Triple Creek Community Development District

Board of Supervisors’ Meeting April 17, 2018

District Office:
9428 Camden Field Parkway Riverview, Florida 33578
813.533.2950

www.triplecreekcdd.com

TRIPLE CREEK
COMMUNITY DEVELOPMENT DISTRICT AGENDA
April 17, 2018 at 10:00 a.m.

Rizzetta & Company Inc., located at 9428 Camden Field Parkway, Riverview, Florida, 33578.

District Board of Supervisors	Grady Miars	Chairman	
	Bruce Kaschyk	Vice Chairman	
	Ellen Johnson	Assistant Secretary	
	Bob Allen	Assistant Secretary	

District Manager	Keith Turney

Christine Perkins	Assistant Secretary

Rizzetta & Company, Inc.	
District Counsel	Jennifer Kilinski	Hopping Green & Sams, P.A.	
District Engineer	Jamie Scarola	Scarola Associates	

All Cellular phones and pagers must be turned off while in the meeting room.

The District Agenda is comprised of four different sections:

The meeting will begin promptly at 10:00 a.m. with the first section which is called Audience Comments. The Audience Comment portion of the agenda is where individuals may comment on matters that concern the District. Each individual is limited to three (3) minutes for such comment. The Board of Supervisors or Staff is not obligated to provide a response until sufficient time for research or action is warranted. IF THE COMMENT CONCERNS A MAINTENANCE RELATED ITEM, THE ITEM WILL NEED TO BE ADDRESSED BY THE DISTRICT MANAGER OUTSIDE THE
CONTEXT OF THIS MEETING. The second section is called Business Administration. The Business Administration section contains items that require the review and approval of the District Board of Supervisors as a normal course of business. The third section is called Staff Reports. This section allows the District Manager, Engineer, and Attorney to update the Board of Supervisors on any pending issues that are being researched for Board action. The fourth section is called Business Items. The business items section contains items for approval by the District Board of Supervisors that may require discussion, motion and votes on an item-by-item basis. Occasionally, certain items for decision within this section are required by Florida Statute to be held as a Public Hearing. During the Public Hearing portion of the agenda item, each member of the public will be permitted to provide one comment on the issue, prior to the Board of Supervisors’ discussion, motion and vote. Agendas can be reviewed by contacting the Manager’s office at (813) 533-2950 at least seven days in advance of the scheduled meeting. Requests to place items on the agenda must be submitted in writing with an explanation to the District Manager at least fourteen (14) days prior to the date of the meeting. The final section is called Supervisor Requests. This is the section in which the Supervisors may request Staff to prepare certain items in an effort to meet residential needs.

Public workshops sessions may be advertised and held in an effort to provide informational services. These sessions allow staff or consultants to discuss a policy or business matter in a more informal manner and allow for lengthy presentations prior to scheduling the item for approval. Typically, no motions or votes are made during these sessions.

Pursuant to provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this meeting is asked to advise the District Office at (813) 533-2950, at least 48 hours before the meeting. If you are hearing or speech impaired, please contact the Florida Relay Service at 7-1-1, who can aid you in contacting the District Office.

Any person who decides to appeal any decision made by the Board with respect to any matter considered at the meeting is advised that this same 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 the appeal is to be based.

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT DISTRICT OFFICE  9428 CAMDEN FIELD PARKWAY RIVERVIEW, FL 33578
Board of Supervisors	April 16, 2018
Triple Creek Community Development District
AGENDA
Dear Board Members:

The Regular meeting of the Board of Supervisors of the Triple Creek Community Development District will be held on Tuesday, April 17, 2018 at 10:00 a.m. at the offices of Rizzetta & Company Inc. located at 9428 Camden Field, Riverview, Florida 33578. The following is the agenda for this meeting:

CALL TO ORDER/ROLL CALL
AUDIENCE COMMENTS
BUSINESS ADMINISTRATION
Consideration of the Minutes of the Board of Supervisors’
Regular Meeting held on March 20, 2018 .................................................. Tab 1
Consideration of Operations & Maintenance Expenditures
for February 2018 ....................................................................................... Tab 2
Ratification of Series 2017AB Construction
Requisitions #260-267 & #268-271............................................................ Tab 3
D.	Ratification of Change Order #8................................................................. Tab 4
STAFF REPORTS
Field Services Manager
Presentation of March 2018 Field Inspection Report .................... Tab 5
Presentation of Sitex Response to the March 2018
Field Inspection Report.................................................................. Tab 6
Sitex Aquatics
Presentation of April 2018 Sitex Aquatics Inspection Report ....... Tab 7
District Counsel
District Engineer
District Manager
BUSINESS ITEMS
Consideration of Resolution 2018-08, Approving RFP
for Infrastructure Construction Project in Villages G2, I, and J ................. Tab 8
Consideration of Acceptance of Triple Creek Boulevard
Extension Infrastructure.............................................................................. Tab 9
Consideration of Acceptance of Conveyance of Public Improvements
from Mattamy ............................................................................................. Tab 10
Consideration of Task Order #7 from Dennis J. Benham........................... Tab 11
Consideration of Proposal from Global Industrial
for Outdoor Trash Cans .............................................................................. Tab 12 F.	Presentation of Fiscal Year 2016-2017 Audit............................................. Tab 13
SUPERVISOR REQUESTS
ADJOURNMENT

We look forward to seeing you at the meeting. In the meantime, if you have any questions, please do not hesitate to call us at (813) 533-2950.

With Warm Regards,

Christine Perkins
Christine Perkins District Manager

Tab 1

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT
March 20, 2018 - Minutes of Meeting
Page 1

MINUTES OF MEETING

Each person who decides to appeal any decision made by the Board with respect to any matter considered at the meeting is advised that 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.

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

The regular meeting of the Board of Supervisors of Triple Creek Community Development District was held on Tuesday, March 20, 2018 at 6:00 p.m. at the Triple Creek Amenity Center located at 11920 Streambed Drive, Riverview, Florida, 33579.

Present and constituting a quorum:

Grady Miars	Board Supervisor, Chairman
Bruce Kaschyk	Board Supervisor, Vice Chairman
Bob Allen	Board Supervisor, Assistant Secretary
Keith Turney	Board Supervisor, Assistant Secretary
Ellen Johnson	Board Supervisor, Assistant Secretary

Also present were:

Christine Perkins	District Manager, Rizzetta & Company, Inc.
Scott Green	Field Services Manager, Rizzetta & Company, Inc.
Gregg Gruhl	Amenity Services Manager, Rizzetta Amenity Services
Scott Smith	Regional Manager Community Services, Rizzetta Amenity Services
Lindsay Whelan	District Counsel, Hopping Green & Sams (via phone)
Kyle Thornton	District Engineer, Genesis Group
Robert Nelson	Greenpointe Holdings
Rick Herndon	Sitex Landcare
James Butler	Clubhouse Manager

FIRST ORDER OF BUSINESS	Call to Order/Roll Call

Ms. Perkins called the meeting to order and read the roll call.

SECOND ORDER OF BUSINESS	Audience Comments

There were no audience members present.

THIRD ORDER OF BUSINESS	Consideration of Minutes of the Board of Supervisors’ Regular Meeting held on February 20, 2018

On a Motion by Mr. Turney, seconded by Mr. Allen, with all in favor, the Board approved the Supervisors’ Regular Meeting Minutes from the meeting held on February 20, 2018 for the Triple Creek Community Development District.

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT
March 20, 2018 - Minutes of Meeting
Page 2

FOURTH ORDER OF BUSINESS	Consideration of Operation and Maintenance
Expenditures for January 2018

On a Motion by Ms. Johnson, seconded by Mr. Kaschyk, with all in favor, the Board ratified the Operation and Maintenance Expenditures for January 2018 in the amount of ($78,471.21) for the Triple Creek Community Development District.

FIFTH ORDER OF BUSINESS	Ratification of Series 2017AB Construction Requisitions # 215, 244-259

REQUISITION NO.	

PAYEE	

AMOUNT	

SUBACCOUNT	
215-B Revised	TC Venture 1, LLC	$15,425.92	General B	
244-B	Dennis J. Benham, P.S.M.	$11,714.00	General B	
245-F1	Dennis J. Benham, P.S.M.	$1,690.00	Village F1	
246-B	Ferguson Waterworks	$146.27	General B	
247-B	Hopping Green & Sams	$141.00	General B	
248-K	The Kearney Companies, LLC	$9,675.00	Village K	
249-B	The Kearney Companies, LLC	$104,914.97	General B	
250-B	Triple Creek CDD	$2,491.50	General B	
251-B	Genesis Group	$41,082.08	General B	
252-B	Hillsborough County BOCC	$23,385.00	General B	
253-B	Genesis Group	$38,304.12	General B	
254-F1	Genesis Group	$5,393.16	Village F1	
255-G1	Genesis Group	$1,136.64	Village G1	
256-K	Genesis Group	$10,081.75	Village K	
257-B	Hopping Green & Sams	$352.50	General B	
258-K	The Kearney Companies, LLC	$11,725.00	Village K	
259-F1	RIPA & Associates, LLC	$16,775.00	Village F1	

On a Motion by Ms. Johnson, seconded by Mr. Kaschyk, with all in favor, the Board ratified the Series 2017AB Construction Requisitions #215,244-259 for the Triple Creek Community Development District.

SIXTH ORDER OF BUSINESS	Staff Reports

Field Services Manager
Presentation of the February 2018 Field Inspection Report

Mr. Green presented the February 2018 Field Inspection Report for the Board’s review, mentioning that some plant material had been affected by the recent frost, however most of the plants will rebound. Mr. Green communicated that the property is continuing to improve, irrigation issues have been fixed, and he also summarized some housekeeping items that included trimming around irrigation boxes, tree straightening, and pruning. Discussion ensued regarding remove of a dead palm tree, as well as an area of zoysia that was holding water by the amenity.

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT
March 20, 2018 - Minutes of Meeting
Page 3

Presentation of the Sitex Landscape Response to the February 2018 Field Inspection Report

Mr. Herndon communicated that he would assess identified issues right after the meeting conclusion. Mr. Green mentioned that Sitex has been doing a great job taking care of issues prior to each meeting.

Sitex Aquatics

Presentation of the March 2018 Sitex Aquatics Inspection Report

Ms. Perkins presented the March 2018 Sitex Aquatics Inspection Report to the Board. There were no specific inquires regarding the current state of the waterways.

District Counsel

Ms. Whelan had no report.

District Engineer

Mr. Thornton communicated that he had met with the County the previous week regarding the pipe failure by the amenity center, as they would not be able to get to that for at least four months. Mr. Thornton also relayed that the RFP for the next Phase would be up for review next month, as well as many neighborhoods have been cleared and are ready for building new homes. Additionally, the new amenity center is in the permitting process and is moving ahead at full speed.

District Manager

Ms. Perkins informed the Board that the next regularly scheduled meeting will be on Tuesday, April 17, 2018 at 10:00 a.m. and to be held at the offices of Rizzetta & Company Inc., located at 9428 Camden Field Parkway, Riverview, Florida 33578.

Ms. Perkins additionally communicated that the Wildlife Trapper has detained a total of 17 wild boars since the end of January, and therefore perhaps it would be recommended to
continue services until there’s a cease in boar activity.

Clubhouse Manager

Mr. Butler communicated that the dead bolt locks at the entrance towers were recently replaced, as well as inquired if the Board would like to have pavers installed under any new prospective trash can locations.

SEVENTH ORDER OF BUSINESS	Discussion of Doggie Waste Station Locations

Poop 911 Proposal #1
Poop 911 Proposal #2

Ms. Perkins presented two proposals from Poop 911 pertaining to the installation of three new doggie waste station locations, as well as the new annual maintenance pricing to include the new stations. Mr. Perkins also communicated that an addition two stations were installed at the beginning of this fiscal year that were approved in the last fiscal year, and therefore the District would be over-budget in this line item by approximately $318.00 by year-end. Discussion ensued regarding the placement of the three new waste station locations, as well as the forthcoming waste stations coming out of the construction funds for the new villages.

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT
March 20, 2018 - Minutes of Meeting
Page 4

On a Motion by Mr. Turney, seconded by Ms. Johnson, with all in favor, the Board approved the Proposals from Poop 911 in the amount of ($1,035.00) for the installation of three new doggie waste stations, and ($2,067.00) for the annual maintenance agreement for the Triple Creek Community Development District.

EIGHTH ORDER OF BUSINESS	Consideration   of   Proposals   from  Rizzetta
Amenity Services for Pool Monitors

Mr. Smith presented the Rizzetta Amenity Services proposal for Pool Monitors, providing a background for the Board and summarizing each available option. Ms. Perkins confirmed that both options fit within the District’s current budget under the Management Contract. Mr. Turney recommended proceeding with Option 1 to have coverage seven days per week. Discussion ensued regarding hiring practices, identification of pool monitors, and invoicing.

On a Motion by Mr. Turney, seconded by Mr. Allen, with all in favor, the Board approved the Proposal from Rizzetta Amenity Services for Pool Monitors in the amount of ($10,682.00) for the Triple Creek Community Development District.

NINTH ORDER OF BUSINESS	Supervisor Requests

Mr. Allen inquired about a location of water flow from Triple Creek and Talavera/FishHawk where there was just dirt present and suggested dressing it up with some sod. Mr. Thornton confirmed that this area was seeded about a month ago that hasn’t yet had time to take, and that the District is only responsible for areas behind the fences.

Ms. Perkins communicated that unfortunately Mr. Allen will be relocating out of state in the coming months, and therefore he will be resigning from the Board once he moves. Discussion ensued regarding Mr. Allen being an incredible positive contribution to the Board, and that the Board would address a potential vacancy when the time is appropriate.

TENTH ORDER OF BUSSINESS	Adjournment

On a Motion by Mr. Allen, seconded by Mr. Kaschyk with all in favor, the Board adjourned the meeting at 6:35 p.m. for the Triple Creek Community Development District.

Secretary/Assistant Secretary	Chairman/Vice Chairman

Tab 2

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT
DISTRICT OFFICE · 12750 CITRUS PARK LANE · SUITE 115 · TAMPA, FLORIDA 33625

Operation and Maintenance Expenditures February 2018
For Board Approval

Attached please find the check register listing the Operation and Maintenance expenditures paid from February 1, 2018 through February 28, 2018. This does not include expenditures previously approved by the Board.

The total items being presented: $46,553.17

Approval of Expenditures:

 	Chairperson

 	Vice Chairperson

 	Assistant Secretary

Triple Creek Community Development District
Paid Operation & Maintenance Expenditures
February 1, 2018 Through February 28, 2018

Vendor Name	Check Number	Invoice Number	Invoice Description	Invoice Amount	

Ballenger & Company, Inc.	
001720	
18023	
SWFWMD Report & Pump Maint	
$	215.00	

Bates Electric, Inc.	
001721	
117935	01/18
Lighting Repairs	
$	830.00	
BOCC	001725	8992542002 01/18	11920 Streambed Dr 01/18	$	532.87	
Bruce T. Kaschyk	001735	BK022018	Board of Supervisors Meeting	$	200.00	

Ellen Johnson	
001733	
EJ022018	02/20/18
Board of Supervisors Meeting	
$	250.73	

Fleetwash, Inc.	
001727	
x-1236068	02/20/18
Pressure Wash - Pool Area,	
$	718.20	

Florida Department of Revenue	
001726	
Sales Tax 01/18	Clubhouse Canopy Sales Tax Payable 01/18	
$	8.83	
Frontier Florida LLC dba	001729	81367159000430145	813-671-5900 02/18	$	247.87	
Frontier		02/18			
Genesis Group	001722	58965	Engineering Services 12/17	$	315.00	
Grady E. Miars	001736	GM022018	Board of Supervisors Meeting	$	200.00	

Hopping Green & Sams	
001728	
98171	02/20/18
General Legal Services 12/17	
$	1,092.88	
Hopping Green & Sams	001734	98541	General Legal Services 01/18	$	3,329.98	
Jerry Richardson	001740	1086	Monthly Hog Removal Service 02/18	$	1,750.00	
Keith A Turney	001743	KT022018	Board of Supervisors Meeting	$	200.00	

NewAgeTutors LLC dba	
001745	
1008	02/20/18
Website Fees 02/18	
$	80.00	
VGlobalTech
NVirotect Pest Control, Inc.	
001723	
142743	
Pest Control Acct #9501 01/18	
$	60.00	
NVirotect Pest Control, Inc.	001737	144811	Pest Control Acct #9501 02/18	$	60.00	
Rizzetta & Company, Inc.	001719	INV0000030110	District Management Fees 02/18	$	3,925.00	
Rizzetta Amenity Services, Inc.	001730	INV00000000004586	Amenity Services 02/18	$	1,913.60	
Rizzetta Amenity Services, Inc.	001730	INV00000000004611	Out of Pocket Expenses 01/18	$	89.00	
Robert D. Allen	001732	RA022018	Board of Supervisors Meeting	$	200.00	

Sitex Aquatics LLC	
001738	
2402A	02/20/18
Aquatic Maintenance & Wetland	
$	2,615.00	
			Monitoring 02/18		

Triple Creek Community Development District
Paid Operation & Maintenance Expenditures
February 1, 2018 Through February 28, 2018

Vendor Name	Check Number	Invoice Number	Invoice Description	Invoice Amount	

Sitex Land LLC	
001739	
4493	
Monthly Landscape Maintenance	
$	9,945.17	

Sitex Land LLC	
001739	
4689	02/18
Fertilizer	
$	7,856.00	
Suncoast Pool Service, Inc	001741	4306	Pool Services 02/18	$	850.00	
SWFWMD	001724	020818 SWFWMD	Village G2 Permitting	$	2,491.50	
Tampa Electric	001742	Electric Summary	Electric Summary 02/18	$	6,129.54	
		02/18			
Times Publishing Company	001731	591114 02/09/18	Legal Advertising 02/18	$	152.00	
Vanguard Cleaning Systems of Tampa Bay	001744	75903	Monthly Cleaning Service 02/17	$	295.00	

Report Total				
$	46,553.17	

Ballenger & Company, Inc. 2335 64th Pl N
St. Petersburg, FL. 33702

I	ice

Date	Invoice#	
1/2712018	18023	

Bill To	
Triple Creek CDD
l 2750 Citrus Park Lane
Suite 115
Tampa, FL 33625	

P.O. No.	Terms	Project

Net 15

Quantity	Description	Rate	Amount
Water Use Reporting to State Agency	215.00	215.00

Thunk you for your business.
                                      $215.00

Bates Electric, Inc.
7901 Hopi Place Tampa, Florida 33634
(813) 888-7050
www.bateselectric.com

Triple Creek Subdivision

12141 Triple Creek Blvd Riverview	FL

InvoiceDate: 1/23/18
Inv#: 117935

Reference:	Triple Creek Subdivision
12141 Triple Creek Blvd. Riverview

Job#: 65586- 3000
Reference: exterior lighting repairs CustomerPO#:

APPLICATION FOR PAYMENT

Provide labor and/or materials to complete the following:
Furnish & install ( IO) LED wet-location rated lamps.
Convert exterior landscaping lights to direct wire line voltage.
Work performed as proposed.	830.00

Total:	830.00

Work Authorized	fames Butler JobCompleted: 1/17118

Payment terms: net 30
Many thanks for your business!

HIiisborough
County Florida

CUSTOMER NAME
TRIPLE CREEK COO

Service Address: 11920 STREAMBED DR

S.Pag& 1 of 1

ACCOUNT NUMBER	BILL DATE I DUE DATE I
8992542002	01/31/2018	02/21/2018

METER NUMBER

PREVIOUS DATE

PREVIOUS
READ

PRESENT DATE

PRESENT
READ

CONSUMPTION IN GALLONS

READ
TYPE

METER DESCRIPTION

60842286	12/21/2017

5786	01/25/2018

6275	48900

ACTUAL	WATER

Service Address Charges		Summary of Account Charges		
Customer BillCharge	$4.11	Previous Balance	$1,370.80	
Purchase Water Pass-Thru	$143.28	Net Payments - Thank You	($1,370.80)	
Water Base Charge,	$21.38	Total Account Charges	$532.87	
Water Consumption Charge	$94.66	
Sewer Base Charge	$51.83	jAMOUNTDUE	$532.871	
Sewer Usage Charge	$217.61	 	

Total Service Address Charges

$532.87

Important Musage

Do you have a large yard with high water irrigation usage? Call Paula Staples, UF/IFAS Extension Hillsborough County, (813) 744-5519 X 54142, to see If a free irrigation evaluation can help lower your outdoor water use and conserve water for our future.
Based on a recent meter reading, It appears there may have been a change in your water consumption. More lnfonnatlon is at our website:
http://www.hlllsboroughcounty.org/en/residents/property-owners-a nd•renters/water-and-sewer/consumption-usage-and-tlps

Date Rec o KFu"..8Il"a o"  Co.,Inc. FEB O  6_2018 0/M approval	c P		Date 21911 a Date entered		FEB O 9 2018 Fund CY)I _GL S3toct=oc   C/301

Consumption History x 1000 Gallons

Check# 		_

HIilsborough
County rb,"'-:-

112s 12121 11121 1012, 912!1 e/25 7121l	111te	5123 •	'J/27	212, 1/20	
2018				2017	

ELECTRONIC PAYMENTS BY CHECK OR
Automated Payment Line: (813) 276 8526 Internet Payments: HCFLGov.net/WaterBill Additional   Information: HCFLGov.net/Water

Make checks payable to: BOCC

ACCOUNT NUMBER: 8992542002

THANK YOU/

lll 11l11111111111111•11•1111•11l111111111 111111111111,1
TRIPLE CREEK CDD
3434 COLWELL AVE STE 200
TAMPA FL 33614-8390

1111l1I

DUE DATE	02/21/2018	
AMOUNT DUE	$532.87	
AMOUNT PAID		

5,412

0089925420021	00000532879

TRIPLE CREEK CDD

Meeting Date:  2/20/18

SUPERVISOR PAY REQUEST

Name of Board Su etvisor	Check if
resent	Check if
aid	
Grady Miars	X	X	
Bruce Kasch k	X	X	
	X	X	
Keith Turne	X	X	
Bob Allen	X	X	

EXTENDED MEETING TIMECARD

Meeting Start Time:	10:02 AM	
Meeting End Time:	11:01 AM	
Total Meeting Time:	59 Minutes	

ITime Over	() Hours:	N/A	

!Total at $175 per Hour:	N/A	

DM Signature: 		/J	

TRIPLE CREEK CDD

Meeting Date:  2/20/18

SUPERVISOR PAY REQUEST

Name of Board Supervisor	Miles traveled	Travel Reimbursement	Pay this
amount	
GradyMiars	0	$	-	$	-	
Ellen Johnson	114	$	50.73	$	50.73	

OM Signature:		/J	

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l.l,:,•

FL:::TWASH
PO BOX 36014, Newark, NJ 07188-6014

Return Service Requested

Remittance Section
Account Number: Invoice Number: Work Order Number: Location:
Invoice Date: Invoice Due Date: Total Due:

71557 x-1236068
FS54867
158
01/23/2018
02/22/2018
$718.20

TRIPLE CREEK CDD 11902 STREAMBED DRIVE
RIVERVIEW Fl 33579

Amount Enclosed:	$

Maka checks payable to Flaatwash Inc.

FLEETWASH
PO BOX 36014
Newark, NJ 07188-6014
,1111,ii 1'111••••1111 11111111,1,..1,1 I1111•1111I•111111111•111•I1

Keep lower portion for your records - Please return upper portion with your payment.
Important Messages	
To pay this Invoice with a credit card, complete the Information below & fax a copy of the entire invoice to: 973-882-1832 MC /    VISA  /  AMEX #  	
Card Holder. 	_	Expires:. 		Sec Code: 		_

Give us a call for all your Facility Service needs!
1(800)847-3735

I	Customer·
AccountNumber	Invoice Date	..	
Invoice Number	
Due Date	eflects PaylTle t I
Received Throuah  ..	
71557	01/23/2018	x-1236068	02/22/2018		
I Quantity•	Item
Number	
Description ofWork	..			
1	71557	MISCELLANEOUS
r
Uate Hee O lilZZSHi:l <':i LO., incF. EB O 1 20_18
D/M approval	C'P	Date 2191  a Date entered - -- EEB O l.l.,,,_._018:..--_
FtmdiJ.OLGL 5=) QQC lrtoI
Check#------------	$665.00	$665.00	

Visit our brand new website/	WWW.FLEETWASH.COM

		

	

			

Note: Fuel Surcharge.		Sub Total:	$665.00	
Please Send/Reference Invoice #x-1236068 with Payment.		Fuel Surcharge:	$53.20	
Work Order Number. FS54867		Sales Tax:	$0.00	
		TOTAL DUE:	$718.20	
If you have questions regarding your bill, please call us at (800) 847-3735 or visit us on the web at www.fleetwash.com

FLEETWASH
Facility Services

FS54867

ACCOUNT NAME
lr\p\e Cree\(.	26 LAW DRIVE FAIRFIELD, NJ 07004 800-847-3735	CUSTOMER SIGNATURE		
1-1  ·--, -··T··-   ,··--, --,
ACCOUNT#	i:?1 _51 L.J	LOCATION#
ll./2		

PURCHASE ORDER#	

Billing Address	Location of Service

Name	
Street	
City	
State	ZIP	
REF#	

Description:	prol	area	

i'-)

Job(s) Performed	Subtotal+

.1	Compactor	
2	HVAC	
3	Gas Station	
4	Canopy	
5	Building Wash	
6	Graffiti Removal	
7	Hood Cleaning	
B	Sidewalks	
9	Sweeping	
10	Utter Patrol	
l1	Re-Imaging	

12	Snow Plow	
13	Salting	
14	Landscaping	
15	Debris Clean-Out	
16	Line Striping	
17	Oil Spill Clean-Up	
18	Pressure Washing	
19	House Washing	
20	Deck/Patio Washing	
21	Misc. (Dsalbe above)	
22	case Cleaning	

0	6
0
1
2
3
4
5
6
7	I
8,

<	

9

      1 *Gallons of wash water recovered and taken to a FLEETWASH facility at-----:- - fofinal examination.   *This amount will only be entered if  requested by our customer.   This amount is an estimate of the recovered gallons. This amount may be entered at either the wash site or at the disposal
facility. Wash waste water is non-hazardous. There are no legal requirements for a manifest.

 Sales and Use Tax Return

DR-15 R. 01/15
TC
Rule 12A•1,097
Florida Administrative Code
Effective 01/15

FLORIDA

You may file and pay tax onllne or you may complete this return and pay tax by checl< or money order and mall to:

Florida Department of Revenue 5050 W Tennessee Street Tallahassee, FL 32399-0120
Please read the Instructions for DR-15 Sales and Use Tax Returns (Form DA-15N) before you complete this return. Instructions are posted on our website at www.florldarevenue.com.

•

I  -..."""'r.'!>1-'80 Ili>'>al. -..  0.Q es AND use TAX RETURN

'!:>5"'
Include u•" tmr. on lnl•rnel I out-ol•SIJll!f untax&d porchaau -	
/&.

Florida	1. Gross Sales	2. Exam	Sales
Sal811/Servk:11
8. Taxable PurohaHe
Commercial Rentale
Transient Rentafll

HD/PM Date:	/
Taxable Amount

I	DR-15 R. 01,r;-i

I

TaxDue	_
- S

E.   Food lBaveragtVwndlng  ... 	.,......,...:'--.-•-'.;:.-,----'''---'-.,,.;.----'--'----'-o-....::;....-------C---1--------=, 	:::-f

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TrlllllllentRentalRate:. 06a,O Surtax.Rate •• ol p<.ReportlngPtrtodO:A.O aoli

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Total Amount of Tax Due
Leu  Lawful Deductlona
7, Net Tax Due

1----------1

'-- Eat Tax Pd/ DOR Cr Memo
9, Plue Est Tax Due Current Month
1--------=--1

r;

FLORIDA DEPARTMENT OF REVENUE 5050 W TENNESSEE ST TALLAHASSEE FL 32399-0120
□Due: fe,'o  0	a,o1,Cjr'

10Amount Due
11, l..w C;H;8'1;R .OH;m&A;a
12, Plus Pen!llty
Plus lntereet
Amount Due with Ratum

Late After: fi':) A al$
Check here ff payment was made electronically,

91□□ □ 2□1 79999□□□1□0 3031 D 4999999999 □□□□ 5

Ff:b u d 2018
LJaif, Htlt; ll t1lLlelh,	";,	-----
0/M aoprovai ~- f:._f_"."''"·-::a1.t 21911 a
Date entered .. ..	FEB O 9 20 1-8

Fund W)		_rn..JodoL/	,.i 		_
Check#  		 	

.......
Frontier
COMMUNICATIONS

··· ·C·F?_is. · 1 5

?1.16/1 B...
201

TRIPLE CREEK COD
Your Monthly Invoice

Account Summary
New Charges Due Date BIiiing Date
Account Number
PIN
Previous Balance
Payments Received Thru 1/23/18 Thank you for your payment I Balance Forward
New Charges
Total Amount Due

Page 1 of 4

2/28/18
2/04/18
813-671-5900-043014·5
2197
201.20
-201.20

.00
247.87
$247.87

517-CP	I, Cf1f.1r)

We're here to help you achieve
your business goals in 2018.
Your business never stands still. Call now, and one of our
Small Business Experts will analyze your ever-changing needs and recommend the right solutions to help you succeed.
Call for your FREE Account Review.
1.844.255.7308
Suvkt11Vtlilblktyv11fe,
0 2018 FrontillCommunlc1tl011,Corporation

To Pay Your Bill
.L;iOnline: Frontier.com '9 1.800.801.6652
Pay by Mail

To Contact Us
tit Chat: Frontier.com OOnline: Frontier.com/helpcenter
01,800.921.8102	B Email: ContactBusiness@ftr.com

Fr	tier

'         , '	_._,
PAYMENT STUB
Total Amount Due
New Charges Due Date

4  8

$247.87
2/28/18

COMMUNICATIONS
P.O. Box 5157, Tampa, FL 33675

AB 0100139683971 8 8 A
i11•I111111iiu11111 • I1••1••1.11 Ill•• h,,,•111111,, .11111.1u11•1
TRIPLE CREEK COD 12750 CITRUS PARK LANE SUITE 115
TAMPA, FL 33625-3784

Account Number	813-671-5900•043014-5
Plsase do not tend corrstpondsncs with your payment Make check, payablt to Frontier
Amount Enclosed	$
To change your billing address, call 1-800-921-8102

FRONTIER
PO BOX 740407
CINCINNATI OH 45274-0407
I11II   II  illl111I I I1•h111I•1I111h I11111111I111I111'11111111I11 II   I

544□048136715900043014□0□□0□□ 0□□□□□□247875

.......
Frontier
COMMUNICATIONS

Date of Bill Account Number

Page 2  of 4
2/04/18
813-671-5900-043014-5

 	

Receive your bill electronically and you'll be joining the nearly 1.2 million Frontier' customers currently receiving a paperless bill.
It's easy! Go to frontier.com/paperless, select billing changes, log into your profile and choose paperless billing

For Billing and Service Questions, Call 1-800-921-8102, 7 am-7 pm Monday-Friday, 9:30 am-4 pm Saturday or visit www.Frontier.com.

IF YOU HAVE ANY QUESTIONS, BILLING CONCERNS, OR A RECURRING ISSUE, PLEASE CONTACT OUR
FLORIDA-BASED CUSTOMER CARE TEAM AT 1-888457-4110. OUR FLORIDA TEAM IS EAGER TO HELP YOU GET SPECIALIZED ATTENTION.
PAYING YOUR BIU
Pay online, by phone, by mail or at any Authorized Payment Location. Paying by check authorizes Frontier to make a one-time electronic funds transfer from your account, as early as the day your check is received. Visit Frontier.com to set up recurring electronic payments to streamline bill payment.
LATE PAYMENTS, RETURNED CHECK FEES and PAST DUE BALANCES
You are responsible for all legitimate, undisputed charges on your bill. If you  pay your bill after the due date, you  may be charged a fee (including a Treatment Charge if your account has been delinquent for 3 consecutive months and your past due balance is greater than $99), your service may be interrupted and you may have to  pay a reconnection charge to  restore service, A fee may be charged for a check that is returned by the bank for any reason. Continued  nonpayment of  undisputed  charges (incl. 900 and long distance charges) may result in collection action and a referral to credit reporting agencies, which may affect your credit rating. When making an on line payment, please allow time for the transfer of funds. If the funds are not received by Frontier by the due date, a fee may be assessed.
IMPORTANT CONSUMER MESSAGES
You must pay all basic local service charges to avoid basic local service disconnection. Failure to pay other charges will not cause disconnection of your basic service but this may cause other services to be terminated. Frontier Bundles may include charges for both basic and other services.
Frontier periodically audits its bills to ensure accuracy which may result in a retroactive or future billing adjustment.
Frontier Internet users may be charged a fee to receive a paper copy of their bill. An electronic copy of your bill is available for no charge at frontier.com/gopaperless.
SERVICE TERMS
Visit Frontier.com/terms, Frontier.com/tariffs or call customer service for information on applicable tariffs, price lists and other important Terms, Conditions and Policies ("Terms") related to your Frontier services - voice, internet and/or video - including limitations of liability, and early termination fees and the effective date of and billing for the termination of service(s). Frontier's Terms, include a binding arbitration provision to resolve customer disputes (Frontier.com/terms/arbitration). We encourage you to review the Terms as they contain important information about your rights and obligations, and ours. By using or paying for Frontier services, you are agreeing to these Terms and that disputes will be resolved by individual arbitration.
Hard of Hearing, Deaf, Blind, Vision and /or Mobility Impaired customers may call 1-877-462-6606 to reach a consultant trained to support their communication needs.

TRIPLE CREEK CDD
Date of Bill
Account Number

Page 3 of 4
2/04/18
813-671-5900-043014•5

CURRENT BILLING SUMMARY
Local Sarvlc11 from 02/04/18 to 03/03/18
Qty D11cription	813/871•5900,0
Bade Chargu
Frontier Solutions for Business - 2 Year Term Access Recovery Chrg-Bus
Federal Subscriber Line Charge - Bus Federal Excise Tax
Federal USF Recovery Charge
FCA Long Distance - Federal USF surcharge FL State communications services Tax
FL state Gross Receipts Tax county Communications services Tax
FL Telecommunications Relay Service Hillsborough county 911 surcharge
Total Basic Charges
Non Basic Chargta
FiOS Internet 50/50 2Vr - Business
5 IP Addref!llas
Other Charges-Detailed Below Partial Month Charges-Detailed Below Federal Excise Tax
FCA Long Distance. Federal USF surcharge FL State Communications services Tax
FL State Gross Receipts Tax
county communications services Tax Total Non Baeic Charg10
V1d10
FiOS Local TV Priv Cable Card Rental
Partial Month Charges-Detailed Balow FCC Regulatory Recovery Fee
FL Video communications service Tax FL State Gross Receipts Tax
county Video communications services Tax county Sales Tax
FL state Sales Tax
Total Vidoo
Toll/Other
Other Charges-Detailed Below
FCA Long Distance - Federal USF surcharge FL State communications services Tax
FL State Gross Receipts Tax county communications services Tax
Total Toll/Other

TOTAL

Ch11rg1
87.00
2.04
6.50
.26
1.67
1. 95
4.88
2.50
4.57
.10
.40
111,87

124.99
20.00
-17,07
-30.00
,09
.39
·,  91
,47
.86
06,HS

34.99
5.99
-10,00
.08
1.24
.63
1.15
.06
.36
34.50

3.99
.78
,23
.12
.22
5.34

247.87

CUSTOMER TALK
If your bill reflects that you owe a Balance Forward, you must make a payment Immediately In order to avoid collection activities. You must pay a minimum of $96.39 by your due date to avoid disconnection of your local service. All other charges should be paid by your due data to keep your account current.

Important Service Information...
Frontier has bean providing local customers with Susy Lina Verification and Busy Lina Interrupt. Beginning March 1, 2018, Busy Verification Services & Busy Lina Interrupt SE1rvlces will be discontinued. Questions? Please contact customer service.

Closed Captioning Contact Information...
If you have a question or concern about closed captioning on any program, please call Frontier at 1·877-462-6606. You can also send wrlltGn correspondence by fax to 1·304·340-0283, by email to Vldao.Closed.Captlon@ftr.com, or by mall to Frontier, 1500 MacCorkle Avenue, Charleston, WV 25396, Attn: Anthony Kasey, Manager.

For up-lo•date channel Information please visit: http://fronller.com/channalupdatas

Local Franchise Au!hor!ly • FIOS TV Your FCC Community ID Is: FL1304

•• ACCOUNT ACTIVITY**

ty Ducr:1.ption
Business High Spead Internet Fee	AUTOCH 2/04 Frontier Road work Recovery surcharge
AUTOCH 2/04
Solutions Bundle Discount	AUTOCH 2/04 Federal Primary carrier Single Line Charge
AUTOCH 2/04

1 .99
.95
·22.00
1.99

carrier cost Recovery surcharge
813/$11 •HOO
Partial Month Chargu
FiOS Video Discount 99 MO FiOS Internet Bus 99 MO
913/1571 •ei!JOO

AUTOCH 2/04
tubtotll.l
PROMOTION 2/04 3/03 PROMOTION 2/04 3/03
Subtot,11.l

3.99
·13,08
-10,00
-30.00
•40.00

Subtotal	-53.08

CIRCUIT ID DETAIL
88/KQXA/491718/	/VZFL

••••••1• er
COMMUNICATIONS

TRIPLE CREEK COD
Date of Bill Account Number

Page 4  of 4
2/04/18
813-671-5900-043014-5

Detail of Frontier Charges
Toll charged to 813/671-5900

Detail of Frontier Com of America Charges
Toll charged to 813/671-5900
Legend Call Types:
DD· Day

Caller Summary Report
Main Number
***Customer summary

Calls
11
11

Minutes
31
31

Amount
.00
.00

Caller Summary Report

Intra-Lata Interstate Intrastate
***Customer summary

Cal.l.s	Minutes	Amount
2	7	.00
8	20	.00
1	3	.00
11	31	.00

I

V  I	HF.AL/TY

lamJ,cape Architecture Urban Design Engmeermg
Planning

1000 N. 1\shley Drive
Suite 900
Tampa, FL 33602

Tel  813.620ASOO

I

Fax  813.22L4980
www.GenesisGroup.com

INVOICE	Invoice Date :
Invoice#: Invoice Due : Project:

Triple Creek Community Devel. Dist
3434 Colwell Avenue, Suite 200
Tampa, FL. 33614

1/23/2018
58965
2/22/2018
061980009
Page 1 of1

kgallant@rlu:etta.com	TOTAL DUE THIS INVOICE:	$	315.00
ATTN:	Joe Roethke

For Professional Services Rendered through: 12/31/2017
Triple Creek • CDD Engineer
Copy; Kaitlyn Gallant <kgallant@rlzzetta.com>

Phase: P01 -	Meetings / Misc. Engineering Svcs.	HOURS	RATE PER HOUR	AMOUNT

Principal/Officer-Prof. Eng IV
CDD meetings (12/19/17)

 	
1.50	210.00
Sub-Total Labor:

315.00
315.00

Approved by:

Kyle L. Thornton, P.E.

E	ES I

WE APPRECl4TE YOUR BUSINESS

INVOICE TOTAL	$315.00

For billing lnqulrles, contact: Dennis Henchen
Project Accountant
DHenchen@GenesisGroup.com

Remit via Check:
Genesis
1000 N. Ashley Drive Suite 900
Tampa, FL 33602-3718

Remit via ACH Payment: Wells Fargo Bank Routing#: 063107513
Account#: 8116094205

Far additional assistance, please contact 77m Leal, CFO at (813) 620-4500 x5158 or contact your Genesis Project Manager

Hopping Green & Sams
Attorneys and Counselors

119 S. Monroe Street, Ste. 300
P.O. Box 6526
TaHahassee, FL 32314
850.222.7500
================================= STATEMENT=================================
January 25, 2018
Triple Creek Community Development District	Bill Number	98171	
c/o Rizzetta & Company
3434 Colwell Avenue, Suite 200	Billed through	12/31/2017	
Tampa, FL 33614		

General Counsel/Monthly Meeting		
TCRCDD	00001	JLK		

FOR PROFESSIONAL SERVICES RENDERED
12/01/17	AHJ	Prepare work authorization regarding geotechnical services; confer with Perkins regarding same.

0.80 hrs

12/05/17	LCW

12/05/17	AHJ

12/08/17	AHJ

12/11/17	JLK

12/15/17	DGW

12/19/17	JLK

12/19/17	LCW

12/20/17	JLK

12/20/17	LCW

12/27/17	AHJ

Review tentative agenda and confer with staff regarding same.

Prepare work authorization regarding additional irrigation services; confer with Perkins and Thornton regarding same.

Finalize work authorization for irrigation services; confer with Perkins and Thornton regarding same.

Conference call with landowner on platting and easement options; confer regarding acquisition packages.

Disseminate legislative update to board members.

Review draft agenda and financials and confer with Whelan on same. Attend board meeting.
Post meeting wrap up with Whelan. Follow-up from board meeting.
Confer with Perkins regarding agenda items.

0.10 hrs

1.40 hrs

0.50 hrs

0.50 hrs

0.20 hrs

0.50 hrs

1.00 hrs

0.30 hrs

0.30 hrs

hrs

Total fees for this matter

DISBURSEMENTS
Document Reproduction Travel

Total disbursements for this matter

$995.50

89.50
7.88

$97.38

MATTER SUMMARY

Triple Creek COD - General Cou	Bill No. 98171	Page 2
=======================================================================================
Jaskolski, Amy H. - Paralegal	2.80 hrs	125 /hr	$350.00	
Wilbourn, David - Paralegal	0.20 hrs	125 /hr	$25.00	
Kilinski, Jennifer L.	1.30 hrs	235 /hr	$305.50	
Whelan, Lindsay C.	1.40 hrs	225 /hr	$315.00	
TOTAL FEES			$995.50	
TOTAL DISBURSEMENTS			$97.38	
TOTAL CHARGES FOR THIS MATTER			$1,092.88	
BILUNG SUMMARY

Jaskolski, Amy H. - Paralegal	2.80 hrs	125	/hr	$350.00	
Wilbourn, David - Paralegal	0.20 hrs	125	/hr	$25.00	
Kilinski, Jennifer L.	1.30 hrs	235	/hr	$305.50	
Whelan, Lindsay C.	1.40 hrs	225	/hr	$315.00	
TOTAL FEES				$995.50	
TOTAL DISBURSEMENTS				$97.38	
TOTAL CHARGES FOR THIS BILL				$1,092.88	

Please include the bill number on vour check.

FEBO z

C'P	2/9/18
\	  

Hopping Green & Sams
Attorneys and Counselors

119 S. Monroe Street, Ste. 300
P.O. Box 6526 Tallahassee, FL 32314
850.222.7500
================================= STATEMENT=================================
February 15, 2018
Triple Creek Community Development District	Bill Number	98541	
c/o Rizzetta & Company	Billed through	01/31/2018	
3434 Colwell Avenue, Suite 200			
Tampa, FL 33614			

General Counsel/Monthly Meeting			
TCRCDD	00001	JLK			
EOR PROFESSIONAL SERVICES RENDERED			
01/02/18	LCW	Review tentative agenda and confer with staff regarding same.	0.10 hrs	
01/03/18	JLG	Prepare responses to notice to owners received from Ajax Paving Industries of Florida, LLC, Trans-Phos, Inc. and Oldcastle APG South, Inc.	0.50 hrs	
01/04/18	AHJ	Confer with Thornton and Perkins regarding agreement for well installation agreement.	0.40 hrs	
01/05/18	JLK	Confer with landowner and staff regarding status of various conveyances, escrow payments and financing related questions.	0.50 hrs	
01/12/18	LCW	Prepare for board meeting.	0.40 hrs	
01/16/18	JLK	Review agenda and financials and confer with Whelan on same.	0.70 hrs	
01/16/18	LCW	Travel to and attend board meeting; prepare wildlife management agreement; prepare addendum to Newberg pump installation agreement.	4.40 hrs	
01/18/18	LCW	Return travel from board meeting.	2.30 hrs	
01/19/18	DGW	Disseminate legislative update to board members.	0.30 hrs	
01/24/18	JLK	Conference call on escrow and Lennar conveyance documents.	0.40 hrs	
01/25/18	JLK	Conference call with staff on construction options and timelines.	0.30 hrs	
01/26/18	JLK	Conference call regarding conveyance status; prepare deeds and acquisition documentation; disseminate same.	1.00 hrs	
01/26/18	LCW	Confer with Perkins regarding proposal for maintenance of additional stormwater ponds.	0.20 hrs	
01/29/18	DGW	Disseminate legislative update to board members.	0.30 hrs	
01/30/18	MCE	Respond to auditor request.	0.10 hrs	
01/30/18	JLK	Audit response.	0.10 hrs	

Triple Creek COD - General Cou	Bill No. 98541	Page 2
=======================================================================================

01/31/18	CGS	Monitor proposed legislation which may impact district.

Total fees for this matter

DISBURSEMENTS
Document Reproduction Travel
Travel - Meals United Parcel Service

Total disbursements for this matter

1.70 hrs

$3,177.50

1.75
132.94
9.75
8.04

$152.48

MATTER SUMMARY

Jaskolski, Amy H. - Paralegal	0.40 hrs	125	/hr	$50.00	
Stuart, Cheryl G.	1.70 hrs	355	/hr	$603.50	
Wilbourn, David - Paralegal	0.60 hrs	125	/hr	$75.00	
Gillis, Jennifer L. - Legal Assistant	0.50 hrs	100	/hr	$50.00	
Kilinski, Jennifer L.	3.00 hrs	235	/hr	$705.00	
Whelan, Lindsay C.	7.40 hrs	225	/hr	$1,665.00	
Eckert, Michael C.	0.10 hrs	290	/hr	$29.00	
TOTAL FEES	$3,177.50	
TOTAL DISBURSEMENTS	$152.48
--------	
TOTAL CHARGES FOR THIS MATTER	$3,329.98	

BllUNG SUMMARY

Jaskolski, Amy H. - Paralegal	0.40 hrs	125	/hr	$50.00	
Stuart, Cheryl G.	1.70 hrs	355	/hr	$603.50	
Wilbourn, David - Paralegal	0.60 hrs	125	/hr	$75.00	
Gillis, Jennifer L. - Legal Assistant	a.so hrs	100	/hr	$50.00	
Kilinski, Jennifer L.	3.00 hrs	235	/hr	$705.00	
Whelan, Lindsay C.	7.40 hrs	225	/hr	$1,665.00	
Eckert, Michael C.	0.10 hrs	290	/hr	$29.00	
TOTAL FEES	$3,177.50	
TOTAL DISBURSEMENTS	$152.48	
TOTAL CHARGES FOR THIS BILL	$3,329.98	

Please include the bill number on vour check.

... -o-	JI.-,&.£.

State Wildlife Trapper 2103 W Rio Vista Avenue Tampa, FL 33603 US
trapperjerry@gmail.com
INVOI

BILL TO
Triple Creek CDD

INVOICE# 1086 DATE 02/16/2018
DUE DATE 03/0112018 TEAMS Net 15

ACTIVITY	QTY	RATE	AMOUNT	
Monthly hog removal @ $1400.00 monthly:State Wildlife Service Service for February 2018		1,400.00	1,400.00	
Hrap/ 3 cameras currently in use.				
LTD Removed: 8 hogs YTD Removed: 8 hogs MTD Removed: 8 hogs				
Notes: We are using every means possible in order to eliminate the hog population in your area.				
Set-up Fee:State WIidiife Trapper		350.00	350.00	

9 month contract February • October 2018 Thank you for doing business with us.

BALANCE DUE	$1,750.00

Maka all checks payable to; Jerry Richardson

A late fee of 15% late tea will ba appUad If not paid within 1o days from date.

If you have any questions concerning this Invoice, please contact:
Jerry Richardson, Phone 813·390-9578; email • trapperjerry@gmail.com

A 30 day notice Is required to terminate trapping service In wrtling.
Termination fees may apply•	

II	• ♦ •••

VGlobalTech
636 Fanning Drive
Winter Springs, Fl 32708 contact@vglobaltech.com www.vglobaltech.com

!NVOI
BILL TO
Mr. Joe Raethke
Rlzetta • Triple Creek CDD 3434 Colwell Ave. Suite 200 Tampa, Fl 33614 USA

INVOICE # 1008
DATE 02/13/2018
DUE DATE 03/15/2018
TERMS Net30

ACTIVITY
Web Malntenanca:CDD Community Cara Sites - Maintenance
COD Updates as needed

RATE	
80.00	80.00

You may pay onlina via CCN or ACH or mail a check payable to "VGlobalTech" at the above address.

BALANCE DUE	$80.00

PEST CONTROL SERVICES
16210 North Florida Avenue Lutz, Fl 33549

JM 2 fi 1018

Office: 813.968. 7031
Toll Free: 888.908.8388
www.Nvirotect.com

Triple Creek COD

t·tHC u H.LtJJlt(i ij   (_;{),'  d·H .:, "~--=-·'·,-- « ·

.	C2	·-·-...nate_.21s11a,,.

INVOICE

11920 Streambed Dr.
".f ', 1 ·~ 

,::	( I

Riverview, FL 33579,tr!
;   1	•. -d!,,,.J

FEB O 2 2018	Account   Number:
C!;;; ·	l( ,'.'/(	-Invoice Number:
t;t--:] ...	-··--	Previous Balance:

9501
142743

·oate:1\

-' vL'7-

\.c.1D.  ,,:H..i..,

Commercial Generill-Pests

$60.00

Call for a FREE lawn Care Quote!
Next service FREE for each referral!*

SalesTax:
Service Amount:

$0.00
$60.00

Save 10% with yearly prepayment!*
•Exclusions apply. Contact office for details.

Check/Cash:--	----
Technician{s}:  (  J,  )	\\ 
V 

Inspection Area
Jcommercial
_ Residential
/outside
-L'!nside

Bank
_ edical
v-f'rofessional Retail Industrial

Frequency
_ ice Per Month VMonthly
_ Every Other Month
_ Quarterly Annual Additional

Type of Service
_ iting System
\LGeneral Household Rodent Control Termite Control Termite Renewal
_ Tube System

General Interior Pests / Termite	Treatment

1\crobdt Ants
 Ant•;
Bees

Crazy 1\nts
Dr;,in Flies
_ Drywood Terrrntes
Fire Ant,,
Fleas
... Gerrnc1n Rodches

Ghost Ants
Paper 1Nas ps
_   ruraoh A.nts
JPrriventati\1e
Roaches
Silverfish

. Sub 1 errn1tw;
T1ch

Advion 1:\nt 8J!l Station 1% Advion Ant Gei Bait 05% Advton Roach Bait Stn .5% Advion Ro,1ch GPI Bait .6% Alpine /,e,osol
_ l\vert Dry flow Bait 054'1; crv1 Insect Monitors D,:kko S F Paks
92ntrol	u1d
,/1nsp\cCt1on

MJxforcE, Quantum .03%
N1ban FG 5%
'-L1 e ri mc0  te r Sweep Tdurus 06¾
T4 h tc1r Xtrd .2S%
Jransport GHP 11%
Transport Mtkron .11%
Vector 810 'i
Wa p Freeze 240%

Rodent Control
Exclusions	 	
Mice Rats

Treatment Contrac Blox Tin Cats Final Blox

Giue Boards
Rodent Bait Stations
_ Snap Traps

PAYMENT DUE UPON RECEIPT.	We accept Visa, Mastercard and Discover.
Ask us about automatic payments and paperless billing!

PEST CONTROL SERVICES
16210 North Florida Avenue
Lutz, FL 33549

Triple Creek COD
11920 Streambed Dr.
Riverview, FL 33579

Office: 813.968.7031
Toll Free: 888.908.8388
www.Nvirotect.com

INVOICE
Account Number:
Invoice Number: Previous Balance:

9501
144811
$0.00

Date: Z..- l 3-1fs

Commercial General Pests

$60.00

Call for a FREE Lawn Care Quote!

SalesTax:

$0.00

Next service FREE for each referral!* Save 10% with yearly prepayment!*
*Exclusions apply. Contact office for details.
«--	-*

Service Amount:	$60.00
Check/Cash: 		_ Technician(s): W \	\

ln!jectlon Area
\!'tommercial Residential o utside
2'nside

Bank Medical
rofessional Retail Industrial

Frequency
Twice Per Month onthly
_ Every Other Month
_ Quarterly Annual Additional

Type of Service
_ Baiting System eneral Household
Rodent Control Termite Control Termite Renewal
_ Tube System

General Interior Pests/ Termite
Acrobat Ants	Ghost Ants
ArKentme Ants	PapE>r Wci'.,p'.:>
Bees	/4ldlrlOh  Ants
Carpenter Ants	reventat1ve
Crazy Ants	Ror1ches
Dr;:iin Fltes	S1lveri1st1
Drywood Term1tt>'>	Spiders
F11e /\ntc,	Sub T erm1tes
FIPns	ficks
German Roaches

Rodent Control
Exclusions		 Mice
Rats

Treatment
Advlon Ant Rall Stdtton 1%
Advion Ant Gel Brtit 05%
. Advion Roach Bait Stn .5% Aciv,on Roach Gel Bait 6% Alpine Aeror,ol
AvPrt Dry Flow BJ1t 054%. CM  lmecl   Monitor, Oµ,kko S F. Pab
Gentrol l1qu1d
0rispection

Treatment Contrac Blox Tin Cats Final Blox

Maxforce Quantum .03%
Niban FG 5%
/renrnetPr SwePp
Trl\ffU'> 06%
yt tar )(tr il 25%
1 r,;n 5po rt GHP 11%
Tr;:insport M1kron 11%
Vector 810 5
Wasp FrPeze 24Y%

Glue Boards
_ Rodent Bait Stati ?: ·
_Snap Traps

PAYMENT DUE UPON RECEIPT.	We accept Visa, Mastercard and Discover.

l    5 20?1]

Ask us about automatic payments arttf.}Jbplii,leS-5rbilJ1tigL ut vU., me.----
Instructions:	------  ...   ----···-··---"·--..	.. I)/fuL:U.Jl.lrDVai --e,i,,,. ·"'·"-= )ate: 2116/j 8
Oate entererJ	FEB 1 5 2018

F• !O(i (}QJ.·- Gt'::]iJf. . oc Cj	[ I

Rizzetta & Company, Inc.
3434 Colwell Avenue
Suite 200
Tampa FL	33614

Bill To:

Invoice

Date	Invoice#	
2/1/2018	INV0000030110	

TRIPLE CREEK COD
3434 Colwell Avenue, Suite 200
Tampa FL	33614

	Services for the month of	Terms	Client Number	
	February	Upon Receipt	00535	
Descri tlon	Rate	Amount	
District Management Services·3	r Administrative Services. I Accounting Services
Financial & Revenue Collections Field Services ·>(,·,-,,l 

1f'l:6/18
C?J	z 5 2016

 	

	1.00
1.00
1.00
1.00
1.00	$1,533.33
$375.00
$1,166.67
$300.00
$550.00	$1,533.33
$375.00
$1,166.67
$300.00
$550.00	
	Subtotal	$3,925.00	
	Total	
$3,925.00	

Rizzetta Amenity Services, Inc
3434 Colwell Avenue
Suite 200
Tampa FL	33614

Bill To:

Invoice

Date	Invoice#	
2/9/2018	INV00000000004586	

Triple Creek COD 3434 Colwell Ave.
Suite 200
Tampa FL	33614

Services  for  the month of		Terms	Client Number February	Due on receipt		00035
Descri tion	Q	Rate	Amount

Amenity Management Services

C'f	2/1(3/1JL

JEB .L.5J018

1.00	$1,913.60	$1,913.60

Subtotal	$1,913.60

Total	$1,913.60

Rizzetta Amenity Services, Inc
3434 Colwell Avenue
Suite 200
Tampa FL	33614

Bill To:

Invoice

Date	Invoice#	
1/31/2018	INV00000000004611	

Triple Creek CDD 3434 Colwell Ave.
Suite 200
Tampa FL	33614

Services for  the month of	Terms	Client Number
January	Due on receipt	00035
Descri tlon	Q	Rate	Amount

Cell Phone
Auto Mileage & Travel

25.00
64.00

$1.00
$1.00

$25.00
$64.00

2/16/18

Subtotal	$89.00

Total	$89.00

Sitex Aquatics LLC
SITEX	7643 Gate Pkwy, #104-127
FL 32256

I	i..ce

Bill To	
Triple Creek CDD
3434 Colwell Ave., Ste 200
Tampa, FL 33614	

P.O. No.	Terms	Project

Net 30

Quantity	Description
Aquatic Maintenance Wetland Monitoring Trash Removal in Ponds
Mdige Fly Treatment Pond

Rate

1,416.67
833.33
!50.00
215.00

Amount
1,416.67
833.33
150.00
215.00

Date	Invoice#	
2/l/2018	2402A	

2/5/18

15.00

SITEX

Sitex Land LLC
7643 Gate Parkway #104-127
Jacksonville, FL 32256
941-468-6267	I	l...  o_m_ce_@_s_ite_x_1a_nd_s_ca_p_e. co_m	 	,

Invoice

Date	Invoice#	
2/1/2018	4493	

Bill To	
Triple Creek COD
3434 Colwell Ave., Ste 200
Tampa, FL 33614	

	P.O. No.	Terms	Project	
		
Due on receipt		
Quantity	Description	Rate	Amount	
	Monthly Common Area Landscape Maintenance

,	.J       '!     $	J.----
uate Hee O f11ldlfo ,  1 u	fH	FEB O 5 2018
0/Mapprova,_G..?	oate 21911 a
Oateentered.	.. _JE.§.J g 2018_
FuncLCQj_ Gl $_?.SQQ oc_ a:f_
f't1ci I, •
\jl ;,,Cr.. ff

	9,945.17	9,945.17	
	Total	$9,945.17	

Sitex Land LLC
7643 Gate Parkway #104-127
Jacksonville, FL 32256

Invoice

Date	Invoice#	
2/4/2018	4689	

Bill To	
Triple Creek CDD
3434 Colwell Ave., Ste 200
Tampa, FL 33614	

	P.O. No.	Terms	Project	
		
Due on receipt		
Quantity	Description	Rate	Amount	
	Bahia Fertilizer I 6-0-8 at 352#s
St. Augustine Fertilizer 16-0-8 132#s
Zoysia Fertilizer 16-0-08 75#s (the Zoysia app has gone up due to the amount of new turf in the playground area)
Pest Control for January & February
Approved Proposal - Install Top Choice Ant Treatment to high traffic areas throughout the community

 

	1,000.00
416.00
1,000.00

1,440.00
4,000.00	1,000.00
416.00
1,000.00

1,440.00
4,000.00	
	Total	$7,856.00	

Suncoast Pool Service
P.O. Box 224
Elfers, FL 34680

Invoice

Date	Invoice#	
2/112018	4306	

Bill To	
Triple Creek CDD c/o Rizzetta and Co
12750 Citrus Park Lane Suite 115
Tampa, FL. 33625	

	P.O. No.	Terms	Project	
	
Feb 2018	
Net30		
Quantity	Description	Rate	Amount	

Swimming Pool Service including chemical balance, debris removal from surface and bottom of swimming pool, vacuuming, tile cleaning and skimming.

Operational checks of pumps, filter system, chemical feeders, flow meters and vacuum gauges. Chemicals Included.

   2/9/18	
FEB O 9 2018	

850.00	

850.00	
Thank you for your business.	Total	$850.00	
	Phone#			
	{727) 271-1395		

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

DISTRICT OFFICE · 12750 CITRUS PARK LANE · SUITE 115 · TAMPA, FLORIDA 33625

Check Request

Amount:	$2,491.50

Date:	02/08/18

Payable To:	SWFWMD

Mail check to:	Genesis Group, Attn: Kyle Thornton
1000 N. Ashley Drive, Suite 900
Tampa, FL 33602

Description:		Village G2 Permitting to be reimbursed by the Construction Account

Requested By:	Kaitlyn Gallant

Manager Approval:	 	

Code to:	001-57900-4799	2,491.50
001-20200	2,491.50

Kaitlyn Gallant

From:	Kyle L. Thornton, P.E. <kthornton@genesisgroup.com>
Sent:	Tuesday, February 06, 2018 4:50 PM
To:	Kaitlyn Gallant
Subject:	Triple Creek

Kaitlyn,

I need another check; Payable to: SWFWMD For: $2,491.50
G2 permit review – from the General Construction fund

Kyle L. Thornton, P.E.

Right-click here to download pictures. To help protect your privacy, Outlook prevented automatic download of this picture from the Internet. GENESIS - From Vision to Reality

Senior Vice President

1000 N. Ashley Drive, Suite 900
Tampa, FL 33602 www.GenesisGroup.com

w: (813) 620‐4500 x5115 m: (813) 629‐6492
e: KThornton@GenesisGroup.com

Electronic Communications Disclaimer

1

Triple Creek COD
TECO Meter Reading 01/12/18- 02/09/18
Due 03/08/18

 	Account		Billing Date	Service Address	Code	Amount 	
211005281400	2/15/2018	Triple Creek Tract D	001-53100-4307	$	722.29	
211005281640	2/15/2018	Triple Creek Tract A	001-53100-4307	$ 1,318.98	
211005281160	2/15/2018	Balm Riverview/Trpl Crk PHI	001-53100-4307	$	766.38	
211005282317	2/15/2018	Triple Creek BL PH2	001-53100-4707	$	681.23	
211005282515	2/15/2018	Triple Creek PH 2	001-53100-4707	$	973.52	
211005282705	2/15/2018	Triple Creek PH C	001-53100-4707	$	722.29	
211005280915	2/15/2018	12198 Triple Creek Bl Pmp	001-53100-4301	$	227.31	
211005280683	2/15/2018	12141 Triple Creek Bl Pmp	001-53100-4301		
211005281889	2/15/2018	12113 Triple Creek BL	001-53100-4301	$	69.57	
221002207761	2/15/2018	13315 Dorado Shores Ave	001-53100-4301	$	124.80	
211005282127	2/15/2018	11920 Streambed Dr CLBHS	001-53100-4304	$	523.17	
			TOTAL	$	6,129.54	
			
Summary		
		General Service	1-53100-4307	$	5,184.69	
			1-53100-4301	$	421.68	
			1-53100-4304	$	523.17	
			TOTAL	$	6,129.54	

TAMPA EL.E:CTRIC

ACCOUNT INVOICE

AN EMERA COMPANY

TRIPLE CREEK CDD TRIPLE CREEK TRACT D RIVERVIEW, FL 3357&-0000		

Your Account Summary		
Previous Amount Due	$680.96	
Peyment(s) Received Since Last Statement	-$680.96	
Current Month's Charges	 	$722.29 	
Total Amount Due	$722.29	

tampaelectric.com  j	f "# <i) 8• I in

Statement Date: 02/15/2018 Account:211005281400

fol1E@i1HWm ID)
JI FEB 2 0 2018 B!)
BY•··••11c"'••· ····"" ········

Always assume that a downed power line is energized. Visit tampaelectric.com/safety for more safety tips.

Amount not paid by due date may be assessed a late payment charge and an additional deposit.

Helping neighbors in need
Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure prompt credit, please return stub portion of this bill with your payment. Make checks payable to TECO.

