CORDOVA PALMS CDD REQUISITION SUMMARY Cordova CDD 2022-2 Bonds-Acquisition and Construction Account 126173 Wednesday, October 11, 2023 TO BE APPROVED/RATIFIED Date of Requisition Req # Payee Reference INVOICE AMOUNT Cordova CDD 2022-2 Bonds-Acquisition and Construction Account 118690 FOR RATIFICATION 8/14/2023 40 ETM Cordova Palms Phase 3 CEI Services (WA#7) Invoice 209388 (July 2023) 9,386.32 $ 8/14/2023 41 ETM Cordova Palms Phase 4 - US1 Water Main Corssing (WA#8) Invoice 209389 (July 2023) $ 7,200.00 8/14/2023 42 ETM Amenity Center and Dog Park (WA#1) Invoice 209365 (July 2023) $ 162.89 8/14/2023 43 ETM Phase 4 Recreation Pond(WA#10) Invoice 209353 (July 2023) $ 6,954.55 8/23/2023 44 Vallencourt Cordova Palms Phase 2 - Application for Payment 14 (July 2023) $ 208,478.47 8/23/2023 45 AJ Johns, Inc. Cordova Palms Phase 3 - Contractor Application for Payment No. 23001-07 (August 2023) $ 96,225.79 9/12/2023 46 ETM Phase 4 Recreation Pond(WA#10) Invoice 209852 (Aug 2023) $ 5,040.00 9/12/2023 47 ETM Cordova Palms Phase 3 CEI Services (WA#7) Invoice 209893 (Aug 2023) $ 4,797.32 9/12/2023 48 ETM Cordova Palms Phase 4 - US1 Water Main Corssing (WA#8) Invoice 209894 (Aug 2023) $ 1,800.00 9/25/2023 49 AJ Johns, Inc. Cordova Palms Phase 3 - Contractor Application for Payment No. 23001-08 (Sept 2023) $ 550,520.56 9/27/2023 50 Vallencourt Cordova Palms Phase 2 - Application for Payment 15 (Sept 2023) $ 250,068.15 Cordova CDD 2022-2 Bonds-Acquisition and Construction Account FOR RATIFICATION $ 1,140,634.05 Date of Requisition Req # Payee Reference INVOICE AMOUNT Cordova CDD 2022-2 Bonds-Acquisition and Construction Account 118690 FOR APPROVAL Cordova CDD 2022-2 Bonds-Acquisition and Construction Account FOR APPROVAL $ - TOTAL REQUISITIONS TO BE APPROVED AT OCTOBER 11, 2023 CDD MEETING $ 1,140,634.05 Scope of Work CORDOVA PALMS COMMUNITY DEVELOPMENT DISTRICT WORK AUTHORIZATION NO. 11 2023/2024 GENERAL CONSULTING ENGINEERING SERVICES England, Thims & Miller, Inc. shall provide general consulting engineering services for the Cordova Palms Community Development District as directed by the Board of Supervisors or their designee. General consulting services shall include, but not be limited to: 1. Attending Meetings 2. Preparation of Engineering Reports and Studies 3. Preparation of Cost Estimates and Budgets 4. Technical Support for Community Development District Staff 5. Development and Analysis of District Projects 6. Operation and Maintenance Inspections 7. Prepare Presentation Documents for District Meetings The outlined services shall be performed on a time and material basis at the currently approved rate and expense schedule. The estimated fee shall not be exceeded without further authorization. This estimated fee is not a guaranteed maximum cost. ESTIMATED FEE ...................................................................................................................................... $11,600.00 ENGLAND-THIMS & MILLER, INC. HOURLY FEE SCHEDULE – 2023* POSITION HOURLY RATE CEO/CSO………………………………………………………………………………………. $400.00 /Hr. President……………………………………………………………………………………… $350.00 /Hr. Executive Vice President………………………………………………………………. $335.00 /Hr. Vice President ……………………………………………………………………………… $260.00 /Hr. Senior Engineer/ Senior Project Manager…………………………………….. $215.00 /Hr. Project Manager………………………………………………………………………….. $200.00 /Hr. Director………………………………………………………………………………………… $185.00 /Hr. Engineer………………………………………………………………………………………. $175.00 /Hr. Assistant Project Manager …………………………………………………………… $155.00 /Hr. Senior Planner /Planning Manager………………………………………………. $200.00 /Hr. Senior Environmental Scientist……………………………………………….…… $215.00 /Hr. Planner………………………………………………………………………………………… $163.00 /Hr. CEI Senior Project Engineer………………………………………………………… $230.00 /Hr. CEI Project Manager/Project Administrator……………………………….. $184.00 /Hr. CEI Senior Inspector……………………………………………………………………… $163.00 /Hr. CEI Inspector ……………………………………………………………………………….. $132.00 /Hr. Senior Landscape Architect………………………………………………………….. $184.00 /Hr. Landscape Architect…………………………………………………………………….. $165.00 /Hr. Senior Technician/Senior Specialist……………………………………………. $163.00 /Hr. GIS Program Manager……………………………………………………..