.00			S0.00		$45,120.00	S0.00	Yes	17.00%	$0.00	S0.00	
82.	PERFORMANCE BOND	1	LS	$60 76B.OO	$60,768.00	$0.00	$60,768.00		$60,768.00		S0.00	$3,038.40	Yes	17.00%	$10,330.56	$516.53	
83.	6" SCHEDULE 40 GREY	60,530	LF	$2S.17	$1,523,540.10	S0.00			S0.00		$1.523.540.10	S0.00	Yes	17.00%	$0.00	$0.00	
84.	CONCRETE DUCT BANK	S,490	LF	$14.97	$82,185.30	$0.00			S0.00		582,185.30	S0.00	Yes	17.00%	so.oo	S0.00	
83.	2" SCHEDULE 40 GREY	lS,212	LF	$1S.10	$229,701.20	S0.00			$0.00		$229,701.20	$0.00	Yes	17.00%	SO.OD	$0.00	
85.	2" FITTINGS	l	LS	$26 8B4.00	$26,884.00	$0.00			SO.OD		$26,884.00	S0.00	Yes	17.00%	SO.OD	S0.00	
86.	4" SCHEDULE 40 GREY	Sl,000	LF	$20.31	Sl.035.8I0.00	SO.OD			$0.00		$1.035.810.00	S0.00	Yes	17.00%	SO.DO	SO.DO	
87.	4"& 6" FITTINGS	1	LS	$64 118.00	$64,118.00	S0.00			S0.00		$64,118.00	S0.00	Yes	17.00%	S0.00	S0.00	
88.	30' TA:; LED SINGLE HEAD LIGHT	22	EA	$12 274.00	S270,028.00	$0.00			$0.00		S270.028.00	S0.00	Yes	17.00%	SO.DO	S0.00	
89.	30' TALL POLE WITH TWIN HEADS	24	EA	$14 363.00	S344.7I2.00	S0.00			$0.00		$344,712.00	SO.OD	Yes	17.00%	S0.00	S0.00	
90.	ADD BLACKE DYETO CONCRETE POLES	46	EA	$909.00	S4I.8I4.00	$0.00			$0.00		$41,814.00	S0.00	Yes	17.00%	S0.00	$0.00	
91.	SPLICE BOXES	52	EA	$S,770.00	$300,040.00	SO.DO			S0.00		$300,040.00	S0.00	Yes	17.00%	SO.OD	S0.00	
92.	LAYOUT/AS-BUILTS	1	LS	$17,410.00	Sl7.4I0.00	S0.00			$(LOO		$17,410.00	S0.00	Yes	17.00%	SO.DO	S0.00	
93.	HANDHOLES	lS	EA	$3,14S.OO	S47,175.00	S0.00			S0.00		$47,175.00	SO.OD	Yes	17.00%	SO.OD	$0.00	
94.	MAHOLES	4	EA	$7,793.00	$31,172.00	$0.00			S0.00		531.172.00	S0.00	Yes	17.00%	S0.00	$0.00	
																	
95.	LANDSCAPE/IRRIGATION																
96.	MOBILIZATION/GENERAL CONDITIONS	1	LS	$29,S60.00	$29,560.00	S0.00			$0.00		$29.560.00	$0.00	Yes	17.00%	$0.00	S0.00	
97.	PERFORMANCE BOND	1	LS	$22 693.00	S22.693.00	so.oo	$22,693.00		$22,693.00		$0.00	$1,134.65	Yes	17.00%	$3,857.8 I	$192.89	
98.	SURVEY/LAYOUT	1	LS	$6 880.00	$6,880.00	S0.00			S0.00		$6,880.00	S0.00	Yes	17.00%	S0.00	S0.00	
99.	LANDSCAPE	1	LS	$421,116.00	$421,116.00	S0.00			so.oo		$421,116.00	S0.00	Yes	17.00%	$0.00	S0.00	
100.	IRRIGATION	1	LS	$393,612.00	$393.612.00	S0.00			S0.00		$393,612.00	S0.00	Yes	17.00%	S0.00	S0.00	
101.	MAINTENANCE	1	LS	$73,440.00	$73,440.00	$0.00			S0.00		$73,440.00	S0.00	Yes	17.00%	$0.00	S0.00	
102.	SOD/GROUND COVERING	1	LS	$141 212.00	$141,212.00	S0.00			$0.00		$141,212.00	$0.00	Yes	17.00%	$0.00	S0.00	
																	
104.	Chan•• Order #1 Fire Access Rd																
105.	Install Fire Access Rd. 8'' lime Rock with Prime	9,111	SY	$14.20	SI 29,376.20	$0.00			$0.00		$129,376.20	S0.00	No	0.00%	S0.00	$0.00	
106.	Install Two Extra Fire llvdrant Assemhh•	2	EA	$6,400.00	$12,800.00	$0.00			$(1.00		$I2,ROO.OO	$0.00	No	0.00%	S0.00	SO.OU	
107.	Install Extra PVC with FittinllS	1	LS	$	3,200.00	$3,200.00	So.oo			S0.00		$3,200.00	SO.DO	No	0.00%	S0.00	$0.00	
108.	Extra Labor/Crew and Equipment to Facilitate Install	1	LS	$	69,800.00	$69,800.00	S0.00	$18,000.00		$18,000.00		$51,800.00	$900.00	No	0.00%	S0.00	S0.00	

																	

	SUBTOTAL				Sl4,420,382.69	$0.00	$421,217.00	S62I ,735.00	$1,042,952.00	7%	S13.377.430.69	$52,147.60			$174,241.84	$8.712.09	
	GRAND TOTALS				$14.420.382.69	so.oo	S42,2I I7.00	$621,735.00	$1.042.952.00		Sl3.377.430.69	$52,147.60			SI74,241.84	SB.712.09	

Use Column I on Contracts wh<.Tc variable retaina(!c for line items ma, aoolv.	ARCHITECT'S PROJECT NO:
G

Users may obtain validation of this document by requesting of the license a comple1ed AJA Document D401 - Certification of Documents Authenticity

AlADOCUMENTC703 CONTINUATONSHEETFOR0702 1992£DntON A14 01992
rHE AM!:RIC.\N NSTITUTEOF ARCHtrfCTS, 1735NEW YORKAI/ENUE, N.W WASlllNGTON, DC 20006-5231	G703•1992

PROGRESS PAYMENT AFFIDAVIT

STATE OF FLORIDA COUNTY OF LAKE

BEFORE ME, the undersigned authority, duly qualified and authorized in the State and County aforesaid to administer oaths and take acknowledgements, this day, personally appeared	Everett Rozar	who being by me first duly sworn, deposes and says:

The facts and matters contained and recited in the Affidavit are based upon personal knowledge of the Affiant.
Affiant is the Owner of	RCS Construction Company. Inc.	, a North Dakota Corporation company (hereinafter the "Contractor")
Contractor and	Kelly Park VB Development. LLC		(hereinafter the "Owner") have executed, delivered and entered into that certain CONTRACT AND AGREEMENT dated	December 4. 2023	(hereinafter the
"contract").
Affiant now requests partial payment under the Contract. In Consideration of Owner providing such partial payment, Contractor hereby provides this Affidavit upon which Owner intends to rely.
Contractor is not aware of any Claims that would require an adjustment of the Contract Time or the Contract Price except for any Change Order Requests or Change Order Proposals previously submitted in writing to Owner prior to execution of this Affidavit.
Contractor releases any Claims for an adjustment to the Contract Time or the Contract Price except for those previously made in writing and delivered to Owner prior to execution of this Affidavit.
Affiant states that all bills for labor, services or materials furnished, delivered, installed or performed on the job site through the date of this Affidavit have been FULLY paid and that no lien for such may properly be filed, recorded or enforced. Waiver and Release of Lien upon Progress
Payment forms for every such potential lienors are provided herewith through 06/07/2024
Affiant states that, except as provided herein, all bills for labor, services or materials furnished, delivered, installed or performed on the job site through the date of this Affidavit have been FULLY paid and that no lien for such may properly be filed, recorded or enforced. Waiver and Release of Lien Upon Progress Payment forms for every such potential lienor are provided herewith, except as provided below:

Name of Lienor	 Amount due for labor1 services or Or Potential Lienor	materials furnished, delivered1

Installed or performed

1. Central Florida Turf Pros	$3,200.00	
2. Florida Design Consultants, Inc.	$977.50	
3. Fortiline, Inc.	$692,154.30	
4. Oldcastle Infrastructure	$242,008.38	
5.  Quality Petroleum	$9,522.38	

FURTHER AFFIANT SAYETH NOT.

RCS Construction Company, Inc.

--�----..-.:::;_---'--�	'' Affiant

F3fc:a:::±\-

Sworn to a�subscribed before me this	13th	day of June	2024, by
�zctv'	, who(check one): [ X] is personally known to me, [ ] produced a driver's license (issued by a state of the United States within the last five (5) years) as identification, or [ ] produced other identifica•		 Affiant did take an oath.

Notary Public State of Florida Comm# HH276625
CE,	Expires 6/19/2026

Print Name:	Victo i E	uteria 	 _ Notary Public, State of Florida
Commission No.:._-'H'-'-H=--==-27'-'6=-=6=2=5	
MCyommission Expires:	06/19/2026

JOINDER AND INDEMNIFY AGREEMENT

Contractor, joins in the execution of this Affidavit for the purpose of adopting all representations of fact contained therein. Contractor understands that this Affidavit will be relied upon by Owner for all purposes relating to the Contract. Contractor agrees to indemnify, hold harmless and defend the Owner from, against and with respect to any and all loss, cost, damage and expense, including reasonable attorneys' fees, arising out of any claims by laborers, subcontractors or materialmen who might claim that they have not been paid for labor, services or material.

A Florida Corporation Company

By:��	 Name: Everett Rozar Title:  President

(CORPORATE SEAL)[where applicable]

WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of$ 990,804.40	, hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished through 06/07/2024 to Double B Development and Kelly Park VB Development, LLC on the job of Wyld Oaks Infrastructure to the following property:
S of Kelly Park Rd & Effie Dr.
3620 W Kelly Park Rd.
Apopka, FL 32712, Orange County {description of property)

This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified.
DATED on June 24, 2024.
Lienor RCS Construction Company, Inc. Address 295 E SR 50, Suite 1,

Pri	e: ody Bass lts•�e�dent

State of Florida
County of-=L=ak=e'-----
The foregoing instrument was acknowledged before me this  24th	day of_J'--'u=n=-e
20 	li_, by , as of said company, who has presented as identification or is personally known to me.

VlCTORIA E. 1.AUTERIA
Notarv Publlc
§tilt@ gf Florida
comm# l'lH27661J
f.l(�lfill G/'1,,g/ifll6

		Victoria E Lauteria	 Print, Type or Stamp Commission

DEVELOPER'S PAYMENT AFFIDAVIT

STATE OF FLORIDA
COUNTY OF 8RAN6t,l:Ni)-Cl't-1" �I:vE�

BEFORE ME, the undersigned authority, duly qualified and authorized in the State and County aforesaid to administer oaths and take acknowledgements, this day, personally
appeared \+e.<l><A: M.'�r¾,e\1 m:. , who being by me first duly sworn, deposes and says:
The facts and matters contained and recited in the Affidavit are based upon personal knowledge of the Affiant.
Affiant is the authorized representative of Golden Gem Community Development District (hereinafter the "Owner").
Kelly Park VB Development LLC has assigned to Owner its rights and obligations under the Site Construction Agreement for Infrastructure Improvements dated December 4, 2023, as amended (hereinafter the "Contract") with RCS Construction Company of Central Florida, Inc. ("Contractor").
Affiant states that, excluding retainage withheld by Contract, the Contractor has been paid for all labor, services, materials and equipment furnished under the Contract through the date of the Contractor's most recent prior payment application dated 		N/ A		_
Affiant states that, excluding retainage withheld by Contract, the Contractor will be paid for all labor, services, materials and equipment furnished under the Contract through the date of the Contractor's current payment
application dated 	 6/7 /24 		_

FURTHER AFFIANT SAYETH NOT.

By:

Printed Name: 1-lerb�, f  (Y\ 	ed5e.0J JJJ­
Title: Vice Chair

STATE OF FLORIDA
COUNTY OF 'INDDh·\ W-\1��
Sworn to (or affirmed) and subscribed before me by means of�hysical presence or □ online notarization, thisrday of-SuJt	2024, by ttc..rk.c+v}'\.12,� )-, '.l1jC'
(Signature of Notary Public • State of Florida)

(Print, Type, or Stamp Commissioned Name of Notary Public)
_L	Personally Known OR 	Produced Identification
Type of Identification Produced 	

SHANNONCONN
Commission# HH014043
Expires October 24,2024
Bonded Thnl Budgt(Noca,y SelVlce$	St!A��ON  CJ)NN
Io/ �41;2y

10	20	�o

oGRAPHIC SCAl£ IN FUT

=	I  I

ORA!NAGE STRUCT\JRE TA8l£	
Sllt<!\J!	""	Ill a.
�	"'n.
(tt)	
...,	PSNIT	et U4..U	117.<.»)	
...,	PS NIT	lltUln	111,._..)	
	P51UT	nt 1»..71	111>($)
111»,l)	
...,	
PSIUT	
1111:UU.5	
117171
117	
....
..,,	
�NIT	...""'	IIUl(�
:II�	
	PSNIT	•inn	111'0;\)	

cornv.cTOR TO COORONATE 'MTH UlUlY PRO'/.OERS FOR �"ECTJ(H TO EX. HRA.STRUCl\.R£

NOffS:

& 2.

1, J kVJ P eorrou STRVCT\.R£S TO BE CO,.�TRVCT!O PER n>OT NXX 42$-001 A.'41J

I
EXIST. R/« LM�

STA. 0+81.M. -22.50 LT
COHST. 12• VALVE
STA:o+�.tS CfT:34.oo'\.T
S'M FM nJnRt cc,,;s(Cnc:»4

srue

SlA:1♦00.25 CfT:3&00\.T
FM f"UTIJR( CCN�'tCTiCli

SAl>UllROAD

..

l CE CO,.'ST.
n.E.G  ., ,• ,	• ElEc'

,r P'JCW!J W	W

...

�T4\'Ja• R-!600.00'
l•2l4.M'
C8•SM'Jl'23"£
c-21urt

....

425---010. CURB NET

�

TYPES 5 A.-..0 & TO BE
1

16"X���	:_
1V5>•LC\l£l RTAOTEoRmWmk.'"'L,' ,

CXRECrauJ.. 9C1tE: USO£R
(SC£

f	 	

.

+

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  I	

2+00
.,...

a· P\.-c R£CtAM
R£
t:>• PVC n,

STA:2+3-4.81
OfT:&00\.T

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GVmR

•

e•

EX. POlriOt PCU	 STA. 1♦00.23, 2l.02 RT I	TO 8C RO.OCATtO	(:(H$T. &"X:4• TEE
,	tclt'ST.  VAL'tf.

1

1	cc»,,"ST. 4• WL\£
OOU:CT l.N)tR R(CUJM	�'1r���OlRT
_	ctffiT. 10• VM.\'f.

PROPOSED R./,t L"''t'

�T·U'J,s•

- - �!m.;--- - - --- - -

r ... {.:"�"�	--·-•·m• - ---	- - ---	- - ---	- - ---	- - ---	- - ---	- - ---  -	--- - -

I 		V

� r I /fVTVR£ R/fl DOXCAW-1

CS•SM"J1"2J"C
C-214...H'

NOTES:

CC,,:ST. 6'F\.A�OID
P£R roor r-;oo: 520-001

j}-�_j
I 'I	I
II .l	I

INDUSffilAL DEVELOPMENT

CCffiRACTOR TO \'tR:l'Y THE lOCATIOi, 9Z£, A,� OCPTH C1' AU ��G UllJT.ES PR.OR TO C"''ST-
2. COHRACTOR TO 0-.�J,.'�Y E»S�UTUTY MA'iHOt.LS. PUl.L 90):B. A.'D VAl\'E 80>rS TitAT fAU .,.nt-'4 f'ROPOS£0 R()AO-.A,Y A.\(J S!OEWALK A.r«. .ADJJSTED TO Fl.-..sHEO QU,0£ A"«J Aftt:. 11UJTIC RATED. IF DCDIED
"-OT 10 BE TRAfTIC RATtD BY rRA.� lm.JTY �	CQORACTOR
10 RtP\.ACE 111TH lRNTIC RATED PER: UTIHY P�OV..oot
J. CCHTRACTOR TO >.O.IJST fil. UTUf£S U0S. R:VS, V>-'4-tOt.CS. A.� VM.\'£
eo�s TO f1S{S>@ GRADE AS R(QJ"Rro.

REV 1 cITY covvnns	5/8/23  GTS
8 0 RE\1S!ONS	5/30/23  GTS

BO RE\1S!ONS 2

1/12/24

GTS

WYLD OAKS INFRASTRUCTURE

SHEET NUMBER

REV 2 CITY COlr.fVEUTS	 2/08/24

GTS

Kimley>>>Horn

0 2023 K1'.ILEY-HOfi!l AJ;O ASSOC!AITS. l\:C.
H5 24TH STRE(T, SUiJE 200, \-'£RO BEACH, Fl 32960 PHO�:E: 772-794-4100
V\'hWKIVLEY-HORN.CO\! REQSTRY UO. 35106

PREPARED FOR
KELLY PARK VB DEVELOPMENT, LLC	01

Ho.

REVlS!O.•lS

OATE	BY

CllY OF APOPKA	FLORIDA

KHA PROJECT
147864000	
DATE
02/03/23	
SCAU: AS SHOW�l	
ocsc.-.t:o ev	
ORU,'-1 BY	
0!£CX[O BY	

2/IJ/24

GRAPHIC SCALE IN FEET
0	10	20	40

DRA!NAC£ STRUCTURE TABLE	NOTtS:
J A>.Q P BOTTQ.I STRIJCnRS TO BE
C(f.'$TllVCTm PER l'DOT NXX 425-001 A'D
&	-42)-010.
CURB N.ET �s 5 A."1/J Cl TO.8!;, ,.,..,	
"."-.CU<
,.	Tff	"V'nQ.	...n.
(n.J		
	,BCl"i	lltlll.>I	��	S1uu. �Im,\;!�  10IO.\t: A�,.��
(  N�A'«:£. TO l'DOT STA\fJA.im lh1>EX
425-001.	
....,
...	.ON!J	IOtlll>l	�,..,._..,		
	P>N!J	... 121.l!			

STA. 5-HO.12, -ll.50 LT
CU.'ST. 12"X6• 1tt
CCt,'ST. g• VAL\-£
FlR£. trn:>RA.'-IT

sta. 9♦M.U. -22.50 lt

u�o·

CCtiST.	ttt
CCHST. 10• VAL\£

STA. 9♦94..2"2. -2:2.!,0 LT
cc.HST. 12"X6• TtE

r�i���\1:ll50 LT

I

/STA:10-+0J.19 CiT:34.00'U
SM  fOR fV�	C:a'\."«CTiOH
STA:1o+12.2J CiT:34.00'LT SM FOR AJ1VR£ tw.'£CTICN
�TRACTOR TO RVN
WATER w..a..'"'I. RECl.A:\I
loi'A'S,, A""3 fORCC MJ.,.'f

1

/  LNXR CAS �  (M',)

•

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:,:

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CQ,'$T, 8" VAL\t:
WIST. -4" VAL\-£

STA:5-♦1CWO Cff:38.M'RTJ
srue FOR fVM.E ta't.�CTICtl

STA. 5+10.�. 29.07 RT
�T.IO"'X6"M
eot.-ST. t0" VAL\{
CClh"ST. e• VALV£.

\	STA. lo+OJ..1a, 29.00 RT

m

CCffl:T. 10"X&•
c:th"ST. 10• VAl\t:
c:cmT. g• VAL\'t

INDUSTRIAL DEVELOPMENT

PiOTES:
I. COOTRACTOR TO \'ERif'Y TH( LOCATiOH, SZE. A.14:J D£Pnt « AU. rnsr�'iG
Ul'Ull£S PRi<1t TO Cet."ST-

rm

2. CCHTRACTCR TO 0.'9JR£ A.'<Y msr,;G UTIUTY �A."JiCUS. PlU 80)1:S, A."tlJ VAl\t: 80)1$ MU		'Nnt"N PROPOS£O ROADWAY A.'J:J SOO'J.U( A.� AO,J,JSTED TO �	QU,0C A.VJ A.'U: TIWTIC RATED, F 0£0IED t<.OT TO 8E TRAFnC RATtO BY fRA.� UTUTY PROY.OER, �TRACTCR TO RCPLACC NT'H 11WTIC RATED PfR UlUTY PRO\UR.

au«

l. WHRACTCR TO AOJJST ALL unJT£S U>S. R'cUS. MA.'1KUS, A.� VAL\'E
eoxrs TO JNg.£0	AS f.!QJ.REO.

147864000

REV 1 CITY COVVEliTS	5/8/23  GTS	Kimley>>>Horn	KHA PROJECT

SHEET NUMBER

8 0 RE\1S?0,1�S
a o RE\1s1m�s 2
Rtv 2 CITY cow..•EtHS

5/30/23
1/12/24
2/08/24

GTS
GTS GTS

C 2023 K1\ILEY-HO::lll AHO ASSOC!Al(S. l��C.

DATE
02 03/23
SCALE AS SHO'h'N

WYLD OAKS INFRASTRUCTURE
PREPARED FOR

SADLER ROAD ROADWAY PLAN

445 24TH SJRC:EJ, SUii[ 200. 'It.RO BEACH, fl. 32960	C£S:G,'\'[0 BY

KELLY PARK VB DEVELOPMENT, LLC	02

!
1 �lo.

REV.S!ONS

DATE	BY

PHONE: 772-794-4100
'ftlm.KIVLEY-HOfUI.C0'-1 REG>STRY IIO. 35106

M:Alli� BY CHE0:(0 BY

CITY OF APOPKA	FLORIDA

2/13/24

I

Ii
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I
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Hr,•

&&

TABl(	
........	1'A'.	....
Vt)	..,..
(tl)	
..,.
...,	"'""'	
llitlll12	
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.,	
5HllltlD	
RM.UU7	",Ixll 'i	
... ,
..,,	
&NIT	
et HUS	t�	
	NND	Bt ltltl	11uo;,1	

DRAINAGE STRUCTURE

f,/OT[S:

1J.A."ZJ P 80TTOl,I STRUCl\ftES 10 8C
CCtismucrm POI: ft>OT N>CX •2s-001 A."D 42S-01Q.
2. 0..ft8N.£TT'IPCS5A.'4J6T08C
CCHSTRUCTCD P£R FOOT N)O( 42S-021.