TAMPA E:L.li:CTRIC

AN EMERA COMPANY

WAYS TO PAY YOUR BILL

mail	phone online	pay agent
See reverse side for more information

Account: 211005281400

C Amc11.mtEr1i::lo ed

OOOOGgf/4 01 AB O◄O 33625 FTEC0102151823132610 00000 05 0100000() 008 06 32283 002
1·1 1111··11 ··11·1·1·11··111111hlll1111· 1·11·11·h·11l1111h111·1
TRIPLE CREEK COD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

656321185369

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

6563211853692110052814000000000722297	Page 1 of 4

TAMPA ELECTRIC
ANEr-1ERA   C□MP A N Y

Contact Information
Residential Customer Care

df):J-?D J ()BOO (Polk Count/)
en<l ,:.";!3-0<300 (A!i o!hiar co J;-1!1ns)

Commercini Customer Care

Hearing Impaired/TTY

Power Outages Toll-Free
>ff l -r )g0 i O l 0
Energy-Saving P.-ograms
;:{1--,)- )/'.) t:}(()

tampaelectric.com

Maii Payments to
r! ( ,, )

A!I Other Correspondence Tampa Electric

Understanding Your Electric Charges

Fuel Charge

'I\'

Past Dua

Rate Schedule

'//: j.

Renewable Energy;;,, ''·('

Share

F!pc[: ;:r ci t:
f}cJ}- :r-n; (:h•;rov L•:i
c:1r1 '.) ;J n1Hdf 1	yoti-

rr:nr,:!·i,,, (:i(;c;,,.,j
co:·1\. !) u r ,t 1 r:	(k-:(lt:t

Average kWh per  day    ,     ,, :.   •i1:J')L	

Basic SQrvice Charge f·. r,:-:,.,, j ;•, , .. J,',

Bright Choicesm

Estin1ated

ir,d ,J::v ,j.lft-;:cr:1,,1-:;

1,j;;y·
;::Ci:t;::,u-'d	1. 1·-.,d!;i ,fr/.

Florida Gross Receipts Tax

:flLf.f,>'":.
-1<:1 !d:1

: .1f:t ;o 1_:id:,­
!:CL:_ { ;!,: :

Total Amnunt Due    T,,.,. ""  r	1 { ·: :-_;t···:, 1,\'\•i l!('. t),(,!';Jt (1Ul -;)'[(;:

:T : Tr7 f").1\TF CJ;·-.;

Zap Cap Systems

 tampaelectric.com

Your payment options are:
Sc f·,t?d ti: t.1 ee nne--iinH-; c1 .-cl U1, inu pc-:::-,T:1er-,1 -, iJl ta1npaelectric.com L -:;·:q
r.1•!;A:1 i V(\;'. ;1/!'r'l'P\-H:\ \:·1 \hi e:1L'.(•f (:-!d t \·-.-<::':\cr:{? [)'.E•r:1s{: rl ip\'J
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,r  tampaelectric.com .•

,      ;;,! 866-689-6469

   ta1npaelectric.co1n	
Page 2 of 4

TAMPA ii:l..!i:CTRIC:

AN EMERA COMPANY

ACCOUNT INVOICE
tampaelectric.com  I f "JI <p S•	in

Account:	211005281400
Statement Date:	02/15/2018
Current month's charges due  03/08/2018

Details of Charges - Service from 01/12/2018 to 02/09/2018

Service for: TRIPLE CREEK TRACT D, RIVERVIEW. FL 33579-0000	Rate Schedule: Lighting Service

Lighting Service Items LS-1 (Bright Choices) for 29 days
Lighting Energy Charge	i012 kWh @$0,03207/kWh

S32A5

Fixture & Maintenance Charge Lighting Pole/ Wire
Lighting Fuel Charge Florida Gross Receipt Tax Franchise Fee
Lighting Charges

23 F'1xtures
23 Poles
1012 kWh @SD.03095/kWh

S316.02
$340.86
S3U2
$1.64
S0.00

$722.29

Total Current Month's Charges	$722.29

Important Messages
Fuel sources We Use to Serve You
For the 12-month period ending December 2017, the percentage of fuel type used by Tampa Electric to provide electricity to its customers was:

-Natural Gas & Oil*
-Coal

67%
29%

-Purchased Power	4%
*Oil makes up less than 1%

Important Program Information for Lighting Customers
Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program. The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting. The conversion program, which is expected to be effective in February 2018 and will take up to five years to complete, will offer updated rates and several new fixture and pole options. As part of the program, some current options will be closed to new customers.

To view rate details for all lighting fixtures and poles, please visit tampaelectric.com/rates, and select Customer Communications. If you prefer to receive a copy of the rates via U.S, Mail, please call 813-635-1500 and select Option 5 to make a request.

Page 3 of 4

Regis	r now for help during emergencies

Tampa E!ec1ric i,nows some of our customers have special rieecls w,  1 ich  c21n lle aided throJgh :ocai governmentfl; agP.r:1.iPs Sud1 needs could be caused by a corrmunily-w,de emP.rgenc:y. f;:ie;h 1.O1mty WP. serve a•lov:s its residems to pre-register with a iocai response tearr tha1 orovides a,d tc persons wn,o require special ass1slance during evacuaticns and sheltering because of disabilities.
F::r fYlore irforrrulior:. rl0.as0 ca11 tho spe:::ial-reeds reqistry iri your area·

(813) 307-8063  (H1llstorough CoL.rty)
(727) 847-2411 (Pasco Ccurty)
(863) 298-7027 (Polk County)
(727) 464-3800 (Pirml as Co,r1ly)
\k:;1ks slay ng sarc i:1 urr:erg0r1c,cs a
:oo prior-ty.

Medical Watch
Tarnp21 Eec:ric·s t'vledicai Wa:cl1 program 1ejenii es resder1l'al cuslcrn-;rs wbo use e:ectrically powereo.
;ire ::;u::;lairiing equipment.

P,jrl 1c;pal!o•1 1n  tr1:) tv\iclica  Wtitch program does not provide prior,ty resturc1t:or1. Tf1e µroyrarn does not 011tr.rnotic:c1lly extenri se1vicP. rFJyment options nor does it guarantee
: 1nint0.rn1ptAfi olrc,ctnc serv;ce.
The objective of the Medea; Watch program is \O encourags cusloJT1ers to notify Tampa Electric of their s;tuat ons so that special pra::::edures cari be irnµi tHlHJ·r1  ted \//hen:
O1sco:1necticw of custorner elect!'ic
;orvce .s n:1quired in rnsrorse to electric b P non-pay111ent:
Plannec setvice i:,terruptrons must occur rrn power line equ,pTerr
11:a1nterance.
Tc qua ify. he pat:ent 1·esbi:1;1 at the
cusiorner cf record's acbrcs:; rnus\:
Be deoendenl 1.mon elcc:ric;:il,y
;)owereci rneciical eq:J,prnent to
:ustair: life;

Be: c:erl'fied as c 1ig:b: e by his or r1er Forida-licensecl attending hysiclart.
Note: CJs,0111e,s are solely respu11sible for any backup equ,prnent or power
::.upp'y. Tar mci Electric recorrF1ends
that cLsloMers riave a weii-plc11neci course of 2c:ior0   in the ever~t cf a pcwer outage or iriorrl;ptiori of ssn;ice.
Cali Tampa Eloctr,c m apply for r.;art,c patw1 ;n t:1e /edical Watch progra1T,:
(813) 225-5051 (HUsbcrougr·1 County)
(863) 298-6051 (Polk Cm;my)
1-888-223-0800 (A!I otrer ::::cunt:es &
oul-of-slc1le1

TECO
TAMPA ELECTRIC
ANEMe:;RA COMPANY

tarnoae:c:,c;lr,c.corr;

Page4 of 4

TAMPA ELECTRIC
ANli:MERA C□MPANY

TRIPLE CREEK COD TRIPLE CREEK TRACT A RIVERVIEW, FL 33579-0000

Your Account Summary		
Previous Amount Due	$1,243,52	
Payment(s) Received Since Last Ststement
Curr.mt Month's Charges	-$1,243.52	
Total Amount Due	$1,318.98	

mJo)	tm	R wmw

ACCOUNT INVOICE
tampaelectric.com I	f ._'P 8• I in

Statement Date: 02/15/2018 Account:211005281640

Al FEB 2 0 2018 II}
BY:······ ··	..-

Always assume that a downed power line is energized. Visit tampaelectric.com/safety for more safety tips.

Amount not paid by due date may be assessed a late payment charge and an additional deposit.

Helping neighbors in need
Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure prompt credit, please return stub portion al this bill with your payment. Make checks payable to TECO.

TAMPA ELECTRIC
ANEMERA  C□M P A N Y

WAYS TO PAY YOUR BILL

mail	phone online	pay agent
See reverse side for more information

Account:211005281640

656321185370

TRIPLE CREEK COD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

6563211853702110052816400000001318987	Page 1 of4

TAMPA ELECTRIC:

AN EMERA COMPANY

Contact Information
Residential Customer Care

Commercial Customer Care

Hearing lmpairediTTY
l 11
Power Outages To!I-Free
dll- :)gg 101()
Energy-Saving Programs
<{ 1 :?T i-3:309

tampaelectric.com

Mail Payments to

P,(J  LG>-. 11:JlH

Ail Other Correspondence Tampa Electric

Understanding Your Electric Charges

Fuel Charge

Average kWh per day	

Basic Service Charf1e f' ' ,:Fci 1,;
Bright Choic•Js u Budget Billing C)p':1

Energy Charge

Fioridn State Tax

Past Due

Rate Schedule

'f( - ,;:
'f:r.

Renewable Energy,,., , 1:r·

Share

Total Amount Due
d,1,,·

Zap Cap Systems

 tarnpaelectric.com

Your payment options are:

"Scht-:Cltilt-: frt-',? <,ne-lir:li:. er rt:?cu·nnq prJyn\(,r ;::; ;::t tan1paelectric,corn L· ::,q

Ii U ·1:r•q •< ; qt

\;f: ( r a;qi=t\J '{;

 tarnpae!ectric.con1 ,

:,. a 1     ,       r •J	tampaeleclric.corn,,

larnpaelectric.com, 1..1:, 866-689-6469
r:(1Jr1'. c, er;: J·: ( rFd.1

Page 2 oi4

TAMPA El..lii:CTR!C:

AN EMERA COMPANY

Account:	211005281640	
Statement Date:	02/15/2018	
Current month's charges due	03/08/2018	

Details of Charges - Service from 01/12/2018 to 02/09/2018

ACCOUNT INVOICE
tampaelectric.com  I f W 'Pg a in

 	
Service for: TRIPLE CREEK TRACT A. RIVERVIEW, FL 33579-0000

Lighting Service Items LS-1 (Bright Choices) for 29 days	Rate Schedule: Lighting Service	
Lighting Energy Charge	1848 kWh @$0.03207/kWh	$59.27	
Fixture & Maintenance Charge	42 Fixtures	$577.08	
Lighting Pole I Wire	42 Poles	$622.44	
Lighting Fue! Charge	1848 kWh @ $0.03095/kWh	$57.20	
Florida Gross Receipt Tax	$2,99	
Franchise Fee	S0.00	
Lighting Charges	$1,318.98	
Total Current Month's Charges	$1,318.98	

Important Messages
Fuel sources We Use to Serve You
For the 12-month period ending December 2017, the percentage of fuel type used by Tampa Electric to provide electricity to its customers was:
-Natural Gas & Oil*	67%
-Coal	29%
-Purchased Power	4%
*Oil makes up less than 1%

Important Program Information for Lighting Customers
Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program. The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting. The conversion program, which is expected to be effective in February 2018 and will take up to five years to complete, will offer updated rates and several new fixture and pole options. As part of the program, some current options will be closed to new customers.

To view rate details for all lighting fixtures and poles, please visit tampaelectric.com/rates, and select Customer Communications. If you prefer to receive a copy of the rates via U.S. Mail, please call 813-635-1500 and select Option 5 to make a request.

Page 3 of 4

Register now for help during emergencies

Tampa E:ec:ric :,nows some of our cciston:ers have special :,eeds wnicn c2m be c:1ioed throJgti 'ocai grn.:srnn'P-ntrl' ngenci8s. Such needs
could be caused by a comrnunity-w-de eri1ergency. Ei,ch r:out ty we servA atlows its ,esidents to  pre-register  w1tl' a :oca1 response team iha 1 provides a,d to persons wi10 require spec1ai assistance during evacuations and
st-:eltering because of disaoiiities.
For mom information. plcasn c;:id the spe:::::ial-reec!s reqistry 1n your at·ea:
(813) 307-8063 (H1lis1Jorough County)
(727) 847-2411 (Peeco Ccunly)

(863) 298-7027 (Polk County)
(727) 464-3800 (PinGlas Cour1ly)
\1ake slay,r1g safe i 1 mrergenc cs a
top prionty.

Medical Watch
T arnpa EIectnc·s Medical Watch program iderrif.es ,fsder1t;, I cuslDrriers who use e!ecticaiiy powered,
ife :sust21ir1irig equipment.

Parl1c1pal1cn 1n  :ho Mndica1  Walch program does not provide prior,ty re;:;lorn\:or1. The program doe::, nol autommically AXl8nd service pc1yrnent opiions nor does it yuarar1tee 11nintp,rruptAri Alrn::tnc serviCA.
The obJectve of the Medtcai W8tch prograrr is to encourage :::ustor,er·s to notify Tampa Eleclnc of their s,tuat:ons so that special procedures cari be irnplernented wrieri:
Disconnec1,01 of customer electric service :s roc1uircd in resporse to electric bdi non-pe.yment:
Plaflned service interrupt,ons must occur for po,Ne, li•1e equ:prnent rnair1tena11ce.
lo  qua1ifv . he  pat,e:it nssiohq at ti1e
cus\c>rncr  C)f  record'!- addrEss '.nu ;!:
Be cfo;Jencjem ,JPon eicctris::ii,y
poweri=ici me:iical equ1prrem :o
;-;u lair: life;

82 ccrl,fied 35 rn1g1b!e by ·,is or her Fiorida-licensecl attending ollysicicm.
Note: Cu"'!orners ;;1re solely r espor1 sible for any backup equ,pn,ent or power supµ;,,. Tarr1:Ja Electric recumme,Kb lhat custcrners have a we:i-pl8'1ned course of action in the evert of a p:::wer outage or interruption of service.
Cali Tampa Elecinc 10 apply for oartic;pation in the Medical Watct1 program:
(813) 225-5051 (Hiilsborougt1County)
(863) 298-6051 (Polk CrnJnty)
1-888-223-0800 (All ctr.er count,es &
oul-of-slale)

TECO
TAMPA ELECTF<!IC
AN CMl!!:RA COMPANY

Page4 of4

TAMPA ELECTRIC

ANEMERA COMPANY		

TRIPLE CREEK COD
BALM RIVERVIEW TRPL CRK PH1		
RIVERVIEW, FL 33579-0000		

Your Account Summary·		
Previous Amount Due	$122,07	
Peymant(s) Received Since Last Statement	-$722.07	
Cu!'rent Month's Charges	$766.38	
Total Amount Due	$766.38	

BY:	*•HI

ACCOUNT INVOICE
tampaelectric.com  I	f W'P 8• al in

Statement Date: 02/15/2018 Account: 211005281160

Always assume that a downed power line is energized. Visit tampaelectric.com/safety for more safety tips.

Amount not paid by due date may be assessed a late payment charge and an additional deposit.

Helping neighbors in need
Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure prompt credit, please return stub portion of this b1il with your payment. Make checks payable to TECO.

TAMPA ELECTRIC ANE:MERA COMPANY

WAYS TO PAY YOUR BILL

mail	phone online	pay agent
See reverse side for more mtc,rmation

Account:211005281160

656321185368

TRIPLE CREEK COD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

6563211853682110052811600000000766387	Page 1 of4

----------
T
TAMPA ELECTRIC:
AN EMERA  c;□MP ANY

Contact Information

i-J 1:1 ? ):) (lf!CI(; (1
HG.3-?99-0800

Residential Customer Care

Commercial Customer Cnrc

Hearing Impaired/TTY
711
Power Outages Toll-Free

Energy-Saving Programs
HIJ-//:·1 -; Hf)

tampaelectric.com

Mail Payments to
TFC'(J

Al! Other Correspondence
Tampa Electric

Understanding Your Electric Charges

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Kilowatt-Hours (kWh)

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Basic Servicg Charge
pi	d·'.1q z t  >./Ii:'(' 1u  yn,
Bright  Choice!ilsr,    :-!,,

Budget Billing

Fiorida Gross R<:aceipts Tax

Florida State Tax    '-	,,,,:, -,,,- ::.x

p1(
;Jy T;·;:np:i f

Late Payment Charge

Renewab!a Energy,r.,

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Your payment options arQ:
$       Sctx1du:e  fret:; 1..F1t -t!rne or rr.::c r !nD payrrH:11t  ;/  tan1p..:1electric.cotn  ,\-, r:<; :-, c 1er:: r:q e <:;::-.,;ri v	{:t;:r
lv!:::::! your pny r;·:t!n1	lf:1:: f :1c!n ·1cd =:: rl'/t ;(.p(:,. Pif!i-J , -,	:1u:T:1	,1c:i•/f'.!1V

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Page 2 of 4

TEG

TAMPA EL!i:CTRIC
ANEMERA t:□MPANY

Account:	211005281160	
Statement Date:	02/15/2018	
Current month's charges due	03/08/2018	

Details of Charges - Service from 01/12/2018 to 02/09/2018

ACCOUNT  INVOICE
tampaelectric.com  j f WI 'P 3+ A in

 	
Service for: BALM RIVERVIEW TRPL CRK PH1, RIVERVIEW, FL 33579-0000

Lighting Service Items LS-1 (Bright Choices) for 29 days	Rate Schedule: Lighting Service	
Lighting Energy Charge	1890 kWh @ S0,03207/kWh	$60,61	
Fixture & Maintenance Charge	18 Fixtures	$213.66	
Lighting Pole / Wire	18 Poles	$430.56	
Lighting Fuel Charge	1890 kWh @ $0,03095/kWh	$58.50	
Florida Gross Receipt Tax	$3.05	
Franchise Fee	$0,00	
Lighting Charges	$766.38	
Total Current Month's Charges	$766.38	

Important Messages
Fuel sources We Use to Serve You
For the 12-month period ending December 2017, the percentage of fuel type used by Tampa Electric to provide electricity to its customers was:
-Natural Gas & Oil*	67%
-Coal	29%
-Purchased Power	4%
*Oil makes up less than 1%

Important Program Information for Lighting Customers
Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program. The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting. The conversion program, which is expected to be effective in February 2018 and will take up to five years to complete, will offer updated rates and several new fixture and pole options. As part of the program, some current options will be closed to new customers.

To view rate details for all lighting fixtures and poles, please visit tampaelectric.com/rates, and select Customer Communications. If you prefer to receive a copy of the rates via U.S. Mail, please call 813-635-1500 and select Option 5 to make a request.

Page 3 of 4

Register now for help during emergencies

Tampa E1octric knows some of our custo,1°ers have special neecls wt1ich car be oided through ,oca, g0vP.rnrne:n:i1, ;-ioencies. Such nP.ecls c:.JLJc; be cciused by a corrmuni!y-wide P.n7 ergency. ;::ach rn,mty WP. serve ailows its residents to pre-register witl-, rl !oca, response learr that pmvides
ad  tc persons w0  10  require special c1;;s:st,mce clurin9 evacuc1:i,ms &IC.l stieltering because of disabilities.
For mom infonration. p!oaso c;:i,I the
sr:;ecial-r.eeds registry 11" your a·-ea·

(813) 307-8063 (Hilisborouqh CoLrty)
(727) 847-2411 (Pasco Ccurly)
(863} 298-7027 (Polk Coumy)
(727) 464-3800 ( Pinda , Cour1ly)
Mak; slay1ng  safe in crrcrgenc,us a
t,:,p pnor,ty.

Medical Watch
l ':ilTpa E'ec:ric's Medical Watch
::tiJ'_p:1m identifies res,der1l1d cuslcn1e1 s
\'vl o use eiectrically pow-erec! ife eiuslc.inini,J equipment.

Parlicipa!1or1 ,n ,i-1'., Mcd ica 1 W;,tch program does net provide priorly restorc1\ior1. Tr1e progrwTl does riot autorni"lt1csl!y P.XtencJ sP.1-vice paymet t options r'or does it guc1rantee 1ininterrupted el2ctr1c sPrv1ce.
The obJect,vs of the Med1c ai Watch pograrn is to encourage custor'le,s lo notify Tampa Eloctnc of the:r s1tua11ons so that special procedures can oe irnpl emer1 l ec! when:
Disconnect;on of customer electri:: serviui 1s r8quimci in rnsro se; to electi-ic b I! non-payn,ent:
Planned service intsr,upt1ons must
occur for pmver lirie equ,prren,_
•11ai'.1tsnaqce.
To quality, t!,e patient ,-esicinp a! tt,e custornsr :Jf record\, addr0,ss rr1cJs::
Be dcmendeni upon e:c-c,ric::il,y powered rneciicsl ?.'.":jd prnen' to sustaw liii:1;

Be ccrl'iiGd ::is eiig b:e by nic, or qer F!o,ida-!icensecl attending Pl1ysic:art.
Note: C:.1;;,lorr1srs c1re ::,olsly resporsible
ror any backup equ,pment or power
::,uµµ:y. Ta!Tif..Jc:t Electric recorw1e'.1ds
,hat custcmers 11sve a \'.'e:1-plarp1ed course of acticr in l'ie event of a power outage er 1rternJptio,1 of service.
Cali Tampa Electr,c to apply for p;;;rt c pat:o:i :n trie fvedicai Watch orograrr:
(813) 225-5051 U--li:lsb')rougri County)
(863) 298-6051 (Polk Coun\·)
1-888-223-0800 iAI! ott:er c:cum es &
0:.1I or stale)

TECO,
TAMPA ELECTRIC
ANEMr:RA COMPANY

Page4 of4

TAMPA EL.ECTRIC
ANEMERA COMPANY

TRIPLE CREEK CDD TRIPLE CREEK BLVD PH2
RIVERVIEW, FL 33579-0000

Your Account Summary
Previous Amount Due
Payment(s) Received Since Last Statement

Current Month's Charg1:1s
. Total Amount Due

$641.93
-$641.93
_..!§.!.lA.
$681.23

ACCOUNT INVOICE
tampaelectric.com   I	f "I tp 8+ •	in

Statement Date: 02/15/2018 Account: 211005282317

lo) mwmxwmn
.Q FEB 2 0 2018 I!)
BY:	"'••1:

Always assume that a downed power line is energized. Visit tampaelectric.com/safety for more safety tips.

Amount not paid by due date may be assessed a fate payment charge and an additional deposit.

Helping neighbors in need
Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure pmrnpt credit, please return stub portion of this bill with your payment. Make checks payable to TECO.

WAYS TO PAY YOUR Btu	Account: 211005282317

TAMPA EL.ECTRIC::

AN EMERA COMPANY

mail	phone online	pay agent
-•-- - ·-·•--   ·•--- -  --· -·-·· ---··----
See reverse side for more information

656321185373

TRIPLE CREEK CDD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

6563211853732110052823170000000681235	Page 1 of4

TAMPA ELECTRIC

ANEMERA COMPANY

Contact Information
Residential Customer Care
e 13 ?2·1-oeoo q L!:)t:o v()· lr_Jtl
fi(i3 ?<J9·0HC)O lfJo:h. Cn:n 1yl
BB8·?2;i-OBOO (,1\ll ():her C{)i.Jr1\:e ·:.)

Commercial Customer Care

Hearing Impaired/TTY

''

1-1 !
(

Power Outages Toil-Free
:)UB- 1010
Energy-Saving Programs
(11 :-)-<? l'; - J -JOU

tampaelectric.com

Mail Payments to

All Other Correspondence Tampa Electric
F.(). t:J)X ; l 1
Tt·j,/]Cd, 1-1 33GOl U 1-11

Understanding Your Electric Charges

Fuel Charge

11·L:ciuce F.1f:H.i: ·cuv ')•ou
;););lSCd thrnuuh Len; ft. t l St;;';pher:;

Kilowatt-Hours {kWh)

Renewabh, Energyn<•

r:c•p ptlV [t·1e c :croy [)i!i \ z.
c1·1n  bf:   ili<)de, or ',CHJ
uopc11 un ynur t:i:IL Y(1u 1

Average kWh per day T,',c ,;·1,• ,,,), 

Basic. Service Charge

Bright Choices.,,,

Budget Billing

Energy Charge
\ r C'1"  (H_;·z ;\r; ·:.,_-,d,

Estimated !f

Florida State Tax

'.'y'	:f:(  )\; I

day
·cl.·; S'.iJ!U(f:•::')

Franchise Fee
,-ll i:/,. - ';'•-- t'.1C:
:°(;t:

tampaalectric.corn

Your payment options are:

"'SchtJdL,!8 free r:r:,, '.,rnr; {) 1 !1 c11!1:r1q p£l"/rn1·Ji•ts r1: tampaulectric.cotn ::: JrirJ ,J,
"'r,;;;:_:ii; )'Ct;( Dr!yrr1r;n( .n '.'.li·,'. f·.'ilC!u:)cCi ( ! i'.' f-.'.i Cp t 1 .   F'iC:iJ :f;	,:,LE!'

tampaelaclrk.com

866-639-6469

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tampaelectric.com c

ta1npctP.leciric com

Page 2 of 4

TE	
TAMPA ELECTRIC

ANEMERA COMPANY

Account	211005282317	
Statement Date:	02/15/2018	
Current month's charges due	03/08/2018	

Details of Charges - Service from 01/12/2018 to 02/09/2018

ACCOUNT INVOICE
tampaelectric.com I f t1'P 8• .I in

 	
Service for: TRIPLE CREEK BLVD PH2, RIVERVIEW, FL 33579-0000

Lighting Service Items LS-1 (Bright Choices) for 29 days	Rate Schedule: Lighting Service	
Lighting Energy Charge	1680 kWh @ SO 03207/kWh	$53.88	
Fixture & Maintenance Charge	16 Fixtures	$189.92	
Lighting Pole/ Wire	16 Poles	$382.72	
Lighting Fuel Charge	1680 kWh @ S0.03095/kWh	$52.00	
Florida Gross Receipt Tax	$2.71	
Franchise Fee	$0.00	
Lighting Charges	$681.23	
Total Current Month's Charges	$681.23	

Important Messages
Fuel sources We Use to Serve You
For the 12-month period ending December 2017, the percentage of fuel type used by Tampa Electric to provide electricity
to its customers was:
-Natural Gas & Oil"	67%
-Coal	29%
-Purchased Power	4%
*Oil makes up less than 1%

Important Program Information for Lighting Customers
Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program. The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting. The conversion program, which is expected to be effective in February 2018 and will take up to five years to complete, will offer updated rates and several new fixture and pole options. As part of the program, some current options will be closed to new customers.

To view rate details for all lighting fixtures and poles, please visit tampaelectric.com/rates, and select Customer Communications. If you prefer to receive a copy of the rates via U.S. Mail. please call 813-635-1500 and select Option 5 to make a request.

Page 3 of 4

Register now for help during emergencies

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T,m1pa Eec'.ric k,nows sorre of our CLlSton,ers have special needs which car, Lie aided  lhoJgh  'uca' 9nvernrrPmc1: a9enc1P.s. Such nsEKls coulo be cciused by ci corrmunity-w:de emF-rgency. Each county WA servA a!!ows its residents to pre-register  witl0
a :ocai respons8 lean, tha· provides
a,d tc persons w'io requit·e special dSSiS1ance during eVi::icuc1tbris 2u1d shelteiing because of disabilities.
Fm more inforr,T1r tio17   plP.8SG ca!I tho
special-reeds reqistry in your area:
(813) 307-8063 (Hillsborough Cot..nly)
(727) 847-2411 (Pc:isco County)
(863) 298-7027 (Polk Coumy)
(727) 464-3800 /Pinelias Codr1ty)
[vkiks slc1y1ng safe in crriergenc;os a top prior,ly

Medical Watch
r arTpa E ec:ric's Medical Watcl1 cro9rr1rr1 idf-lrrif,es res denk I customers wro use e'ectricaliy powered,
ife- )vstd11i,1g equipment

Perl!cipal (Fl 1n 1,1,3 M<Jdici..l! W,,lch program does ,1ot provide prionty restoratio11. The program does not r1utomr1tically nxtond s9rvicP. p r1ym211  t options nor does ii guarcirites uninterrupwri 01P.r:tn; serv;ce.
The obJeCtlVe of the Med,cci: Watch program is to sncourage customers tc notify Tampa Flsr:tnc of their siluat;ons so that speciai proc:edLlt'es can be imple rne11 ted   •Nhsn:
Disconnect;on of customer electric service .s mquirod in response to electric b,I! non-payrr.ert:
Plarnecl sen,ice i:1terrupt,ons mJs: occur for powsr lirie equ1prnen\ '.Tia1·1terance.
To qua:ify, t,·,e pat'ent tesi-Jinq at trie
c cJs1o rrn1 r of  '\ cord\, , ddrss:; rrus':
Be dcuendeni upon ciectr-i al;y
,x,werec: r:1eciical equ,pment to
u to:r1 lif ;

88 c:nMicd ,is n!ig,b:e by his or r1er F:o:ic:a-:icensecl atte1 dir1g ollysicicin.
Nole: CJs:orrBrs me ::,Olsly respGr'.sit.Jle to,· any ba:::kup equ:prrent or power ur;piy. farripa Electri::: 1eccrrrriends
+rial custcmers have a W8li-pla•y:ecl c::urse of acrior in the e' enl of a power outage or irlerruption of ssr-.ti::c
Cal Tampa Elsctrc to apply for cartcpat-on ;n ti1e Medica: Watch program:
(813) 225-5051 (Hitlsborough County)
(863) 298-6051 (Polk Cr:unty)
1-888-223-0800 {Ail otl,er counties & oul-of-slale)

TECO
TAMPA. ELECTRIC
ANE l:NA COMPANY

Paga4 of4

TAMPA li::LE:C:TRIC:

AN ii:MERA COMPANY

ACCOUNT INVOICE
tampaelectric.com  I	f W'P 8"* ii in

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TRIPLE CREEK COD TRIPLE CRK PH2 RIVERVIEW, FL 33579-0000

Your Account Summary
Previous Amount Due
Payment(s) Received Since Last Statement ·
Current Month's ChargQs
Total Amount Due

$917.79
-$917.79
 	$973.52 
$973.52

Statement Date: 02/15/2018 Account: 211005282515

BY; ...! ....................
Amount not paid by due date may be assessed a late payment charge and an additional deposit.

Helping neighbors in need

Always assume that a downed power line is energized. Visit tampaelectric.com/safety for more safety tips.

Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure prompt credit, please return stub portion of this b1il with your payment. Make checks payable to TECO.

WAYS TO PAY YOUR BILL	Account: 211005282515

TAMF"A E:LEC:TRIC: AN ii:MERA C:□ M P A N Y

mail	phone online	pay agent
See reverse side for more information

656321185374

TRIPLE CREEK COD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

6563211853742110052825150000000973522	Page 1 of 4

TEC
TAMPA ELECTRIC:

ANli:MERA COMPANY

Contact Information
Residential Customer Care

86 3 29 1-0BOO

c:ol1:11yJ

BBB<223 oeoo (/\[! nlher CO.H)liE}c:;)

Commercial Customer Gare

Hearing hnpairediTTY

Power Outages Toll-Free Energy-Saving Programs
1:1 ;-1:-) 3 )(1 )

tampaelectric.com

Maii Payme11ts to
1 i 1.:C1
' {) - 130: :31 7,18

All Other Correspondence
Tampa Eieclric
P/J. F}n: 1 l i
Td'.'lf)d I I ]3b(J1 (l 1 11

Understanding Your Electric Charges

Basic Service Charge /\ f,:,:ed ;,, :'t
\ 1\'i(Ji; :: J -;Cf\'i( L ((J \'\ L
Bright Choice s.,

uf

;ik'

Fuel Charge C; ,.
:·n·rt'

('.;d ,;-1'0U!-i fr ·:.i;! fue: s pplit-}.:·1 :t'
C:i p;-u):t_ u_, dfi;f)d t:iFt,.(;;s.,_

r

If

·n yc:1.11
1/,'/  l'   d   t:

Renewable Energy•,,

r;v p pay '.tH-: cr:CrLJy t:HJS, (,f
1t/ 1on C(Jr1 fH.) rnnc!e, ui yCJU
nn y(an L,i!i. ',{(1tF
,-,; '.(:hed by T, ;:,,:1;:x1 Eiec\1:(
1 h: :qt:;; vJd.1 hn o,:isi dtH-_i ant•
--;Oi=S  <\(:i': FX fr,.1rJ THE Dt\Tr'() -
:. '.tH \  yt:u r:1   1/\    you,

Average kWh pe;  day	· ,,,. ,;•;,;r,;rv	 d:)'y.

tan1paeiectri<:.:.corn

Your payment options are:

"Schf:duie r,fH (-qf,: \i'-ilt"! {1: :ect1:r1n J n; yrncr:!s ; t tampaolectric.corrl ti:11·?1 r.: r r:<-
r·1.i1::!d yc1u r p1Jyn1(,qt;; ; :t.; r'r.ck, 11-·d f n\h?.icot-,. Pit",:1:·;:,	•1t,1i·,	:·tt•)::\/E
Pr;y;: pc1:;or	·i:  ::qf;;;:  r-,,    :,:11:;irJ	,11::\' 1

C,J.,, ,;' ,:,1•

tampaelectric.com

\/\  (l'',;  (   lt°'.\i!	,j"	,.,,,i .{,,qr:,,;\ c:7 ~·/	.: tarnpaelectric.com •	866-689-6469

(        /\                    j	

tampaHl c,ric.com

Page 2 of 4

TEG
TAMPA ELECTRIC::
ANEMEP.A COMPANY		

Account	
211005282515	
Statement Date:	02/15/2018	
Current month's charges due	03/08/2018	

Details of Charges - Service from 01/12/2018 to 02/09/2018

ACCOUNT INVOICE
tampaelectric.com  I f.,,'Pg+ a in

SeJYice for: TRIPLE CRK PH2, RIVERVIEW, FL 33579-0000	Rate Schedule: Lighting Service

Lighting Service Items LS-1 (Bright Choices) for 29 days
Lighting Energy Charge	1364 kWh @ S0,03207/kWh

S43,74

Fixture & Maintenance Charge Lighting Pole/ Wire
Lighting Fuel Charge Florida Gross Receipt Tax Franchise Fee
Lighting Charges

31 Fixtures
31  Poles
1364 kWh @ S0,03095/kWh

5425,94
$459.42
S42,22
$220
S0,00

$973.52

Total Current Month's Charges	$973.52

Important Messages
Fuel sources We Use to Serve You
For the 12-month period ending December 2017, the percentage of fuel type used by Tampa Electric to provide electricity to its customers was:

-Natural Gas & Oil*
-Coal

67%
29%

-Purchased Power	4%
*Oil makes up less than 1%

Important Program Information for Lighting Customers
Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program, The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting. The conversion program, which is expected to be effective in February 2018 and will take up to five years to complete, will offer updated rates and several new fixture and pole options. As part of the program, some current options will be closed to new customers,

To view rate details for all lighting fixtures and poles, please visit tampaelectric.com/rates, and select Customer Communications, If you prefer to receive a copy of the rates via U,S. Mail, please call 813-635-1500 and select Option 5 to make a request

Page 3 of 4

Register now for help during emergencies

T;m1pa Eiectric ;.;nows sorre of our cc1storners ha,;e special 'leeds which c::Jr; be cJided through 'oca' govr;r1ment.1i ,19Pncies. Such nr,P.cls coulo bs caused by a cornmunity.v./de ome-rCJ0nr.y. f=2ch rnunty WP. sRrve ziilows its esicJen:s to pre-register with a locai response tearr Iha' provides
ad to persons w·10 1·equire special ass1slar1ce durin9 evacuaims arid sretteririg because of disabilities.
:=m riore inforrrnticn. please c;:iil  theo
special-needs I·eqistry ir· your area:
(813) 307-8063 (Hillsborouqh Ccuriy)
(727) 847-2411 /Pasco Cour'.ly)

(863) 298-7027 (Polk Coumy)
(727) 464-3800 (Pinehas County)
f.t kc stay ng safe i:1 srrergcr1c;cci a
top pnorty.

Medical Watch
T arnpa E'ecmc·s Medical Watc! 1
::rog,·;am iderltir es ,es,denlal cusicn,ers
'!v'ho use eiec::rically powereo, ife c:uslai11i,i(,) equipment.

P;,rticipat:on 1n i'lc, M<:dica: Walch program does net provide prionty restorat:011. The IYoyram dues riot
,1utnm,1tIcally extencJ sorvics p,1yrn2rt
options nor does il guc:1rar1lee
11nintemmted etrctr:c serv,rn.
The obJectve of the Medea! Watch program is o encourage custor1e!·s to notify Tamoa Etectnc of rhe:r s1tuat:ons so that special ixoceclures can be imµle1r:ented v!r1e'1:
Disconnect,or, uf customer electric: service ,s required i'l response lo electric b:li non-pay:11ent:
Plarined service i:1terruptons mdst
occur for pov.1er line eqiJ;p'rerF
111ai!llena:1ce.
To qua1  i fy, t:1e patent ··esic1hq at t,,e
custornBr or :-cco 'tJ's ( ddrcs:J :--nu :;t:
Be) cfo:Jcndcni mon e ec1ric;ai y poweret 1:1eciicc:! o.q.1 pIr en7 to susta:r, li'e;

Bs ccrliiied as e ig bie by r,j,; or rier F!oricla-licer.sed attendi:1g pl1ysk;ia:1.
Note: Cuswmsrs cJre solely 1esµcr,sible 7or any backup equ'pn:ent Oi po'Ner supp'y. TcWlfJi::l Electric rec:crrnnerds
that c:tJStomws riave a we1l-pl  annecl
course of ac:ior in the evsrtd 2: pcwer
outage CJr iriterruplion cf ssrvi::s.
Cal' Tampa Elsctr,c to aopty for oart,c pat,on In the t-;edicai 'Natch program:
(813) 225-5051 (Hi,lsborough County)
(863) 298-6051 (Poli< County)
1-888-223-0800 (Ail ether sount,es &
out-of•slale}

TECC>
TAMPA ELl!:CTRIC
AN!EMERA COMPANY
lurr1pap!e:.:lr:c;,cor-1

Page4 of 4

TAMPA ELECTRIC
ANEMERA COMPANY

TRIPLE CREEK CDD TRIPLE CRK, PH C
RIVERVIEW, FL 33579-0000

lo) Il@llJIVlll
JI FEB 2 0 2018
BY:,...,_..............................

ACCOUNT INVOICE
tampaelectric.com	j	f W 'Pg+ I in

Your Account Summary		
Previous Amount Due	$680.96.	
Peyment(sj Received Since Last Statement	-$680.96	
Current Month's Chargts	 	$722.29 	
Total Amount Due	$722.29	

Statement Date: 02/15/2018 Account:211005282705

Always assume that a downed power line Is energized. Visit tampaelectric.com/safety for more safety tips.

Amount not paid by due date may be assessed a late payment charge and an additional deposit.

Helping neighbors in need
Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure prompt credit, please return stub portion of this bill with your payment. Make checks payable to TECO.

WAYS TO PAY YOUR BIU	Account: 211005282705

TAMPA ELECTRIC

ANEMERA C:CMPANY

mail	phone online	pay agent

-·  -	-
See reverse side for more information

Amount Enclosed	$-	'--   -   -
656321185375

TRIPLE CREEK COD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

6563211853752110052827050000000722295	Page 1 of4

TAMPA ELECTRIC ANEME:RA C::□ M P A N Y

Contact Information
Residential Customor Care
(]1'.1-??J-()HOO	C2c1u;1:yJ

86'.3 299-0FlOO

Commercial Cu:-;tomer Care
i:.(jt,) i33/- 6£49

Hearing Impaired/TTY
11-1
Power Outages Toil-Free

Energy-Saving  Programs
l'i	/ J 'tq(j:,-J

tampaelectric.com

Mail Payments to
! L c:(;

All Other Correspondence Tampa Electric
(), ! j()/, 1 1
,,; --KiU 1 -0 -1  1

Understanding Your Electric Charges

Average kWh pef day T'., .1.- · ;,qc
1c:; dny.

Bas.ic Service Chargo ;\ '.,•.c•d

Bright Choices,., , ""

:>:l:::·:q p•
:·,r-'r\,iC(· (J/;c,j;
Energy Charge 11 , •
:·,1. -  ''/ ,-- --d	:, ij J.:

Estimated   r i;. ''ti;;

:d.-:-11:y  dri!1_•;,

;) nv.rL-u St!f\"!CP :n '/(H ,,

rw  ;'1,J.u:·;.J:.\;-j { CCt::;J.r\;:".,

0.

'',, ,,, ,,
I\ 1:,

U; ·;tt'':::1::· t ;:i_ rJi. ·'Y­

Kilowatt-Hours (kWh)

Renewilb!e Energysv.

Share

.q·,;:1 F:eci:·:c ·1r,d he,
·p  Di::iy  n·1fl 1-1r1 t·nJ l  i:l.l!  c:·

::oi1 CtJ1i LJe n1i Jd1 nr yoL

1
:,IOU: Dlii_ \'ct ,
c i-,t':d t)y Tn:T1pr:_i Elect:.,

Total Arnoun! Due

/\iii PR './i() ;S
i>t:',,:-e	t Ji·11 r•
Zap	Cap	Systems

:X:T -.,iD THE D/\ -t : CJ>i
.'.-ir:::t yot: p;'.]y yc.'tl:. tJ:i'
·c,'.1 cf ::;1:.:r ·.,'1t.-f.:

\\1:1 bP pa -;r dtJ(., ,;:1r··

q; (i iU.

f_)i::· -;•;~{ 1 [['.,\'•\ or: ;, :fr, fw?! :-:;up;);i;: r:·;
--:1 ,; ; J t1r n,o;,; to :,;:n;Ji'l t,F:Ctr:(

, L J
.::i•.\j

Florida State Tax

Franchise Fee
;t;L):::, ·.irO[JC!i).' r(
:;1;.,:P!:.  J 1( 1   ff;(-)	l .( I

tan1paelectric.com

Your payment options are:
*   Scrieduln free cr:e•!!1;1f1	1(- Cu1 r1nn 1Fry111t•:nt:·; al tarnpa(:lactric.con1 u:·.ir:u -_-·11;
"  1\,i;: !!  ynur  p:: yn 1 n     •r1 th(-: p·:c.,'t1(,cd  <-;n-,1e:opc,  ?;ease•

11'     P;::,­
C.;rr· di ; :t< :·:t!!
?;:-":y tJy L:ed·: c
(/\   LC l'/e; it -:: 1  (     (  -;

,1JW''   r,,	tampaelectric.c:om

Please note;

Page 2 of 4

TE

TAMF'A li::LE:CTRIC
AN i,;ME:FIA C:□M P A N Y

Account:	211005282705	
Statemenl Date:	02/15/2018	
Current month's charges due	03/08/2018	

Details of Charges - Service from 01/12/2018 to 02/09/2018

ACCOUNT INVOICE
tampaelectric.com  I f W 'Pg ii in

Service for; TRIPLE CRK, PH C, RIVERVIEW, FL 33579-0000	Rate Schedule: Lighting Service

Lighting Service Items LS-1 (Bright Choices) for 29 days
Lighting Energy Charge	1012  kWh @ S0.03207/kWh	S32.45

Fixture & Maintenance Charge Lighting Pole / Wire
Lighting Fuel Charge Florida Gross Receipt Tax Franchise Fee
Lighting Charges

23 Fixtures
23 Poles
1012 kWh @ S0.03095/kWri

$316.02
S340.86
S31.32
$1.64
S0.00

$722.29

Total Current Month's Charges	$722.29

Important Messages
Fuel sources We Use to Serve You
For the 12-month period ending December 2017, the percentage of fuel type used by Tampa Electric to provide electricity to its customers was:
-Natural Gas & Oil*	67%
-Coal	29%
-Purchased Power	4%
*Oil makes up less than 1%

Important Program Information for Lighting Customers
Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program. The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting. The conversion program, which is expected to be effective in February 2018 and  will take up to five years to complete, will offer updated rates and several new fixture and pole options. As part of the program, some current options will be closed to new customers.

To view rate details for all lighting fixtures and poles, please visit tampaelectric.com/rates, and select Customer Communications. If you prefer to receive a copy of the rates via U.S. Mail, please calf 813-635-1500 and select Option 5 to make a request.

Page 3 of 4

Register now for help during emergencies

Tamp,1 Ekic.ric i<nows some of our customers have special rieeds w1,ic1, c21r be aided through :ocal gov0rrin,f:m8, ,1gnrdP.s. S11ch nP.erls could be caused by a corrnnu11ity-w1de 0mergenr.y. Ec1ch r.ounty WA sP.rve ailov:s its ··esiden•s to pre-register with
;i ioca, rssponse 1eam th.:r omvides aid Lr.: persons v·no require special a ;sist:ince durin9 evacuations and sheltering becuuse of dis8lJilities.
Fer rioro inforrr,Jior. pl0ase cail ih0 special-needs reqistry in your area:
(813) 307-8063 (H1llsborouqh Ccun!y)
(727) 847-2411 (Pasco C::;unly)

(863) 298-7027 (Polk Courny)
(727) 464-3800 (Pincl1as County;
rv1aks slc1y;ng safe i,1 ernergenc,os a
top 1::rior'ty.

Medical Watch
i arnpa E'ec:1ic· Medical Watcl1
mog,-arri identif:es res,denLal cuslcrr+i:s
,_,.:toe, u:,e eiec:ricaliy powereo ife ;:,uSlai11i11g \:KJGipment.

Parlicipal:on :n ihc M,Jdicai Walch program does ,1ot provide prior,ty restoratiun. The program does not auiomat1cnlly ff..:iend servic2 payrne, t options r1  or c'oes il  1uc1rar1tee
uninten-,1prnri electr:c service.
The obJectve of the Medica1 Watch prograrT' is to encourage customers to nolify Tarnpa Eleclnc of th81r s,tuaions so that special procedures can be 1rnµlerner·ted wr1eri:
Disconnect,or; of customer electric serv,ce .s required in resp:;nse to electric bil1 non-paymenr:
Plarnecl service interruptons r-us: oc;cur fer po1,ver line equ:pTen,. mainterance_
To qua ify, tf,e pat:ent residn J at tt1e
custorner or record's addres :; rThJs :
Be dcnenoen1 upon e'eciri:::::i! '/ powered rr1e,:iical eq:_1,pment to
::;u;,,lcH'. liie;

BG cmLficd : s eiig,b!e by his or 11er F,o:icia-iicer,secl attending 1Jhysic:ar1.
Note: Cu"tom"rs are ::,Olely respunsible
fo( any backup eciu.prrent or pm•ver
::,uppiy. Tcm10c1 tleclric recon;r'.1erds mat ct;stome-s haw, a weil-plannecl c::;urse of actior in ths event of a power outage or interruption of ser icc.
Cali Tampa Electnc ro aoply for part;c:pat;on in the Medicai \<V2tch program:
(813) 225-5051 (Hi,isborou9,, County)
(863) 298-6051 (PolK Counry)
1-888-223-0800 {All other coumes & out-of slate}

TECO
TAMPA ELECTRIC
ANEM RA COMPANY

Page4 of 4

TAMF'A EL.ECTRII::

ANEMEAA COMPANY

TRIPLE CREEK CDD 12198 TRIPLE CREEK BL
RIVERVIEW, FL 33579-0000

BY: .........................

ACCOUNT INVOICE
tampaelectric.com   I	f --I tp 84  ti in

Your Account Summary		
Previous Amount Due	$685.01	
Payment(s) Received Since Last Statement	-$685.01	
Current Month's Charges	 	$227.31 	
Total Amount Due	$227.31	

Statement Date: 02/15/2018 Account: 211005280915

Always assume that a downed power line is energized. Visit tampaelectric.com/safety for more safety tips.

Amount not paid by due date may be assessed a late payment charge and an additional deposit.

Helping neighbors in need
Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure pmmpt credit, please return stub portion of this b1II with your payment. Make checks payable to TECO.

TAMF'A EL.ECTRIC

ANEMERA COMPANY

WAYS TO PAY YOUR BILL

mail	phone  online	pay agent
See reverse side for more mformation

Account:211005280915

Amount Enclosed

656321185367

TRIPLE CREEK COD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

656321185367211 □□528 □915□□00000227315	Page 1 of4

TAMPA ELECTRIC
ANEMERA  C□MP  A N Y

Contact Information
Residential Customer Care
() 1 J /. 3-080() 
BG3-299-0800  (Poi!< c:o:1n1y;
t'JdB-?23-0BOO (Al1 nlfK?r co:1n'.1es)

Commercial Customer Care

Hearing Impaired/TTY
l 1 l
Power Outages Toll-Free

Energy-Saving Programs
::-1 l:; ,1 JUU

tampaelectric.com

Mai! Payments to PJ; HoxJ13H)
T.1 ,,.1p J. Ft, :-t1G -i-1

Ail Other Correspondence Tampa Electric

Understanding Your Electric Charges

Fuel Charge

Kilowatt-Hours (kWh)

Average kWh pm· day   • 1·,   .''.r,,;:,:1e.,	
PL" ,'hly

'l\

Late Payment Charge   --a,;	l h'

;, li't: ui(:;";l\-' uf

-:::: o: s :n

Energy Charge    -:-1,,, 1.·
:!Ji!I.

Florida State Tax ;\ p. ::;;,:cw :,ix

Renewable Energy,r,,

: ;\-:in pay   d1c  f:   •ct gy t);11s r·
Jri C.L:J;--; fX: :111:.i(Jfl. Or 'yCl\;'
I you, l>i!L You,·
;:t;d by T;imoa E!eci

Totai Amount Due :ii<"

i'.1c1'. yc·u p;-:;y \/('Ct U•:.
.( of - f i \fl('J-'.

Zap Cap Systems·

Basic Service Charge 1\ f;x(1,'.
'.)[\:'.: dr::n	;r,i Y(l\,J:
Bright Choicasw Ti., ,,

Budge! Billing   O;i,1.·r:<1. rY,F
,-,q p,;;1ods •-;t  ;01. r
1:;Jc,h r,-,, :1 :r·

Municipal Public Service Tax ,    ..   :' t h ! ,:i,r, :IJ :·,(•	.r1c!• .0+· ,:,".

:-(.	                .tampaelectric.com

Your payment options are:

"ScJH:!clu!e f:et or  . rnt : or ff-:C l; ,r;u pavn;{:_,-.: :; / tampaHlectric.con1 u:;;nq :·J (_i11	q u v1ad ;nu:- p;:rl::it,;:1 1n !/11;: rmr.!e:::,,·d i:i:r1\,c;!iCpH F'ie;::: t,	;:,l)Tc» '	:i> '. t:! de>_:

P,;:r	,--i\)C•:!	--:.n,; t'f	ll:iv.=:                  tampaelectric.com

866-689-6469.

Please note: "

tampae!ectric:.c;om

Page 2 of 4

TAMPA EI...ECTRIIC:
AN EMERA CCJMPANY		

Account:	
211005280915	
Statement Date:	02/15/2018	
Current month's charges due	03/08/2018	

Details of Charges - Service from 01/12/2018 to 02/09/2018

ACCOUNT INVOICE
tampaelectric.com   J      f	'P 8• Ii in

Service for: 12198 TRIPLE CREEK BL, RIVERVIEW, FL 33579-0000	Rate Schedule: General Service - Non Demand

Number		Reading	Reading		Multiplier	Billing Peri	
C16598	02/09/2018	72,844	70,679	2,165 kWh		29 Days	

Meter

Read Date

Current

Previous

Total Used	od

Basic Service Charge Energy Charge
Fuel Charge
Florida Gross Receipt Tax
Electric Service Cost

2,165 kWh @S0.06184/kWh
2,165 kWh @S0.03132/kWh

S19.94
$133.88
S67.81
S5.68

$227.31

Tampa Electric Usage Hisitory
Kilowatt-Hours Per Day (Average)

DEC--------184

zi ---76
JAN	211
NOV-159

 		ocr. 79

Total Current Month's Charges

$227.31

SEP-64
AlJG 	108
JlJL	gg
JUN	••-,120
MAY.	 ._ 13:z
APR rg
MAR-64
FEB	60
2017

Important Messages
Fuel sources We Use to Serve You
For the 12-month period ending December 2017, the percentage of fuel type used by Tampa Electric to provide electricity to its customers was:
-Natural Gas & Oil*	67%
-Coal	29%
-Purchased Power	4%
*Oil makes up less than 1%

Important Program Information for Lighting Customers
Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program. The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting. The conversion program, which is expected to be effective in February 2018 and will take up to five years to complete, will offer updated rates and several new fixture and pole options. As part of the program, some current options will be closed to new customers.

To view rate details for all lighting fixtures and poles, please visit tampaelectric.com/rates, and select Customer Communications. If you prefer to receive a copy of the rates via U.S. Mail, please call 813-635-1500 and select Option 5 to make a request.

Page 3 of 4

Register now for help during emergencies

TcJmpa Elec'.ric ;..nows some or our customers have special neecls whici, car: be aiued through 1 oca' gov0.rnmr,n:a: arJCt:c:iAs. S11r:h ne0ds cculc be caused by a corrnnunily-w-de P.m0rgenr:y. Esch r:01111ty we serve a:lows its residen:s to pre-register witi, a iocc1i response ti: am Iha• provides
aid le persons vrm require special as ;,sl::ince during evacu&icns and shelterhg because of disabilities.
F::r mom irformatior, r,lcaso ca:I the
special-needs registry ir  your area:

(813) 307-8063 (Hillsborough C::::ur,ty)
(727) 847-2411 (Pasco Ccunly)
(863) 298-7027 (Po!k Coun'y)
(727) 464-3800 (Pim;lias Co,mly;
'-:lake slaying safe in cmcr;;icricies iJ
iop pnor,ty.

Medical Watch
I a1Tp21 Eec:ric's Medical 'Natch
Dm9rcff'.l identif:es res:der11,d cuslcrners
\vh) use e!ectrically povvereo
,iie '.>Ustainir1y equiµrmmL

Participation In Ifie; cdica 1 Walch program does r,ol pr-ovi:ie prior:ty restoration. Tf1e fYO!,fal:1 Joes nol a.itcmat1cally nxtencJ smvic2 payrnrrt options nor Joes it guc1rw1iee unintP.rr:ip,RCl el8clnc sorv:1.e.
The ob;ect1ve of +he Med:ca· Watch program is to encourage custoniers le notify Tampa Eleclr;c of their s1tual:ons so that special procedures cari be implernented when:
Disconnection of customer electric Sf'HVICP. is mquirnd ir, response to electric bili non-payrrent:
Planned service interi-upbons Pl.JSt occur for ;:.;owe, lirie equ:prren' mainlera•1c9_
To cr,1a•ity, ti,e pat:ent residin J at t:-1e
cu ;iornr:r of record\; lJdcJrc ;s rnusl:
Bt) dnpcndcn Jpon e'.ectricaliy
powereci meoical equ·pment to
:0U::ilc1·r, hie;

Bs ccrli:1cd 35 8Iig.b1r:: by 'lie, or her Fiorioa-iicensecl attendinc; pltysicic1r1.
Note: Cuswme's :::ire ::;olely 1 spunsible for any backup equ,prrer:t or pm'v'er supp,y. far 1pa Electric rec:.m•P1er1ds riat custorne,-s have a \' e:i-plc1nn ecl ccurse of ac ior in the evsr:t of a pc:wer o:Jlage or inierrupliori of smvi:::c.
Cali Tampa Elsctrc '.o apply for part:c;pat,on :n lhe tv'.eclica: Watch progran,:
{813) 225-5051 (Hi,lsborough Count/,
(863) 298-6051 (Polk CounryJ
1-888-223-0800 (A'i other scunt,es &
oul •Or.·slale)

TECO.
TAMPA ELECTRIC
ANEMe::RA COMPANY

larnpae!eslr:c.corT1

Page4 of 4

TAMPA E:LECTRIC

ANEMERA COMPANY

TRIPLE CREEK CDD 12141 TRIPLE CREEK BL
RIVERVIEW, FL 33579-0000

Your Account Summary
Previous Amount Due

Payment(s) Received Since Last Statement Credlt balance after payments and credits Current Month's Charges
Total Amount Due

BY: ....................""..........

-$66.64
$0.00

-$66.64
 	$	
-$8.16

ACCOUNT INVOICE
tampaelectric.com   I	f W tp g fl in

Statement Date: 02/15/2018 Account:211005280683

Always assume that a downed power line is energized. Visit tampaelectric.com/safety for more safety tips.

Amount not paid by due date may be assessed a late payment charge and an additional deposit.

Helping neighbors in need
Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure prompt credit, please return stub portion of this bi!! with your payment. Make checks payable to TECO.

WAYS TO PAY YOUR BILL	Account: 211005280683

TAMPA li.:LE:CTRIC

AN EMERA COMPANY

mail	phone online	pay agent
See reverse side for more mformat10n

Amount Enclosed	$-   ------
656321185366

TRIPLE CREEK CDD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

6S632118536621100S2806830000000008166	Page 1 of 4

TAMPA ELECTRIC AN!.MERA COMPANY

Contact Information

Residential Customer Care d61- 9 }0BOO (Pod< (;ou:1ty)
BB!]-2?3-08()() (l\l! o!fJf r co 1q\ PSI

Commercial Customer Care

Hearing lmp.:?ired!TTY
/ 11
Power Outages Toll-Free

Energy-Saving  Programs
()'l 3 ? i ) ::t)(Y.1

tampaelectric.com

Maii Payments to
T! C:CJ

Ali Other Correspondence Tampa Eleclric
i.)JJ l3nfl,
r L  J:)t"JOt-0 l

Understanding Your Electric Charges

p:1',c.d. -.u <:' i;tv:f·:1· iti y ti' Bright Ciwicess., -·
F \£•ci1
Bud9et Billing

(:J1- ctr1f
,!     1d cneJ'd;

f Pt  :t-:rf)! ;
,:: ;::;,.:,;(l:·:

p c , 1d ;:-:  1
:·k: t--::i >L!'

Kiiowatt-Hours (kWh) , ,·,,. ,,::;,,,.

Avaraf1ellWhperday     '''"	·.,,,1,:,,·'i(·(,_•·	 Basic Service Charfta .:\ r,;f'd

Past Due   ;:>,,,.

Rate Schedule

Renewable Energyc.u

·n;-:,:'\\- -J\}:!   - t:U;t l;';

apCap Systems	::.,, ,;,

Z

tampaa!ectric.com

Your payment options are:
1!    Schh'h!i\'; rr1_ e CrH--  ..l 'j "1I         'T'" l'   r·n-  ..,•,,·n·, ,r-t•·  -•-'tamp• alectrir  con	1	'

il;:_i ii  v< it:'  p:1y rr1cri\  ;   r,; -;  ; ,_  :.1i1-:. ·ic: ; ./\:;.; :/k,\·f .::;i.-:- ; :(Jtit-·/,   ;t · c,u: : ,;·	r   j     L;r : r;;;':J:- ;:\: -:

tampaeleciric.com l 

tan,paelectric.com
'CH;:·;:	(;d,i	d '1

c./, 866-689-6469

t<1mpaelectric.com ,; •
Page 2 of 4

TAMPA E:LE:C::TRIC
AN EMERA COMPANY

ACCOUNT INVOICE
tampaelectric.com  j f W'P 8• ii in

}J6

Account:	211005280683
Statement Date:	02/15/2018
Current month's charges due DO NOT PAY

Details of Charges - Service from 01/12/2018 to 02/09/2018

Service  for: 12141  TRIPLE CREEK  BL, RIVERVIEW, FL 33579-0000	Rate Schedule: General Service • Non Demand

Number	Read Date	Reading	:::;
Reading	Total Used	Multiplier	Billing Peri	
C21063	02i09/2018	48,957	48,559	398 kWh	1	29 Days	

Meter

Current

Previous	od

Basic Service Charge Energy Charge
Fuel Charge
Florida Gross Receipt Tax
Electric Service Cost

398 kWh @S0,06184/kWh
398 kWh  @$0,03132/kWh

S19.94
$24.61
S12.47
$1.46

$58.48

Tampa Electric Usage History
Kilowatt-Hours Per Day

(Average)

JJA;N i1\l----M		27
OE.C	3,(
NOV•- - - - - ■ -N-•••	22

Total Current Month's Charges

 		ocr-3
SEP t0.4
$58.48	AUG ,03
JUL-.-10

MJAUYN 	        1.2.15

APR-4
MAR--,1
fl'EB -3
2017

Important Messages
Fuel sources We Use to Serve You
For the 12-month period ending December 2017, the percentage of fuel type used by Tampa Electric to provide electricity to its customers was:

-Natural Gas & Oil*
-Coal
-Purchased Power

67%
29%
4%

*Oil makes up less than 1%

Important Program Information for Lighting Customers
Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program. The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting. The conversion program, which is expected to be effective in February 2018 and will take up to five years to complete, will offer updated rates and several new fixture and pole options. As part of the program, some current options will be closed to new customers.

To view rate details for all lighting fixtures and poles, please visit tampaelectric.com/rates, and select Customer Communications, If you prefer to receive a copy of the rates via U.S. Mail, please call 813-635-1500 and select Option 5 to make a request.

Page 3 of 4

egister now for help during emergencies

Ta111pa Eieclric :mows some of our customers have special needs whic11 c::in l>e aiued ttiruugh :oca: governmPnra; cigenc:1Ps. S11c:h t1GP-ds
could be caused by a conimunity-w1de emergP.ncy. E2c:h c:ouniy WP. sc=Jrve a!iows its esidents to pre-register  with a local response  l8arr  Iha: provides a:d to persons wr10 require special ass;stance during evacuaiions and sheltering because of disabilities.
For more inforn°ation. pl,1ase c:::i\l the special-reeds registry in your area:
(813) 307-8063 (HillsborouQh CoL.Jnty)
(727) 847-2411 (Pasco CoL.Jrly)

(863) 298-7027 (Polk County)
(727) 464-3800 (Pinei!as County)
r,,fakc slay'ng SdfD in error gene es 2
top priority

Medical Watoh
T:1mpa Eieci:ric's tv1edicai Wat.ch
orog,am 1 jentires res:derit,; I cuslmr,ers
\Vlio use e!ec:rically powereci
ir:::: susloinir1<,J equiµrnenl.