……..……. $180.00 /Hr. GIS Analyst ………………………………………………………………………………….. $140.00 /Hr. GIS Consultant……………………………………………………………………………… $150.00 /Hr. Senior Engineering Designer / Senior LA Designer………………………… $160.00 /Hr. Engineering Intern ………………………………………………………………………. $140.00 /Hr. Engineering/Landscape Designer…………………………………………………. $140.00 /Hr. CADD/GIS Technician…………………………………………………………………… $132.00 /Hr. Project Coordinator / CSS…………………………………………………………… $100.00 /Hr. Administrative Support………………………………………………………………… $95.00 /Hr. *ETM’s standard hourly billing rates are reevaluated annually prior to the beginning of the calendar year. CHANGE ORDER No. 3 DATE OF ISSUANCE: September 27, 2023 EFFECTIVE DATE: September 27, 2023 OWNER's Contract No. N.A. OWNER: Cordova Palms Community Development District CONTRACTOR: A.J. Johns, Inc. Contract: Cordova Palms Phase 3 Project: Cordova Palms Phase 3 ENGINEER's Contract No. 22-433 ENGINEER: England – Thims and Miller, Inc. You are directed to make the following changes in the Contract Documents: Description: Deletion of the 2nd Lift Asphalt Paving, Sleeves and FPL Infrastructure Reason for Change: To be performed by others Attachments: (List documents supporting change) A.J. Johns correspondence dated September 25, 2023 By execution of this change order document, the Contractor acknowledges that all issues related to Contract Time and Compensation for the work associated with these changes are resolved. CHANGE IN CONTRACT PRICE: CHANGE IN CONTRACT TIMES: Original Contract Price $ 4,865,968.05 Original Contract Times: Substantial Completion: 350 days Ready for final payment: 394 days (days) Net Increase/Decrease from previous Change Orders No. 0 to No. 2 $ 22,176.46 Net change from previous Change Orders No. -0- to No. -2-. Substantial Completion: 0 . Ready for final payment: 0 . (days) Contract Price prior to this Change Order: $ 4,888,144.51 Contract Times prior to this Change Order: Substantial Completion: 350 days Ready for final payment: 394 days (days) Net Increase/Decrease of this Change Order: $ (289,681.43) Net Increase this Change Order: Substantial Completion: 0 . Ready for final payment: 0 . (days) Contract Price with all approved Change Orders: $ 4,598,463.08 Contract Times with all approved Change Orders: Substantial Completion: 350 days Ready for final payment: 394 days (days) RECOMMENDED: APPROVED: ACCEPTED: By: By: By: _____________________ ENGINEER (Authorized Signature) OWNER (Authorized Signature) CONTRACTOR (Authorized Signature) Date: Date: Date: ___________________ EJCDC 1910-8-B (1996 Edition) Prepared by the Engineers Joint Contract Documents Committee and endorsed by The Associated General Contractors of America and the Construction Specifications Institute. CORDOVA PALMS COMMUNITY DEVELOPMENT DISTRICT Fiscal Year 2023 Assessments Receipts Summary ASSESSED # O&M UNITS ASSESSED SERIES 2021 DEBT ASSESSED SERIES 2022-1 DEBT ASSESSED SERIES 2022-2 DEBT ASSESSED FY23 O&M ASSESSED TOTAL ASSESSED DREAM FINDERS 583 438,700.00 - - 264,870.00 703,570.00 AMH DEV 139 - - - 68,148.00 68,148.00 TOTAL DIRECT INVOICES (1) (2) 722 438,700.00 - - 333,018.00 771,718.00 ASSESSED REVENUE TAX ROLL - TOTAL ASSESSED 722 438,700.00 - - 333,018.00 771,718.00 DUE / RECEIVED BALANCE DUE SERIES 2021 DEBT RECEIVED SERIES 2022-1 DEBT RECEIVED SERIES 2022-2 DEBT RECEIVED O&M RECEIVED TOTAL RECEIVED DREAM FINDERS (0.00) 438,700.00 - - 264,870.00 703,570.00 AMH DEV 0.00 - - 68,148.00 68,148.00 TOTAL DIRECT RECEIVED 0.00 438,700.00 - - 333,018.00 771,718.00 TAX ROLL DUE / RECEIVED - - - - - - TOTAL DUE / RECEIVED 0.00 438,700.00 - - 333,018.00 771,718.00 (1) D/S Direct Assessments are due: 35% due 12/1/22, 4/1/23 and 30% due 9/1/232 (3) Series 2022 Bonds are under capitalized interest until 11/1/2023 REQUISITION (SERIES 2022-2 PROJECT) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Second Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: (B) Name of Payee: 40 England-Thims & Miller, Inc. First Citizens ABA Routing #053100300 Jacksonville, FL Account #9061592290 - England, Thims & Miller, Inc. (C) Amount Payable: $9,386.32 (D) 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): Phase 3 CEI Services (WA#7) - Invoice 209388 (July 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: (2022-2 Bonds Acquisition and Construction Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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. REQUISITION (SERIES 2022-2 PROJECT) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Second Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: (B) Name of Payee: 41 England-Thims & Miller, Inc. First Citizens ABA Routing #053100300 Jacksonville, FL Account #9061592290 - England, Thims & Miller, Inc. (C) Amount Payable: $7,200.00 (D) 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): Phase 4 - US 1 Water Main Crossing (WA#8) Invoice 209389 (July 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: (2022-2 Bonds Acquisition and Construction Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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. REQUISITION (SERIES 2022-2 PROJECT) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Second Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: (B) Name of Payee: 42 England-Thims & Miller, Inc. First Citizens ABA Routing #053100300 Jacksonville, FL Account #9061592290 - England, Thims & Miller, Inc. (C) Amount Payable: $ 162.89 (D) 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): Cordova Palms Amenity Center & Dog Park (WA#1) Invoice 209365 (July 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: (2022-2 Bonds Acquisition and Construction Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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. REQUISITION (SERIES 2022-2 PROJECT) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Second Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: (B) Name of Payee: 43 England-Thims & Miller, Inc. First Citizens ABA Routing #053100300 Jacksonville, FL Account #9061592290 - England, Thims & Miller, Inc. (C) Amount Payable: $ 6,954.55 (D) 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): Phase 4 Recreation Pond (WA#10) Invoice 209353 (July 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: (2022-2 Bonds Acquisition and Construction Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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. REQUISITION (2022-2 Bonds Acquisition and Construction-Account #126173) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Third Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: 44 (B) Name of Payee: Vallencourt Construction Co., Inc. ACH & Wire Instructions: Receiving Bank: Synovus Bank 1148 Broadway Columbus, GA 31901 ABA Routing Number: 061100606 Beneficiary Name: Vallencourt Construction Co, Inc. 449 Center St. Green Cove Springs, FL 32043 Account Number: 1011287909 (C) Amount Payable: $ 208,478.47 (D) 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): Cordova Palms Phase 2 – Application for Payment 14 (July 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: 2022-2 Bonds Acquisition and Construction-Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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 The undersigned lienor, upon payment from the lienee, of the sum of$ , hereby its lien and right to oclra mima tae lriieanls i nfucrlundisihn tegod at htllhe cr floaouilmlgohws, icnhga ndgeesc orribdeedrs p, oror pdeermtya :nodns t hweh jaotbs ooef v_e__r_ f_o__r_ l_a_b__o_r_,_ s__e_r_v_i_c_e_ w_s_,_a_i_v_e_s_ _a_n__d_ _r_e_l_a__s_es Project: Location: Invoice#: rbTeehphisra elwfs eoanifv tLesir et nhanaotdr .h ree/lesahsee i sd oanes a nuotht ocroivzeerd a angye nlatb oofr L, sieenrvoirc aens,d o hr ams aatuetrhiaolrsi tfyu rtnoi eshxeecdu atfet ethr itsh We daaivteer s apnedci fRieedle. a Tseh eo fu Lnideenr osingned Dated on: Lienor’s Name: Address: Phone: By: Printed Name: Title: STATE OF COUNTY OF by ____________T_h__e_ _f_o_r_e_g__o_i_n__g_ i_n__s_t_r_u_m ofe _n_t_ _w__a_s_ _a_c_k__n_o__w__le__d_g__e_d_ _b__e_f_o_r_e_ _m_, ea t_h_i_s_ _____________________ _d_a_y__ o__f_ _____, _o_n__ b__e_h__a_l_f_ o__f _t_h_e__ c_o__r_p_o__r_a_t_i_o_n_. Personally known __________ or Produced Identification __________ Type of Identification N o t a r y P u b l i c NOTE: This is a statutory form prescribed by Section 713.20, Florida Statutes (1996). Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form. WAIVER AND RELEASE OF LIEN CONDITIONAL UPON PROGRESS PAYMENT Cordova Palms Community Development … 08/17/2023 Cordova Palms Phase 2 Project Manager 08/31/2023 449 Center Street Vallencourt Construction Co. Inc. Green Cove Springs, FL 32043 U.S. Highway 1, Saint Johns, FL (904) 291-9330 Christian Taylor 208,478.47 Christian Taylor DocuSign Envelope ID: 9534FE4C-CA89-4132-BE19-81D8E8B6A497 REQUISITION (2022-2 Bonds Acquisition and Construction-Account #126173) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Third Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: 45 (B) Name of Payee: A.J. Johns, Inc. 3225 Anniston Road Jacksonville, FL 32246 (C) Amount Payable: $ 96,225.79 (D) 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): Cordova Palms Phase 3 – Application for Payment 23001-07 (August 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: 2022-2 Bonds Acquisition and Construction-Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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 REQUISITION (SERIES 2022-2 PROJECT) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Second Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: (B) Name of Payee: 46 England-Thims & Miller, Inc. First Citizens ABA Routing #053100300 Jacksonville, FL Account #9061592290 - England, Thims & Miller, Inc. (C) Amount Payable: $ 5,040.00 (D) 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): Phase 4 Recreation Pond (WA#10) Invoice 209852 (August 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: (2022-2 Bonds Acquisition and Construction Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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. REQUISITION (SERIES 2022-2 PROJECT) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Second Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: (B) Name of Payee: 47 England-Thims & Miller, Inc. First Citizens ABA Routing #053100300 Jacksonville, FL Account #9061592290 - England, Thims & Miller, Inc. (C) Amount Payable: $ 4,797.32 (D) 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): Cordova Palms Phase 3 CEI (WA#7) Invoice 209893 (August 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: (2022-2 Bonds Acquisition and Construction Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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. REQUISITION (SERIES 2022-2 PROJECT) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Second Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: (B) Name of Payee: 48 England-Thims & Miller, Inc. First Citizens ABA Routing #053100300 Jacksonville, FL Account #9061592290 - England, Thims & Miller, Inc. (C) Amount Payable: $ 1,800.00 (D) 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): Cordova Palms Phase 4 US-1 Water Main Crossing (WA#8) Invoice 209894 (August 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: (2022-2 Bonds Acquisition and Construction Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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. REQUISITION (2022-2 Bonds Acquisition and Construction-Account #126173) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Third Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: 49 (B) Name of Payee: A.J. Johns, Inc. 3225 Anniston Road Jacksonville, FL 32246 (C) Amount Payable: $ 550,520.56 (D) 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): Cordova Palms Phase 3 – Application for Payment 23001-08 (September 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: 2022-2 