_£ l. ���!}�51, 0-25 TO 8E CAST IHTO
&

·"-5'	"-5'•

t.lATCH LINE�HEET 07

GRAPH!C SCALE �I fTET

♦

9	1�  2.0	4_0

·PROPOSED R/W lH

STA. ���a. .-:�3a4�?'-	

1	lJ WJ

c::ctlSr. 10" VAL\£	...................,r,,. E.Jd

an

DEttcC::.r·.�tJ
A."JJ SOOUrUC
RAW PER fl)()f
NXX52l-oo2
(M'.)
SlA:lz.t-87.47
C'IT:1&00"\.T

f"f!(:KYDRA.'H STA. 14+10.04, -2&.$2 ll
CC.H'Sf. 12�,- TC£'
CONST. 12" VALW:
CCHST. 6° VALVE

-�:.����$0 LT
CONST. 12' YAl\{
STA. Ot2.Ut, 37.41 RT
.CCHST. u-• VAL\£
_STA. 14+02.4t, -22.49 LT
CON$T. 12''X6• 1U
.£0HST. 1• YALW:

.STA:IHK.5,J OfT:J&.00'\.T
SM roq run.rte t:a-.'1:Cn()I
...,..,

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C'Ch"ST. CONCR£1t $00'JJ.J(	\ --	&C0.,�110\S STVB rM FUl\.lRE CfA."i(CTIW

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PltCPOSCD R/fl lH	CClh'ST.	ra::
ca,.-sr. 4' VAL\'E
CfflST. 4• PWC

GAS A.'<J D.LCTltCAi..
srues rOAruTI.RE

sec u  auo� rCR

-;fr:�

occ.,ufToNnJ TJOH Cl" BOX
STA. 1l+71.◄4. 22.97 RT
CONST. e·xa· ttt COh'ST. e• VAL\£ c:o,,tST. a• VU.YE

-�;��.�••�"  RT
CONST. a· VAL�
COHST. 4" VAL\'E
-:�·}�7�:�����

nRC Hlt)fU.'fT

-�t����J.00 RT
CCh"ST. a• VAl\-t
CCh'ST. 4" VAL\£

&

�-..cc�
STA. 00+00.00
t ca.-sr. cmc. CAi\£•

t

STA. 13+5.$.II
C:C,.,'ST. SADl£.R RO>l>

STA:1l+M.40 OfT:32..ll'RT STVO fOA 1\ITI./5'(( W,NtCTiai

NQT[S:
t. tcffTRACTM 10 \Otlf'Y n£ LOC>.nct4, 9ZC.. A.� DEPTH CF All DOSllh'<.1
U1'.JffS PfWR TO cc,._'ST-

eron

1. C0"f1RACTOQ 10 0.�	A.'ff OOSTNG UttJTY MA.'ff:ll.£S. PUU.. 90):£$,
A.'4J VM..\'E	TMAT f"AL.L WIJH)f PROPOSCO ROAO.-AY ,._,-r, SCO'AlX
AAt. AO.AJST[O TO rH9£D QU,D£ ,._..,, AAf_ nu.rnc RATtO..F oco,m
1'0T TO 8£ TlWTIC RATED BY FRASOfS[ UTUTY PltOW)(R, camtA.ClOA TO R£PlJ.C£ '111TH TR>JTIC RATrD POI ururv PROYOUl
COHlRAC:TM TO MAl'ST AU. UTIJTICS U0S. R.US. VA'iHCU� A\'O VAL\'E
BOXES TO FMS«.D CRA.DC AS RCQWtCO.

INDUSTRIAL DEVELOPMENT

REV 1 CllY COVVEtHS	I 5/6/2J IGTS I	_
e o REVIS!oNs	Is/J0/2J Icrs I	V 1�In,•""'" U 	 _

--	- I	------	V./.{_V.J/L.J

e·o REViS1m1s t2	( 1/12/24 I GTS f	1'-11 I llr-:V ,,,  I II.•1 11	I	0ATE	I WYLD OAKS INFRASTRUCTURE

PREPARED FOR

REV 2 CITY C0VVOITS	f 2/06/24 f GTS I	I	I
..., n,1, .,.,..,,_ ..,_._.a,_.,, • .,..,.,,..,., .... ,,.,-	I\:> �un.•1
Kt=LLY PARK VB DEVELOPMENT, LLC

SADLER ROAD ROADWAY PLAN

SHEET NUMBER

03

.--,........� ,, ...-,,.	,uu
Y,,1,"Nl(lVt rv-MMU r:f'lu  RF"r:.iC:TAV flt\ "\C..tAA

  I ()RAJ,•, 8Y   --1

t"J.n't'".-rn •v

f'ITV f'lr- APf'\PltA

FLORIDA

2/ll/24

f
I
i
t
GRAPH.JC SCALE L1l fEE T
0	10	20	◄0

I	ORA!NACE	
STRUCTURE TABLE
I	
	m(U( fff  7-8- ":if	
	...,
...	·""	n1.n	::J	
		
4MIT	
ltlttaD	1�4JM
::,41J	
	.0.-JI
,,	
•Mll	
lltUW		
		f1 NIT	nt nu,	1<&0:,)	
	.-.-,�,	"""	0Jt11W	m-WN	
		f1 NIT	...'""	'""'')	

&
NO!tS:
J A."IIJ P eonou STRUCl\.ft£S 10 BE CCfiSlRUCTID POt rDOT N)C)( OS-COi A� 42$-010.
0JR9 N.[1nPCS � "-'1> 6 TO BE

I

=

�  42S-  .

SJA.�;t 1;!::.0�
OCMST�.. YAL'il

3	STA.  lltC4C4H..S"0TI"..'1-"22"·&x'a".5·"01't"lt :l\r't:

S'M.11 RHERTOUASI C:A.-.D!loGPV..o.:J

□
TO	1 /IIDTJt TO
.	OU<>'!Q P\A\'S)

a•

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CCNST. 12• VAL\'£
CC,.:SJ.  YAL\t
�ST. cx;t;CRCT£ s«W>VC

STA. 27♦11,JO. -:1...o L�-,
CCHST. 12�• � 1
COl"ST. � VALVE

CCffST. 12�10" Tt£	b
COH'ST. to• YAL'wt	�	I

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n.£C	R£C .....

CCHST, 11I YAL\t:

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., 	 .,_t- 	 ,..	 ., 	 ,..	 ..,	 ,..		,,_
T

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STA. uc+c.tmU:r&. ,.oH·n.0·8 RT
cc.HST. 10" VAL\-t
CONST. &• YAl�

STA. 2.lH0..27, 2t..OO RT c:Gl'ST. to"XI· TIE CCliST. 10" YM.'wt
CONST. a• YAL'wt

INDUSTRIAL DEl/'ELDPMENT

I

!"-EX. PAA<n LN:

I I
I

REV I CllY COVVOITS
B'O RE\1�0.'�S

5/8/23
5/30/2J

GTS
GTS

810 R(VlS!O.'lS 2	1/12/2◄  GTS

Kimley>>>Horn

SCAU AS SHow,,

0ATE
02 D3/23

KHA PROA:CT
147864000

SHEET NUMBER

WYLD OAKS INFRASTRUCTURE

!i=-+-R"EV"-2'C-I.T.Y.C.O.V.\.IE,N,T!S.!..!..._=='=	�2/0=8/2�◄�GTS

PREPARED FOR

�l t--t--------------------f	4-�
!l1--t----------------4---1	1

0 2023 K1VLEY-HO-.�/I AND ASSOCIATES. 1\C,

O<EO<CD BT

OC.S<,..,ED 8T

4'45 24TH SJR££1. SUH£ 200, \'ERO BEACH, fl J2960 PHONE: 772-794-4100

KELLY PARK VB DEVELOPMENT, LLC	05

MAVNll1"

Pio.

RE\'IS!ONS

0ATE	BY

V.WN,KIVLEY-HORN,CO\I  REGiSTRY UO, J5l06

CITY Of APOPKA	FLORIDA

2/13/24

REQUISITION

The undersigned, an Authorized Officer of Golden Gem Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture between the District and U.S. Bank Trust Company, National Association, Fort Lauderdale, Florida, as trustee (the "Trustee"), dated as of June 1, 2024 (the "Master Indenture"), as amended and supplemented by the First Supplemental Trust Indenture between the District and the Trustee, dated as of June 1, 2024 (the Master Indenture as amended and supplemented is hereinafter referred to as the "Indenture") (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):
Requisition Number: 06

Name of Payee:	Kutak Rock LLP

Amount Payable:	$9,079.00

Purpose for which paid or incurred (refer also to specific contract if amount is due and payable pursuant to a contract involving progress payments, or, state Costs of Issuance, if applicable):
Fund, Account and/or subaccount from which disbursement is to be made:
Series 2024 Acquisition and Construction Account

The undersigned hereby certifies that obligations in the stated amount set forth above have been incurred by the District, that each disbursement set forth above is a proper charge against the Series 2024 Acquisition and Construction Account and the subaccount, if any, referenced above, that each disbursement set forth above was incurred in connection with the acquisition and construction of the Phase 1 Project and each represents a Cost of the Phase 1 Project, and has not previously been paid.
The undersigned hereby further certifies that there has not been filed with or served upon the District notice of any lien, right to lien, or attachment upon, or claim affecting the right to receive payment of, any of the moneys payable to the Payee set forth above, which has not been released or will not be released simultaneously with the payment hereof.
The undersigned hereby further certifies that such requisition contains no item representing payment on account of any retained percentage which the District is at the date of such certificate entitled to retain.

A-1

Originals or copies of the invoice(s) from the vendor of the property acquired or services rendered with respect to which disbursement is hereby requested are on file with the District.
GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

CONSULTING ENGINEER'S APPROVAL FOR NON-COST OF ISSUANCE REQUESTS ONLY

If this requisition is for a disbursement from other than the Costs of Issuance Account, the undersigned Consulting Engineer hereby certifies that this disbursement is for a Cost of the Phase 1 Project and is consistent with: (i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the Phase 1 Project with respect to which such disbursement is being made; and (iii) the report of the Consulting Engineer attached as an Exhibit to the First Supplemental Trust Indenture, as such report shall have been amended or modified on the date hereof.

Consulting Engineer
Kevin M Roberson, Senior Vice President
Kimley-Horn and Associates, Inc.

A-2

A-3

K U T A K  R O C K  L L P
TALLAHASSEE, FLORIDA
Telephone 404-222-4600
Facsimile 404-222-4654

Federal ID 47-0597598

May 29, 2024

Check Remit To: Kutak Rock LLP PO Box 30057
Omaha, NE 68103-1157

ACH/Wire Transfer Remit To:
ABA #104000016
First National Bank of Omaha
Kutak Rock LLP A/C # 24690470
Reference: Invoice No. 3396251 Client Matter No. 47123-2
Notification Email: eftgroup@kutakrock.com

Golden Gem CDD
c/o Governmental Management Services 219 East Livingston Street
Orlando, FL 32801	Invoice No. 3396251
47123-2

Re:	Bond Validation
For Professional Legal Services Rendered

04/02/24	J. Gillis	0.60	105.00	Confer with Orange County Clerk	
				regarding fee for certificate of no	
				appeal; draft certificate of no appeal;	
				draft cover letter to Orange County	
				Clerk regarding same	
04/02/24	A. Willson	0.20	63.00	Review and revise certificate of no	
				appeal; confer with Gillis regarding	
				same	
04/19/24	J. Gillis	0.20	35.00	Finalize certificate of no appeal and	
				letter	to	Orange	County	Clerk	
				regarding	same;	coordinate	
				dissemination of same	
04/24/24	J. Gillis	0.40	70.00	Follow up on status of certificate of	
				no appeal	

TOTAL HOURS	1.40

KUTAK ROCK LLP
Golden Gem CDD May 29, 2024
Client Matter No. 47123-2 Invoice No. 3396251
Page 2

TOTAL FOR SERVICES RENDERED	$273.00

DISBURSEMENTS

Miscellaneous	7.00 VENDOR: ORANGE COUNTY CLERK	OF	COURT; INVOICE#:  040324;  DATE:
4/3/2024 - Filing Fee - Certificate of No Appeal for Bond Validation

TOTAL DISBURSEMENTS	7.00

TOTAL CURRENT AMOUNT DUE	$280.00

K U T A K  R O C K  L L P
TALLAHASSEE, FLORIDA
Telephone 404-222-4600
Facsimile 404-222-4654

Federal ID 47-0597598

May 29, 2024

Check Remit To: Kutak Rock LLP PO Box 30057
Omaha, NE 68103-1157

ACH/Wire Transfer Remit To:
ABA #104000016
First National Bank of Omaha
Kutak Rock LLP A/C # 24690470
Reference: Invoice No. 3396252 Client Matter No. 47123-4
Notification Email: eftgroup@kutakrock.com

Mr. George Flint Golden Gem CDD
c/o Governmental Management Services 219 East Livingston Street
Orlando, FL 32801	Invoice No. 3396252
47123-4

Re:	Series 2024 Construction
For Professional Legal Services Rendered

04/01/24	J. Gillis	0.70	122.50	Draft cost share agreement for Wyld	
				Oaks construction project	
04/01/24	A. Willson	1.10	346.50	Review construction and acquisition	
				items;	confer	with	Edwards	
regarding same
04/02/24    A. Willson	0.60	189.00	Call   with   team   regarding
construction acquisition items 04/05/24    J. Gillis	0.80	140.00	Confer   with   staff   regarding
acquisition of phase 1 project improvements;	prepare memorandum, checklist and sample forms regarding same
04/05/24	A. Willson	0.80	252.00	Confer with Kaleita, Beninati, Barry,
Edwards	and	Cadence	team	
04/08/24	A. Willson	4.60	1,449.00	regarding construction items Review	and	revise	forms	of	
04/09/24	A. Willson	1.60	504.00	construction acquisition items
Review permit transfer application	

04/10/24	
J. Gillis	
0.60	
105.00	and plat; confer with team regarding construction, plat and permit items
Draft  temporary  construction  and	
				access	easement	agreement	with
Kelly Park VB Development	

04/10/24	A. Willson	1.10	346.50	Confer	with	Kaleita	regarding
acquisition items
04/11/24	A. Willson	1.20	378.00	Review construction, acquisition and
assignment items; confer with team regarding same
04/12/24	A. Willson	1.40	441.00	Review	and	revise	construction
assignment documents
04/18/24	J. Gillis	0.30	52.50	Review	contract	assignment
documents and confer with staff regarding same
04/25/24	J. Gillis	1.80	315.00	Draft	assignments	for	site
construction agreements with RCS for both infrastructure and mass grading improvements with acquisition	of	completed improvements to date
04/25/24    A. Willson	0.40	126.00	Review  and  revise  construction
contract assignment documents 04/26/24    A. Willson	1.40	441.00	Review  and  revise  construction
assignment documents
04/29/24    J. Gillis	1.20	210.00	Review  and  revise  assignment
packages for site construction agreements with RCS for both infrastructure and mass grading improvements with acquisition of completed improvements to date; confer with staff regarding same
04/29/24    A. Willson	1.80	567.00	Review  and  revise  construction
assignment documents and temporary construction easement; confer with Edwards regarding direct purchase of materials
TOTAL HOURS	21.40

TOTAL FOR SERVICES RENDERED	$5,985.00	
TOTAL CURRENT AMOUNT DUE	$5,985.00	
UNPAID INVOICES:		
February 29, 2024	Invoice No. 3355544	280.50	
March 29, 2024	Invoice No. 3368718	976.50	
April 30, 2024	Invoice No. 3382994	126.00	
TOTAL DUE	$7,368.00	

KUTAK  ROCK  LLP
TALLAHASSEE, FLORIDA
Telephone 404-222-4600
Facsimile 404-222-4654

Federal ID 47-0597598

June 29, 2024

Check Remit To: Kutak Rock LLP PO Box 30057
Omaha, NE 68103-1157

ACH/Wire Transfer Remit To:
ABA #104000016
First National Bank of Omaha
Kutak Rock LLP
AIC # 24690470
Reference: Invoice No. 3412072 Client Matter No. 47123-4
Notification Email: eftgroup@kutakrock.com

Mr. George Flint Golden Gem CDD
c/o Governmental Management Services 219 East Livingston Street
Orlando, FL 32801	Invoice No. 3412072
47123-4

Re:	Series 2024 Construction
For Professional Legal Services Rendered

05/02/24

A. Willson

0.60	189.00

Confer with Kaleita and Flint regarding construction easement items

05/03/24
05/08/24

05/09/24

05/14/24
05/14/24

05/16/24

05/17/24

A. Willson

A. Willson

A. Willson

J. Gillis
A. Willson

A. Willson

A. Willson

0.20
0.40

1.50

0.30

0.30

0.30

63.00

126.00

126.00

262.50

94.50
94.50

94.50

Confer	 with	 Edwards	 regarding construction assignment items Confer	with	Edwards	regarding construction acquisition; confer with Taylor	 regarding	real		property acquisition items
Work session with Gillis regarding real property acquisition documents Draft	acquisition	package	for unimproved land
Confer	with	Taylor	regarding acquisition of property
Confer	with	Edwards	regarding acquisition items
Confer with Edwards, Kaleita and Benenati regarding construction acquisition items

KlJTAK KUt;K LLP
Golden Gem CDD June 29, 2024
Client Matter No. 47123-4 Invoice No. 3412072
Page 2

05/20/24

A. Willson

1.70	535.50

Prepare land acquisition items; confer with Gibbons, Beninati, Roberson and Edwards regarding assignment of agreements

05/21/24	A. Willson	0.20	63.00	Confer	with	Roberson	regarding
construction requisition process	
05/21/24	A. Willson	0.40	126.00	Review change order; confer with	
				Edwards,	Beninati,	Barry	and	
				Gibbons	regarding	construction	
				contract assignment	
05/22/24	A. Willson	0.40	126.00	Review cover letter to RCS; revise	
				assignment	documents	to	reflect	
				comments from Barry	
05/23/24	A. Willson	0.20	63.00	Continue	rev1ewmg	construction	
				assignment	items;	confer	with	
05/28/24	
A. Willson	0.20	
63.00	Gibbons and Barry regarding same
Confer	with	Walda	regarding property conveyances	
05/29/24	A. Willson	0.60	189.00	Confer with Taylor, Edwards and	
				Kaleita regarding conveyance of real	
				property items	
05/29/24	A. Willson	0.50	157.50	Confer	with	Walda	regarding	
				purchase and sale language	
05/30/24	A. Willson	0.80	252.00	Confer	with	Flint,	Beninati,	
				Edwards,	and	Kaleita	regarding	
construction	assignment	and	real property acquisitions	

05/31/24

A. Willson

0.60	189.00

Confer	with	team	regarding construction and acquisition items

TOTAL HOURS	9.60

TOTAL FOR SERVICES RENDERED TOTAL CURRENT AMOUNT DUE

$2,814.00
$2.814.00

REQUISITION

The undersigned, an Authorized Officer of Golden Gem Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture between the District and U.S. Bank Trust Company, National Association, Fort Lauderdale, Florida, as trustee (the "Trustee"), dated as of June 1, 2024 (the "Master Indenture"), as amended and supplemented by the First Supplemental Trust Indenture between the District and the Trustee, dated as of June 1, 2024 (the Master Indenture as amended and supplemented is hereinafter referred to as the "Indenture") (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):
Requisition Number: 07

Name of Payee:	RCS Construction Co. Inc.

Amount Payable:	$104,618.31

Purpose for which paid or incurred (refer also to specific contract if amount is due and payable pursuant to a contract involving progress payments, or, state Costs of Issuance, if applicable):
Fund, Account and/or subaccount from which disbursement is to be made:
Series 2024 Acquisition and Construction Account

The undersigned hereby certifies that obligations in the stated amount set forth above have been incurred by the District, that each disbursement set forth above is a proper charge against the Series 2024 Acquisition and Construction Account and the subaccount, if any, referenced above, that each disbursement set forth above was incurred in connection with the acquisition and construction of the Phase 1 Project and each represents a Cost of the Phase 1 Project, and has not previously been paid.
The undersigned hereby further certifies that there has not been filed with or served upon the District notice of any lien, right to lien, or attachment upon, or claim affecting the right to receive payment of, any of the moneys payable to the Payee set forth above, which has not been released or will not be released simultaneously with the payment hereof.
The undersigned hereby further certifies that such requisition contains no item representing payment on account of any retained percentage which the District is at the date of such certificate entitled to retain.

A-1

Originals or copies of the invoice(s) from the vendor of the property acquired or services rendered 1.vith respect to which disbursement is hereby requested are on file with the District.
GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

Authorized Officer

CONSULTING ENGINEER'S APPROVAL FOR NON-COST OF ISSUANCE REQUESTS ONLY
If this requisition is for a disbursement from other than the Costs of Issuance Account, the undersigned Consulting Engineer hereby certifies that this disbursement is for a Cost of the Phase 1 Project and is consistent with: (i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the Phase 1 Project with respect to which such disbursement is being made; and (iii) the report of the Consulting Engineer attached as an Exhibit to the First Supplemental Trust Indenture, as such report shall have been amended or modified on the date hereof.

Consulting Engineer
Kevin M Roberson, Senior Vice President
Kimley-Horn and Associates, Inc.

A-2

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF	PAGES	3

TO OWNER:
Kelly Park VB Development. LLC
660 Beachland Blvd. Vero Beach, FL 32963 FROM CONTRACTOR:
RCS CONSTUCTION CO. INC. 295 E. HWY 50 SUITE I
CLERMONT, FL 34711 CONTRACT FOR:

PROJECT: Wyld Oaks

VIA ARCHITECT:

APPLICATION NO: 7
Revised 7/18/24

PERIOD TO:	7/11/24

PROJECT NOS: CONTRACT DATE:

Distribution to:

§

OWNER ARCHITECT CONTRACTOR

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment. as shown below, in connection with the Contract. on1inua1ion Sheet, AIA Document 0703, is auached.

The undersib'lled 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 1ha1 current payment

ORK,IN I CON I RA( I Sil 1
2	ct chance by Chance Ordcn,
l. CO  I RACl \l  I 10 DAT[ (I me I  1)
4 I OTAL COM PU fl D & SI ORLL> TO
DATE	(Column O on 0703)
RETAINAOE:	�4h.60X 29

	6.520,ll2X07 
	69.7, 7.00 
6.S."9. I •.07
	-1,9CJ9,0l,5.77 

shown herein is now due.

	5_%ofComple1ed Work		 (Column D + Eon 0703)

Slate
Subscribed and sworn to before me this

County of: LAKE
11th day of July. 2024

5 % of Stored Material

U45.00

Notary Public:_,,, ,,,,.,rvcv,.,,a-

(Column Fon 0703)		

Total Retainage (Lines 5a + Sb or

ENGINEER'S CERTIFICATE FOR PAYMENT

da
in&
2025

fotal m Column I ol Ci703 I
IOIAI IAR IDITS�RFIAI  A(il
(Line 4 Less Line 5 Total)
LESS PREVIOUS CERTIFICATES FOR		
PAYMENT (Line 6 from prior Certificate)
8 ( lJRRF T P·\Y fl T Dlll
'I RAI.A Cl IO I INISII, INCI l'DING RI· JAi AGE
(Line 3 less Line 6)

Total Completed and Stored To Dale That is Eligible For COD Paymen Total Retainagc At 5%

	249.953.2'1
	4.749.J12.4H 

$	4,302.271.03 
	44b,8414'i 
	I ,840,702.5<l

	1,424,562.20 
	71,228.11

...

In accordance with the Contract Documents. based on on-site observations and the data comprising the application. the Enb,ineer certifies to the Owner that to the best of the Engineer'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.
AMOUNT CERTIFLED ........... $	446,841.45
(Auach expla11atio11 if amou111 certified differs ji-0111 the amount applied. Initial all figures 011 this Application a11d 0111he Conti11uatio11Sheet that are changed to conform with the amount certified.)
ENGINEER:	�	Kevin Roberson, Kimley-Horn and Assoc.