Participat1on n ,,w Medica 1 Watch program does not provide prior:ty
restt.Jrc1t1or1. Tr1e pru 1rarn does nol automc1tic:;:;lly extPnn service payrnsrt options nor :foes it guoirarnee
,   mintnrruptP.,J 0ler:tric: serv,r:e.
The obJect:ve of thP. Med,ca: Watch prograrT. ism encourage ,:;ustor1ers to notify Tampa Elsclr<c of their s1luat1ons so that special orocedures can be implemented whe'l:
Disconr ection of custorner electric serv,cE: 1s requit·oo in response to electric bill no•1-payn1ert:
Planneci service iritern.;pt ons must occur for power line equ1prren'. mairitena:ice.
To qualify, ti1e pat'ent residh j at tne
custorner of rccorcfs (:jddn s rnust:
Be dependent upon e:ec\ri ;ai;y
1Jowere.::; n1ec:icai equ pment o
::;usta,n life,

Bn certified c1s el1g b;e by nis or her F!oridcHicensed attending physic;a,1.
Note: CuslOmers are solely responsible fo, any backLlp equ.pment or power supp,y. Tampc1 Electric rec;urrnne'.1ds l:lat customers have a weil-pla"lned csurse of ac,ion in the event of a power outage er in!ern1i-:;lion cf service
Cal, Tampa Electr,c '.o apply for oart;c,pat\on 1n irie Medicai Watch orogran-,:
(813) 225-5051 (Hi!lsborougri County)
(863) 298-6051 (Poli< County)
1-888-223-0800 (Ai otrer ccunres &
out-of-slate)

TECO
TAMPA ELECTRIC
ANEMltRA COMPANY

larriDae:eclric.curr·

Page4 of 4

TAMPA E:LECTRIC

ANEMERA i;;CMPANY

TRIPLE CREEK CDD 12113 TRIPLE CREEK BL
RIVERVIEW, FL 33579-0000

ACCOUNT INVOICE
tampaelectric.com  I	f W tp 84  .I in

Statement Date: 02/15/2018 Account: 211005281889

 	
Your Account Summary
Previous Amount Due	
$82.19	
Payment(s) Received Since Last Statement	-$82.19	
Current Month's Chargn	 	$69.57 	
Total Amount Due	$69.57	

Jo) ll IilIWllJiil
I	fEB 2 0 2018 JY}
--BY: ...•	,..
Amount not paid by due date may be assessed a late payment cnarge and an additional deposit.

Helping neighbors in need

Always assume that a downed power line is energized. Visit tampaelectric.com/safety for more safety tips.

Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure prompt cred,t, please return stub port,on of this bill with your payment. Make checks payable to TECO.

WAYS TO PAY YOUR BILL	Account: 211005281889

TAMPA E:LECTRIC

Amount Enclosed

mail	phone online	pay agent

AN  EMERA  i;:□MP ANY

_, -

,,  

--------- - -

See reverse side for more mformation

656321185371

TRIPLE CREEK COD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

6563211853712110052818890000000069574	Page 1 of4

TAMPA ELECTRIC
ANEMERA COMPANY

Contact Information

Residential Customer  Care n1 J L?:-3 odoo n i··::, ·1,Jro·l\J"1 B63-;:gq.oeoo (F\)J, c;f,1dnry)
BB8-2?'.3-0800 (/\Ii oth1.:;r (:(J\1n:,c ;)

Commercial Customer Care

Hearing lmpaircdiTTY
/ 11

Power Ouiagcs To!I-Free
-- 1 i(·)B  H;1U

Energy-Saving  Programs d"l .)T i: _·/J(f'J

tampaelectric.com

Mail Payments to

All Other Correspondence Tampa Electric

Understanding Your Electric Charges

Average kWh por day 
{id'y.

Basic Service Charge

Kilowatt-Hours (kWh)  ,	" t,.,

Bright Choices,,., ~

Laie Paymen: Charge ,.,,,,

Budget Billing

,:  \,.	,.,,

'):;:,

Energy Charge

.l''/et,-  Chi:·1 v1
Estimated    !'. T	-·:i::1. :,· c ·;·.t:J:;

R,mewable Energy,., -, ,

Florida Gross Receipts Tax

Total Amount Due

ij      (	:J·
;:..,('i  dd  !."i;L!c·,.-
Franchise Fee
1J: ( 1;) t·.'1
'.!Y; )· .-t··

T;:irc:;)ti Fk C!:- (; and Jh-)
•:('.:!['; pt:.l'f '.ht=: t·':1t·iit}y t>i
HJl1\-_.,n C.dr, hf: ff1rldt;, or ycu,
;X!\-:.:11 ()r 1 yo\.11 LJIIL Your
11:d	-;:ti::_.!:t:d  by  T,: rnpa  E1ect;
:=-1rut;:-) v·.r :l r,e pasi dun
.,:y; i":x: F • ;) --:-HE o; ·TF (Ji\

tampaelectric.com

Fuel Charge    Cc: t u(    ft1 ::1 thP(	·)1,:-:1:Jur:t: r;:r-:ct ,c:\y yut,
pt1; 1.  i1;:!:;nd    uc,; cc<!: ,	c; :<:•t:d  \hn)u Jt'-•  frcn1 \.c! scn;)l1P•

Your payment options are:

,. SchfKJult1 frf G (' f'i ( 1 UflH·!
fvi::.i,/ )'Our pc1vrr f rii :':, 01£ :
f');:r, ,i; pe:::.;r 1 r: C1!1c

866-689-6469
d1

tampaelectric.com c,, ,,;. Ct::,,,·•,,/

Page 2 of 4

TAMPA El..EC:TR!IC:

AN E:ME:RA COMPANY		

Account:	
211005281889	
Statement Date:	02/15/2018	
Current month's charges due	03/08/2018	

Details of Charges - Service from 01/12/2018 to 02/09/2018

ACCOUNT INVOICE
tampaelectric.com  I f -  'Pg. a in

Service for: 12113 TRIPLE CREEK BL, RIVERVIEW, FL 33579-0000	Rate Schedule: General Service - Non Demand

Number		Reading	Reading	Total Used	Multiplier	Billing Peri	
K23530	02/09/2018	36,332	35,818	514 kWh		29 Days	

Meter

Read □ate

Current

Previous	=	od

Tampa Electric Usage History

Basic SeNice Charge		$19,94		
Energy Charge	514 kWh @ $0,06184/kWh	$31.79		
Fuel Charge	514 kWh @; $0,03132/kWh	$16,10		
Florida Gross Receipt Tax
Electric Service Cost		£1,74D	
$69.57	
Total Current Month's Charges			$69.57	

Kilowatt-Hours Per Day (Average)

NOV

EC-1 17

2J':Nm 	1189
OCT 	15

SEP 16
.JlJL .uo 	016
JUN	18
MAR-	•--      - -	

,r;:; --------- 2

MAY 	--.18
APR	21
■-- - - ■ 24
◄

Important Messages
Fuel sources We Use to Serve You
For the 12-month period ending December 2017, the percentage offue! type used by Tampa Electric to provide electricity to its customers was:
-Natural Gas & Oil*	67%
-Coal	29%
-Purchased Power	4%
*Oil makes up less than 1%

Important Program Information for Lighting Customers
Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program, The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting, The conversion program, which is expected to be effective in February 2018 and will take up to five years to complete, will offer updated rates and several new fixture and pole options, As part of the program, some current options will be closed to new customers.

To view rate details for all lighting fixtures and poles, please visit tampaelec:tric.com/rates, and select Customer Communications. If you prefer to receive a copy of the rates via U.S. Mail, please call 813-635-1500 and select Option 5 to make a request.

Page 3 of4

Register now for help during emergencies

Tarnpa E:ectric "nows son e of our cc1storrers have special neecls which car be c1ided through ioca! gov2rr11110m;:i! agencies. Sur.h nf':8ds c:.:uld be caused by a corrn11un:iy-w,de er11P.rgency. Each county WP. sc=:rve a1lows its resiaen'.s to pre-register with a !ocai response tearT  tha, provides a,d to pe1·sons w10 require special assislcmce duriri9 evacua:i:Jns c1rid sheltering because of d1saoiliries.
F:cr mom inforrr,,tior. ploasc! ccJd the
special-needs registry ir your area

(813) 307-8063 (Hdisborouqh CcuntJ)
(727) 847-2411 (Pasco Cm..,,ty}
(863) 298-7027 (Polk Coun:y)
(727) 464-3800 iPird:as CoT1ty;
Make slay,ng safe i'l ernergcrnc es a
:oo pnor:ty.

Medical Watch
r3n,pa E'.ectric's N1eclical Watci1
::rogr,:irn ideniifes res der1l1cJI cusl,:rr:e1s
wro use e,ectrically powerec1
,jfe cousl;,,i11ing 8LJUiprne11t.

P,Jrlicipalw1 in :rw Medica: Walch program does ;,ct provide prior,ty resloratur1. The proyrwn does nut automaticcJlly extenrl service rr1yrnent options rior doe ; it guc1rantee 1mintP.rrt1riiP.ri elsctr'r. ser,;:rn.
Tne ob1ec, t ve of the fv1edtcai Watch program is to sr,courage custorners t•:; notify Tampa Elcctnc of their s1tuat.ons
so that special procedL1res can be
implemened when:
Disconr,ection of customer electci::; service 's required in response to electric b:i1 non-psyn,ent:
Planned service i'lterrupt:ons m.Jst occur fer !JOV!er line equ,prr1en. '17ainter"a'ic9.
To qua!ify, t:-,e p3t:ent :·esidhg at the
custorner ()f record's t:;ddn ss rnust:
B,; dependcn 1  upon eiec1rica, l  y powerec: medical eC[Ll,pment to sust,M, life;

Be, ccrlficd ,£, e:ig,b!e by r1is or 1,er F!o··ioa-iic:ensecl atter ding physic,a'I.
Note: Cu;-;.tor11ers ;:1re "'oh:,ly I Bsporsil.ile
+or any backup equ:pn ent or po'Ner supf.iy. Tc:HrlPa Electrk; recan rnerids that custor1ers have a weil-planried
cc:urse of ac:c, j'.7 the 6'1fml cf a pswer
ocJtage ::ir ir 1er(uplion er s er ice.
Cal: Tampa Elsctnc ro apply for oart,c:pal:oq ,n t•1e tv'.edica1 \iVaich orogran;:
(813) 225-5051 {HUsborougt1 County)
{863) 298-6051 (Polk Co1m:y)
1-888-223-0800 (. ii other coLn'.:es &
out-or-stale)

TECO
TAMPA 1!!:LECTRIC
AN ltMl!RA COMPANY
l r:1rJcH11e:; tr:c. corr;

Page 4 of 4

TAMPA ELECTRIC
ANE:ME:RA  i;: □M P A NY

TRIPLE CREEK COD
13315 DORADO SHORES AVE RIVERVIEW, FL 33579

ACCOUNT INVOICE
tampaelectric.com  I	f W tp St I in

Statement Date: 02/15/2018 Account:221002207761

i

:i: 0 "'
l
I

Your Account Summary
Previous Amount Due
Payment(s) Received Since Last Statement
Current Month's Charges
Total Amount Due

$56.26

-$56.26
 	$124.80 
$124.80

BY:.................--.•...•

Always assume that a downed power line is energized. Visit tampaelectric.com/safety for more safety tips.

Amount not paid by due date may be assessed a late payment charge and an additional deposit.

Helping neighbors in need
Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure prompt cred,t, please return stub portion of this bill with your payment. Make checks payable to TECO.

TAMPA ELECTRIC ANE:ME:RA l;;□MP A N Y

WAYS TO PAY YOUR BILL

mail	phone online	pay agent
See reverse side for more mk:irmation

Account:221002207761

AmountEnclosed

626691562387

TRIPLE CREEK COD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

6266915623872210022077610000000124808	Page 1 of4

TEC
TAMPA ELECTRIC

ANEMERA COMPANY

Contact Information
Residential Customer Care
  Cn: 1n 11./ }
BG3-?D J--OBOO (Po:k c;oun1/)
BBH )?J-!IBOO (/\!! ()\hnr· co:,H1lie ;)

Commerciai Customer Care

Hearing impaired/TTY
r 1 1
Power Outages To!I-Free
C1ll !::,(HJ l()i(J
Enel'gy-Saving Programs
(l1 J- :-:' /i1- 3 JUfJ

tampaelectric.com

Mai! Payments to
TL(:C}

All Other Correspondence Tampa Electric
'I.'
33Cd1 01

..0..
I
g

0

j
g

Understanding Your Electric Charges

Fuel Charge

Kiiowatt-Hours (kWh)

Avernge kWh per day	
;Ji:!'/

Renewable Energy,,. 'j , .

:(1n C(H; be iTHJdc. Pf )-,;.J11:
(!n 'yOl;l' tJil '{uu1

Total Arnount Duo

Basic Service Charge .'\ :,,:,:,; i

Bright Choicesr.,..

Florida Gross Ro<:f!ipts Tax

Florida State Tax ,:\ ;'1 ,,.,11eq ; ta:-: :-iiJLS :d t : 1
•:1,1>>	11:r:;n1:. ,:) er ,';t':i.:,.,1n c
'.  './,;)(;

Late Payment Charge

[J:J\·'.'  n:·.1	,·= 1•

Rate Sctu:idule    · 1" •  Y!i<>1,· · '.   ,,,, 1    ·,,  .1,  p,,..,	,,.,,.,,1:• · ·,,,

tarnpaelactric.com.

Your payment options are:

f•/1:Jii v1.:u1      pa'(:1vn! ::·-,  t!Jn f::i!C :: _:,cd  ,:;1.vc:·opc
1',;.J! ,:;11:'.JP:,'.J·-d ptJy; f;rn rJ(Jt•n:
;, ;'( :d ,J;;(V•:('

fee dc:!\·1·•

866-€89-6469

®    Sc\·1 ?1Juh: f·f:e l>nP tirr;c	:r c,.ini ·10 p;:Jyn-a:-r11 --: i·:t ian1paolectric,co1n ;_;:;•r:q :-1	q (!
"'

,,·.,t   tampaelectric.com	C.-1

'lnmpaelectric.com f'<.
Page 2 of 4

TAMPA ELECTRIC

ANEMERA COMPANY

ACCOUNT INVOICE
tampaelectric.com I f "'# <;, S-t Ii in

Account:	221002207761
Statement Date:	02/15/2018
Current month's charges due  03/08/2018

Details of Charges - Service from 01/12/2018 to 02/09/2018

Service for: 13315 DORADO SHORES AVE, RIVERVIEW, FL 33579	Rate Schedule; General Service - Non Demand

Number		Reading	Reading		Multiplier	Billing Peri	
C55855	02/09/2018	2,266	1,270	996 kWh		29 Days	

Meter

Read Date

Current

Previous

==	Total  Used	od

Basic Serv;ce Charge	$19.94		
Energy Charge	996 kWh @S0.06184/kWh	$61.59		
Fuel Charge	996 kWh @SQ.03132/kWh	$31.19		
Florida Gross Receipt Tax	$2.89		
Electric Service Cost	$115.61		
Slate Tax	$9.19		
Total Electric Cost, Local Fees and Taxes		$124.80	
Total Current Month's Charges		$124.80	

Tampa Electric Usage History

FEB---------34

Kilowatt-Hours Per Day (Average)

-32
DEC-,t
NOV-<1
J,0.2
0

Important Messages
Fuel sources We Use to Serve You
Forthe 12-month period ending December 2017, the percentage of fuel type used by Tampa Electric to provide electricity to its customers was:

-Natural Gas & Oil*
-Coal

67%
29%

-Purchased Power	4%
*Oil makes up less than 1%

Important Program Information for Lighting Customers
Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program. The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting. The conversion program, which is expected to be effective in February 2018 and  will take up to five years to complete, will offer updated rates and several new fixture and pole options. As part of the program, some current options will be closed to new customers.

To view rate details for all lighting fixtures and poles, please visit tampaelectric.com/rates, and select Customer Communications. If you prefer to receive a copy of the rates via U.S. Mail, please call 813-635-1500 and select Option 5 to make a request.

Page3 of4

Regis	r now for help during emergencies

Tampa E1ectric knows son e of our customers have special needs V hic:, can be aided though \ica' governrnemn: nger cies Sw:h needs could be cciuseu by ci corrmunity-wide ern8rgency. Eac!1 cout1ty we sArve a:iows its resioen':s to pre-register with a :ocai rsspons0  team  that  orovidcs a:d lo persons wrio require special ass'stance during evacuations and shelteririg because of disabilities.
For more inforrr:2ti:x1 plense ca,I tho special-needs registry in your arna:

(813) 307-8063 (H1llsborouQh County)
(727) 847-2411 (Pasco Courlyj
(863) 298-7027 (Polk County)
(727) 464-3800 (Pindas County)
Mi.lks slaying si.lfe iri emergencies a op pnor;ty.

Medical Watch
rarT1pa Eectnc's Medical Watch
:m>grarn dendiieS res de'lt,21 custcrne, s
wl0 o use e:ectricall11  powered,
.ife susl 21ini11y eq1.;iµrner1l.

Parl,cipal,on n !r1c MccJic,11 Walch program does not pi-ovicie prionty reslcrc1t,or1. Tr1e µ,uyrarn dues not a,itornaticrill,y 0:Xlf')nd service payment
ootions nor doe il Q'Jarantee w1intP.rrLJot1:d 1c·lroctr1c: serv;ct'l.
The obJect1ve of the fv1ecllcai Watch program is to encourage customers to notify Tampa Electr:c of the;r 5,lt1a',ons so that special procedures can be implerner11_ed wheri:
Disconnecton of custo•rer electric service 1s mquirccJ in resporsR to e!ec:tric brli non-pay,rent:
Planned servic:e interruptons must occur fcr r:;ower line eq-J;prrenl 1rainterance.
To qua;ity, the pat,erit ;-esidinQ at he CJ:;torner of .·ecor<fs addr ,i;;; mus :
Be cfooencjent upon e!ecl:ical;y
oowere::i r1eclical equprr:ent lo

BG c1:rt:f1cd ::is eiig,b'e by his or her ;::0°ida-iicensed alter.ding pliysicid'L
Note: CJstor11crs clre "'olsly Jespor'sible for any backup eq, u p rr1ent or power
:,Upp'y. Tarr1oa Elect:ic reccrnrqer1us that custorie,s nave a weil-plannecl c:::urse of actior in trie event of a power OLJlage or 1nternJplion cf service.
Cali Tampa Electric 1o apply for partic;pal!O:J ,n the ti;edica1 Watch orograrn:
(813) 225-5051 (HHsborougri County)
(863) 298-6051 (Poli< Crnm y)
1-888-223-0800 (Ail other ::ountes &
oc1l o'-slC:Jle)

'TECC>.
TAMPA ELECTRIC
ANt:ME:RI\ COMPANY
lGn1uue!eclr.c.corr1

Page4 of 4

TAMPA EL.EC:TRIC
ANEMERA COMPANY

TRIPLE CREEK COD
11920 STREAMBED DR, CLBHS RIVERVIEW, FL 33579-9315

BY,: .... -..  ······...- .......

ACCOUNT INVOICE
tampaelectric.com I	f W tp 8+ I, in

Your Account Summary		
Previous Amount Due	$600.86	
Payment(s) Received Since Last Statement	-$600.86	
Miscellaneous Credits	-$88.22	
Credit balance after payments and credits	-$88.22	
Current Month's Charges	 	$611.39 	
Total Amount Due	$523.17	

Statement Date: 02/15/2018 Account:211005282127

Always assume that a downed power line is energized. Visit tampaelectric.com/safety for more safety tips.

Amount not paid by due date may be assessed a late payment charge and an additional deposit.

Helping neighbors in need
Our Share program makes it easy for you to help customers in need pay their electric and/or natural gas bills. Visit tampaelectric.com/share and peoplesgas.com/share to learn more.

To ensure prompt credit, please return stub port,on of th,s bill with your payment. Make checks payable to TECO,

WAYS TO PAY YOUR BILL	Account: 211005282127

TAMPA EL.EC:TRIC: AN EMERA COMPANY

mail	phone onHne	pay agent
See reverse side for more mformation

656321185372

TRIPLE CREEK COD
12750 CITRUS PARK LN, STE 115
TAMPA, FL 33625-3784

MAIL PAYMENT TO: TECO
P.O. BOX 31318 TAMPA, FL 33631-3318

6563211853722110052821270000000523176	Page 1 of 5

TE
TAMPA ELECTRIC
ANEMERA  i;,;□MP  A N Y

Contact Information
Residential Custonwr Care

tG3<J Y1 OflUO (Pn!k Coun 1y )
BCiH<?>'J OfHJO (Al! oth': r co;Jq 1e: )

Comrnerciai Customer Care

Hearing Impaired/TTY
1·1-1
Power Outages Toll-Free

Energy-Saving Programs
d -1 ? / ) ,)· ;!J:·'

tampaelectric.com

Mail Payments to TFCO

Al! Other Correspondence
Tampa Eiectric
r.::i cJ t?,o>: 1 1

Understanding Your Electric Charges

AvernHo kWh per day T,,,, ,,,,, '"'I\
Basic Service Charge    /\ r,x,·d ,n  ii';;.,	
, ,,,\'lei.-' tc ye::, :uc( t1c:-·1

Bright Choicesw
·;]t' F;t=?LU,r_

ci >; _t, 1c· tv
d t<Jp1:1r:l':

tampaelectric.com.

Y<>,ur paymont options are:
":::.L  t1t::dt:1t·!  :r:-'t\  ur1F   '.r 1t:;	rc:cur;:r1q  p;r_1rr1tTh  .;;  ta,npaelectric.com L:"-;ii   J     clH-:ci  ,1q   r1	'  1:r:

i;\ \, 1 •

·{1 i<,..
(y   f:i	".J(:d

' d I 866•689-6469.

i'/1;J:i \'C'tjr pr,:v1-r1en! 1r1 '.h:,; (- :r1ck:!-,t;d Oi:\'(:!l.'1f.•fl Pind :,:;  ;(\\•; 1,/!,c	fc:- fJ{}!i\_'f :'.,:

Fuel Chargo

1v vn _.
fLt:1 .'"it:P!J;,:,
Tarrq:,i;:J f !

Renewable Energyw

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tampaelactric.com,

Page 2 oi 5

TAMPA ELECTRIC

ANEMERA COMPANY

Account:	211005282127	
Statement Dale:	02/15/2018	
Current month's charges due	03/08/2018	

Details of Charges - Service from 01/09/2018 to 02/08/2018

ACCOUNT INVOICE
tampaelectric.com  I f W'P 8·6 in

Service for: 11920 STREAMBED DR, CLBHS, RIVERVIEW, FL 33579-9315	Rate Schedule: General Service Demand• Standard

Meter	Read Date	Current	Previous	=	Total Used	Billing Period	
Number
L08008	
02/08/2018	Reading
87,655	Reading
80,353	
7,302 kWh	Multiplier	
31 Days	
L08008	02/08/2018	15.91	0	15.91 kW		31 Days	

$'164.00 8228.70

Tampa Electric Usag" History

Basic Service Charge		$33.24	(Average)	
Demand Charge	16 kW @810.25000/kW		
Energy Charge	7,302 kWh @$0.01754/kWh	$128.08	JAN	244	
Fuel Charge	7,302 kWh @ SO.03132/kWh		
Capacity Charge	16 kW @ SO.20000/kW	$3.20	NOV
OCT-288	
Energy Conservation Charge	16 kW @$0.87000/kW	$13.92	AU0	,2ge:	
Environmental Cost Recovery	7,302 kWh @S0.00342/kWh	$24 97		JUL	291
JUN----------.2B2	
Florida Gross Receipt Tax
Electric Service Cost		$15.28	
$611.39	MAY	278
APR-288
MAR _		2&4	
Total Current Month's Charges			$611.39	FEB	275
2017	

Kilowatt-Hours Per Day
i	2:ie

DEC-	--    -	-	1

SEP	2-43801

---------16

Billing Demand
(Kilowatts)

------------•ts•-•17

------6170

Load Factor
(Percentage)

Miscellaneous Credits

Deposit Refund
During our annuai review of accounts, we found that your account is over-secured. We have credited a portion of your deposit to better refiect your typical usage.
Interest for Cash Security Deposit - Electric

-$88.00

-$0.22

-------67,24

Total Current Month's Credits	-$88.22

Page 3 of 5

Fuel sources We Use to Serve You
For the 12-month period ending December 2017, the percentage of fuel type used by Tampa Electric to provide electricity to its customers was:
-Natural Gas & Oil*	67%
-Coal	29%
-Purchased Power	4%
*Oil makes up less than 1%

Important Program Information for Lighting Customers

Tampa Electric is seeking approval from the Florida Public Service Commission to update its outdoor lighting program. The company has proposed a new conversion program to replace existing high-pressure sodium and metal halide fixtures with new energy-efficient LED lighting. The conversion program, which is expected to be effective in February 2018 and will take up to five years to complete, will offer updated rates and several new fixture and pole options. As part of the program, some current options will be closed to new customers.

To view rate details for all lighting fixtures and poles, please visit tampaelectric.com/rates, and select Customer Communications. If you prefer to receive a copy of the rates via U.S. Mail, please call 813-635-1500 and select Option 5 to make a request.

Page4 of 5

gister now for help during emergencies

Tampa E!ectric Knows some oi our customers have special neecls which can be aided through iocai governmenmi agencies. Such needs could be caused by a community-wide emergency. Each county we serve a!lows its resiaents to pre-register wilt: a local response team that provides aid to persons who reqGire special assistance during evacuations and sheltering because of disabilities.
Fer more informatiori. please crnl the special-needs registry in your area:

(813) 307-8063 (Hillsborough County)
(727) 847-2411 (Pasco County)
(863) 298-7027 (Polk County)
(727) 464-3800 (Pinelias County)
Make slay;ng safe in emergencies a top prionty.

Medical Watch
Tampa Electric's Medical Watcl1 program identifies residential cuslcrners 'Nho use eiectrically powered,
!ife-sustaining equipment.

Parl!cipat:on in the Medical Walch pI·ogram does not provide priority restoration. The program does not automatIcally extend service payment options nor does it guarantee uninterrupted electric service.
The objective of the Medical Watch program is to encourage custor11ers to notify Tampa Electric of their sItuat1ons so that special procedures can be implernented when:
Disconnectior of custoq1er electric service rs required in response lo electric b:I! non-payment
Plarined service interruptions must occur for power line equipment maintenance.
To quaiify, the patient residing at the customer of record's address must:
Be dependent upon e!ectrical1y powered meclical equprnent to sustain life;

Be cerlrfied as eiigib 1e by liis or her Florida-!icer:sed attending physicicm.
Note: Custornsrs are soiely responsible for any backup equ:pment or power supply, Tampa Electric: recommends that customers have a ;,ve!l-planned course of action in the event of a power outage or iriterruption of service.
Call Tampa Electnc to aoply for participation in the Medicai Watch program:
(813) 225-5051 (Hiilsborough County)
(863) 298-6051 (Polk County)
1-888-223-0800 (Ail other counties &
out-of-state)

TECO.
TAMPA ELECTRIC
ANEMERA COMPANY
lampae!ectnc.corn

Page 5 of 5

ijtifilts

tampabay.oom

ADVERTISING INVOICE

Times Publishing Company
P.O. Box 175
St. Petersburg, FL 33731-0175 Toll Free Phone: 1 (877) 321-7355 Fed Tax ID 59-0482470
AD SALES HOURS
M - TH 7:30 - 6:30
FRI 7:30-5:30
CUSTOMER SERVICE HOURS
M-F 8:00 - 5:00

PAYMENT DUE UPON RECEIPT

I/

. 2/16/18

Times Publishing Company
P.O. Box 175
St. Petersburg, FL 33731-0175 Toll Free Phone: 1 (877) 321-7355
ADVl!RTISING INVOICI!	DO NOT SEND CASH BY MAIL
PLEASE MAKE CHECK PAYABLE TO: TIMES PUBLISHING COMPANY

Thank you for your business

TRIPLE CREEK COD
ATTN: RIZZETTA & COMPANY -AP 12750 CITRUS PARK LANE STE 115
TAMPA, FL 33625

REMIT TO:

TAMPA BAY TIMES DEPT 3396
P.O. BOX 123396
DALLAS, TX 75312-3396

10010702100000000059111409020000152000000000000000000000000000000000000000000005

591114

Tampa Bay Times
Published Daily

LEGAL NOTICE

STATE OF FLORIDA	}
COUNTY OF Hillsborough Counfy

Before the undersigned authority personally appeared Amy Robison who on oath says that he/she is Legal Clerk of the Tampa Bay Times a daily newspaper printed in St. Petersburg, in Pinellas County, Florida; that the attached copy of advertisement, being a Legal Notice in the matter RE: TRIPLE CREEK CDD was pub­ lished in Tampa Bay Times: 2/9/18. in said newspaper in the issues
of Tampa Tribune Southeast

Aftiant further says the said Tampa Bay Times is a newspaper published in Hillsborough County, Florida and that the  said newspa­ per has heretofore been continuously published in said Hillsborough
County, Florida, each day and has been entered as a second class mail matter at the post office in said Hillsborough County, Florida for a period of one year next preceding the first publication of the attached copy of advertisement, and affiant further says that he/she neither paid not promised any person, firm or corporation any discount, re­ bate, commission or refund for the purpose of securing this advertise­ ment for publication in the said newspaper
.		f(<J-D,u ,,,,	

S9l1\4-'

21912018

NOTICE OF PUBLIC MEETING TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT
Toe Board of Supervisors of the Triple Creek Community Development District will hold a regular meeting on Tuesday, February 20, 2018 at 10:00 a.m., at the offices of Rizzetta & Company, Inc. located at 9428 Camden Field Parkway, Riverview, FL 33578. The purpose of the meeting is to consider organizational matters related to the District and any other business which may properly come before it.
Toe meeting will be open to the public and will be conducted in accordance with the provisions of Florida law for community development districts. The meeting may be continued in progress without additional published notice to a time, date and location stated on the record at the meeting.
A copy of the agenda may be obtained at the office of the District Manager, Rizzetta & Company, Inc., located at 9428 Camden Field Parkway, Riverview, FL 33578, (813) 533-2950, during normal business hours.
There may be occasions when one or more Supervisors will participate by telephone.
Pursuant to provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate In this meeting is asked to advise the District Office at loast forty-eight (48) hours before the meeting by contacting the District Manager at (813) 533-2950. If you are hearing or speech impaired, please contact the Florida Relay Service at 7-1-1, who can aid you 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 the appeal is to be based.

Triple Creek Community Development District Christine Perkins, District Manager

Sworn to and subscribed bf fore me this 02/09/20 I 8.

I

Personally kno..,,'11

l.,./'
or produced identification

Type of identification produced----------

Vanguard Cleaning Systems of Tampa Bay
12108 North 56th St.
Suite 8
Tampa, FL. 33617
Tampa, FL 33617

Triple Creek CDD
3434 Colwell Ave. Suite 200
Tampa, Fl 33614

I

Date

Invoice#

2/1/2018

75903

P.O. No.	Due Date

February (2/1/2018 - 2/28/2018) Monthly Service - October -April 2 days serviced per week

Description

Qty
1

3/3/2018

Rate
295.00

Amount
295.00T

Phone#	813-849-6500 ext.207	
E-mail		
ALPerkins@vanguardcleaning.com		

Subtotal

$295.00

(0.0%)	$0.00

$295.00

Tab 3

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SERIES 2017AB CONSTRUCTION REQUISITION RECAP FOR BOARD RATIFICATION APRIL 17, 2018

REQUISITION NO.	

PAYEE	

AMOUNT	

SUBACCOUNT	
260-B	Basham & Lucas Design Group, Inc.	$9,450.00	General B	
261-B	The Kearney Companies, LLC	$83,991.94	General B	
262-G1	Newberg Irrigation, Inc.	$21,663.80	Village G1	
263-B	RIPA & Associates, LLC	$200,491.25	General B	
264-E	RIPA & Associates, LLC	$800.50	Village E	
265-F1	RIPA & Associates, LLC	$29,239.91	Village F1	
266-G1	RIPA & Associates, LLC	$61,347.73	Village G1	
267-B	Tampa Electric Company	$43,983.95	General B	
268-B	Genesis Group	$27,579.28	General B	
269-K	Genesis Group	$1,651.49	Village K	
270-B	Hopping Green & Sams	$1,331.00	General B	
271-B	Hillsborough County BOCC	$11,640.00	General B	

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

DISTRICT OFFICE · 9428 CAMDEN FIELD PARKWAY · RIVERVIEW, FLORIDA 33578

March 20, 2018

Thomas J. Radicioni
THE BANK OF NEW YORK TRUST COMPANY, N.A.
10161 Centurion Parkway
Jacksonville, FL 32256

RE:	Special Assessment Bonds, Series 2017AB Requisitions for Payment

Dear Thomas:

Below please find a table detailing the enclosed requisition(s) ready for payment from the Districts Acquisition/Construction Trust Account.

PLEASE EXPEDITE PAYMENT TO THE PAYEE(S) VIA UPS

REQUISITION NO.	
PAYEE	
AMOUNT	
SUBACCOUNT	
260-B	Basham & Lucus Design Group, Inc.	$9,450.00	General B	
261-B	The Kearney Companies, LLC	$83,991.94	General B	
262-G1	Newberg Irrigation, Inc.	$21,663.80	Village G1	
263-B	RIPA & Associates, LLC	$200,491.25	General B	
264-E	RIPA & Associates, LLC	$800.50	Village E	
265-F1	RIPA & Associates, LLC	$29,239.91	Village F1	
266-G1	RIPA & Associates, LLC	$61,347.73	Village G1	
267-B	Tampa Electric Company	$43,983.95	General B	

If you have any questions regarding this request, please do not hesitate to call me at (813) 533-2950. Thank you for your prompt attention to this matter.

Sincerely,
TRIPLE CREEK
COMMUNITY DEVELOPMENT DISTRICT

Christine Perkins District Manager

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017B

The undersi gned, a Responsible Officer of Triple Creek Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture dated as of June l, 2012 from the District to The Bank of New York Mellon Trust, N.A., as trustee (the "Trustee"), as supplemented by the Second Supplemental Trust Indenture dated as of February l, 2017 (the "Indenture" ), (all capitalized terms used herein shall have the meaning ascribed to such term in the Inden ture):

March 16, 2018

Requisition Number: CR260-B

Name of Payee: Basham & Lucas Design Group, Inc.
7645 Gate Parkway Suite 201
Jacksonville, FL 32256

Amount Payable: $9,450.00

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): Invoice # 7354 for Project # 17-85

Fund or Account from which disbursement to be made: 2017B Acquisition and Construction Account

The undersigned hereby certifies that:
obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs of Issuance payable from the Acquisition and Construction Fund that have not previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services rendered with respect to which disbursement is hereby requested.
TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

>- -z	c...,.«-< , 6?r

7 C	\  

By:

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

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

...,........Co nsulting Engineer

Invoice

DATE	INVOICE #	
3/13/2018	7354	

BILL TO

7645 Gate Parkway Suite 201
Jacksonville, FL 32256

Triple Creek CDD
C/O Rizzetta & Company Attn: Joe Roethke
3434 Colwell Ave #200
Tampa, FL 33614

(904) 731-2323

www.bashamlucas.com

PROJECT	Exibit "B" Amenity Construction #17-85	
CONTRACT SERVICES	CONTRACT	TO DATE	Total %	AMOUNT DUE	
Part 1: Contractor Pre-qualification and Bid Process	3,200.00	1,600.00	100.00%	1,600.00	
Part 2: Shop Drawings Review for the Amenity	20,000.00		0.00%	0.00	
Center:Hourly at $100.00 per hr(Not to exceed					
$20,000)					
Part 3: Construction Administration: Revision to	15,000.00		19.00%	2,850.00	
drawings per owner: 28.5 hours @$100 per hour					
				0.00	
Additional Services: Revisions to pool engineering				5,000.00	
We look forward to working with you!	TOTAL	$9,450.00	

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017B

The undersigned, a Responsible Officer of Triple Creek Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture dated as of June 1, 2012 from the District to The Bank of New York Mellon Trust, N.A., as trustee (the "Trustee"), as supplemented by the Second Supplemental Trust Indenture dated as of February 1, 2017 (the "Indenture"), (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):

March 16, 2018

Requisition Number: CR261-B

Name of Payee: The Kearney Companies, LLC
9625 Wes Kearney Way Riverview, FL 33578

Amount Payable: $83,991.94

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):  Pay  Application  #8  for Triple Creek Villages K, Land Amenity Center

Fund or Account from which disbursement to be made: 2017B Acquisition and Construction Account

The undersigned hereby certifies that:
obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs of Issuance payable from the Acquisition and Construction Fund that have not previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services rendered with respect to which disbursement is hereby requested.
TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

:::-,;

C V<V"<= IS>

C	)

By:

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

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

Consulting Engineer

•

KEARNEY
COMPANIES
Office (813) 421-6601

THE KEARNEY COMPANIES, LLC.
9625 Wes Kcamcy Way, Riverview FL 33578	Fax (813) 421:-6701

Underground Utilities	Site Development

CONTRACTOR'S  APPLICATION FOR PAYMENT
PROJECT:	TRIPLE CREEK VILLAGES K & L, AMENITY CENTER	PROJECT NO.:	0038-01
PAYMENT REQUEST NO.:	8	FOR PERIOD:	1/31/2018	TO	2/28/2018
1.  ORIGINAL CONTRACT AMOUNT.   ,  .  .   .   .  .  ,  .  .   .  .  ,  .  .  .   .  .   .  .  .  .   .  .  .  .   .  .  .   .  •   .   .   .  .  $	2,315,315.15

2.  APPROVED CHANGE ORDERS & CONTINGENCIES . . . . , . . . . . . . . . . . . . . . . .  .  ,  .  .  .  ,  . •  •    ._ $.,     _
CURRENT CONTRACT AMOUNT 	=.  $=====
VALUE OF WORK COMPLETED TO  DATE    95%	$ 1,869,256.71
5.   LESS AMOUNT RETAINED	10%   *	.  .  .  .  .  . . •	.  .  .  .  .  .  .  .  .  . .  $	134,748.96
..PARTIAL RETAINAGE RELEASE

_,(_3_4_1.,_64_1_.8_1.,_)
=1'= 9=7=3,6=7==3=•=3==4

6. NET AMOUNT EARNED TO DATE ..		   $	1,734,507.75 	
7. LESS AMOUNT OF PREVIOUS APPLICATIONS ..........•...		$	1,650,515.81	
8.  TOTAL AMOUNT UNPAID TO DATE.	$	188,906.91		
9. PREVIOUS APPLICATIONS UNPAID	$	104,914.97	 		

CURRENT  PAYMENT DUE THIS APPLICATION	=

$#== 8=3=,=9=9==1=.94= _.,,

CERTIFICATION OF CONTRACTOR	/	%/Jri<l)i1f
0 66

1/ -

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

CONTRACTOR: THE EARNEY COMPANIES, LLC.
BY:	rx.J:	

DATE:	2/28/2018

TITLE:	PROJECT MANAGER

STATE OF FLORIDA	} COUNTY OF HILLSBOROUGH	}
The foregoing instrument was acknowledged by Sherry Spurlock, Project Manager of THE KEARNEY COMPANIES, LLC., a Florida Corporation, on behalf of the corporation before me this 28th day of

C"i'. '!'  t •f,;.:.,

,.....,,,,

JOYCE M. ZEVOLA

\:,j•	;	EXPIRES: June 13, 2021	k

MY COMMISSION # GG 103334	.

••••..,..l,,•• Bondod Thru Notary Pubffc Unlk:rwrllero f

.. l

February	, 2018.   He/she is personally known to me or has produced 	as identification.

Nata,yStamp

CERTIFICATION OF ENGINEER

•

KEARNEY
COMPANIES
Office (813) 421 6601

- INVOICE -
THE KEARNEY COMPANIES, LLC.
9625 Wes Kearney Way, Riverview FL 33578

Ng 18059

Fax (813) 421-6701

Underground Utilities	Site Development

SOLD TO:  TRIPLE CREEK COD	PROJECT:	TRIPLE CREEK VILLAGES K & L, AMENITY CENTER

ROM THIS INVOICE UNLESS AUTHORIZED.

-I-NVOICE OATE

INVOICE NUMBER

Amount

CLERICAL ERRORS ARE SUBJECT TO CORRECTION. DO NOT MAKE DEDUCTIONS F

JOB NO.
0038-01

CUST.NO.	W.O.NO.	PERCENTAGE COMPLETE

Description

	
CONTRACTOR'S PAY APPLICATION #	8	$ 93,324.38		
* LESS 10% RETAINAGE		$	9,332.44		
TOTAL AMOUNT DUE		$ 83,991.94	$	83,991.94	

* RETAINAGE PARTIALLY RELEASED				
PLEASE REMIT TO:		
THE KEARNEY COMPANIES, LLC.		
Please addq	ATTN: Dept. AIR		
9625 Wes Kearney Way		
Riverview, FL 33578		
PLEASE PAY FROM THIS INVOICE NO STATEMENT WILL BE RENDERED		
INVOICES DUE PER AGREEMENT - NO DISCOUNTS. UNPAID AMOUNTS WILL BEAR INTEREST AT 1½% PER MONTH, WHICH		
IS AN ANNUAL PERCENTAGE RATE OF 18%. PURCHASER AGREES TO PAY ALL COSTS AND FEES FOR COLLECTION ON AC­		
COUNTS REMAINING UNPAID IN EXCESS OF 30 DAYS INCLUDING, BUT NOT LIMITED TO, ATTORNEYS' FEES AND ATTORNEYS'		
FEES ON APPEAL.		

BILL TO:	TRIPLE CREEK COD
PROJECT: TRIPLE CREEK VILLAGES K & L, AMENITY CENTER PROJ ECT #: 0038--01

THE KEARNEY COMPANIES, LLC.
9626 WES.KEARNEY WAY
RIVERVIEW, FL 33578
(813) 421-6601

SCHEDULE OF VALUES

APPLICATION NO.: APPLICATION DATE PERIODTO: GCIOWNER'S NO.:

8
2/211/2:018
2/28/2018

A	B	C

D	E	F	G	H

ITEM
Nb .	DESCRIPTION OFWORK	CONTRACT VALUE	FROM PREVIOUS APPLICATION	THIS PERIOD	TOTAL COMPLETED &STORED
TOOATE	
%	BALANCE TOFINiSH	RETAINAGE	
	SCHEDULE A-AMENITY GENERAL CONDITIONS			
$	.
$	374.54
$	.
$	1,432.95
$	624.23
$	.			$	.
$	-
$	.
$	1,432.95
$	624.22
$		
1.	MOBILIZATION	$	40.988 .72	$	40,986,72		$	40,986.72	100%		$	4,098.67	
2.	NPOES PERMIT & COMPLIANCE	$	7,490.80	$	7,116.26		$	7,490.80	100%		$	749.08	
3,	MAINTENANCE OF TRAFFIC	$	1,722.00	$	1,722.00		$	1,722.00	100%		$	172.20	
4.	CONSTRUCTION STAKEOUT/RECORD SURVEY	$	26,659.00	$	25,793.10		$	27,22(i.05	95%		$	2,722.61	
5.	GEOTECHNICAL & MATERIAL TESTING	$	12,484.50	$	11,236.05		$	11,860.28	95		$	1,186.03	
6.	PAYMENT & PERFORMANCE BOND	$	17.147.17	$	17,147,17		$	17,147;17	100%		$	1,714.72	
	TOTAL SCHEDULE A·AMENITY GENERAL CONDITIONS	$ 108,490.19	$ 104,001.30	$	2,431;72	$	106,433.02	98%	$	2,057.17	$ 10,643.31	
	SCHEDULE B -AMENITY EARTHWORK			$	-
$	a
$	-
$	.
$	.
$	.
$	-
$	-
$	-
$	.
$	3,4 37.38			$	-
$	-
.$	-
$	-
$	.
$	13,768.35
$	4,274.25
$
$	319.21
$	-
$	859.34	
$	4,959.07
$	484.80
$	6,090 .18
$	1,753.20
$	1,753.52
$	4,130.51
$	-
$	1,210 .30
$	95.77
$	1,926 .44
$	1,632 .76	
1.	CLEARING & GRUBBING	$	49,590 .69	$	49,590.69		$	49,590,69	100%			
2.	DISC SITE	$	4,848.00	$	4,848.00		$	4,848.00	100%			
3.	CUT VOLUME (UNADJUSTED)	$	60,901.77	$	60,901,77		$	60,801.77	100%			
4.	FILL VOLUME (UNADJUSTED)	$	17,532.00	$	17,532,00		$	17,532.00	100%			
5.	STOCKPILE ON ADJACENT AREA (UNADJUSTED)	$	17,535.16	$	17,535.16		$	17,535.16	100%			
6.
7.	SODDING
SEEDING & MULCHING	$	55,073.40
$	4,274.25	$	41,305.05
$	.		$	41,305.05
$	.	75%
0%			
B.	SILT FENCE	$	12,103.00	$	12;103.00		$	12 ,103.00	100%			
9.
10 .	INLET PROTECTION
DEWATERING	$	1,276 .66
$	19,264.44	$	957.65
$	19,284.44		$	957 .65
$	19,284.44	75%
100%			
11 .	FINAL GRADING	$	17,188.90	$	12 ,890.18		$	16,327.56	95%			
	TOTAL SCHEDULE B • AMENITY EARTHWORK	$ 259,586.47	$	236,927.94	$	3,437.38	$	240,385.32	93%	$	19,221.15	$ 24,036.55	
	SCHEDULE C -AMENITY ROADWAY		
$	-
$	84,791.62
$	32,431.14
$
$	40,286.80
$	3,106.12
$	52,675.00
$	.
$	.
$	5,068.24
$	.
$	-
$	.	
$ 66,847.86
$	.
$	.
$	-
$	.
$	.
$	-
$	6,736.38
$	3,585.50
$	.
$	.
$	.
$	.	
$	66,847.86
$	84,791.62
$	32,431.14
$	-
$	40,266.80
$	3,106.12
$	52,675.00
$	6,736.38
$	3,585.50
$	5,088.24
$	-
$	.
$	-		
$	-
$	-
$	-
$	9,500.22
$	.
$	.
$	.
$	.
$	.
$	1,689.41
$	9,451.20
$	13,511.68
$	159.90	

$	6,684,79
$	6,479.16
$	3,243.11
$	.
$	4,026.66
$	310.61
$	5,267.50
$	673.64
$	356.55
$	506.82
$	-
$	.
$	.	
1.	1 3/4" SP ASPHALTIC CONCRETE	$	66,847.86				100%			
2.	6" CRUSHED CONCRETE	$	84,791.62				100%			
3,	8" STABILIZED SUBGRADE (LBR 40)	$	32,-431.14				100%			
4.	TYPE 'D' CURB	$	9;500.22				0%			
5.	TYPE 'F' CURB W/STABILIZATION	$	40,266.80				100%			
6.	VALLEY GUTTER	$	3;106.12				100%			
1.	5'X4" CONCRETE SIDEWALK	$	52,675,00				100%			
6.	6'X4" CONCRETE SIDEWALK	$	6,736.38				100%			
9.	10'X4" CONCRETE SIDEWALK	$	3,585.50				100%			
10.	ADA RAMPS (5' WIDE}	$	6,757.65				75%			
11.	DUMPSTER ENCLOSURE	$	9,451.20				0%			
12 .	SIGNAGE Be STRIPING	$	13,511.68				0%			
13.	PARKING LOT WHEEL STOPS	$	159.90				0%			
	TOTAL SCHEDULE C -AMENITY ROADWAY	$ 329,821.07	$ 218,338.92	$ 77,169.74	$	295,508,66	90%	$	34,312.41	$ 29,550.86	
	SCHEDULED -AMENITY POTABLE WATER SYSTEM		
$	-
$	1,910.40
$	5,053.62
$	.
$	965.36
$	11,884.58
$	154.17
$	3,100.80
$	3,083.04
$	3,550.92
$	609.08
$	3,744.84
$	615.12
$	803.64
$	7,052.76
$	2,469.13
$	498.25
$	2,782 .45
$	.
$	.
$	2,046.96	$	.
$	-
$	.
$	.
$	-
$	-
$	.
$	-
$	-
$	.
$	-
$	.
$	.
$
$	.
$	.
$	-
$	-
$	.
$	-
$	-	
$	.
$	1,910.40
$	5,053.62
$	-
$	965.36
$	11,884.58
$	154.17
$	3,100.80
$	3,083.04
$	3,550.92
$	609,08
$	3,744.84
$	615.12
$	903.64
$	7,052.76
$	2,489.13
$	498:25
$	2,782.45
$	-
$	.
$	2,046. 96		
$	2,060.34
$
$	.
$	3,592.68
$	-
$	-
$	-
$	.
$	.
$	-
$	.
$	-
$	.
$
$	-
$	.
$	-
$	-
$	2,204.29
$	10,616.36
$	2;046.97	
$	.
$	191.04
$	505.36
$	.
$	96 ,54
$	1,188.46
$	15.42
$	310.08
$	308.30
$	355.09
$	60.91
$	374.46
$	61.51
$	90,36
$	705 . 28
$	248.91
$	49 .83
$	278.25
$	.
$	.
$	204.70	
1.	CONNECT TO EXISTING 12" W/M	$	2,060.34				0%			
2 .	1" POLYETHYLENE WATERLINE	$	1,910.40				100%			
3.	2: POLYETHYLENE SERVICE (LIFT STATION}	$	5,053.62				100%			
4.	3/4" PE WATERLINE SERVICE & BACKFLOW PREVENTER ASSEMBLY	$	3,592.68				0%			
5.	6" PVC, C-900	$	965.38				100%			
6 .	12" PVC PIPE C-900	$	11,884.58				100%			
7.	2"BEND	$	154.17				100%			
8.	2" TEE FITTINGS	$	3,100 .80				100%			
9 ,	2"GATEVALVE	$	3,083.04				100%			
10.	B"GATEVALVE	$	3,550.92				100%			
11.	BLOW-OFF ASSEMBLY	$	609.08				100%			
12.	6' FIRE HYDRANT ASSEMBLY	$	3,744.84				100%			
13.	1" TEMPORARY BLOW-OFF & GATE VALVE	$	615.12				100%			
14 .	6' TEE FITTINGS	$	903.64				100%			
15 .	12'' GATE VALVE	$	7,052.76				100%			
16 .	12" BEND FITTINGS	$	2,489.13				100%			
17	12" TEE FITTINGS	$	498.25				100%			
18 .	SING.LE SERVICE, SHORT SIDE	$	2,782.45				100%			
19.	2" METER ASSEMBLY	$	2,204 .29				0%			
20.	TEMPORARY CONSTRUCTION METER	$	10,818.36				0%			
21.	CHLbRINATION & PRESSURE TESTING	$	4,093.93				50%			
	TOTAL SCHEDULED - AMENITY POTABLE WATER SYSTEM	$	71,165.58	$	50,444.94	$	.	$	50,444.94	71%	$	20,720.64	$	5,044.50	
	SCHEDULE E • AMENITY SANITARY SEWER			
$	.
$	.
$	-
$	-			
$	-
$	-
$	.
$	-		
1.
2.	s• PVC, SOR 26 (0'-6' CUT)
8' PVC, SOR 26 (6'-8' CUl}	$	6,160.56
$	2,108.05	$	6,160.56
$	2,108.05		$	6,160.56
$	2,108.05	100%
100%		$	616.08
$	210.81	
3.	SANITARY MANHOLE (0'-6' CUl)	$	4,167.58	$	4,167.58		$	4,167.58	100%		$	416.76	
4.	SANITARY MANHOLE (6'·8' CUl)	$	4,597.48	$	4,597,48		$	4,59 7.48	100%		$	459.75	
h 0038-01 Triple Creek Village K&L-Amenity• Pay App 8 800000	Page j of5	2128/2016 12:22 PM

BJ.LI. TO:	TRIPLE CREEK CDD
PROJECT: TRIPLE CREEK VILLAGES K & L, AMENITY CENTER PROJECT#: 0038-01

THE KEARNEY COMPANIES, LLC.
9625 WES KEARNEY WAY RIVERVIEW, FL 33578
(813) 421-6601

SCHEDULE OF VALUES

APPLICATION NO.· APPLICATION DATE PERIOD TO: GC/OWNER'S NO.:

8
2/28/2018
%/28/2018

A	B	c

D	E	F	G	H

ITEM
NO.	DESCRIPTION
OF WORK	CONTRACT
VALUE	FROM
PREVIOUS APPLICATION	THIS
PERIOD	TOTAL
COMPLETED &STORED
TO DATE	
%	BA CE
TOFINISH	RETAINAGE	
5,	SINGLE SERVICE (HILLSBOROUGH COUNTY)	$	402.57	$	-402.57
$	3,637.30
$	111.54
$	4,263.90
$	-
$	-
$	54,852.46
$	-
$	276.80
$	713.99
$	198.04
$	14,188.44
$	4,458.45
$	3,623.52
$	512.16
$	133.44
$	325.74
$	3,541.47	$	-
$	-
$	-
$	-
$	-
$	2,062.05
$	3,226.61
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	.
$	-
$	-	$	402.57
$	3,637.30
$	111.54
$	4,263.90
$	-
$	2,062.05
$	58,019.07
$	-
$	276.80
$	713,99
$	198.04
$	14,188.44
$	4,458.45
$	3,623.52
$	512.16
$	133,44
$	325,74
$	3,541.47	100%	$	-
$	-
$	-
$	-	$	-40.26
$	363.73
$	11.15
$	426.39
$	-
$	206.21
$	5,807.91
$	-
$	27,68
$	71.40
$	19.80
$	1,418.84
$	445.85
$	362.35
$	51.22
$	13,34
$	32.57
$	354.15	
6.	DOUBLE SERVICE (HILLSBOROUGH COUNTY)	$	3,637.30				100%			
7.	8' STUB & PLUG (GRAVITY SEWER}	$	111,54				100%			
8.	DEWATERING	$	4,263.90				100%			
9.	INFILIEXFIL TESTING	$	1,845.36				0%  $	1,845.36		
10.	TELEVISE SANITARY SEWER (CCTV)	$	2,062.05				100%	$
$	6,453.23
$	1,228.60
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-		
11.	PRIVATE PUMP STATION (48" DIA)	$	64,532.30				90%			
12.	CONNECT TO EXISTING 8" FM	$	1.228.60				0%			
13.	4" PVC, C-900 FM	$	276.80				100%			
14.	4" PLUG VALVE	$	713.99				100%			
15.	4" X 2" REDUCER	$	198.04				100%			
16.
17,	B" PVC, C-900 FM
e•PLUG VALVE	$	14,188.44
$	4,458.45				100%
100%			
18.	8"BEND	$	3,623.52				100%			
19.	B"TEE	$	512.16				100%			
20.	B"CAP	$	133,44				100%			
21.	TEMPORARY BLOW-OFF	$	325.74				100%			
22.	PRESSURE TESTING (FM)	$	3,541.47				100%			
	TOTAL SCHEDULE E -AMENITY SANITARY SEWER	$ 123,089.34	$	108,273.49	$	5,288,86	$	113,562.15	92%	$	9,527.19	$ 11,356.23	
	SCHEDULE F -AMENITY STORM DRAINAGE			
$	-
$	-
$	-
$	.-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	.
$	4,996.88			
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-		
1.	15" CLASS Ill RCP	$	9,933.84	$	9,933.84		$	9,933.84	100%		$	993,38	
2.	18" CLASS Ill RCP	$	18,170.32	$	18,170.32		$	18,170.32	100%		$	1,817.03	
3.	24" CLASS Ill RCP	$	19,753.20	$	19,753,20		$	19,753.20	100%		$	1,975.32	
4.	30" CLASS Ill RCP	$	12,048.20	$	12,048.20		$	12,048.20	100%		$	1,204.82	
5.	HILLSBOROUGH CO. TYPE 1 CURB INLET	$	17,894.70	$	17,894.70		$	17,894.70	100%		$	1,789.47	
6.	HILLSBOROUGH CO. TYPE 1 CURB INLET W/J-BOTTOM	$	3,578.94	$	3,578.94		$	3,578.94	100%		$	357.89	
7.	FOOT "TYPE E" INLET	$	16,548.36	$	16,548:36		$	16,548.36	100%		$	1,654.84	
8.	DITCH BOTTOM INLET , TYPE ''C"	$	1,458.48	$	1,458.48		$	1,458.48	100%		$	145.85	
9.	24" X. 24" YARD DRAIN STRUCTURE	$	5,763.50	$	5,763.50		$	5,763.50	100%		$	576.35	
10.	CONTROL STRUCTURE (FOOT MODIFIED TYPE "D" INLEl)	$	4,112.07	$	4,112.07		$	4,112.07	100%		$	411.21	
11.	6" PVC UNDERDRAIN	$	8,835.44	$	8,835.44		$	8,835.44	100%		$	883.54	
12.	UNDERDRAIN CLEANOUT	$	862.28	$	862,28		$	862.28	100%		$	86.23	
13.	30"FDOTFES	$	8,524.60	$	8,524,60		$	8,524.60	100%		$	852.46	
14.	FOOT MANHOLE	$	6,189.42	$	6,189.42		$	6,189.42	100%		$	618.94	
15.	TELEVISE STORM SEWER (CCTV)	$	9,993.75	$	4,996,87		$	9,993.75	100%		$	999.38	
	TOTAL SCHEDULE F AMENITY STORM DRAINAGE	$ 143,6!,7.10	$	138,670,22	$	4,996.88	$	143,667.10	100%  $	-	$ 14,368.71	
	SCHEDULE G -AMENITY UNCLASSIFIED ITEMS			
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-			$	-
$	-
$	-
$	-
$
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	15,498.00		
1.	TREE BARRICADES	$	13,415.36	$	13,415.36		$	13,415.36	100%		$	1,341.54	
2.	ROOT PRUNING	$	1,974.15	$	1,974.15		$	1,974.15	100%		$	197.42	
3,	6" PVC, SOR 26 (B'-8' CUT}	$	339.56	$	339.56		$	339.56	100%		$	33.96	
4.	6" PVC, SOR 26 (8'-10' CUT)	$	241.44	$	241.44		$	241.44	100%		$	24.14	
5.	8" PVC, SDR 26 (8'-10' CUl}	$	1,197.96	$	1,197.96		$	1,197.96	100%		$	119.80	
6.	B" PVC, SOR 26 (10'-12' CUT)	$	1,177.98	$	1,177.98		$	1,177.98	100%		$	117.80	
7.	SANITARY MANHOLE (B'-1O' CUT}	$	2,470.26	$	2,470.26		$	2,470.26	100%		$	247,03	
8.	SANITARY MANHOLE (10'-12' CUT}	$	2,708.34	$	2,708.34		$	2,708.34	100%		$	270.83	
9.	6" SANITARY CLEANOUT	$	308.90	$	308.90		$	308.90	100%		$	30.89	
10.	2" POLYETHYLENE GREEN FM	$	3,200.00	$	3,200.00		$	3,200.00	100%		$	320.00	
11.	8" PVC, SOR 35 - STORM	$	3,228.79	$	3,226.79		$	3,226.79	100%		$	322.68	
12.
13.	10" PVC, SOR 35 - STORM
5' VINYL COATED FENCE	$	4,068.00
$	15,498.00	$	4,068.00
$	.		$	4,068.00
$	-	100%
0%		$	406.80
$	-	
	TOTAL SCHEDULE G -AMENITY UNCLASSIFIED ITEMS	$	49,826,74	$	34,328.74	$	-	$	34,328.74	69%	$	15,498.00	$	3,432.89	
	SCHEDULE H -VILLAGE K GENERAL CONDITIONS			$	-
$	-
$	-
$	-
$	-
$	-			$	-
$	-
$	-
$	-
$	-
$	-		
1.	MOBILIZATION	$	25,290:oa	$	25,298.08		$	25,298.08	100%		$	2,529.81	
2.	NPDES PERMIT & COMPLIANCE	$	6,253.15	$	6,253.15		$	6,253.15	100%		$	625.32	
3,	MAINTENANCE OF TRAFFIC	$	8,302.50	$	8,302.50		$	8,302.50	100%		$	830.25	
4.	CONSTRUCTION STAKEOUT/RECORD SURVEY	$	38,253,00	$	38,253,00		$	38,253.00	100%		$	3,825.30	
5.	GEOTECHNICAL & MATERIAL TESTING	$	11,008.50	$	11,008.50		$	11,008.50	100%		$	1,100.85	
6.	PAYMENT & PERFORMANCE BOND	$	12,814.51	$	12,814.51		$	12,814.51	100%		$	1,281.45	
	TOTAL SCHEDULE H -VILLAGE K GENERAL CONDITIONS	$ 101,929.74	$	101,929.74	$	-	$	101,929.74	100%	$	-	$ 10,192.98	
	SCHEDULE I - VILLAGE K EARTHWORK			
$	-
$	-
$	-
$	.			
$	-
$	-
$	-
$	-		
1.	CLEARING & GRUBBING	$	5,856.40	$	5,856.40		$	5,856.40	100%		$	585,64	
2.	SAW CUT EXISTING ASPHALT & REMOVAL	$	4,744.11	$	4,744.11		$	4,744.11	100%		$	474.41	
3.	DEMO EXISTING SIDEWALK	$	1,101.32	$	1,101.32		$	1,101.32	100%		$	110.13	
4.	DISC SITE	$	4,444.00	$	4,444.00		$	4,444.00	100%		$	444;40	

h  0038-01 Triple Creek Village K&L-Amenlly- Pay App 8 800000	Page 2 of 5	2/28/2018 12:22 PM

BILL TO;	TRIPLE CREEK C:DD
PROJECT; TRIPLE CREEK VILLAGES K & L, AMENITY CENTER PROJECT#; 0D38-01

THE KEARNEY COMPANIES, LLC.
9625 WES KEARNEY WAY RIVERVIEW, FL 33578
(813)421-6001

SCHEDULE OF VALUES

APPLICATION NO.: APPLICATION DATE PERIOD TO; GC/OWNER'S NO.;