Bonds Acquisition and Construction-Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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 REQUISITION (2022-2 Bonds Acquisition and Construction-Account #126173) The undersigned, an Authorized Officer of Cordova Palms 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 The Bank of New York Mellon Trust Company, N.A., Jacksonville, Florida, as trustee (the "Trustee"), dated as of December 1, 2021 (the "Master Indenture"), as amended and supplemented by the Third Supplemental Indenture from the District to the Trustee, dated as of July 1, 2022 (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: 50 (B) Name of Payee: Vallencourt Construction Co., Inc. ACH & Wire Instructions: Receiving Bank: Synovus Bank 1148 Broadway Columbus, GA 31901 ABA Routing Number: 061100606 Beneficiary Name: Vallencourt Construction Co, Inc. 449 Center St. Green Cove Springs, FL 32043 Account Number: 1011287909 (C) Amount Payable: $ 250,068.15 (D) 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): Cordova Palms Phase 2 – Application for Payment 15 (September 2023) (E) Fund or Account and subaccount, if any, from which disbursement to be made: 2022-2 Bonds Acquisition and Construction-Account #126173) 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 2022-2 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 Series 2022-2 Project and each represents a Cost of the Series 2022-2 Project, and has not previously been paid] OR [this requisition is for Costs of Issuance payable from the Costs of Issuance Account that 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 The undersigned lienor, upon payment from the lienee, of the sum of$ , hereby its lien and right to oclra mima tae lriieanls i nfucrlundisihn tegod at htllhe cr floaouilmlgohws, icnhga ndgeesc orribdeedrs p, oror pdeermtya :nodns t hweh jaotbs ooef v_e__r_ f_o__r_ l_a_b__o_r_,_ s__e_r_v_i_c_e_ w_s_,_a_i_v_e_s_ _a_n__d_ _r_e_l_a__s_es Project: Location: Invoice#: rbTeehphisra elwfs eoanifv tLesir et nhanaotdr .h ree/lesahsee i sd oanes a nuotht ocroivzeerd a angye nlatb oofr L, sieenrvoirc aens,d o hr ams aatuetrhiaolrsi tfyu rtnoi eshxeecdu atfet ethr itsh We daaivteer s apnedci fRieedle. a Tseh eo fu Lnideenr osingned Dated on: Lienor’s Name: Address: Phone: By: Printed Name: Title: STATE OF COUNTY OF by ____________T_h__e_ _f_o_r_e_g__o_i_n__g_ i_n__s_t_r_u_m ofe _n_t_ _w__a_s_ _a_c_k__n_o__w__le__d_g__e_d_ _b__e_f_o_r_e_ _m_, ea t_h_i_s_ _____________________ _d_a_y__ o__f_ _____, _o_n__ b__e_h__a_l_f_ o__f _t_h_e__ c_o__r_p_o__r_a_t_i_o_n_. Personally known __________ or Produced Identification __________ Type of Identification N o t a r y P u b l i c NOTE: This is a statutory form prescribed by Section 713.20, Florida Statutes (1996). Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form. WAIVER AND RELEASE OF LIEN CONDITIONAL UPON PROGRESS PAYMENT Cordova Palms Community Development … 09/26/2023 Cordova Palms Phase 2 Project Manager 09/30/2023 449 Center Street Vallencourt Construction Co. Inc. Green Cove Springs, FL 32043 U.S. Highway 1, Saint Johns, FL (904) 291-9330 Christian Taylor 250,068.15 Christian Taylor This audit trail provides a detailed history of the online activity, events, and signatures recorded for this document, in compliance with the ESIGN Act. All parties have chosen to use electronic documents and to sign them electronically. These electronic records and signatures carry the same weight and have the same legal effect as traditional paper documents and wet ink signatures. Audit Trail Title 202232 - PayApp - Cordova Palms Phase 2 - Vallencourt Construction Co. Inc. - Sep2023 File name 202232_PayApp_CordovaPalmsPhase2_VallencourtConstructionCoInc_Sep2023.pdf Audit trail format MM/DD/YYYY Status Signed Document history Created 09/26/2023 17:10:03 EDT Created by Christian Taylor (christiant@vallencourt.com) IP: 50.237.44.42 Signed 09/26/2023 17:18:03 EDT Signed by Christian Taylor (christiant@vallencourt.com) IP: 50.237.44.42 Page 18 a Siteline !J Siteline