Total Earned Which Is Eligible For COD Payment. Less Retainage

	1,353,334.09 

By:	1ffei

7-24-24

Less Amount Previously Paid By COD Current Payment Due By COD

Total ompleted and Stored To Date - Elib,iblc For KPVBD Payment Total Retainage Al 5%
Total Earned Which Is Eligible For KPVBD Payment Less Retainage Less Amount Previously Paid By KPVBD
Current Payment Due By KPVBD

	1,248,715.78 
104.618.31

3.574.503.57
	178,725.18 
	3,395.778.39 
	3,053,555.25 
342.223.14

	fVI	Date:		

This Certificate is not negotiable. The AMOUNT CERTLFIED is payable only 10 the Contractor named herein. Issuance, payment and acceptance of payment arc without prejudice to any rights of the Owner or Contractor under this Contract.

CMANOE ORDER SUMMARY	ADDITIONS	DEDUCTIONS	
Total changes approved in previous months by Owner	$69.787.00	$0.00	
Total a  roved this Month	$0.00	$0.00	
lOfAIS	69,7 7.00	.0.00	
NL· I Cl IAN<,I. bv Chan •e Order	69.787.0(1		
			
IA DOCUMENT G702 APPLICATION ANO CERTIFICATION FOR PAYMENT 1992 EDITION AIA C>1992	THE AMERtCAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE.• NW, WASHINGTON. DC 2000e:-52V2
Users may obtain validation of this document by requesting a completed AJA Document D401 - Certification of Document's Authenticity from the Licensee.
••• Co111rac1or a�rees rlwt O-,..,,er will pm ll'ith 1rl1a1 f1111di11�,s nwulable wl,ich ma, 1101equal rhe C11rreut Pnrmelll Due. A11v u11pn1d balance will remain 011 acco11111 /or Owner 10 paJ with furure fu11ds.
ote: Items in RED FO Tare automaticall  calculated from the G703 form or from item within this G702 Form. Do  OT hand enter the e item on this sheet.

DEVELOPER'S REPRESENTATIVE CERTIFICATE FOR PAYMENT

Wyld Oaks- Mass Site Gradin,: Pay Application #7 Pay Application Period Throu,:h 7/11/24

In accordance with the Contract Documents, based on on-site observations and the data comprising
this application, the Developer's Representative certifies to the Owner that to the best of the Developer's Representative'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.

AMOUNT CERTIFIED.	$446,841.45
(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.)

DEVELOPER'S REPRESENTATIVE:

By:	Date:

	7/24/2024	
Name: 	 Timothy R. Dennard	 Title:'		President
This Certificate is not negotiable. The AMOUNT CERTIFIED is payable onJy 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 l>oc1Nncrit G702., APJ>UCA 11ON ANDCERTlflCA"l1ON!'OR PAYMENT.1·on1aining
C'ontractor's siftl\cd ccrtilkaunn 1s atl3choJ	APPLICATION NO, 7 APPLICATION DATE,	711112024	

UscColwnri I on Contracis where ,-anahlc rctouna�c for lineitems11\3V apply.	PERIOD TO, ARCHITECT'S PROJECT NO·	7/1112024	

A	IJ	("			F		II	I	J		K	I	L	M	I	N	I	(l	I	
11'1.:M
NO	

l)f.�'Rll"I JONOf- \\'ORK	SCIIEUUlXD
VAi.iii:	W"OR	COMPI Ell.I)•	MAIERIAl..5 PRFSENTI.Y Sl'ORf:U (NOTIN
DORE)	IOIAL
COMPI h"Tl:J) ANUSTOREIJ lUOATI:.
(l)•E•n	

((i	,,,
(.')	
llA(.AN('l:.
ro l'INISII
(C-GJ	
RE'IArNAGE
CaK'11la1ed at S%		COO	l•n1tibilnv		1t1'VUO I.U,1b1.b1y	
			fROM l'RfVIOUS
Al'l'UCAl'lON O>•E)	1111SPl:RIOD							o/.tll,.ilw:t(\f
l'a)'TTrnl Dyl'DD	I oialCOftl)lc1cd Ard
Swred'rt:>l>a1e
l�iblel·orJ'a)Urrl
llv('DD	
fo11I(f)IJKcu,1n!1.RC
(pis,.,	•:;. Flqi.ible F,or
Pa)menl IJy
KJIVJ!I)	TuWCoo�lc1edArtl
StQfOJ To Dale
l;lqtible h•r P1yrra1
llvKPVUU	
TNalKJ'VOI)
Rctaimj?'e/jl s•.		
		Qw""'	Unit	'"''	T°"I																
	iChf'rnl {;ondi1 on�.l\1obUl.lll •n. :SUr\CV																			
1.	MOBIUZATION	l	LS	S2SO 000.00	S1SO.OOO.OO	S:?50.000.00	S0.00		S:?50.00000	100�♦	S0.00	S12.500.00	997'1	$24.92500	SU462S	9001•�	S:?25.075 00	SI 1.251 75		
2.	ATTORNEY FEE	I	LS	S95 000.00	595.000.00	595.00000	S0.00		S95.00000	100-'.	S0.00	$4,750.00	9.97".	S9.411 SO	$471�	9003•,	S8S.S28 50	S-t276 41		
3.	GENERAL CONDITION$	I	LS	S21457.44	521.457.44	519,500.00	S0.00		519.SOO.OO	91�.	$1.957.44	S97S.00	9.97",	Sl.9� 15	S97 21	90.03',,	SI 7.555.85	S8?779		
4,	PERFORMANCE BONO	I	LS	SSO 494.SO	580.494 50	SS0.494.50			S80.494 .SO	100.,.	sooo	S4,02'173	9.97"/4	S8,025 JO	$401 27	9003•·	S72.469 20	S3.623 "'6		
5.	LAYOUT/ASBUILTS	1	LS	$48 391.2S	S48.391 25	SJl,700.00	SS.500.00		$37,200.00	11',	Sll,19U5	Sl,86000	9.97"•	SJ.708.84	$18544	9(1.03•,,	SJJ.491.16	$Ui7J..56		
6.	SWWWP	I	LS	S10 003.75	SI0,003 75	$7,650.00	S950.00		58.60000	86•1,	SI .403 75	S43000	9.9�♦	S857 42	$42117	9(!03',	$7.7-l2.5&	S387 tJ		
7.	SILT FENCE	I	LS	S38 618.08	S.38.618.08	$38.618.08			S38.618.08	100'1•	sooo	Sl.9)-090	9.97",	S3Jt50.22	$19:..SI	90.03'•	SH.76786	51.?,8 l9		
8.	TREEPROTECTION	1	LS	S19 718.90	519,718 90	S0.00			sooo	o••	519.718.90	S0.00	99,-A,	sooo	sooo	9003',,	sooo	sooo		
9,	CONSTRUCTION ENTRY	2	EA	�12 461.65	$24.923 JO	$5,000.00	$7.500.00		SL'.!,500.00	50'/4	$12.42] 30	S625.00	9_9,-;.	Sl.246.25	562 JI	90.o:m	SI 1.253 75	5562.69		
10.	CLEAR srr '1lMVL00AKS	I	LS	$S2000.00	$52.000.00	$49,000.00	53,000.00		s.s2.ooo_oo	100-,.	S0.00	S2.600_00	9_9.,...	S�U84-W	S259.,.,	9003•,	S46.815 60	S2,.l4Q 7tl		
11.	DEMO STRUCTURES •WYLO OAKS	1	LS	$34500.00	SJ.-1.500.00	5)..i.500.00	S0,00		5)4.500.00	100'1.	S0.00	Sl.725.00	9.9.,..	S3.439.65	$171 98	9003'·•	S31.060.35	51.55302		
12.	DEMO PAVEMENT	3658	SY	SS.92	$21,655.36	SI.S.800.00	$3.000.00		$18,80000	rn,	S2.855.J6	S9.:&000	9.9?t'A	Sl.874.36	S9.l72	900)•-·	$16.925 6-1	5$46 28		
13.	OEMO CONCRfTE	960	SY	S9.S6	S9.177.60	SR,000.00	SI ,177.60		59.17700	100�.	sooo	5458.88	9.97"i-	$91501	$45.75	9001•,,	58 26'2 59	S413 13		
14.	MASSGRADE	1273657	CY	S>.42	SJ.082.24? 9.1,	S2.6k4.30�.00	5180,000.00		$2.864.308.00	93%	5217.941.94	$143,'21.S.40	9.97°o	$285.571.51	514,278.58	90,03..a	52.578.7]6 49	5128.936 R2		
15.	DEMO GOLDEN GEM PROPERTY	I	LS	sss 333.23	555.33) 23	S33.2SO.OO	SIl.000.00		S44.250.00	80'/e	SI 1.083 2J	$2.212.50	9.974',.	S4,41l 73	5220.59	9003'1•	$39.838 28	S1.99191		
16.	OOUBLE SILT FENCE FOR STOCK PILE AREA	3800	LF	$4.35	516.530.00	S0.00			S0.00	o�.	516.530.00	S0.00	997'•	sooo	sooo	9003••	sooo	sooo		
17.	HYDRO SEED STOCK PILE AREA	S7000	SY	Sl.00	$57,000.00	S0.00			S0.00	0%	557,000.00	S0.00	9.97'-,	S0.00	SO.(IO	90.03�•	S0,00	S0.00		
18.	OVER EXCAVATE SOILS AREAS S' IN DEPTH	47682	CY	ss.s2	$263.204.64	5105.112.0D	$145,000.00		5250.11200	95•1,	SJJ.092.6-l	$12.505.60	9.97o/,	$24,936 17	$1,246.81	90 03�♦	$225.175.83	511,25879		
19.	GRADE SITE	I	LS	S42 707.00	$42.707 00	S0.00	$14,000.00		$14.000.00	33•-.	$28.707.00	S700.00	9.9701.	Sl.39.S il.O	$69 79	9003',	512.604.�	S6l0 21		
20	EROSION BLANKET	l	LS	c;2s 851.20	525,851.20	S0.00			sooo	0%	525,SSI 20	S0.00	9.9.,.,	sooo	sooo	9003•.	sooo	sooo		
21.	WELLA80NOONMENT• WYLD/GOlDEN GfM	4	EA	S9 700.00	S38.XOOOO	S18.500.00	S0.00		SIIC.500.00	48•,	SZ0.30000	s<.>25.00	9.9�♦	SI.X44 45	$92 2::!:	90.03'-•	$16.655.55	S832 78		
22.	CLEAR SITE/GOLDEN GEM	1	LS	�51 000.00	$51,00000	524,000.00	S\5,000.00		S39,000.00	76',-;.	s12.000.00	S1.950.00	9.97�•	SJ,888 10	Sl94 4'.!	9003'1.	S35,IJI 70	51.755.59		
23.	SODPONDS	67270	SY	S4.81	SJ:!.l,568.70	S0.00			sooo	0%	5323,5611 70	S0.00	9_970/4	sooo	sooo	90.03%	sooo	sooo		
24.	PONDLINER 30 MILL	20645	SF	$3.57	$73.702.65	sooo			S0.00	o•,	$73.70:! 65	SOBO	99,-/.	S0.00	sooo	90OJ•�	sooo	S000		
25.	HYDRO SEED BOTTOM OF PONDS	72900	SY	�1.00	$72,900.00	S0.00			S0.00	o,.	572,900.00	S0.00	9.9-r1,	S0.00	S0.00	90.0J•,,	S0.00	S0.00		
26.	OEWATERING	I	LS	S30 000.00	SJ0.000.00	S0.00	514.000.00		S1-'.000.00	47♦-♦	$16.00000	S700.00	9.9-r1•	SI J95.&0	S6979	9003'0	S12.60420	S6J0 21		
27.	SEED/MULCH	I	LS	c;354 813.60	SJ�.813.60	5000			sooo	0'♦	S35-UI) 60	sooo	9.970,,	sooo	sooo	9003.,,.	sooo	sooo		
28.	60" HOPE	1414	LF	�274.81	S388.581.34	S:!43.JR2.72	522,000.00	S0.00	S265,382.72	68�.	Sl.23.198.62	SIJ..269.14	100,.	S:!65.382.72	SIJ,269.14	o.oo•,.	S0.00	sooo		

G

Al>.DOCUU£NTGT03 CO...l!NUA'10NSl-1CETfOAG702 1II02(0HION Al>. 011192
111€..>J,A(Rl(;JtNl�TIT\ll[OfAA<:.. fE:CTS H35NEWVOf1:l'(>,\/(MJ( NW WA,$HIN()fQNOC i'Q00&,�2)2	G703-1992

All)A,:_1cument G702. Al'PIJCA'I ION AND CEltl l:FIC'A HON H)N.l'AYM�NT. contanllnl! ("on1ractor's s1�neJ ceriification i:s attacho.J

A	ll	C	fl	I	E		G	II	I	J	K	I			I	I	
ll(M
NO.	
Ol�"i<"'RIP'I IONOf "''ORK	SClll:l)UJ FD VAl.llli	WOkk C'OMl'Lb II l>	MA'll·k.1/\t.S
l'RESEN11.Y S'IORJ;I) tNOTIN DORE)	'IOIAI
COMl'U-:'11'1> JI.ND�TORJ,I) 1\)0ATh
(1)-+l�+f)	"
<G q	llAJJ\NCT l'Ql:JNISII ({.'.(j)	RfTAINAGE
Cak1.d;oitod11s•.	(;l)))l:.J1<'lhlJI	Kl'VtU)l,l11t1t,dll	
			FROM l'R.l�VK>US
ArPIXA"l'l()N
(U• E)	fllr.-: PERl()I)						..,ru,ibkt-o.
PayulC'l• HyCDIJ	·101a1Colfl)lclcdAn1
SIOrt>JTo Dtl� f.ti$:iblcfort',)1'1)M
llvCDD	TonlC'OORcq;\l'llge
� j,.	·♦F�lo,
P1yn1Ct1 lly
KPVTID	TOtllll�k:'lodAn:I
S1cin:dlP l>ttc F)iJiblcl'l'lfPl)Tlli:11 llvKPVIIU	
folal KJ'VHU Rcta�c�.s,.		
		Qmmty	""	'"''	1'01.111															
29.	CONTROL STRUCTURE	1	LS	$7 33).82	S7.3JI.K2	S000	57,331.82	S2.900.00	S10,231 82	140•.•	($2.900001	5511.59	100--.	SI0.:?31 1.12	SSI 1.59	0.00•··	sooo	sooo		
30.	MANHOLE	8	EA	$8 144.54	Sf;S.156.J;):	S0.00	$14.()00.00	S.24,000 00	$)1!,000.00	58'4	S27.156..J:!	Sl.900.00	100',	$18.000.00	Sl.90000	o.oo♦•	sooo	sooo		
31.	BUBBLE UP	3	EA	$6 067.44	S\8,202.J:!	sooo			S0.00		S18 . .2023:?	SO.Ot)	100''-	S000	S000	0.00',	sooo	S000		
32.	BOX CULVERT	617	lf	SJ 317.89	SSI1,138.11	$715.104.0S	S0.00	S0.00	S?IS.10405	1111•-.	S98.0.3408	$35.755 20		S715.104.0S	$35.755 20	000',	suoo	sooo		
33.	TVLINES	1	LS	$34 017.00	534.017.00	S0.00			S0.00	o-,	534.017.00	S0.00	100�.	S0.00	S0.00	o.oo•.	S000	S000		
																				
	Chanae Orders																			
	C0#1Builder Risk Insurance	1	LS	$ 69,787.00	S697117.00	$69.787.00	S000		569,78700	I0(W,	S000	S3.4S9.35	997•.	$6,957 76	$)47.89	90 03•,	562.829 .2-1	S::l,141 46		

																				

																				

																				

																				

																				

																				

																				

	SUBTOTAi.				S6,589JHS.07	S4,528.706 JS	$443,459.4.2	S26.900.00	$'4.999.065 77	76'·•	S1.590.74930	$249.953.29		SI .424,562.::?0	S71.22&.11		S3.S74,50J 57	Sl7S,7.2518	
	GRANO TOTALS				S6.589JJ15.07	S4,528.706.35	S443.459.42	S.:!6,900.00	S-4.999.065.77		S1.590.749.JO	S249,953.29		SI ,4:?4,56.2 ':?0	S?l.228.11		S3.574,503.57	5178,7::!518	

U" Colwnn l onC"ontnictswk!fe\'a0<1blerct.aina('e f« Ii' ne,1ansmav11-1".

APPLICATION NO: APPLICATION DATE:
PERIOD TO:
,. ARCHITE-CTS PROJECT NO

0
7111/2024
7/11/2024

Users may obtain validation of this document by requesting of the hcense • completed AIA Document D401• Certification of Documents Authenticity

/l,,jJ,,.OQCUlr,'(NJG10l COl'll\""1ATIOf<Sl-ff:EfJORQJOO, IWZEOITIOH /1,,jA o,m
lk( N,1£Rt(:-.N1NS,11TlJfE Of- AAC..1w::1s ,rn ...E. w T()Fl'!C Avt:M.IE NW W�NOT� CIC l'QOOO,�	G703·11>92

PROGRESS PAYMENT AFFIDAVIT

STATE OF FLORIDA COUNTY OF LAKE

BEFORE ME, the undersigned authority, duly qualified and authorized in the State and County aforesaid to administer oaths and take acknowledgements, this day, personally appeared	Jody Bass	, who being by me first duly sworn, deposes and says:

The facts and matters contained and recited in the Affidavit are based upon personal knowledge of the Affiant.
Affiant is the Owner of	RCS Construction Company, Inc.	, a North Dakota Corporation company (hereinafter the "Contractor")
Contractor and	Kelly Park VB Development, LLC	(hereinafter the "Owner") have executed, delivered and entered into that certain CONTRACT AND AGREEMENT dated	December 4, 2023	(hereinafter the "contract").
Affiant now requests partial payment under the Contract. In Consideration of Owner providing such partial payment, Contractor hereby provides this Affidavit upon which Owner intends to rely.
Contractor is not aware of any Claims that would require an adjustment of the Contract Time or the Contract Price except for any Change Order Requests or Change Order Proposals previously submitted in writing to Owner prior to execution of this Affidavit.
Contractor releases any Claims for an adjustment to the Contract Time or the Contract Price except for those previously made in writing and delivered to Owner prior to execution of this Affidavit.
Affiant states that all bills for labor, services or materials furnished, delivered, installed or performed on the job site through the date of this Affidavit have been FULLY paid and that no lien for such may properly be filed, recorded or enforced. Waiver and Release of Lien upon Progress
Payment forms for every such potential lienors are provided herewith through 07/10/2024
Affiant states that, except as provided herein, all bills for labor, services or materials furnished, delivered, installed or performed on the job site through the date of this Affidavit have been FULLY paid and that no lien for such may properly be filed, recorded or enforced. Waiver and Release of Lien Upon Progress Payment forms for every such potential lienor are provided herewith, except as provided below:

Name of Lienor Or Potential Lienor	Amount due for labor, services or materials furnished, delivered, Installed or performed	

1.  Alta Construction Equipment	
$5,250.00	
2. Central Florida Turf Pros	$6,200.00	
3. Florida Design Consultants	$1,140.00	
4. Koncept Carma, Inc.	$770.00	
5. Krane Development, Inc. dba ADS Services, Inc.	$0.00	
6. Mid Florida Materials Co.	$0.00	
7.  Mobil Modular	$1,543.44	
8. National Trench Safety	$1,640.46	
9.  Oldcastle Infrastructure	$66,780.00	
10. Quality Petroleum Corporation	$58,096.15	
11. RGH Waste and Disposal	$1,773.08	
12. Street Smart Rentals LLC	$1,389.93	

FURTHER AFFIANT SAYETH NOT.

&'2;\�.

RCS Construction Company, Inc.

�ia,.U--::	, Affiant
Sworn to and subscribed before me this	11th	day of  July	,2024, by

-s

	 wh(coheck one • X] is personally known to me, [ ] produced a driver's license (issued by a state of the Uni d Sta es within the last five (S) years) as identification, or [ ] produced other identif ation,	---=::,,,-r-+	Affiant
did take an oath.

N!	VICTORIA E. LAUTERIA

i	�

Nota<v Public
State of Florida
<a,	� Comm# HH276625
• ti •	Expires 6/19/2026

Print Name:	Victoria	L uteria Notary Public, State of Florida
Commission No.:_--'H""'"H;..:,=.27.:....6=6=2=5'---------
My Commission Expires:	06/19/2026

JOINDER AND INDEMNIFY AGREEMENT

Contractor, joins in the execution of this Affidavit for the purpose of adopting all representations of fact contained therein. Contractor understands that this Affidavit will be relied upon by Owner for all purposes relating to the Contract. Contractor agrees to indemnify, hold harmless and defend the Owner from, against and with respect to any and all loss, cost, damage and expense, including reasonable attorneys' fees, arising out of any claims by laborers, subcontractors or materialmen who might claim that they have not been paid for labor, services or material.

A Florida Corporation Company

Bv�IJ,�	 Nam�Bass
Title:	Vice President

(CORPORATE SEAL)[where applicable]

WAIYER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of$ 446,841.45	, hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished through 07/11/2024 to Double B Development and Kelly Park VB Development, LLC on the job of Wyld Oaks Mass Grading Improvements to the following property:
S of Kelly Park Rd & Effie Dr.
3620 W Kelly Park Rd.
Apopka, FL 32712, Orange County (description of property)

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

DATED on July 22, 2024.

Lienor RCS Construction Company, Inc. Address 295 E SR 50, Suite 1,
	Clermont FL 34711	
By:§fAe;,_;;	;,
Pri	a	Jody Bass
Its:��sident

State of Florida
County of _L_a_k_e�---
The foregoing instrument was acknowledged before me this 22nd	day of_J_u_ly	_ 20_M_, by, as of said company, who has presented as identification or is personally known to me.

Signatur	N

VICTORIA E. LAUTE�§eal)
Notary Public State of Florida Comm# HH276625
Expires 6/19/2026
		Victoria E Lauteria	 Print, Type or Stamp Commission

REQUISITION

The undersigned, an Authorized Officer of Golden Gem Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture between the District and U.S. Bank Trust Company, National Association, Fort Lauderdale, Florida, as trustee (the "Trustee"), dated as of June 1, 2024 (the "Master Indenture"), as amended and supplemented by the First Supplemental Trust Indenture between the District and the Trustee, dated as of June 1, 2024 (the Master Indenture as amended and supplemented is hereinafter referred to as the "Indenture") (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):
Requisition Number: 08

Name of Payee:	RCS Construction Co. Inc.

Amount Payable:	$904,849.30

Purpose for which paid or incurred (refer also to specific contract if amount is due and payable pursuant to a contract involving progress payments, or, state Costs of Issuance, if applicable):
Fund, Account and/or subaccount from which disbursement is to be made:
Series 2024 Acquisition and Construction Account

The undersigned hereby certifies that obligations in the stated amount set forth above have been incurred by the District, that each disbursement set forth above is a proper charge against the Series 2024 Acquisition and Construction Account and the subaccount, if any, referenced above, that each disbursement set forth above was incurred in connection with the acquisition and construction of the Phase 1 Project and each represents a Cost of the Phase 1 Project, and has not previously been paid.
The undersigned hereby further certifies that there has not been filed with or served upon the District notice of any lien, right to lien, or attachment upon, or claim affecting the right to receive payment of, any of the moneys payable to the Payee set forth above, which has not been released or will not be released simultaneously with the payment hereof.
The undersigned hereby further certifies that such requisition contains no item representing payment on account of any retained percentage which the District is at the date of such certificate entitled to retain.