8
2/28/2018
2/28/2018

A	B	C	D	E	F	G	H
ITEM
NO.	DESCRIPTION OFWORK	CONTRACT VALUE	FROM PREVIOUS APPLICATION	THIS PERIOD	TOTAL COMPLETED &STORED
TO DATE	
%	BALANCE TO FINISH	RETAINAGE	
5.	CUT VOLUME (UNADJUSTED)	$	19,581.60	$	19,581.60	$	-
$	-
$	-
$	C
$	-
$	-
$	-
$	-	$	19,581.60	100%	$	-
$	-
.$	-
$	-
$	-
$	-
$	-
$	-	$	1,958.18	
6.	FILL VOLUME (UNADJUSTED)	$	10,475.20	$	10,475.20		$	10,475.20	100%		$	1,047.52	
7.	EXPORT TO VILLAGE I	$	11,042.04	$	11,042.04		$	11,042.04	100%		$	1,104.20	
8.	SODDING	$	23,390.52	$	23,390.52		$	23,390.52	100%		$	2;339.05	
9.	SILT FENCE	$	8,164.-00	$	8,164.00		$	8,164.00	100%		$	816.40	
10.	INLET PROTECTION	$	1,767.96	$	1,767.96		$	1,767.96	100%		$	176.80	
11.	DEWATERING	$	13,478.05	$	13,478.05		$	13,47(!.05	100%		$	1,347.81	
12.	FINAL GRADING	$	13,159.00	$	13,159.00		$	13,159.00	100%		$	1,315.90	
	TOTAL SCHEDULE I - VI.LLAGE K EARTHWORK	$ 117,204.20	$ 117,204.20	$	$	117.204.20	100%	$	-	$ 11,720.42	
	SCHEDULE J - VILLAGE K ROADWAY			$	-
$	-
$	-
$	-
$	-
$	-
$	.
$	-
$	-
$	-			
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-		
1,	1 3/4" SP ASPHALTIC CONCRETE	$	40,203.99	$	40,203.99		$	40,203.99	100%		$	4,020.40	
2.	6" CRUSHED CONCRETE OR UMEROCK	$	47,576.89	$	47,576.89		$	47,576.89	100%		$	4,757.69	
3.	6" STABILIZED SUBGRADE (LBR 40)	$	19,126.17	$	19,126.17		$	19,126.17	100%		$	1,912.62	
4.	MIAMI CURB W/STABILIZATION	$	44,017;05	$	44,017.05		$	44,017.05	100%		$	4;401.71	
5.	TYPE 'P CURB W/STABILIZATION	$	1,383.06	$	1,383.06		$	1,383.06	100%		$	138.31	
6,	VALLEY GUTTER	$	2,479.20	$	2,479.20		$	2,479.20	100%		$	247.92	
7.	5'X4" CONCRETE SIDEWALK	$	12,717.25	$	12,717.25		$	12,717.25	100%		$	1,271.73	
8.	ADA RAMPS (5' WIDE)	$	7,092.96	$	7,092.96		$	7,092.96	100%		$	709.30	
9.
10.	ADA RAMPS (10' WIDE}
SIGNAGE & STRIPING	$	4,179.06
$	6,455.66	$	4,179.06
$	6,455,66		$	4,179.06
$	,6,455.66	100%
100%		$	417.91
$	645.57	
	TOTAL SCHEDULE J -VILLAGE K ROADWAY	$ 185,231.29	$ 185,231.29	$	-	$	185,231.29	100%	$	.	$ 18,523.16	
	SCHEDULE K - VILLAGE K POTABLE WATER SYSTEM			
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-			
$	1,848.04
$	-
$	-
$	-
$	-
$	-
$
$	-
$	.
$	-		
1.
2.	CONNECT TO EXISTING 6" W/M
s PVC, C-900	$	3,696.09
$	15,743.91	$	1,848.05
$	15,743.91		$	1,848.05
$	15,743.91	50%
100%		$	184.81
$	1,574.39	
3.
4.	6" GATE VALVE
e• FIRE HYDRANT ASSEMBLY	$	5,326.38
$	6,663.12	$	5,326.38
$	6,663.12		$	5,326.38
$	6,663.12	100%
100%		$	532.64
$	666.31	
5.	6" TEE FITTING	$	292.55	$	292.55		$	292.55	100%		$	29.26	
6.	SINGLE SERVICE, SHORT SIDE	$	10,024.00	$	10,024.00		$	10,024.00	100%		$	1,002.40	
7.
8,	SINGLE SERVICE, LONG SIDE
TEMPORARY CONSTRUCTION METER	$	5,013.18
$	10,209.52	$	5,013.18
$	10,209.52		$	5,013.18
$	10,209.52	100%
100%		$	501.32
$	1,020.95	
9.	6" BEND FITTING (ALL BENDS)	$	3,067.74	$	3,067.74		$	3,067.74	100%		$	306.77	
10.	CHLORINATION & PRESSURE TESTING	$	4,451.02	$	4A51.02		$	4,451.02	100%		$	445.10	
	TOTAL SCHEDULE K • VILLAGE K POTABLE WATER SYSTEM	$	64,487.51	$	62,639.47	$	-	$	62,639A7	97%	$	1,848.04	$	6,263.95	
	SCHEDULE L - VILLAGE K SANITARY SEWER			
$	.
$	.
$	-
$	-
$	-
$	-
$	-
$	.
$	-
$	-
$	-
$	.			
$	-
$	-
$	-
$	-
$
$	-
$	-
$	-
$	-
$	-
$	-
$	-		
1.	B' PVC, SOR 26 (0'-6' CUT}	$	4,323.20	$	4,323.20		$	4,323.20	100%		$	432.32	
2.	8" PVC, SOR 26 (6'-8' CUT)	$	8,749.20	$	8,749.20		$	8,749.20	100%		$	874.92	
3.	B" PVC, SOR 26 (8'-10' CUT)	$	4,809.72	$	4,809.72		$	4,809.72	100%		$	480.97	
4.	8" PVC, SOR 26 (10'-12' CUT)	$	5,361.84	$	5,361.84		$	5,361.84	100%		$	536.18	
5.	8" PVC, SOR 26 {12'-14' CUT)	$	4,263.10	$	4,263.10		$	4,263.10	100%		$	426.31	
6.	SANITARY MANHOLE (0'-8' CUT)	$	6,338.91	$	8,338,91		$	6,338.91	100%		$	633.89	
7.	SANITARY MANHOLE (6'-8' CUT)	$	7,125.57	$	7,125.57		$	7,125;57	100%		$	712.56	
8.	48" (DIA) SANITARY MANHOLE (12"-14" CUT)	$	3,452.19	$	3,452.19		$	3,452;19	100%		$	345.22	
9.	REMOVE OR REPlACE EXISTING MH (INCLUDE DISPOSAL)	$	27,373.10	$	27,373.10		$	27,373.10	100%		$	2,737.31	
10.	SINGLE SERVICE (HILLSBOROUGH COUNTY)	$	3,876.30	$	3,876.30		$	3,876.30	100%		$	387.63	
11,	DOUBLE SERVICE (HILLSBOROUGH COUNTY)	$	16,887.12	$	16,887.12		$	18,887.12	100%		$	1,688.71	
12.	CONNECT TO EXISTING B'' STUB-OUT	$	4,930.10	$	4,930.10		$	4,930.10	100%		$	493.01	
	TOTAL SCHEDULE L -VILLAGE K SANITARY SEWER	$	97,490.35	$	97,490.35	$	-	$	97,490.35	100%	$	-	$	9,749.03	
	SCHEDULE M - VILLAGE K STORM DRAINAGE			
$	-
$	-
$	-
$	-
$	-
$	.			
$	-
$
$	-
$	-
$	-
$	-		
			I						
1.	15" CLASS Ill RCP	$	4,126.96	$	4,125.96		$	4,126.96	100%		$	412.60	
2.	18" CLASS In RCP	$	17,210.62	$	17,210.62		$	17,210.62	100%		$	1,721.06	
3.	HILLSBOROUGH CO. TYPE 1 CURB INLET	$	28,901.12	$	28,901.12		$	28,901.12	100%		$	2;890.11	
4.	FOOT TYPE C INLET	$	1,359,80	$	1,359,80		$	1,359.80	100%		$	135.98	
5.	18" FOOT FES	$	8,828.36	$	8,828.36		$	8,828.36	100%		$	882.84	
6.	TELEVISE STORM SEWER (CCTV)	$	4,274.25	$	4,274.25		$	4,274.25	100%		$	427.43	
	TOTAL SCHEDULE M - VILLAGE K STORM DRAINAGE	$	64,700.11	$	64,700.11	$	-	$	64,700.11	100%	$	-	$	6,470.02	
	SCHEDULE N - VILLAGE K OFFSITE ROADWAY			$	-
$	-
$	-
$	-
$	-			
$	-
$	-
$	-
$	-
$	-		
1.	REMOVE CURB	$	4,089.55	$	4,089.55		$	4,089,55	100%		$	408.96	
2.	ILLAND RESURFACE	$	28,319.28	$	28,319.28		$	28,319.28	100%		$	2,831.93	
3.	1" FC 9.5	$	2,837.25	$	2,837.25		$	2,837.25	100%		$	283,73	
4.	"SP 12..5	$	3,796.00	$	3,796.00		$	3,796.00	100%		$	379.60	
5.	8" CRUSHED CONCRETE OR LIMEROCK	$	4,754.75	$	4,754.75		$	4,754.75	100%		$	475.48	

h 0038-01 Triple Creek Village K&L-Amenlly - Pay App 8 800000	Page 3of5	2/28/2018 12:22 PM

BILL TO:	TRIPLE CREEK CD.D
PROJECT: TAIPLE CREEK VILLAGES K & L, AMENITY CENTER PROJECT #: 0()38-01

THE KEARNEY COMPANIES, LLC.
9626 WES KEARNEY WAY RIVERVIEW, Fl 33578
(813) 421-6601

S.CHEDULEOF VALUES

APPLICATION NO.: APPLICATION DATE PERIOD TO: GC/OWNER'S NO.:

8
2/28/2018
2/28/2018

A	B	C	D	E	F	G	H
IT
NO.	DESCRIPTION OFWORK	CONTRACT VALUE	FROM PREVIOUS APPLICATION	THIS PERIOD	TOTAL
COMPLETED &STORED
TO DATE	
%	BALANCE
TO FINISH	RETAINAGE	
8.	12: STABILIZED SUBGRAOE (LBR 40}	$	4,437.47	$	4,437.47	$	-
$	-
$	-
$	-	$	4,437.47	100%	$	-
$	-
$
$	-	$	443.75	
7,	SIGNING ANO STRIPING	$	6 ,455.66	$	6,455.66		$	6 ,455.66	100%		$	645.57	
8.	TYPE "F" CURB WISTABILIZATION	$	7,577.70	$	7,577.70		$	7.577.70	100%		$	757.77	
9.	REMOVE ANO REPLACE ADA RAMP	$	8 ,946.80	$	8,946.80		$	8 ,948 .80	100%		$	894.68	
	TOTAL SCHEDUL.E N - VILLAGE K OFFISTE ROADWAY	$	7 1.214.46	$	71,214.46	$	-	$	71,214.46	100%	$	-	$	7 ;12 1.47	
	SCHEDULE O - VILLAGE K UNCLASSIFIED ITEMS			$	-
$	-
$	-					
1.
2.	INFILJEXFIL TESTING
TELEVISE SANITARY SEWER (CCTV}	$	2,653.96
$	4,e3s .·as	s	2,653.96
$	4,935.35		$	2,653.96
$	4,935.35	100%
100%	$	-
$	-	$	265.40
$	493.54	
3.	15" FOOT FES	$	1,934.27	$	1,934.27		$	1,934.27	100%	$	$	193.43	
	TOTAL SCHEDULE O -VILLAGE K UNCLASSIFIED ITEMS								
		"	1;:11, ..,"""'.;J,Q	"	tt	;io. ;)O	,;	"	:,• ..,........ 00	'""'"'		:,u ... ,	
	SCHEDULE P- VILLAGE L GENERAL CONDITIONS			
$	-
$	-
$	-
$	-
$	-
$	.			
$	-
$	-
$	-
$	-
$	-
$	-		
1.	MOBILIZATION	$	19,574.20	$	19,574.20		$	19,574 .20	100%		$	1,957.42	
2.	NPDES PERMIT & COMPLIANCE	$	5,761.15	$	5,761.15		$	5,761 .1 5	100%		$	576.12	
3.	MAINTENANCE OF TRAFFIC	$	5 ,842.50	$	5,842.50		$	5,8 42,50	100%		$	584.25	
4.	CONSTRUCTION STAKEOUT/RECORD SURVEY	$	24,600,00	$	24,600.00		$	24, 600.00	100%		$	2,460.00	
5.	GEOTECHr,.jlCAL & MATERIAL TESTING.	$	6,6 91.20	$	6,691.20		$	6 ,691 .20	100%		$	669.12	
6.	PAYMBilT & PERFORMANCE BOND	$	10,330.79	$	10,330.79		$	10,330.79	100%		$	1,033.08	
	TOTAL SCHEDULE P - VILLAGE L GENERAL CONDITIONS	$	72,799.84	$	72,799.84	$	-	$	72,799.84	100%	$	-	$	7 ,279.99	
	SCHEDULE Q • VILLAGE L EARTHWORK			
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-			
$	.
$	.
$	-
$	-
$	-
$	-		
1 .	CLEARING & GRUBBING	$	3,194.40	$	3,194.40		$	3,194.40	100%		$	319.44	
2.	SAW CUT EXISTING ASPHALT & REMOVAL	$	645.12	$	645.12		$	645.12	100%		$	64.51	
3.	DEMO EXfSTING CURB	$	1,601.65	$	1,601.65		$	1,601.65	100%		$	160.17	
4.	DEMO EXISTING SIDEWALK	$	8,251.00	$	6,251.00		$	6,251.00	100%		$	625.10	
5.	DEMO .EXISTING STORM	$	2,061.80	$	2,061.80		$	2;061.80	100%		$	206.18	
6.	DISC SITE	$	2,424.00	$	2,424.00		$	2,424.00			$	242 .40	
7.	CUTVOLUME {UNADJUSTED)	$	2,411.84	$	2,411.64		$	2,411.64	100%  $	-
100%  $	-
100%  $	-	$	241.16	
8.	FILL VOLUME {UNADJUSTED)	$	7,6 58.40	$	7,658.40		$	7,658.40		$	765.84	
9.	IMPORT FROM ADJACENT STOCKPILE	$	28,005 .90	$	28,005.90		$	28,0 05.90		$	2,800.59	
10.	SODDING	$	18,283.76	$	16,283.76		$	16,283.76	100%	$	-
$	-
$	-
$
$	-	$	1 ,628.38	
11.	SILT FENCE	$	6,172.40	$	6,172.40		$	6,172.40	100%		$	617.24	
12.	INLET PROTECTION	$	1,178.64	$	1,178.64		$	1,178.64	100%		$	117.86	
13.	DEWATERING	$	6,558.70	$	6,558.70		$	6,558.70	100%		$	655,87	
14.	FINAL GRADING	$	6,826.60	$	6,826.60		$	6,826.60	100%		$	682.66	
	TOTAL SCHEDULE Q VILLAGE L EARTHWORK	$	91,274.01	$	91,274.01	$	.	$	91,274.01	100%	$	-	$	9,127.40	
	SCHEDULER VILLAGE L ROADWAY			
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-			$	-
$	-
$	-
$	.
$	-
$	-
$	-
$	.
$	-
$	-
$	-
$	-
$	-		
1.	1 3/4" S-1 ASPHALTIC CONCRETE	$	18,891.60	$	18,891.60		$	18,891.60	100%		$	1,889 . 16	
2.	6" CRUSHED CONCRETE OR LIMEROCK	$	21,400.10	$	21,400.10		$	21,400.10	100%		$	2,140.01	
3.	6" STABILIZED SUBGRADE (LBR 40)	$	8,390.50	$	8,390,50		$	8,3 90.50	100%		$	839.05	
4 .	MIAMI CURB W/STABILIZATION	$	18,976.85	$	18,978.65		$	18.976.65	100%		$	1,897.67	
5.	TYPE 'F' CURB W/STABILIZATION	$	1,6TT..BO	$	1,677.60		$	1,677.60	100%		$	167.76	
6.	5 FT WIDE SIDEWALK	$	13,091.70	$	13,091.70		$	13 ,0 91.70	100%		$	1,30 9.17	
7.	6 FT WIDE SIDEWALK	$	23,722.13	$	23,722.13		$	23,722.13	100%		$	2,372 .21	
8.	ADA RAMPS (5' WIDE}	$	6,301.08	$	6,301.08		$	8,301.08	100%		$	630.11	
9.	ADA RAMPS (6' WIDE}	$	8,598,24	$	8,598.24		$	8,598.24	100%		$	859.82	
10.	1" MILL AND OVERLAY	$	18, 174.00	$	18,174.00		$	18,174.00	100%		$	1,817.40	
11.	30" HIGH DRY STACK BLOCK WALL (W/COLUMNS & STEPS}	$	56 ,842. 50	$	56.842.50		$	58,842.50	100%		$	5,684.25	
12.	SIGNAGE & STRIPING	$	861.00	$	861.00		$	86f.00	100%		$	86,10	
13.	16 SPACE PARKING LOT (COMPLETE CONSTRUCTION)	$	41,572.86	$	41,572.86		$	41,572.86	100%		$	4,157.29	
	TOTAL SCHEDULER VILLAGE L ROADWAY	$ 238,499.96	$	238,499.96	$	-	$	238,499.96	100%	$	-	$ 23,850.00	
	.SCHEDULES VILLAGE L POTABLE WATER SYSTEM			

$
$	.
$	-
$	-
$	-
$	-
$	-
$.	-
$	-
$	-			

$	1,232.03
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-
$	-		
1.	CONNECT TO EXISTING 6' W/M	$	2,464.06	$	1,232 .03		$	1,232.03	50%		$	123.20	
2.	6"'PVC,C-900	$	6 ,585 .72	$	8 ,585.72		$	8,585.72	100%		$	856 .57	
3.	6" GATE VALVE	$	2,663.19	$	2,663:19		$	2,663.19	100%		$	268.32	
4.	6" FIRE HYDRANT ASSEMBLY	$	3,331.56	$	3,331.56		$	3,331.56	100%		$	333.16	
5,	6" TEE FITTING	$	292,55	$	292.55		$	292.55	100%		$	29.26	
6.	6" BEND FITTINGS (ALL BENDS)	$	2,510.70	$	2,510.70		$	2,510.70	100%		$	251.07	
1 .	SINGLE SERVICE, SHORT SIDE	$	4,835.60	$	4,835.60		$	4,835.60	100%		$	483,56	
8.	SINGLE SERVICE, LONG SIDE	$	3,899.14	$	3,899.14		$	3,899.14	100%		$	3 89,91	
9.
1Q.	TEMPORARY CONSTRUCTION BACKFLOW
CHLORINATION & PRESSURE TESTING	$	10,209.52
$	3,974.12	$	10,209.52
s	3,974.12		$	10 ,209.52
$	3,974.12	100%
100%		$	1,020.95
$	397.41	
	TOTAL SCHEDULES - VILLAGE L POTABLE WATER SYSTEM	$	42,766.16	$	41,534.13	$	-	$	41,534.13	97%	$	1,23:;!, 0 3	$	4,153.41	
h 0038-01 Triple Creek Village K&L-Amenily- Pay App 8 800000	Pl(l(Je4ot5	2128/2018 1 2:22PM

BILL TO:

_TRIPLECREEK COD

THE KEARNEY COMPANIES, LLC, 9626 WES KEARNEY WAY RIVERViEW, FL 33578

APPLICATION NO.:	8

PROJECT: TRIPLE CREEK VILLAGES K & L, AMENITY CENTER PROJECT #: 0038-01
A	B	C

(813)421-6601

SCHEDULE OF VALUES
D

APPUCAllON DATE PERIOD TO: GC/OWNER'S NO.:
E	F	G	H

2/28/2018
2/2812018

ITEM
NO.	DESCRIPTION OF WORK	CONTRACT
VALUE	FROM
PREVIOUS APPLICATION	THIS
PERIOD	TOTAL
COMPLETED & STOR.ED
TO.DATE	
%	BALANCE
TO FINISH	RETAINAGE	
									
	SCHEDULE T • VILLAGE L SANITARY SEWER			
$	.
$	-
$	.
$	.
$	-
$	.
$	.
$	-
$	-			
$	.
$	. .
$	-
$	-
$	-
$	-
$	-
$	.
$	-		
1.	8" PVC, SDR 26 (0'-10'.CUT)	$	7,876.48	$	7,878.48		$	7,876.48	100%		$	787.65	
2.
3.	8' PVC, SDR 26 (10'-14' CUT)
SANITARY MANHOLE (0'-10' CUT)	$	5,472.18
$	7,208.82	$	5,472.18
$	7,208.82		$	5,472.18
$	7,208.82	100%
100%		$$	547.22
720.88	
4.	48" (DIA) SANITARY MANHOLE (10'-14" CUT)	$	3,532 .46	$	3,532.48		$	3,532.46	100%		$	353.25	
5.	SINGLE SERVICE (HILLSBOROUGH COUNTY)	$	1,5 50.52	$	1,550.52		$	1,550.52	100%		$	155.05	
8.	DOUBLE SERVICE (HILLSBOROUGH COUNTY)	$	11,258.08	$	11,258.08		$	11,258.08	100%		$	1,125.81	
7.	.8" CONNECT EXISTING STUB-OUT	$	3,559 .94	$	3,559.94		$	3,559.94	100%		$	355.99	
8.	INFIL/EXFIL TESTING	$	982.77	$	982.77		$	982.77	100%		$	98 .28	
9.	TELEVISE SANITARY SEWER (CClV)	$	4,913 .85	$	4,913.85		$	4,913,85	100%		$	491.39	
	TOTAL SCHEDULE T• VILLAGE L SANITARY SEWER	$	46 ,355,10	$	46,355.10	$	.	$	46,355.10	100%	$	-	$	4,835.52	
	SCHEDULE U • VILLAGE L STORM DRAINAGE			
$	.
$	-
$	-
$	.
$	.
$	-			
$	-
$	.
$	.
$	-
$	-
.$	.		
1.	15" CLASS Ill RCP	$	3,208.18	$	3,206.16		$	3,206.16	100%		$	320.62	
2.	18' CLASS Ill RCP	$	5,310.34	$	5,310.34		$	5,310.34	100%		$	531.03	
3.	FOOT DITCH BOTTOM TYPE E INLET	$	2,638 .49	$	2,838.49		$	2,636.49	100%		$	283,65	
4 .	FOOT MANHOLE	$	3,842.04	$	3,842.04		$	3,842.04	100%		$	384;20	
5.	FOOT MANHOLE W/ BOTTOM	$	3,448.02	$	3,448.02		$	3,448 .02	100%		$	3 44.80	
6.	1.5"FOOTFES	$	1,934.27	$	1,934.27		$	1,934.27	100%		$	193.43	
	TOTAL SCHEDULE U • VILLAGE L STORM DRAINAGE	$ · 20,377.32	$	20,377.32	$	-	$	20,377.32	100%	$	-	$	2,037.73	
	SCHEDULE V • VILLAGE L UNCLASSIFIED ITEMS			
$	.
$	-
$	.			
$	-
$	.
$	-		
1 .	TELEVISE STORM SEWER (CClV)	$	1,771.20	$	1,771.20		$	1,771.20	100%		$	17712	
2 .	CONNECT EXISTING RCP	$	1,587.45	$	1,587.45		$	1,587.45	100%		$	158.75	
3.	CONNECT EXISTING INLET	$	2,456 .38	$	2,456.36		$	2,456.38	100%		$	245.64	
	TOTAL SCHEDULE V • VILLAGE L UNCLASSIFIED ITEMS	$	5,815 .03	$	5,815.03	$	-	$	5,815.03	100%	$	.	$	581,51	
	CONTRACT SUMMARY			

$	2,431.72
$	3,437:38
$   77,169.74
$	.
$	5,288.86
$	4,996.88
$	-
$	.
$	-
$	-
$	.
$	.
$	-
$	-
$	.
$	-
$	-
$	-
$	-
$	.
$	.
$	.			
$	2,057.17
$	19,221.15
$	34,312.41
$	20,720.64
$	9,527.19
$	.
$	15,498.00
$	.
$	-
$	.
$	1,848.04
$	-
$	.
$	-
$	-
$
$
$	.
$	1,232.03
$
$	.
$	.		
1.	SCHEDULE A· AMENITY GENERAL CONDITIONS	$ 108,490.19	$	104,001.30		$	108,433.02	98%		$ 10,643.31	
2.	SCHEDULE B - AMENITY EARTHWORK	$ 259,586 .47	$	236,927.94		$	240,365.32	93%		$ 24,036.55	
3 .	SCHEDULE C -AMENITY ROADWAY	$ 329,621.07	$	218,338.92		$	295,508.66	90%		$ 29,550.86	
4.	SCHEDULED· AMENITY POTABLE WATER SYSTEM	$	71,165.58	$	50,444.94		$	50,444 .94	71%		$	5,044.50	
5.	SCHEDULE E- AMENITY SANITARY SEWER	$ 123,089.34	$	108,273.49		$	113,562.15	92%		$ 11,356.23	
6.	SCHEDULE F • AMENITY STORM DRAINAGE	$ 143,667 .10	$ 138,670.22		$	143,667.10	100%		$ 14,388.71	
7.	SCHEDULE G• AMENITY UNCLASSIFIED ITEMS	$	49,828.74	$	34,328.74		$	34,328 .74	69%		$	3,432.89	
8.	SCHEDULE H- VILLAGE K GENERAL CONDITIONS	$ 101,929 .74	$	101,929.74		$	101,929.74	100%		$ 10,192.98	
9.	SCHEDULE I• VILLAGE K EARTHWORK	$ 117,204.20	$	117,204.20		$	117 ,204.20	100%		$ 11,720.42	
10 .	SCHEDULE J. VILLAGE K ROADWAY	$ 185,231.29	$	185,231.29		$	185,231.29	100%		$ 18,523.16	
11.	SCHEDULE K-VILLAGE K POTABLE WATER SYSTEM	$	64,487.51	$	62,639.47		$	62,639.47	97%		$	6,263.95	
12.	SCHEDULE L - VILLAGE K SANITARY SEWER	$	97,490.35	$	97,490.35		$	97,490.35	100%		$	9,749.03	
13.	SCHEDULE M• VILLAGE K STORM DRAINAGE	$	64,700.11	$	64,700.11		$	64,700.11	100%		$	6,470.02	
14	SCHEDULE N• VILLAGE: K Oi=FSITE ROADWAY	$	71,214.46	$	71,214.46		$	71,214.46	100%		$	7,121.47	
15 ,	SCHEDULE O• VILLAGE K UNCLASSIFIED ITEMS	$	9,523.58	$	9,523.58		$	9,523.58	100%		$	952.37	
18.	SCHEDULE P. VILLAGE L GENERAL CONDITIONS	$	72,799.84	$	72,799.84		$	72,799.94	100%		$	7,279,99	
17.	SCHEDULE Q • VILLAGE L EARTHWORK	$	91,274.01	$	91,274.01		$	91,274.01	100%		$	9,127.40	
18.	SCHEDULER - VILLAGEL ROADWAY	$ 238,499.96	$	238,499.96		$	238,499.96	100%		$ 23,850.00	
19.	SCHEDULES-VILLAGE L POTABLE WATER SYSTEM	$	42,788.16	$	41,534.13		$	41,534;13	97%		$	4,153.41	
20.	SCHEDULET • VILLAGE L SANITARY SEWER	$	46 ,355 .10	$	46,355.10		$	46,355.10	100%		$	4,635.52	
21.	SCHEDULE U • VILLAGE L • STORM	$	20,377.32	$	20,377.32		$	20,377.32	100%		$	2,037.73	
22.	SCHEDULE V - VILLAGE L UNCLASSIFIED ITEMS	$	5,1;!15 . 0 3	$	5,815.03		$	5,615.03	100%		$	581.51	
	TOTAL ALL SCHEDULES	$ 2,315,315.15	$ 2,117,574.14	$ 93,324.38	$ 2,210,898,52	95%	$	104,416.83	$ 221,090.01	
	TOTAL CHANGE ORDERS	$ (341,841.81)	$ (341,641.61)	$	.	$ (341,641.81)	
0%	$	-	$ (34,164.19)	
	ADJUSTED CONTRACT TOTAL	$  1,973,673.34	$ 1,776,932.33	$ 93,324.38	$ 1,869,256.71	95%	$ 104,416.63	$ 134,748.96	
	CHANGE ORDERS						$	.
$	.
$	.
$	.
$	-
$	-
$	.		
_C0#1	CDD DIRECT PURCHASE MATERIALS	$	(80,723.70)	$	(80,723.70) $	-
$	(50,384.24)  $	.
$     (150,828.12)   $	-
$	(48,510.35}  $	-
$	(11,040.35) $	.
$	(155.05)  $	.	$	(80,723.70)	100%		$ (8,072.37)	
C0#2	CDD DIRECT PURCHASE MATERIALS	$	(50 ,384 .24)		$	(50;384.24)	100%		$	(5,038.42)	
C0#3	CDD DIRECT PURCHASE MATERIALS	$ (150,828.12)		$	(150,828.12)	100%		$ (15,082.81)	
C0#4	COD DIRECT PURCHASE MATERIALS	$	(48,510 .35)		$	(48,510.35)	100%		$	(4,851.04)	
C0#5	COD DIRECT PURCHASE MATERIALS	$	(11,040.35)		$	(11,040.35)	100%		$	(1,104.04)	
C0#6	COD DIRECT PURCHASE MATERIALS	$	(155.05)		$	(155.05)
$	.	100%
0%		$	(15.51)
$	-	
			$	.	$	-					
	TOTAL CHANGE ORDERS	$ (341,841.81)	$ {341,641.81)	$	-	$ (341,841.81)	0%	$	.	$ (34,164.19)	

h ·0039-01 triple Creek Village K&L-Amenity • Pay App 8 800000	Page 5 of 5	2128/2018 1 2:22PM

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017A, VILLAGE Gl

The undersigned, a Responsible Officer of Triple Creek Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture dated as of June 1, 2012 from the District to The Bank of New York Mellon Trust, N.A., as trustee (the "Trustee"), as supplemented by the Second Supplemental Trust Indenture dated as of February 1, 2017 (the "Indenture"), (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):

March 16, 2018

Requisition Number: CR262-Gl

Name of Payee: Newberg Irrigation, Inc.
3336 36th Avenue North
St. Petersburg, FL 33713

Amount Payable: $21,663.80

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): Pay  Application  #4  for Project #Triple Creek Irrigation - Village Gl

Fund or Account from which disbursement to be made: 2017A Acquisition and Construction Account, Subaccount Village Gl

The undersigned hereby certifies that:
obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs of Issuance payable from the Acquisition and Construction Fund  that  have  not  previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services rendered  with  respect to  which disbursement is hereby requested.
TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT
By	Si?
Board of Supervisors

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

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

Consulting Engineer

License:

Newberg Irrigation, Inc.
3336 36th Avenue North St. Petersburg FL 33713 727-521-6620

Progress Billing
Application: 4 Period: 02/19/2018

Owner: Triple Creek COD
12750 Citrus Park Lane Suite 115
Tampa FL 33625

Job Location: Triple Creek Irrigation

Application For Payment On Contract
Original Contract......................................	291,081.00
Net Change by Change Orders................	41,958.00
Contract Sum to Date...............................	333,039.00
Total Complete to Date............................	153,988.80

Contractor's Certification of Work

The undersigned contractor certifies that, to the best of the contractor's knowledge, the work on the above named job has been completed in accordance with the plans and specifications to the level of completion indicated on the attached schedule of completion.

Contractor: 		Date:	 -23- /8

Total Retained..........................................
Total Earned Less Retained....................

0.00
153,988.80

Less Previous Billings..............................	132,325.00

Current Payment Due............................. I	21,663.80I
Balance on Contract.................................	179,050.20

Terms: Invoices are due and payable 1DY from the date of invoice. All overdue amounts will be charged a service charge of
% per annum. Please make checks payable to: Newberg Irrigation, Inc.
Thank you for your prompt payment.

PROGRESS BILLING	Application: 4
Period: 02/19/2018

Schedule of Work Completed

Description of Work	Scheduled	Changes	Contract	Previous	Current Comp.	Stored Mat.	Total Comp.	%	Balance	Retained	
Locate and Excavate	14,558.00		14,558.00	11,646.40	1,455.80		13,102.20	90.00	1,455.80		
Mainline, Conduit &	51,573.00		51,573.00	15,471.90	5,157.30		20,629.20	40.00	30,943.80		
Control System	49,725.00		49,725.00	14,917.50	4,972.50		19,890.00	40.00	29,835.00		
Spray Sprinkler Hea	17,534.00		17,534.00	5,260.20	1,753.40		7,013.60	40.00	10,520.40		
Lateral Pipe and Fitti	76,856.00		76,856.00	23,056.80	7,685.60		30,742.40	40.00	46,113.60		
Rotary Sprinkler Hea	12,784.00		12,784.00	639.20	639.20		1,278.40	10.00	11,505.60		
Drip Irrigation	45,218.00		45,218.00						45,218.00		
Well/Pump/Controls	19,375.00		19,375.00	19,375.00			19,375.00	100.00			
As Builts	3,458.00		3,458.00						3,458.00		
Well Pump#2		18,986.00	18,986.00	18,986.00			18,986.00	100.00			
Electric #1 and #2		22,972.00	22,972.00	22,972.00			22,972.00	100.00			
Totals:	291,081.00	41,958.00	333,039.00	132,325.00	21,663.80		153,988.80	46.24	179,050.20		

Page  2 of2

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017B

The undersigned, a Responsible Officer of Triple Creek Community Development District (the "District") hereby  submits  the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture  dated  as of  June  I,  2012  from  the  District to The Bank of New York Mellon Trust, N.A., as trustee (the "Trustee"), as  supplemented  by  the  Second  Supplemental  Trust Indenture dated as of February I, 2017 (the "Indenture"),  (all capitalized  terms  used  herein  shall  have the meaning ascribed  to such term  in the Indenture):

March 16, 2018

Requisition Number: CR263-B

(8)	Name of Payee: RIPA & Associates, LLC
1409 Tech Blvd., Ste 1
Tampa, FL 33619

Amount Payable: $200,491.25

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): Pay Application #12RET for Project #0l-1707A- Village El, Village Fl and Village F2

Fund or Account from which disbursement to be made: 2017B Acquisition and Construction Account

The undersigned hereby certifies that:
obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs of Issuance payable from the Acquisition  and  Construction  Fund  that  have  not  previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services rendered with respect to which disbursement is hereby requested.

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

By:

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

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

Cons iiiting Engineer

 	-C'	

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017A, VILLAGE E

The undersigned, a Responsible Officer of Triple Creek Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture dated  as of June  l,  2012  from  the District to The Bank of New York Mellon Trust, N.A., as trustee (the "Trustee"), as supplemented by the  Second  Supplemental  Trust Indenture dated as of February l, 2017 (the "Indenture"), (all capitalized  terms  used  herein shall  have the meaning ascribed  to such term  in the Indenture):

March 16, 2018

Requisition Number: CR264-E

Name of Payee: RIPA & Associates, LLC
1409 Tech Blvd., Ste 1
Tampa, FL 33619

Amount Payable: $800.50

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 oflssuance, if applicable): Pay Application #12RET for Project #0l-1707A- Village E

Fund or Account from which disbursement to be made: 2017A Acquisition and Construction Account, Subaccount Village E

The undersigned hereby certifies that:
l.	obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs of Issuance payable from the Acquisition and Construction  Fund  that  have not  previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services rendered  with respect to  which disbursement is hereby requested.

 	25

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

?	.

By  Chainn	-1".y
Board of Supervisors

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

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

ng Engineer

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017A, VILLAGE Fl

The undersigned, a Responsible Officer of Triple Creek Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture dated  as of June  I,  2012  from  the District to The Bank of New York Mellon Trust, N.A., as trustee (the "Trustee"), as supplemented by the  Second  Supplemental  Trust Indenture dated as of February I, 2017 (the "Indenture"),  (all capitalized  terms used herein shall have the meaning ascribed  to such term  in  the Indenture):

March 16, 2018

Requisition Number: CR265-Fl

Name of Payee: RIPA & Associates, LLC
1409 Tech Blvd., Ste 1
Tampa, FL 33619

Amount Payable: $29,239.91

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): Pay Application #12RET for Project #0l-1707A- Village Fl

Fund or Account from which disbursement to be made: 2017A Acquisition and Construction Account, Subaccount Village Fl

The undersigned hereby certifies that:
l.	obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs of Issuance payable from the Acquisition and Construction Fund  that  have  not  previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services rendered with  respect to  which disbursement is hereby requested.
TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT
ByCMirm 	.y	zj
Board of Supervisors

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

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

:::c:C
ulting Engineer

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017A, VILLAGE Gl

The undersi gn ed, a Responsible Officer of Triple Creek Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture  dated  as of  June  1,  2012  from  the District to The Bank of New York Mellon Trust, N.A., as trustee (the "Trustee") , as supplemented  by  the  Second  Supplemental  Trust Indenture dated as of February I,  2017 (the "Indenture "), (all capitalized  terms  used  herein shall have the meaning ascribed  to such term  in  the Indentur e):

March 16, 2018

Requisition Number: CR266-Gl

Name of Payee: RIPA & Associates, LLC
1409 Tech Blvd., Ste I
Tampa, FL 33619

Amount Payable: $61,347.73

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 oflssuance, if applicable): Pay Application #12RET for Project #0l-1707A- Village GI

Fund or Account from which disbursement to be made: 2017A Acquisition and Construction Account, Subaccount Village GI

The undersigned hereby certifies that:
obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs of Issuance payable from the Acquisition and Construction Fund that have not previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the  services  rendered  with  respect to  which disbursement is hereby requested.

::-,::..	.J <?<r .,Xf

/ : '\

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

By:

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

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

 	
nsulting Engineer

==-	-

APPLICATION AND CERTIFICATION FOR PAYMENT	AJA DOCUMENT G702

TOOWNER:	PROJECT:	APPLICATION  NO:	12RET	Distribution to:
Triple Creek COD	Triple Creek CDl)..VHJage E, F and GI	t::)OWNER

CJ

c=)ENGJNEER
PERIOD TO:	12/31/17	CONTRACTOR
FROM CONTRACTOR:	VJA ENGINEER:	CJ
RlPA & Associates, LLC	Genesis Group	CJ
1409 Tech Blvd., Ste. 1	1000 N Ashley Dr Ste 900	PROJECT NOS:	0U707A
Tampa, FL 33619	Tampa, FL 33602
CONTRACT FOR:	.CONTRACT DATE:	RAl71289

CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below. in connection with the ContracL Continuation Sboet, AlA Document 0 703, is atmched.

The undersigned Contractor certlfil!!l lhat to the best of the ContraclDr's knowledge, infonnation and belief the Work covered by1his Application for Payment bas.been completed in accordaoc wi1h lhe Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received rmm the Owner, .and that cumnt payment shown herein is now due.

ORIOINAL CONTRACT SUM
2. NET CHANGES BY CHANOE ORDERS
CONTRACT SUM TO DATE {Line I ± 2)
4. TOTAL COMPLETED & STORED TO
DATE	(Column G on 0703)
RETAINAGE :

$ 	7,737,870.25 
$ 	(2,005,343.21)
s 	5,732,527.04 
$ 	5.7.!2,527.04 

LANDOWNER

CONTRACTOR:	RfPA & Associates, LLC

(Column

-0%	of Completed Work	$

0.00

RETAINAGE

-'- iii2_ S .-.k:. 

Date:.1Jz.lia

 fl(),"'M!li0!111,_,.., l,OI!	

D +Eon 0703)	-----
OO    $ 9,240.00
b.	 0.
(Column Fon 0703)
Tolal Retainage (Lfnes Sa+ Sb or

Total in Column I ofG703)
TOTAL EARNED LESS RETAINAGE
,Line 4 Less Line5 To.. l)
LESS PREVJOUS CERTIRCATES FOR PAYMENT(Linc6 from prior Certificate)
CURRENT PAYMENT DUE THIS APPLICATION
BALANCE TO FlNISH, INCLUDINO RETAlNAOE
PREVIOUS  APPLICATIONS UNPAJD
TOTAL AMOUNT UNPAID TO DATE

s 	0.00
s	5,732,527.04

s 	5.431,407Ji5 
s 	301,119.39 
$ 	0.00 
s 	533,006.09 

U MM AR

Total changes approved
in previous months by Owner

$160,982.94

52.166.326.15

(Atlach explanation if amounpt trtifie#J iffers from the ammmt applied. Initial all figures on this App/lC"ation and onthe Conptrua,iuft?heet th9t are changed to confonn with the pmount cmijied.) ENGINEER:
By:	,	(	Da_te:  _	       _    _    _    _    _    _
egotiable. The AMOUNT CERTIFIED fs payable only to the
Contractor nam	erein. Issuance, payment and acceptance of payment are without

prejudice to an{ rights of the OWnet or Contractor under this Contract.

(S:?.005,343.21)

NET CHANGES by Change Order

$2,166,326.15

$160,982.94

TOTALS

.$0.00

S0.00

Total ap_l)_roved this Month

.$	834,125.48

In accordance with the Contni.ct Documents, based on on-site observations and the data comprising the application. the Engi11eer certifies to the Owner that to the bestof the Engineer's knowledge. infonnation 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 . .. . . . . . _ .•  $	$291,879.40 [CDD]
$9,240.00 [LANDOWNER]

/  7	.,/	/ 

AIA DOCUMeNTG702 • APPLICATION AND CeRTIFICATION FOR PAVMOO • 19112 EOITION • ...,,.  · <!:111192	THE f,MERICANiNSTITOTEOF ARCHITECTS, 1735 NEW YORK AVE., N.W•• WASHINGTON, DC10006-,5292
Users may obtain vaOdatlon of this document by requesting a completed AIA Document D401 - Certification of Documenrs Authenticity from the Licensee•.
E1  (General) - $109,403.06	F2 - $42,886.04	LAND OWNER
F1 - $77,442.06		G1 - $61,347.73	$9,240.00 E2/E3 - $ 800.50

JTEM NO.	

DES CRIPTIONOFWORK	

OTY	CONTRACTSUMTO DATE		
				
BASE.CONTRACT	
ESTIMATEOQUANTITY	TOTAl
WORK IN
Pl.ACE	TOTAL WORK IN
PlACE	TOTAL
WORK IN
PLACE	PERCENT COM?t. ETE	
BALANCE TO FINISH	R E·T"AI'NAGE
o	
			UNIT	UNIT
PRICE	VALUE	THIS
E STiMATE	PREV
E STIMATE	TOTAL
ESTIMATE	THIS
PER roo	PREV
APPLICA TION	TO
DATE	TO
DATE	10
DATE	r
DATE.	
	SCHEDULE														
	PHASE E1														
	GENERAL CONDITIONS E1														
1	MOblllzatio,i	1.00	LS	$9,600.00	59 .600 .00	0.00	1. 00	1. 00	$0.00	$9.600 .00	59.600.00	100%	S0.00	S0.00	
2	NPOESCornpliance	1 ,00	LS	5,8 150 ,00	$8 .150 ,00	0 ,00	, 1 00	1 00	S0.00	S8 ,15,0 00	$8 .150 ,00	100%	S0.00	S0.00	
3	Maintenance of Traffic:	1 .00	LS	S3 ,750 .00	S-3.750 .00	000	1.00	1.00	$0.00	$3, 750 .00	53.750 .00	100%	S0.00	S0.00	
4	Const Stakoou1/ Record Survey • By ConttaciOf	1.00	LS	$44,50000	544,500,00	0.00	1,00	1 00	so.oo	544 ,500 ,00	$4,4 500 .00	100%	S0,00	S0.00	
5	Paymenl& Performance Bond• ByContractor	1 .00	LS	S23 ,000 .00	523.000 .00	0 .00	1.00	,1 00	S0.00	523.000.00	523.000.00	100%	S0.00	sooo	
	TOTALGENERAL CONDITIONS E1				$89.00,0 00				$0.00	$89,000.00	$89.000.00	100%	$0.00	S0.00	
															
	EARTHWORK E1														
1	Clearing & Grubbing	3.00	AC	11,000 .00	563 ,000 .00	000	3.00	3.00	$0.00	5 6, 3 000 .00	$63,000 .00	100'4	so.oo	S0.00	
2	SawCutEidstlng Asphall & Removal	276.00	SY	58.65	52.367.40	0.00	27, 600	276.00	S0.00	S2.3!17.40	5,2 367 .40	100%	S,0 00	S0.00	
3	DemoE,'<islSidewalK (crushlor reuseas on-SrteRip Ra p)	850.00	LF	Sl .15	s 2.sn ,50	0,00	850,00	850.00	S0.00	S2.6n.50	$, 2Sn. 50	100%	S0.00	S0.00	
4	DiscSite	4.00	AC	5355 .00	Sl ,420.00	0.00	4.00	4.00	S0.00	Sl ,420.00	$1,420.00	100%	S0,00	S0.00	
5	CUIVolume	400.00	CY	S2.45	$980.00	,0 00	40, 000	400.00	S0.00	$98,0 00	$980.00	100%	so.oo	S0 .00	
6	Flit Votume	20 ,700 .00	CY	$4.85
=	$100,395.00	0.00	20700,00	20700.00	S0.00	$100,395,00	S100,395.00	100%	S0,00	S0.00	
7	SOdd,ng	7,600.00	SY		516.72000	0 00	760000	760000	S0.00	s16 .no .oo	$16,720.00	100%	so.oo	so.oo	
B	Se<,l<l ng & Mllicning	12,615.00	SY	S0.25	$3.153.75	o.oo	12615 .00	12615 . 00	S0.00	$3.153.75	$3,15375	100%	so.co	S0 .00	
s	sm Fence	8 ,100 .00	Lf	$1.20	$9,720,00	0.00	8100,00	8100.00	S0.00	$9,720.00	S, 97Z0.00	100%	sooo	S0.00	
10	Inelt Pro1ectlon	11.00	EA	598.20	Sl.08020	0.00	11,00	11.00	S0.00	1 .080 .20	51,080 .20	100%	S0.00	S0.00	
11	Dewaleting (Fo, AllAspects orP,o)Ocl I	1 00	LS	$9,200.00	$9,200.00	o.oo	1 ,00	,1 00	so.oo	$9 .200 .00	S9 ,200 . 00	1 00%	S0 .00	$0 .00	
1 2	Fl na l Gradiog	1.00	LS	S21,50000	s21.soo.oo	0,00	1,00	100	S0,00	$21,500.00	$21,50000	100%	S0.00	S0.00	
	TOTAL EARTHWORK E1				$232,233 .85				SO.OD	$232.233 ,85	5232,233 , BS	100%	$,0 00	$0.00	
															
	BASE AND PAVING E1														
1	1 .31 · S-1 Asphamc Concrete	7,743.00	SY	59.25	$71,622.75	0,00	7743 00	7743.0Q	S0.00	571,622.75	S71,622.75	100%	S0.00	so 00	
2	6""Cn.JShed Concrete	7,743 .00	SY	$10 ,30	S79 ,752 .90	000	7743 ,00	77 43.00	S0 .00	579 . 752 .90	579.752 90	100%	S0,00	50.00	
3	6"Stabilized Sut,grade(LBR40)	7.743,00	SY	$6.85	S53,039.55	0,00	7743.00	7743.00	S0.00	553,039.55	553.039.55	100%	SO.OD	so 00	
4	Miami Curt>.,1s1 atJ111<lao1n	5 ,500 .00	LF	S11.05	S60,775.00	0,00	5500.00	5500.00	50.00	$60.775.00	S60.775.00	100%	S0.00	sooo	
5	TyPe'F' Cum w/Stabmzation	77000	LF	$1,2 50	59.625.00	000	770.00	770.00	S0.00	$9,625.00	$9,62500	100%	S0.00	50.00	
6	ValleyG\111"1	84 .00	LF	S2L45	5 1.80180	0.00	84.00	84.00	S0.00	S1,80180	$1,801.80	100%	so .co	S0.00	
1	5'x4·concrete S	lk	,2 250.00	LF	$19.50	$43.875.00	0,00	2250.00	2250.00	S0,00	$43,875.00	543.875.00	100%	S0.00	5000	
8	s·xs ConcreteSldewalk	50 00	LF	$2565	$1,282.50	000	50.00	50.00	S0.00	S1.282.50	Sl ,28250	100%	so.oo	50.00	
9	1O'x•4 Concrete Sidewalk	96,00	LF	S39.05	$,3 748.80	0.00	!16.00	96.00	S0.00	S-3.748 ,80	53.7 4, 8 80	100 %	S0.00	S0.00	
10	10'>16..   ConcreteStdewalk	2 ,100 ,00	LF	$51.30	S107,730 00	0.00	2100.00	2100.00	S0.00	S107,730.00	S107.730.00	100%	S0.00	so 00	
11	ADA Ramps(S'wide)	19,00	EA	S8'10.00	S15.960.00	000	19.00	19 .00	$0.00	515,960.00	S15,960.00	100%	$0,00	S0.00	
12	ADA Ramps (10'wide)	5.00	EA	s1 ,200.00	$6,000.00	0.00	5.00	5,00	S0,00	56.000.00	$6,000,00	100"A,	so.co	S0 .00	
13	FOOT852 Aluminum Hand Rall(P OWde, Coated Bl )	665.00	LF	S7360	$48.944 00	0,00	665.00	665,00	S0.00	S48.94400	548,944 00	100%	so.oo	sooa	
14	FOOT Concre te Wall (looude Struc11Jfal)	550 .00	l.F	$310 . 00	S1 70 ,500 . 00	000	550 . 00	5 50.00	S0 . 00	5170.500 .00	5170 ,500 _00	100%	SO.OD	S0 .00	
15	Pedeslrian Bridge (Made by Yori< Bridge or Eq-ml)	1,00	LS	S240,000.00	S240.000.00	0.00	1.00	1.00	S0.00	$240,000.00	$240,000.00	100%	S0.00	so 00	

TrfpteCreekCOD•Villtgt E, F andG1	APPLICATION FOR PAYMENT RIPA l ASSOC1ATES PROJE0f • ,01 1707A

PAVAF P FROM TO

12RET
1211117
12/31117

Trlplec, ..  kCOD-Villl!I'E,f  10dGI	APPLICATION FOR PAYMENT

RIPA& ASSOCIAlESPROJECT#01-11071<

PAYA.PP FROM TO

12RET
12/1117
12/31117

ITEM NO.	

DESCRIPTtON OF WORK	

OTV	CONTRA.Cl SUM TOOATE		
				
BASE CONTRACT	
ESTIMATEDQUANTITY	TOTAL
WORKIN
PLACE	TOTAL
WORK IN PLACE	lOTAL
WORK IN
PLACE	
PERCENT COMPLETE	
BALANCE TO FINISH	o,;
REJAINAGE	
			
UNIT	UNIT
PRICE	
VALUE	Tt,IS
ESTIMATE	PREV
ESTIMATE	TOTAL.
EST!MA,if	THIS
PERIOD	•REV
APPLICATION	,o
OAlE	TO
DATE	TO
OATE	TO
DATE	
16	SlopsSigns	2.00	EA	5335.00	$670.00	0,00	2.00	2.00	SO.DD	$67000	S670.00	100%	S0.00	SO.DD	
17	Speed Umil Sign	1.QO	EA	S370.00	S370.00	0.00	1.00	1.00	$0.00	$370.00	$370.00	100'.<,	S000	S0,00	
18	RoaoEll<IS,gns	24.00	EA	$245.00	55.88,0 00	0.00	2,4 00	2,4 00	S0,00	$5 880.00	S5,880.00	100%	S0.00	SOOD	
19	Slreet Signs	2 00	EA	5400.00	$800.00	0.00	2.00	2.00	SD.00	$800 .00	$80,0 00	100%	SO.OD	$000	
	TOTAL BASE ANO PAVING E1				$922,377.30				$0.00	$922,377.30	$922,377,30	100¾	$0.00	SMO	
															
	POTABLE WATER DISTRIB UTIONE1														
1	Connect to ExlsUng 12" WIM	I 00	LS	$2,80000	S,2 800.00	0,00	1 00	100	SOOD	S,2 800 00	$2 ,800 ,00	100%	so.oo	S0,00	
2	'Z' Polye1hyleoe Serv,ce(LiftSialionI	45.00	LF	$110,00	54,950.00	0.00	45.00	45.00	SO.DD	54 ,950.00	S4,950 00	100%	S0.00	S0,00	
3	6" PVC, C-900	160.00	LF	512.85	52,056.00	0 00	160,00	16,0 00	S0.00	52,056.00	$2,05600	100%	S0.00	$0 ,00	
4	8" PVC PipeC-900	1,22,0 00	LF	$14,60	$17,812.00	0 00	122000	122000	S000	S17.812.0	0	$17,81100	100%	SO.OD	S0 ,00	
5	1'Z' PVC Pipe C-900	1,900.00	LF	S31,80	S60.420.00	0.00	1900.00	1900.00	Sil.DO	$60,420.00	$60,420 00	100%	SO.OD	S0 ,00	
6	2"GatoValvo	1 ,00	EA	$490 ,00	$490 .00	0 00	1.00	1.00	S0.00	$490 .00	5490 .00	100%	S0.00	S0.00	
1	6" GaleValve	5.00	EA	$870 .00	$4, 350 .00	0.00	5.00	5.00	so.oo	$,4 350.00	$4.350.00	100%	S0.00	S0,00	
8	Blow-Off Assemby{See County Orwg No W-6A)	800	EA	$1,200 00	S9,600 .00	0 00	8.00	8.00	S0.00	S9 ,600 .00	S9,600,00	100%	S0,00	SO.DO	
9	6" FireHydran t Assembly	600	EA	$3 ,700.00	$22 ,200.00	0.00	6.00	6.00	S0,00	S22,200.00	$22,20000	100"/4	$0.00	S0.00	
10	8" Gate Valve	8.00	EA	$1 ,250 .00	s,0,000.00	0.00	8.00	8 .00	so.oo	S I0,000 .00	s10 .000 .00	100%	$,000	so.oo	
11	8" Tee F fnlng	200	EA	$400,00	5800,00	000	2.00	2.00	S0.00	S800,00	S800,00	100%	S0,00	S0.00	
12	a·Be(J(!Filt,ngs	2.00	EA	S260.00	5520.00	O.QO	2. 00	2.00	SO.DO	S520 .00	$52000	100%	50.00	$0.00	
13	12" Gate Valve	1.00	EA	$2 ,250.00	S 1S,750.00	0.00	7.00	7.00	S0.00	515,750.00	S1S,750.00	100¾	S0.00	$0.00	
14	12"Bend fllllogs	9,00	EA	$46000	$4,140,00	000	900	9.00	so 00	$4,14000	S<l,140 ,00	100%	sooo	SO. DO	
15	12" Tee F1HingS	3.00	EA	$1,100. 00	$3,300 .00	0.00	3.00	3.00	SO.OD	53,300 .00	$3,30000	!00%	SO.OD	$0 00	
16	12·CrossF-i ttings	1,00	EA	$850,00	$850,00	0.00	1.00	1,00	SO.DO	$850 ,00	S850,00	100%	S0.00	S0.00	
17	Slnglo SeMce,Short Side	20.00	EA	.$240,00	$4,800.00	0.00	2000	20,00	SO.DO	$4,80000	$4,800,00	100%	S0,00	S0.00	
18	Single Service, Long SJde	18 ,00	EA	532,5 D0	55,850 .00	0.00	18.00	18.00	S0.00	SS,850.00	S5,85000	100%	SO.DO	S0 . 00	
19	TernPora,Y Construct.ion Meler	1.00	EA	S9.600 00	$9,600,00	0,00	1,00	1,00	SO.OD	$9,600 .00	$9 ,600 00	100%	$0,00	S0.00	
'20	Chk>nnation& P<eSSure Testing	1 .00	LS	S 6.150 .00	$6,150 .00	0.00	1 ,00	1 .00	S,0 00	56,150 ,00	$8,150 .00	100%	S0.00	50.00	
	TOTAL POTABLE WATER DISTRIBUTION E1				$186,433.00				$0.00	$186,438.00	$186,438.00	100%	$0.00	$0,00	
															
	SANITARY SEWER El														
1	8" PVC, SOR 2610'·14'Cul)	73000	LF	517 10	S12,483.00	0.00	730.00	no.oo	S0 .00	$12,483 .00	$1 2,483 ,00	100%	S0,00	so00	
2	8" P VC, SOR 26 (14'-16' Cul)	910,00	LF	532.10	S29,211.00	0.00	910.00	910.00	SO.DO	$29 ,211.00	$29, 211 ,00	100%	S0.00	50.00	
3	8" PVC.SOR 26 (16'-18' CU1)	1 ,2'70.00	LF	$4 1.20	S52,324.00	000	1270,00	1270.00	S0.00	$52,324.00	$52,324.00	100¾	S0.00	S0.00	
4	8" PVC, C.900(18'-20'CuVLS)	170 00	LF	S54 70	59,299 ,00	000	17000	170,00	$0.00	S9,29900	59,299,00	100%	S0,00	SO.DO	
5	SanitaryManhole(0'•14' Cul)	4.00	EA	53.200.00	512 ,800.00	0.00	4.00	4.00	SO.OD	Sl2,800.00	$12,800.00	100%	$0.00	$0Jl0	
6	s· (Dia)Sanitary Manhole (14'-16' Cul)	4 00	EA	S5,000.00	520,000.00	0.00	4.00	4.00	so 00	S20,000 .00	$20 ,000 00	100%	SO.OD	SO.DO	
7	5' (Ola)Sanllary ManllOle(16'-18' Cut)	4.00	EA	55, 25, 0 00	$21,00000	0,00	4 00	400	S0,00	S21,000 00	$21,000,00	10011	$0,00	sooo	
8	5'(Ola)s ... taryManllol• (18'-20'Cut)	1.00	EA	55,850.00	$5,850.00	0.00	1.00	1.00	50.00	$5,850.00	55,850.00	100%	S0.00	S0.00	
9	Single Service(HillSbOrough County)	500	EA	5595.00	$2,975.00	0.00	5.00	5.00	so 00	52,975 . 00	52 ,975 . 00	100%	S0,00	S0.00	
10	Ooutlia Service (Hills.boroUgtiCounty)	1000	EA	STT5,00	514,72500	000	1, 9 00	1900	so 00	$14,725.00	S14,725,0	0 i00%	so 00	so00	
11	8" SIU!>& Plug	7.00	EA	S630.00	$4,410.00	0.00	7.00	7.00	S0.00	54,410.00	54,410.JJO	100%	S0.00	:.o.oo	

(ft

TriploCrooCOD-Vill19eE,FIndG1	APPLICATION FOR PAYMENT

RIPA t ASSOCIATESPROJECT#01,1707A

PAYAPP FROM TO

12RET
12/1117
12131/17

IT EM
NO_	

DESCRIPTIONOFWORk:	

OTV	CONTRACT SUM TO DATE		
				
BASE CONTRACT	
ESllMAiED OUANtrTV	TOTAL
WOAKIN
PlACE	TOTAL
WOR IN
PLACE	TOTAL
WORKIN PLAC E	
•ERCENT COMPLETE	
8ALIINCE
TOFINISH	RET°AI"NAGE	
			
UNIT	UNIT
PRICE	
VAI.UE	THIS
EST IMATE	PREV
ESTIMATE	TOTAL
ESTIMATE	THIS
PERIOD	PREY
APPLICATION	TO
DATE	TO
DATE	TO
DATE	TO
DATE	
12	Oewatenng	1.()1)	LS	S33.00000	5330, 00.00	000	1,00	1.00	S0,00	S33,00000	S33,00.000	100%	S0.00	so 00	
13	tn fil/Exfil Testing	1.00	LS	S4,700,00	S4.700_QO	000	1 .00	1.00	$0 .00	$,4   7001 00	S4.700J)O	100%	S0,00	$0_00	
1 4	Te le viseSanitary Sewer ICCTVI	3, 080,00	LF	S3.05	$9,39400	0.00	3080-00	3080.00	so_oo	S9 ,394.00	$9,394.00	100%	SO.DO	so_oo	
15	Pump Slal!On(8' Dia,)	1-00	EA	$360,000,00	S360.000.00	0.00	1.00	1.00	so 00	S360,000.00	S360,000 00	100%	SO.OD	so_aa	
16	Connect lo E.xlsa"9 6" FM	1.00	lS	S4,100.00	S4,100,00	0.00	1.00	1 00	so_oo	$,4 100.00	S4.100 00	100%	SO.DO	SO.OD	
17	4" PVC C-900 FM	15700	LF	sa.10	$1,271.70	0,00	16700	16700	S0.00	$1,271.70	S1,271.70	100%	sooo	sooo	
18	4" P lug Valve	2-00	EA	S675 00	51,350_00	o_oo	2.00	2_00	so_oo	51.35000	$1,350.00	100'1!,	so_oo	S0.00	
19	4"Bend	2.00	EA	S256.00	S510.00	0.00	2 00	2.00	SO.DO	$5 1 0 ,00	S510 .00	100%	S0.00	S0.00	
20	6" PVC, C-900 FM	1,953.00	LF	514_25	5 27 . 830 . 25	0 .00	1 953 00	1953 . 00	S,0 00	$27,830.25	$27,830.25	100%	$0,00	S0,00	
21	5• PlugVal've	5 .00	EJ\	$1,050.00	S5.250.00	0.00	5 _00	5 .00	so.oo	$5,25000	S5.250.00	100%	SO.DO	S0.00	
22	6" Ber<I	_1• 00	EA	5330.00	$4,620.00	000	14 00	14.00	SO.DO	S<l,620,00	S4 .620.00	100%	S0.00	S0,00	
23	s· Tee(1c u11nTee)	2.00	EA	$1.500.00	$3,000.00	0.00	2.00	2.00	S0.00	53.000.00	SJ,000,00	100%	$0,00	S0,00	
24	G"Gap	100	EA	$200.00	S2DO 00	0 ,0 0	1. 00	1.00	SO.DO	S200.00	$20-000	100'!1	50.00	SO.DO	
25	f MCas ing	2aoo	LF	S6 8-80	51-926-40	000	2800	2800	S0.00	51,926,40	$1,926.40	t00%	so.co	S0.00	
26	ARV Structure & Assembly	1,00	EA	$4,200 00	$, 4 200.00	0,00	1.00	1,00	so.co	S4.200 .00	5 4. 200.00	100%	S0,00	SO.DO	
7.7	Press,•·Testing!FM)	100	lS	sa.ooooo	5, 3 900 .00	0,00	1 ,00	100	S0-00	53.900.00	53.900.00	100o/,	S0.00	S0.00	
	TOTAL SANITARY SEWER E1				S650,329.35				so.oo	$650 .3 29 . 35	$ 650 ,3 29.35	100%	$0.00	S0.00	
															
	STORM DRAINAGE E1														
1	15" ClassIll RCP	42_00	LF	$23 -3 0	5979 _50	000	42.00	42.00	SQ_OO	$978 60	$978 .60	l OOo/o	$0_00	$0_00	
2	18"ClassIll RC P	58.00	LF	$28.40	51,647.20	0.00	58,00	58,00	S0,00	$1,64, 7 20	$ 1,647.20	100%	S0.00	S0,00	
3	24• ClassIII RCP	439 00	Lf	54460	519,579,40	0,00	439.00	A39 .00	S0 ,00	$ 19 ,57 9. 40	$19 ,579.40	100%	SOOD	SOOD	
4	30• ClassIII RC P	-158.00	LF	$65-10	S10.285-80	0.00	158.00	158.00	so_oo	510.285 _80	SI0 ,285 _80	1 00%	so_oo	so_oo	
5	36"ClaSSIll RCP	5, 1 00	LF	S84.65	54,317,15	0,00	51.00	51,00	so.co	$4.317 ,15	54,317 1 5	100%	S0 .00	SO.OD	
6	60"ClassIll RCP	190.00	LF	$185.00	53, 5150-00	0,00	19000	190,00	so_oo	535 . 150 . 00	$ 3, 5 150 ,00	100%	5000	_sooo	
7	(3) Trfple 58 •, 91•· Class III ERCP	52,00	LF	s1.200.00	SG2,40Q_QO	0.00	6200	52.00	SQ_DO	S62 ,400 _QO	S62.400.00	100%	SQ_DO	S0-00	
8	HMls bO!Ough Co , Type 1 CurbImel	9.00	EA	S4,,so_oo	5 37, 350.00	000	9,00	9,00	so.co	537,35000	537,350.00	100%	so.co	so_oo	
9	Hlllsbo<ough Co. Type1 Curb Inlet wl J-Bottom	2.00	EA	55.250.00	510,500.00	0.00	2,00	2,00	SO.DO	510,50 0.00	S1,0 500.00	1DO%	S, 0 00	so.co	
1 0	FOOTMan hole w/ J. Bollom	1,00	EA	S3,90000	$3,90000	0,00	1 00	1,00	so.co	S3.900-00	S3,900.00	100%	S0.00	so.co	
1 1	6" PVC Underd/ain	1,800.00	LF	s11_s s	S21,510.00	000	1800 00	1800 00	so.co	521.510 .00	521 ,510.00	100%	S0.00	so.co	
1 2	U ndcrd,a!n Cleanoul	13,00	EA	$1B5.00	$, 2◄05.00	0 .00	13 ,00	13 ,00	S0,00	52.405_00	$,2 ◄05. 00	100%	so.co	S0.00	
13	FOOTSlraight Conorete End Wall(Tnple Pipe)	11, 400	LF	$375.00	S42,750.00	0,00	114,00	114,00	S0-00	$42,750.00	$42,7-5000	10014	so.co	S0.00	
14	Televise Storm sewer(CClV)	1,052_00	lF	$6 _1 0	5 6, 4 17 . 20	0.00	1052,00	1052,00	S0.00	5, 6 417.20	56,417.20	100%	S0,00	so_oo	
	TOTAl STORM DRAINAGEE1				$259,190.35				S0.00	$25, 9190.35	$259,190.35	100, ,	SO.OD	$0.00	
															
	ROI\O SLEEVE CROSSING E1														
1	2• Sct>40 PVC	11200	lf	$4.80	S537.60	0,00	112,00	112,00	$0,00	S537.60	5537.60	11>0%	S0,00	so.co	
2	3• Sen 40 PVC	112.00	lF	S5.55	S82160	0.00	112,00	112,00	S-000	$621.60	562160	100%	S0-00	SO.OD	
3	4" ScJ140PVC	140.00	lf	56-15	5861.00	000	14000	14000	SO.DO	586100	5861.00	100%	so.co	$0.00	
4	6" 5ch40PVC	11200	LF	$8-15	S912.80	0.00	11, 200	112.00	SO.DO	591,2 80	S9_1 2 80	1 00%	S0,00	SO.OD	
	TOTAL ROAD SLEEVE CROSSING E1				$2,933.00				$0,00	$2,933.00	$2,933.00	100%	SO.OD	S0.00	

IT EM
NO	

DESCRIPTIONOFWORK	

OTY	CONTRAC T SUM TO DATE		
				
BASE CONTRACT	
ESTIMATED OUANTITV	TOTAL
WO k.lN
PtACE	TOTAL WORK IN
PLACE	TOTAL WOR  IN
PLACE	
PERCENT
COMPLETE	
BALANCE
TO FINISH	Rf:T"AI"NAGE	
			
UNIT	UNIT
PRICE	
VALUE	THIS
EST IMATE	PREV
ESTIMA TE	TOTAL
ESTIMA TE	THIS
PER IOD	PREV
APPLICATION	TO
DATE	TO
OAiE.	TO
DATE	TO
DATE	
															
	CHANGEORDER #2 • PHASEE1														
1	CPO Credit·Feryuson• Waler	1,00	LS	(579,314.82)	($79,31, 4 82)	Q_OQ	1.00	1_00	so_oo	( 579,314.82 )	(5 79,314 .82)	100%	SOCIO	S0.00	
2	CPOCredit- Fergusoo- Sower	1 00	LS	( 522 , 442_68 )	( 522,442 . 68)	0 00	1 ,00	1 . 00	S0-00	(S22,442.68)	($22,442.68)	100%	S0,00	S0.00	
3	DPOCredit - F8f9US011- Force Mai n	1,00	LS	($22,072.05)	($22,072,05)	0.00	1,00	1 Oo	S000	(S22,072,05)	(S22,07205)	100%	S0,00	$000	
4	CPOCredft - Fe(9uson - Uncfe<draln	100	LS	(S5.764 .90)	($5,764 . 90)	0 00	1.00	1 _00	5 0 . 00	($5,764.90)	(S, 5 7_64 90)	100%	so.co	$0 .00	
5	CPO Credi t - Fery uson- Steeves	1,00	LS	($812-20)	(5812.20)	o_oo	1.00	1 00	S0.00	($812.20)	($812 20)	100%	so00	S0.00	
6	CPO Tax Sa"1ngs	1.00	LS	($7,824.40)	(57,824.40)	0.00	1.00	"JOO	S0.00	(S7,824,40)	($7,82/140)	100%	so.co	so 00	
	TOTALCHANGE ORDER #2 • PHASE E1				(S138,231,05)				$0.00	($138,231.05)	($138,231.05)	100%	$0.00	$0.00	
															
	CHANGE ORDER #3· PHASEE1														
	E1 - G1:otechnlcal Te s11ng														
1	E1 - FteldTecilok::ian 5ervices	1,00	ls	$1,8 006 .00	S180, 06.00	0.00	1.00	1.00	so.co	S18,006 .00	S18 ,006 00	100%	$0 00	$000	
2	E1 • t.abratoiy Testing	1 00	LS	S4,932 00	S4.932.00	000	1 00	1 00	S0.00	S4.932.00	$4,932.00	100%	$0,00	so.oo	
3	El - Engl-ng&Project Manag•men l	1,00	LS	$2.520,00	52.520.00	0,00	,.oo	100	sooo	S2.52000	$,2 52000	100%	S0.00	S0.00	
	TOTALCHANGE ORDER #3 • PHASE E1				$25,458.00				so.oo	$25,458 .00	$25,4 58.00	100'4	$0.00	$0.00	
															
	CHANGE ORDER #4• PHASE E1														
1	DPOCredit· Rln er . SlormPipe	100	LS	($38,64607)	(S38.646.07)	0,00	1 00	1 _00	so_oo	(S38 ,646 _07)	($ 38 , 646.07)	100%	so_oo	50.00	
2	OPO TaxSavings	1 00	LS	( 52, 338 .76 )	( $2.338.76)	0.00	, 00	_ , oo	so.oo	(52.338 .76)	($2,338 .76 )	100%	S0.00	$0,00	
	TOTALCHANGE ORDER #4 · PHASE E1				($40,984.83)				SO.DO	($40,984.83)	($40,984.83)	100'4	$0.00	S0.00	
															
	CHANGE ORDER #5 • PHASEE1														
1	CPOCredit·MlaJlllc TNG • Sewer Stru:turcs	11)()	LS	(S24,149.00)	($24.149.00)	000	1.00	1.00	S0.00	($24,149.00)	($2 4,149.00)	100%	SO00	S0,00	
2	DPO Credit • AUanDC TN G · LiltStation	1,00	LS	($23,755.70)	(S23.755.70)	0,00	1,00	100	S000	(S23,755.70	)	(523,755.70)	100%	S0.00	so.co	
3	CPO Credi t • All anl lC TNG • Storm Structures	100	LS	($17,844.80)	(517,844,80)	000	,_oo	1 _00	so_oo	($ 17.844 _80)	($ 17 , 844 .80)	100%	so00	S0.00	
4	CPO Tax $av,ngs	100	LS	($3,9.54,97)	(S3,9 54,97)	000	, 00	_ , oo	S0.00	(S3,954,97)	($3, 954.97)	100%	so.co	50 ,00	
	TOTALCHANGE ORDER #5- PliASEE1				($69,70,447)				$0,00	($69,70, 447)	($69,70U7)	100%	$0.00	$0.00	
															
	CHANGE ORDER #6• PHASEE1														
	CTBDIRECTPURCHASE ORDER														
1	DPOCredit- SoilCefnenl Base	( 2,981.00)	TN	516.00	(547.696,00)	000	-2981.00	-298100	S0.00	($47,696.00)	(S47,696,00)	100%	SO.OD	50 .00	
2	CPO Tax Savings	1.00	LS	(52,661.76)	(52.86,1 76)	0.00	1.00	,_oo	so.co	( S2 ,861 , 76)	($2,86176)	100%	so 00	so.co	
	EARTHWORK E1														
1	ExcavationorTemporaryPOOOS	2 , 700 00	CY	$2 -45	$6,615.00	0.00	2700.00	2700.00	S0.00	S6,615.00	S6.6t5.00	100%	$000	S0.00	
	ROAD SLEEVECROSSINGS E1														
1	Z-Sch40PVC	SM, 0 00	LF	$4 ,80	$4,5 12.00	0,00	94000	940.00	$0.00	S<,51_2 00	SA,512.00	100%	S0.00	S0.00	
2	3• SclJ 40 PVC	(112.00)	LF	S5.55	(5621 60)	000	112.00	-112.00	S0,00	(S621.60)	(5621.60)	100%	$,0 00	$0.00	
3	4"SCh40PVC	2,340.00	LF	56.15	$14,391,00	0,00	2340.00	2340.00	S0.00	$14,391 00	S14,39100	100¾	$0,00	S000	
4	s·sch40PVC	(11200)	LF	$8,15	(S912.8	0)	0,00	-112.00	-112.00	$0.00	(5912_80 )	($912 . 80)	100%	so 00	$0.00	
	STORM DRAINAGE E1														

TripleCreek CDO-Villaqt E, F tnd GI	APPLICATION FOR PAYMENT RIPA &ASSOCIATESPROJfCT#QI 1707A

PA'f APP
rnoM TO

12RET
12/1117
12/31/17

Triplec,eeiCODV- illage E. F ...    GI	APPLICATION FOR PAYMENT

RIPA& ASSOCIATESPROJECT# 01,1707A

PAV AP? FROM TO

12RET
12/111 7
12f.)1/17

ITEM NO.	