A-1

Originals or copies of the invoice(s) from the vendor of the property acquired or services rendered with respect to which disbursement is hereby requested are on file with the District.
GOLDEN GEM COMMUNI1Y DEVELOPMENT DISTRICT

AuthorizJd Officer

CONSULTING ENGINEER'S APPROVAL FOR NON-COST OF ISSUANCE REQUESTS ONLY
If this requisition is for a disbursement from other than the Costs of Issuance Account, the undersigned Consulting Engineer hereby certifies that this disbursement is for a Cost of the Phase 1 Project and is consistent with: (i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the Phase 1 Project with respect to which such disbursement is being made; and (iii) the report of the Consulting Engineer attached as an Exhibit to the First Supplemental Trust Indenture, as such report shall have been amended or modified on the date hereof.

Consulting Engineer

Kevin M Roberson
Kimley Horn and Associates, Inc

A-2

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702	PAGE ONE OF	PAGES	4

TO OWNER:
Kelly Park VB Development, LLC
660 Beachland Blvd. Vero Beach, FL 32963 FROM CONTRACTOR:
RCS CONSTUCTION CO. INC. 295 E. HWY 50 SUITE I
CLERMONT, FL 34711 CONTRACT FOR:

PROJECT: Infrastructure - Wyld Oaks	APPLICATION NO:

PERIOD TO:
VIA ARCHITECT:

PROJECT NOS: CONTRACT DATE

2

7/11/24

Distribution to:

§

OWNER ARCHITECT CONTRACTOR

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract Continuation Sheet, AJA Document G703, is auachcd.

ORIGI Al CON I RACT "li 1

I 4,205.206,4Q

The undersigned Contractor ccnifies 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 Cenificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due.

1 Net change t,, Change Orders
3. CO l Rf\CI SllM TOD\ ff (I me I  2)
4  fOI  I COMPLYlFD& SfORLD 10
DATE	(Column G on G703)
RETAINAGE:
	5_% of Completed Work (Column D +Eon G703)
5 % of Stored Material
(Column Fon G703)
Total Retainage (Lines 5a + 5b or

	215,176.20 
	I 4,420.J82.6Q 
	2. I R2.3 I 7.00 

	65.295.10 

	43,820.75 

CONTRACTOR:	RCS CONSTRUCTION CO., INC.

By: -�"'6r"":h�i-="'-==---------- Date	7_/_1_l/_20_2_4

VICTORIA E. LAU ERIA
Notary Public State of Florida Comm# HH27662
/2026

l otal m Ct>lumn I or G703 l		

ENGINEER'S CERTIFICATE FOR PAYMENT

TOl Al f.AR I D LISS Rfl \I  I\GI
(Line 4 Less Line 5 Total)
LESS PREVIOUS  ER"nFICATES FOR		
PAYMENT (Line 6 from prior Cettificate)
R CURRLNl PAY 11. 'I DIJr	�
'l BAL.ANCL IO �lNISII, INC'LUDI 
(Line 3 less Line 6)

Total Completed and Stored To Date Allocated To Cadence Total Retainage At 5%

Total Completed and Stored To Date Allocated To COD	$1,821,183.11	This Cenificate is not negotiable. The AMOUNT CERTIFIED is payable only to the	
Total Retainage At 5%		$91,059.16 	Contractor named herein. Issuance, payment and acceptance of payment are without	
Total Allocated To COD, Less Retainage		$1,730,123.95 	prejudice to any rights of the Owner or Contractor under this Contract.	
Less Previous Balances Due By COD		$825,274.65 		
Current Payment Due By COD	$904,849.30		

Total Allocated To Cadence, Less Retainage Less Previous Balances Due By Cadence Current Payment Due By Cadence

	2.!1Tl,201 l'i 

$   	9_9_0'-,8_04_.4_0_
l,OX::?,3Qb.75 •••
	12,347,181.54 

	$361,133.89 
	$18,056.69 
	$343,077.20 
	$165,529.75 
$177,547.45

In accordance with the Contract Documents, based on on-site ob ervations and the data comprising the application, the Engineer cenifies to the Owner thal to the best of lhe Engineer'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 lo payment of the AMOUNT CERTIFIED.
1,082,396.75
AMOUNT CERTIFIED ........... $ 	

(Allach expla11atio11 ifa111011m certified differs.from the a111011nt applied. Initial al/figures 011 this Applica1io11 and onthe Comi1111a1io11 Sheet that are changed to conform with the a111011nt certified.) ENGINEER:	///. "",//	_	Kevin Roberson, Kimley-Horn and Assoc.
{f,IJ'tl'''�	8-2-24
By: 	 Date: 	

CHANGE ORDER SUMMARY
Total changes approved in previous months by Owner Total a roved this Month

han)!C Order

ADDITIONS
$215,176.20

215.I 76.20
215.17620

DEDUCTIONS

0.00

AIA DOCUMENT G702 APPUCATION ANO CERTIFICATION FOR PAYMENT 1992 EDITION AIA @1992	THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., NW. WASHINGTON, DC 20006-5292
Users may obtain validation of this document by requesting a completed AJA Document 0401 - Certification of Document's Authenticity from the Licensee.
••• Ca11trac1or ae;rees that Owner will pm· ,mi, what f1111di11(( ,s Ol'a1/able ll'hich mm·1101 eq11al the C11rre111Pav111e111 D11e. A11r 1111paid ba/a11ce u·i/1remam 011acco1111t for Ow11er ta pm \l'itl, f11111ref1111ds.
otc: Items in RED F'O T arc automatically calculated from the G703 form or from items within this G702 Form. Do  OT hand enter these items on this sheet.

AJA Documcru G702, APPLICATION AND CERTIFICATION FOR PAYMENT. containing
Contractor's signedcertification1s attached.

Use Column I on Contraw wh.erc variable rnaina�e for line 11cms may aoolv.

APPLICATION NO: APPLICATION DATE:
PERIOD TO: ARCHITECTS PROJECT NO·

2
7/11/2024
7/11/2024

A	I)	C	0	E	f	G	II	I	J	K	I.	M	N	0	I'	
rrnM
NO	
01.:SCRIP"I ION OF WORK	SCIIEDUIJ:D VALUE	WORK COMl'I..E'IEIJ	MA'IEklALS
PRESf:N"ll,Y STORED (NOT IN DORE)	rQTAL
COMPJ.1m:o AND STORED TO DATE (l)+E+F)	,I

(\I +CJ	BALANCE
TOFD',IISII
(C·Gl	RETAIN AGE
(IF VARl/\Dl.E
RAnl)	Considered
�SMrcd
lrnprm-\."lncrll�	Pi.'l'tClll Elii,!iblc For Payment llyCa<k.>noc	Total Complctt.'d And Ston.-dTo Date Eligible For Pa)1tk.'fll By Cadence	
To1al Cadence Rt.1ain:igc (J/l 5��	l\.'Tt4.-nl Ehgiblc ForPaym\.-"fll HyCDD	TOlal Cot11plctcd And Slon:d To l>a1c Eligible For Payrncm llyCDD	
TolalCDD
Rctamagc@IS'•	
			fllOM PKEVIOUS
APPLICATK>N
(IJ+E)	111'1S PERIOD													
		Quanlity	Unil	l�cc	1011\															
	ll.l'Dl'r21 LOmllt ORJI, Mobll7.al on. :-tun·cv																			
1.	MOBILIZATION	1	LS	513 750.00	SIJ,750.00	S5 000.00	S8 750.00		$13,750.00	100%	S0.00	S687.50	Yes	17.00-/4	S2,3:.17.50	Sll6.88	8'.\.00%	Sl1412.50	S570.63	
2.	GENERAL CONDITIONS	1	LS	$221 250.00	S22 I ,250.00	S2l 000.00	S47,000.00		S70 000.00	32%	5151,250.00	SJ 500.00	Yes	17.00%	Sll,900.00	SS9S.OO	83.00%	SS8 100.0U	52 905.00	
3.	PERFORMANCE BONO	1	LS	$103 750.00	SIOJ,750.0U	SIOJ.750.00			SIOJ,7S0.00	100%	S0.00	SS 187.SO	Yes	17.00%	Sl7.6)7,S0	S881.88	83.00%	S86 112.SO	S4,305.6J	
4.	LAYOUT/ASBUILTS	1	LS	$96 51B.75	S96 518.75	54 420.00	S 17 000,00		S21420.00	22%	S75 098.75	SI 071.00	Yes	17.00%	SJ 641.40	Sl82.07	83.00%	S 17,778.60	S888.93	
5.	SWWWP	1	LS	$28 750.00	528 750.00	SI 500.00	SI 500.00		SJ 000.00	10%	S25 750.00	Sl50.00	Yes	17.00%	S510.00	S25.50	83.00%	S2 490.00	Sl24.50	
6.	SILT FENCE	21818	LF	$1.81	$39 490.58	S7 200.00	S 18,900.00		S26,!00.00	66%	Sll,390.58	SI 305.00	Yes	17.00%	S4,437.00	5221.85	83.00%	S21 663.00	Sl,OSJ.15	
7.	TREE PROTECTION	2930	LF	$6,73	Sl9 718.90	S0.00			S0.00	0%	Sl9,718.90	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	S0,00	S0.00	
8.	CONSTRUCTION ENTRY	2	EA	$12 647.28	525,294.56	S0.00			SO.OU	0%	S25 294.56	S0.00	Yes	17.00%	S0.00	S0.00	ID.00%	S0.00	so.oo	
9,	MASS GRADING	31971	CY	52.81	S89 838.51	SJJ 250.00	S28 000.00		S61 250.00	68%	S28,588.51	SJ 062.50	Yes	17.00%	SIO 412.50	S520.6J	83.00%	sso 8)7.50	S2 541.88	
10.	ROADWAY GRADING	1	LS	$97 182.84	S97,l82.84	S0.00	S 19 000.00		S 19,000.00	20%	578 182.84	5950.UO	Yes	17.00%	SJ 230.00	Sl61.50	83.00%	SI 5 770.00	S788.50	
11.	SOD BEHIND CURB	10613	SY	$3.69	SJ9,161.97	SU.00			S0.00	0%	539 161.97	S0.00	Yes	17.00%	S0.00	SU.00	83.00%	S0.00	S0.00	
12.	10" FORCE MAIN	S244	LF	$70.72	S370 855.68	S92 160.00	524 000.00	S43 540.00	5159 700.00	43%	5211,155.68	S7 985.00	Yes	17.00%	S27 149.00	$1,357.45	83.00%	5132.551.00	56,627.55	
13.	10" PLUG VALVE	14	EA	$S 619.75	S78 676.50	S6 250.00	S5 500.00	547,(KIO.OO	S58,750.00	75%	S 19 926.50	S2 937.50	Yes	17.00%	S9 987.50	5499.38	83.00%	S48 762.50	52,4.18,13	
14.	12"XIO" WET TAP	2	EA	$16 066.18	S32,IJ2.36	SO.O<>			S0.00	0%	S32,IJ2.l6	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	S0.00	
15.	6" FORCE MAIN	648	Lf	$50.13	SJ2 484.24	so.oo		SJ,200.00	5),200.00	10%	529,284.24	5160.00	Yes	17.0()%	5544.00	527.20	83.00%	52,656.00	S132.80	
16.	6" PLUG VALVE	12	EA	$3 905.17	S46,862.04	S0.00		SJ 054.00	S7 054.00	15%	SJ9 808.04	SJ52,70	Yes	17.1)()%	S1.199.18	559.96	83.00%	S5 854.82	S292.74	
17.	4" FORCE MAIN	20	LF	S36.17	S723.40	SO.O<l			S0.00	0%	5723.40	50.00	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	S0.00	
18.	4" PLUG VALVE	1	EA	52 366.34	S2 366.34	SO.I)()		5690.00	5690.00	29�0	SI 676.34	534.50	Yes	17.00�0	SI 17.30	S5.87	83.00%	5572.70	S28.64	
19	FORCE MAIN FITTINGS	1	LS	$78 184.45	S78,184.45	SO.IIO		S66 952.00	S66 952.00	86%	511,232.45	Sl,347.60	Y,s	17.00%	SI 1,381.84	5569.09	8).()0%	555.570.16	52,778.51	
20,	TESTING	I	LS	$12 278.25	512 278.25	S0.00			S0.00	0%	Sl2 278.25	S0.00	Yes	17.00%	50.00	SO.<IO	83.00%	so.oo	S0.00	
21,	18" HOPE	931	LF	$50.28	S46,810.68	S 10 056.00	S 14 000.00	S8 800.00	532 856.00	70%	513 954.68	SI 642.80	Yes	17.00%	S5 585.52	S279.28	83.00"/4	S27 270.48	SI 363.52	
22.	24" HOPE	1279	LF	573.70	S94,262.l0	S40 180.00	58,500.00	S22,618.00	571 298.00	76%	$22,964.30	SJ 564.90	Yes	17.00%	S12 120.66	S606.0J	83.00%	$59,177.34	S2 958.87	
23.	42" HOPE	106	LF	S246.26	S26,10l.56	S0.00		519185.00	S191K5.00	73%	56,918.56	S959.25	Yes	17.00o/o	Sl.261.45	Sl63.07	83.00%	SI 5 923.55	5796.18	
24.	48" HOPE	691	LF	$320.16	5221 230.56	so.no		589,000.00	589 000.00	40%	Sl32 230.56	S4,450.UO	Yes	17.00%	Sl5 130.00	5756.50	83.()0%	S7J 870.00	SJ,693.50	
25.	54"/60" HOPE	1462	LF	$360.14	S526 524.68	S0.00			S0.00	0%	S526 524.68	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	SO.O<l	SU.00	
26.	60" HOPE	64	LF	5480.83	$30,773.12	S0.00		S7,200.00	57 200.00	23%	S23 573.12	5360.00	Yes	17.00-/4	S1,224.00	561.20	83.00%	55 976.00	5298.80	
27.	36" HOPE	1394	LF	$114.98	5160 282.12	548,00/1.()0	S23 000.00	532 000.00	SI0),000.00	64%	557,282.12	S5 150.00	Yes	17.00%	517,510.00	S875.50	83.00%	S85 490.00	S4 274.50	

AIAOOCIJI.IENl 0703 CONTINIJATION SHEET FOR.G701 1092 EDITION Al" CU:191
THE AMERICAN lNSTITt/lE OF ARCH1TECTS 173SNEW YORICAVENVE. NW WASHINGTON DC 20006-�32

G703-19Q2

AIA Document G702. APPLICATION AND CERTIFICATION FOR PAYMENT. conrnimng
Contractor's signal certification is attached.

Use Column I on Contrads where variable rctainas:c for line items may apply.

APPLICATION NO: APPLICATION DATE:
PERJOOTO: ARCHITECT'S PROJECT NO·

2
7/11/2024
7/11/2024

A	ll	C	D	I	E	F	G	II	1	J	K	L	M	N	0	p	

ffEM
NO.	

DES('RIPl'ION OF WORK	SCllEDIJU�D VALUE	WORK' MPI.E HJ	MAICRIAI.S
PRESl:."N11,Y STORED (NQT[N
DORI:)	!OJAI.
COMPLE1H) ANDSTORl.:ll TO DATE
(D-+-E-t-F)	�
(G+C)	OAI..ANCE
TO FINISH
!C-G)	R.E.TAINAGE (D;VARIAI.ILI; KATI!)	CousiJcro.1
�stiarec1
ht1pro\'\.'11ICUI�	
Pcm.-n1 Eligible
Foe' Pa)m nt
ByDdcncc	
To1al (.;('lllplctcd And
Stc,red To Date
Elig1hlc For 1'1)11\1.."Ut
!Iv Cadence	
To!alCadt.'llO!
R1.1a11ugc@. s�•	Po..-«:Cnt l:h[!.iblc
ForP&�l..,'111
HyCDD	l'Nal Completed And S1ored To Dale EligiblcFOfl'aym<.-nl
l.lvCDD	
TOlalC'DD
Rctanugc(a s•.	
			FROM l'REVIUUS
APPI.ICATK)N
CD+ E)	TIIIS PERIOD													
		Qwmlity	Uni1	l'ncc	TOia!															
28.	72" HDPE	1381	LF	$747.54	Sl.032 352.74	S0.00			S0.00		S1 032.352.74	S0.00	Yes	17.1)()%	S0.00	S0.00	R.l.00%	S0.00	S0.00	
29.	TYPE "P" MANHOLE	4	EA	$15	330.53	$61.322.12	S4.600.00		S8 000.00	S12 600.00		S48.722.12	S6lo.oo	Yes	17.(>0%	S2.142.00	Sl07.10	33.00%	SIO 458.011	S522.90	
31.	TYPE P-5 WITH "J"' BOTTOMS	11	EA	S12 400.26	S136,402.86	S0.00		S29,100.00	S29,100.00		S107,302.86	S1.455.00	Yes	17.00%	S4.947.00	S247.35	83.00%	S24 153.00	Sl.2117.65	
32.	TYPE P-5 INLETS	2S	EA	$6 492.88	Sl62 322.00	533,000.00		Sll,000.00	544 000.00		5118 322.00	S2 200.00	Yes	17.00%	57.480.00	Sl74.00	83.00%	SJ6 520.00	SI 826.00	
33.	TYPE P-6 WITH "J"' BOTTOMS	8	EA	$14 844.13	S 118 753.04	S0.00		S2J 800.00	S2J 800.00		594 953.04	SI 190.00	Yes	17.00%	54.046.00	S202.l0	83.00%	519	754.00	S987.70	
34.	TYPE P-6 INLETS	4	EA	$7 220.65	S28.882.60	S0.00		$4,400.00	S4,400.()(l		S24,482.60	S220.00	Yes	17.00%	$748.00	SJ7.40	33.00%	Sl.652.00	S 182.60	
35.	TYPE "J" BOTTOM WITH TYPE "A" MANHOLE	1	EA	$33 164.59	533	164.59	S0.00		Sl9,000.00	519 000.00		514 164.59	$9511.00	Yes	17.00%	Sl,2311.110	Sl61.50	ID.00%	S15.770.00	S788.50	
36.	BOX CULVERT 5'Xl0'	280	LF	$1 319.81	S369.546.80	S2281105.00			S228.005.<MJ		$141541.80	SI 1.400.25	Y<S	17.00%	SJ8 760.85	SI 938.04	83.00%	S189.244.15	59.462.21	
37.	lV LINES	1	1.S	$31	S24.38	S31	524.38	S0.00			S0.00		Sll 524.38	S0.00	Yes	17.00%	SO.DO	S0.00	8J.00%	S0.00	SO.OIi	
38.	8" C-900	487	Lf	$S0.94	524	807.78	S0.00	S7 800.00	SI 500.00	S9 l00.00		S15.507.78	5465.00	Yes	17.00%	SI 581.00	$79.05	83.00%	S7.719.00	S385.95	
39.	16" DIP	2.581	LF	$131.18	SJJ8	575.58	SO.I)()		S241 576.00	$241 576.00		S96.999.58	S12.078.80	Yes	17.00%	$41.067.92	52.053.40	83.00%	S200 508.08	S10 025.40	
40.	12" C-900	2,752	Lf	$87.96	S242 065.92	S 124.960.00		S39.000.00	S16l 960.00		S78 105.92	S8 198.00	Yes	17.00%	S27.87J.20	SI 393.66	83.00%	S136 086.80	S6,804.34	
41.	6" C-900	816	LF	$37.07	S30 249.12	S4 680.00		S 1,700.00	S6,380.00		S23,869.12	SJ19.IMJ	Ycs	17.00%	S 1,084.60	SS4.2J	83.00%	55	295.40	S264.77	
42.	12'" GATE VALVE	13	EA	$4 796.85	S62	359.05	S56 000.00		56 700.00	$62 700.00		15)40.95)	53 135.00	Yes	17.00%	SI0.659.00	S5J2.95	83.00%	$521)41.00	Sl,6112.05	
43.	6" GATE VALVE	13	EA	$1 903.55	$24	746.15	S0.00			S0.00		S24 746.15	S0.00	Yes	17.00%	S0.00	so.oo	83.00%	SO.OIi	S0.00	
44.	16" GATE VALVE	18	EA	SB 950.47	5161	108.46	S0.00			so.oo		S161,108.46	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	SO.OD	
45.	8"' GATE VALVE	17	EA	$2 648.89	S45 031.13	S0.00			S0.00		545.0JI.IJ	S0.00	Yes	17.00%	so.no	S0.00	83.00%	S0.00	sn.oo	
46.	RELOCATE FHA	I	EA	$3 474.SO	Sl.474.50	SO.OIi			S0.00		S3.474.50	so.oo	Yes	17.00'/4	S0.00	S0.00	83.00%	S0.00	S0.00	
47.	FIRE HYDRANT ASSEMBLY	18	EA	$6 239.51	SI 12311.18	S0.00			S0.00		SI 12311.18	S0.00	Yes	17.(,0%	S0.00	S0.00	83.(}()%	S0.00	SO.Oil	
48.	ARV	1	EA	S7 426.58	S7 426.58	S0.00			S0.00		$7 426.58	S0.00	Yes	17.00%	S0.00	so.oo	83.00%	S0.00	SO.OIi	
49.	16"'Xl2"' WET TAP	1	EA	S15 160.96	515 160.96	S5 800.00		SI 700.00	S7 500.00		S7 660.96	5375.00	Yes	17.00%	S 1.275.00	S63.75	83.00%	S6 225.00	SJI 1.25	
50.	16"Xl6" WET TAP	1	EA	S33 555.01	SlJ	555.01	S0.00			S0.00		SlJ 555.01	S0.00	Yes	17.00%	SO.DO	S0.00	83.00%	S0.00	SO.OU	
51.	14"DIRECTIONAL DRILL	80	LF	$173.41	Sil	872.80	SJ,200.00		S4 000.00	S7 200.00		S6.672.80	S360.00	Yes	17.00%	S 1,224.00	S61.20	83.00%	S5.976.00	S298.80	
52.	JUMPER	2	EA	$2 787.30	55	574.60	S0.00			S0.00		S5 574.60	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	S0.00	
53.	RESTORATION/MOT FOR OFFSITE WORK	1	1.S	$33	392.21	SJ]	392.21	S0.00			S0.00		S33 392.21	SO.OD	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	SO.OU	
54.	WATER FITTING	1	1.S	$122 471.75	$122471.75	S46 000.00		$44,700.00	S90 700.00		Sll 771.75	54 535.00	Yes	17.00%	515419.00	S770.95	83.00%	S75.2SI.OO	SJ,764.05	
55.	TESTING	1	1.S	Sil	475.00	S 11 475.00	S0.00			so.oo		Sll.475.00	so.oo	Yes	17.00%	S0.00	S0.00	83.00%	so.oo	$11.00	
56.	8"" REUSE	5,392	LF	$49.11	S264	801.12	S60.480.00		S6J.000.00	S 123 480.00		S14I 321.12	S6 174.00	Yes	17.00%	S20.991.60	Sl.049.58	83.00%	S 102.488.40	55,124.42	
57.	8" GATE VALVE	17	EA	$2 738.50	546 554.50	SO.IMJ			S0.0<)		S46 554.50	S0.00	Yes	11.00•1o	S0.00	S0.00	83.00%	S0.00	S0.00	
58.	4""REUSE C·900	S90	LF	$30.67	$18.095.30	S0.00			SO.<lO		$18 095.JO	so.oo	Yes	17.0(Wo	S0.00	S0.00	83.00%	so.oo	S0.00	
59.	4" GATE VALVE	14	EA	s2 295.78	532	140.92	S0.00			S0.00		S32 140.92	S0.00	Yes	17.00%	S0.00	so.oo	8).00%	S0.00	S0.00	
60.	30'"X8" WET TAP	2	EA	$12	237.97	S24 475.94	$0.00			S0.00		S24,475.94	S0.00	Yes	17.00%	SO,IMJ	S0.00	RJ.00%	SO.I)()	S0.00	
61.	10" DIRECTIONAL DRILL	80	LF	$136.25	S10 900.00	S0.00		S2 400.00	S2.400.00		S8 500.00	Sl20.00	Yes	17.00%	5408.00	S20.40	83.00%	SI 992.00	S99.60	
62.	REUSE JUMPER	2	EA	$2 737.14	SS.474.28	S0.00		S4,600.00	S4.600.00		S874.28	S2l0.00	Yes	17.00%	$782.00	S39.I0	83.00%	SJ 818.<lO	Sl90.9U	
63.	REUSE FITTINGS	1	1.S	S41	221.83	S41.221.8J	SO.IMJ		S2J.000.00	S2J.000.00		!18221.8]	Sl.150.00	Yes	17.00%	SJ.910.00	S195.50	83.00%	$19.090.00	S954.50	
64.	REUSE TESTING	1	1.S	$9	750.38	S9 750.38	SO.OD			S0.00		59 750.)8	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	50.IM)	S0.00	
65.	TYPE "D" INLET	1,487	Lf	$21.25	$JI	598.75	S0.00			S0.00		531 598.75	S0.00	Yes	17.00%	SU.00	S0.00	83.(1(}%	S0.00	S0.00	
66.	TYPE "F" CURB	17,78S	LF	S28.13	S500 292.05	S0.00			SO.OD		S5(MJ.292.05	S0.00	Yes	17.00%	$0.00	S0.00	83.00%	S0.00	so.on	
67.	10' CONCRETE SIDEWALK	3,647	LF	S61.44	$224	071.68	S0.00			SO.OD		S224 071.68	S0.00	Yes	17.00%	so.oo	S0.00	83.00%	S0.(M)	SU.00	
68.	10' HCR	11	EA	$2 7SO.OO	SJO 250.00	S0.00			S0.00		S30.250.00	S0.00	Yes	17.00%	so.on	S0.00	83.00%	S0.00	S0.00	
69.	5' SIDEWALK	6,S62	LF	$29.94	S 196 466.28	S0.00			SO.O<I		Sl96 466.28	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	S0.00	
70.	S" HCR	14	EA	$1481.2S	S20 737.50	SO.O<l			SO.O<I		SlO 737.50	SO.<MJ	Yes	17.00%	S0.00	S0.00	8).()()%	S0.00	Sll.00	
71.	12" STABILIZATION	2S,301	SV	S5.42	$137	131.42	S0.00			S0.00		S137.IJl.42	so.oo	Yes	17.00%	$0.00	S0.00	83.00%	S0.00	S0.00	
72.	1" SP 12.5 1ST LIFT	21,349	sv	$13.81	S294	829.69	S0.00			SO.O<l		5294.829.69	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	SO.OD	

AIA00CVMENTG103 CONTINIJAIIOHSHEE1FOR01'02 1"2EOIIIOH A/A 01!illG2
rnE AMERICAN IHSnn.nE Of' it.RCHITECTS 1735 NEW YORI( AVENUE NW WASttlNGTON DC :2000&-6Z3l	0703-1992

A/A DOCUMENT G'703	P... loffPat,N

AIA Oocumnll G702, APPLICATION ANO CERTIFICATION FOR PAYMENT. con1ainmg
Comractor's s1gnM CC'ftificauon asauachtd.

	I)	C	D	I	E	I'		II	I	J	K	I,	M	N	0	p	
'
fn�M
NO	
Dl·SCRIPTION OF WORX	
SCIUJDULEll
VAl.l.JE	WOKK OMl'U�IH)	MArl,iRIALS PkESEN"ll.Y STORED INOTIN
DOREJ	IOTAJ.
COMPU:.i'ED AND STORED TO DATE
(l).E+I�)	..
IG•C)	
BALANCE 'IO FINIS!! IC-GI	RETAINAGli
(n:vARlJ\BLE
RATE)	Considcn-d "Slwcd bnprovcrnent�	Pen:t.'111 Fli1iblc For Paymcm Hy Cadence	Total Completed And S1orcdT0Da1e Eligible For Payn1L"III
HvCadence	
lotalCa<ll..--no.:
Rcu1na,c(!115%	Pcrcan Eligible ForPaym.:111 IJyCL>D	foial Complch.'d And Slon:d l'o 1>a1e lilicibk For Payment
O•C))D	
lNalCDD Reta1113ge(a15••	
			l'KCJM PKJ;VK)US
APl'LICATION
(D-+-E)	'nllSPERIOD													
		Q11.1111ity	Unit	1-ri�	Total															
73.	l" SP 95 ASPHALT WITHIN 6 MONTHS OF CFC	21,349	SY	S17.63	S376 382.87	SO.IIO			SO.OU		S376 382.87	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	S0.00	
74.	l" SP 9.5 ASPHALT	21,349	SY	S13.71	$292,694.79	S0.00			S0.00		S292.694.79	S0.00	Yes	17.00%	S0.00	S0.00	8).00-/4	S0.00	so.on	
75.	10" LIME ROCK	21,349	SY	$24.71	S527,533.79	S0.00			so.oo		S527 533.79	S0.00	Y<S	17.00%	S0.00	S0.00	83.00%	S0.00	Sll.00	
76.	STAMPED ASPHALT	1,680	SF	$13.75	S23 100.00	S0.00			S0.00		S23 100.00	S0.00	Y<S	17.0f)%	S0.00	S0.00	83.00%	S0.00	S0.00	
78.	TEMP MARKING	1	LS	$18 402.50	SIS,402.50	S0.00			S0.00		SIS 402.50	S0.00	Y<S	17.00%	S0.00	S0.00	83.00%	S0.00	SU.00	
79.	PERMENATE MARKINGS	1	LS	$72 12S.OO	S72 125.011	S0.00			Sll.00		S72,l25.00	S0.00	y,.	17.00%	S0.00	S0.00	83.00%	S0.00	S0.00	
																				
80.	ORY UTILITIES																			
81.	MOBILIZATION/GENERAL CONDITIONS	1	LS	S45 120.00	S45 120.00	S0.IXl			so.oo		S45 120.00	S0.00	Yes	17.00%	SO.Oil	S0.00	83.00%	S0.00	S0.00	
82.	PERFORMANCE BONO	I	LS	$60 768.00	S60 768.1IO	S60,768.00			S60,768.00		so.oo	S.1.038.40	Y<S	17.00%	510 330.56	5516.53	83.00%	S50 437.44	S2 521.87	
83.	6" SCHEDULE 40 GREY	60,530	LF	525.17	S 1,523 540. IO	SO.lkl			S0.00		S 1,523.540.10	S0.00	Yes	17.00%	SO.IIO	S0.00	83.00%	S0.00	S0.00	
84.	CONCRETE DUCT BANK	S,490	LF	$14.97	S82 185.30	SO.Oil			S0.00		S82,l85.30	S0.00	Yes	17.00-/4	S0.00	S0.00	8.J.00%	S0.00	S0.00	
83.	2"SCHEDULE 40 GREY	15,212	LF	S!S.10	S229,701.20	S0.00			S0.00		S229 701.20	S0.00	Y<S	17.00%	so.oo	S0.00	83.00%	S0.00	S0.1IO	
85.	2" FITTINGS	1	LS	$26884.00	S26 884.00	S0.00			S0.00		S26,884.00	S0.00	Y,s	l7.fl0%	S0.00	SO.DO	83.00%	so.no	S0.00	
86.	4" SCHEDULE 40 GREY	Sl,000	LF	$20.31	SI 035 810.00	$0.1IO			SO.OU		SI 035.810.00	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	SO.OU	
87.	4"& 6" FITTINGS	1	LS	S64 118.00	564.118.00	so.oo			SO.DO		S64,118.00	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	S0.00	
88.	30' TA-· LED SINGLE HEAD LIGHT	22	EA	$12 274.00	S270 028.00	SOJIO			S0.00		S270 028.00	SO.Oil	Yes	17.()0t'/4	so.oo	S0.00	83.00%	so.on	S0.00	
89.	30' TALL POLE WITH TWIN HEADS	24	EA	$14 363.00	S344 712.00	S0.00			S0.00		S344,712.00	S0.00	Yes	17.00%	S0.00	Sll.00	83.00%	so.on	S0.00	
90.	ADD BLACKE DYETO CONCRETE POLES	46	EA	S909.00	$41,814.00	S0.00			S0.00		S4l,8l4.00	Sil.OU	Yes	17.00%	SO.DO	S0.00	83.011%	S0.00	Sll.00	
91.	SPLICE BOXES	52	EA	$5 770.00	S3111l 040.00	S0.00			S0.00		5300,040.00	S0.llll	Y<S	17.00%	S0.00	S0.00	83.00%	S0.00	S0.00	
92.	LAYOUT/ AS-BUilTS	1	LS	$17 410.00	Sl7410.00	S0.00			S0.00		Sl7 4l0.00	Sll.00	Yes	17.00-/4	S0.00	S0.00	83.00%	S0.00	Sll.00	
93.	HANDHOLES	IS	EA	$3 145.00	S47 175.00	S0.00			S0.00		S47 175.00	S0.00	Yes	17.00%	S0.00	S0.00	&J.oo�,	S0.00	S0.00	
94.	MAHOLES	4	EA	S7 793.00	SJ! 172.00	SO.Oil			so.no		SJl,172.00	S0.00	Yes	17.00%	S0.00	$0.00	83.1}0%	so.on	Sll.00	
																				
95.	LANDSCAPE/IRRIGATION																			
96.	MOBILIZATION/GENERAL CONDITIONS	l	LS	S29 S60.00	$29,560.00	S0.00			SO.Oil		129,560.00	S0.00	Yes	17.(,0%	S0.00	S0.00	83.00%	S0.00	S0.00	
97.	PERFORMANCE BOND	1	LS	$22 693.00	S22,693.00	S22 693.00			S22 693.00		S0.00	SI 134.65	Yes	17.00%	SJ 857.81	S 192.89	83.00%	SIS,835.19	S941.76	
98.	SURVEY/LAYOUT	1	LS	S6 880.00	S6 880.00	S0.00			S0.00		S6,880.00	S0.00	Yes	17.00%	S0.00	S0.00	83.00%	S0.00	S0.00	
99.	LANDSCAPE	1	LS	5421 116.00	5421 116.00	S0.00			SO.Oil		S421.116.00	so.oo	Y,s	17.00%	so.on	S0.00	83.00%	S0.00	SO.IIO	
100.	IRRIGATION	1	LS	S393 612.00	S39J 612.00	S0.00			SO.Oil		S393.612.00	S0.00	Yes	17.00%	so.no	S0.00	83.00o/.	S0.00	SO.llll	
101.	MAINTENANCE	1	LS	$73 440.00	S73 440.00	SO.OIi			S0.00		S73 440.00	SO.OU	Yes	17.()()%	so.no	so.no	83.00%	SU.00	Sll.00	
102.	SOD/GROUND COVERING	1	LS	S141 212.00	Sl4I,2I2.00	S0.00			S0.00		S141,212.00	S0.00	Y,s	17.00%	S0.00	S0.00	83.00%	SO.Oil	S0.110	
																				
104.	Chana:e Order #1 Fire Access Rd																			
105.	Install Fire Access Rd. 8" lime Rock with Prime	9,111
,	SY	$14.20	S129 376.20	S0.00			S0.00		Sl29 376.20	S0.00	No	0.00%	so.on	so.oo	l00.00o/.	S0.00	S0.00	
106.	Install Two Extra Fire Hydrant Assembly	2	EA	$6,400.00	S12 800.llll	so.on	Sl2,8o<I.OO		Sl2 800.00		S0.00	5640.00	No	O.OO�'o	S0.00	S0.00	100.00o/e	S12.800.00	$640.00	
107.	Install Extra PVC with Fittinu	,	LS	s 3,200.00	SJ.200.00	SO.Oil	SJ 200.00		SJ 200.00		S0.00	Sl60.00	No	0.00%	SO.OU	S0.00	100.00%	SJ 200.00	S 160.00	
108.	Extra Leber/Crew and Equipment to Facilitate Install		LS	S 69.800.00	$69 800.00	SIS 000.00	S24 000.00		S42 000.00		S27 800.00	$2 100.00	No	0.00%	S0.00	S0.00	100.00%	S42,000.00	S2, 100.00	

																				

	SUUTOTAL				S14.420,382.69	Sl,042,952.00	$262,950.00	S876,41S.00	S2. I 82.3l 7.00	15%	S12,238.065.69	S109,115.85			S36l.l33.89	S 18.056.69		Sl,821.183.11	S9l,059.l6	
	GRAND TOTALS				S14,420.382.69	S 1,042.952.00	S262,950.00	S876,415.00	S2, I 82,317.00		S 12,238,065.69	Sl09.l 15.85			5)61,13).89	S 18.056.69		Sl,821,183.11	S9l.059.l6	

Use Column I on Con1rac:1s whttt vanable n:tainue for hne ncms mav 11nnlv,

APPLICATION NO: APPLICATION DATE:
PERIOD TO: ARCHITECTS PROJECT NO·
G

2
7/11/2024
7/11/2024

Uaer• may obtain validation of thl• document by requesting of the llcenae a completed AIA Document D401 • Certification of Documents AuthenUc1ty

AJAOOCU�tENT(HOl C0NT!NU-'110NSHE.E1�0Fl(l7tt'l 1W2EOIT!ON /AJA 0!992
THE AMEA,CANIHSTITUIE Of ARCHITECTS. 17:ISHfW YORK AVl;NUE NW W"5HING10N DC 10008--5232	G703-1GG2

DEVELOPER'S REPRESENTATIVE CERTIFICATE FOR PAYMENT

Wyld Oaks- Infrastructure Application #2 Period Through 7/11/24

In accordance with the Contract Documents, based on on-site observations and the data comprising
this application, the Developer's Representative certifies to the Owner that to the best of the Developer's Representative'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.

AMOUNT CERTIFIED.	$1,082,396.75
(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.)

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.

THIRD PARTY BENEFICIARY'S ENGINEER CERTIFICATE FOR PAYMENT

In accordance with the Contract Documents, based on on-site observations and the data comprising this application, the Third Party Beneficiary's Engineer certifies to the Owner to the best of the Third Party Beneficiary Engineer'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.

AMOUNT CERTIFIED........................................................................	$	
(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.)

THIRD PARTY BENEFICIARY'S ENGINEER:

By:		Date:			 Name:				
Title:`		

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.

WAIYER AND RELEASE OF LIEN UPON PROGRESS PAYMENT

The undersigned lienor, in consideration of the sum of$ 1,082,491.75	, hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished through 07/11/2024 to Double B Development and Kelly Park VB Development, LLC on the job of Wyld Oaks Infrastructure to the following property:
S of Kelly Park Rd & Effie Dr.
3620 W Kelly Park Rd.
Apopka, FL 32712, Orange County (description of property)

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

DATED on July 22, 2024.

Lienor RCS Construction Company, Inc. Address 295 E SR 50 Suite 1

	Clermont FL 34711	

State of Florida
County of_L_ak_e		_
The foregoing instrument was acknowledged before me this  22nd	day of _J�u=ly.... 
20 M_, by , as of said company, who has presented as identification or is personally known to me.

�L,,-

Sig7/4atur of NotaryPu£blic (Seal).
�putf.-J J
		Victoria E Lauteria	 Print, Type or Stamp Commission

PROGRESS PAYMENT AFFIDAVIT

STATE OF FLORIDA COUNTY OF LAKE

BEFORE ME, the undersigned authority, duly qualified and authorized in the State and County aforesaid to administer oaths and take acknowledgements, this day, personally appeared	Jody Bass	, who being by me first duly sworn, deposes and says:

The facts and matters contained and recited in the Affidavit are based upon personal knowledge of the Affiant.
Affiant is the Owner of	RCS Construction Company, Inc.	, a North Dakota Corporation company (hereinafter the "Contractor")
Contractor and	Kelly Park VB Development, LLC	(hereinafter the "Owner") have executed, delivered and entered into that certain CONTRACT AND AGREEMENT dated	December 4. 2023	(hereinafter the "contract").
Affiant now requests partial payment under the Contract. In Consideration of Owner providing such partial payment, Contractor hereby provides this Affidavit upon which Owner intends to rely.
Contractor is not aware of any Claims that would require an adjustment of the Contract Time or the Contract Price except for any Change Order Requests or Change Order Proposals previously submitted in writing to Owner prior to execution of this Affidavit.
Contractor releases any Claims for an adjustment to the Contract Time or the Contract Price except for those previously made in writing and delivered to Owner prior to execution of this Affidavit.
Affiant states that all bills for labor, services or materials furnished, delivered, installed or performed on the job site through the date of this Affidavit have been FULLY paid and that no lien for such may properly be filed, recorded or enforced. Waiver and Release of Lien upon Progress Payment forms for every such potential lienors are provided herewith
through  07/10/2024
Affiant states that, except as provided herein, all bills for labor, services or materials furnished, delivered, installed or performed on the job site through the date of this Affidavit have been FULLY paid and that no lien for such may properly be filed, recorded or enforced. Waiver and Release of Lien Upon Progress Payment forms for every such potential lienor are provided herewith, except as provided below:

Name of Lienor	 Amount due for labor1 services or Or Potential Lienor		materials furnished, delivered1
Installed or performed

1.  Atlantic Directional Drilling, Inc.	$16,900.00	
2. Central Florida Turf Pros	$12,400.00	
3. Dixie Lime & Stone	$904.98	
4. Fortiline, Inc.	$693,412.11	
5.  Quality Petroleum	$2,023.01	

FURTHER AFFIANT SAYETH NOT.

RCS Construction Company1 Inc.

---+-"-f���::t---'"�'---F�"-----�--'	'' Affiant

Sworn to and subscribed before me this	11th	day of  July	,2024, by
	_,wh(coheck one): [ X] is personally known to me, [ ] produced a driver's license (issued by a state of the United States within the last five (5) years) as identification, or [ ] produced other identificati	Affiant
did take an oath.

VICTORIA E. LAUTERIA
Notary Public
� state of Florida

Print Name:	Victoria	a teria ------
Notary Public, State of Florida
Commission No.:---H--H-2'7-6-6'-2=5 -�-==-------

.	,._,,i comm# HH276625

, �	Expires 6/19/2026

MyCommission Expires:	06/19/2026

JOINDER AND INDEMNIFY AGREEMENT

Contractor, joins in the execution of this Affidavit for the purpose of adopting all representations of fact contained therein. Contractor understands that this Affidavit will be relied upon by Owner for all purposes relating to the Contract. Contractor agrees to indemnify, hold harmless and defend the Owner from, against and with respect to any and all loss, cost, damage and expense, including reasonable attorneys' fees, arising out of any claims by laborers, subcontractors or materialmen who might claim that they have not been paid for labor, services or material.

A Florida Corporation Company

��,m��-�	 Title:	Vice President
{CORPORATE SEAL)[where applicable]

REQUISITION

The undersigned, an Authorized Officer of Golden Gem Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture between the District and U.S. Bank Trust Company, National Association, Fort Lauderdale, Florida, as trustee (the "Trustee"), dated as of June 1, 2024 (the "Master Indenture"), as amended and supplemented by the First Supplemental Trust Indenture between the District and the Trustee, dated as of June 1, 2024 (the Master Indenture as amended and supplemented is hereinafter referred to as the "Indenture") (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):
Requisition Number: 09

Name of Payee:	Kutak Rock LLP

Amount Payable:	$8,559.30

Purpose for which paid or incurred (refer also to specific contract if amount is due and payable pursuant to a contract involving progress payments, or, state Costs of Issuance, if applicable):
Fund, Account and/or subaccount from which disbursement is to be made:
Series 2024 Acquisition and Construction Account

The undersigned hereby certifies that obligations in the stated amount set forth above have been incurred by the District, that each disbursement set forth above is a proper charge against the Series 2024 Acquisition and Construction Account and the subaccount, if any, referenced above, that each disbursement set forth above was incurred in connection with the acquisition and construction of the Phase 1 Project and each represents a Cost of the Phase 1 Project, and has not previously been paid.
The undersigned hereby further certifies that there has not been filed with or served upon the District notice of any lien, right to lien, or attachment upon, or claim affecting the right to receive payment of, any of the moneys payable to the Payee set forth above, which has not been released or will not be released simultaneously with the payment hereof.
The undersigned hereby further certifies that such requisition contains no item representing payment on account of any retained percentage which the District is at the date of such certificate entitled to retain.

A-1

Originals or copies of the invoice(s) from the vendor of the property acquired or services rendered with respect to which disbursement is hereby requested are on file with the District.
GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

Authorized Officer

CONSULTING ENGINEER'S APPROVAL FOR NON-COST OF ISSUANCE REQUESTS ONLY
If this requisition is for a disbursement from other than the Costs of Issuance Account, the undersigned Consulting Engineer hereby certifies that this disbursement is for a Cost of the Phase 1 Project and is consistent with: (i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the Phase 1 Project with respect to which such disbursement is being made; and (iii) the report of the Consulting Engineer attached as an Exhibit to the First Supplemental Trust Indenture, as such report shall have been amended or modified on the date hereof.