DESCRIPTIONOF WORK	

QTY	CONTRACT SUMTO DATE		
				
BASECONTRACT	
ESTIMATEDOUANTln'	TOTAL
WORKIN
PLACE	TOTAL
WORK IN
Pl.ACE	TOTAL
WORK IN
PlACE	
PERCENT
COMPl.ETE	
BALANCE
TO FI NISH	
01>
RETAINA.GE	
			
UNIT	UNIT
PRICE	
VAlUE	THIS
ESTIMATE	PREV
ESTIMATE	TOTAL
ESTIMATE	THIS
PERIOD	PREY
APPI.ICATION	TO
DATE	TO
DATE	TO
DATE	TO
OATE	
1	1 s· c 1- 111RC P	48 . 00	LF	$26 .10	$ 1 ,252 .80	o.oo	48 00	48.00	S0.00	$1,252.80	$1,252.80	100'1,	so.oo	$0 .00	
2	1S- Class Ill RCP	64.00	LF	$29 83	$1,909.12	000	64.00	64 00	so.oo	$1,90912	S1,909.12	100%	S0.00	5000	
:i	24•Class Ill RCP	312.00	LF	$47.92	$14,951.04	0.00	312.00	312.00	S0.00	514,951.04	S14.951.04	100%	S0.00	$0.00	
4	COniroJ s1n.1c1ure (FOOT Modlfiad Type·o·lnlel)	1.00	EA	S4.650,00	$4,650.00	0.00	1 00	1,00	$0.00	S4,650.00	$4,650.00	100%	so.oo	S0.00	
5	FOOTManhole	,.oo	EA	S3 ,250 . 00	S6,500 .00	0 ,00	2 . 00	2 .00	S0 .00	S6.500 .00	$6,500 . 00	100%	so.oo	$000	
6	RCPBrick Plug	1 00	EA	S2T, T 68	S277 .68	0 .00	1 00	1.00	S0 ,00	5277 .68	S277 .68	1 00%	S0.00	S0.00	
1	15· RCP fES	1.00	EA	$,1 500.00	51,500.00	0.00	1.00	1 00	S000	S1.50.00	$1.50000	100%	S000	$0.00	
B	1S- RCP FES	1.00	EA	$1,650.00	S1.650.00	0.00	1.00	1.00	S0.00	$1,650.00	Sl .650.00	100%	S0.00	$0,00	
9	PostMoun1ee1Flberg1ass Skimm	4, 0 00	LF	S86.57	$,3 462 80	000	40,00	4000	S0,00	53,462,80	S3,462.80	100%	S0 ,00	S0.00	
10	TeleviseSIOrm Sewor(CCTV)	424.00	lF	S6.10	52,586.40	0.00	424.00	424.00	sooo	$2,586 .40	S, 2 586 . 40	100%	S0.00	50.00	
11	Oewa1ering	1.00	LS	S5.700.00	SS.700.00	0.00	1.00	1.00	S0.00	SS,700.00	55 ,700.00	100%	S0.00	so.oo	
	TOTALCHANGE ORDER #f> • PHASE El				$17,865.68				SOD. O	$17 ,8 65.68	$17 ,8 65.68	100 %	so.oo	S0.00	
															
	CHANGE ORDER #9• PHASEE1														
1	OPO Reconcma lioo-Fe,yuson-Vlllag• E1	1.00	LS	$15, 630.64	S1, 5 630 64	0.00	1,00	1.00	SO.OD	$ 15,630.64	S15,630 .64	100o/o	S0 .00	S0 .00	
2	6% TaxonAbove	1.00	LS	5936.22	S936.22	0,00	100	100	S0.00	S936.22	S936,22	100,.	S0,00	S0.00	
	TOTAl CHANGE ORDER #9 • PHASE El				$16,566.86				S0,00	$16,566.86	- $16,566,86	100%	$0.00	S0.00	
															
	CHANGE ORDER #10 • PHASE El														
	STRIP SOD AS DIRECTED 12-11 TO12-15														
1	Superinlendeflt	5.00	HR	S95.00	$475 ,00	o.oo	5 .00	5 ,00	SO.DO	$ 4 75 .00	S475.00	100%	S0.00	SO.OD	
2	Foreman	8.00	HR	$85,00	S68, 0 00	0,00	8,00	8.00	S0.00	$68000	$68000	100%	S0,00	SO.OD	
3	SkidSteer Loader	46 ,00	HR	$68.00	$3,128.00	0.00	4600	46,00	so.oo	53, 128 .00	$3, 1 28.00	100o/o	so .oo	S0.00	
4	Box Blade Tractor	4600	HR	S68.00	$3,128.00	000	46.00	46,00	S0.00	$3,128.00	$3,128.00	100%	S-000	$0.00	
5	Dump Truck	16.00	HR	$100.00	Sl ,600,00	0.00	16.00	1,6 00	S0.00	S1.600.00	$1,600.00	100¾	S0,00	SO.OD	
	TOTALCHANGE ORDER #10 - PHASE El				$9,011,00				$0.00	$9,011.00	$9,011.00	100','.	$0.00	$0.00	
															
	TOTAL PHASE El				$2,162,483.04				so.oo	$2,182 , 483.04	S2, 162.48 3 .04	100 %	S0 . 00	$0.00	
															
	PHASE F1														
	GENERAL CO NDITIONS fl														
1	Moollizatloo	LOO	LS	S9 ,600 . 00	S9.60000	000	1.00	1.00	$000	$9600.00	S9,600.00	100%	50.00	$0.00	
2	NPOES compllance	1 .00	LS	$4 ,850 .00	S4.850.00	0,00	1.00	1.00	$0.00	S4,850.00	$,4 850.00	100%	S0.00	S0.00	
3	Maintenanceof Traffic	1,00	lS	,s .200 .00	s1.200 .00	0,00	1 00	100	so.oo	S1.200 . 00	$1 ,200 .00	100'1,	$0.00	S0.00	
4	C<>nsl. S1a•oou1I Rccnrd Survey• ByC<>n actO<	1.00	LS	$51, 000 .00	$51, 000 .00	0-00	1,00	1.00	S000	551,000.00	$51,000.00	100'4	S0.00	so 00	
5	Payme11t & Performance Bond - ByContracto<	1 .00	LS	$ 14, 250 .00	S14, 250 .00	0.00	1 .00	1.00	S0 .00	$14,250 .00	$1,4 250 .00	100%	S0,00	sooo	
6	Snt Fence	B.100.00	LF	s1 20	$,7 320.00	000	6100.00	610000	$0.00	$7,320.00	$, 7320.00	100%	S0.00	S0.00	
1	E>ds ng 1n1e ts - Eroston Proteclk>n	8.00	EA	598 . 20	$78560	0.00	8.00	800	S0.00	$785.60	$785.60	100'4	SO.OD	SOOD	
	TOTAL GE NERALCONDITIONS F1				$89,005.60				$0.00	$89,005 .60	$89,00 5.60	100 ¾	S0.00	$0 .00	
															
	EARTHWORK Fl														

TripleCreekCOO-Village E,Fand GI	APPLIC,lTlON FOR PAYMENT

Rll'A&ASSOOIATESPRDJECT # 01,1707A

PAY APP FROM TO

12RET
121117
12/31/17

ITEM NO	

DESCRIPTION OFWOR!(	

OTV	CONTRACT SUM TODATE		
				
BASECONTRACT	
ESTIMATED O UANTITY	TOTAL WORK IN
PLACE	TOTAL
WOR!(IN
PLACE	TOTAL
WORKIN
PLACE	
PERCENT COMPLETE	
8ALANCE TOFINISH	o..
RETAlNAGE	
			
UNIT	UNIT
PRICE	
V•LUE	THIS
ESTIMATE	PREV
ESTIMATE	TOTAL
E STIMATE	TH'5
PERIOO	PAEV
APPLICA.110N	TO
DAlE	ro
OAlE	TO
DATE	w
DATE	
1	Cleanng 8 Grubbing	31;()0	AC	$1,800.00	S64,800.00	0.00	36.00	36.00	SO.DO	S&!,600.00	S64,800.00	100%	SO.OD	S000	
2	DiscSIie	3, 000	AC	5'355.00	S10.650.00	0.00	30.00	30.00	SO.DO	$10,650.00	S10,65000	100%	SO00	SO.OD	
3	Cul VOiume( UnadJusled)	108,900,00	CV	$2.10	$228,690.00	000	108000.00	10890000	$0 00	S228.690,00	S228.690.00	100%	SO.OD	S0.00	
4	Sodding	2,5 750 00	SY	$2 45	S63,087 .50	0.00	25750 .00	25750 .00	SO.DO	S63,087.50	S63,08750	100%	so00	S0 ,00	
5	Se<!Olng 3 Mulcn lng	6 ,114 .00	SY	so 25	S1 , 528 50	0 ()0	611400	6114.00	SO.DO	S1 ,528 .50	Sl ,528 ,50	100%	so.oo	S0,00	
6	oewate,;ng	1.00	LS	$4, 050000	$4, 060000	0.00	, 00	100	SO.DO	$40,600 .00	$40 .600 .00	100%	S0,00	SO.OD	
7	Flna! Grading	1 00	LS	520. 000.00	$20,000.00	0.00	1.00	1.00	S0,00	S20,000.00	$20,000,00	100%	S0,00	SO.OD	
	TOTAL EARTHWORK 1'1				$429,256.00				SO.DO	$429,256.00	$429,256.00	100%	so.oo	$0 , 00	
															
	PAVING ANO BASE F1														
1	I 314" S-1 Asphallic Concrele	5 70500	SY	59.20	$52.486.00	0.00	5705.00	5705.00	S0,00	S52.486.00	S52.486.00	100'l4	S0,00	SO.DO	
2	s· CrusheoConcrele Base	5,705.00	SY	SI0,30	$58,761.50	0,00	5705.00	5706.00	SO.DO	SSB,761.50	$58.761,50	100%	SO.OD	S0.00	
3	6" Slabil,zed Sullgrooe(LBR 40)	,5 705.00	SY	S6 .85	S39,079.25	000	5705.00	570500	S0,00	539,079.25	S39.07.925	100%	S0.00	S0.00	
4	MiamiCurt> w/S tabilization (Full Depth)	5,002.00	LF	511,05	SSS,272.10	0.00	5002.00	5002.00	S000	555,27.210	$55,27210	100%	S0,00	SO.OD	
5	5• Wide Rd)bon Curt>	3,013 .00	LF	59,80	529 .527 ,40	0.00	3013.00	3013.00	S000	S29.527.40	529.527 40	100%	sooo	So.oo	
6	5'x4• Conc(ete Sidewalk	300 00	LF	S19.50	55,850,00	000	300,00	30000	S0,00	S5,8,5000	S5.850.00	100'Y·	S0.00	so.co	
7	10' Wide AsphaltPavement(w/base& subgrade)- Trail	1,663.00	SY	525.90	$43.071.70	0.00	1663.00	1663.00	S0,00	$43,071.70	543,071.70	100%	$0,00	so.co	
1l	ADA Ramps (5' wide)	4.00	EA	SS40 .00	53.360 .00	0.00	4 .00	4.00	S000	$3.360.00	$3.360.00	100%	sooo	$0.00	
9	12" Wtce• ConcreteBlock Wall	1.430.00	LF	S94,10	S134.563.00	0.00	1430,00	1430.00	so.co	S134. 563 .00	5134.56300	100°/4	so.oo	S0 . 00	
10	Wood BoardWal	,1 300.00	SF	$45,25	S58,825.00	0.00	1300.00	130000	SO.DO	SSS.82500	S58,825.00	100llo	S0 ,00	$0.00	
11	Sigoaga & Striping	1 00	LS	52,20000	$2,20000	0.00	1.00	1.00	SO.OD	52.200 . 00	52.200 .00	IOOll,	sooo	so 00	
	TOTAL PAVING AND BASE F1				$432,995.95				$0.00	$432,995.95	$482,995.95	100%	S0.00	$0.00	
															
	POTABLE WATER DISTRIBUTIONF1														
1	Conoecl lo Exlsllng 6' W/M	1.00	EA	51.250.00	S1.250.00	0.00	1 00	1.00	S0.00	S1.250.00	S1,250.00	100'11	SO.DO	$0.00	
2	6' PVC P11»C-900	2.700.00	lF	$1050	$28,350.00	0 00	270000	270000	$0.00	S28,350,00	528.35000	100%	so.oo	S0.00	
3	S- FireHydrant AssemblylW/TeeFitting Connecuon	5.00	EA	S3.700,00	518.500.00	0.00	5.00	5.00	S0.00	S16,500 00	S18.500.00	100%	SO.OD	S000	
4	s·Gate Valve	11.00	EA	5870.00	$9,570.00	o.oo	11 .00	1,1 00	S0.00	S9,570 .00	S9.570 .00	100%	so00	SO.DO	
5	6" BE!lld FIU,ngs	1 2.00	EA	S185 .00	$2 ,220 00	0,00	12.00	12,00	$0,00	$2,220.00	S2.22000	100o/,	S0,00	S0.00	
6	ll Tee Fitbngs	2.00	EA	$290. 00	$580.00	0.00	2.00	2.00	S0.00	S58000	$580.00	10D%	$0.00	S0.00	
7	SklgleService, Shon S1de	41 ,00	EA	$240.00	.$9,840.00	0.00	41.00	41.00	SO.DO	59 ,840 .00	$9 ,8'10 .00	\Oil%	SO.Oil	SO.DO	
8	SingleService, Long Side	33.00	EA	$325,00	$1, 0 725.00	0,00	33,00	33,00	SO.DO	$1,0 725 .00	SI,0 725.00	100%	so.oo	sooo	
9	Temp0rary Construc1km M eler	1 .00	EA	$9.900.00	S9.900.00	000	1,00	1,00	SO.DO	S9.900.00	$,9 900.00	1(10%	S0 .00	S0 .00	
10	Ch lor1narioo,Sampling & Pressure Testing	1 ,00	LS	.$, 4750,00	S 4,750.00	0.00	1.00	1,00	sooo	$4,750 . 00	S,1,750.00	100¾	SO.DO	S0.00	
	TOTAL POT,lBLE WATER DISTFVBliTIO N Fl				$95,685.00				$0.00	$95,685.00	U S,685.00	100%	S0.00	$0,00	
															
	SANITARY SEWER F1														
1	8' PVC. SOR 26 (0'-10' Cul)	1.713.00	lF	$15,00	S25,695,00	0,00	1713,00	1713.00	S0.00	526,695.00	$2, 5695.00	100%	S0,00	SO.DO	
2	8" PVC.SDR 26 (10'·12' Cul)	424.00	LF	$17.10	57,250.40	000	424.00	424.00	SO.DO	S7 .250-40	S7,250.40	100%	SO.DO	S000	
3	8" PVC.SDR26(12'•14'Col)	179.00	LF	520.35	3.642 65	000	17900	179.00	5000	SJ,64265	S3.6d.265	100¾	S0.00	S0.00	
4	S8nllary Mantiote(O'·B' Cul)	600	EA	S2.◄00   ,00	S12,000	. 00	0.00	5.00	5.00	SO.DO	S12.00000	s 12.000.00	100¾	SO.DO	S0,00	

... , ,i

TripleCreekCOO-Vilt eE,FindG1	APPLICATION FOR PAYMENT RIPA & SSOCJATES PROJECT#01- \707A

PA YAPP
FROM TO

12RET
12J1117
12J31117

1TEM
NO.	

DESCRIPTION OFWORK	

QTY	CONTRAC  T SUMiOOATE		
				
BASE CONTRACT	
ESTIMI\TEO OUANTrrY	lOTAL
WORKIN
Pl.ACE	TOTAL WORIUN
Pl.ACE	TOTAL
WOR IN PLACE	
l'ERCENT COMPLETE	
BALANCE
TOFlNJSH	
Dll
RETAlNAOE	
			
U IT	UNIT
PRICE	
VALUE	THIS
ESTIMP,TE	PREV
ESTIMATE	TOTAL
ESTIMATE	THI.S
?ERKlO	PREV
APPLICATION	TO
DATE	TO
DATE	TO
DATE	TO
OATE	
5	Sanilaly Manr,ole(IMO' Cull	00	EA	S2,800 00	S, 1,200,00	000	4,00	4,00	S0,00	S11,200,00	s11.200.00	1(1()%	$0,00	So.oo	
6	Sanlto,y Man r,ole (10'•f2' Cul)	2.00	EA	S3,000.00	S6,000.00	0 00	200	2.00	S0.00	SG,000 ,00	SG,00,0 00	100%	$0 ,00	S0.00	
7	Sanllo,y ManhOle (12'-H ' Cul)	,1 00	EA	$3.45,0 00	$3,45000	000	1.00	1.00	$0.00	53,45000	$3,450.00	100%	$000	so 00	
8	SingleService(HIISborot'Jh Couoty)	18,00	EA	$595.00	$10.710 ,00	0.00	18,00	18.00	S0.00	510,710,00	$10,710,00	100%	S0.00	50.00	
9	OoiJOlo Service(Hlllsbomugl\ County)	29.00	EA	$775.00	$22,475,00	000	2900	29.00	$000	$22,47,500	S22,47,5 00	100%	S0.00	50,00	
10	8" PVC Slul>-oot Coooeclloo	1,00	EA	$45,0 00	$45,0 00	0.00	1 00	1.00	S0.00	5450,00	545000	100%	so 00	S0.00	
11	Ocwatefir,g	1 ,00	LS	S27 .500 .00	$27, 500 ,00	, 0 00	1 .00	1 .00	s,o oo	527.500 ,00	S2 7,SOO,OO	100%	S0.00	$0.00	
12	lnftVEJ<OI Tesling	1,00	LS	S3,900.00	S3,900,00	0,00	1.00	1,00	S0.00	SJ.900,00	$3,90, 000	100%	S0.00	S0,00	
13	Te leviseSarilarySewer(CCTV)	2,31,6 00	LF	53.05	$7,063.80	,0 00	2316.QO	2316.00	$0 .00	S7,063.80	57,063.80	100%	S000	S0,00	
	TOTAL SANITARY SEWER F1				$141,336.85				S0.00	$141;336,85	S141, 336.85	100 %	$0.00	S0.00	
															
	STORM DRAINAGE F1														
1	15' Class Ill RCP	358.00	LF	S23.30	S, B341 dO	0 .00	358.00	358.00	so.oo	$8 ,341-40	S 8,34 1 40	100%	S, 0 00	S, 000	
2	lB" ClassHI RCP	183.00	LF	S28.40	$,5 197.20	0,00	183.00	183.00	S0.00	$5,197,20	$5,197.20	100%	,o.oo	$000	
3	24" Class ill RCP	1,354.00	LF	S38.30	S51,858.20	0,00	1354,00	135400	S0,00	S5, 1 858.20	$51.858,20	100%	S0.00	.$0,00	
'	30- Class Ill RCP	390.00	LF	S52.SO	$2,0 475 .00	0 ,00	390 .00	390.00	S0.00	$2, 0 475.00	520,47500	100%	S0.00	S0,00	
5	.35• Class UIRCP	175.00	LF	$72 ,10	S12,617.50	0,00	175.00	175.00	$0.00	$12,617 SO	$12,617,50	100%	S0.00	S0,00	
6	Inlet Type1 (HC)	15 00	EA	54,150.00	S62,250.00	0,00	1500	1500	$0.00	S62.250.00	S62,250,00	100%	$0,00	sooo	
7	FOOT Manhole	2.00	EA	$3,250 .00	56.500.00	0.00	2.00	2.00	$0.00	$6,500.00	S6,500.00	100%	S0.00	S0,00	
8	Control Slnicture(FOOT Modified Type •o• lnlel)	1,00	EA	53,500 .00	Sr3 500.00	0,00	1.00	1 00	$0,00	'$3,500.00	SJ,500.00	10()%	S0.00	S0,00	
9	COntn>I SINCture(FOOT MO<fif,cO Type.,..1011!1)	1 00	E A	S9,650 .00	$9,650,00	0,00	100	1 00	S0,00	59,650.00	$,9 650 00	100%	S0,00	S000	
10	EJ<istlng IntelType1 (HC)-{Tie In)	2.00	EA	S695.00	$1,390.00	0.00	2.00	2 .00	S0.00	S 1,390.00	51,390.00	100%	S0,00	S0.00	
11	Exlsling FOOT Manrole-(Tle In)	1 .00	EA	$4,000 .00	$4,000 .00	000	1 ,00	, l 00	$0 ,00	$4 ,000.00	$4,000 .00	100%	S0.00	S0,00	
12	EslsUng Inlet TypeC-(Tie In)	100	E'A	$4,65000	S4,65000	0.00	1.00	T.00	moo	$4,650,00	54,650.00	HM!%	50 ,00	S0.00	
13	Control Structure-ConcreteWf!ArWalt (74 LF)	1.00	EA	SJS,000.00	SSB,000.00	0.00	,.oo	1.00	S,000	S38,0,0000	S38,000. 00	100%	S0.00	S0.00	
14	1&-FDOTFES	1 00	EA	$1,650 00	$1,650.00	0 00	, 00	1.00	5000	$1,650.00	Sl,650.00	100%	$0.00	$000	
15	2'1" FDOT FES	1,00	EA	$1,750 ,00	51.750.00	0 00	1.00	1.00	sooo	$1.750.0	0	$1,750.0	0 100%	SO00	S0.00	
16	30" FOOTFES	1.00	EA	52.300.00	S2,300.00	0.00	1.00	1.00	so.oo	S2,300.00	$2,30000	100%	so 00	S0,00	
17	35- FOOTFES	1.00	EA	$2,750,00	$2,750.00	0.00	1 00	1,00	sooo	S2 ,750,00	52 ,750.00	100%	S0.00	so 00	
18	Oewatertng	1 00	LS	S18,500, 00	S, 8,500 .00	0.00	1 .00	1,00	S0 .00	s,s. soo.oo	$18,500.00	100%	$0,00	S0.00	
19	Televisa Sloon Sewer(CCTV)	2,460.00	LF	S6.35	$15,621.00	0.00	2A60.00	2460,00	sooo	$15.62,010	$1, 5621,00	100%	SO.OD	S0.00	
20	FOOTType -E Inlet
u_,n	4.00	EA	S2,55,0 00	S,0,200.00	0,00	4 00	4 00	S0.00	s10,200.00	S10.200.00	100%	sooo	so00	
21	6"	(FineAggregate)	150.00	LF	S11,95	S1,792.50	0.00	150.00	150,00	$,0 00	S1,792.50	$,1 792.50	100%	S0,00	S0.00	
22	UnderdJaln aoanol.11	3.00	EA	$185.00	$555 .00	, 0 00	3.00	3 ,00	S0 ,00	S555 ,00	$555 ,00	100%	$0.00	S0.00	
	TOTAL STORM DRAINAGE F1				S283 , 547 .80				$0 .00	$283 , 547.80	$28,3 $47.80	100¾	sa.oo	$0,00	
															
	ROAD SLEEVE CROSS ING F1														
1	2" Sch 40 PVC	9000	LF	$4.80	5432,00	0,00	90.00	90,00	sooo	$432 .00	5432.00	100%	S0,00	$000	
2	4• Sci\40PVC	120 00	Lf	$6.15	$ 738.00	0,00	120.00	120,00	$0,00	$738,00	S738.00	100%	S, 000	S0.00	
3	6" Sch 40 PVC	30.00	LF	$8.15	$244.50	0.00	90,00	30,00	S0,00	$244.50	5244.50	100%	$000	S0.00	
	TOTAL ROAD SLEEVE CROSSING F1				$1,414.50				$0.00	$1,1114,50	Sl,414 ,50	10Qo,/	$0 ,00	$0,00	

hf/I

ITEM NO	

DESCRIPTION OFWORK	

OTY	CONTRACT SUM TO DATE		
				
BASE CONTRACT	
ESTIMATED OUANmv	TO TAL
WORKIN
PLJ\CE	TOTAL
WORKIN
PLJ\CE	TOTAL
WORKIN
PLACE	
Pf CENT
CO!,IPLETE	
BALANCE
10 FINISH	
0%
RElA INAGE	
			
UNIT	UN'l
PRICE	
VALUE	THIS
ESTIM ATE	PREV
ESTIMATE	TOTAL
ESTIMATE	f H!S
PERIOD	PREY
AP:iucATION	TO
DATE	TO
DATE	TO
OATE	TO
DATE	
															
	CHANGEORDER #6· PHASE F1														
	CTB DIRECT PURCHASE ORDER														
1	DPO Cred • SollCementBase	(2,19600)	TN	$16.00	(S3,5 136 00)	0.00	-2196,00	·2196.00	S0,00	(535,136,00)	(S35.136 00)	1<Ml'I',	sooo	sooo	
2	DPO Ta,,Sav,ogs	1.QO	LS	(52, 108. 16)	($2 , 108.16)	0 .00	1.00	1.00	S0 .00	(52, 108 .16 )	(5 2,108 .16)	100'l',	S0.00	S000	
	TOTAL CHANGEORDER #6 • PHASEF1				($37,244.16)				S0,00	($37 ,244.16 )	($37,2 44.1 6)	100 %	$0,00	$,0 00	
															
	CHANGEORDERlf7 • PHASEF1														
	ATLANTIC TNG-VILLAGE F1														
1	DPO,c ed • sar11ary Strucrures	1.00	LS.	($15,600.70)	($1.S,600.70)	0.00	1,00	1 00	S0.00	($15,600.70)	($15.600,70)	100%	sooo	so 00	
2	DPO Credit •Stam,Structures	1.00	LS	($2,2 364.50)	(522,364.50)	0,00	1,00	1 00	S0,00	1522,364.50)	($2,2 364.50)	100%	S0,00	S0.00	
	FERGUSON WATERWORKS-VILLAGE F1														
1	DPO Crecm Water Main	1,00	LS	($40,895.70)	(540,895.70)	0,00	1,00	1.00	$000	(S40,89,750)	($40,895 70)	100%	$0,00	SD.OD	
2	DPO Cre,m - SaotlaryP tpe	1.00	LS	($22.911,04)	($22,911,04)	0,00	1.00	1 00	S0,00	(522,911.04)	($22,911.04)	100%	50,00	S0.00	
3	DPO Credit - UnderDrain	1,00	LS	($442 ,66)	(544,2 66)	0.00	1,00	1.00	S0.00	(5442 .66)	(5442.66)	100%	5000	S0,00	
	RINKER-VILLAGEF1														
1	OPOCredll.S.lorm Pipe	1,00	LS	($61,861.23	)	(561,881,23)	0.00	1.00	1,00	S0,00	($61,881.23)	($61.881.23)	100%	sooo	S0.00	
	TOTALCHANGEORDER lf7 •PHASE F1				($164,095.83)				$0.00	($164,095.83)	($164,095.83)	100%	$0.00	50.00	
															
	CHANGE ORDER • PHASEF1														
,	F1 GEOTECHNICAL TESTING														
	Flel Te<hlcnlanSONlces	1.00	LS	$11,750.00	S11,750.00	0.00	1.00	1.00	S0.00	$11,750.00	511,750,00	100%	S0.00	so.oo	
2	L aboralory TesUng	1 ,00	LS	$3 , 186 . 00	53. 186.00	0,00	1,00	1,00	SO.OD	$3 . 186 00	53 ,186 . 00	100%	S0.00	S0,00	
3	Engineeriog & Project Management	1,00	LS	51, 400 ,00	S1,400 ,00	000	100	1,00	so00	$1,400 , 00	S1,400 ,00	100%	so.oo	W,00	
	TOTALCHANGEORDER • PHASE F1				$16,336.00				S0.00	$16,336.00	$16,336.00	1001/4	so.oo	$0.00	
															
	CHANGEORDER 119 • PHASEF1														
	IIILLAGE F1-DP0RECONCILIATION														
1	DPOReconc1hati0n-Fe,guson-ViUagt!F1	1 ,00	LS	S22, 031 .79	S22,031.79	0.00	1,00	1.00	S0.00	$22,031.79	522,031,79	100%	S0,00	$0,00	
2	OPO Reconcilla1t0 Rlnke-r Vitlage F1	100	LS	$18,762.28	518,762.28	0 00	1 00	1.00	sooo	S18.762.28	$18,762,28	100%	$,0 00	S0,00	
3	OPO Reconcihallor>-AUantic-Vlllagc F1	1.00	LS	$1,760.55	$1,760 .55	0.00	1.00	1.00	so.oo	S1,760 . 55	S1 ,760. 55	100%	SQ.00	S0.00	
4	DPO Reconcillatkm-CTB-VillageF1	1.00	LS	S10,00960	510,009,60	0.00	1,00	1.00	so.oo	$10 , 009 . 60	$10,009 . 60	100%	S0,00	S0.00	
5	6% Taxon Above	1.00	LS	S3.153.85	$3,153 ,85	0 00	100	1,00	S0.00	53, 153,85	$3,153 ,85	100%	S0,00	S0.00	
	TOTALCHANGEORDER #9• PHASEF1				S55,718.07				so.oo	$55,718 .07	$55,718 .07	100¾	SO.DO	$0.00	
															
	TOTALPHASEF1				S1,3!13,955 .78				$0.00	$1,393,955.78	$1,3!13,955,78	100%	SO.OD	SO.OD	
															
	PHASEF2														
	GENERAL CONDITIONS F2														
1	Mobliization	1 00	LS	$9,600 ,00	$9 ,600 00	0.00	1.00	1.00	S0,00	$9,600,00	59,600,00	100%	S0,00	S0.00	
2	NPOES PennIt & COmpliallCe	1. 00	LS	$4 .050 00	$4 , 050 .00	0. 00	1 00	1 .00	$,0 00	S,,,050,00	$4.05000	100%	sooo	SO.OD	

T pl•c,..kCDD-Vll1l g 1 E, F tndG1	APPLICATION FOR PAYMENT RIPA &ASSOCIATES PROJECTN01-170/A

PAV APP FROM TO

12RET
12/1/17
12/31/17

TrfploCree COO-Vlllag t E,Ftnd G1	APPLICATION FOR PAYl,IENT

RIPA g ASSOCl TESPROJECT #Ql, 1707A

PAY APP FROM TO

12RET
1211/17
12/3 1117

ITEM
NO	

DESCRIPTIONOF WORK	

QTY	CO TRACTSUM10 OATE		
				
BASE CONTRACT	
ESTIMATEOOUANTITY	TOTAL
WORK IN
PLACE	TO TAL
WORK IN
PLACE	TOTAL
WORXIN PLACE	
PERCENl
COMPLETE	
BALANCE
TO FINISH	
Oll
RETAINAGE	
			
UNIT	UNIT
P"RICE	
VALUE	THIS
ES11UATE	PREV
ESTlt.tATC	TOTAL
ESTIMATE	THIS
PERIOD	PR€V
APPl JC .ATION	TO
OATE	TO
OATE	TO
OATE	TO
CATE	
3	Ma int enanceof Traffic-	1 00	LS	51 ,200 .00	S1 ,200 .00	0. 00	, 1 00	1 ,00	so.oo	S1,200.00	$1,200.00	100%	S0.00	so.oo	
4	ConsLS takeout / Record Su<Vey- By Co11trae 10r	1 00	LS	533.000 00	S33 ,000.00	0,00	,1 00	1.00	S0,00	$33,000.00	S33,000.00	100%	$0.00	S0.00	
s	Payment & PerformanceBono• ByConlrac!or	1.00	LS	$10,100.00	s1 0.100 oo	0 00	1 ,00	1 ,00	S0 ,00	$ 1 0, 1 00 .00	s10 .100 . 00	100%	sooo	S0 ,00	
6	S ill Fe nce	4,800.00	LF	5120	$5,760.00	0.00	4800.00	4800.00	so.co	$5 ,760.00	SS,76,0 00	100%	so.co	S0 ,00	
7	sting lnte1s • Ems10nProtecUon	&00	EA	S98.20	558920	000	600	6.00	so.oo	SS89.20	SS89.20	1()0%	50.00	sooo	
	TOTALGENERAL CONDITIO NS F2				$64,299.20				SO.DO	$6,4 299.20	$6, 4 299.20	1 00%	$0.00	so.co	
															
	EARTHWORK F2														
1	Clearing & Grubbing	21.00	AC	S2.25,0 00	547 ,250.00	, 0 00	21 ,00	21.00	S0 ,00	$47 ,250 .00	$47,250.00	100%	so.co	S0.00	
2	OtscSOe	17 00	AC	5355 ,00	S6.035 .00	000	17.00	1700	S0,00	$6.035.00	$6,035.00	100%	S0,00	S0,00	
3	Cul Volume(UOacljuS1cd )	2,050 .00	CY	$2.10	$4,305.00	0.00	2050.00	2050.00	so.oo	$ 4 , 305.00	$4 ,J05 .00	1 00¾	so.oo	so.oo	
4	SOddi119	9 .760 00	SY	$ 2 .45	$23,912 . 00	0 .00	9760.00	9760.00	S0.00	523,912.00	S23,912.00	100%	sooo	S0 .00	
5	Seed ing & Mulch ing	6,864.00	SY	5025	51.716.00	0.00	6864,00	llll6400	S0,00	S'l,71600	$1,716.00	100%	S0,00	S0,00	
6	Oewaterifll	1.00	LS	S720 00	$720.00	0.00	1.00	1.00	S000	$720.00	$720.00	100%	5000	so.oo	
7	Fina l G radl 119	1,00	LS	$1,7 500.00	$17,50000	0.00	1.00	1.00	S000	S17 50000	5175.00,00	100%	S0,00	S0.00	
B	Imported Fill for Pad Gra<fi"9	7,400 .00	CY	57 ,00	$51 ,800 ,00	000	7400 .00	740000	S0.00	55,1 800 00	$51,800 00	100%	S,0 00	S0,00	
	TOTAL EARTHWORK F2				$15,3 238.00				$0 ,00	$153 ,236.00	$153,238 .00	100 ¾	$0..00	SO.OD	
															
	PAVING ANO BASE F2														
1	1 314•s. 1 Asphaltioc onc,e te	6.621.00	SY	S920	S6, 0 913.20	0.00	6621.00	&621.00	S0.00	560 ,91320	500 .913.20	100')1,	S000	S0.00	
2	6" CrushedConcrete Base	6.621.00	SY	$ 10.30	568,196.30	0.00	&621,00	&621 00	S0 .00	568 , 196.30	S68.196 .JO	100%	S000	so 00	
9	5·Slab[fziedSut,grade(LBR40)	,6 621 00	SY	$6,65	54,5 353,85	0.00	&621 00	662100	S0.00	$45,35385	545.353.65	100¾	S0,00	S0,00	
4	Miami Curo w/Slabllizalion (FullDepth)	5,616,00	LF	511,05	$62,056.80	0.00	5616.00	5616.00	sooo	56 2,056 .80	$6,2 056.80	100qle	so.oo	S0.00	
6	1ntersecoon- Vall")' Gu er (Coooty Dolail TD•6)	70.00	LF	S50,!l0	$3,563,00	0,00	70,00	7000	S0.00	S3.563.00	$3.563.00	100°.4	so.co	S0.00	
6	5'x4·ConcreteS tde"Nalk	398.00	LF	$19,50	$7, 761.00	0,00	398,00	398.00	S0,00	S7,76,1 00	S7.761 00	100%	S0.00	S0.00	
1	10'x4" Conorete Si<Jewatk	800 ,00	lf	539 ,05	$ 3 1 ,240 .00	0 .00	800.00	800 00	$000	$31.240,00	$31,240.00	100%	S0,00	so 00	
8	lO' x 6" S i>el! Material· Trail(w/Sllt Footeon BolllSldo)	935.00	LF	S25.50	$23,8d2.50	0.00	935.00	935.00	so00	$23 ,842 ,50	$23,842.50	100%	S0.00	S0.00	
9	ADARamps{5' wide )	7.00	EA	S&I0,00	$5,880 .00	0,00	7,00	7,00	S0.00	55.880.00	55,880.00	100%	S0,00	50,00	
10	ADA Ramps (10'wide)	8.00	EA	S1,200.00	59,600 ,00	0.00	800	8 00	S000	$9,600,00	$9,600.00	100'11	S0.00	SQOO	
11	Slgnage &Strip;ng	1.00	LS	Sfi,250.00	$6,250.00	0.00	1.00	1.00	SO.DO	SG.250 ,00	56,250.00	100%	S0.00	so_oo	
	lOTAL PAVING ANO BASE F2				$324,656.65				$0.00	!.324,656,65	$324,656.65	100%	so.oo	$0 .00	
															
	POTABLE WATER OISTRIBUT10 N F2														
1	Come< l to Exlsbng 8" W/M	2.00	EA	$1.250,00	$2 .500 00	0.00	2.00	2.00	50.00	52,500 ,00	SZ.500,00	100%	S0.00	$,0 00	
2	e· PVC PipeC-900	3,128.00	LF	S14.&0	545, 668 ,80	0 ,00	312800	3128,00	so00	54,5 668. 80	$45 ,668 ,80	100%	S0,00	SO 00	
3	6" Ffre Hydrant ASsembly/W(Tee A lling Connectloo	5.00	EA	$3,700,00	$1,8 500.00	0.00	5.00	5.00	SO.CO	518,500.00	51, 8500.00	1QO%	so.oo	SO.OD	
4	8" Gal"Valve	19.00	EA	$400,00	$7.600,00	0.00	19.00	1900	S0.00	S7,600.00	57,600.00	100%	S0.00	so 00	
5	e·Be nd Alllngs	8.00	EA	5260 ,00	$2.080 ,00	0.00	8.00	8.00	S0.00	52,080,00	S2,080,00	100%	S0,00	S0.00	
6	a· Tee f itt,ngs	4.00	EA	540000	$1,600.00	0.00	4.00	4.00	S0.00	$1,600,00	51,600.00	100%	so.oo	50 . 00	
7	S lng re Sctvlce,S""'1Side	47,00	EA	S240.00	$11.2IIO00	0.00	4, 7 00	47,00	SO.DO	$11,280,00	$11,280.00	100'!1,	S0.00	S0.00	
8	s;ngio&!<vice, Long Si d&	31.00	EA	5325.00	51, 0 075,00	0.00	31.00	31.00	S000	S10,016,00	$10,015.00	100%	S0,00	S000	

ITEM NO.	

OESCRIP 'TION OF WOR K	

QTY	CONTRACT SUMTODATE		
				
B4SE CONTRACT	
EGTIMATEO OVANTITY	T01AL WORK IN PLACE	TOTAL WORK IN PLACE	TOTAL
WORK IN PLACE	
PERCENT COMPLETE	
BALANCE TOFINISH	
0%
RETAINAGE	
			
UNrT	UNlf
PRICE	
VALUE	THIS
ESTIMATE	PREV
ES TIM ATE	TOTAL
ESTIMATE	THIS
PERIOD	PRE V
APPllCA1 ION	TO
DATE	TO
DATE	TO
DATE	TO
DATE	
9	Temporary Coostruttion Meter	UlO	EA	S9.00000	59,900.00	0.00	1.00	1.00	so.co	S9,900 .00	S9 .900 ,00	1 00 %	S000	S0.00	
,o	Ctllol'fnatk,n, Sampling & Pressure Testni g	100	LS	55.◄00 .00	S5.400 .00	o.oo	1 .00	1 .00	S O. DO	55.40000	SS.4,0000	100%	S0,00	S0,00	
	TOTAL POTABI.EWATER DISTRIBUT IO N F2				S114,60J.80				S0.00	S114,603.80	S114,60J,80	100%	$0.00	so.oo	
															
	SAN IT ARY SEWERF2														
1	8" PVC, SOR 26 (0--10' Cut)	1.JJ7.00	LF	515,00	S20.055.00	0.00	1337.00	1337.00	sooo	52,0 055.00	520,055.00	100%	S0.00	S, 0 00	
2	8"P VC. SOR 26 (10'·12' Cut)	323.00	LF	S17.10	S5,523.30	0.00	32300	323,00	SO.OD	55 ,523.30	55,523.30	100%	S0.00	S, 0 00	
3	8" PVC.SOR 26 (12'·14' Cui)	379.00	lF	S20.35	57,712.65	0 00	379.00	37900	S0.00	S7,712.65	57,71265	100%	so.oo	sooo	
4	8" PVC, SOR 26 (14-' 16' Cut)	39700	LF	S29.60	S11,751.20	0.00	397.00	397,00	S0,00	S11,75120	511,751,20	100%	S0.00	S0,00	
5	Samta,y Manhole (0'-8'Cut)	5.00	EA	S2.400.00	$ 12,000 .00	0 00	5.00	5.00	S0.00	S12,000.00	512.000.00	100%	S0.00	S0.00	
6	San ilaryM"'1trole (8'· 10' CUI)	1.00	EA	S2.800.00	S2,800.00	0.00	1.00	1.00	so.oo	S2 ,800 .00	52 ,800 00	1 00%	S0 .00	S0.00	
7	Sanlia,YMarl'<>le (I 0'-1 2' Cul)	2.00	EA	S3,000.00	S6.000.00	0.00	2.00	2.00	S0.00	$6,000.00	$6,00000	100%	S0,00	SOOD	
B	Sanilary Manho le (14'-16' Cul)	2.00	EA	$3,900 .00	$7,800 .00	0 00	2.00	2,00	S0.00	$7,800.00	$7,800 .00	100%	S0 .00	so.co	
9	SingleSe,vfce(HillsboroughCOu\'11)')	1 5 .00	EA	S595.00	S8,925.00	0.00	15.00	15.00	50.00	SS,925.00	S8.92500	100%	S0.00	SO.DO	
,o
,,	Oout>le Senilce(Hutsborough Coon,y)	32.00	EA	S775 ,00	S2 4,800.00	0.00	32.00	32,00	50 .00	S24,800.00	S24,800,00	1001<,	S000	SO.DO	
	8"St lJb..oul Co nnecbon	2.00	EA	5450 ,00	S900 ,00	0 00	2.00	2.00	so 00	$900 .00	S900 .00	1 00%	SO.DO	S0 .00	
12	Oewaten"rlQ	1.00	LS	$29,500.00	$29 ,500.00	0.00	1.00	1.00	so.oo	S29 ,500 ,00	529 .500 00	100%	so.co	so00	
13	lnlWExOITesHng	1.00	LS	$4.150.00	S4,150.00	0.00	1.00	1,00	S,0 00	$,4 150.00	S4,150,00	1()0%	S0.00	so.oo	
t 4	T ele vis e 5anilary Sewer (CCTV)	,2 436.00	LF	$305	$7,429.60	000	243600	2436.00	SO. DO	$7 ,429.80	S7 A29.80	100%	so.co	so.co	
	TOT ALSANITARY SEWER F2				$149,346.95				$0.00	$149, 341;.95	S149,346.95	100 %	SO.OD	SO.DO	
															
	STORM DRAINAGE F2														
1	15 " Class Ill RCP	65 ,00	LF	S23.30	5,1 514.50	0 00	6/;.00	65.00	so.co	S1151◄. 50	S1, 514 . 50	1  00%	so.co	S0 .00	
2	18" C lass Ill RCP	300.00	LF'	S28 .40	58 .520 .00	0.00	300,00	300,00	so.co	58,520 .00	58.520.00	100%	S0.00	S0.00	
3	24" Class Ill RCP	240.00	LF	538.30	S9.192.00	0.00	240,00	240.00	S, 0 00	$9,19200	S9,192.00	100%	so.oo	so00	
4	30· Class Ill RCP	870,00	LF	$52.50	$45,675.00	0.00	870.00	870.00	S0.00	$45,675.00	$45.675.00	100%	Sll.00	S0.00	
5	36" Class III RC P	320.00	lF	S72 10	S23,072 00	0.00	320.00	32000	so.co	S23,072.00	523.072.00	100%	S0.00	so.oo	
6	42" Class III RC P	4 75.00	LF	$90.65	S43,058.75	0.00	475.00	475 00	S0.00	543,058,75	543,058. 75	100%	S0,00	S0,00	
7	InletType 1 (HC)	14,00	EA	$4,150.00	S58,100 ,00	0 00	14.00	14,00	so00	$58,100.00	S58,100.00	100%	$0.00	so.oo	
B	FOO T Ma nhole	4.00	EA	$3,250.00	S13.000.00	0 00	4.00	4.00	50.00	513,000.00	513.000.00	100'11,	S0 .00	S0.00	
9	Oewaiering	1.00	LS	$18.50000	S18,500.00	0.00	1.00	1.00	so.co	S16.500.00	518.500,00	100%	$000	S0.00	
10	TelevisaSiorrn$"""'(CCTV)	2.270,00	LF	$6,35	S14,41, 4 50	0.00	2270,00	2270,00	S0 00	S14,41◄.50	514.414.50	100%	S0.00	S0,00	
11	6" UNOERDRAIN (FINE AGGREGA TE)	480.00	LF	S11,95	S5,736.00	0.00	480.00	480.00	S0.00	55,736,00	55,736.00	100%	so.oo	$0 ,00	
12	UNOERORAIN CLEANOUT	5.00	EA	S185 ,00	$925 .00	0.00	5.00	500	S0.00	$925 .00	S92S.OO	1 00%	S0.00	S0.00	
	TOTAl STORM DRAINAGE F:t				$241,707 .75				$0.00	$241 ,707.75	$241 ,707.7S	100 '.I•	S0.00	so.oo	
															
	ROAD SLEEVE CROSSING F2														
1	2" Sc/\40PVC	90.00	LF	54 ,80	5432.00	0 00	90,00	90,00	so.co	$432.00	$432.00	10()%	S0.00	S000	
2	4• Scn40 PVC	270.00	LF	S6 15	$1,660.50	0.00	2.70.00	270.00	so.co	S1,660.50	S1.660 50	100%	S0.00	SO.OD	
3	o·Sci\ 40 PVC	60.00	LF	S8.15	$<189 .00	0 ,1)0	60 .00	60 .00	so.co	5◄89   . 00	5489.00	100%	S0,00	S,0 00	
	TOl Al ROAD SLEEVE CROSS ING F2				$2,581.50				$0.00	$2,581.50	$2,581.50	100,-.	S0.00	S0,00	

TripleG,..  kCOO.Vlllogo E.F andGI	APPLICATIONFOR PAYMENT RIPA&ASSOCIATES PROJECT#OI 1707A

PAY APP FROM TO

12RET
12/1 /17
12/31/17

TripleCreekCOO-Vill,ge E,f tndGt	APPLICATION FOR PAYMENT RIP&ASSOCIATESPROJECT # 0I.1707A

PAY APP FROt,1 TO

12RET
1211117
12/31 /17

ITEM NO.	

OESCRJPTIONOF WORK	

OTY	CONTRACT SUM TO DATE		
				BASECONTAACT	
ESTIMATED QUANTITY	TOTAL
WORK IN PLACE	TOTAL
WORK IN PLACE	TOTAL
WORK IN
PLACE	
PERCENT COMPLETE	
BALANCE
TO FINISH	Ill ,
RETA!NA.GE	
			
UNIT	UNIT
PRtCE	
VALUE	TH1S
ESTIMATE	PREV
ESnM.ATE	TOTAL
ESTIMATE	THIS
PERIOD	PREV
APPLICATION	TO
□A.TE:	TO
OAlE	TO
DATE	TO
□ATE	
															
	CHANGEORDER #2 • PHASEF2														
1	CPOCredil - FefgUSOn - Waler	1,00	LS	(S103.57092)	($103,570.92	)	0.00	1.00	1,00	SD,00	(S103,570.92)	(S103.570,92)	100%	so00	$0.UO	
2	CPOCredil - Ferguson· Sewer	1 00	LS	($22,285.24)	(S22,285.24)	0.00	1,00	1.00	so00	(S22.285,24)	($22.285,24)	100%	so 00	$000	
3	CPOCredit- Ferguson- Sleeves	1.QO	LS	($686.40)	(S686.40)	0.00	1.00	1.00	S0.00	($686.40)	(5686.40)	100%	SO.OD	SO.OD	
•	CPOTax Savings	1 00	LS	($7,592.56)	($7,592.56)	0.00	1.00	1.00	SO.DO	(S7 592.56)	(S7.592,56)	100%	$0.00	SO.OD	
	TOTA L CHANGEORDER #2• PHASEF2				($134.135.12)				$0.00	($134,135.12)	($134,135,12)	100%	$0.00	$0.00	
															
	CHANGEORDER #3 • PHASEF2														
	EARTHWORK f2														
1	I VotUflle (Lol"YJ HBt..1• FromBh,tj ) - RepJaces 1mpor1	, 7 400.00	CY	$2.75	S20,350.00	0.00	7400.00	7400.00	S0.00	$2, 0 350.00	520.350.00	100%	$0.00	$0.00	
2	FillVolume(LongHaulFromBlv .)• Replaces FIii FonnE2/E3	•s.soo.oo	CY	$2 75	$127,87500	000	46500.00	46500.00	sooo	S127 875,00	S127.875.00	100%	S0,00	S0.00	
3	ImportedFill	(7,40.000	) CY	$7.00	($51,80000)	0,00	•7400.00	-7400.00	S-0.00	(S51,800.00)	(S51.800,00)	100%	S-0.00	S0 ,00	
	TOTALEARTHWORK F2				$96,425.00				$0,00	$96,425.00	$96,425.00	100'/1	so.oo	SO.OD	
															
	GEOTECHNICAL TESTING F2														
1	F2 - AekiTeohnic:ian Ser.nces	1,00	LS	$22 ,863.60	$22,863.60	0.00	1.00	1.00	S-000	$22,863.60	$22,863.60	100'1(,	S000	S0.00	
2	F2 • Labralory Testi"9	1,00	LS	$3,762.00	$3.762.00	0.00	1.00	1.00	S0.00	SJ.762.00	$3,762.00	100%	S0 ,00	S0.00	
3	F2 - Engineering& ProjeclMaoagemoot	1.00	LS	$2.7,3000	$,2 730.00	0.00	1.00	1.00	S0,00	S2,730.00	S2.730 00	100%	S0,00	S0.00	
	TOTAL GEOTECHNICAL TESTING Fi				$29,35 5-60				S0.00	$29,355.60	$29,355.60	100¾	$0.00	S0.00	
															
	SEEDING & MULCHING F2														
1	See<llog & Mulc/11"9	81,46000	SY	$025	S20,365.00	000	81460.00	81460.00	S0.00	S20. 365.00	520.365.00	100%	S000	so.oo	
	TOTA L -SEE DING & MULCHING F2				$20,365.00				S0.00	$20,365.00	$20,365.00	100¾	SO.OD	SO.DO	
															
	T OTAL CHA N GE ORDER #3- PHASE F2				$146,145.60				$0.00	$146,145.60	$146,145.60	100,.-	SO.OD	$Q.00	
															
	CHANGE ORDER #4 • PHASEF2														
1	DPO Credit · R;n1<er • StonnPipe	1,00	LS	($63,01,348)	($63,013.48)	000	1,00	1 00	S0.00	($63.013,48)	($63,01348)	100%	S0,00	S0.00	
2	DPO TaxSa'lings	100	LS	(53,80081)	($3,800.81)	0.00	1.00	,.oo	S000	($'3,80081)	($3.800.81)	100%	sooo	S0 .00	
	TOTALCHANGE ORDER #4 • PHASEF2				(566,814.29)				$0,00	($66,814.29)	($66,814.29)	100%	$0 ,00	$0.00	
															
	CHANGEORDER#5 • PHASEF 2														
1	OPO Credit· Attandc TNG- Sewer Structures	1,00	LS	($12 ,430 .75)	($12,430 .75)	000	1.00	1,00	S0.00	(512,430.75)	($12,430.75)	100%	S0,00	so.oo	
2	DPO Credi!·AllanlieTNG• S10rm Slructures	1.00	LS	($1, 9141.55)	($191, 41.55)	000	1.00	100	SO.DO	($19, 141. 55)	(S19,141.55)	100%	S000	SO.DO	
3	DPO TaxSavings	, 00	LS	($1,904,33)	($1,904.33)	0,00	1,00	, 1 00	so 00	(51.904.33)	(S1,904.33)	100%	S0,00	50.00	
	TOTAL CHANGE ORDER #5 • PH ASE F2				(533,476.63)				$0.00	($33,476.63)	( 3.476.63)	100%	$0,00	$0.00	
															
	CHANGEORDER #6 • PHASEF2														
	CTBDIRECTPURCHASE ORDER														
1	OPO Crecm• Soil CenienlBase	(2.549,00)	TN	$16.QO	($40,7$4.00)	000	-254900	-254900	S0.00	(S40,7$4.00)	($40,784.00)	100%	S0.00	S000	

lh f ll

TrfpltCrNk COD-Vni,goE,FInd Gt	APPLICATIONFOR PAYMENT fllPA& ASSOCIAJES PROJEC1 t 0M707A

PAV APP FROM TO

12 RET
1211117
12/31 /17

ITEM
NO.	