Consulting Engineer
Kevin M Roberson
Kimley Horn and Associates, Inc

A-2

K U T A K  R O C K  L L P
TALLAHASSEE, FLORIDA
Telephone 404-222-4600
Facsimile 404-222-4654

Federal ID 47-0597598

July 25, 2024

Check Remit To: Kutak Rock LLP PO Box 30057
Omaha, NE 68103-1157

ACH/Wire Transfer Remit To:
ABA #104000016
First National Bank of Omaha
Kutak Rock LLP A/C # 24690470
Reference: Invoice No. 3425107 Client Matter No. 47123-4
Notification Email: eftgroup@kutakrock.com

Mr. George Flint Golden Gem CDD
c/o Governmental Management Services 219 East Livingston Street
Orlando, FL 32801	Invoice No. 3425107
47123-4

Re:	Series 2024 Construction
For Professional Legal Services Rendered

06/04/24	A. Willson	0.20	63.00	Confer	with	Edwards	and	Flint
regarding		construction		and acquisition	items;	review	items
	regarding same	
06/05/24	A. Willson	0.30	94.50	Confer	with	Edwards,	Flint	and	
				Taylor regarding land acquisition	
06/06/24	A. Willson	0.60	189.00	Review	construction	assignment	
				documents	
06/07/24	A. Willson	0.20	63.00	Confer with Murray regarding land	
				acquisition items	
06/10/24	A. Willson	2.80	882.00	Confer with Edwards, Barry, and	
				Flint	regarding	acquisition	and	
				assignment	items;	review	items	
				regarding same; revise mass grading	
				construction assignment agreement	
06/11/24	A. Willson	6.20	1,953.00	Confer	with	Edwards	and	Flint	
				regarding	construction	and	
acquisition items; continue preparing items regarding same

06/12/24    A. Willson	1.80	567.00	Confer with Edwards and Gibbons
regarding construction assignment items; confer with Kaleita regarding land conveyance items; review and revise same
06/13/24    J. Gillis	0.30	52.50	Confer   with   staff   regarding
acquisition documents for mass grading improvements and infrastructure improvements; review same
06/13/24    A. Willson	1.40	441.00	Confer with Murrah and Edwards
regarding real estate conveyance items; confer with Ridgely regarding execution of same; continue reviewing and revising items regarding same
06/14/24    A. Willson	4.30   1,354.50	Review  items  for  construction
contract assignment; review revision to same; confer with team regarding land acquisition; review items regarding	same;	prepare correspondence to McRae; confer with Edwards and Gibbons regarding same
06/17/24    A. Willson	1.80	567.00	Confer  with  Gibbons,  Edwards,
Barry and Roberson regarding contract assignments and pay requisitions; review and revise letter from Trustee regarding availability of funds
06/18/24    A. Willson	2.60	819.00	Confer with Gibbons and Edwards
regarding assignment of construction agreements and payment review process; confer with Roberson, Barry, and Edwards regarding plat language; revise plat signatory language
06/21/24    J. Gillis	0.40	70.00	Draft conveyance tracking chart

06/21/24	A. Willson	3.90	1,228.50	Prepare assignment and acquisition	
				items	for	submittal;	review	and	
				revise	same;	confer	with	Barry,	
				Beninati,	Roberson,	and	Flint	
				regarding same; review requisition	
				items	
06/24/24	J. Gillis	0.30	52.50	Coordinate recording of construction	
				and access easement agreement with	
				Kelly Park VB Development	
06/26/24	A. Willson	0.20	63.00	Confer	with	Edwards	regarding	
construction assignment documents
TOTAL HOURS	27.30

TOTAL FOR SERVICES RENDERED		$8,459.50	
DISBURSEMENTS			
Filing and Court Fees	99.80		
TOTAL DISBURSEMENTS		99.80	
TOTAL CURRENT AMOUNT DUE		$8,559.30	
UNPAID INVOICES:			
May 29, 2024	Invoice No. 3396252		5,985.00	
June 29, 2024	Invoice No. 3412072		2,814.00	
TOTAL DUE		$17,358.30	

REQUISITION

The undersigned, an Authorized Officer of Golden Gem Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture between the District and U.S. Bank Trust Company, National Association, Fort Lauderdale, Florida, as trustee (the "Trustee"), dated as of June 1, 2024 (the "Master Indenture"), as amended and supplemented by the First Supplemental Trust Indenture between the District and the Trustee, dated as of June 1, 2024 (the Master Indenture as amended and supplemented is hereinafter referred to as the "Indenture") (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):
(A)	Requisition Number: 10

(B)

(C)

Name of Payee: Amount Payable:

Kelly Park VB Development, LLC

$734,031.58

Purpose for which paid or incurred (refer also to specific contract if amount is due and payable pursuant to a contract involving progress payments, or, state Costs of Issuance, if applicable):
Fund, Account and/or subaccount from which disbursement is to be made:
Series 2024 Acquisition and Construction Account
The undersigned hereby certifies that obligations in the stated amount set forth above have been incurred by the District, that each disbursement set forth above is a proper charge against the Series 2024 Acquisition and Construction Account and the subaccount, if any, referenced above, that each disbursement set forth above was incurred in connection with the acquisition and construction of the Phase 1 Project and each represents a Cost of the Phase 1 Project, and has not previously been paid.
The undersigned hereby further certifies that there has not been filed with or served upon the District notice of any lien, right to lien, or attachment upon, or claim affecting the right to receive payment of, any of the moneys payable to the Payee set forth above, which has not been released or will not be released simultaneously with the payment hereof.
The undersigned hereby further certifies that such requisition contains no item representing payment on account of any retained percentage which the District is at the date of such certificate entitled to retain.

Originals or copies of the invoice(s) from the vendor of the property acquired or services rendered with respect to which disbursement is hereby requested are on file with the District.
GOLDEN GEM COMMUNITY DEVELOPMENT DISTRICT

AuthrizedOfficer

CONSULTING ENGINEER'S APPROVAL FOR NON-COST OF ISSUANCE REQUESTS ONLY
If this requisition is for a disbursement from other than the Costs of Issuance Account, the undersigned Consulting Engineer hereby certifies that this disbursement is for a Cost of the Phase 1 Project and is consistent with: (i) the applicable acquisition or construction contract; (ii) the plans and specifications for the portion of the Phase 1 Project with respect to which such disbursement is being made; and (iii) the report of the Consulting Engineer attached as an Exhibit to the First Supplemental Trust Indenture, as such report shall have been amended or modified on the date hereof.

Consulting Engineer
Kevin M Roberson
Kimley Hom and Associates, Inc

Invoice#	Project	Description	CDD Eligible?	% Eligible	Total	0122	0222	0322	0422	0522	0622	0722	0822	0922	1022	1122	1222	0123	0223	
		Phase 1 ESA	No		4,000.00	3,600.00	400.00													
		Umited Due Diligence	No		9,500.00	4,750.00	4,750.00													
		Conceptual Masler Planning	No		19,250.00	10,587.50	5,775.00	2,887.50												
		Natural Resource Assessment (NRA)	No		8,100.00	7,290.00	810.00													
		Office Expense 5%	No		2,042.50	1,311.38	586.75	144.37												
		Cost Planning Assislance	No		5,500.00		2,750.00	1,650.00	550.00	275.00	275.00									
		Phase 1 ESA	No		4,000.00		1,000.00	3,000.00												
		Umited Due Diligence	No		4,500.00		4,500.00													
		Conceptual Master Planning	No		7,000.00			1,750.00	2,100.00	3,150.00										
		Natural Resource Assessment (NRA)	No		6,000.00		1,500.00	4,500.00												
		Office Expense 5%	No		1,350.00		487.50	545.00	132.50		13.75	171.25								
		Phase 2 ESA- 202 Acres	No		26,000.00			26,000.00												
		Phase 2 ESA- 34 Acres	No		7,200.00			7,200.00												
		Office Expense 5%	No		1,660.00			1,660.00												
		Traffic Impact Analysis	No		19,500.00				1,950.00	11,700.00	1,950.00	1,950.00		1,950.00						
		MDP For Rezoning	No		26,200.00				6,550.00	2,620.00	7,860.00	5,240.00	2,620.00		1,310.00					
		Master Stormwater Report	Yes	100%	35,400.00			1,770.00	1,770.00	5,310.00	7,080.00	7,080.00	5,310.00	7,080.00						
		Office Expense 5%	No		4,055.00			88.50	513.50	1,152.75	844.50	713.50	396.50	345.75						
		Masler Grading Plans	Partially	9.97%	19,500.00								10,725.00	8,775.00						
		Master Stormwater Modeling	Yes	100%	13,440.00								5,376.00	8,064.00						
147864000	Kelly Park Crossing	Roadway Layout Site Planning	Yes	100%	9,400.00								2,350.00	7,050.00						
		Tree Survey	No		17,000.00								14,450.00	2,550.00						
		Tree Mitigation Plans	No		8,500.00									7,225.00	425.00	850.00				
		Onsite Roadway Design Plans	Yes	100%	250,000.00									12,500.00	12,500.00	25,000.00	50,000.00	25,000.00	25,000.00	
		Onsile Roadway Drainage Design Report	Yes	100%	35,000.00									22,750.00		3,500.00	1,750.00	3,500.00	1,750.00	
		Office Expense 5%	Pro-Rata By Month	17,642.00								1,645.05	3,445.70	646.25	1,467.50				
							
		Master Grading& Earthwork Revisions	Partially	9.97%	41,475.00		
		Masler Stormwater Revisions	Yes	100%	32,150.00		
		Golden Gem Parcels Concep Grading & Stormwati	Yes	100%	9,400.00		
		Tree Mitigation & lnvenlory Revisions	No		29,250.00		
		Onsite Roadway Lighting Plans	Yes	100%	30,800.00		
		MDP Revision & Rezoning Assistance	No		21,000.00		
		Office Expense 5%	Pro-Rata By Month	8,203.75		
							
		Meetings & Coordination	Pro-Rata By Month	252,675.00	4,612.50	5,635.00	5,330.00	3,875.00	5,115.00	7,750.00	11,790.00	13,060.00	15,060.00	17,472.50	17,900.00	12,150.00	20,290.00	12,120.00	
		Rezoning Report	No		34,185.00			370.00	3,810.00	3,935.00	1,890.00	4,240.00	3,570.00	1,360.00	1,190.00	3,740.00				
		Dry Utility Coordination	Yes																	
		City Platting Review	No		23,367.50								1,700.00	510.00	4,702.50	4,070.00	3,910.00	900.00	1,760.00	
		Onsite Permitting	No		34,277.50										4,237.50	1,100.00	1,260.00	4,545.00	3,985.00	
		Outside Agency Permitting	No		24,705.00								300.00	310.00			7,910.00		690.00	
		Bidding Assistance	No		24,410.00											2,600.00			360.00	
		Continued Permitting Assistance	No		3,880.00															
		Expenses	Pro-Rata By Month	47,428.84		488.44	977.17	7,987.79	387.55	21.26	214.30	387.38	1,075.65	7,583.81	217.12	992.70	4,122.43	477.37	
		Office Expense	Pro-Rata By Month	20,397.46	230.63	281.75	285.00	384.25	514.27	411.02	801.53	931.50	861.96	1,380.06	1,470.42	1,160.58	1,286.75	945.75	
					1,211,999.55	32,382.01	28,964.44	58,157.54	29,623.04	34,159.57	28,095.53	32,200.58	62,821.43	100,913.06	51,447.62	61,915.04	79,133.28	59,644.18	47,088.12	

CDD Summary For Invoice 147864000	al Yes
al Partially
al Variable By Month	Yes
Partially		428,245.00
6,079.21
171,400.96	1,770.00  1,770.00  5,310.00  7,080.00  7,080.00  13,036.00  57,444.00  12,500.00  28,500.00  51,750.00  28,500.00  26,750.00
1,069.28	874.87
226.28  1,247.54  1,135.26  2,909.15  4,674.73  4,829.79  14,815.89  13,894.22  14,685.97  11,417.47  21,576.86  10,799.78	
		Pro-Rata By Month			
*For expenses that are pro-rata by month, the allocation rate is calculated as the proportion of eligible expenses to ineligible
expenses each month. The resulting percentage is then applied to the pro-rata expenses.	1,996.28  3,017.54  6,445.26  9,989.15  11,754.73  18,935.07  73,134.75  26,394.22  43,185.97  63,167.47  50,076.86  37,549.78	

		Phase 1 ESA	No		4,900.00	490.00	
		Limited Due Diligence	No		9,000.00	2,250.00	
		Natural Resource Assessment	No		7,200.00	5,760.00	
		Reimbursable Expenses	No		1,563.02		
		Office Expense	No		133.00		
		Phase 2 ESA	No		48,000.00		
		Grading & Earthwork Revisions	Yes	100%	19,170.00		
		Stormwater Revisions	Yes	100%	29,150.00		
147864004	Kelly Park 55 Acre DD	Tree Survey	Partially	9.97%	5,250.00		
		Tree Mitigation Plans	Partially	9.97%	10,500.00		
		Utility Construction Plans	Yes	100%			

Invoice#	Project	Description	COD Eligible?	% Eligible	Total	o=	0222	0322	0422	0522	0622	0722	0822	0922	1022	1122	1222	0123	0223	
		City Platting Review	Partially	9.97%	18,600.00		
		City Permit Assistance	Partially	9.97%	26,635.00		
		Outside Agency Permitting	Partially	9.97%	51,050.00		
		Gopher Tortoise Relocation	Partially	9.97%	41,427.50		
		Meetings & Coordination	Variable By Month	Variable By Month	508,872.50		
		Reimbursable Expenses	Variable By Month	Variable By Month	60,559.19		
		Gopher Tortoise GFD	Partially	9.97%			
		Office Expense	Variable By Month	Variable By Month	32,749.52		
					874,759.73	8,500.00	

COD Summary For Invoice 147864004	al Yes
al Partially
al Variable By Month	Yes
Partially Variable By Month		48,320.00
15,300.21
64,686.20		
*For expenses that are pro-rata by month, the allocation rate is calculated as the proportion of eligible expenses to ineligible
expenses each month. Theresulting percentageis then applied to the pro-rata expenses.		

1,996.28  3,017.54  6,445.26  9,989.15  11,754.73  18,935.07  73,134.75  26,394.22  43,185.97  63,167.47  50,076.86  37,549.78

734,031.58

al COO Eligible Expen

Invoice#	Project	Description	CDD Eligible?	% Eligible	Total	0323	0423	0523	0623	0723	0823	0923	1023	1123	1223	0124	0224	0324	
		Phase 1 ESA	No		4,000.00														
		Umited Due Diligence	No		9,500.00														
		Conceptual Masler Planning	No		19,250.00														
		Natural Resource Assessment (NRA)	No		8,100.00														
		Office Expense 5%	No		2,042.50														
		Cost Planning Assislance	No		5,500.00														
		Phase 1 ESA	No		4,000.00														
		Umited Due Diligence	No		4,500.00														
		Conceptual Master Planning	No		7,000.00														
		Natural Resource Assessment (NRA)	No		6,000.00														
		Office Expense 5%	No		1,350.00														
		Phase 2 ESA- 202 Acres	No		26,000.00														
		Phase 2 ESA- 34 Acres	No		7,200.00														
		Office Expense 5%	No		1,660.00														
		Traffic Impact Analysis	No		19,500.00														
		MDP For Rezoning	No		26,200.00														
		Master Stormwater Report	Yes	100%	35,400.00		
		Office Expense 5%	No		4,055.00		
		Masler Grading Plans	Partially	9.97%	19,500.00		
		Master Stormwater Modeling	Yes	100%	13,440.00		
147864000	Kelly Park Crossing	Roadway Layout Site Planning	Yes	100%	9,400.00		
		Tree Survey	No		17,000.00		
		Tree Mitigation Plans	No		8,500.00		
		Onsite Roadway Design Plans	Yes	100%	250,000.00	12,500.00		25,000.00	25,000.00	12,500.00		12,500.00				12,500.00			
		Onsile Roadway Drainage Design Report	Yes	100%	35,000.00			1,750.00											
		Office Expense 5%	Pro-Rata By Month	17,642.00	625.00		6,687.50	1,250.00	625.00		625.00				625.00			
							
		Master Grading& Earthwork Revisions	Partially	9.97%	41,475.00			20,737.50	6,221.25	4,147.50	4,147.50	6,221.25							
		Masler Stormwater Revisions	Yes	100%	32,150.00			16,075.00	4,822.50	3,215.00	3,215.00	4,822.50							
		Golden Gem Parcels Concep Grading & Stormwati	Yes	100%	9,400.00			6,580.00	470.00	470.00	940.00	940.00							
		Tree Mitigation & lnvenlory Revisions	No		29,250.00			8,775.00	8,775.00	4,387.50	2,925.00	4,387.50							
		Onsite Roadway Lighting Plans	Yes	100%	30,800.00			3,080.00	3,080.00	6,160.00	4,620.00		1,540.00	3,080.00	7,700.00	1,540.00			
		MDP Revision & Rezoning Assistance	No		21,000.00			1,050.00	4,200.00	4,200.00	2,100.00	4,200.00	4,200.00	1,050.00					
		Office Expense 5%	Pro-Rata By Month	8,203.75			4,152.37	1,378.44	1,129.00	897.37	346.57	287.00	13.00					
							
		Meetings & Coordination	Pro-Rata By Month	252,675.00	12,830.00	19,860.00	14,350.00	16,310.00	16,490.00	13,460.00	1,140.00		1,140.00	1,880.00	2,610.00	380.00	65.00	
		Rezoning Report	No		34,185.00	510.00	1,020.00								2,850.00	4,560.00	570.00	570.00	
		Dry Utility Coordination	Yes														2,835.00	2,082.50	
		City Platting Review	No		23,367.50	2,015.00	1,340.00			380.00	950.00	1,130.00							
		Onsite Permitting	No		34,277.50	5,580.00	720.00	720.00	540.00	2,850.00	4,180.00	570.00	1,900.00	2,090.00					
		Outside Agency Permitting	No		24,705.00	11,385.00			1,610.00	2,050.00			450.00						
		Bidding Assistance	No		24,410.00	1,620.00	1,800.00	5,040.00	2,160.00	1,140.00	1,900.00	1,900.00	4,560.00	760.00	570.00				
		Continued Permitting Assistance	No		3,880.00				3,880.00										
		Expenses	Pro-Rata By Month	47,428.84	24.30	288.70	588.07	3,335.00	726.78	887.51	25.89	3,474.67	1,380.32	6,451.50	1,382.36	4.60	3,061.30	
		Office Expense	Pro-Rata By Month	20,397.46	1,697.00	1,237.00	1,005.50	1,225.00	1,145.50	1,024.50	237.00	345.50	199.50	265.00	358.50	189.24	135.87	
					1,211,999.55	48,786.30	26,265.70	115,590.94	84,257.19	61,616.28	41,246.88	39,045.71	16,757.17	9,712.82	19,716.50	23,575.86	3,978.84	5,914.67	

CDD Summary For Invoice 147864000	al Yes
al Partially
al Variable By Month	Yes
Partially		428,245.00
6,079.21
171,400.96	12,500.00	52,485.00  33,372.50  22,345.00  8,775.00  18,262.50  1,540.00  3,080.00  7,700.00  14,040.00  2,835.00	2,082.50
2,067.53	620.26	413.51	413.51	620.26
5,644.27	16,452.49  13,146.70  11,031.72  5,985.04  1,222.66	500.00  1,205.89  5,952.61	3,755.97	477.78	2,561.16	
		Pro-Rata By Month			
*For expenses that are pro-rata by month, the allocation rate is calculated as the proportion of eligible expenses to ineligible
expenses each month. The resulting percentage is then applied to the pro-rata expenses.	18,144.27	71,005.02  47,139.45  33,790.23  15,173.54  20,105.42  2,040.00  4,285.89  13,652.61  17,795.97  3,312.78	4,643.66	

		Phase 1 ESA	No		4,900.00	4,410.00									
		Limited Due Diligence	No		9,000.00	6,750.00									
		Natural Resource Assessment	No		7,200.00	1,440.00									
		Reimbursable Expenses	No		1,563.02	1,563.02									
		Office Expense	No		133.00		133.00								
		Phase 2 ESA	No		48,000.00			40,800.00	7,200.00						
		Grading & Earthwork Revisions	Yes	100%	19,170.00					13,419.00	3,834.00	1,917.00			
		Stormwater Revisions	Yes	100%	29,150.00					26,235.00		2,915.00			
147864004	Kelly Park 55 Acre DD	Tree Survey	Partially	9.97%	5,250.00							262.50	4,987.50		
		Tree Mitigation Plans	Partially	9.97%	10,500.00								5,250.00	5,250.00	
		Utility Construction Plans	Yes	100%			

Invoice#	Project	Description	COD Eligible?	% Eligible	Total	0323	0423	0523	0623	0723	0823	0923	1023	1123	1223	0124	0224	0324	
		City Platting Review	Partially	9.97%	18,600.00						760.00	1,800.00	1,520.00	2,745.00	1,520.00	3,230.00	760.00	1,140.00	
		City Permit Assistance	Partially	9.97%	26,635.00								2,460.00	1,062.50	11,962.50	10,560.00	590.00		
		Outside Agency Permitting	Partially	9.97%	51,050.00						14,682.50	13,355.00	10,110.00	11,197.50	1,325.00		380.00		
		Gopher Tortoise Relocation	Partially	9.97%	41,427.50												6,082.50	34,697.50	
		Meetings & Coordination	Variable By Month	Variable By Month	508,872.50		2,660.00		2,880.00	1,800.00	380.00	12,155.00	33,157.50	61,255.00	22,942.50	61,890.00	60,167.50	54,987.50	
		Reimbursable Expenses	Variable By Month	Variable By Month	60,559.19			520.18	537.69	605.95	428.75		791.90	412.12	538.74	31,344.16	1,360.66	17,896.83	
		Gopher Tortoise GFD	Partially	9.97%															
		Office Expense	Variable By Month	Variable By Month	32,749.52				144.00		719.46	1,256.26	2,173.39	3,528.66	1,736.50	6,669.20	3,127.08	4,177.95	
					874,759.73	14,163.02	2,793.00	41,320.18	10,761.69	42,059.95	20,804.71	33,660.76	60,450.29	80,200.78	45,275.24	113,693.36	72,467.74	112,899.78	

	al Yes	Yes		48,320.00	39,654.00	3,834.00	4,832.00							
COD Summary For	al Partially	Partially		15,300.21		1,539.62	1,537.12	2,425.45	1,496.00	1,999.73	1,374.86	778.91	3,573.00	
Invoice 147864004	al Variable By Month	Variable By Month		64,686.20	2,405.95	426.01	4,218.28	3,601.44	6,500.02	2,514.21	9,960.36	6,446.13	7,683.11	
*For expenses that are pro-rata by month, the allocation rate is calculated as the proportion of eligible expenses to ineligible
expenses each month. The resulting percentage is then applied to the pro-rata expenses.	42,059.95	5,799.63	10,587.40	6,026.89	7,996.02	4,513.94	11,335.23	7,225.03	11,256.11	

71,005.02  47,139.45  75,850.18  20,973.17  30,692.82  8,066.90  12,281.90  18,166.55  29,131.20  10,537.81  15,899.77

18,144.27

734,031.58

al COO Eligible Expen

Invoice#	Project	Description	CDD Eligible?	% Eligible	Total	0424	0524	0624	
		Phase 1 ESA	No		4,000.00				
		Umited Due Diligence	No		9,500.00				
		Conceptual Masler Planning	No		19,250.00				
		Natural Resource Assessment (NRA)	No		8,100.00				
		Office Expense 5%	No		2,042.50				
		Cost Planning Assislance	No		5,500.00				
		Phase 1 ESA	No		4,000.00				
		Umited Due Diligence	No		4,500.00				
		Conceptual Master Planning	No		7,000.00				
		Natural Resource Assessment (NRA)	No		6,000.00				
		Office Expense 5%	No		1,350.00				
		Phase 2 ESA- 202 Acres	No		26,000.00				
		Phase 2 ESA- 34 Acres	No		7,200.00				
		Office Expense5%	No		1,660.00				
		Traffic Impact Analysis	No		19,500.00				
		MDP For Rezoning	No		26,200.00				
		Master Stormwater Report	Yes	100%	35,400.00		
		Office Expense 5%	No		4,055.00		
		Masler Grading Plans	Partially	9.97%	19,500.00		
		Master Stormwater Modeling	Yes	100%	13,440.00		
147864000	Kelly Park Crossing	Roadway Layout Site Planning	Yes	100%	9,400.00		
		Tree Survey	No		17,000.00		
		Tree Mitigation Plans	No		8,500.00		
		Onsite Roadway Design Plans	Yes	100%	250,000.00		
		Onsile Roadway Drainage Design Report	Yes	100%	35,000.00		
		Office Expense 5%	Pro-Rata By Month	17,642.00		
							
		Master Grading& Earthwork Revisions	Partially	9.97%	41,475.00		
		Masler Stormwater Revisions	Yes	100%	32,150.00		
		Golden Gem Parcels Concep Grading& Stormwati	Yes	100%	9,400.00		
		Tree Mitigation & lnvenloryRevisions	No		29,250.00		
		Onsite Roadway Lighting Plans	Yes	100%	30,800.00		
		MDP Revision & Rezoning Assistance	No		21,000.00		
		Office Expense 5%	Pro-Rata By Month	8,203.75		
							
		Meetings & Coordination	Pro-Rata By Month	252,675.00		
		Rezoning Report	No		34,185.00				
		Dry Utility Coordination	Yes			7,512.50	225.00		
		City Platting Review	No		23,367.50				
		Onsite Permitting	No		34,277.50				
		Outside Agency Permitting	No		24,705.00				
		Bidding Assistance	No		24,410.00				
		Continued Permitting Assistance	No		3,880.00				
		Expenses	Pro-Rata By Month	47,428.84	57.21	807.66		
		Office Expense	Pro-Rata By Month	20,397.46	375.63	11.25		
					1,211,999.55	7,945.34	1,043.91		

CDD Summary For Invoice 147864000	al Yes
al Partially
al Variable By Month	Yes
Partially		428,245.00
6,079.21
171,400.96	7,512.50	225.00

432.84	818.91	
		Pro-Rata By Month			
*For expenses that are pro-rataby month, the allocation rate is calculated as the proportion of eligible expenses to ineligible
expenses each month. The resulting percentage is then applied to the pro-rata expenses.	7,945.34  1,043.91	

147864004	

Kelly Park 55 Acre DD	Phase 1 ESA
Limited Due Diligence Natural Resource Assessment Reimbursable Expenses Office Expense

Phase 2 ESA	No No No No No

No		4,900.00
9,000.00
7,200.00
1,563.02
133.00

48,000.00		
		Grading & Earthwork Revisions
Stormwater Revisions	Yes
Yes	100%
100%	19,170.00
29,150.00		
		TreeSurvey
Tree Mitigation Plans	Partially
Partially	9.97%
9.97%	5,250.00
10,500.00		
		Utility Construction Plans	Yes	100%			

Invoice#	Project	Description	COD Eligible?	% Eligible	Total	0424	0524	0624	
		City Platting Review
City Permit Assistance Outside Agency Permitting Gopher Tortoise Relocation Meetings & Coordination Reimbursable Expenses Gopher Tortoise GFD
Office Expense	Partially
Partially Partially Partially
Variable By Month Variable By Month Partially
Variable By Month	9.97%
9.97%
9.97%
9.97%
Variable By Month Variable By Month 9.97%
Variable By Month	18,600.00
26,635.00
51,050.00
41,427.50
508,872.50
60,559.19

32,749.52	1,900.00  1,275.00  1,950.00

647.50
55,935.00  73,225.00  65,437.50
5,532.39	589.82

2,690.20  3,427.00  3,099.82	
					874,759.73	66,705.09  78,516.82  70,487.32	

COD Summary For Invoice 147864004	al Yes
al Partially
al Variable By Month	Yes
Partially Variable By Month		48,320.00
15,300.21
64,686.20	
253.99
6,396.51	
127.12
7,701.01	
194.42
6,833.17	
*For expenses that are pro-rata by month, the allocation rate is calculated as the proportion of eligible expenses to ineligible
expenses each month. Theresulting percentageis then applied to the pro-rata expenses.	6,650.50	7,828.13	7,027.59	

14,595.84  8,872.04  7,027.59

734,031.58

al COO Eligible Expen

Section VIII

Section B

Section 1

July 12, 2024

ATTN: Jody Bass
RCS Construction Company 295 State Rte 50
Clearmont, FL 34711

RE:	Wyld Oaks - Summary of Plan Changes- Revision 8 & Revision 9

Dear RCS Construction,

The following listed items detail the summary of changes for the Wyld Oaks development located in the SWQ of FL-429 and W Kelly Park Road.

Infrastructure Plans:
Revision 8- Effie Utility Crossings
Relocated Driveway locations on Effie drive per Master Site Plan coordination.
Revised locations of Drainage Structures: D-32, D-35, D-04,D-9, D-47, D-19,
D-60, D-21, D-57
Added D-90 and D-91, and D-72
Revised utility and drainage stub locations per revised driveway locations and added additional drainage stubs.
Revised location of low point of structure D-19 and removed raised cross walks.
Added information for utility crossings Revision 9 – Effie ROW Revisions
Removed one (1) northbound lane on Effie Drive at intersection with Kelly Park Road, and associated curbing and sidewalk.
Revised typical section and grading in this area.
Revised and relocated Drainage structures D-01, D-09, D-26, from Type 5 Curb Inlets to a Median Inlet Type 8/9. & Revised and relocated Str D-12, D- 13 and D-14 from left wing to right wing Type 5 inlet.
Removed portion of Reclaimed water main and Sanitary sewer force main associated with this area and added caps, blow off valves and plug valves.

Thank you in advance for your assistance. If you should have any questions or comments, please don’t hesitate to contact me at kevin.roberson@kimley-horn.com or 772-794-4035.

Sincerely,

Kevin M. Roberson, P.E.

kimley-horn.com

445 24th Street, Suite 200, Vero Beach, FL 32960

772 794 4100

Infrastructure - Wyld Oaks Date: 08/01/2024
Change Order -02

Plan Revision 8
CO #	General Description	Quantity	U/M	Unit Cost	Notes	Days	Total CO	
	Revision 8				`			
1	Storm - D-24 Remove 54" HDPE	-16	LF	$360.14	Sheet 7	-0.3	$	(5,762.24)	
2	D-24 Add 36" HDPE	16	LF	$114.98	Sheet 7	1	$	1,839.68	
3	Reuse - Delete 8"x4" Tee	-1	EA	$281.00	Sheet 7	-0.01	$	(281.00)	
4	Delete 8" Gate Valve	-1	EA	$2,648.89	Sheet 7	-0.1	$	(2,648.89)	
5	Add 4" PVC Reuse Pipe	70	LF	$30.67	Sheet 7	0.2	$	2,146.90	
6	Add Storm Structure D-72	1	LS	$41,180.00	Sheet 8	3	$	41,180.00	
7	Curb Minus - "F" Curb	-171	LF	$28.13	Sheet 8	1	$	(4,810.23)	
8	Add- Type "D" Curb	184	LF	$26.58	Sheet 8	1	$	4,890.72	
9	Add 54"/60" HP	54	LF	$360.14	Sheet 8	1	$	19,447.56	
10	Add 54"/60 Cap	1	LS	$1,170.00	Sheet 8	0.1	$	1,170.00	
11	D-21 - Delete 18" HP	-38	LF	$50.28	Sheet 8	-0.2	$	(1,910.64)	
12	D-21 - Add 48" HP	125	LF	$320.16	Sheet 8	1	$	40,020.00	
13	D-21 - Add 48" Cap	1	EA	$770.00	Sheet 8	0.01	$	770.00	
14	D-21 - Add Core	1	EA	$1,440.00	Sheet 8	0.1	$	1,440.00	
15	D-22 - 36" HP	16	LF	$114.98	Sheet 8	0.1	$	1,839.68	
16	Add - 36" Cap	1	EA	$620.00	Sheet 8	0.01	$	620.00	
17	Add - 36" Core	1	EA	$580.00	Sheet 8	0.01	$	580.00	
18	Force Main Add - 6" PVC FM Pipe	185	LF	$50.13	Sheet 8	0.3	$	9,274.05	
19	Add - 10"x6" Tee	2	EA	$998.00	Sheet 8	0.01	$	1,996.00	
20	Add-10" Plug Valve	2	EA	$5,619.75	Sheet 8	0.1	$	11,239.50	
21	Add-6" Plug Valve	2	EA	$3,905.17	Sheet 8	0.01	$	7,810.34	
22	Add-6" Cap	2	EA	$197.00	Sheet 8	0.01	$	394.00	
23	Reuse Main Add - 6" PVC FM Pipe	90	LF	$50.13	Sheet 8	0.3	$	4,511.70	
24	4" Gate Valve	1	EA	$990.00	Sheet 8	0.2	$	990.00	
25	4" Stub Out	1	EA	$705.00	Sheet 8	0.01	$	705.00	
26	Water -Delete 16"x6" Tee	-1	EA	$810.00	Sheet 8	-0.1	$	(810.00)	
27	Delete 16"x8" Tee	-1	EA	$1,020.00	Sheet 8	-0.01	$	(1,020.00)	
28	Delete 6" Gate	-1	EA	$1,903.55	Sheet 8	-0.01	$	(1,903.55)	
29	Delete 16" Gate Valve	-1	EA	$8,950.47	Sheet 8	-0.3	$	(8,950.47)	
30	Delete 8" PVC Pipe	-60	LF	$50.94	Sheet 8	-0.3	$	(3,056.40)	
31	Delete 6" PVC Pipe	-60	LF	$37.07	Sheet 8	-0.3	$	(2,224.20)	
32	Delete 6" Cap	-1	EA	$202.00	Sheet 8	-0.01	$	(202.00)	
33	Delete 8" Cap	-1	EA	$274.00	Sheet 8	-0.01	$	(274.00)	
34	16" x10" Cross	1	EA	$1,440.00	Sheet 8	0.02	$	1,440.00	
35	10" Gate Valves	2	EA	$4,202.00	Sheet 8	0.5	$	8,404.00	
36	10" PVC C-900	125	LF	$74.90	Sheet 8	0.5	$	9,362.50	
37	10" Stub Outs	2	EA	$240.00	Sheet 8	0.01	$	480.00	
38	Stamped Asphalt - Delete	-1680	LF	$13.75	Sheet 8 & 9	-2	$	(23,100.00)	
39	Curb Minus - "F" Curb	-244	LF	$28.13	Sheet 8	1	$	(6,863.72)	
40	Add- Type "D" Curb	244	LF	$26.58	Sheet 8	1	$	6,485.52	
41	Storm - D-90 Storm Manhole Added	1	EA	$11,280.00	Sheet 9	0.5	$	11,280.00	
42	D-91 Storm Manhole Added	1	EA	$11,280.00	Sheet 9	0.5	$	11,280.00	
43	Add - 48" Core D-60	1	EA	$1,440.00	Sheet 9	0.2	$	1,440.00	
44	Add - 48" Core D-90	1	EA	$1,440.00	Sheet 9	0.3	$	1,440.00	
45	Add 48" HP Pipe	132	LF	$320.16	Sheet 9	1	$	42,261.12	
46	Water - 10" Gate Valves	2	EA	$4,202.00	Sheet 9	0.5	$	8,404.00	
47	10" PVC C-900	125	LF	$74.90	Sheet 9	0.5	$	9,362.50	
48	Delete 16" Gate Valve	-1	EA	$8,950.47	Sheet 9	-0.3	$	(8,950.47)	
49	Delete 6" PVC C-900	-60	LF	$37.07	Sheet 9	-0.01	$	(2,224.20)	
50	Delete 8" PVC C-900	-60	LF	$50.94	Sheet 9	-0.01	$	(3,056.40)	
51	Reuse - Add - 4" PVC Pipe	50	LF	$30.67	Sheet 9	0.2	$	1,533.50	
52	Force Main - Add - 6" PVC Pipe STA 12+70	50	LF	$50.13	Sheet 9	0.2	$	2,506.50	
53	Curb Minus - "F" Curb	-228	LF	$28.13	Sheet 10	0.5	$	(6,413.64)	
54	Add- Type "D" Curb	228	LF	$26.58	Sheet 10	0.5	$	6,060.24	
55	Storm - Delete 60" HP - 16+70	-21	LF	$480.83	Sheet 10	-0.1	$	(10,097.43)	
56	Add - Adjust D-47	1	LS	$590.00	Sheet 10	0.2	$	590.00	
57	Add - Adjust D-07	1	LS	$630.00	Sheet 10	0.2	$	630.00	
58	Water - Add - 8" C-900	55	LF	$50.94	Sheet 10	0.3	$	2,801.70	
59	Reuse - Add - 4" PVC Pipe	55	LF	$30.67	Sheet 10	0.2	$	1,686.85	
60	Force Main - Add - 6" PVC Pipe STA 16+69	55	LF	$50.13	Sheet 10	0.2	$	2,757.15	
61	Survey/3-D Files	1	LS	$12,994.00	All - Revsion 8	5	$	12,994.00	
62	As/Builts	1	LS	$7,644.00	All - Revsion 8	3	$	7,644.00	
63	Additional Well Abandonment	3	EA	$9,700.00	3-Wells not shown on Plans	2	$	29,100.00	
64	Curb Minus - "F" Curb	-131	LF	$28.13	Sheet 11	0.5	$	(3,685.03)	
65	Add- Type "D" Curb	131	LF	$26.58	Sheet 11	0.5	$	3,481.98	
							$	-	

TOTAL CHANGE ORDERS TO DATE	Total Days	25.43  $	238,046.18

Infrastructure - Wyld Oaks Date: 08/01/2024
Change Order -04

Conduit Install - Lighting & Irrigation

CO #	General Description	Quantity	U/M	Unit Cost	Notes	Days	Total CO	
	Conduit Install							
1	2" Schedule 40 Grey PVC - Low Power Lighting - Sleeving	2100	LF	$12.80		2	$	26,880.00	
2	
Communications Sleeving

2" Irrigation - Sleeving	1900	LF	$13.40		2	$	25,460.00	
3	Layout for Sleeving	1	LS	$3,300.00		2	$	3,300.00	
4	As-built and Locate Sleeving	1	LS	$4,700.00		3	$	4,700.00	

								

								
								
							$	-	

This change order is accepted by X____________________	Date_________________

TOTAL CHANGE ORDERS TO DATE	Total Days	9	$	60,340.00

Section C

Section 1

Golden Gem
Community Development  District

Unaudited Financial Reporting
August 31, 2024

Table of Contents

	Balance Sheet

	General Fund

	Series 2024 Debt Service Fund

	Series 2024 Capital Projects Fund

	Month to Month

	Long Term Debt Report

Golden Gem	
Community Development District	
Combined Balance Sheet	
August 31, 2024	
General	Debt Service	Capital Projects	Total	
Fund	Fund	Fund	Governmental Funds	

Assets:	
Cash:	
Operating Account	
Investments	
Series 2024	
Revenue	
Interest	
Sinking Fund	
Prepayment	
Reserve	
Capitalized Interest	
Acquisition & Construction	
Cost of Issuance	
Due from Developer	
Due from General Fund	
Prepaid Expenditures	

$	-	
$	-	
$	-	
$	-	
$	-	
$	-	
$	-	
$	-	
$	-	
$	-	
$	-	

$

Total Liabilites	$	9,730	$	-	$	-	$	9,730

Total Assets	$	13,004	$ 5,704,370	$  19,757,827	$	25,475,201	
Liabilities:	
Accounts Payable	$	9,730	$	-	$	-	$	9,730	
Contracts Payable	$	-	$	-	$	-	
Due to Capital	$	-	$	-	$	-	$	-	

Fund Balance:	
Nonspendable:	
Deposits and Prepaid Items	
Assigned:	
Debt Service - Series 2024	
Capital Projects Fund	
Unassigned	

$

13,004

-

$

$	-	
$	-	
$	-	
$	-	
$  2,712,768	
$  2,991,603	
$	-	
$	-	
$	-	
$	-	
$	-	

$

-

-

$

$	-	
$	-	
$	-	
$	-	
$	-	
$	-	
$	19,711,942	
$	45,885	
$	-	
$	-	
$	-	

$

-

-

$

$	-	
$	-	
$	-	
$	-	
$	2,712,768	
$	2,991,603	
$	19,711,942	
$	45,885	
$	-	
$	-	
$	-	

$

13,004

-

$	-	
$	-	
$	3,274	

	
$  5,704,370	
$	-	
$	-	

	
$	-	
$	19,757,827	
$	-	

 
$	5,704,370	
$	19,757,827	
$	3,274	

Total Fund Balances	$	3,274	$ 5,704,370	$  19,757,827	$	25,465,471	
					
Total Liabilities & Fund Balance	$	13,004	$  5,704,370	$	19,757,827	$	25,475,201	

Golden Gem	
Community Development District	
General Fund	
Statement of Revenues, Expenditures, and Changes in Fund Balance	
For The Period Ending August 31, 2024	

Adopted	Prorated Budget	Actual		
Budget	Thru 08/31/24	Thru 08/31/24	Variance	

Revenues:					
Developer Contributions	$	94,677	$	72,987	$	72,987	$	-	

Total Revenues	$	94,677	$	72,987	$	72,987	$	-	
Expenditures:					
General & Administrative:					
Supervisor Fees	$	9,000	$	8,000	$	2,800	$	5,200	
FICA Expenditures	$	689	$	612	$	214	$	398	
Engineering	$	11,250	$	10,000	$	8,348	$	1,653	
Attorney	$	18,750	$	16,667	$	16,611	$	55	
Annual Audit	$	-	$	-	$	-	$	-	
Assessment Administration	$	-	$	-	$	-	$	-	
Arbitrage	$	-	$	-	$	-	$	-	
Dissemination	$	-	$	-	$	833	$	(833)	
Trustee Fees	$	-	$	-	$	-	$	-	
Management Fees	$	28,125	$	25,000	$	24,093	$	907	
Information Technology	$	1,350	$	1,200	$	1,156	$	44	
Website Maintenance	$	2,650	$	2,356	$	2,150	$	206	
Telephone	$	225	$	200	$	-	$	200	
Postage & Delivery	$	750	$	667	$	193	$	474	
Insurance	$	5,000	$	5,000	$	3,616	$	1,384	
Printing & Binding	$	750	$	667	$	149	$	518	
Legal Advertising	$	11,250	$	10,000	$	9,231	$	769	
Other Current Charges	$	3,750	$	3,333	$	192	$	3,141	
Office Supplies	$	468	$	416	$	1	$	415	
Travel Per Diem	$	495	$	440	$	-	$	440	
Dues, Licenses & Subscriptions	$	175	$	175	$	125	$	50	

Total Expenditures	$	94,677	$	84,732	$	69,713	$	15,019	

Excess (Deficiency) of Revenues over Expenditures	$	-	$	3,274	
		
Fund Balance - Beginning	$	-	$	-	
		
Fund Balance - Ending	$	-	$	3,274	

Golden Gem	
Community Development District	
Debt Service Fund Series 2024	
Statement of Revenues, Expenditures, and Changes in Fund Balance	
For The Period Ending August 31, 2024	

Adopted	Prorated Budge	Actual	
Budget	Thru 06/30/24	Thru 06/30/24	Variance	

Revenues:		
Assessments - Tax Roll	$	-	
Interest	$	-	

$	-	
$	-	

$	-	
$	39,054	

$	-	
$	39,054	

Total Revenues	$	-	$	-	$	39,054	$	39,054	

Expenditures:		
Interest - 11/1	$	-	$	-	$	-	$	-	
Principal - 5/1	$	-	$	-	$	-	$	-	
Interest - 5/1	$	-	$	-	$	-	$	-	
Total Expenditures	$	-	$	-	$	-	$	-	

Excess (Deficiency) of Revenues over Expenditures	$	-	$	39,054	

Other Financing Sources/(Uses):

Bond Proceeds	$	-	
Transfer In/(Out)	$	-	

$	-	
$	-	

$ 5,665,317	
$	-	

$ 5,665,317	
$	-	

Total Other Financing Sources/(Uses)	$	-	$	-	$ 5,665,317	$ 5,665,317	
		
Net Change in Fund Balance	$	-	$	-	$ 5,704,370	$ 5,665,317	
		
Fund Balance - Beginning	$	-	$	-	$	-	$	-	
		
Fund Balance - Ending	$	-	$	-	$ 5,704,370	$ 5,665,317	

Golden Gem	
Community Development District	
Capital Projects Fund	
Statement of Revenues, Expenditures, and Changes in Fund Balance	
For The Period Ending August 31, 2024	

Adopted	Prorated Budget	Actual	
Budget	Thru 08/31/24	Thru 08/31/24	Variance	

Revenues:		
Developer Advances	$	-	
Developer Contributions	$	-	
Interest	$	-	

$	-	
$	-	
$	-	

$	13,466	
$	-	
$	154,425	

$	13,466	
$	-	
$	154,425	

Total Revenues	$	-	$	-	$	167,891	$	167,891	

Expenditures:		
General & Administrative:		
Capital Outlay	$	-	$	-	$ 10,180,726	$  (10,180,726)	
Capital Outlay - COI	$	-	$	-	$	989,675	$	(989,675)	

Total Expenditures	$	-	$	-	$11,170,401	$ (11,170,401)	

Excess (Deficiency) of Revenues over Expenditures	$	-	$(11,002,510)	

Other Financing Sources/(Uses):		

Bond Proceeds	$	-	
Bond Discount	$	-	
Transfer In/(Out)	$	-	

$	-	
$	-	
$	-	

$ 30,884,683	
$	(124,346)	
$	-	

$	30,884,683	
$	(124,346)	
$	-	

Total Other Financing Sources/(Uses)	$	-	$	-	$ 30,760,337	$	30,760,337	
		
Net Change in Fund Balance	$	-	$	-	$19,757,827	$  30,760,337	

Fund Balance - Beginning	$	-	$	-	$	-	$	-	
		
Fund Balance - Ending	$	-	$	-	$ 19,757,827	$	30,760,337	

Golden Gem	
Community Development District	
Month to Month	

Oct	Nov	Dec	Jan	Feb	March	April	May	June	July	Aug	Sept	Total	

Revenues:														
Developer Contributions	$	-	$	-	$	-	$	-	$  23,094	$  14,329	$	8,496	$	7,758	$	7,422	$	-	$  11,889	$	-	$  72,987	

Total Revenues	$	-	$	-	$	-	$	-	$ 23,094	$ 14,329	$  8,496	$  7,758	$  7,422	$	-	$ 11,889	$	-	$ 72,987	