DESCRIPTION OF WO K	

QTY	CONTRACT SUMTODATE		
				
BASE CONTRACT	E STIMAreo0 \JANTtTY	TOTAL
WOR K.IN PLACE	TOTAL
WORK.IN PLACE	TOTAL
WORK IN
PLACE	
PE.RCEN1
COMPLETE	
BALANCE
TOFINISH	
0%
RETAIN-AGE	
			UNIT	U NIT
PRICE	VALUE	THIS
ES TIMATE	PREV
ESTIMATE	TOTAl
ESTIMl!irE	THIS
PERIOD	PRE.V
APPLICATlON	TO
DATE	TO
DATE	TO
DATE	TO
o.r e	
2	OPO Tax Sa\,i119s	1 .00	LS	(S2.44 7 ,04)	(52,44704)	0,00	100	100	$0 00	($2,447,04)	($2.44704)	100%	S0,00	$0,00	
	TOTAL CHANGE ORDER #6· PHASE F2				($43,231.04)				$0100	1$43,231.04)	1$43.231,04)	100%	S0.00	$0.00	
															
	CHANGE ORDER #9• PHASE F2														
	VILLAGEF2-DPORECONCILIATION														
1	OPO RecoocUi.alioo-Rinker VnlageF2	1.00	LS	$7,943.20	$7,943.20	0.00	1.00	1.00	$,0 00	$7,943.20	S7,943.20	100%	$000	S0.00	
2	6%TaxOM AbOve	1 ,00	LS	S476 .59	S476.59	0.00	1.00	1.00	S, 000	$476.59	$476.59	100%	50.00	5,0 00	
	TOTALCHANGE ORDER #9• PHASE F2				$8,419.79				$0,00	$8,419.79	$8,419.79	100¼	$0.00	SO.DO	
															
	TOTAL PHASEF2				$927,342.16				$0.00	$927,342.16	$927,342.16	100%	$0.00	$0.00	
															
	PHASEG1														
	GENERAL CONDITIONS G1														
1	Moblliz.alkm	1.00	LS	5, 9600.00	S9.600.00	0 00	100	1.00	S0,00	$9,600.00	$,9 600.00	100	S0,0	0	S0,0	
2	NPDES Compl,ar,ce	1.00	LS	$,5 250.00	55,250.00	0.00	1.00	1.00	SO,(JQ	S5,250 .00	SS,250 .(J(J	1 00%	so.co	S0,00	
3	Malntooanceor Traffic	1 00	LS	$1 ,200 00	$1 ,200 .00	o.oo	1.00	1.00	50.00	S 1,20000	$,1 200.00	100%	S0,00	so.oo	
4	Consl.Slakec ut I Reco rd Survey • By Contractor	l 00	LS	S4, 6 000,00	$46,000,00	0 00	1.00	1.00	S0,00	$46,00.00	$46,000.00	100%	S0.00	S0,00	
5	Payment & Perlormanco Bond• ByContrac1or	1.00	LS	$17 ,000 00	$ 17, 000 .00	0.00	1.00	1.00	S0.00	$ 17,000.00	$17,000.00	100%	so.oo	S0 . 00	
6	Si ll Fence	6,900.00	LF	S1.20	$8,28, 000	0.00	6900.00	6900.00	S0,00	$8,280.00	S8.280,00	100%	S, 000	50,00	
	TOTAL GENERAL CONDITIONS G1				$87,330 .00				S0.00	$87,330 .00	$87,330.00	100¥0	S0.00	so.co	
															
	EARTHWORK G1														
1	CleaM119 & Grubbing	28.00	AC	52.000,00	556,000.00	0,00	28,00	28,00	S0,00	$56,000.00	S56,000.00	100%	S0.00	S, 0 00	
2	DiscSite	24.00	AC	5355,00	SB.520.00	0.00	24.00	24.00	S0,00	$8,520.00	SB,520.00	100%	so.oo	S000	
3	cutVolume (Unadjusted)	'.35,880 .00	CY	$2.10	S75.348.00	0.00	35880.00	35880,00	S0.00	S75,3"8.00	S75,348.00	100%	S0.00	S0,00	
4	SOddlng	20,955.00	SY	$2.45	&51, 339,75	0.00	20955.00	2095500	S0,00	551,339,75	551,339.75	100%	S, 0 00	so.oo	
5	Seeding & Mulching	,8 506.00	SY	S0.25	S2,126.50	0.00	8506.00	8506.00	S0.00	$2,126.50	$,2 126.50	100%	S0.00	SOOD	
6	Dewa teling	1.00	LS	S2.000.00	SZ,000,00	0.00	1.00	1 00	S0.00	$2,000.00	52,00000	100%	S0.00	S0.00	
7	Flnal Grading	1 00	LS	S21.500.00	S21.500.00	0.00	1,00	1 00	so.co	521.500 ,00	S21.500 00	100%	S0,00	S0.00	
6	Imported FIii	10 ,400.00	CY	S7.00	$72.800.00	o.oo	1 0400.00	10400 .00	S O.OD	S72 ,800. 00	57 2,800 .QO	100%	sooo	so.oo	
9	Im portedFill for Pad Grading	5,800.00	CY	5 7,00	M0.600 ,00	000	5800,00	SS-0000	so.oo	$40,600 , 00	$ 40, 600 . 00	100%	so.oo	S 0 . 00	
	TOTAL EARTHWORK G1				$330,234,ZS				$0,00	$330,234.ZS	$330 ,234.25	100%	$0,00	$0.00	
															
	PAVING ANO BASE G1														
1	1 :t/4' S·1 Asphallle COncmte	9.275.00	SY	59.25	$85,793.75	0.00	927, 500	927500	so.co	S85,79375	S85.793 75	100%	S0,00	S0,00	
2	6' Crushed concrete Base	9,275.00	sv	S10.30	S95.532.50	0.00	9275.00	9275.00	SO.OQ	$95 ,532 .50	$95,532.50	10()'%	S,0 00	S0 .00	
3	6' StabilizedSUbgracle( LBR40)	9,275.00	SY	S6.85	$63,533 .75	0.00	9275.00	9275,00	S0.00	563, 533.75	$63,533.75	100%	$0.00	S0.00	
4	MiamiCurt> w/Stal>'lizallon(FullDeplh)	6,960.00	LF	511.10	S77,256,00	000	696000	6960,00	5000	$77,256,00	S77.256 00	100%	S0,00	so00	
5	6' Wide RibbOn Curll	64200	LF'	S11 05	S7,09410	0.00	642.00	642-00	so.co	S7 i094 .10	$7,094 .10	100%	S0.00	so.co	
6	lnle rsec6on. VaJ1eyGutter (County Detail T0•6)	140.00	LF	SSD.90	$7,126 ,00	0 ,00	140 00	140.00	so.co	$7 .126 , 00	S7 ,1 26 .00	100 %	S0 .00	S0 . 00	
7	S' xA• COnc,ete S;,Jewalk	1,84000	LF	S19.50	S35,800 ,00	0.00	1840 00	1840,00	so 00	S3S,880,00	$3 .880.00	100%	S0.00	SO 00	

0

11 110 1

ITEM NO	

DESCRl?Tro   N·  OF  WORK,	

QTY	CONTRACT SUM TO DATE		
				
BASE CO+HRACT	
ESTI M ATEOQUANTITY	TOlAl WORK IN Pl.ACE	TOTAL WORl<IN Pl.ACE	TOTAL
WORKI"'
Pl.ACE	
PERCENT
COMPLETE	
BALANCE
TO FINISH	
Oll
RETAJNAGE.	
			
UNIT	UNlT
PRICE	
VALUE	rHIS
ESTIMATE.	PREV
EST IMATE	10iAL
ESTIMATE	!HIS
PERIOD	PREV
APPLICATION	TO
DATE	TO
DATE	TO
DATE	TO
OATE"	
8	10' x•r  Conacte S1dewalk	;86.00	lF	539.05	S22,883.30	0,00	5116.00	586.00	SO.OD	$ 2, 2883.30	$22.88330	100%	SO.OD	SO.OD	
9	10·WkleAS1l alt Pavement (wlbas c & $Ubgrade.) • Troll	'.146.00	SY	$2590	SS,961 40	a.OD	346,00	346.00	SO.OD	$8 ,961 40	$, 8 961 .40	100%	SO.DO	SO.DO	
10	10 'x 6' S hellMaterial- Trall (w/Silt Fenc• onsou,Side)	720.00	Lf	$2550	S1B.360.00	0,00	720.00	72000	SO.OD	$1,8 360.00	S18,36000	100%	SO.DO	S0,00	
11	ADA Ramps (5' wide)	1700	EA	$84000	S14,28000	0,00	17.00	17.00	SO.OD	S14,280 .00	$1 4,280 ,00	100%	SO.OD	-S0,00	
12	ADA Ramps (10·Wo<le)	4 00	EA	$1,200.00	S, 4 B,00 00	000	4.00	4,00	SO.DO	54 ,800 . 00	$,4 8 0000	100%	SO.OD	$0 ,00	
13	12"Wlde4      Concrele BlockWall	203.l>O	LF	$92 60	S18,797.80	0,00	203.00	203.00	$0.00	$18,797.80	S1B.797.8o	100%	SO.OD	SO.DO	
14	Signage& Striping	1.00	LS	S, B350 00	SS,350.00	0,00	1.00	1.00	SO.OD	SS,350.00	S8.35000	100¾	SO.OD	S0 ,00	
	TOTAL PAVING AND BASEG1				$468,648.60				50.00	$468,648.G0	$4 68.Ml!.60	100%	S0.00	$0 ,00	
															
	POTABLE-WATER DISTRIBUTION G1														
1	4" PVCPVCC-900	796.00	LF	S, B10	S6,447.60	0.00	796.00	796.00	50 ,00	$6,447.60	S6,,417.60	100%	S0.00	S0 .00	
2	6"PVCPipe C-900	1.680.00	LF	S10,50	$17,640.00	0.00	1680.00	1680.00	SO.OD	517, 640.00	517,640.00	100%	so.co	S0 .00	
3	8"PVCPlpeC-900	1,842.00	Lf	S1, 4 60	$26,893.20	0,00	184200	184200	SO.DO	S2,6 893.20	$2,6 893 .20	1 00%	SO.OD	S0 ,00	
4	6" FifeHydrant Assembly/wffeeFlt1ing Connecllon	7 00	EA	$3,700 00	S25,900.DO	o.oo	7.00	7.00	SO.OD	525 ,900.00	$25.90000	10D%	so.oo	$0 ,00	
5	4• Ga te Va l'Je	4.00	EA	S715.00	S2,860 00	000	4.00	4 00	SO.DO	$2 ,860 .00	S2 .860,00	100%	SO.OD	SO.DO	
6	6" Ga10Valve	11,00	EA	$870 .00	$9,570 .00	0.00	)100	1100	S0,00	S9,5,7000	S9,570.00	100%	S0.00	S0 ,00	
7	B" GaleValve	13.00	EA	54 0, 000	SS,20000	000	13.00	13.00	SO.OD	$5 ,200 .00	55, 200.00	100%	SO.DO	SOOD	
B	4"BenoFlttings	12.00	EA	S150 ,00	$1,800.00	, 0 00	12.00	1200	S0.00	S l,800.00	$1,800.00	100%	so.co	SO.OD	
9	6"Ben<IFittings	16.00	EA	5185 ,00	$2 ,960.00	0.00	16.00	16.00	SO.OD	5,2 960 ,00	$2, 960.00	100%	sooo	SO.DO	
10	6" TeeFittings.	1 00	EA	S290.00	S29000	0.00	1 00	1 00	SO.OD	$290.00	5290.00	100%	SO.OD	$0 .00	
11	6" Cross Flttiflgs	1.00	EA	$395.00	S395.00	0.00	1.00	1.00	5000	S395,00	S39S.CIO	100°.4	SO.DO	SO.DO	
12	B"Bel>df ittlr,gs	6.00	EA	S260 00	$1,560.00	0.00	6.00	6.00	SO.OD	$1, 560.00	S1,560,oei	100%	SOOD	S000	
13	e Tee Fittlrgs	500	EA	5400.00	S, 2 000.00	0,00	5,00	500	SO.DO	S, 2 000.00	52.000,00	100%	SO.OD	S0 ,00	
14	e·xs-Rooucer	l 00	EA	S235.00	S235.00	, 0 00	1.00	1.00	SO.DO	S235 .00	5235 ,00	100%	so.oo	SO.OD	
15	Blow-Oft Assem by(See County Orwg No W-6A)	1.00	EA	$1.,20)(_00	$1,200.00	0.00	1.00	1.00	SO.OD	S l, 200.00	S,1 200.00	100%	SO.OD	S0 ,00	
16	SingleSer;k,;e ShonSide	61 00	EA	S240,00	$14,640.00	0.00	61,00	6100	SO00	S14,640.00	$14,640.00	100%	$0.00	S0,00	
17	Single SeNIC<!. Long Side	,, 00	EA	S325.00	5, 4 550.00	0.00	14.00	14.00	SO.OD	$4,550.00	$4.550,00	100%	$0.00	so.oo	
16	Temporary Constn,ctlonMoter	1. 00	EA	$9,900 00	S9,900.00	0.00	1.00	1.00	SO.DO	59, 900,00	5, 9900.00	10tl'l4	SOOD	S0 ,00	
19	C rinatlon.Sampllng & PressureTesting	1 00	LS	S7,350,00	$, 7 350.00	0.00	1 00	1 00	50-00	S7,350.00	S7,35000	100¾	SO.OD	SOOD	
	TO TAL POTABLE WATER DISTRIBUTION G1				$14 1 ,390 .81)				$0 .00	$141 ,390.80	$141,390.80	100"/,	SO.DO	10.00	
															
	SANITARY SEWER G1														
1	8" PVC, SOR 26 (0'·10' Cul)	3,584 00	LF	$15,00	$53,760.00	, 0 00	3584.00	3511<1. 00	SO.DO	553 ,760 .00	S53.760,00	100%	so.oo	S0 .00	
2	Sanitary ManhOle (0'-8' Cut)	24.00	EA	S2.400 00	$57,60000	0.00	24,00	2400	SO.OD	$57,600 .00	S57 ,600, oei	100%	S0,00	S0 ,00	
3	Sanllary Manhele (10'-12' CUI)	2 00	EA	$, 3 000.00	S6,00, 000	0,00	200	200	SO.OD	$6, 000.00	$6,000.00	100%	SO.DO	SO.DO	
4	SingleSer.lie• (HIiisboroughCounty)	16 00	E/\	S59500	$,9 520.00	, 0 00	16.00	16.00	SO.DO	59 ,520 .00	S9 .520,00	100%	so.oo	SO .DO	
5	DoobleServ\ce(Htr\StlOIOIJ9h Count)')	33.00	EA	S775.00	$25 ,575.00	0,00	3300	33.00	SO.OD	$25 ,575.00	S25,575 .00	1 00¾	so.co	S,0 00	
6	s· S tub&P!Ug	1.00	EA	5450.00	545000	0.00	100	1 00	SO.DO	$450 .00	$450.00	100%	SO.OD	SOOD	
7	lnfil/Exfil Testtng	1.00	LS	$4,000.00	5,4 900.00	0.00	1.00	1.00	SO.DO	5 4,900.00	$,1 900.00	100%	$000	S0,00	
8	Dewateong	1.00	LS	S'.14,500 00	$34,500.00	0.00	1 00	1 00	SO.DO	S 34,500.00	S34S. OO.OO	100%	SOOD	S0 ,00	
9	Telev,seSa<>itary s.w.,.(CCTV)	3.5114,00	LF	S, 3 05	$1,0 931,20	0,00	3584,00	358400	so00	S10.931.20	$10,931 20	100%	SO.OD	$000	

Triple CrNkCOD-'lllltgt E, F tnd 01	APPLICATIONFOR PAYMENT PA&ASSOCIAfESPROJECl# 01•1707A

AYAPP
FROM
10

12RET
1211117
12/31/17

ITEM
NO.	

DESORIPT10N OF WORK	

QTY	CONTRAC T SUM TO OATE		
				
eAse CONTRACT	
ESTIMATEDQ UANTITY	TOTAL
WORKIN
PLACE	l O TA L
WO   K IN
PLACE	TOTAL
WORt<tN
PLACE	
PERCE.NT COMPLETE	
BALANCE
TO FINISH	R TA°JN"AGE	
			
UNIT	UNIT
PRICE	
VALUE	THIS
ESTIMATE	P'11EV
ESTIMATE	TOTAL
ESTl'AATE	THIS
PERJOD	PREV
APPLICATION	TO
DArE	TO
DATE	TO
DATE	TC
OATE	
	TOTAL SANITARY SEWER G1				$203,236.20				S0.00	$203,236.20	$203,236.20	100%	$0.00	$0, 00	
															
	STOR M DRAINAGE G1														
1	15" Class III RCP	179.00	LF	523.30	S4,170 ,70	0 00	179.00	17900	sooo	54 ,170, 70	$4 . 170 70	1 00%	so.Oo	S,0 00	
2	1 6" Class Ill RC P	427 00	LF	$28.40	S12,126.80	0.00	427 00	427,00	S0.00	$12,126.80	$12.126.80	100%	$0.00	S0.00	
3	24" Class Ill RCP	1,024.00	LF	$36.30	S39,219.20	0.00	1024.00	1024.00	S0.00	$39 ,219 .20	$39.219,20	100%	SO.DO	sooo	
4	30" Class III RCP	714 .00	LF	S52.50	53 7,485.00	0.00	71, 4 00	714.00	S0.00	$37,485.00	$37.48, 5 00	100%	S0,00	$0 ,00	
5	36" Class Ill RCP	33.00	LF	$72.10	S2.379.30	0.00	33.00	33.00	S0.00	$2,379.30	$2,379 30	100%	S0.00	S0.00	
I,	Inlet Type1 (HC)	16.00	EA	54,150,00	566,400.00	0.00	16.00	16.00	S0.00	566 ,400.00	566 ,400.00	100%	SO.QO	S,0 00	
1	FOOTType -C Inlet	1.00	EA	51,900.00	S1,900.00	0.00	1 00	1 00	$0.00	$1,900.00	$1,900 00	100%	S0.00	S0.00	
8	FOOTType·E Inlet	2.00	EA	52,550.0	0	SS,100.00	0.00	2.00	2.00	S0.00	$5,100.00	$5.10000	100%	S0.00	S0.00	
9	COn1ol S truc1ure (FOOT MOdlfied T)l)e"D" Inlet)	2.00	EA	$,3 500.00	S7.000,00	0,00	2.00	2.00	S0.00	$7,000.00	$7,000.00	100%	S0.00	so.oo	
10	FOOTManhole	4.00	EA	$3,250.00	$13,000.00	0.00	4.00	4.00	S0.00	$13,000.00	$13.000,00	100%	$, 000	so.oo	
11	30" FES	5.00	EA	S2,300.00	S11,500.00	0.00	5.00	5.00	S0.00	511,500.00	$11,500.00	100%	S0.00	so.oo	
12	36"FDOT FES	1.00	EA	S2,750.00	52,750.00	0.00	1.00	100	S0,00	S2.750.00	S2,750 00	100%	$0.00	S0,00	
,1.3	Dewalerlng	1,00	LS	S27.500.00	S27.50000	0.00	1.00	1.00	S0.00	S27,500.00	$27,500.00	100%	SO.Oil	sooo	
	Televise Stom, Sewet(CCTV)	2,377.00	LF	56.35	$15,093.9	5	0.00	237700	2377 00	S0.00	S15,093 .95	$15 ,093 95	100%	S0.00	SO.Oil	
15	FOOTManoole	1.00	EA	$3,250.00	$3,250.00	0.00	1 00	1.00	S0.00	53,250,00	$3,25000	100%	S0.00	S0.00	
16	6" UNDERDRAIN( FINEAGGREGA"IE)	94000	LF	S11.95	511,233.00	0.00	940.00	940.00	$0.00	S1,1  233.00	S11.233	. 00	1 00%	S0.00	sooo	
17	UNDERORAIN CLEANOUT	11 .00	EA	5185.00	$2,035.00	0.00	1100	11.00	SO.Oil	$2,035.00	$2,035 00	100%	S0.00	SO.Oil	
	TOTAL STORM DRAINAGE G1				$262 ,14 2.95				S0.00	$262,142.95	$262,142,95	100%	$0.00	$0,00	
															
	ROAD SLEEVE CROSSING GI														
l	2" Scn40PVC	150,00	LF	$,1.80	S720 .00	0.00	150 .00	150.00	S0 .00	572000	$720 00	100l4	S0,00	S0,00	
2	• Sch 40 PVC	300.00	LF	$6,15	S1,845.00	0.00	300.00	300.00	$0.00	$1,845.00	$1,845.00	100%	50.00	SOCIO	
	6" Sch40PVC	60.00	LF	SB.IS	5489.00	0.00	60.00	60.00	S0.00	1'189.00	$489.00	100%	S0.00	S0 .00	
	TOTAL ROAD SLEEVE CROSSING GI				SJ.054.00				$0.00	$3,054.00	$3,054.00	100%	50.00	$0.00	
															
	CHANGE ORDER #2 • PHASEGI														
l	OPO Credit • Ferguson • Water	1 00	LS	(S70,079.16)	(S70,079.16)	0.00	1.00	1,00	S0.00	($70,079,16)	($70.079.16)	1001"	$000	S0.00	
2	OPO Credit- F erguson- Sewer	1.00	LS	(546,522.35)	(S46,522.35)	0 00	1.00	1.00	$0.00	($46,522.35)	($46,52, 235)	100%	50.00	so.oo	
3	OPO Credit• Ferguson Sleeves	1.00	LS	($753.40)	(5753.40)	0.00	1.00	1.00	$0,00	($753.40)	($753,40)	100%	$0.00	S0.00	
4	DPOT;ixS""1ngs	1.00	LS	($7,041.29)	($7,041 29)	0.00	1,00	1.00	S0.00	($7,041.29)	($7,041.29)	100%	S0.00	S0.00	
	TOTAL CHANGE OR DER #2 • PHASE GI				($124,396.20)				S0.00	($124,396.20)	($124,396.201	100%	$0.00	S0.00	
															
	CHANGE ORDER #3 • PHASEGT														
	EARTHWORK G1														
1	FIii Volume (Long Haul From Blvd.)· Replaces lfTIPor1	16 .200 ,00	CV	52.75	S44.550.00	0.00	16200.00	16200.00	S0.00	544,550.00	$44,550.00	100%	S0.00	so.oo	
2	mI parted Fill	(16,200 .00)	CY	$7.00	(5113.400.00)	0 00	·16200.00	- 16200.00	S0.00	($113,400.00)	($113.400.00)	100%	S0.00	$0,00	
	TOTAL EARTHWORK GT				($68,850.00)				S0.00	($68,85-0.00)	($68 ,850 .001	100 '1,	$0.00	S0.00	

TripleCreek COD-VJMage E, f andGI	APPLICATIONFOR PAYMENT RIPA& ASSOCIATES PROJECHOt 1707A

PAY APP FROM TO

12RET
12/1117
12131/17

Tn ple Cree, COD-1/illoge E,F ,nd GI	APPLICATION FOR PAYMENT RlPA &ASSOCIATESPROJECT #Ol- 1707A

PAYA.PP FROM TO

12RET
12/1/17
12131117

ITEM NO	

DESCRIPTIONOF WORK	

OTY	CONTRACTSUM TO DATE		
				
8ASE CONTRACT	
ESTIMATED OUANTfTY	TOTAL
WORK.IN
PLACE	TOTA L WOR K IN
PLACE	TOTA L
WOR lr-,l
PLACE	
PERCENT COMPLETE	
8ALANCE TOFINISH	
0'4
REi AINAQ.  E	
			
UNIT	UNIT
PR1CE	
VALUE	rn,s
ESTIMATE	PREV
ESTIMATE	TOTAL
ESTIMATE	THIS
PERIOD	PREV
APPLICATION	TO
DATE	TO
DATE	TO
DATE	TO
OATE	
	GEOTECHNICAL TESTING G1														
1	G1 - Flcld TechnlCianSerw:es	1,00	LS	$2, 1952.80	S21.95.280	0,00	1.00	1.00	sooo	$21 ,952 . 80	$21,95280	100%	SOOD	$,0 00	
2	GI - LaDratory TesUng	1,00	LS	$,3 624.00	$3,62 4.00	0.00	1,00	1.00	S0.00	$3,624.00	$3,624.00	100%	SO.OD	S0 .00	
3	G1 - Eng fneering & Project Management	1.00	LS	$2,340.00	$2,340.00	0,00	1,00	1.00	S0.00	$2,340.00	S2,340,00	100%	so.oo	$0 ,00	
	TOTA L GEOTECHN I CAL TESTINGG1				$27,916.80				$0.00	$27,916.80	$27,916,80	100%	$0.00	$0,00	
															
	Seeding & Mulch lng G1														
1	See<!lng &Mulching	90,915.00	SY	S0.25	$22,728.75	0,00	1l0915.00	W9 15.00	S0.00	S22,728.75	$22,728,75	100%	SO.OD	S0.00	
	TOTAL -SEEDING & MULCHING G1				$22,728.75				$0.00	$22,728.75	$22,728.75	100%	S0.00	so.oo	
															
	TOTAL CHANGE ORDER #3 • PHASEG1				($18,204.45)				$0.00	($18,204.45)	($18.204.•5)	100%	$0.00	S0.00	
															
	CHANGEORDER #4- PHASE G1														
1	DPO Creditp                Inker - S10,m Pipe	1.00	LS	($59,165.57)	(S59,165.57)	0,00	1.00	1.00	so.oo	($59 ,165 . 57)	($59 ,165 , 57)	100%	SO.OD	S, 000	
2	DPO TaxSavings	1.00	LS	($3,559.94)	(53,559.94)	0.00	1,00	1 00	so00	(S3, 559.94)	(SJ.559 .94)	100%	SO.OD	S0 ,00	
	TOTAL CHANGE ORDER #4 • PHASEG1				($62,725.51)				$0.00	1$62,725.51)	1$62,725.51)	100%	$0.00	$0.00	
															
	CHA NGE ORDER #5• PHASE G1														
1	DPO Credil• AUanfic TNG • Sewer Slructures	1 ,()0	LS	(S20.720.45)	(S20,720.45)	0,00	1 00	100	so00	($20,720.45)	($20, 720,45)	100%	S0,00	S, 000	
2	OPO Cre<!il • Atlantic TNG • Stomi Structures	1. 00	LS	(S28,630.15)	(528,630.15)	0.00	1.00	1.00	SO.DO	(S28 ,630.1 5)	(S28,6..'l0,15)	100%	S0.00	S0,00	
3	OPO Tax Savings	1.00	lS	($2,991.04)	($2,991.04)	0.00	1 00	1 00	SO.DO	(52 ,991.04 )	($,2 991.04)	100%	S0.00	S, 000	
	TOTAL CHANGEORDER #5 • PHASEG1				($52.341.64)				S0.00	($52.341.&4)	($52,341.&4)	100'/4	$0,00	so.oo	
															
	CHANGEORDER 116 • PHASE G1														
	CTB DIRECT PURCHASE ORDER														
1	OPO Credll SollCement Base	(3 ,571 00)	TN	$16.00	(S57, 136.00)	0.00	-357,1 00	-3571 .00	S0,00	(S57 ,1 36.00)	(S57,136 .00)	100%	SOOO	S0.00	
2	OPO Tax Savings	I 00	lS	(S3,428.16)	(S3.428,16)	0.00	1.00	1 00	S0,00	($3,428.16)	(S3.428,16)	100%	S000	SO.OD	
	TOTALCHANGEORDER #1;-PHASE G1				($60,564.16)				SO.OD	($60,564.16)	($60,564.16)	100')',	so.oo	so.oo	
															
	CHA N GE ORDER #9• PHASEG1														
	VILLAGEG1·DPO RECOl'ICILIAn ON														
1	CPO ReconciliatiOn-Ferguson.VlllageG1	1.00	LS	55 1,621 91	$51,821 91	0.00	100	1 00	sooo	S51 ,821 .9 1	$ 51,82 1 ,91	100%	S0 , 00	SO.DO	
2	6% Tax on Ab<>ve	1.00	lS	SJ,109 .31	$3. 109.31	0.00	1,00	100	SO.OD	S3.109 .31	$,3 109.31	100%	so.oo	S0.00	
	TOTALCHANGEORDER #9 • PHASE G1				$54,931.22				$0.00	$54,931.22	$54,931.22	10091.	so.oo	S0. 00	
															
	TOT A L PHASEG1				$1,232,736.06				$0.00	$1,23, 2736.06	$1,232,736.06	100%	$0.00	$0.00	
															
	PHASEE2/E3														
	GENERALCONDITIONS E2/E3														
1	Mobilization	1 00	LS	$6.4 00 ,00	56,400, 00	0,00	1 .00	1 00	S0,00	$,6 400.00	$6,40000	100%	S000	S0.00	
2	NPDES Permit & Compliance	1.00	LS	$5 300.00	55.300.00	0.00	1.00	1.00	sooo	$5 , 300.00	S5.300 . 00	100%	S0 . 00	SO.OD	

tl11,,(: t

ITEM
NO	

OESCRPI1"01  N OF WOR:	

01Y	CONTRACT SUMTOOATE		
				
SASE,CON"TRACT	
ESTMI  AT!:O QUANTITY	TOTAl.
WOR.KIN
PLACE	TOTAL WORKIN
PLACE	TOTAL
WORl( IN
DLACE.	
PE CEN1
COMPLETE	
BALANCE
TO FINISH	
0%
RETAINAGE.	
			
UNIT	UNIT
PRICE	
VALUE	THIS
ESTIMATE	PREV
ESTIMATE	TOTAL
ESTlMATE	TH IS
PERIOD	PREV
APPLICATION	TO DATE	10
CATE	TO CATE	TO DATE	
3	Mamternmce or Traffic	1.00	LS	5!!60.00	$860.00	0.00	1.00	1,00	50,00	$860,00	S860,00	100%	so 00	S0,00	
4	Const. Stake0ut / ROGOr(l Survey• ByContractor	1 00	LS	$39.500 .00	$39 ,500.00	0,00	1.00	,1 00	SO.Oil	$39, 500 ,00	$39 .500 .00	100 %	S0 .00	S0.00	
5	Payment& PerformanceBond - SyContractor	1,00	LS	S8.250.00	S,8 250.00	0,00	100	mo	50 .00	58,250.00	SB.250.00	100",(,	S0.00	SO.OD	
	TOTAL GENERAL CONCJTIONS E2/c3				$60,310.00				$0.00	$60.310.00	$6, 0310.00	100¾	$, 000	$0.00	
															
	EARTHWORK E2/E3														
1	Clearing & Grubblfl!I	25 ,00	AC	$4,100 .00	$102.500 .00	0.00	25.00	2500	SOOD	S102 ,500 . 00	$102.500 . 00	100%	S0,00	S0.00	
2	Cut Volume (Unadjusted)	227,000.00	CY	S0.70	5158 ,900 00	0,00	22700000	22700, 000	SO.Oil	S158.900 ,00	$158 .900.00	100¾	so 00	SO.Oil	
3	Sooong	47 ,000 .00	SY	S2 . 45	$115.150 .00	0.00	47000.00	47000,00	S0,00	5)1,5 150.00	511,5 150.00	100%	so.oo	SO.Oil	
4	seeding & Mulching	25,000.00	SY	S025	S6.2500	0	0.00	2500000	25000,00	SO.DO	5,6 250.00	SG.250.00	100%	S0.00	SO.OD	
5	S Iii Fence	,5 350.00	LF	S1-20	$6,420.00	0.00	5350.00	535000	SO.Oil	5,6 420 .00	5 6.420 . 00	1 00%	S0 . 00	S0 .00	
6	TreeBamcades-	400.00	LF	$3 35	$1,340.00	0.00	400,00	400,00	S0,00	SJ,340.00	Sl ,340.00	100%	sooo	S000	
7	Dowatanng (Fo r a llaspecisof PrQJect)	1.00	LS	s110.ooo.o	o	SI 10.000 ,00	0,00	1.00	1,00	SO.Oil	$11,0 000 .00	S110,000.00	100%	SO.DO	SO.OD	
B	Final G""1,ng	100	LS	S8,650.00	$8,650-00	0.00	,1 00	1 00	S0,00	58,650 00	$8,650.00	100%	so00	S0 .00	
	TO TAL EARTHWORK E2/E3				$509,210.00				$0,00	$509,210.00	$509,210.00	100¾	S0.00	S0.00	
															
	STORM ORAINAGEE2/E3														
1	15" Class IllRCP	203.00	LF	S23.30	$4,729.90	0,00	203,00	203.00	SO.Oil	5,4 729.90	S 4. 729.90	10011,	:io00	S0 ,00	
2	18" CtassIll RCP	1,647.00	LF	$28.40	S46,774.80	0,00	164700	1647,00	S0,00	$46,774.80	546,774.80	100%	S0.00	SO.OD	
3	24" Crass IllRCP	394,00	LF	$38.30	$15,090.20	0.00	394.00	394.00	so.oo	S15 ,090 20	$15 ,090 . 20	100%	so 00	SO.OD	
4	30"Class111 RC P	468 .00	LF	$52_50	$2 4 , 570 00	o.oo	468 . 00	468 .00	SO.OD	$2,4 570.00	S2 4.570 .00	100%	so00	SO.OD	
5	36" ClassIll RCP	57,00	LF	S72.10	$4,109,70	0.00	57,00	57.00	SO.OD	$4 ,109.70	54 ,109.70	100%	S0.00	SO.Oil	
6	6CTClass Ill RCP	158.00	LF	S17500	S27,650.00	0.00	158.00	158.00	S0,00	$27,650.00	S27.650.00	100%	so00	S0.00	
7	Hillsborwgh Co, Typ,e Curb Inlet	13.00	EA	S3.600.00	$46,800.00	0,00	1300	13.00	50,00	$4, 6800.00	546.80000	100%	so.oo	SO.OD	
8	D1\CllBoi1om Inlet, Type E	1.00	EA	S2,550.00	$2.550.00	0.00	, 1 00	1,00	S0,00	$,2 550.00	5,2 550.00	100%	S, 0 00	SO.DO	
9	cootrorStructu"'(FOOTMoameoType·o·lnief)	1 00	EA	SJ,500,00	$3,500.00	0.00	1.00	1,00	.0 ,00	SJ,S00.00	S3.50000	100%	sooo	S0 ,00	
10	15" FOOT FES	3.00	EA	S\,500.00	54,500.00	0.00	3.00	3.00	SO.Oil	S4. 500 ,00	54.500.00	100%	so00	S0.00	
11	18" FOOT FES	9.00	EA	$,1 650.00	514.850.00	o.oo	, 9 00	9 ,00	S0 ,00	$ 1,4 850 .00	514 ,850 .00	100%	S0.00	S0.00	
12	24" FOOTFES	3.00	EA	Sl .750,00	$5,250.00	0.00	,3 00	300	SQ.Oil	S5,250 .00	55.250.00	100%	$0 00	S0.00	
13	30" FOOT FES	4.00	EA	$2,300.00	S9,200.00	0,00	4 00	,400	so.oo	S 9,200.00	$9,200 .00	100%	so00	$0,00	
14	36' FOOT FES	1 00	EA	$2,750.00	$2, 750.00	o.oo	1 00	1 ,00	S0 ,00	S2 . 750 ,00	52.750 .00	100 %	S0 .00	SO.OD	
15	6CT FOOTFES	1,00	EA	$,5 700.00	$5,700.00	0.00	100	1,00	SO.OD	S5 ,700 .00	5,5 700 .00	100%	S0.00	50.00	
16	M1tt9a 1100 Area Plallling	1.00	LS	S7.100.00	$7,100.00	0.00	100	1.00	S0,00	$7,100.00	S7,100,00	100%	so.oo	S0.00	
17	TeleviseSlom, Sewer(CCTV)	2,92700	LF	S6.35	$18,586.45	0.00	2927 00	2927,00	SO.OD	$ 1,8 586 .45	S18 ,586.45	100%	S0.00	SO.OD	
18	FOOTManhole	1,00	EA	$3,250,00	53, 250,00	000	100	100	SO.OD	53 , 250 .00	5,3 250.00	101)%	S0.00	S0.00	
19	ConlmlStruclurn Wofr Wall	1.00	EA	$8 ,400.00	58,400.00	0.00	1.00	1,00	SO.OD	S8.4 00.00	5,8 4 00 . 00	)00%	SO.OD	S0 .00	
	TOTAL STORM DRAINAGE E21E3				s-255,361.05				S0.00	$255,361.05	S2SS,361.0S	100 '/.	S0.00	$0.00	
															
	E2/E3ALTERNATEADD														
1	C le.,J[r,g &,Grubbll!Q	41 _00	AC	S2.90000	S118,900.00	0.00	41.00	41,00	so.oo	S 1 18, 900 00	$118.900 , 00	100 %	S0 ,00	so 00	
2	P lace& Compact E.Xcavated Ma1enat	180 ,500,00	CY	S l .40	$252,70000	0. 00	18050000	180500,00	SO.OD	S252,700 .00	S252.700.00	1 QO'lf.	$0.00	$0.00	

	
Al'PLICI\TIONfOR PAYMENT			PAYAPP
FROM		12RET
12/1117		
				TO		12/31/17				
	RlPA&ASSOCIATESPROJECT#Ol 1701A		

			

			

			

			

			

			

			

			

			

			

			

			

			

			

Tripl eCroekCOD-VllltgeE,FIOdG1	APPLICATION FOR PAYMENT

RlPAA ASSOCIATESPROJECU01 I707A

?-"YA.PP
FROM
ro

12RET
12/1117
12/31/17

ltEM NO,	

OESCRIPrlO.'ltOF WORK	

on'	CONTRACT SUM TOOATE		
				
BASe CO:,tTRI\CT	
ESTIMATEOOUA.NTITV	T OTAL
W ORK IN PLACE	TOTAL WOR)(.lN
PLACE	TOTAL
WORK.IN PLACE	
PERCENT COMPLETE	
BALANCE
TO FtNISH	

RETA!NAGE	
			
UNIT	UNIT
PRICE	
VALUE:	THIS
ESTIMATE	PREV
ESTIMATE	TOTAL
E STIMATE	TH IS
PERIOD	PREY
APPLICATION	ro
DATE	TO
DATE	TO
DATE	TO
DATE	

3	
Stockpile Off-Phase(within1,000Feet)(adjusted)	46,500,00	CV	S150	S69,750.00	0.00	4650000	◄6500 00	S0.00	S69,750 .00	569.750.00	100l4	S0,00	$000	
4	Sodding	4,000 ,00	SY	S2.45	S9.800,00	0.00	•000.00	4000.00	S0,00	S9,800,00	S9,800.00	100%	S000	$0.00	
5	Seeding & MUiching (Additlona4)	198,50000	SY	S0,25	549,625,00	0,00	198500,00	198500.00	S, 000	$49,625.00	549.625,00	100%	S0.00	S0.00	
	TOTALE2/El ALTERNATE AOD				5500,TTS.OO				S0.00	ssoo.ns.oo	$500 ,775 .00	100 %	$0 ,00	$0.00	
															
	CHANGEORDER U • PHASE E2/El														
1	Genera.I Conditions E.2JE3	(1 .00)	LS	S52,060 ,00	($52,060, 00)	000	(1 00)	(1.00)	S000	($52.06000)	($52.060,00)	100%	so.oo	S0 . 00	

2	
Eartl1Wol1c E 2/E 3	(1 .00)	LS	S501.450 ,00	($501 , 450 .00)	0,00	(1 .00)	(1 . 00)	S0 .00	(S50 1 ,450,00)	( $501,450 . 00)	100%	S0 ,00	$0 ,00	

3	S tormDrainageE2/E3	(1 .00)	LS	S255,361.05	($255,361.05)	0.00	(1.00)	(1,00)	S0,00	(5255,361,05)	($255,361,05)	100%	so.co	S0 .00	
•	E2/E3AlternateAdd	(1.00)	LS	5500,775,00	(5500.775,00)	0.00	(1.00)	(100)	S000	(SS00.77500)	($500.775,00)	100%	so.oo	so.co	
	TOTAL CHANGEORDER #3 • PHASE E2/E3				(51,309,646,05)				SO.OD	(51 ,309,646.05)	($1.309.646,05)	100o/1	$0.00	$0,00	
															
	TOTALPHASE E2JE3				$16,010.00				S0,00	$16,010.00	516,010.00	100%	$0.00	$0.00	
															
	CO N TRA C T SUM M ARY														
1	GENERALCONDITIONS E1				$B9.00000				S0,00	589,00000	589.000.00	100%	sooo	$0.00	
2	EARTHWORK E1				$232,233.85				soco	S232,233.85	$232.233 ,85	100%	S0,00	S0.00	
3	BASEANDPAVINGE1				$922.377.30				S0,00	S922.377.30	$922.377.	100%	S0,00	S0.00	
4	POTABLE WATEf<DISTRIBUTION E t				5186.438,00				S0 ,00	5186,438 ,00	5186 .438 .00	100%	sooo	S0 .00	
5	SANITARY SEWER E1				$650,329.35				S000	5650,329,35	$650.329.3.'I	100%	S0,00	so.oo	
6	STO RM DRAINAGE E1				$259.19,0 35				S0,00	S259,190,35	$259,190,35	100'k	S0,00	so.co	
7	ROADSLEEVECROSSING E1				$2.933.00				S0.00	52,933,00	$2.933.00	1QO'k	$000	S0.00	
C0#2	CHANGE ORDER112• PHASE E1				(5138,231 05)				S0,00	($138.23• .05)	(Sl 38,231,0S)	100'llo	S0.00	so.co	

C0#3	CHANGE ORDER #3 • PHASE E1				$25,458.00				S0.00	S25.458.00	S25.458.00	100'k	S0,00	SO.CO	
C0#4	CHANGEORDER -PHASE E1				($40.98483)				S0.00	(S40,984,83)	(s◄0 , 984   , 83)	1 00%	S0 . 00	so.co	
CO#S	CHANGE ORDER #S- PHASE E1				($69,704 47)				so.oo	(S69.704 .47)	(S69 ,704.47)	100%	S0 .00	so.oo	
C0#6	CHANGE ORDER /lil• PHASE E1				S17,865 68				S0,00	$17,865,68	S1, 7865,68	100%	$0.00	S0.00	
C0#9	CHANGE ORDER #11- PHASE E1				S16,56,6 86				S0.00	516,566.86	S16.566.86	100%	S, 000	S0,00	
C0/110	CHANGE ORDER #10-PHASE E1				$,9 011.00				sooo	59,0 11 00	S9.01 , 1 00	1 00%	sooo	50 ,00	
	TOTAL PHASE E1				52,162,483.0	4			SO.OD	$2, 1 62,483 .04	$2, 16,2 483.04	100%	$0,00	so.OD	
															
8	GENERAi.CONDITIONSF1				$89.00, 560				so.oo	589.005.60	589,005 60	100%	$0.00	so.co	
9	EARTHWORK F1				$42,9 256.00				S0.00	5429,256.00	$429.256.00	100%	so00	S0.00	
10	PAVING AND BASE Fl				$482.995.95				S0,00	5482.995.95	5482,995.95	100%	so.oo	so.co	
11	POTABLEWATERDISTRIBUTIONF1				595.685.00				S0,00	$95,685,00	595.685,00	100%	so.oo	S0 . 00	
12	SANITARY SEWER F1				$141,336.85				50.00	S1'1 ,336.85	S141.336,85	100%	so.co	S0.00	
13	STORM DRAINAGE F1				5283,54,7 80				,sooo	$283.547 . 80	S283,5'7,80	100%	so00	so.co	
14	ROAD SLEEVE CROSSING F1				$1,414.50				S0,00	S1.414 50	S1.414 50	100%	$0.00	S0.00	
C0#6	CHANGE ORDER 116• PHASE F1				(537,244.16)				S0.00	(S37,244.16)	($37.244,16)	100%	so00	$0 ,00	
C0#7	CHANGE ORDER#7 - PHASEFt				($164,095.83)				S0.00	(S164.09,5 B3)	($164.095 83)	100%	$0 00	S0.00	
00#8	CHANGE ORDER 118• PHASE F				S16,336.00				5000	S16.336,00	516,336,00	100%	$0 .00	so.co	

....,;1

ITEM
NO ,	

DESCRIPTIONOFWORK	

oti	CONlRACT SUM TODATE		
				
SASE CONTRACT	
ESTIMATEOQUANTITY	TOTAL WOR K IN
PLACE	TOTAL WORl<,IN
PLACE	TOTAL
WOR>(IN
PLACE	
PERCENT
COMPLElE	
BALANCE
TO FINISH	
0%
RETAINAGE	
			
UNIT	UNIT
PRICE	
VALUE	THIS
ESTIMATE	PREV
ESTIMATE	TOTAL
ESTIMATE	IBIS
PERIOD	PREY APPLICATION	TO
DATE	TO DATE	TO DATE	TO DATE	
C0#9	CHANGE ORDER #9 - PHASE F1				$55,718.07				S0.00	S55.718,07	S55.718.07	100%	sooo	S0 ,00	
	TOTALPHASE F1				$1,393.955.78				$0.00	$1,393,955,78	$1,393,955.78	100'4	$0.00	SO.DO	
															
15	GENERAL CONDITIONS F2				$6,4 299.20				S0.00	S64,299.20	S64.299.20	100%	sooo	S0 ,00	
16	EARTHWORK F2				S153.238 .00				S0.00	$153,238.00	S153.238.00	100%	so.co	S0.00	
17	PAVING ANO BASE F2				532, 4656,65				S0.00	$32•.658.65	$324,656.65	100%	S0.00	S0.00	
18	POTABLE WATER DISTRIBUTION F2				Sl 14.603.80				S0,00	$114,603,80	$11, 4 603.80	100%	so.co	50.00	
19	SANITARY SEWER F2				$149,346.9	5			S0.00	S1•9.346.95	$149.346.95	100%	so.co	50.00	
20	STORM DRAINAGE F2				S2,41707,75				S0.00	$241.707,75	$241,70775	100%	50.00	50.00	
21	ROADSLEEVE CROSSING F2				$2,581.SO				S000	S2.58.150	$2.581.50	100%	S0.00	S0.00	
C0#2	CHANGE ORDER f/2 - PHASE F2				($134,1 .12)				S0.00	(S134,1 .12)	($134,135.12	) 100%	S0.00	50.00	
C0#3	CHANGE ORDER #3 - PHAS€ F2				$146,145.60				S0.00	$146,145,60	$146,145.60	100%	so.oo	SO.DO	
C0#4	CHANGE ORDER#4 - PHASE F2				($66.814.29)				S0.00	($66,814.29)	($66,814.29)	100%	so.oo	S0.00	
C0/15	CHANGE ORDER #5 - PHASE F2				(Sl:l.476.63)				S0.00	(S:13,476,83)	($33,476.63)	100%	so.co	S0.00	
C0#6	CHANGE ORDER #6 - PHASE F2				($43.231.04)				S0.00	(S43.231,04)	($43,231.04)	100%	S0.00	50.00	
C0#9	CHANGE ORDER #9 - PHASE F2				S8.419.79				S0.00	$8,419.79	SS.◄19  . 79	100%	so.oo	so.oo	
	TOTAL PHASE F2				$927,342.16				$0.00	$927,342.16	$927,342.16	100%	$0.00	$0.00	
															
22	GENERAL CONDITIONS G1				S87 .330.00				S0.00	$87.330.00	$87,330.00	100%	S0.00	S0.00	
23	EARTHWORK G1				S330.234.25				S0.00	5330.234.25	S330.234.25	100%	S0.00	S0.00	
24	PAVING ANDBASEGI				$468,648.60				S0.00	S468,648.60	$468,648.60	100%	W.00	$0.00	
25	POTABLE WATER DISTRIBUTIONG1				S141,390.80				S0.00	S141.39080	$141,390.80	100¾	SO.DO	S0.00	
26	SANITARY SEWER G1				$203.236.20				S0.00	$203.236.20	$203.236.20	100%	$0.00	$0.00	
27	STORM DRAINAGE GI				S262,142.95				S0.00	5262.142,95	S262,142.95	100%	S0.00	so.oo	
28	RO ADSLEEVE CROSSING GI				53.054 00				S0.00	53,054.00	$3.054.00	100¾	S0.00	S0.00	
C0#2	CHANGE ORDER #2- PHASEG t				($124.396.20)				S0.00	($124.396.20)	(S124.396.20)	100%	S0.00	S0.00	
C0#3	CHANGE ORDER113- P HASEGI				(518.2 04.45)				S0.00	(S18.204,45)	(S18.204,45)	100¾	S0.00	so.oo	
C0#4	CHANGE ORDER 114 - PHASEGI				($62.725,51)				S0.00	($62,725.51)	($62.725.51)	100%	S0.00	50.00	
CO#S	CHANGE ORDER !15- PHASEG 1				($52 .341.64)				S0.00	($52.341.64)	(S52.34.164)	100%	S0.00	S0.00	
C0#6	CHANGE ORDER#6 - PHASEGI				(560.564.16)				S0.00	(560,564.16)	(S60.564,16)	100'4	S0.00	so.oo	
COl/9	CHANGE ORDER #9- PHASEGI				$54.931.22				S0.00	S54.931.22	S54,931-22	100%	SO.OD	S0.00	
	TOTAL PHASEG1				$1.2,32736.06				SO.OD	$1,2 32,736.06	$1,232,736.06	100°1.	$0.00	$0.00	
															
29	GENERAL CONDITIONS E21E3				SS0.310.00				S0.00	$60,310.00	560.310.00	100%	S0,00	S0.00	
30	EARTHWORK E21E3				S509.210.00				S0.00	$509.210 .00	S509 ,210.00	100%	S0.00	so.oo	
31	STORM DRAINAGE E21E3				S255,361.05				S0.00	S255.361.05	$255,361.05	100%	S0.00	so.oo	
32	E2/E3ALTERNATEADD				S500 ,775.00				so.oo	S500.775.00	$500,775.00	100%	so00	S0.00	
C0#3	CHANGE O RDER113- PHASE E21E3				(S1,309.646.05 )				S0.00	(Sl , 309,646.05)	(St ,309,646.05)	100%	S0.00	S0.00	
	TOTAL PHASE E21E3				$16 ,010.00				$0.00	$16,010,00	$16,010.00	100¾	$0.00	$0.00	
															
	TOTAL ALL SCHEDULES				$5 ,732.527 ,04				$0.00	$5,731.5, 27.04	$5,732,527.04	100%	$0.00	$0.00	

TripleCreekCOO-VillageE,F1MGt	APPLICATIONFOR PAYMENT RIPA&ASSOCIATESPROJECT#01 1707A

PAV APP FROM TO

12RET
1211117
1213111?

Tripi•Creek CDD•\111l1g o E,FondG1	APPLICATION FOR PAYMENT

ITEM
NO	

DESCRIPTIONOF WORK	

OTY	CON TRAC1- SUM 10 OAT E		
				
BASE CONTRATC	
ESTIMATED Ot.JANTITY	TOT AL WORK1N PtACE	TOTAL
WORk lN
PLACE	TOTAL WORK IN PLACE.	
PERCENT
COMPLE TE	
BAlANCE.
TO FINISH	
0%
RETAINAGf	
			
UNIT	UNI T
PRIOE	
VALUE	THIS
ESTIMATE	PREV
ESTIMATE	TOTAL
ESTIMATE	THIS
PER>OD	PRE V
A PP l. tC ATION	TO
DATE	TO
DATE	TO
DATE	TO
DATE	
															
	ORIGINAL CONTRACT VALUE														
	PHASEE1				$2.342,501.85				$0.00	$2,342.501,85	52,342,501,85	100%	S0.00	S0.00	
	PHASEFl				S1,523.241,70				sooo	S1,523,241.70	$1,523,241.70	100%	S0,00	S0.00	
	PHASEF2				S1.050.433.8	5			S0.00	S1,050,433.85	Sl,050,433.85	100%	S0 .00	$0.00	
	PHASEG1				$1,496,036.80				S0.00	$1,496.036,80	S1.496,036.80	100%	S0 ,00	S0.00	
	PHASEE2/E3				S1.325.656.05				S0.00	$1,325,656.05	$1,325,656.05	100%	S0.00	S0.00	
	TOTAL ORIGINAL CONTRACT VALUE				$7,737,870 .25				so.oo	S7,737,870.25	$7,737,87.025	100¾	$0,00	$0.00	
															
	CHANGE ORDERS														
	CHANGE ORDER #2				($396,762,37)				so.oo	($396,762.37)	(S3 96,762.37)	100%	S0.00	S0.00	
	CHANGEORDER #3				(S1,156.246.90	)			$0.00	($1,156.24690)	(S1,156,246.90)	100%	S0,00	SD 00	
	CHANGEORDER114				($ 1 70,52 4 . 63)				SO.OD	($170.524 ,63)	($1 70,524 63)	100%	S0,00	S0,00	
	CHANGEORDER #5				(5155.522,74)				$0.00	($155,522.7	4)	($155,522 74)	100%	so00	SO.OD	
	CHANGEORDER IIB				($123,173.68)				$0.00	($123.173.68)	($123.17.368)	100%	S0,00	SD.00	
	CHANGEORDER /f7				(5164,095,83)				so00	(S164,095.83)	(S164,09583)	100%	S0,00	so 00	
	CHANGEORDER #11				516, 336.00				SO.OD	S16 ,336.00	516,336.00	100%	S000	SD.00	
	CHANGE ORDER #9				S135,635.94				S0.00	S135,635.94	5135,6, 3594	100%	S0,00	SD 00	
	C HANG E ORDER #10				S9.011.00				S0.00	59,011,00	S9,011 00	100%	S0,00	sooo	
	TOTALCHANGE ORDERS				($2,005,343.21)				$0.00	($2,005,34311I	($2,005,343.21)	100%	so.oo	50 .00	
															
	ADJUSTEDCONTRACT TOTAL				$5,73,2 527.0	4			$0.00	$5,732,527,04	$5,732,527.04	100%	50 .00	$0.00	

RIPA& ASSOCIATES PROJECT# OI 1707A

P"V APP FROM TO

12RET
1211117
12/31/17

't)M! : I

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017B

The undersigned, a Responsible Officer of Triple Creek Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture dated as of June 1, 2012 from the District to The Bank of New York Mellon Trust, N.A., as trustee (the "Trustee"), as supplemented by the Second Supplemental Trust Indenture dated as of February 1, 2017 (the "Indenture"), (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):

March 16, 2018

Requisition Number: CR267-B

Name of Payee: Tampa Electric Company
c/o ED Billing
P.O. Box 173169 Tampa, FL 33672

Amount Payable: $43,983.95

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): Invoice # 20180374 for WR#2066489-l for Bore Primary Conduit set (3) Phase Transformer and Cable

Fund or Account from which disbursement to be made: 2017B Acquisition and Construction Account

The undersigned hereby certifies that:
obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs of Issuance payable from the Acquisition and Construction Fund  that have  not  previously  been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services  rendered  with  respect to which disbursement is hereby requested.

-

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

By:

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

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

Ca'l'isulting Engineer

Invoice

Date	Invoice #	
02/23/2018	20180374	

Bill To

TRIPLE CREEK CDD

9428 CAMDEN FIELD PARKWAY RIVERVIEW, FL 33578-0519

Tampa Electric Company c/o ED Billing
P.O. Box 173169 Tampa, FL 33672

TO ENSURE PROMPT CREDIT PLEASE RETURN ENTIRE BILL WITH YOUR PAYMENT - MAKE CHECK PAYABLE TO TAMPA ELECTRIC.

	WR#	Terms	Due Date	
	2066489-1	Net 30	03/25/2018	
Description	Amount	
Location: Dorado Shores Ave/Triple Creek Blvd

Bore primary conduit, set (3) phase transformer and cable.

It is understood that construction will not be scheduled until the payment has been received and Tampa Electric Company is in receipt of signed and executed easements (when required).	
$43,983.95	
For inquiries regarding this invoice, call your Tampa Electric Field Engineer @ (813)228-4111.	Total	$43,983.95	
	Payments/Credits	$0.00	
	Balance Due	$43,983.95	
Pursuant to FPSC Rule 25-6.064, Florida Administrative Code, a customer may request a review of a Contribution-in-Aid-of-Construction charge within 12 months following the in-service date of the new or upgraded facilities. Upon request, Tampa Electric shall true up the charge to reflect actual costs and revenue received. Based on the true-up calculation, the customer will either receive a refund from Tampa Electric for any overcharges, or receive a bill for undercharged amounts. To request a review, please contact One Source at 813-635-1500 option#2.	

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

DISTRICT OFFICE · 9428 CAMDEN FIELD PARKWAY · RIVERVIEW, FLORIDA 33578

April 3, 2018

Thomas J. Radicioni
THE BANK OF NEW YORK TRUST COMPANY, N.A.
10161 Centurion Parkway
Jacksonville, FL 32256

RE:	Special Assessment Bonds, Series 2017AB Requisitions for Payment

Dear Thomas:

Below please find a table detailing the enclosed requisition(s) ready for payment from the Districts Acquisition/Construction Trust Account.

PLEASE EXPEDITE PAYMENT TO THE PAYEE(S) AS FOLLOWS:

HOPPING GREEN & SAMS VIA USPS
ALL OTHERS VIA UPS

REQUISITION NO.	
PAYEE	
AMOUNT	
SUBACCOUNT	
268-B	Genesis Group	$27,579.28	General B	
269-K	Genesis Group	$1,651.49	Village K	
270-B	Hopping Green & Sams	$1,331.00	General B	
271-B	Hillsborough County BOCC	$11,640.00	General B	

If you have any questions regarding this request, please do not hesitate to call me at (813) 533-2950. Thank you for your prompt attention to this matter.

Sincerely,
TRIPLE CREEK
COMMUNITY DEVELOPMENT DISTRICT

Christine Perkins District Manager

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 20178

The undersigned , a Responsible Officer of Triple Creek Community Development District (the " District ") hereby s ubmit s the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture dated as of June I, 2012 from the District to The Bank ofNew York Mellon Trust, N.A., as trustee (the "Trustee"), as supplemented  by the Second Supplemental  Trust Indenture  dated as of February I, 2017 (the "Ind enture"), (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):

March 30, 2018

Requisition Number: CR268-B

Name of Payee: Genesis Group
1000 N. Ashley Drive, Suite 900
Tampa, FL 33602-3718

Amount Payable: $27,579.28

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 oflssuance, ifapplicable): Invoice #'s 59217, 59219, 59220 and 59222 for period ending 02/25/18

Fund or Account from which disbursement to be made: 2017B Acquisition and Construction Account

The undersigned hereby certifies that:
.	obligations in the stated amount set forth above have been incurred by the District , or
this requisition is for Costs oflssuance payable from the Acquisition and Construction Fund that have not previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services rendered with respect to which disbursement is hereby requested.
TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

-·_   :----; "'---    r;V_ . ?. <r   ...:; <"-?

/ C

\  

By:

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

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

Consulting t.ngmeer

Landscape Architecture Urban Design Engineering
Planning

1000 N. Ashley Drive
Suite 900
Tampa, FL 33602

Tel  813.620.4500
Fax 813.221.4980
www.GenesisGroup.com

3/22/2018	
59217	
4/21/2018	
061980004	
Page 1 of 1	

Invoice Date :	
Invoice # :	
Invoice Due :	
Project :	

INVOICE

Triple Creek Community Devel. Dist	
3434 Colwell Avenue, Suite 200	
Tampa, FL. 33614	
cboccio@rizzetta.com	

ATTN:	Joe Roethke

TOTAL DUE THIS INVOICE:	$

657.25

For Professional Services Rendered through: 2/25/2018	
Triple Creek Master Amenity Center	
ASA #2, #11 & #4.
Copy; Kaitlyn Gallant <kgallant@rizzetta.com>	

Phase: P01 -	Site Design Services	HOURS	RATE PER HOUR	AMOUNT
Principal/Officer-Prof. Eng IV	2.00	210.00	420.00

Proj Mgr. Landscape Architect IV	
Construction services	

120.00	
Sub-Total Labor:	

210.00	
630.00	

1.75

REIMBURSABLES	
Mileage, Lodging, Parking, Airfare	

AMOUNT	
27.25	

Sub-Total Reimbursables:	27.25

Approved by:	
Kyle L. Thornton, P.E.	

WE APPRECIATE YOUR BUSINESS

INVOICE TOTAL	$657.25

Remit via ACH Payment: Wells Fargo Bank Routing #: 063107513
Account #: 8116094205	Remit via Check: Genesis
1000 N. Ashley Drive Suite 900
Tampa, FL 33602-3718	For billing inquiries, contact:
Dennis Henchen Project Accountant
DHenchen@GenesisGroup.com	
For additional assistance, please contact Tim Leal, CFO at (813) 620-4500 x5158 or contact your Genesis Project Manager	

Genesis
Project Detail Charges

Grouped by: Project

Report as of Date: 3/22/2018 Period End Dates: 2/4/2018 Thru 2/25/2018 Transaction Dates: 1/29/2018 Thru 2/25/2018

Class /	Actv/

Bill

Document

Detail

Transaction Period End Reg /

Hours /

Expense Cost

Effort

EVC Code / Name

GL Acct

Task / Co / Org

Unit

Ind

Number

Type

Date

Date

OT	Quantity

Rate	Amount	Rate	Amount

Project: 061980004 - Triple Creek Master Amenity Center
Project :   061980004 - Triple Creek Master Amenity Center	Clnt : 06198 - Triple Creek Community Devel. Dist	Resp Org : 150000	Start Date : 9/15/2015 Phase : P89 - Reimbursable Expenses
Task : **** - Default
Expense
5030	Mileage, Lodging, Parking, Airfare

*****	DEFAULT
Mileage - Amenity Ctr Pruning - SF

5030

****

GGI 150000

052	B

6217	U

2/9/2018	2/25/2018	50.00

0.0000

0.00

0.5450

27.25

Account 5030 Total Expense Total

50.00	0.00	27.25
50.00	0.00	27.25

Task **** Total	0.00  (Hrs)	0.00
Phase P89 Total	0.00  (Hrs)	0.00
Project 061980004 Total	0.00  (Hrs)	0.00

27.25
27.25
27.25

Triple Creek Master Amenity Center Total

0.00

(Hrs)

0.00

27.25

Generated : 3/22/2018 4:35:11PM

Page:	4

" !;"	"  o	1
Tampa  GGI Equinox

0
(I)

0 1-

Vehicle Tracking

Date	Mileage

...

					

					

Be Safe: Buckle-up and refrain from using mobile phones while driving. As a courtesy to others, please fill up the tank if less than half full.

C:\Users\emaynor\Documents\Fleet\Mileage Logs\Mileage 2016\VehfcleMileagelog.xlsx

Landscape Architecture Urban Design Engineering
Planning

1000 N. Ashley Drive
Suite 900
Tampa, FL 33602

Tel  813.620.4500
Fax 813.221.4980
www.GenesisGroup.com

Invoice Date :	
Invoice # :	
Invoice Due :	
Project :	

3/22/2018	
59219	
4/21/2018	
061980013	
Page 1 of 1	

INVOICE

Triple Creek Community Devel. Dist	
3434 Colwell Avenue, Suite 200	
Tampa, FL. 33614	
kgallant@rizzetta.com	

ATTN:	Joe Roethke

TOTAL DUE THIS INVOICE:	$

23,096.11

For Professional Services Rendered through: 2/25/2018	
Villages G2, I, and J Engineering	
Email Kaitlyn Gallant	

Phase: P01 -	Design and Permitting	HOURS		RATE PER HOUR		AMOUNT	
Design Technician I	14.50		45.00		652.50	
Engineering Department Manager III	1.00		190.00		190.00	
Graduate Engineer III	21.00		70.00		1,470.00	
Landscape Designer II	21.50		65.00		1,397.50	
Principal/Officer-Prof. Eng IV	54.00		210.00		11,340.00	
Proj Mgr. Landscape Architect IV	3.50		120.00		420.00	
Project Engineer I	53.00		85.00		4,505.00	
Senior Landscape Designer II	5.00		85.00		425.00	
Senior Landscape Designer III	9.00		95.00		855.00	
Technician I	1.00					

REIMBURSABLES	
Contract Services (Flatwoods Consulting)	
Reproduction,Printing,Copies	
Mileage, Lodging, Parking, Airfare	
Fees/Permits/Recording (HC As Built Review Fee)	

AMOUNT	
563.50	
722.92	
2.19	
517.50	

35.00	
Sub-Total Labor:	

35.00	
21,290.00	

Sub-Total Reimbursables:	1,806.11

Approved by:	
Kyle L. Thornton, P.E.	