Expenditures:														
General & Administrative:														
Supervisor Fees	$	-	$	-	$	-	$	-	$	600	$	-	$	-	$	1,200	$	1,000	$	-	$	-	$	-	$	2,800	
FICA Expenditures	$	-	$	-	$	-	$	-	$	46	$	-	$	-	$	92	$	77	$	-	$	-	$	-	$	214	
Engineering	$	-	$	-	$	-	$	-	$	1,343	$	1,943	$	1,643	$	760	$	2,660	$	-	$	-	$	-	$	8,348	
Attorney	$	-	$	-	$	2,058	$	4,337	$	3,780	$	2,436	$	754	$	2,814	$	433	$	-	$	-	$	-	$  16,611	
Annual Audit	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-			$	-	$	-	
Assessment Administration	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-			$	-	$	-	
Arbitrage	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-			$	-	$	-	
Dissemination	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	417	$	417	$	-	$	833	
Trustee Fees	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-			$	-	$	-	
Management Fees	$	-	$	-	$	-	$	2,218	$	3,125	$	3,125	$	3,125	$	3,125	$	3,125	$	3,125	$	3,125	$	-	$  24,093	
Information Technology	$	-	$	-	$	-	$	106	$	150	$	150	$	150	$	150	$	150	$	150	$	150	$	-	$	1,156	
Website Maintenance	$	-	$	-	$	-	$	-	$	-	$	-	$	1,750	$	100	$	100	$	100	$	100	$	-	$	2,150	
Telephone	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-			$	-	$	-	
Postage & Delivery	$	-	$	-	$	-	$	-	$	38	$	7	$	54	$	4	$	2	$	56	$	31	$	-	$	193	
Insurance	$	-	$	-	$	-	$	3,616	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	3,616	
Printing & Binding	$	-	$	-	$	-	$	-	$	61	$	-	$	44	$	-	$	-	$	44	$	-	$	-	$	149	
Legal Advertising	$	-	$	-	$	-	$	-	$	7,043	$	1,617	$	-	$	572	$	-	$	-	$	-	$	-	$	9,231	
Other Current Charges	$	-	$	-	$	-	$	-	$	-	$	-	$	38	$	38	$	39	$	39	$	38	$	-	$	192	
Office Supplies	$	-	$	-	$	-	$	-	$	-	$	0	$	0	$	0	$	0	$	0	$	1	$	-	$	1	
Travel Per Diem	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	-			$	-	$	-	
Dues, Licenses & Subscriptions	$	-	$	-	$	-	$	-	$	125	$	-	$	-	$	-	$	-	$	-	$	-	$	-	$	125	
Total Expenditures	$	-	$	-	$  2,058	$ 10,277	$ 16,310	$  9,278	$  7,558	$  8,855	$  7,585	$  3,930	$  3,862	$	-	$ 69,713	

Excess Revenues (Expenditures)	$	-	$	-	$  (2,058)	$ (10,277)	$	6,784	$	5,051	$	938	$  (1,098)	$	(163)	$  (3,930)	$	8,027	$	-	$	3,274	

- 5 -

Golden Gem	
Community Development District	
Long Term Debt Report	

	

Series 2024 Special Assessment Revenue Bonds	
Interest Rate:	5.15% to 6.00%	
Maturity Date:	11/1/2055	
Optional Redemption Date:	On or After 5/1/2034

Reserve Fund Definition:	50% MADS After Release Conditions Reserve Fund Requirement:		$2,712,768
Reserve Fund Balance:	$2,712,768

Bonds outstanding - 5/31/2024	$36,550,000 Less: May 1, 2029 Principal		$0	
Current Bonds Outstanding	$36,550,000	

- 6 -

Section 2

Golden Gem
Community Development District

Funding Request #6
June 14, 2024

Bill to:	Wyld Oaks Development

Payee	

General Fund	

1	

GMS- Central Florida, LLC
Invoice # 7 - Management Fees June 2024	

$	3,377.02	
2	Kimley-Horn and Associates
Invoice # 28089719 - Engineering Services April 2024	
$	1,642.50	
3	Kutak Rock, LLP
Invoice # 3396191 - General Counsel April 2024	
$	753.57	
4	Tribune Publishing Company, LLC
Invoice # 094133261000 - Legal Advertising	
$	572.00	
5	Supervisor Fees - 03/13/2024 Meeting
Craig Linton, Jr.	
$	215.30	
	H.M. Ridgely, III Taylor Edwards George Hamner, Jr. Duane "Rocky" Owen	$	215.30
$	215.30
$	215.30
$	215.30	
		
$	7,421.59	

	Total:	$	7,421.59 

Please make check payable to:

Golden Gem Community Development District
6200 Lee Vista Blvd, Suite 300
Orlando, FL 32822

GMS-Central Florida, LLC
1001 Bradford Way
Kingston, TN 37763

Invoice

Bill To:
Golden Gem COD 219 E. Livingston St. Orlando, FL 32801

Invoice#: 7
Invoice Date: 6/1/24
Due Date: 6/1/24
Case:
P.O. Number:

Description	Hours/Qty	Rate	Amount

Management Fees - June 2024		3,125.00	3,125.00	
Website Administration - June 2024		100.00	100.00	
Information Technology- June 2024		150.00	150.00	
Office Supplies		0.09	0.09	
Postage		1.93	1.93	

�re lm rE aw lE�				
ill] JUN I 4 2024	w				
By				

Total	$3,377.02	
Payments/Credits	$0.00	
Balance Due	$3,377.02	

Please remit payment electronically to:
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.
Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA
Account Number:	2073089159554
ABA#:	121000248	

94104	If paying by check, please remit to:
KIMLEY-HORN AND ASS0OATES, INC.
P.O. BOX 932520
ATLANTA, GA 31193-2520	
Please send remittance
information to:	payments@kimley-horn.com	
I	

GOLDEN GEM COD
C/O GOVERNMENTAL MANAGEMENT SERVICES 219 EAST LIVINGSTON ST
ORLANDO, FL 32801

Federal Tax Id: 56-0885615
For Services Rendered through Apr 30, 2024

Invoice Amount: $1,642.50
Invoice No:	 28089719 Invoice Date:	Apr 30, 2024
Project No:	147968000.3
Project Name:	GOLDEN GEM COD INTERIM
Project Manager:	ROBERSON, KEVIN Client Reference:	RESOLUTION 2024-05

COST PLUS MAX
Description	
Contract Value	Amount Billed to Date	Previous Amount Billed	Current Amount Due	
INTERIM ENGINEERING	25,000.00	4,927.50	3,285.00	1,642.50	
Subtotal	25,000.00	4,927.50	3,285.00	1,642.50	
Total COST PLUS MAX	1,642.50	
Total Invoice: $1,642.50

lfil MAY 2 8 2024	w
By

m[E fffi [E □ wre�

If you have any questions, please contact Zach.Reuther at 561-234-4519 or Zach.Reuther@kimley-horn.com.	31ZSR

GOLDEN GEM COD
C/0 GOVERNMENTAL MANAGEMENT SERVICES
219 EAST LMNGSTON ST

Invoice No: Invoice Date:

28089719
Apr 30, 2024

ORLANDO, FL 32801

Project No:	147968000.3
Project Name:	GOLDEN GEM CDD INTERIM
Project Manager: ROBERSON, KEVIN

COST PLUS MAX

Task	
Description	
Hrs/Qty	
Rate	Current Amount Due	
0lINTERIM ENGINEERING	ANALYST	1.0	160.00	160.00	
	PROFESSIONAL	0.5	245.00	122.50	
	SENIOR PROFESSIONAL II	2.0	380.00	760.00	
	TECHNICAL SUPPORT	4.0	150.00	600.00	
TOTAL 0lINTERIM ENGINEERING	7.5	1,642.50	
TOTAL LABOR AND EXPENSE DETAIL	1,642.50	
This page is for informational purposes only. Please pay amount shown on cover page.

31ZSR

KUTAK  ROCK  LLP
TALLAHASSEE, FLORIDA
Telephone 404-222-4600
Facsimile 404-222-4654

Federal ID 47-0597598

May 29, 2024

Check Remit To: Kutak Rock LLP PO Box 30057
Omaha, NE 68103-1157

ACH/Wire Transfer Remit To:
ABA #104000016
First National Bank of Omaha
Kutak Rock LLP A/C # 24690470
Reference: Invoice No. 3396191 Client Matter No. 47123-1
Notification Email: eftgroup@kutakrock.com

Golden Gem CDD
c/o Governmental Management Services 219 East Livingston Street
Orlando, FL 32801	Invoice No. 3396191
47123-1

Re:	General Counsel
For Professional Legal Services Rendered

04/03/24	A. Willson	0.30	94.50	Confer	with  Flint	and	Edwards	
04/05/24	A. Willson	
0.60	
189.00	regarding upcoming board meeting Confer with team regarding ongoing	
04/06/24	R. Dugan	0.10	27.50	district items
Prepare  Fiscal  Year 2025  budget	
04/12/24	J. Gillis	0.60	105.00	documents
Draft assignment documents for site	
				construction	agreement	for	mass	

04/12/24	

A. Willson	

0.80	

252.00	grading improvements between Double B Development and RCS Construction
Attend monthly call	
04/15/24	J. Gillis	0.20	35.00	Draft	notice	of	master	special assessment lien	

TOTAL HOURS	2.60

KUTAK ROCK LLP
Golden Gem CDD
May 29, 2024		
Client Matter No. 47123-1 Invoice No. 3396191
Page 2		
TOTAL FOR SERVICES RENDERED		$703.00	
DISBURSEMENTS			
Freight and Postage	50.57		
TOTAL DISBURSEMENTS			
TOTAL CURRENT AMOUNT DUE		$753.57	

Orlando Sentinel
-	MEDIA GROUP

INVOICE

PO Box8023
WIiioughby, OH 44096

adbilling@tribpub.com 844-348-2445

Invoice Details BIiied Account Name: Billed Account Number: Invoice Number: Invoice Amount:
Billing Period: Due Date:

Golden Gem Cdd CU80173779 094133261000
$572.00 05/27/24 - 06/02/24
07/02/24

Page 1 of2

Invoice Details

	Un	

Description	A Slzial Rate

Total

v

\....$/22/24 OSC94133261
l/{iS/29/24

Classified Listings, Online GG_BOS_Budget_FY25_061224 Notice 7639121

572.00

I

lfn)lE lm l€ D \YI rEfm
W] JUN 13 2024 �
By

Invoice Total:	S572.00

Account Summary
Current	1-30	31-60	61-90	91+	Unapplled
Amount	
572.00	0.00	0.00	0.00	0.00	0.00	

Please detach and retum this portion with your payment.

Orlando Sentinel
- GROUP

POBox8023
WIiioughby, OH 44096

Remittance Section Billed Period:
BIiied Account Name: Billed Account Number: Invoice Number:

05127124 • 06/02/24
Golden Gem Cdd CU80173779 094133261000

Return Service Requested

i!27800Dl3J.	PRESORT PBPS001 <B>
11•1111111•1111111•u1•11h•..11•11•h•11111•111h•h••'n"11111
l',ll'jS GOLDEN GEM COD
�	STACIE VANDERBILT 219 E LIVINGSTON ST ORLANDO FL 32801-1508

For questions r&gardlng this billing, or change of address notification, please contact Customer Care:

Orlando Sentinel POElox8023 Witloughby, OH 44096

MEOIA GROUP

Published Daily ORANGE County, Florida
�
Golden Gem CDD - CUS0l 73779 219 E Livingston St
Orlando, FL 32801

BWTo;
Golden Gem CDD - CUS0l 73779 219 E Livingston St
OrlB.lldo, FL 32801

State Of Florida County Of Orange
Before the undersigned authority personally
appeared
Rose Williams, who on oath says that he or she is a duly authorized representative of the ORLANDO SENTINEL, a DAil..Y
newspaper published in ORANGE County, Florida; that the attached copy of advertisement, being a Legal Notice in:
The matter of 1USO-Public Hearing Notice Was published in said newspaper by print in the issues of, or by publication on the newspaper's website, if authorized on May 22, 2024; May 29, 2024.
Affiant further says that the newspaper complies with all legal requirements for publication in Chapter 50,Florida Statutes.

RIiiie Williams

Signature of Affiant	Name of Affiant

Sworn to and subscn"bed before me on this 30 day of May, 2024,
by above Affiant, who is pecsonally known to me (X) or who has produced identification ( ).

Signature of Notary Public

Name of Notary, Typed, Printed, or Stamped

7639121

MEDIA GROUP

GOLDIJ4 GEMCINMUffnY
DEYB.OPMENJ DlffRICT
NGnCEOF PUBUC IEARING lOCONSIDER
. THEADOPDON OFTHE RSCAJ.YEAR
102lffliJ1,U.f�1ffl'i.li'll."w
The Boord of Supervisors ("Board") of the Golden Gem Community DeveloPment District C"Dlatrlct") wlll hold a publlc hearing on June 12, 2024 at 1�:30 a.m. at the offices of Governmental Mana;ement Services - Central Florida, LLC,
219 East Llvlng1ton Street, Orlando, Florlda 32801, for the purPolle of heartng comments and obfectlons on
�  acloPtlcn of the proPOSed budget
{"PrOPQSecl Budget") of the Olstrlc:t for the fiscol Year be91nnln11 October 1, 2024 and ending September 30, 2025 ("Fiscal Y.ecr . 2024fl02S''l. A regular board meeflni> of the Dlatrlct will also be held at that time where the Bocrd may con11lder any ofner business fhat may properlY come before It. A copy of the qgenda and Pro1>0sed Budget may be obtained at the officea ofthe Olatrlc:t Manager, 219 East Livingston Street, Orlando, Florida 3280l, {407) IUl-5524 ("District Manager's Office"), during normal business hours.
The publlc hearing and meeting ore open to the public and will bit conducted In accordance with the provisions of Florida law. The publlc hearing and meeting.. may be continued to a date, ttme, and place to be r;peclfied an the record at the meeting. There may be oc:caalons when Board Supervisors or Cllltrlct Staff may parllc:lpafe bv speaker telephone.
Any person requiring special accommodations at this meeting be<:Quse of a dlsabfllty or physical Impairment should contact the Dlstrlc:t Manoeer's Office at least fortv-efuht
(411) hours prior to the meeting. If YoU
<1re hearing OI" spee<;h lmpalred, pleaH contact the Florida Relay Servi� by dialing 7-1-1, or 1-800-955-8711 (TTY}
I l-800-955-8770 (Volc:e), for aid In c:onfactlng the Dls.trlct Manaser's Office.
Each. peraon who·decide& to appeal einv decision meide by the Board with respect kl. csnv matter considered at the publlc hec:irfng or meeting Is odvlsed that siert0n wltl need a record af pruceedlnus and that accordingly, tt,e person may need to ensure that a verbatim record of the proceeding, la mode, lncludlng the testimony and evidence UPOfl which such appeal Is to be baled,
George S. Flint
District Manager
GovDrnmental Management Service! - Central Florida, LLC
7619121	ffl,5M/'1m.t
7639121

Golden Gem	
Community Development District	

Funding Request #7	
July 17, 2024	

Bill to:	Wyld Oaks Development	

Payee	General Fund

1	GMS- Central Florida, LLC	
	Invoice # 8 - Management Fees July 2024	

$	3,891.75

2	Kimley-Horn and Associates	
	Invoice # 28395884 - Engineering Services May 2024	

$	760.00

$	4,651.75

Total:

$	4,651.75

Please make check payable to:

Golden Gem Community Development District	
4530 Eagle Falls Place	
Tampa, FL 33619	

GMS-Central Florida, LLC
1001 Bradford Way
Kingston, TN 37763

Invoice

Bill To:
Golden Gem CDD 219 E. Livingston St. Orlando, FL 32801

Invoice#: 8
Invoice Date: 7/1/24
Due Date: 7/1/24
Case:
P.O. Number:

Description	Hours/Qty	Rate	Amount

Management Fees - July 2024 Website Administration - July 2024 Information Technology - July 2024
Dissemination Agent Services - July 2024 Office Supplies
Postage Copies		3,125.00
100.00
150.00
416.67
0.06
56.37
43.65	3,125.00
100.00
150.00
416.67
0.06
56.37
43.65	

Total	$3,891.75	
Payments/Credits	$0.00	
Balance Due	$3,891.75	

Please remit payment electronically to:	If paying by check, please remit to:	
Account Name:	KIMLEY-H0RN AND ASSOCIATES, INC.
Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANOSCO, CA 94104
Account Number:	2073089159554
ABA#:	121000248	KIMLEY-H0RN AND ASSOCIATES, INC.
P.O. BOX 932520
ATLANTA, GA 31193-2520	
Please send remittance	payments@kimley-horn.com information to:		

GOLDEN GEM CDD
C/O GOVERNMENTAL MANAGEMENT SERVICES 219 EAST LIVINGSTON ST
ORLANDO, FL 32801

Federal Tax Id:  56-0885615
For Services Rendered through May 31, 2024

Invoice Amount: $760.00
Invoice No:	 28395884 Invoice Date:	May 31, 2024
Project No:	147968000.3
Project Name:	GOLDEN GEM CDD INTERIM
Project Manager:	ROBERSON, KEVIN Client Reference:	RESOLUTION 2024-05

COST PLUS MAX
Description	
Contract Value	Amount Billed to Date	Previous Amount Billed	Current Amount Due	
INTERIM ENGINEERING	25,000.00	5,687.50	4,927.50	760.00	
Subtotal	25,000.00	5,687.50	4,927.50	760.00	
Total COST PLUS MAX	760.00	
Total Invoice: $760.00

By

If you have any questions, please contact Zach.Reuther at 561-234-4519 or Zach.Reuther@kimley-horn.com.	31ZSR

GOLDEN GEM COD
C/0 GOVERNMENTAL MANAGEMENT SERVICES
219 EAST LIVINGSTON ST

Invoice No: Invoice Date:

28395884
May 31, 2024

ORLANDO, FL 32801

Project No:	147968000.3
Project Name:	GOLDEN GEM CDD INTERIM
Project Manager: ROBERSON, KEVIN

COST PLUS MAX

Task	
Description	
Hrs/Qty	
Rate	Current Amount Due	
0lINTERIM ENGINEERING	SENIOR PROFESSIONAL II	2.0	380.00	760.00	
TOTAL 0UNTERIM ENGINEERING	2.0	760.00	
TOTAL LABOR AND EXPENSE DETAIL	760.00	
This page is for informational purposes only. Please pay amount shown on cover page.

31ZSR

Golden Gem	
Community Development District	

1	GMS- Central Florida, LLC	
	Invoice # 9 - Management Fees August 2024	

2	Kimley-Horn and Associates	
	Invoice # 28699678 - Engineering Services June 2024	

3	Kutak Rock, LLP	
	Invoice # 3425115 - General Counsel June 2024	
	(Please note invoice total is $3,246.83, balance will be requested on FR#9)	

Funding Request #8	
August 14, 2024	

Bill to:	Wyld Oaks Development	

Payee		General Fund	
			
		$	3,823.23	
			
		$	2,660.00	
			
		$	753.57	

$	7,236.80	

Total:	
$	7,236.80	

Please make check payable to:			

Golden Gem Community Development District	
4530 Eagle Falls Place	
Tampa, FL 33619	

GMS-Central Florida, LLC
1001 Bradford Way
Kingston, TN 37763

Invoice

Bill To:
Golden Gem COD 219 E. Livingston St. Orlando, FL 32801

Invoice#: 9
Invoice Date: 8/1/24
Due Date: 8/1/24
Case:
P.O. Number:

Description	Hours/Qty	Rate	Amount

Management Fees - August 2024 Website Administration - August 2024 Information Technology - August 2024
Dissemination Agent Services - August 2024 Office Supplies
Postage		3,125.00
100.00
150.00
416.67
0.51
31.05	3,125.00
100.00
150.00
416.67
0.51
31.05	

Total	$3,823.23	
Payments/Credits	$0.00	
Balance Due	$3,823.23	

Kimley>))Horn	lnv_o_ic_e_fo_r _Pr_of_es_s_io_na_l_S_erv_i_ce_s

Please remit payment electronically to:	If paying by check, please remit to:	
Account Name:	KIMLEY-HORN AND ASSOCIATES, INC.
Bank Name and Address:	WELLS FARGO BANK, N.A., SAN FRANCISCO, CA 94104
Account Number:	2073089159554
ABA#:	121000248	KIMLEY-HORN AND ASSOCIATES, INC.
P.O. BOX 932520
ATLANTA, GA 31193-2520	
Please send remittance	payments@kimley-hom.com infonnation to:		

GOLDEN GEM COD
C/0 GOVERNMENTAL MANAGEMENT SERVICES 219 EAST LIVINGSTON ST
ORLANDO, FL 32801

Invoice Amount: $2,660.00
Invoice No:	 28699678 Invoice Date:	Jun 30, 2024

Federal Tax Id: 56-0885615
For Services Rendered through Jun 30, 2024

Project No: Project Name: Project Manager:
Client Reference:

147968000.3
GOLDEN GEM COD INTERIM ROBERSON, KEVIN
RESOLUTION 2024-05

COST PLUS MAX

Description	
Contract Value	Amount Billed to Date	Previous Amount Billed	Current Amount Due	
INTERIM ENGINEERING	25,000.00	8,347.50	5,687.50	2,660.00	
Subtotal	25,000.00	8,347.50	5,687.50	2,660.00	
Total COST PLUS MAX	2,660.00	

If you have any questions, please contact Zach.Reuther at 561-234-4519 or Zach.Reuther@kimley-hom.com.

Total Invoice: $2,660.00

31ZSR

Kimley>))Horn	La_b_or_a_nd_E..x..pe_ns_e_D_et_ail

GOLDEN GEM COD
C/0 GOVERNMENTAL MANAGEMENT SERVICES
219 EAST LIVINGSTON ST

Invoice No: Invoice Date:

28699678
Jun 30, 2024

ORLANDO, FL 32801

Project No:	147968000.3
Project Name:	GOLDEN GEM COD INTERIM
Project Manager: ROBERSON, KEVIN

COST PLUS MAX

Task	
Description	
Hrs/Qty	
Rate	Current Amount Due	
0lINTERIM ENGINEERING	SENIOR PROFESSIONAL II	7.0	380.00	2,660.00	
TOTAL 0llNTERIM ENGINEERING	7.0	2,660.00	
TOTAL LABOR AND EXPENSE DETAIL	2,660.00	
This page is for infonnational purposes only. Please pay amount shown on cover page.

31ZSR

K U T A K  R O C K  L L P
TALLAHASSEE, FLORIDA
Telephone 404-222-4600
Facsimile 404-222-4654

Federal ID 47-0597598

July 25, 2024

Check Remit To: Kutak Rock LLP PO Box 30057
Omaha, NE 68103-1157

ACH/Wire Transfer Remit To:
ABA #104000016
First National Bank of Omaha
Kutak Rock LLP A/C # 24690470
Reference: Invoice No. 3425115 Client Matter No. 47123-1
Notification Email: eftgroup@kutakrock.com

Golden Gem CDD
c/o Governmental Management Services 219 East Livingston Street
Orlando, FL 32801	Invoice No. 3425115
47123-1

Re:	General Counsel
For Professional Legal Services Rendered

06/05/24    A. Willson	1.10	346.50	Review  and  revise  landowner
funding agreement; confer with Vanderbilt and Flint regarding meeting agenda; review and revise same; review and revise engineering agreement; confer with Roberson regarding same
06/11/24    A. Willson	2.30	724.50	Prepare  resolutions  for  board
meeting; confer with Flint and Vanderbilt regarding same; review comments regarding engineering agreement
06/12/24    J. Gillis	0.20	35.00	Review  comments  received  on
	agreement for engineering services
with Kimley-Horn; confer with staff regarding same	
06/12/24	A. Willson	5.60	1,764.00	Travel to and attend board meeting;	
				post meeting follow up	

TOTAL HOURS	9.20

KUTAK ROCK LLP
Golden Gem CDD July 25, 2024
Client Matter No. 47123-1 Invoice No. 3425115
Page 2		
TOTAL FOR SERVICES RENDERED		$2,870.00	
DISBURSEMENTS			
Meals	31.78		
Travel Expenses	345.05		
TOTAL DISBURSEMENTS		376.83	
TOTAL CURRENT AMOUNT DUE		$3,246.83