WE APPRECIATE YOUR BUSINESS

INVOICE TOTAL	$23,096.11

Remit via ACH Payment: Wells Fargo Bank Routing #: 063107513
Account #: 8116094205	Remit via Check: Genesis
1000 N. Ashley Drive Suite 900
Tampa, FL 33602-3718	For billing inquiries, contact:
Dennis Henchen Project Accountant
DHenchen@GenesisGroup.com	
For additional assistance, please contact Tim Leal, CFO at (813) 620-4500 x5158 or contact your Genesis Project Manager	

Genesis	
Project Detail Charges	

Grouped by:

EVC Code / Name

Actv/	Bi

Transaction Dates: 1/29/2018 Thru 2/25/2018	
Period	Reg	Hours /	Expense Cost	Effort	
Date	OT	Quantity	Rate	Amount		Rate	Amount	

Document	Detail	Transaction	
Number	Type	Date	

Class /	
GL Acct	

Task / Co / Org	Unit	In

Project : 061980013 - Villages G2, I, and J Engineering	
Phase : P89 - Reimbursable Expenses	
Task : **** - Default	

Clnt : 06198 - Triple Creek Community  Devel. Dist	Resp Org : 150000	Start Date : 4/20/2017

Expense						
5010	Contract Services					
010915	Flatwoods Consulting Group, Inc.	5010	****	GGI	150000	

66155	E	2/1/2018	2/4/2018	
		Account 5010 Total	

0.0000	490.00	
	490.00	

563.50	
563.50	

722.92	
722.92	

B	1.1500

5020	Reproduction,Printing,Copies				
03053	LDI Printing & Signs	5020	****	GGI	150000	

B	65945	E	1/31/2018

1/31/2018	0.0000	628.63

1.1500

Account 5020 Total	628.63
5030	Mileage, Lodging, Parking, Airfare

*****		DEFAULT	5030	****	GGI 150000 Mileage - Cty Delivery - Zak
*****	DEFAULT	5030	****	GGI 150000
Mileage - Cty Drop off - ZaK

052	B	6217	U

052	B	6217	U

1/31/2018	2/25/2018

2/20/2018	2/25/2018

1.00	0.0000	0.00	0.5450	0.55

3.00	0.0000	0.00	0.5450	1.64

Account 5030 Total	4.00	0.00	2.19

517.50	
517.50	
1,806.11	

5050	Fees/Permits/Recording

02865	HILLSBOROUGH COUNTY BOARD 5050	****	GGI 150000

B	15152	E	2/21/2018	2/25/2018	0.0000	450.00
Account 5050 Total	450.00
Expense Total	1,568.63
Task **** Total	0.00    (Hrs)	1,568.63

1.1500

1,806.11	
1,806.11	
1,806.11	

Phase P89 Total	0.00    (Hrs)	1,568.63
Project 061980013 Total	0.00    (Hrs)	1,568.63

Report Total	0.00	(Hrs)	1,568.63	1,806.11

ge:	1	

Generated :  3/23/2018  10:53:57AM	Pa

Remit to:
Flatwoods Consulting Group Inc.
8306 Laurel Fair Circle Suite 120

Bill To

Tampa, FL 33610

Invoice

Date	Invoice #	
2/1/2018	4664	

Genesis Group
1000 N. Ashley Drive Suite 900
Tampa, FL 33602

PO No.	Terms	Project	
	Net 30	Triple Creek Village G2 (001-EPa)	

Item	Description	Budget	Prior Amt	Curr %	Total %	Amount	
Lump Sum	Environmental Permitting Support	9,800.00		5.00%	5.00%	490.00	
Thank you for your business.	Total	$490.00	
	Payments/Credits	$0.00	
	Balance Due	$490.00	

Phone #	E-mail	Web Site	
(813)-600-5747	sgonzalez@flatwoodsconsulting.com	www.flatwoodsconsulting.com	

LDI Printing & Signs
3914 US Hwy 301 N.Suite
300
Tampa, FL 33619
(813)740-1953
LDI@LDItampabay.com

INVOICE

BILL TO
Genesis Group 1000 N. Ashley Dr. Suite 900
Tampa, FL 33602

SHIP TO
Genesis Group 1000 N. Ashley Dr. Suite 900
Tampa, FL 33602

INVOICE # TP204462
DATE 01/31/2018
DUE DATE 03/02/2018
TERMS Net 30 Days

SHIP VIA	JOB NAME	PO NUMBER	ORDERED BY
Delivery	Triple Creek Ph 4 Village G2 6198-013-G2	Alistair

ACTIVITY	QTY	RATE	AMOUNT

Color Products-Services:D Size Color
D 24x36 Color

235	2.50	587.50T

SUBTOTAL	587.50	
TAX (7%)	41.13	
TOTAL	628.63	
BALANCE DUE	$628.63

Signature  	
Above signed acknowledges receipt of material and represents that the reproduction of said material does not violate any copyright laws and agrees to indemnify and hold LDI harmless against all claims and expenses for an illegal copywright infringement of such material

" !;"	"  o	1
Tampa  GGI Equinox

0
(I)

0 1-

Vehicle Tracking

Date	Mileage

...

					

					

Be Safe: Buckle-up and refrain from using mobile phones while driving. As a courtesy to others, please fill up the tank if less than half full.

C:\Users\emaynor\Documents\Fleet\Mileage Logs\Mileage 2016\VehfcleMileagelog.xlsx

1 1=--■--. -	-

-	-+-:--

-----=B----·=o-.c.-=:......(,,_-=-•;:.	 ;J	.s-oo (ti

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15151

Fl0rid<1

Wells Fargo Bani<, NA

FO Su:_tl i fwtµ., fl.3 A:b,i,it ;?.JJ
11• 0  0  0  0  0   1 5 1 5 1111	1:0  i;  :l 10  ? 5 l. 31:

wellsfargo.com

NP

: I

Requisitioned By: ltem(s): Description:

 Zachary Kowsh	

 The Reserve At Pradera Phase 3 As-Built Review Fee	

 To be reimbursed by Client- Beazer Homes	

Vendor Name: Quantity:

-HC-BO-CC-----------Telephone No.:	 	
 	1	Amount Each:	 	$300.00

Tax, Freight, Etc.:
Total Amount of Purchase:

 	$0.00 
 	$300.00 

Method of Payment:	Check
-	-	-	....(..C,.a,,,s  ,-h:--C-,""a'"h reg,

.c..,= h-ce .,...-kE=,tc,..,...),...	_

Terms:	N/A
.........(,..,..N..t,..,e.,.30'""D'"""ay-s.,....N. ,_..t,...l.e.,.nv.o-..,i.c e-., E.,t..c  _.),.

Justification and Use:  	
 To be reimbursed by Client-  Beazer Homes	

NOTE: Justification for purchase is require	nd should include appropriate backup documentation.

.._ _ ,,........  

Requisitioned By:

 	..,.. 	,,..._....,-.. 	

Date: #_	_

Division Manager:	---""""'"----------	Date:	 	

All Software / Hardware purchases require Systems Administration Review:

Date:	 	
Craig Anderson
Any Purchase over $500.00 Requires Board Approval Prior to Purchase:
Date of Board Review:	 	
Board Initials:	BEM 		MTL 		GBW   	

Revsion: 2008-04-04

Check Requisition - .xlsx	4/04/2008

_

Admin (190) ----

CE&I	(111)   	

Gnsville (610) ----

(150) ---­
(310) ---­
(210) ----

GL Acct No.:	 	
Date Entered: 		Tampa Vendor No.:	 	Tally GL Month:	 	Jax

Requisition No.---------

Accounting Department Only

Genesis Group Requisition Form

Project Number:	 4269-035-		7	Date Needed: 	2/16/2018	
Date of Requisition:	-Fe-bru-ary 1-5,-201-8 ---------
Requisitioned By:	 Zachary.   Kowsh	_
ltem(s):	The Reserve At Pradera Phase 3 As-Built Review Fee

Description:	To be reimbursed by Client - Beazer Homes

Vendor Name: Quantity:

-HC-BO-CC-----------Telephone No.:	 	
 	1	Amount Each:	 	$300.00 
Tax, Freight, Etc.:	 	$0.00 

Method of Payment:	Check

Total Amount of Purchase:	 	$300.00 

Terms:	N/A

-	-	-	.....(,.C,,,a..s...h,.,....C.,.-h,..a-rge",""C',,-.h,.ec..k.,.""E'"t""c'"...),...---	---(,N..,e. t =3o D- ysa	, Net-lnvo-ice, Etc.-) 
Justification and Use:  	

 To be reimbursed by Client  -   Beazer Homes	

NOTE: Justification for purchase is require	nd should include appropriate backup documentation.

----'---

+-------

Requisitioned By:	--+-:,,,'---..,.._----,,-'---+-------	Date: #-	-	-

Division Manager:	---"""""'----------	Date:	 	

All Software / Hardware purchases require Systems Administration Review:

Date:	 	
Craig Anderson

Any Purchase over $500.00 Requires Board Approval Prior to Purchase:
Date of Board Review:	 	

Board Initials:	BEM -----	MTL -------	GBW   	
Revsion: 2008-04-04

Check Requisition - .xlsx	4/04/2008

Landscape Architecture Urban Design Engineering
Planning

1000 N. Ashley Drive
Suite 900
Tampa, FL 33602

Tel  813.620.4500
Fax 813.221.4980
www.GenesisGroup.com

3/22/2018	
59220	
4/21/2018	
061980014	
Page 1 of 1	

Invoice Date :	
Invoice # :	
Invoice Due :	
Project :	

INVOICE

Triple Creek Community Devel. Dist	
3434 Colwell Avenue, Suite 200	
Tampa, FL. 33614	
kgallant@rizzetta.com	

ATTN:	Joe Roethke

TOTAL DUE THIS INVOICE:	$

1,503.84

For Professional Services Rendered through: 2/25/2018	
Village F1 Construction Svcs.	
Email Kaitlyn Gallant	

Phase: P01 -	Construction Observation/Cert.	HOURS		RATE PER HOUR		AMOUNT	
Design Technician I	9.50		45.00		427.50	
Principal/Officer-Prof. Eng IV	2.00		210.00		420.00	
Proj Mgr. Landscape Architect IV	1.25		120.00		150.00	

Sr. Inspector/Sr. Eng Intern II	5.00	
Acceptance package, SWFWMD transfer to operations application, County comments on as-builts,	
LA/IRR enhanced project coordination		
REIMBURSABLES		
Mileage, Lodging, Parking, Airfare		

AMOUNT	
31.34	

95.00	
Sub-Total Labor:	

475.00	
1,472.50	

Sub-Total Reimbursables:	31.34

Approved by:	
Kyle L. Thornton, P.E.	

WE APPRECIATE YOUR BUSINESS

INVOICE TOTAL	$1,503.84

Remit via ACH Payment: Wells Fargo Bank Routing #: 063107513
Account #: 8116094205	Remit via Check: Genesis
1000 N. Ashley Drive Suite 900
Tampa, FL 33602-3718	For billing inquiries, contact:
Dennis Henchen Project Accountant
DHenchen@GenesisGroup.com	
For additional assistance, please contact Tim Leal, CFO at (813) 620-4500 x5158 or contact your Genesis Project Manager	

Genesis
Project Detail Charges

Grouped by:

Report as of Date: 3/23/2018 Period End Dates: 2/25/2018 Thru 2/25/2018

	Class /		Actv/ Bill Document	Detail	Transaction Period End Reg /	Hours /	Expens	e Cost		Effort		
EVC Code / Name	GL Acct	Task / Co / Org	Unit   Ind	Number	Type	Date	Date	OT	Quantity	Rate	Amount		Rate	Amount	
Project :   061980014 - Village F1 Construction Svcs.	Clnt : 06198 - Triple Creek Community Devel. Dist	Resp Org : 150000	Start Date : 7/18/2017 Phase : P89 - Reimbursable Expenses
Task : **** - Default
Expense
5030	Mileage, Lodging, Parking, Airfare

001206	Sherri M. French, PLA

5030

****

GGI  150000	B

66367	E

1/23/2018	2/25/2018

0.0000

27.25

1.1500

31.34

Account 5030 Total Expense Total

27.25	31.34
27.25	31.34

Task **** Total	0.00  (Hrs)	27.25
Phase P89 Total	0.00  (Hrs)	27.25
Project 061980014 Total	0.00  (Hrs)	27.25

31.34
31.34
31.34

Report Total

0.00 (Hrs)	27.25

31.34

Generated : 3/23/2018 11:54:13AM

Page:	1

..

Date	Project Number & Phase		
Lodging	Meals	Taxi
Parking Tolls	Other Expenses	
Total Expenses	
	Project Title		Personal Vehicle						
	Purpose	Rate	Miles	Amount		Breakfast	Lunch	Dinner		Amt.	Detail		
01/10/18	9999-EDU	

0.545		

$0.00				
$39.70				

$39.70	
	ISA Wood Decav Conference-Orlando												
	CEU's for ISA and LA												
01/10/18	9999-EDU	

0.545	

202.2	

$110.20								

$110.20	
	!.§. _YY.ood Deca}'. Cgnference-Orlando												
	CEU's for ISA and LA												
01/16/18	FDT3-235A	

0.545		

$0.00						$27.33	Fuel	

$27.33	
	Pre Construction Meetinq Midwav												
													
01/16/18	FDT3-235A	

0.545		

$0.00			$14.16	$11.76				

$25.92	
	Pre Construction Meetinq Midwav												
													
01/17/18	FDT3-235A	

0.545		

$0.00						$17.17	Fuel	

$17.17	
	Pre Construction MeetinQ Midway												
													
01/12/18	06198-0010	

0.545	

50	

$27.25								

$27.25	
	Dorado Shores												
	Tree Staking Review												
01/22/18	9999-GA	

0.545		

$0.00			

$45.59					

$45.59	
	Deoartment Lunch												
	Post Test Scores												

0.545		

$0.00								

$0.00	

		

0.545		

$0.00								

$0.00	

		

0.545		

$0.00								

$0.00	

TOTALS	gAIAu	l	
252.2	
$137.45	
$0.00	
$0.00	
$59.75	
$51.46	
$0.00	
$44.50	

- -	
$293.16	

Name: Sherri French

Expense Statement
Emp. ID#:	1206	Division:	Tampa	Month: January

mG
Year:	2018

ENESIS

Date

Notes:

E mployeelgnature	.,

lJiid}'t	L-	/-1- ·II

1/22/2018

Landscape Architecture Urban Design Engineering
Planning

1000 N. Ashley Drive
Suite 900
Tampa, FL 33602

Tel  813.620.4500
Fax 813.221.4980
www.GenesisGroup.com

3/22/2018	
59222	
4/21/2018	
061980016	
Page 1 of 1	

Invoice Date :	
Invoice # :	
Invoice Due :	
Project :	

INVOICE

Triple Creek Community Devel. Dist	
3434 Colwell Avenue, Suite 200	
Tampa, FL. 33614	
kgallant@rizzetta.com	

ATTN:	Joe Roethke

TOTAL DUE THIS INVOICE:	$

2,322.08

For Professional Services Rendered through: 2/25/2018	
Village L Construction Svcs.	
Email Kaitlyn Gallant	

Phase: P01 -	Construction Observation/Cert.	HOURS		RATE PER HOUR		AMOUNT	
Design Technician I	6.00		45.00		270.00	
Principal/Officer-Prof. Eng IV	1.50		210.00		315.00	
Proj Mgr. Landscape Architect IV	7.00		120.00		840.00	
	7.50					

REIMBURSABLES	
Reproduction,Printing,Copies	

AMOUNT	
184.58	

Sr. Inspector/Sr. Eng Intern II	
Enhanced landscape project coordination, exfiltration testing,	
acceptance package, final walk thru	

95.00	
Sub-Total Labor:	

712.50	
2,137.50	

Sub-Total Reimbursables:	184.58

Approved by:	
Kyle L. Thornton, P.E.	

WE APPRECIATE YOUR BUSINESS

INVOICE TOTAL	$2,322.08

Remit via ACH Payment: Wells Fargo Bank Routing #: 063107513
Account #: 8116094205	Remit via Check: Genesis
1000 N. Ashley Drive Suite 900
Tampa, FL 33602-3718	For billing inquiries, contact:
Dennis Henchen Project Accountant
DHenchen@GenesisGroup.com	
For additional assistance, please contact Tim Leal, CFO at (813) 620-4500 x5158 or contact your Genesis Project Manager	

Genesis
Project Detail Charges

Grouped by:

Report as of Date: 3/23/2018 Period End Dates: 1/31/2018 Thru 1/31/2018

	Class /		Actv/ Bill Document	Detail	Transaction Period End Reg /	Hours /	Expens	e Cost		Effort		
EVC Code / Name	GL Acct	Task / Co / Org	Unit   Ind	Number	Type	Date	Date	OT	Quantity	Rate	Amount		Rate	Amount	
Project :   061980016 - Village L Construction Svcs.	Clnt : 06198 - Triple Creek Community Devel. Dist	Resp Org : 150000	Start Date : 7/18/2017 Phase : P89 - Reimbursable Expenses
Task : **** - Default
Expense
5020	Reproduction,Printing,Copies

03053	LDI Printing & Signs

5020

****

GGI  150000	B

65884	E

1/30/2018	1/31/2018

0.0000

160.50

1.1500

184.58

Account 5020 Total Expense Total

160.50	184.58
160.50	184.58

Task **** Total	0.00  (Hrs)	160.50
Phase P89 Total	0.00  (Hrs)	160.50
Project 061980016 Total	0.00  (Hrs)	160.50

184.58
184.58
184.58

Report Total

0.00 (Hrs)	160.50

184.58

Generated : 3/23/2018 1:07:53PM

Page:	1

LDI Printing & Signs
3914 US Hwy 301 N.Suite
300
Tampa, FL 33619
(813)740-1953
LDI@LDItampabay.com

INVOICE

BILL TO
Genesis Group 1000 N. Ashley Dr. Suite 900
Tampa, FL 33602

SHIP TO
Genesis Group 1000 N. Ashley Dr. Suite 900
Tampa, FL 33602

INVOICE # TP204254
DATE 01/30/2018
DUE DATE 03/01/2018
TERMS Net 30 Days

SHIP VIA	JOB NAME	PO NUMBER	ORDERED BY
Delivery	Triple Creek Village L	6198-016	Zachary

ACTIVITY	QTY	RATE	AMOUNT

Color Products-Services:D Size Color
D 24x36 Color RL

60	2.50	150.00T

SUBTOTAL	150.00	
TAX (7%)	10.50	
TOTAL	160.50	
BALANCE DUE	$160.50

Signature  	
Above signed acknowledges receipt of material and represents that the reproduction of said material does not violate any copyright laws and agrees to indemnify and hold LDI harmless against all claims and expenses for an illegal copywright infringement of such material

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017A, VILLAGE K

The undersigned, a Responsible Officer of Triple Creek Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture dated as of June I, 2012 from  the District to The Bank of New York Mellon Trust, N.A., as trustee (the "Trustee"), as supplemented by the Second Supplemental  Trust Indenture  dated as of February I, 2017 (the "Indenture"), (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):

March 30, 2018

Requisition Number: CR269-K

Name of Payee: Genesis Group
1000 N. Ashley Drive, Suite 900
Tampa, FL 33602-3718

Amount Payable: $1,651.49

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 oflssuance, if applicable): Invoice# 59221 for Village K

Fund or Account from which disbursement to be made: 2017A Acquisition and Construction Account, Subaccount Village K

The undersigned hereby certifies that:
obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs oflssuance payable from the Acquisition and Construction Fund that have not previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services rendered with respect to which disbursement is hereby requested.
TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

'< -· J, ,,y:

7 ,C',

\

By:

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

.

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

Consulting   Engineer

Landscape Architecture Urban Design Engineering
Planning

1000 N. Ashley Drive
Suite 900
Tampa, FL 33602

Tel  813.620.4500
Fax 813.221.4980
www.GenesisGroup.com

3/22/2018	
59221	
4/21/2018	
061980015	
Page 1 of 1	

Invoice Date :	
Invoice # :	
Invoice Due :	
Project :	

INVOICE

Triple Creek Community Devel. Dist	
3434 Colwell Avenue, Suite 200	
Tampa, FL. 33614	
kgallant@rizzetta.com	

ATTN:	Joe Roethke

TOTAL DUE THIS INVOICE:	$

1,651.49

For Professional Services Rendered through: 2/25/2018	
Village K Construction Svcs.	
Email Kaitlyn Gallant	

Phase: P01 -	Construction Observation/Cert.	BUDGET		HOURS		RATE PER HOUR		AMOUNT	
Design Technician I			1.50		45.00		67.50	
Principal/Officer-Prof. Eng IV			2.00		210.00		420.00	
			9.50					

REIMBURSABLES	
Reproduction,Printing,Copies (LDI)	

AMOUNT	
261.49	

Approved by:	
Kyle L. Thornton, P.E.	

WE APPRECIATE YOUR BUSINESS

Sub-Total Reimbursables:	261.49

Sr. Inspector/Sr. Eng Intern II	
Acceptance package, site inspection(s)	

95.00	
Sub-Total Labor:	

902.50	
1,390.00	

INVOICE TOTAL	$1,651.49

Remit via ACH Payment: Wells Fargo Bank Routing #: 063107513
Account #: 8116094205	Remit via Check: Genesis
1000 N. Ashley Drive Suite 900
Tampa, FL 33602-3718	For billing inquiries, contact:
Dennis Henchen Project Accountant
DHenchen@GenesisGroup.com	
For additional assistance, please contact Tim Leal, CFO at (813) 620-4500 x5158 or contact your Genesis Project Manager	

Genesis
Project Detail Charges

Grouped by:

Report as of Date: 3/23/2018 Period End Dates: 1/31/2018 Thru 1/31/2018

	Class /		Actv/ Bill Document	Detail	Transaction Period End Reg /	Hours /	Expens	e Cost		Effort		
EVC Code / Name	GL Acct	Task / Co / Org	Unit   Ind	Number	Type	Date	Date	OT	Quantity	Rate	Amount		Rate	Amount	
Project :   061980015 - Village K Construction Svcs.	Clnt : 06198 - Triple Creek Community Devel. Dist	Resp Org : 150000	Start Date : 7/18/2017 Phase : P89 - Reimbursable Expenses
Task : **** - Default
Expense
5020	Reproduction,Printing,Copies

03053	LDI Printing & Signs

5020

****

GGI  150000	B

65878	E

1/30/2018	1/31/2018

0.0000

227.38

1.1500

261.49

Account 5020 Total Expense Total

227.38	261.49
227.38	261.49

Task **** Total	0.00  (Hrs)	227.38
Phase P89 Total	0.00  (Hrs)	227.38
Project 061980015 Total	0.00  (Hrs)	227.38

261.49
261.49
261.49

Report Total

0.00 (Hrs)	227.38

261.49

Generated : 3/23/2018 12:07:39PM

Page:	1

LDI Printing & Signs
3914 US Hwy 301 N.Suite
300
Tampa, FL 33619
(813)740-1953
LDI@LDItampabay.com

INVOICE

BILL TO
Genesis Group 1000 N. Ashley Dr. Suite 900
Tampa, FL 33602

SHIP TO
Genesis Group 1000 N. Ashley Dr. Suite 900
Tampa, FL 33602

INVOICE # TP204255
DATE 01/30/2018
DUE DATE 03/01/2018
TERMS Net 30 Days

SHIP VIA	JOB NAME	PO NUMBER	ORDERED BY
Delivery	Triple Creek Village K	6198-015	Zachary

ACTIVITY	QTY	RATE	AMOUNT

Color Products-Services:D Size Color
D 24x36 Color RL

85	2.50	212.50T

SUBTOTAL	212.50	
TAX (7%)	14.88	
TOTAL	227.38	
BALANCE DUE	$227.38

Signature  	
Above signed acknowledges receipt of material and represents that the reproduction of said material does not violate any copyright laws and agrees to indemnify and hold LDI harmless against all claims and expenses for an illegal copywright infringement of such material

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017B

The undersigned, a Responsible Officer of Triple Creek Community Development District (the "District") hereby submits the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture dated as of June I, 2012 from  the District to The Bank ofNew York Mellon Trust, N.A., as trustee (the "Trustee"), as supplemented  by the Second Supplemental  Trust Indenture  dated as of February I, 2017 (the " Ind enture"), (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture) :

March 30, 2018

Requisition Number: CR270-B

Name of Payee: Hopping Green & Sams
119 S. Monroe Street, Ste. 300
P.O. Box 6526 Tallahassee, FL 32314

Amount Payable: $1,331.00

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 Issu ance, if applicable): Invoice # 99324 for Professional Services through 02/28/18

Fund or Account from which disbursement to be made: 2017B Acquisition and Construction Account

The undersigned hereby certifies that:
obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs oflssuance payable from the Acquisition and Construction Fund that have not previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services rendered with respect to which disbursement is hereby requested.
TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

:::	<JC?C,C , q,

,C 

)(

By:

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

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

 		;;d?
Consulting Engineer

Attorneys and Counselors

119 S. Monroe Street, Ste. 300
P.O. Box 6526 Tallahassee, FL 32314
850.222.7500

=================================	STATEMENT =================================

March 23, 2018
Triple Creek Community Development District	Bill Number 99324

c/o Rizzetta & Company 9428 Camden Field Parkway Riverview, FL 33578

Billed through 02/28/2018

2016 Project Construction
TCRCDD	00109	JLK

FOR PROFESSIONAL SERVICES RENDERED
02/01/18	JLK	Confer with Dame on construction accounts and qualified improvements.	0.60 hrs

02/05/18	JLK	Call on conveyances and construction related matters; call with bond counsel on construction expenditure questions; confer with staff on same.

1.30 hrs

02/19/18	LCW	Review Phase 2 plats and determine infrastructure and property to be conveyed to the district; confer with staff regarding same.

2.20 hrs

02/20/18	LCW	Confer with staff regarding status of recordation of deeds for Phase 2 property.	0.20 hrs

02/28/18	JLK	Call with Nelson on various construction related issues, including landscaping and irrigation installation; confer with Whelan on same.

0.70 hrs

02/28/18	LCW	Review notice of commencement for amenity construction; confer with staff regarding same; confer with staff regarding status of Villages K, L and F1 landscape and irrigation installation project.

hrs

Total fees for this matter	$1,331.00

MATTER SUMMARY

Kilinski, Jennifer L.		2.60 hrs	235	/hr	$611.00	
Whelan, Lindsay C.		3.20 hrs	225	/hr	$720.00	
	TOTAL FEES				$1,331.00	
					----------------	
TOTAL CHARGES FOR THIS MATTER	$1,331.00

BILLING SUMMARY

Kilinski, Jennifer L.	2.60 hrs	235	/hr	$611.00	
Whelan, Lindsay C.	3.20 hrs	225	/hr	$720.00	

TOTAL FEES	$1,331.00
----------------

2015 Project Construction	Bill No. 99324	Page  2
=======================================================================================
TOTAL CHARGES FOR THIS BILL	$1,331.00

Please include the bill number on your check.

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT SPECIAL ASSESSMENT BONDS
SERIES 2017B

The undersigned, a Responsible Officer of Triple Creek Community Development District (the "District") hereby submits  the following requisition for disbursement under and pursuant to the terms of the Master Trust Indenture dated as of June  1, 2012 from  the District to The Bank ofNew York Mellon Trust, N.A.,  as trustee (the "Trustee"),  as supplemented  by the Second  Supplemental  Trust Indenture  dated as of February 1, 2017 (the "Indenture"), (all capitalized terms used herein shall have the meaning ascribed to such term in the Indenture):

March 30, 2018

Requisition Number: CR271-B

Name of Payee: Hillsborough County BOCC
Send Check to: Genesis Group 1000 N. Ashley Drive, Suite 900
Tampa, FL 33602-3718

Amount Payable: $11,640.00

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 oflssuance, if applicable): Phase 4 Village J Permitting

Fund or Account from which disbursement to be made: 20178 Acquisition and Construction Account

The undersigned hereby certifies that:
obligations in the stated amount set forth above have been incurred by the District, or
this requisition is for Costs oflssuance payable from the Acquisition and Construction Fund that have not previously been paid;

each disbursement set forth above is a proper charge against the Acquisition and Construction Fund;

each disbursement set forth above was incurred in connection with the acquisition and/or construction of the Project;

each disbursement represents a Cost of the Project which 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.
Attached hereto are originals of the invoice(s) from the vendor of the property acquired or the services rendered with respect to which disbursement is hereby requested.
TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

», 

1,..

,	/  

7 ,/	\

By:

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

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

Cuasult;	

SUBDIVISION CONSTRUCTION – SINGLE FAMILY LOTS 20 BUSINESS DAY REVIEW

Triple Creek Phase 4 Village J (76 Lots) PROJECT NEEDS TO BE SEEN BY:
INITIAL	Total	RESUB	2nd RESUB
NATURAL RESOURCES	$32/LOT	$2,432		$25/LOT*	
SITE ENGINEERING	$27/LOT	$2,052		$15/LOT *	
STORMWATER	$56/LOT	$4,256		$25/LOT*	
UTILITIES-GEORGE	$575	$575			
ZONING	$300	$300	$150*		
TRANSPORTATION					
EPC	$490*	$490	$490*	$490*	
FIRE	$15	$15			
PUBLIC WORKS – DESS					
PUBLIC WORKS - TRAFFIC					
TRANSPORTATION INSP.	$9/LOT	$684			
STORMWATER INSPECTION	$11/LOT	$836			
2ND & SUBSEQUENT RESUBMITTALS
*EPC & Zoning has a resubmittal fee with all resubmittals

Grand Total: $11,640 DISTRIBUTION

3 Plans
Transmittal Letter
Site Application
Owners Affidavit
Deed
County Aerial 1’=200
2 Stormwater Calculations
Sufficiency Checklist
Certification of Complete Submittal
PDF CD of all paperwork and plans

Tab 4

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT CHANGE ORDER SUMMARY
APRIL 17, 2018

CHANGE ORDER#	
CONTRACTOR	
DESCRIPTION	
AMOUNT	CONTRACT #	

8	
Kearney	
Hayes Pipe Supply	
($6,391.15)	
0038-01	

THE KEARNEY COMPANIES, LLC.
9625 Wes Kearney Way, Riverview FL 33578

Office (813) 421-6601
Fax (813) 421-6701

Underground Utilities	Site Development

PROJECT: TRIPLE CREEK VILLAGE K & L/AMENITY CENTER CHANGE ORDER NO. 8
THE KEARNEY COMPANIES PROJECT NO. 0038-01
Date: 31-Mar-18	

Conditions: The changes described herein shall be governed by the terms and conditions of the Contract, and shall not in any way alter the terms of the Contract, but shall hereafter be a part of the Contract.

INV. NO.	DESCRIPTION	Invoice Amount	Sales Tax	TOTAL COST	

1653307	FERGUSON 2/15/2018	$	1,213.40			
1658919	FERGUSON 3/12/2018	$	2,130.64			
1659947	FERGUSON 3/16/2018	$	2,685.35			
		$	6,029.39	$	361.76	$	6,391.15	

			

			

TOTAL		$	(6,391.15)	

The Kearney Companies LLC hereby requests an extension of	 	0	day(s) to the original contract deadline for this work.

The Kearney Companies, LLC.

REASON FOR CHANGE: DIRECT PURCHASE OF MATERIALS BY CDD	

ACCEPTABLE TO:

DATE:	31-Mar-18

DATE:  	

Engineer

DATE:  	

Owner

0038-01 CO8 - CDD Purchase Materials-7	Page 1 of 1

THE KEARNEY COMPANIES, LLC.
9625 Wes Kearney Way, Riverview FL 33578

Office (813) 421-6601
Fax (813) 421-6701

Underground Utilities	Site Development

PROJECT: TRIPLE CREEK VILLAGE K&L/AMENITY CENTER INVOICE TRANSMITTAL FERGUSON
THE KEARNEY COMPANIES PROJECT NO. 0038-01

Date: 31-Mar-18	

INV. NO.	DESCRIPTION	TOTAL COST	
			
1653307	FERGUSON 2/15/2018	$	1,213.40	
1658919	FERGUSON 3/12/2018	$	2,130.64	
1659947	FERGUSON 3/16/2018	$	2,685.35	

			

			

			

			

			

			
			
TOTAL		$	6,029.39	

The Kearney Companies, LLC.

DATE:	31-Mar-18

Invoice Transmittal FERGUSON	Page 1 of 1

Attachment 1

PURCHASE REQUISITION REQUEST FORM

Contact Person for the material supplier.
NAME:	Renie Martin/Ferguson Waterworks ADDRESS:		8008 E. Sligh Avenue, Tam pa, FL 33610
TELEPHONE NUMBER-:		813-=927=-361-4= 	_
Manufacturer or brand, model or specification number of the item.

Quantity needed as estimated by CONTRACTOR. 	_
The price quoted by the supplier for the construction materials identified above.
$ 	6,029.39	
The sales tax associated with the price quote. $ 	3_6_1._7_6 	_
Shipping and handling insurance cost. $-----------
Delivery dates as established by CONTRACTOR.	Per Schedule

OWNER:

CONTRACTOR: ------------------------

-	½\l ck­
,  / t  i	ature

 	1/31/2018	
Date

Attachment 2

PURCHASE ORDER

SEE	ATTACHED	PURCHASE	REQUISITION	REQUEST	FORM	
DATED	March 31 , 2018.			

I.

2.	Triple Creek Community Development District State of Florida sales tax exemption certificate number: 85-8013874191C-l

Triple Creek Community Development District is the Purchaser of the construction materials purchased pursuant to this Purchase Order. Supplier shall provide for the required shipping and handling insurance cost for delivery of the construction materials by the delivery date specified in this Purchase Order.

unity Development District
0
Aut

CONTRACTOR-:	--"T"='"h' e=K=e=a=rne:..y;...=..C.;:=omp===ani=es,-==LLc.C.,;;; 	_

AuthoriJ		ature (Title)

3/31/2018

Date

FERGUSON®	r<ECE!V!:=P
WATERWORKS

h:._.	·

8008 E.S LIGH AVE.	·-r:B2 0  2 l\\
TAMP A, FL 33610-0000
=

1il

   INVOICE NUMBER	TOTAL DUE	CUSTOMER	PAGE	
 	1653307	$1,213.40	51547	1 of 1	
PLEASE REFER TO INVOICE NUMBER WHEN MAKING PAYMENT AND REMIT TO:

FEI-TAMPA, FL WATERWORKS #044

=

Please contact with Questions:   81fs-
--

7_1 \240.1\1 Zl'lEY.

C  CHVP!

/\Nl  l:S.

REMIT TO NEW ADDRESS:
PO BOX 100286
ATLANTA, GA 30384-0286

24681 AB 0.408 E0045X I0080 D3347052615 S2 P5099959 0001:0001

m:

11111111Ii111111111II111•1I11•11•11I11111I1111I111I1111 1111111II
TRIPLE CREEK CDD TRIPLE CREEK K & L
C/O THE KEARNEY COMPANIES 9625 WES KEARNEY WAY RIVERVIEW FL 33578-0506

COUNTER PICK UP 8008 E SLIGH AVE TAMPA, FL 33610-0000

SHIP TO:

I

SHIP	SELL
WHSE.	WHSE.
44	44

TAX CODE

FLE

CUSTOMER ORDER NUMBER

836775

SALESMAN

027

JOB NAME

TRIPLE CREEK K & L

I NVOI CE  DATEI   B   CH

!	02/15/18	99566

ORDERED	SHIPPED	I	ITEM NUMBER	DESCRIPTION

UNIT PRICE	UM

AMOUNT

1	1	I461SS	2PC SC Cl VLV BX 19-22 SWR		40.500	EA	40.50	
11	11	I461SW	2PC SC Cl VLV BX 19-22 WTR		40.500	EA	445.50	
20	20	AFT350PU	6 CL350 CL DI FASTITE PIPE		15.890	FT	317.80	
1	1	GBRNK24	LF 2X24 BRS NIP GBL		74.000	EA	74.00	
20	20	P40SFAM	3 PVC S40 SXF ADPT		3.780	EA	75.60	
4	4	IBRLFCK	LF 2 BRS COUP		17.600	EA	70.40	
2	2	GBRNK12	LF 2X12 BRS NIP GBL		37.450	EA	74.90	
4	4	DG200AAL	2 ALUM MALE ADPT X FEM NPT		4.280	EA	17.12	
4	4	DG200DCAL	2 ALUM DUST CAP		8.770	EA	35.08	
50	50	K62335	600V AQBL WP WIRE CONN		1.250	EA	62.50	

1.......................*,i. 	"..	

··••1t•• ·	

····" ..........................	

.. ........... *.****•**"'**"*"*••··	
INVOICE SUB-TOTAL			
1213.40	
LEAD LAW WINING: ITIS ILLEIAL TO INSTALL PROD CTS THAT ARE NOT "LEAD FREE" IN ACCORDANCE WITH
US FEDERAL R OTHERAPPLI ABLE LAW IN POTABLE WATER SYSTEMS ANTICIPATED FOR HUMAN CONSUMPTION PRODUCTS W TH *NP IN THE D SCRIPTION ARE NOT L AD FREE AND CAN ONLY BE INSTALLEDIN
NON-POTABL APPLICATIONS. UYER IS SOLELY RES ONSIBLE FOR PRODUCT SELECTION.

r

l :\ \

fm\11	,Jf\\  i\\r':
\\' ( \111	\J[.,	0

\.

Looking for a more convenient way to pay your bill?
Log in to Ferguson.com and request access to Online Bill Pay.	--
TERMS:	NET 10TH PROX	ORIGINAL INVOICE	TOTAL DUE	$1,213.40
All past due amounts are subject to a service charge of 1.5% per month, or the maximum allowed by law, if lower. If Buyer fails to pay within terms, then in addition to other remedies, Buyer agrees to pay Seller all costs of collection, including reasonable attorney fees. Complete terms and conditions are available upon request  or at http://wolseleyna.com/terms_conditionsSale.html and are incorporated by reference. Seller may convert checks to ACH.
0001:0001

1FERGUSON®
WATERWORKS
8008 E. SLIGH AVE. TAMPA, FL 33610-0000

   INVOICE NUMBER	TOTAL DUE	CUSTOMER	PAGE	
 	1658919	$2,130.64	51547	1 of 1	
RECEIVED	PLEASE REFER TO INVOICE NUMBER WHEN MAKING PAYMENT AND REMIT TO:

""""""'
-

MAR 1 9 2018
Please contact with Questions: 813-627-1240
THE KEARNEY COMPANI ES

53951 AB 0.408 E0030X 10059 03424637545 S2 P5174253 0001:0001

FEI-TAMPA, FL WATERWORKS #044 REMIT TO NEW ADDRESS:
PO BOX 100286
ATLANTA, GA 30384-0286

SHIP TO:

11I••Ih11II11111111•11111111•IIhI IIIII11111•1•1ii•1 1•111111I  111
TRIPLE CREEK COD TRIPLE CREEK K & L
C/O THE KEARNEY COMPANIES 9625 WES KEARNEY WAY
RI VERVIEW FL 33578-0506

COUNTER PICK UP 8008 E SLIGH AVE TAMPA, FL 33610-0000

SHIP WHSE.
44	SELL WHSE.
44 .	TAX CODE

FLE	CUSTOMER ORDER NUMBER

500426	SALESMAN

027	JOB NAME

TRIPLE CREEK K & L	INVOICE DATE

03/12/18	BATCH
10
99833	
ORDERED	SHIPPED	ITEM NUMBER	DESCRIPTION	UNIT PRICE
4	7 4   I461SW	2PC SC ClVLV BX 19-22 WTR	40.500
6	./ 6    M24LFN25120 DWVALVE     25-3/4 OD INFLOW PROT	51.000
2	/   2   C10151033	STD 12 PLAS WTR MTR BX WI Cl RDR	31.740
2	/2  GBRNK24	LF 2X24 BRS NIP GBL	74.000
1	/ 1   GBRNK48	LF 2X48 BRS NIP GBL	151.000
1	J 1   RBPVTMP	3 BRS PLUG VLV ID -4	17.000
3	./ 1   RBPVTMX	3 BRS PLUG V LV ID - 8	17.000
3	/3  IBRLF9K	LF 2 BRS 90 ELL	18.060
6	/ 6	IBRLFCK	LF 2 BRS COUP	15.560
1	/  1   GBRNKCL	LF 2XCLOSE BRS NIP GBL	11.000
1	./ 1   GBRNKP	LF 2X4 BRS NIP GBL	17.000
6	/ 6    IBRLFBGF	LF 1X3/4 BRS BUSH	3.450
3	/ 3   IBRLFBKF	LF 2X3/4 BRS BUSH	11.500
2	.,-2  GBRNKU	LF 2X6 BRS NIP GBL	24.000
8	8   RBGVTMK	3 BRS GATE VLV ID - 2	17.000
6	fi   RBGVTMU	3 BRS GATE V LV ID -6	17.000
5	/  5    RBGVTM12	3 BRS GATE VLV ID - 12	17.000
30	30   PFBP5CSKM	3 CSK SC IPS BRS PLUG	6.400
2	2   DG200AAL	2 ALUM MALE ADPT X FEM NPT	4.280
2	2   DG200DCAL	2 ALUM DUST CAP	8.770
1	1  FB11777WNL	LF 2 FIP X FIP BALL CURB ST LW	232.730
1	/ 1   FC8477NL	LF 2 MIP X CTS PJ COUP	68.260
1	/ 1	R AP4100	2	RAPTOR ADJ HYO WRCH	42.590
6	/   6    PS67194	2 WOOD HDL CHIP BRSH	2.790
1	/  1   R5225402	1GAL SAF BLUE IND CHOICE DTM ACRY	43.000
1	/ 1   R5233402	1GAL SAF GREE IND CHOICE DTM ACRY	43.000

INVOICE SUB-TOTAL

I•••••••••••*.*......,..,,................, 	••••••••••••••••••*•*•*****
LE AD LAW Wf NING: IT IS ILLEi AL TO INSTALL PROD CTS THAT ARE NOT "LEAD FREE" IN ACCORDANCE WITH
US FEDERAL    R OTHER APPLI  ABLE LAW IN POTABLE WATER SYSTEMS ANTICIPA TED FOR HUMAN CON·S,U"\M\P:T:.._Ii\ON     rEm)j
PROD UCTS W TH *NP IN THE D SCRIPTION ARE NOT L AD FREE AND CAN ONLY BE INSTALLED IN
NON-POTABL   APPLICATIONS.   UYER IS SOLELY RES  ONSIBLE FOR PRODUCTSE L ECT I ON.	f.1.    \ 1"\ 11• ll l   ,   1 ;:1	Lb.
lh     1U.	IUr"  U.\-\N'   :Jt'	tL. -p,_	,
'	.1,,. .2,l    . '	I	I (
u	.....
Looking  for a more convenient way to	Y your bill?

Log in to Ferguson.com and request access to Online Bill Pay.	UM	AMOUNT	
	EA	162.00	
	EA	306.00	
	EA	63.48	
	EA	148.00	
	EA	151.00	
	EA	17.00	
	EA	17.00	
	EA	54.18	
	EA	93.36	
	EA	11.00	
	EA	17.00	
	EA	20.70	
	EA	34.50	
	EA	48.00	
	EA	136.00	
	EA	102.00	
	EA	85.00	
	EA	192.00	
	EA	8.56	
	EA	17.54	
	EA	232.73	
	EA	68.26	
	EA	42.59	
	EA	16.74	
	EA	43.00	
	EA	43.00	
		
2130.64	
	(	----	
TERMS	:	NET	10TH PROX	ORIGINAL	INVOICE	TOTAL DUE		$2,130.64	
All past due amounts are subject to a service charge of 1.5% per month, or the maximum allowed by law, if lower. If Buyer fails to pay within terms, then in addition to other remedies, Buyer agrees to pay Seller all costs of collection, including reasonable
attorney fees. Complete terms and conditions are available upon request or at http://wolseleyna.com/terms_conditionsSale.html and are incorporated by reference. Seller may convert checks to ACH.
0001:0001

FERGUSON®
WATERWORKS

-

8008 E. SLIGH AVE.
=	TAMPA, FL 33610-0000
-		Please contact with Questions: 813-627-1240

MAR 2 2 2018

K

   IN VOICE NUMBER	TOTAL DUE	CUSTOMER	PAGE	
 	1659947	$2,685.35	51547	1of 1	
PLEASE REFER TO INVOICE NUMBER WHEN MAKING PAYMENT AND REMIT TO:

FE I-TAM PA, FL WATERWORKS #044 REMIT TO NEW ADDRESS:
PO BOX 100286
ATLANTA, GA 30384-0286

...
r

5930 1 AB 0.408 E0061X l0111 D3438886735 S2 P5186245 0001:0001
11111111•I  •Iii11•I  1111111•11111111''111lilh111•IIPPI111111' II•
TRIPLE CREEK COD
.	TRIPLE CREEK K & L
C/0 THE KEARNEY COMPANIES
9625 WES KEARNEY WAY RIVERVIEW FL 33578-0506

C O U N T ER P IC K UP 8008 E SLIGH AVE TAMPA, FL 33610-0000

SHIP TO:

SHPI		SELL	TAX CODE	CUSTOMER ORDER NUMBER	SALESMAN	JOB NAME	INVOICE DATE WHSE.	WHSE.
44	44	FLE	464867	027	TRIPLE CREEK K & L	03/16/18	BATCH
10
99881	
ORDERED	SHIPPED	ITEM NUMBER	DESCRIPTION	UNIT PRICE	UM	AMOUNT	
	40
2
2
4
6
4
4
3
2
3
3
10
1
2	./ 40
/  2
/ 2
4
6
/1
i
/2
j3
/  3
/ 10
; 1
.l-	AFT350PU GBRNK48 PSPWT210 GBRNK12 IBRLFCK IBRLF9K GBRNK24 GBRNKCL FNWX410CK IVBLIDS 1461SW P40SFAM C1430BSF500 FC8477NL	6 CL350 CL DI FASTITE PIPE LF 2X48 BRS NIP GBL
2X100 10 MIL PIPE WRAP TAPE LF 2X12 BRS NIP GBL
LF 2 BRS COUP LF 2 BRS 90 ELL
LF 2X24 BRS NIP GBL
LF 2XCLOSE BRS NIP GBL
LF 2 BRS 600# WOG THRO 2PC FP BV 5-114 Cl VLV BX LID SWR
2PC SC Cl VLV BX 19-22 WTR
3 PVC S40 SXF ADPT
14GA 30MM 500 FT COP TRCR WIRE BLUE LF 2 MIP X CTS PJ COUP

INVOICE SUB-TOTAL	15.890
241.810
9.950
56.900
22.230
25.790
120.910
12.000
75.710
9.500
40.500
3.780
52.590
85.320	FT EA EA EA EA EA EA EA EA EA EA EA EA EA	635.60	
							483.62	
							19.90	
							227.60	
							133.38	
							103.16	
							483.64	
							36.00	
							151.42	
							28.50	
							121.50	
							37.80	
							52.59	
							170.64	
							
2685.35	
······
LEAD L US FE PROD NON-	
ERMS:		NET 10TH PROX		ORIGINAL INVOICE	TOTAL DUE		$2,685.35	

·*•·***** #l•···············.......,1.•1, ••   ••   •  ••   •••    ••   •  ••   •••    • •  • ••   ••   ••    .  . . .  . .  . .  .  . .    .... .  .  . .  . .  . .  . .  . . .  .  .
AW Wf  NING: IT IS ILLE   AL TO INSTALL PROD CTS THAT ARE NOT "LEAD FREE" IN ACCORDANCE WITH DERAL ROTHER APPLI ABLE LAW IN POTABLE WATER SYSTEMS ANTICIPATED FOR HUMAN CONSUMPTION UCTS W TH 'NP IN THE D SCRIPTION ARE NOT L AD FREE AND CAN ONLY BE INSTALLED IN
POTABL APPLICATIONS. UYER IS SOLELY RES ONSIBLE FOR PRODUCT SELECTION.

,,,1,tlR				
Looking for a more convenient way to pay your bill?

Log in to Ferguson.com and request access to Online Bill Pay.	--	

All past due amounts are subject to a service charge of 1.5% per month, or the maximum allowed by law, if lower. If Buyer fails to pay within terms, then in addition to other remedies, Buyer agrees to pay Seller all costs of collection, including reasonable attorney fees. Complete terms and conditions are available upon request or at http://wolseleyna.com/terms_conditionsSale.html and are incorporated by reference. Seller may convert checks to ACH.
0001:0001

Tab 5

Triple Creek
FIELD INSPECTION REPORT

March.29th, 2018 Rizzetta & Company
L. Scott Green –	Field Services Manager

Triple Creek

The following are action items for Sitex Landscaping complete. Please refer to the item # in your response listing action already taken or anticipated time of completion. Red text indicates deficient from previous report. Bold Red text indicates deficient for more than a month. Green text indicates a proposal has been requested. Blue indicates irrigation.

   1	

Reference Pic (1) Located at the front entrance to Triple Creek annuals have been rotated and appear to be in good health with good color at the time of this inspection. Ask contractor to monitor bed and ensure it stays weed free and to ensure annuals are receiving adequate water from irrigation.

   2	

Reference Pic (2) Large ditch located at the front of Triple Creek entrance is very wet at the time of this inspection and cannot be mowed. Ask contactor to monitor ditch and mow when it is dry enough for service workers to put mowers in.

2

Triple Creek

   3	
Reference Pic (3) Located at front entrance of Triple Creek on lake bank to front pond there is a dead palm tree that needs to be removed. Ask contractor to submit proposal to remove dead palm tree.

   4	
Reference Pic (4) Located at the front pond on pond bank there is a stump from palm that was removed. Ask contractor to submit proposal to flush cut stump to ground.

Sidewalk at front at of Triple Creek has	5	
some crack weeds that need to be
treated with Herbicide for weed control.

Reference Pic (5) Located in landscape bed at front of Triple Creek in median there is still some up lighting that needs to be adjusted as it is pointing at the ground. Ask contractor to submit date as to when all up lighting will be adjusted.

3

Triple Creek

   6	
Reference Pic (6) Located in landscape bed in median at entrance to Triple Creek another landscape up lighting that needs to be adjusted as it pointed up into he air at nothing.

Reference Pic (7) Located in landscape beds in median of Triple Creek
Blvd. there are still large ant mounds	7	
present. Ask Contractor to spot treat
mounds and disperse of dirt once mound is dead.

Reference Pic (7) Also located in the medians of Triple Creek Blvd. it appears plant material from recent freezing temps is coming back since the rejuvenation pruning was conducted. Ask contractor to continue to monitor this plant material and make any adjustments to Fert/Chem and irrigation as needed.

   8		10. Landscape beds in median do need to be edged and treated with Herbicide for weed control.

Reference Pic (8) Turf located in the medians of Triple Creek Blvd. is inundated with turf weeds in places that need to be treated. Ask contractor to inspect turf and submit Fert/Chem course of action to treat turf weeds.

4

Triple Creek

  09 

Reference Pic (09) Located along Triple Creek Blvd. to right hand side inbound lane there is a curb side tree that is leaning to the left. Tree has straps on it that need to be tightened and adjusted before roots are to strong.

  10 

Reference Pic (10) Triple Creek Blvd. left hand side when driving towards rear of community median that was referenced in last months report has now had new sod installed and irrigation appears to be working properly in area. Ask contractor to monitor turf and make any necessary adjustments in Fert/Chem as needed.

Reference Pic (11) located in landscape bed to left hand side of Streambed there is a tree leaning that needs to be straightened and re- strapped. There is also some exposed irrigation in this landscape bed that needs to be covered up.

  11 

5

Tab 6

TRIPLE CREEK CDD

  SITEX LANDSCAPE  –  MARCH  2018 LANDSCAPE INSPECTION REPORT FOLLOW UP	

Understood, we clean this bed out for weeds on each site vist
Understood, when the ditch is dry we cut it.  When its  wet we go  down as  far  as we can
Will be complete by end of this month
Will be complete by end of this month
We spray crack weeds on a weekly basis.  Will be sure to my guys are on top  of this
asap
asap
we will have all mounds treated within the next few weeks, and stay on top of it better moving forward
understood
Complete
Weed control scheduled for mid April in all turf
Completed
Understood
Completed

Tab 7

Triple Creek CDD

Monthly Report Inspection Date: 4/01/18

Prepared For: Christine Perkins Rizzetta & Company

Prepared By:
Joe Craig
P: 407-717-5851
E:  joe@sitexaquatics.com

Monthly Report

Ponds 2a,2b,4a,4b

 	
	
Ponds received treatment for shoreline grasses and invasive species as needed		
Pond 4c,4d,5a,5b

 	
Ponds received treatment for shoreline grasses and invasive species as needed.	Pond 5A received midge fly treatment	

Monthly Report

Ponds 14,14a,16a,16b

 	
	
Ponds received treatment for shoreline grasses and invasive species as needed		
Pond 16a,16b,38a,38d

 	
Comments: Ponds received treatment for shoreline grasses and invasive species as needed.	

Monthly Report

Ponds 38k1,38k2,wca38,38g1

 	
	
Ponds received treatment for shoreline grasses and invasive species as needed		
Pond 30g2,38f1,canal1,canal2

 	
Comments: Ponds received treatment for shoreline grasses and invasive species as needed.	

Monthly Report

Pond 41a

Comments: Pond has filled back up & water looks good, trash was removed

MONTHLY SUMMARY

March was a great month for weather, we saw a couple mild cold fronts which helped keep the water temps a bit cooler then usual. Algae blooms were at a minimum with only spot treatments being needed. All in all, the ponds are in good shape as we begin the uber active growing season. We will see algae popping up as the water temp heats up & it will be addressed as needed. The new sections labeled Phase 3 & the blvd extension by the school were also added to the monthly service. There is some vegetation growing in these sections that has been treated.

As always please feel free to reach out to myself or one of my staff should you have any questions or concerns.

Regards Joe Craig President
Sitex Aquatics llc

Tab 8

RESOLUTION 2018-08

A RESOLUTION OF THE BOARD OF SUPERVISORS OF THE TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT APPROVING REQUEST FOR PROPOSAL DOCUMENTS FOR THE DISTRICT’S VILLAGES G2, I, AND J INFRASTRUCTURE PROJECT; PROVIDING A SEVERABILITY CLAUSE; AND PROVIDING AN EFFECTIVE DATE.

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

WHEREAS, Chapter 190, Florida Statutes, authorizes the District to maintain systems and facilities for certain basic public infrastructure, including landscaping and irrigation improvements; and

WHEREAS, it is in the District’s best interests to competitively solicit proposals through a Request for Proposals (“RFP”) process for its Villages G2, I, and J infrastructure installation project (the “Project”); and

WHEREAS, the Board desires to approve in substantial form the RFP notice and Evaluation Criteria for the Project attached hereto as Exhibit A; and

WHEREAS, the Board desires to authorize the Chairman or Vice Chairman, in consultation with District staff, to effectuate any revisions to the documents attached as Exhibit A, and the preparation of the additional documents necessary to prepare a final RFP project manual for the Project, and other documents that are in the best interests of the District;

WHEREAS, the Board further desires to authorize the Chairman or Vice Chairman, in consultation with District staff, to approve the scope of the Project that will be subject to the RFP, the timing of the RFP notice, and all procedural matters related to the RFP.

NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF SUPERVISORS OF THE TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT:

SECTION 1. All of the representations, findings and determinations contained above are recognized as true and accurate and are expressly incorporated into this Resolution.

SECTION 2. The Board hereby approves in substantial form the documents attached hereto as Exhibit A, and subject to further review and revision by District staff as finally approved by the Chairman or Vice Chairman.

SECTION 3. The Board hereby authorizes the Chairman or Vice Chairman, in consultation with District staff, to 1) effectuate any revisions to the documents attached as Exhibit

1

A, and the preparation of the additional documents necessary to prepare the RFP; and 2) approve the scope of the Project that will be subject to the RFP, the timing of the RFP notice, and all procedural matters related to the RFP. Consistent with such approvals, the Chairman, Vice Chairman, District Manager, District Counsel, Secretary, and Assistant Secretaries are hereby authorized, upon the adoption of this Resolution, to do all acts and things required of them to effect the procurement contemplated by the RFP, and all acts and things that may be desirable or consistent with the RFP’s requirements or intent. The Chairman and Secretary are hereby further authorized to execute any and all documents necessary to affect the RFP. The Vice Chairman shall be authorized to undertake any action herein authorized to be taken by the Chairman, in the absence or unavailability of the Chairman, and any Assistant Secretary shall be authorized to undertake any action herein authorized to be taken by the Secretary, in the absence or unavailability of the Secretary.

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 17th day of April, 2018.

ATTEST:	TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT

Secretary	Chairman/Vice Chairman

Exhibit A: RFP Notice and Evaluation Criteria

2

Exhibit A

RFP Notice and Evaluation Criteria

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT REQUEST FOR PROPOSAL FOR
VILLAGES G2, I, AND J INFRASTRUCTURE CONSTRUCTION PROJECT

Notice is hereby given that the Triple Creek Community Development District (“District”) will receive proposals for the following District project:

Villages G2, I, and J Infrastructure Construction Project

The contract will require contractors to provide for the construction, labor, materials and equipment necessary to construct and install certain Villages G2, I, and J infrastructure improvements and other associated scopes necessary to complete such improvements, as more particularly described in the Project Manual and in accordance with the plans and specifications.

The Project Manual, consisting of the proposal package, contract, proposal form, plans, and other materials, will be available for public inspection and may be obtained via e-mail beginning April 30, 2018 at 9:00 a.m and for a fee of $150.00, made payable to Scarola Associates Engineering Design and Land Consultants, P.A.

There will be a mandatory pre-bid proposal conference at the offices of Scarola Associates Engineering Design and Land Consultants, P.A., located at 6505 Surfside Boulevard, Apollo Beach, Florida 33572 on May , 2018 at 	.m. Failure to attend may preclude a proposer from responding to this Request for Proposals.

Proposals will be evaluated in accordance with the criteria included in the Project Manual. The District reserves the right to reject any and all proposals, make modifications to the work, award the contract in whole or in part with or without cause, provide for the delivery of the project in phases, and waive minor or technical
 irregularities in any Proposal, as it deems appropriate, if it determines in its discretion that it is in the District’s best interests to do so. Any protest of the Project Manual, including, but not limited to the terms and specifications must be filed with the District within 72 hours of pickup of the Project Manual, together with a protest bond in a form acceptable to the District and in the amount of $10,000.00. Filing will be perfected and deemed to have occurred upon receipt by the District Manager, Rizzetta & Company, Inc., 9428 Camden Field Parkway, Riverview, Florida 33578. In the event the protest is successful, the protest bond shall be refunded to the protestor. In the event the protest is unsuccessful, the protest bond shall be applied towards the District’s costs, expenses and attorney’s fees associated with hearing and defending the protest. Failure to timely file a protest will result in a waiver of proceedings under Chapter 190, Florida Statutes, and other law.

Firms desiring to provide construction services for the referenced project must submit one (1) original and one (1) electronic copy of the required proposal no later than 11:00 a.m. on June 14, 2018 at the offices of Scarola Associates Engineering Design and Land Consultants, P.A., located at 6505 Surfside Boulevard, Apollo Beach, Florida 33572. The District’s Engineer will conduct a special public meeting at 11:00 a.m. on June 14, 2018 at the offices of Scarola Associates Engineering Design and Land Consultants, P.A., located at 6505 Surfside Boulevard, Apollo Beach, Florida 33572 to publicly open the proposals. No official action will be taken at the meeting. The meeting is open to the public and will be conducted in accordance with the provisions of Florida law including but not limited to Chapter 190 of the Florida Statutes. A copy of the agenda for the meeting may be obtained from the District Engineer, at Scarola Associates Engineering Design and Land Consultants, P.A., located at 6505 Surfside Boulevard, Apollo Beach, Florida 33572, or (     ) 	. The meeting may be continued in progress without additional notice to a time, date, and location stated on the record. Pursuant to provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this meeting is asked to advise the District Office at least forty-eight (48) hours before the meeting by contacting Rizzetta & Company, Inc., the District Manager, at (813) 533-2950. If you are hearing or speech impaired, please contact the Florida Relay Service at 1 (800) 955-8770, who can aid you in contacting the District Office.

As further described in the Project Manual, each proposer shall supply a bid bond or cashier’s check in the sum equal to five percent (5%) of the total amount of the bid with its proposal. Proposals shall be in the form provided in the Project Manual and submitted in a sealed envelope pursuant to the Instructions to Proposers. The District reserves the right to return unopened to the Proposer any proposals received after the time and date stipulated above. Each proposal shall remain binding for a minimum of one hundred and twenty (120) days after the proposal opening.

The successful Proposer will be required upon award to furnish a payment and performance bond for one hundred percent (100%) of the value of the contract, with a Surety acceptable to the District, in accordance with section 255.05, Florida Statutes.

All questions regarding the Project Manual or this project shall be directed in writing only to Jamie Scarola, at js@scarola.com, with a copy to District Counsel, Jennifer Kilinski, at jenk@hgslaw.com. No phone inquiries please.

TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT
Request for Proposals – Villages G2, I, and J Infrastructure Construction Project
Evaluation Criteria

Personnel.	(10 Points)

(E.g., geographic locations of the firm’s headquarters or permanent office in relation to the project; capabilities and experience of key personnel, including the project manager and field supervisor; present ability to appropriately staff and manage this project; evaluation of existing work load; proposed staffing levels, etc.)

Proposer’s Experience.	(20 Points)

(E.g. past record and experience of the respondent in similar projects; volume of work previously performed by the firm; past performance for other community development districts in other contracts; character, integrity, reputation, of respondent, etc.)

Understanding of Scope of Work.	(10 Points)

Extent to which the proposal demonstrates an understanding of the District’s needs for the services requested.

Financial Capability.	(10 Points)

Extent to which the proposal demonstrates the adequacy of Proposer’s financial resources and stability as a business entity, necessary to complete the services required.

Price.	(25 Total Points)

Points available for price will be allocated as follows:

15 Points will be awarded to the Proposer submitting the lowest cost proposal , (i.e., the summation of the unit price extensions using quantity estimates provided, the allowances shown, plus the proposal contractor’s fee) for completing the work. All other proposals will receive a percentage of this amount based upon the difference between the Proposer’s bid and the low bid.

10 Points are allocated for the reasonableness of unit prices and balance of bid.

Schedule.	(25 Points)

Points available for schedule will be allocated as follows:

15 Points will be awarded to the Proposer submitting the proposal with the most expedited construction schedule (i.e. the fewest number of days) for completing the work. All other proposals will receive a percentage of this amount based upon the difference between the Proposer’s timeline and the most expedited construction schedule.

10 Points will be allocated based on the Proposer’s ability to credibly complete the project within the Proposer’s schedule without a premium cost for accelerated work and demonstrate on-time performance. These points will also take into account the demonstration of Proposer’s understanding (through presentation in the proposal of a milestone schedule) of how to meet the required substantial and final completion dates and the delivery approach outlined in the Project Manual.

Tab 9

This instrument was prepared by and upon recording should be returned to:

Jennifer Kilinski
HOPPING GREEN & SAMS P.A.
119 South Monroe Street, Suite 300
Tallahassee, Florida 32301	(This space reserved for Clerk)	

SPECIAL WARRANTY DEED
THIS SPECIAL WARRANTY DEED is made this        day of 	_ , 2018, by TC VENTURE 1, LLC, a Delaware limited liability company, whose address is 7807 Baymeadows Road East, Suite 205, Jacksonville, Florida 32256, hereinafter called the “Grantor,” to TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT, a local unit of special- purpose government organized under Chapter 190, Florida Statutes, whose address is at c/o Rizzetta & Company, Inc., 9428 Camden Field Parkway, Riverview, Florida 33578, hereinafter called the “Grantee:”

(Wherever used herein the terms “Grantor” and “Grantee” include all the parties to this instrument and the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations or governmental entities.)

W I T N E S S E T H:

The Grantor, for and in consideration of the sum of $10.00 and other valuable consideration, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the Grantee, all that certain land situated in Hillsborough County, Florida, described as follows:

[Insert tracts and plat book/page reference for ponds and roadway tract]

Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining, and to have and to hold the same in fee simple forever. Such conveyance is subject to all matters of record; however, reference hereto shall not operate to re-impose the same.

The Grantor hereby covenants with said Grantee that the Grantor is lawfully seized of said land in fee simple and that the Grantor has good right and lawful authority to sell and convey said land. Further, the Grantor hereby warrants the title to said land and will defend the same against the lawful claims of all persons or entities whomsoever claiming by, through or under Grantor. Additionally, the Grantor warrants that it has complied with the provisions of Section 196.295, Florida Statutes.

IN WITNESS WHEREOF, the Grantor has hereunto set its hand and seal the day and year first above written.

Printed Name:  	 Witness

TC VENTURE 1 LLC,
a Delaware limited liability company

By:	 Printed Name: 		Printed Name:  	 Witness		Title:  	

STATE OF FLORIDA COUNTY OF  	

The	foregoing	instrument	was	acknowledged	before	me	this	 	day	of
 	,	2018,	by	 		(name),	as
 	(title) of TC Venture 1, LLC, a Delaware limited liability company, and who has personally appeared before me and is personally known to me.

(NOTARY SEAL)

Notary Public Signature

(Name typed, printed or stamped)
Notary Public, State of  	 Commission No.  	                                My Commission Expires:  	 

Note to Examiner: This instrument evidences a conveyance of an interest in unencumbered real estate as a gift and is exempt from Florida documentary stamp tax pursuant to Rule 12B- 4.014(2)(a), Florida Administrative Code.

BILL OF SALE

KNOW ALL MEN BY THESE PRESENTS, that TC VENTURE 1, LLC, a Delaware
limited liability company, with a mailing address of 7807 Baymeadows Road East, Suite 205 Jacksonville, Florida 32256 (“Seller”), and in consideration of the sums set forth in the exhibits attached hereto and for other valuable consideration to it paid by the TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT, a local unit of special purpose government organized and existing under Chapter 190, Florida Statutes, whose mailing address is c/o Rizzetta & Company, Inc., 9428 Camden Field Parkway, Riverview, Florida 33578 (the “District”), the receipt whereof is hereby acknowledged, has granted, bargained, sold, transferred and delivered, and by these presents does grant, bargain, sell, transfer, and deliver unto the District, its successors and assigns, the following described property, assets and rights, to-wit:

All roadway improvements including paving, curb, gutter, stormwater piping, and sidewalks located within or upon that certain real property owned by the Seller and described below; and

All plants, trees, timber, shrubbery, and other landscaping and plantings located within or upon that certain real property owned by the Seller and described below; and

All wastewater, valves, force mains, tees, bends, joint, facilities, and appurtenances thereto located within or upon that certain real property owned by the Seller and described below; and

All potable water lines, pipes, valves, tees, bends, joints, and appurtenances thereto, located within or upon that certain real property owned by the Seller and described below; and

All drainage construction; sub-base, curbs, and stormwater components thereto, located within or upon that certain real property owned by the Seller and described below; and

all located on portions of the real property described in Exhibit A, attached hereto and made a part hereof, situate, lying and being in Hillsborough County, Florida.

TO HAVE AND TO HOLD all of the foregoing unto the District, its successors and assigns, for its own use forever, free and clear and discharged of and from any and all obligations, claims or liens.
AND the Seller does hereby covenant to and with the District, its successors and assigns, that it is the lawful owner of the above-described personal property and assets; that said personal property and assets are free from all liens and encumbrances; that Seller has good right to sell said personal property and assets; that all contractors, subcontractors and materialmen furnishing labor or materials relative to the construction of the personal property and assets have been paid in full; and that Seller will warrant and defend the sale of its said personal property and assets hereby made, unto the District, its successors and assigns, against the lawful claims and demands of all persons whosoever.

[signatures on following page]

IN WITNESS WHEREOF, the Seller has caused this instrument to be executed in its name this         day of 	, 2018.
Witnesses:

(Print Name)

(Print Name)	TC VENTURE 1, LLC,
a Delaware limited liability company

By:	 Its:   		

STATE OF FLORIDA COUNTY OF  	

The foregoing instrument was acknowledged before me this             day of 	_, 2018, by 	, as 	of TC Venture 1, LLC, a Delaware limited liability company, who appeared before me this day in person, and who is either personally known to me, or produced 		as identification.

(NOTARY SEAL)	 	
Notary Public signature

(Name typed, printed, or stamped)
Notary Public, State of  	 Commission No.  	                                        My Commission Expires:  	 	

Exhibit A

[insert legal description]

Exhibit C

Identification of Improvements –  	

TC Venture 1, LLC constructed and/or caused to be completed in and for the Triple Creek Community Development District, the following improvements all located on portions of the real property described as follows:

[INSERT DESCRIPTION OF LOCATION OF IMPROVEMENTS]

All Improvements are as contemplated by the Engineer’s Report and as more generally identified in the chart below:

Contractor	Contract/Invoice	Date	Amount	

				

				

Exhibit D

Identification of Improvements –  	

TC Venture 1, LLC constructed and/or caused to be completed in and for the Triple Creek Community Development District, the following improvements all located on portions of the real property described as follows:

[INSERT DESCRIPTION OF LOCATION OF IMPROVEMENTS]

All Improvements are as contemplated by the Engineer’s Report and as more generally identified in the chart below:

Contractor	Contract/Invoice	Date	Amount	

				

				

Exhibit E

Identification of Improvements –  	

TC Venture 1, LLC constructed and/or caused to be completed in and for the Triple Creek Community Development District, the following improvements all located on portions of the real property described as follows:

[INSERT DESCRIPTION OF LOCATION OF IMPROVEMENTS]

All Improvements are as contemplated by the Engineer’s Report and as more generally identified in the chart below:

Contractor	Contract/Invoice	Date	Amount	

				

				

Exhibit F

Identification of Improvements –  	

TC Venture 1, LLC constructed and/or caused to be completed in and for the Triple Creek Community Development District, the following improvements all located on portions of the real property described as follows:

[INSERT DESCRIPTION OF LOCATION OF IMPROVEMENTS]

All Improvements are as contemplated by the Engineer’s Report and as more generally identified in the chart below:

Contractor	Contract/Invoice	Date	Amount	

				

				

CERTIFICATION OF GGI, LLC D/B/A GENESIS TO
TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT REGARDING ACQUISITION OF SERIES 2017 PROJECT IMPROVEMENTS

 	, 2018

Board of Supervisors
Triple Creek Community Development District

Re:	Triple Creek Community Development District (Hillsborough County, Florida), Acquisition of Series 2017 Project Improvements

Ladies and Gentlemen:

The undersigned, Kyle L. Thornton, P.E., of GGI, LLC d/b/a Genesis, as District Engineer of the Triple Creek Community Development District (“District”), hereby makes the following certifications in connection with the District’s acquisition of certain work product and improvements (“Improvements”), as described in Exhibit A attached hereto, and the Bill of  Sale dated 	, 2018, all of which relate to the acquisition of work product, real property and/or improvements within the District. Unless otherwise stated, all capitalized terms not otherwise defined herein shall have the meaning ascribed thereto in that certain Master Trust Indenture between the District and The Bank of New York Mellon Trust Company, N.A., as trustee, and dated June 1, 2012, as supplemented by the Second Supplemental Trust Indenture also between the District and The Bank of New York Mellon Trust Company, N.A., and dated February 1, 2017, as supplemented by the Third Supplemental Trust Indenture also between the District and The Bank of New York Mellon Trust Company, N.A., as Trustee, and dated February 1, 2017, (together “Indenture”).

The undersigned, an authorized representative of the District Engineer, hereby certifies that:

I have inspected the Improvements, as well as any and all site plans, plats, agreements, construction and development drawings, plans and specifications, surveys, engineering reports, soil reports, and documents of every kind and character whatsoever pertaining or applicable to or in any way connected with the development, construction, and ownership of the Improvements.

The Improvements have been completed in compliance with the applicable governmental requirements, including but not limited to all permits, Hillsborough County regulations and code and, if applicable, FDOT regulations and code.

In my opinion, the Improvements are within the scope of the District’s original capital improvement plan as set forth in the Triple Creek Community Development District Amended and Restated Master Capital Improvement Plan, dated April 11, 2016, as supplemented by the Triple Creek Community Development District Supplemental Engineering Report Special Assessment Bonds, Series 2017, dated January 23, 2017 (collectively, the “Engineer’s Report”); were installed in accordance with their specifications; and are free from obstruction and capable of performing the functions for which they were intended.

The total costs associated with the Improvements are as set forth in Exhibit A. Such costs are accurate and representative of what was actually paid by TC Venture 1, LLC to create and/or construct the Improvements.

All known plans, permits and specifications necessary for the operation and maintenance of the Improvements are complete and on file with the District, and have been transferred, or are capable of being transferred, to the District for operations and maintenance responsibilities.

The Improvements specifically benefit property within the boundaries of the District as described in the Engineer’s Report.

With this document, I hereby certify that it is appropriate at this time to transfer the Improvements to the District for ownership, and operation and maintenance responsibilities.

Under penalties of perjury, I declare that I have read the foregoing certificate and that the facts stated in it are true.

[signatures on following page]

GGI, LLC d/b/a GENESIS

Kyle L. Thornton, P.E.
Florida Registration No. 60279

STATE OF FLORIDA
COUNTY OF  	

The foregoing instrument was acknowledged before me this 	day of 	, 2018, by Kyle Thornton of GGI, LLC d/b/a Genesis, who is personally known to me or who has produced
 	as identification, and did [ ] or did not [ ] take the oath.

Notary Public, State of Florida
Print Name: 		 Commission No.: 	                                                     My Commission Expires:  	

Exhibit A

Identification of Improvements

TC Venture 1, LLC constructed and/or caused to be completed in and for the Triple Creek Community Development District, the following improvements all located on portions of the real property described as follows:

[INSERT DESCRIPTION OF LOCATION OF IMPROVEMENTS]

All Improvements are as contemplated by the Engineer’s Report and as more generally identified in the chart below:

Contractor	Contract/Invoice	Date	Amount	

				

				

AFFIDAVIT REGARDING COSTS PAID

STATE OF FLORIDA COUNTY OF  	

I, Rick Harcrow, as Vice President of TC Venture 1, LLC, a Delaware limited liability company, being first duly sworn, do hereby state for my affidavit as follows:

I have personal knowledge of the matters set forth in this affidavit.

My name is Rick Harcrow, and I am Vice President of TC Venture 1, LLC (the “Developer”). I have authority to make this affidavit on behalf of Developer.

Developer is the developer of certain lands within the Triple Creek Community Development District, a special purpose unit of local government established pursuant to Chapter 190, Florida Statutes (“District”).

The District Engineer’s report, the Triple Creek Community Development District Amended and Restated Master Capital Improvement Plan, dated April 11, 2016, as supplemented by the Triple Creek Community Development District Supplemental Engineering Report Special Assessment Bonds, Series 2017, dated January 23, 2017 (collectively, the “Engineer’s Report”) describes certain public infrastructure improvements and/or work product that the District intends to finance, fund, plan, establish, acquire, construct or reconstruct, enlarge or extend, equip, operate, or maintain pursuant to Chapter 190, Florida Statutes, (“Improvements”)

Pursuant to contracts in place between Developer and certain contractors, engineers and construction related professionals, as may be more particularly identified on the attached Exhibit A, Developer has expended funds to develop the Improvements that are included and described in the Engineer’s Report and are part of the District’s capital improvement plan. The attached Exhibit A accurately identifies the completed Improvements and states, at least in part, the amounts that Developer has spent on the completed improvements. No money is owed to any contractors or subcontractors for any work performed on the completed Improvements.

In making this affidavit, I understand that the District intends to rely on this affidavit for purposes of acquiring the completed Improvements that Developer has developed consistent with the Engineer’s Report.

Under penalties of perjury, I declare that I have read the foregoing and the facts alleged are true and correct to the best of my knowledge and belief.

[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

Executed this 	day of 	, 2018.

TC VENTURE 1, LLC, a Delaware limited liability company

By:	 	
Its:	 	

STATE OF FLORIDA COUNTY OF  	

The	foregoing	instrument	was	acknowledged	before	me	this	 	day	of
 	, 2018, by Rick Harcrow, as Vice President of TC Venture 1, LLC, a Delaware limited liability company, who appeared before me this day in person, and who is either personally known to me, or produced 	as identification.

(NOTARY SEAL)

Notary Public Signature

(Name typed, printed or stamped)
Notary Public, State of  	 Commission No.  	                                My Commission Expires:  	 

Exhibit A

Identification of Improvements

TC Venture 1, LLC constructed and/or caused to be completed in and for the Triple Creek Community Development District, the following improvements all located on portions of the real property described as follows:

[INSERT DESCRIPTION OF LOCATION OF IMPROVEMENTS]

All Improvements are as contemplated by the Engineer’s Report and as more generally identified in the chart below:

Contractor	Contract/Invoice	Date	Amount	

				

				

ACKNOWLEDGMENT OF ACQUISITION OF CERTAIN IMPROVEMENTS AND THE RIGHT TO RELY UPON ANY WARRANTIES AND CONTRACT TERMS FOR THE CONSTRUCTION OF SAME

THIS  ACQUISITION  AND   WARRANTY  ACKNOWLEDGMENT   is  made  the 	day of
 	, 2018, by RIPA & Associates, LLC, a Florida limited liability company, having offices located at 1409 Tech Blvd., Suite 1, Tampa, Florida 33619 (“Contractor”), in favor of the TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT (“District”), which is a local unit of special-purpose government situated in Hillsborough County, Florida, and having offices located at c/o Rizzetta & Company, Inc., 9428 Camden Field Parkway, Riverview, Florida 33578.

SECTION 1. DESCRIPTION OF CONTRACTOR’S SERVICES. Contractor has provided construction services as general contractor in connection with the construction of certain infrastructure improvements (the “Improvements”) for TC Venture 1, LLC, developer of lands within the District (the “Developer”). A copy of the contracts for the construction of said Improvements is attached as Exhibit A (“Construction Contract”). The Improvements constructed and acquired are more generally described in the attached Exhibit B.

SECTION 2. ACQUISITION OF IMPROVEMENTS. Contractor acknowledges that  the District is acquiring or has acquired the Improvements, constructed by Contractor in connection with the Construction Contract attached as Exhibit A, from Developer, and thereby securing the unrestricted right to rely upon the terms of the Construction Contract for same.

SECTION 3. WARRANTY. Contractor hereby  expressly  acknowledges  the  District’s right to enforce the terms of the Construction Contract, including any warranties provided therein and to rely upon and enforce any other warranties provided under Florida law.

SECTION 4. INDEMNIFICATION. Contractor  indemnifies  and  holds  the  District harmless from any claims, demands, liabilities, judgments, costs, or other actions that may be brought against or imposed upon the District in connection with the Improvements identified in Exhibit B because of any act or omission of Contractor, its agents, employees, or officers. Said indemnification shall include, but not be limited to, any reasonable attorney’s fees and costs incurred by the District.

SECTION 5. CERTIFICATE OF PAYMENT. Contractor hereby acknowledges that it has been fully compensated for its services and work related to completion of the Improvements. Contractor further certifies that no outstanding requests for payment exist related to the Improvements identified in Exhibit B, including any payments to subcontractors, materialmen, suppliers or otherwise, and that there is no disagreement as to the appropriateness of payment made for the Improvements. This document shall constitute a final waiver and release of lien for any payments due to Contractor by Developer for the Improvements identified in Exhibit B.

SECTION 6. EFFECTIVE DATE.  This  Acquisition  and  Warranty  Acknowledgement shall take effect upon execution.

ATTEST	RIPA & Associates, LLC, a Florida limited liability company

By:_ 	

[print name]	Its:  	

[print name]

EXHIBIT A
Construction Contract

EXHIBIT B
Identification of Improvements

TC Venture 1, LLC constructed and/or caused to be completed in and for the Triple Creek Community Development District, the following improvements all located on portions of the real property described as follows:

[INSERT DESCRIPTION OF LOCATION OF IMPROVEMENTS]

All Improvements are as contemplated by the Engineer’s Report and as more generally identified in the chart below:

Contractor	Contract/Invoice	Date	Amount	

				

				

WARRANTY, ASSIGNMENT OF RIGHTS AND RELEASE OF RESTRICTIONS ON THE TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT’S RIGHT TO USE AND RELY UPON DRAWINGS, PLANS, SPECIFICATIONS AND RELATED DOCUMENTS CREATED OR UNDERTAKEN IN CONNECTION WITH THE AGREEMENT FOR PROFESSIONAL SERVICES

THIS  WARRANTY, ASSIGNMENT  AND  RELEASE  is  made  the     day of 	, 2018, by GGI, LLC d/b/a Genesis, a Florida limited liability company whose address is 1000
N. Ashley Drive, Suite 900, Tampa, Florida 33602, (“Professional”), in favor of the TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT (“District”), which is a local unit of special- purpose government situated in the Hillsborough County, Florida, and having offices located at c/o Rizzetta & Company, Inc., 9428 Camden Field Parkway, Riverview, Florida 33578, for and in consideration of the sum of Ten and No/100 U.S. Dollars ($10.00), and other good and valuable consideration to it in hand paid by the District, the receipt and sufficiency of which are hereby acknowledged by the Professional.

SECTION 1. DESCRIPTION OF SCOPE OF SERVICES. Professional has provided work product in connection with the construction and/or installation of certain infrastructure improvements for TC Venture 1, LLC, a landowner within the District (“Landowner”). An outline of the scope of services provided by Professional is attached as Exhibit A (“Work Product”).

SECTION 2. USE OF WORK PRODUCT. Professional acknowledges that the District anticipates it will acquire the Work Product from Landowner, and thereby secure unrestricted rights to use and rely upon the same for any and all purposes, including the purposes for which it was intended.

SECTION 3. WARRANTY. Professional hereby expressly guarantees that the  Work Product identified in Exhibit A is fit for any and all purposes, including the purposes for which it is intended. This expressed warranty shall not serve to eliminate any responsibility of Professional for the Work Product under Florida Statutes or case law, or to exclude any implied warranties and responsibilities.

SECTION 4.   RELEASES.   Premised upon the District’s agreement to make no revisions or modifications to the Work Product without prior written permission of Professional, Professional confirms the release of all restrictions upon the District’s right to use and rely upon the Work Product for any and all purposes, including the purposes for which it is intended. Professional hereby affirmatively agrees that the Work identified in Exhibit A is free of all claims, security agreement, encumbrances or liens.

SECTION 5. CERTIFICATE OF PAYMENT. Professional hereby acknowledges that it has been fully compensated for its services and work related to completion of the Work Product. Professional  hereby further  acknowledges  it  has  been  paid  at least $ 	for the Work Product. Professional further certifies that no outstanding requests for payment exist related to the Work Product identified in Exhibit A and that there is no disagreement as to the

appropriateness of payment made for the Work Product. This document shall constitute a final waiver and release of lien for any payments due to Professional by Landowner and/or the District for the Work Product identified in Exhibit A.

SECTION 6.	EFFECTIVE  DATE.	This Warranty, Assignment and Release shall take effect upon execution.

WITNESSES	GGI, LLC, a limited liability company,
d/b/a GENESIS

Signature

[print name]

Print Name

Its: 	

[print name]

EXHIBIT A

Triple Creek CDD Improvements	
Design Documents & Supporting Information	
		April 2018	
			
Payee	Estimated Plan
Value	Remarks	
Work Product Description			

			

			

Tab 10

This instrument was prepared by and upon recording should be returned to:

Jennifer Kilinski, Esq.
HOPPING GREEN & SAMS P.A.
119 South Monroe Street, Suite 300
Tallahassee, Florida 32301	(This space reserved for Clerk)	

SPECIAL WARRANTY DEED

THIS  SPECIAL  WARRANTY  DEED  is  made  this      day of 	, 2018, by Mattamy Tampa/Sarasota LLC a Delaware limited liability company, whose address is 4901 Vineland Road, Suite 450, Orlando, Florida 32811, hereinafter called the “Grantor”, to Triple Creek Community Development District, a local unit of special-purpose government organized under Chapter 189, Florida Statutes, whose address is 9428 Camden Field Parkway, Riverview, Florida 33578, hereinafter called the “Grantee”:

(Wherever used herein the terms “Grantor” and “Grantee” include all the parties to this instrument and the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations or governmental entities.)

W I T N E S S E T H:

The Grantor, for and in consideration of the sum of $10.00 and other valuable consideration, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the Grantee, all that certain land situated in Hillsborough County, Florida, described in the attached Exhibit A.

Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining, and to have and to hold the same in fee simple forever. Such conveyance is subject to all matters of record; however, reference hereto shall not operate to re-impose the same.

The Grantor hereby covenants with said Grantee that the Grantor is lawfully seized of said land in fee simple and that the Grantor has good right and lawful authority to sell and convey said land. Further, the Grantor hereby warrants the title to said land and will defend the same against the lawful claims of all persons or entities whomsoever claiming by, through or under Grantor, but not otherwise. Additionally, the Grantor warrants that it has complied with the provisions of Section 196.295, Florida Statutes.

1

IN WITNESS WHEREOF, the Grantor has hereunto set its hand and seal the day and year first above written.

 	  Witness Name:  	

Witness Name:  		MATTAMY TAMPA/SARASOTA LLC, a
Delaware limited liability company

By:	 Name:	 Title:    		

STATE OF FLORIDA	)
COUNTY OF 		)

The	foregoing	instrument	was	acknowledged	before	me	this	 	day of
 	, 2018, by 	, as   		 of Mattamy Tampa/Sarasota LLC, a Delaware limited liability company, for and on behalf of  said  entity.   He/She [  ] is  personally known  to  me  or [  ] produced 	as identification.

NOTARY STAMP:

Signature of Notary Public

Printed Name of Notary Public

Note to Examiner: This instrument evidences a conveyance of an interest in unencumbered real estate as a gift and is exempt from Florida documentary stamp tax pursuant to Rule 12B-4.014(2)(a), Florida Administrative Code.

EXHIBIT A

DESCRIPTION OF THE REAL PROPERTY

BILL OF SALE

KNOW ALL MEN BY THESE PRESENTS, that MATTAMY TAMPA/SARASOTA
LLC, a Delaware limited liability company, whose mailing address is 4901 Vineland Road, Suite 450, Orlando, Florida 32811 (the “Seller”), and in consideration of the sum of Ten Dollars ($10.00) and other valuable consideration, to it paid by the TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT, a local unit of special purpose government organized and existing under Chapter 189, Florida Statutes, whose mailing address is 9428 Camden Field Parkway, Riverview, Florida 33578 (the “District”), the receipt whereof is hereby acknowledged, has granted, bargained, sold, transferred and delivered, and by these presents does grant, bargain, sell, transfer, and deliver unto the District, its successors and assigns, the following described property, assets and rights, to-wit:

All wastewater, valves, force mains, tees, bends, joint, facilities, and appurtenances thereto, located within or upon that certain real property owned by the Seller and described below; and

All potable water lines, pipes, valves, tees, bends, joints, and appurtenances thereto, located within or upon that certain real property owned by the Seller and described below; and

All drainage construction; sub-base, curbs, and stormwater components thereto, located within or upon that certain real property owned by the Seller and described below; and

a. all located on portions of the real property described in Exhibit A, attached hereto and made a part hereof, situate, lying and being in Hillsborough County, Florida.

TO HAVE AND TO HOLD all of the foregoing unto the District, its successors and assigns, for its own use forever, free and clear and discharged of and from any and all obligations, claims or liens.
AND the Seller does hereby covenant to and with the District, its successors and assigns, that it is the lawful owner of the above-described personal property and assets; that said personal property and assets are free from all liens and encumbrances; that Seller has good right to sell said personal property and assets; that all contractors, subcontractors and materialmen furnishing

labor or materials relative to the construction of the personal property and assets have been paid in full; and that Seller will warrant and defend the sale of its said personal property and assets hereby made, unto the District, its successors and assigns, against the lawful claims and demands of all persons whosoever.

IN WITNESS WHEREOF, the Seller has caused this instrument to be executed in its name this 	day of 	, 2018.

MATTAMY TAMPA/SARASOTA LLC a
Delaware limited liability company

By:	 Name:	 Title:    	

STATE OF FLORIDA	)
COUNTY OF 		)

The	foregoing	instrument	was	acknowledged	before	me	this	 	day of
 	, 2018, by 	, as   		 of Mattamy Tampa/Sarasota LLC, a Delaware limited liability company, for and on behalf of  said  entity.   He/She [  ] is  personally known  to  me  or [  ] produced 	as identification.

NOTARY STAMP:

Signature of Notary Public

Printed Name of Notary Public

EXHIBIT A

DESCRIPTION OF THE LANDS

CERTIFICATION OF GGI, LLC D/B/A GENESIS TO
TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT REGARDING ACQUISITION OF SERIES 2017 PROJECT IMPROVEMENTS

 	, 2018

Board of Supervisors
Triple Creek Community Development District

Re:	Triple Creek Community Development District (Hillsborough County, Florida), Acquisition of Series 2017 Project Improvements

Ladies and Gentlemen:

The undersigned, Kyle L. Thornton, P.E., of GGI, LLC d/b/a Genesis, as District Engineer of the Triple Creek Community Development District (“District”), hereby makes the following certifications in connection with the District’s acquisition of certain work product and improvements (“Improvements”), as described in Exhibit A attached hereto, and the Bill of Sale dated 	, 2018, all of which relate to the acquisition of work product, real property and/or improvements within the District. Unless otherwise stated, all capitalized terms not otherwise defined herein shall have the meaning ascribed thereto in that certain Master Trust Indenture between the District and The Bank of New York Mellon Trust Company, N.A., as trustee, and dated June 1, 2012, as supplemented by the Second Supplemental Trust Indenture also between the District and The Bank of New York Mellon Trust Company, N.A., and dated February 1, 2017, as supplemented by the Third Supplemental Trust Indenture also between the District and The Bank of New York Mellon Trust Company, N.A., as Trustee, and dated February 1, 2017, (together “Indenture”).

The undersigned, an authorized representative of the District Engineer, hereby certifies that:

I have inspected the Improvements, as well as any and all site plans, plats, agreements, construction and development drawings, plans and specifications, surveys, engineering reports, soil reports, and documents of every kind and character whatsoever pertaining or applicable to or in any way connected with the development, construction, and ownership of the Improvements.

The Improvements have been completed in compliance with the applicable governmental requirements, including but not limited to all permits, Hillsborough County regulations and code and, if applicable, FDOT regulations and code.

In my opinion, the Improvements are within the scope of the District’s original capital improvement plan as set forth in the Triple Creek Community Development District Amended and Restated Master Capital Improvement Plan, dated April 11, 2016, as supplemented by the Triple Creek Community Development District Supplemental Engineering Report Special Assessment Bonds, Series 2017, dated January 23, 2017 (collectively, the “Engineer’s Report”); were installed in accordance with their specifications; and are free from obstruction and capable of performing the functions for which they were intended.

The total costs associated with the Improvements are as set forth in Exhibit A. Such costs  are accurate and representative of what was actually paid by TC Venture 1, LLC to create and/or construct the Improvements.

All known plans, permits and specifications necessary for the operation and maintenance of the Improvements are complete and on file with the District, and have been transferred, or are capable of being transferred, to the District for operations and maintenance responsibilities.

The Improvements specifically benefit property within the boundaries of the District as described in the Engineer’s Report.

With this document, I hereby certify that it is appropriate at this time to transfer the Improvements to the District for ownership, and operation and maintenance responsibilities.

Under penalties of perjury, I declare that I have read the foregoing certificate and that the facts stated in it are true.

[signatures on following page]

GGI, LLC d/b/a GENESIS

Kyle L. Thornton, P.E.
Florida Registration No. 60279

STATE OF FLORIDA
COUNTY OF  	

The	foregoing	instrument	was	acknowledged	before	me	this	 		day	of
 	, 2018, by Kyle Thornton of GGI, LLC d/b/a Genesis, who is personally known to me or who has produced 	as identification, and did [ ] or did not [ ] take the oath.

Notary Public, State of Florida
Print Name: 		 Commission No.: 	                                                     My Commission Expires:  	

Exhibit A

Identification of Improvements

TC Venture 1, LLC constructed and/or caused to be completed in and for the Triple Creek Community Development District, the following improvements all located on portions of the real property described as follows:

[INSERT DESCRIPTION OF LOCATION OF IMPROVEMENTS]

All Improvements are as contemplated by the Engineer’s Report and as more generally identified in the chart below:

Contractor	Contract/Invoice	Date	Amount	

				

				

AFFIDAVIT REGARDING COSTS PAID

STATE OF FLORIDA
COUNTY OF  	

I, 	, of Mattamy Tampa/Sarasota LLC being first duly sworn, do hereby state for my affidavit as follows:
I have personal knowledge of the matters set forth in this affidavit.

My name is 	and I am employed by Mattamy Tampa/Sarasota LLC, a Delaware limited liability company (“Developer”), as 	_. I have authority to make this affidavit on behalf of Developer.
Developer is the developer of certain lands within the Triple Creek Community Development District, a special purpose unit of local government established pursuant to Chapter 190, Florida Statutes (“District”).
The District’s Amended and Restated Master Capital Improvement Plan dated April 11, 2016, as supplemented by the Supplemental Engineering Report Special Assessment Bonds, Series 2017, dated January 23, 2017 (collectively, the “Engineer’s Report”), describes certain public infrastructure improvements and/or work product that the District intends to finance, fund, plan, establish, acquire, construct or reconstruct, enlarge or extend, equip, operate, or maintain pursuant to Chapter 190, Florida Statutes.
Pursuant to the contracts described in Exhibit A, Developer has expended funds to develop or acquire certain of the public infrastructure improvements and associated work product, which completed improvements are included and described in the Engineer’s Report. The attached Exhibit A accurately identifies the completed improvements and work product and states the amounts that Developer has spent on those improvements and work product. No money is owed to any contractors or subcontractors for any work performed on the completed improvements and/or work product.

In making this affidavit, I understand that the District intends to rely on this affidavit for purposes of acquiring the completed improvements and work product that Developer has developed consistent with the Engineer’s Report.
Under penalties of perjury, I declare that I have read the foregoing and the facts alleged are true and correct to the best of my knowledge and belief.
Executed this 	day of 	, 2018.

AFFIANT

STATE OF FLORIDA	)
COUNTY OF 		)

The	foregoing	instrument	was	acknowledged	before	me	this	 	day of
 	, 2018, by 	, as 		_ of Mattamy Tampa/Sarasota LLC, a Delaware limited liability company, for and on behalf of said  entity.   He/She [  ] is  personally known  to  me  or [  ] produced 	as identification.

NOTARY STAMP:

Signature of Notary Public

Printed Name of Notary Public

Exhibit A

Identification of Improvements

TC Venture 1, LLC constructed and/or caused to be completed in and for the Triple Creek Community Development District, the following improvements all located on portions of the real property described as follows:

[INSERT DESCRIPTION OF LOCATION OF IMPROVEMENTS]

All Improvements are as contemplated by the Engineer’s Report and as more generally identified in the chart below:

Contractor	Contract/Invoice	Date	Amount	

				

				

ACKNOWLEDGMENT OF ACQUISITION OF CERTAIN IMPROVEMENTS AND THE RIGHT TO RELY UPON ANY WARRANTIES AND CONTRACT TERMS FOR THE CONSTRUCTION OF SAME

THIS  ACQUISITION  AND   WARRANTY  ACKNOWLEDGMENT   is  made  the 	day of
 	,  2018,  by 	,  a 		, having  offices located at 		(“Contractor”), in favor of the TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT (“District”), which is a local unit of special-purpose government situated in Hillsborough County, Florida, and having offices located at c/o Rizzetta & Company, Inc., 9428 Camden Field Parkway, Riverview, Florida 33578.

SECTION 1. DESCRIPTION OF CONTRACTOR’S SERVICES. Contractor has provided construction services as general contractor in connection with the construction of certain infrastructure improvements (the “Improvements”) for Mattamy Tampa/Sarasota LLC, the developer of certain lands within the District (the “Developer”). A copy of the contracts for the construction of said Improvements is attached as Exhibit A (“Construction Contract”). The Improvements constructed and acquired are more generally described in the attached Exhibit B.

SECTION 2. ACQUISITION OF IMPROVEMENTS. Contractor acknowledges that  the District is acquiring or has acquired the Improvements, constructed by Contractor in connection with the Construction Contract attached as Exhibit A, from Developer, and thereby securing the unrestricted right to rely upon the terms of the Construction Contract for same.

SECTION 3. WARRANTY. Contractor hereby  expressly  acknowledges  the  District’s right to enforce the terms of the Construction Contract, including any warranties provided therein and to rely upon and enforce any other warranties provided under Florida law.

SECTION 4. INDEMNIFICATION. Contractor  indemnifies  and  holds  the  District harmless from any claims, demands, liabilities, judgments, costs, or other actions that may be brought against or imposed upon the District in connection with the Improvements identified in Exhibit B because of any act or omission of Contractor, its agents, employees, or officers. Said indemnification shall include, but not be limited to, any reasonable attorney’s fees and costs incurred by the District.

SECTION 5. CERTIFICATE OF PAYMENT. Contractor hereby acknowledges that it has been fully compensated for its services and work related to completion of the Improvements. Contractor further certifies that no outstanding requests for payment exist related to the Improvements identified in Exhibit B, including any payments to subcontractors, materialmen, suppliers or otherwise, and that there is no disagreement as to the appropriateness of payment made for the Improvements. This document shall constitute a final waiver and release of lien for any payments due to Contractor by Developer for the Improvements identified in Exhibit B.

SECTION 6. EFFECTIVE DATE.  This  Acquisition  and  Warranty  Acknowledgement shall take effect upon execution.

ATTEST	Mattamy Tampa/Sarasota LLC, a Delaware limited liability company

By:_ 	

[print name]	Its:  	

[print name]

EXHIBIT A
Construction Contract

EXHIBIT B
Identification of Improvements

Mattamy Tampa/Sarasota LLC constructed and/or caused to be completed in and for the Triple Creek Community Development District, the following improvements all located on portions of the real property described as follows:

[INSERT DESCRIPTION OF LOCATION OF IMPROVEMENTS]

All Improvements are as contemplated by the Engineer’s Report and as more generally identified in the chart below:

Contractor	Contract/Invoice	Date	Amount	

				

				

WARRANTY, ASSIGNMENT OF RIGHTS AND RELEASE OF RESTRICTIONS ON THE TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT’S RIGHT TO USE AND RELY UPON DRAWINGS, PLANS, SPECIFICATIONS AND RELATED DOCUMENTS CREATED OR UNDERTAKEN IN CONNECTION WITH THE AGREEMENT FOR PROFESSIONAL SERVICES

THIS  WARRANTY, ASSIGNMENT  AND  RELEASE  is  made  the     day of 	, 2018, by 	, a _ 	whose address is
 	, (“Professional”), in favor of the TRIPLE CREEK COMMUNITY DEVELOPMENT DISTRICT (“District”), which is a local unit of special-purpose government situated in the Hillsborough County, Florida, and having offices located at c/o Rizzetta & Company, Inc., 9428 Camden Field Parkway, Riverview, Florida 33578, for and in consideration of the sum of Ten and No/100 U.S. Dollars ($10.00), and other good and valuable consideration to it in hand paid by the District, the receipt and sufficiency of which are hereby acknowledged by the Professional.

SECTION 1. DESCRIPTION OF SCOPE OF SERVICES. Professional has provided work product in connection with the construction and/or installation of certain infrastructure improvements for Mattamy Tampa/Sarasota LLC, a landowner within the District (“Landowner”). An outline of the scope of services provided by Professional is attached as Exhibit A (“Work Product”).

SECTION 2. USE OF WORK PRODUCT. Professional acknowledges that the District anticipates it will acquire the Work Product from Landowner, and thereby secure unrestricted rights to use and rely upon the same for any and all purposes, including the purposes for which it was intended.

SECTION 3. WARRANTY. Professional hereby expressly guarantees that the  Work Product identified in Exhibit A is fit for any and all purposes, including the purposes for which it is intended. This expressed warranty shall not serve to eliminate any responsibility of Professional for the Work Product under Florida Statutes or case law, or to exclude any implied warranties and responsibilities.

SECTION 4.   RELEASES.   Premised upon the District’s agreement to make no revisions or modifications to the Work Product without prior written permission of Professional, Professional confirms the release of all restrictions upon the District’s right to use and rely upon the Work Product for any and all purposes, including the purposes for which it is intended. Professional hereby affirmatively agrees that the Work identified in Exhibit A is free of all claims, security agreement, encumbrances or liens.

SECTION 5. CERTIFICATE OF PAYMENT. Professional hereby acknowledges that it has been fully compensated for its services and work related to completion of the Work Product. Professional  hereby further  acknowledges  it  has  been  paid  at least $ 	for the Work Product. Professional further certifies that no outstanding requests for payment exist related to the Work Product identified in Exhibit A and that there is no disagreement as to the

appropriateness of payment made for the Work Product. This document shall constitute a final waiver and release of lien for any payments due to Professional by Landowner and/or the District for the Work Product identified in Exhibit A.

SECTION 6.	EFFECTIVE  DATE.	This Warranty, Assignment and Release shall take effect upon execution.

ATTEST	Mattamy Tampa/Sarasota LLC, a Delaware limited liability company

By:_ 	
[print name]	Its:  	

[print name]

EXHIBIT A

Triple Creek CDD Improvements	
Design Documents & Supporting Information	
		April 2018	
			
Payee	Estimated Plan
Value	Remarks	
Work Product Description			

			

			

Tab 11

EXHIBIT A
FORM OF WORK AUTHORIZATION

April 13, 2018

Triple Creek Community Development District Hillsborough County, Florida

Subject:	Work Authorization Number 7
Triple Creek Community Development District

Dear Chairperson, Board of Supervisors:

Dennis J. Benham, PSM (“Surveyor”) is pleased to submit this work authorization to provide surveying services for the Triple Creek Community Development District (“District”). We will provide these services pursuant to our current agreement dated      May 4       , 2017 (“Surveying Agreement”)   as follows:

Scope of Work
The District will engage Surveyor to:

AMENITY CENTER ELECTRIC LINE
Scope of Services
Stake with lath, electric line at appropriate interval and offset

Fees

Description	Hours	Rate	Total	
2 Man Survey Crew	10	85.00	850.00	
Survey Technician	6	60.00	360.00	
Professional Surveyor and Mapper	2	120.00	 		240.00		
			    $ 1,450.00		

The District will compensate Surveyor pursuant to the hourly rate schedule contained in the Surveying Agreement. The District will reimburse Surveyor all direct costs which include items such as printing, drawings, travel, deliveries, et cetera, pursuant to the Agreement.

This proposal, together with the Surveying Agreement, represents the entire understanding between the District and Surveyor with regard to the referenced work authorization. If you wish to accept this work authorization, please sign both copies where indicated, and return one complete copy to our office. Upon receipt, we will promptly schedule our services.

APPROVED AND ACCEPTED

By:  		Sincerely,

 	Dennis J Benham		

Authorized Representative of
Triple Creek Community Development District	By: 	Dennis J. Benham	

Date:	 	April 13, 2018		

Tab 12

Global Industrial

Account #: 3539164	Quote #: 4463852	Quote Issued: 03/29/2018	
Triple Creek CDD	JBUTLER@RIZZETTA.COM	*Quote Expires 30 Days from Issue	
JAMES BUTLER	Phone: (813) 394-6029		
11920 STREAMBED DRIVE	Fax:		
RIVERVIEW, Florida 33579		
CLICK HERE TO LOGIN AND PLACE THIS ORDER ONLINE.		

Part#

Description

Shipping

Quantity Price

Extended

261926BK Global Industrial™ Thermoplastic Coated 32 Gallon

Mesh Receptacle w/Rain Bonnet Lid - Black

SOUTHEASTERN 4

FRT - TRUCKING

$328.00 $1,312.00

PLEASE BE SURE TO REVIEW OUR TERMS AND CONDITIONS

Item Total: $1,312.00 Estimated Freight:	$284.04
*Total: $1,596.04

Notes
THANK YOU, KAREN ADDED ON LIFT GATE FEES

Thank you for the opportunity to help with your needs. To place your order or for further assistance please contact me.
Name: KAREN SPATES
Email: kspates@globalindustrial.com
Phone: (800) 645-1232
Fax: (800) 336-3818

*Applicable taxes and shipping charges will be added to invoice. This quote is subject to Global Industrial’s Terms and Conditions of Sale

11 Harbor Park Drive, Port Washington, N.Y. 11050
Copyright © 2018 by Global Equipment Company Inc. All Rights Reserved

Tab 13

Triple Creek Community Development District

ANNUAL FINANCIAL REPORT

September 30, 2017

Triple Creek Community Development District ANNUAL FINANCIAL REPORT
Fiscal Year Ended September 30, 2017

TABLE OF CONTENTS

Page Number

REPORT OF INDEPENDENT AUDITORS MANAGEMENT'S DISCUSSION AND ANALYSIS

1-2

3-8

BASIC FINANCIAL STATEMENTS:
Government-wide Financial Statements
Statement of Net Position	9
Statement of Activities	1O
Fund Financial Statements:
Balance Sheet - Governmental Funds	11
Reconciliation of Total Governmental Fund Balances to Net
Position of Governmental Activities	12
Statement of Revenues, Expenditures and Changes in Fund
Balances - Governmental Funds	13
Reconciliation of the Statement of Revenues, Expenditures and Changes in Fund Balances of Governmental Funds to the
Statement of Activities	14
Statement of Revenues, Expenditures and Changes in Fund
Balances -  Budget and Actual - General Fund	15
Notes to Financial Statements	16-28
INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED IN ACCORDANCE WITH
GOVERNMENT AUDITING STANDARDS	29-30
MANAGEMENT LETTER	31-32
INDEPENDENT ACCOUNTANT'S REPORT/COMPLIANCE WITH SECTION
218.415, FLORIDA STATUTES	33

ti Berger, Toombs, Elam,
,OJ Gaines & Frank
Certified Public Accountants	PL

600 Citrus Avenue
Suite 200
Fort Pierce,  Florida 34950
772/461-6120 II 461-1155
FAX: 7721468-9278

Report of Independent Auditors

To the Board of Supervisors
Triple Creek Community Development District Hillsborough County, Florida

Report on the Financial Statements

We have audited the accompanying basic financial statements of Triple Creek Community Development District as of and for the year ended September 30, 2017, and the related notes to financial statements, which collectively comprise the District's basic financial statements as listed in the table of contents.

Management's Responsibility for the Financial Statements

Management is responsible for the preparation and fair presentation of these financial statements in accordance with accounting principles generally accepted in the United States of America; this includes the design, implementation, and maintenance of internal control relevant to the preparation and fair presentation of financial statements that are free from material misstatement, whether due to fraud or error.

Auditor's Responsibility

Our responsibility is to.express an opinion on these financial statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America and the standards applicable to financial audits contained in Government Accounting Standards, issued by the Comptroller General of the United States. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free from material misstatement.

An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial statements. The procedures selected depend on the auditor's judgment, including the assessment of the risks of material misstatement of the financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity's preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity's internal control. Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the financial statements.

We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion.

Member AICPA

Fort Pierce I Stuart
- 1 -
Member AICPA Division For CPA Firms
Private Companies Practice Section

Member FICPA

tt

Berger, Toombs, Elam,

,OJ Gaines & Frank

To the Board of Supervisors
Triple Creek Community Development District

Opinion

In our opinion, the basic financial statements referred to above present fairly, in all material respects, the financial position of the governmental activities and each major fund of Triple Creek Community Development District as of September 30, 2017, and the respective changes in financial position and the budgetary comparison for the General Fund for the year then ended in conformity with accounting principles generally accepted in the United States of America.

Other Matters

Required Supplementary Information··

Governmental accounting principles generally accepted in the United States of America require that the Management's Discussion and Analysis and budgetary comparison be presented to supplement the basic financial statements. Such information, although not a part of the basic financial statements, is required by Governmental Accounting Standards Board who considers it to be an essential part of financial reporting for placing the basic financial statements in an appropriate  operational,  economic,  or historical context.	We have applied certain limited · procedures to the required supplementary information in accordance with governmental auditing standards generally accepted in the United States of America, which consisted principally of inquires of management regarding the methods of preparing the information and comparing the information for consistency with management's responses to our inquiries, the basic financial statements, and other knowledge we obtained during our audit of the basic financial statements. We do not express an opinion or provide any assurance on the information because the limited procedures do not provide us with sufficient evidence to express an opinion or provide any assurance.
Other Reporting Required by Government Auditing Standards
In accordance with Government Auditing Standards, we have also issued a report dated March 23, 2018 on our consideration of the District's internal control over financial reporting and on our tests of its compliance with certain provisions of laws, regulations and contracts. The purpose of that report is to describe the scope of our testing of internal control over financial reporting and compliance and the results of that testing, and not to provide an opinion on internal control over financial reporting or on compliance. That report is an integral part of an audit performed in accordance with Government Auditing Standards in considering Triple Creek Community Development District's internal control over financial reporting and compliance.
Jrxm/ocl	fl
00	4	J /lWJ
Berger, Toombs, Elam, Gaines & Frank
Certified Public Accountants PL Fort Pierce, Florida

March 23, 2018

- 2 -

Triple Creek Community Development District MANAGEMENT'S DISCUSSION AND ANALYSIS
For the Year Ended September 30, 2017

Management's discussion and analysis of Triple Creek Community Development District (the "District") financial performance provides an objective and easily readable analysis of the District's financial activities for the fiscal year ended September 30, 2017. The  analysis provides summary financial information for the District and should be read in conjunction with the District's financial statements.

OVERVIEW OF THE FINANCIAL STATEMENTS

The District's basic financial statements comprise three components; 1) Government-wide financial statements, 2) Fund financial statements, and 3) Notes to financial statements. The Government-wide financial statements present an overall picture of the District's financial position and results of operations. The Fund financial statements present financial information for the District's major funds. The Notes to financial statements provide additional information concerning the District's finances. This report also contains other supplementary information in addition to the basic financial statements.

The Government-wide financial statements are the statement of net position and the statement of activities. These statements use accounting methods similar to those used by private-sector companies. Emphasis is placed on the net position of governmental  activities and the change in net position. Governmental activities are primarily supported by special assessments.

The statement of net position presents information on all assets and liabilities of the District, with the difference between assets and liabilities reported as net position. Net position is reported in three categories; 1) net investment in capital assets, 2) restricted, and 3) unrestricted. Assets, liabilities, and net position are reported for all Governmental activities.

The statement of activities presents information on all revenues and expenses of the District and the change in net position. Expenses are reported by major function and program revenues relating to those functions are reported, providing the net cost of all functions provided by the District. To assist in understanding the District's operations, expenses have been reported as governmental activities. Governmental activities financed by the District include general government, physical environment and debt service.

Fund financial statements present financial information for governmental funds. These statements provide financial information for the major funds of the District. Governmental fund financial statements provide information on the current assets and liabilities of the funds, changes in current financial resources (revenues and expenditures), and current available resources.

- 3 -

Triple Creek Community Development District MANAGEMENT'S DISCUSSION AND ANALYSIS
For the Year Ended September 30, 2017

OVERVIEW OF THE FINANCIAL STATEMENTS (CONTINUED)

Fund financial statements include a balance sheet and  a  statement  of  revenues, expenditures and changes in fund balances for all governmental funds. A statement of revenues, expenditures, and changes in fund balances - budget and actual is provided  for the District's General Fund. Fund financial statements provide more detailed information about the District's activities. Individual funds are established by the District to track revenues that are restricted to certain uses or to comply with legal requirements.

The government-wide financial statements and the fund financial statements provide different pictures of the District. The government-wide financial statements provide an overall picture of the District's financial standing. These statements are comparable to private-sector companies and give a good understanding of the District's overall financial health and how the District paid for the various activities, or functions, provided by the District. All assets of the District,  including land, buildings and improvements, and infrastructure are reported in the statement of net position. All liabilities, including principal outstanding on bonds are included.  The statement of activities includes depreciation on all long lived assets of the District, but transactions between the different functions of the District have been eliminated in order to avoid "doubling up" the revenues and expenses. The fund financial statements  provide  a picture of the major funds of the District. In the case of governmental activities, outlays for long lived assets are reported as expenditures and long-term liabilities, such as general obligation bonds, are not included in the fund financial statements. To provide a link from the fund  financial statements to the government-wide financial statements, a reconciliation is  provided from the fund financial statements to the government-wide financial statements.

Notes to financial statements provide additional detail concerning the financial activities and financial balances of the District. Additional information about the accounting practices of the District, investments of the District, capital assets and long-term debt are some of the items included in the notes to financial statements.

Financial Highlights

The following are the highlights of financial activity for the year ended September 30, 2017.

+ The District's total assets exceeded total liabilities by $3,429,433 (net position). Unrestricted net position for Governmental Activities was $128,364. Net investment in capital assets was $2,596,618 and restricted net position was $704,451.
+ Governmental activities revenues totaled $5,073,474 while governmental activities expenses totaled $2,674,962.

-4-

Triple Creek Community Development District MANAGEMENT'S DISCUSSION AND ANALYSIS
For the Year Ended September 30, 2017

OVERVIEW OF THE FINANCIAL STATEMENTS (CONTINUED)

Financial Analysis of the District

The following schedule provides a summary of the assets, liabilities and net position of the District and is presented by category for comparison purposes.

Net Position

Current assets

 	Governmental  Activities	  2017	2016
$	733,843	$	269,125

Restricted assets	16,426,955	293,951	
Capital assets, net	11,382,446	4,268,668	
Total Assets	28,543,244	4,831,744	
Current liabilities	3,409,498	391,351	
Non-current liabilities	21,704,313	3,409,472	
Total Liabilities	25,113,811	3,800,823	

Net Position			
Net investment in capital assets	2,596,618	1,307,424	
Restricted	704,451	71,586	
Unrestricted	128,364	(348,089)	
Total Net Position	$ 3,429,433	$1,030,921	

The increase in current assets was primarily related to the increase in assessments receivable.

The increase in restricted assets is primarily related to the unspent proceeds from the Series 2017 bond proceeds.

The increase in capital assets is related to the construction in progress additions in the current year.

The increase in current liabilities is related to the accounts payable and contracts retainage payable for the 2017 project.

The increase in long-term debt is related to the issuance of the Series 2017 bonds.

The increase in net position is primarily the result of principal payments in excess of depreciation.

- 5 -

Triple Creek Community Development District MANAGEMENT'S DISCUSSION AND ANALYSIS
For the Year Ended September 30, 2017

OVERVIEW OF THE FINANCIAL STATEMENTS (CONTINUED)

Financial Analysis of the District (Continued)

The following schedule provides a summary of the changes in net position of the District and is presented by category for comparison purposes.

Change in Net Position

	   Governmental Activities		
	 	2017	2016		
Program Revenues		
Charges for services	$	4,447,621	$	537,731	
Grants and contribution	576,839	196,471	
General Revenues		
Miscellaneous revenues	1,089	794	
Investment earnings	47,925	85	
Total Revenues	 5,073,474	735,081

Expenses	
General government	156,592	129,996	
Physical environment	673,307	467,374	
Culture/recreation	58,291	106,609	
Interest on long-term debt	1,786,772	205,076	
Total Expenses	   2,674,962	909,055 	
Change in Net Position	2,398,512	(173,974)	
Net Position - Beginning of Year	   1,030,921	1,204,895 	
Net Position - End of Year	   $	3,429,433       $	1,030,921 	

The increase in charges for services relates to increased special assessments and prepayments for the Series 2017 Bonds.

The increase in grants and contributions is the result of developer capital contributions for the 2017 Project.

The increase in interest is related to the issuance of the Series 2017 Bonds.

- 6 -

Triple Creek Community Development District MANAGEMENT'S DISCUSSION AND ANALYSIS
For the Year Ended September 30, 2017

OVERVIEW OF THE FINANCIAL STATEMENTS (CONTINUED)

Capital Assets Activity

The following schedule provides a summary of the District's capital assets as of September 30, 2017 and 2016.

 	Governmental  Activities	
Description	2017	2016

Land and improvements	$	50,000	$		
Construction in progress		7,621,085		341,212	
Buildings		1,290,129		1,290,129	
Infrastructure		1,218,872		1,218,872	
Stormwater management		1,946,854		1,946,854	
Equipment		91,116		91,116	
Accumulated depreciation	 		(835,610)	 		(619,515)	

Total Capital Assets (Net)	$	11,382,446	$	4,268,668

The activity for the year consisted of additions to land and improvements of $50,000 and construction in progress of $7,279,873 and $216,095 in depreciation.

General Fund Budgetary Highlights

Actual expenditures were less than the total budget for the year ended September 30, 2017 because of lower than anticipated utilities and amenity center management contract expenditures.

There were no amendments to the budget for the year ended September 30, 2017.

- 7 -

Triple Creek Community Development District MANAGEMENT'S DISCUSSION AND ANALYSIS
For the Year Ended September 30, 2017

OVERVIEW OF THE FINANCIAL STATEMENTS (CONTINUED)

Debt Management

Governmental Activities debt includes the following:

In June 2012, the District issued $3,180,000 Series 2012 Special Assessment Bonds. These bonds were issued to finance the acquisition and construction of certain improvements for the benefit of the District. The balance outstanding at September 30, 2017 was $3,055,000.
In February 2017, The District issued Series 2017A and Series 2017B Special Assessment Bonds. The bonds were issued to finance the acquisition and construction of certain improvements for the benefit of the District. The balance outstanding at September 30, 2017 was $19,410,000
The developer advanced the District certain monies that the District has agreed to reimburse the Developer when and if funds become available. The balance outstanding at September 30, 2017 was $101,889.

Economic Factors and Next Year's Budget

Triple Creek Community Development District does not expect any economic factors to have any significant effect on the financial positions or results of operation of the District in fiscal year 2018.

Request for Information

The financial report is designed to provide a general overview of Triple Creek Community Development District's finances for all those with an interest. Questions concerning any of the information provided in this report or requests for additional information should be addressed to the Triple Creek Community Development District, Rizzetta & Company, 12750 Citrus Park Lane, Ste 115, Tampa, FL 33625.

- 8 -

Triple Creek Community Development District STATEMENT OF NET POSITION
September 30, 2017

ASSETS
Current Assets Cash
Accounts receivable Assessments receivable Deposits
Prepaid expenses
Total Current Assets Non-Current Assets
Restricted assets Investments
Capital Assets, Not Being Depreciated Land and improvements Construction in progress
Capital Assets, Being Depreciated

Governmental Activities

$	174,064
3,218
524,692
14,770
 	17,099 
 	733,843 

16,426,955

50,000
7,621,085

Buildings	1,290,129	
Infrastructure	1,218,872	
Stormwater management	1,946,854	
Equipment	91,116	
Less: accumulated depreciation	 	(835,610) 	
Total Non-current Assets	 	27,809,401 	
Total Assets	 	28,543,244 	

LIABILITIES
Current Liabilities
Accounts payable and accrued expenses	1,672,575	
Contracts retainage payable	573,380	
Accrued interest	819,326	
Unearned revenues	9,217	
Bonds payable - current portion	 	335,000 	
Total Current Liabilities	 	3,409,498 	
Non-Current Liabilities		
Developer advance	101,889	
Bonds payable	 	21,602,424 	
Total Non-Current Liabilities	 	21,704,313 	
Total Liabilities	 	25,113,811 	
NET POSITION		
Net investment in capital assets	2,596,618	
Restricted for debt service	704,451	
Unrestricted	 	128,364 	
Total Net Position	   $	3,429,433 	

See accompanying notes to financial statements.
-9-

Triple Creek Community Development District STATEMENT OF ACTIVITIES
For the Year Ended September 30, 2017

Program Revenues
Capital

Net (Expense} Revenues and Changes in Net Position

Functions/Programs

Expenses

Charges for Services

Grants and Contributions

Governmental Activities

Governmental Activities	 	
General government	$	(156,592)		$	66,932	$	$	(89,660)	
Physical environment	(673,307)		195,425	576,839	98,957	
Culture/recreation	(58,291)		24,915	(33,376)	
Interest on long-term debt	(1,786,772)		4,160,349	 	 	2,373,577 	
Total Governmental Activities	$ (2,674,962)		$  4,447,621	$	576,839	2,349,498	

General revenues:
Miscellaneous revenues	1,089	
Investment earnings	 	47,925 	
Total General Revenues	 	49,014 	

Change in Net Position

Net Position - Beginning of year Net Position - End of year

2,398,512

 	1,030,921 
$	3,429,433

See accompanying notes to financial statements.
- 10 -

Triple Creek Community Development District BALANCE SHEET -
GOVERNMENTAL FUNDS
September 30, 2017

General	
Debt Service 200	
Debt Service 201	
Capital		Capital Projects 300	Projects 301	Total
Governmental Funds	
ASSETS						
Cash	$ 164,952		$	$	$	9,112	$	174,064	
Assessments receivable			524,692		524,692	
Accounts receivable				3,218	3,218	
Due from other funds	175				175	
Prepaid items	17,099				17,099	
Deposits	14,770				14,770	
Restricted assets						
Investments, at fair value		283,302	1,916,527	1	14,227,125	16,426,955	
Total Assets	$ 196,996	$	283,302	$ 2,441,219	$	1	$ 14,239,455	$ 17,160,973	

Accounts payable and accrued expenses	$	59,415	$	$	$	$	1,613,160	$	1,672,575	
Contracts/retainage payable		573,380	573,380	
Unearned revenues	9,217		9,217	
Due to other funds		175	175	
Total Liabilities	68,632	2,186,715	2,255,347	

LIABILITIES AND FUND BALANCES LIABILITIES

FUND BALANCES
Nonspendable - prepaid expenses/deposits
Restricted	31,869	31,869	
Debt service		283,302	2,441,219			2,724,521	
Capital projects				1	12,052,740	12,052,741	
Unassigned	96,495					96,495	
Total Fund Balances	128,364	283,302	2,441,219	1	12,052,740	14,905,626	

Total Liabilities and Fund Balances	
$ 196,996	
$	283,302	
$ 2,441,219	
$	1	
$ 14,239,455	
$ 17,160,973	

See accompanying notes to financial statements.		

- 11 -					

Triple Creek Community Development District RECONCILIATION OF TOTAL GOVERNMENTAL FUND BALANCES
TO NET POSITION OF GOVERNMENTAL ACTIVITIES
September 30, 2017

Total Governmental Fund Balances	$ 14,905,626

Amounts reported for governmental activities in the Statement of Net Position are different because:

Capital assets land, $50,000, construction in progress, $7,621,085, buildings, $1,290,129, infrastucture, $1,218,872, stormwater management, $1,946,854, and
equipment, $91,116, net of accumulated depreciation, $(835,610) are not current
financial  resources,  and therefore are not reported at the fund level.	11,382,446

Long-term liabilities, including bonds payable, $(22,465,000), net of bond discounts, net, $527,576 and developer advances, $(101,889), are not due and payable
in the current period, and therefore are not reported  at the fund level.	(22,039,313)

Accrued interest expense for long-term debt is not a current financial use,
and therefore,  is not reported in the fund level.			(819,326) Net Position of Governmental Activities	$	3,429,433

See accompanying notes to financial statements.
- 12 -

Triple Creek Community Development District
STATEMENT OF REVENUES, EXPENDITURES AND CHANGES IN FUND BALANCES -
GOVERNMENTAL FUNDS
September 30, 2017

REVENUES

Totals Debt	Debt	Capital	Capital	Governmental
 	General	Service 200	Service 201	Projects 300	Projects 301	Funds	

Special assessments	$	287,272	$	246,871	$ 3,913,478	$	$	$ 4,447,621	
Developer contributions	511,923			11,698	53,218	576,839	
Miscellaneous revenues	1,089					1,089	
Investment earnings	175	1,464	4,324	31	41,931	47,925	
Total Revenues	 	800,459	248,335	3,917,802	11,729	95,149	5,073,474 

EXPENDITURES
Current
General government	156,592					156,592	
Physical environment	457,212					457,212	
Culture/recreation	58,291					58,291	
Capital outlay				800	7,329,073	7,329,873	
Debt service							
Principal		45,000	3,200,000		207,583	3,452,583	
Interest		198,353	39,356			237,709	
Other debt service	 	805,956	805,956 
Total Expenditures	 	672,095	243,353	3,239,356	800	8,342,612	12,498,216 

Excess (deficiency) of revenues
over (under) expenditures	 	128,364	4,982	678,446	10,929	{8,247,463)	{7,424,742)

Other Financing Sources (Uses)
Long-term debt proceeds	
2,297,304		
20,312,696	
22,610,000	
Bond discounts	(534,531)			(534,531)	
Transfers in
Transfers out		41,780
{29,287)	29,287
{41,780)	71,067
{71,067)	
Total Other Financing Sources (Uses) 	1,762,773	12,493	20,300,203	22,075,469 	
Net change in fund balances	128,364	4,982	2,441,219	23,422	12,052,740	14,650,727	
Fund Balances - Beginning of year		278,320		{23,421)		254,899	
Fund Balances - End of year	$	128,364	$	283,302	$ 2,441,219	$	$12,052,740	$14,905,626	

See accompanying notes to financial statements.
- 13 -

Triple Creek Community Development District RECONCILIATION OF THE STATEMENT OF REVENUES, EXPENDITURES AND CHANGES IN FUND BALANCES OF GOVERNMENTAL FUNDS TO THE
STATEMENT OF ACTIVITIES
For the Year Ended September 30, 2017

Net Change in Fund Balances - Total Governmental Funds	$ 14,650,727

Amounts reported for governmental activities in the Statement of Activities are different because:

Governmental funds report capital outlays as expenditures; however, in the Statement of Activities, the cost of those assets is allocated over their estimated useful lives as depreciation. This is the amount that capital
outlay ($7,329,873) exceeded depreciation ($(216,095)) in the current period.

Governmental funds report bond proceeds ($(22,610,000)) as an other financing source and bond discounts ($534,531) as an other financing use, but the net proceeds increase long-term liabilities at the government-wide level

Repayment of bond principal and developer advances is an expenditure in the governmental funds, but the repayment reduces long-term liabilities at the government-wide level.

Bond discounts are amortized over the life of the bonds as interest. This is the current period amortization.

In the Statement of Activities, interest is accrued on outstanding bonds, whereas in governmental funds, interest expenditures are reported when due. This
is the net amount between the prior year and the current year accruals.

Change in Net Position of Governmental Activities

7,113,778

(22,075,469)

3,452,583

(6,955)

(736,152)

$	2,398,512

See accompanying notes to financial statements.
- 14 -

Triple Creek Community Development District
STATEMENT OF REVENUES, EXPENDITURES AND CHANGES IN FUND BALANCES - BUDGET AND ACTUAL - GENERAL FUND
For the Year Ended September 30, 2017

Original Budget	

Final Budget	

Actual	Variance with Final Budget Positive
(Negative)	
Revenues
Special assessments	
$ 284,008	
$ 284,008	
$	287,272	
$	3,264	
Developer contributions	463,267	463,267	511,923	48,656	
Miscellaneous revenues			1,089	1,089	
Investment earnings			175	175	
Total Revenues	747,275	747,275	800,459	53,184	

Expenditures Current
General government	127,690	127,690	156,592	(28,902)	
Physical environment	472,135	472,135	457,212	14,923	
Culture/recreation	147,450	147,450	58,291	89,159	
Total Expenditures	747,275	747,275	672,095	75,180	

Net change in fund balances	
128,364	
128,364	

Fund Balances - Beginning of year	 						                                                                                                              Fund Balances - End of year		 $	 $	 $	128,364        $	128,364 

See accompanying notes to financial statements.
- 15 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September  30, 2017

NOTE A - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

The financial statements of Triple Creek Community Development District (the "District") have been prepared in conformity with generally accepted accounting principles (GAAP) as applied to governmental units. The Governmental Accounting Standards Board (GASB) is the accepted standard-setting body for establishing governmental accounting and financial reporting principles. The District's more significant accounting policies are described below.

Reporting Entity

The District was established on May 11, 2007 by Ordinance No. 07-14 of the Board of County Commissioners of Hillsborough County, Florida. The District was established pursuant to the Uniform Community Development District Act of 1980, Chapter 190, Florida Statutes, as amended (the "Act"), as a Community Development District. The District was established for the purposes of financing and managing the acquisition, construction, maintenance and operation of the infrastructure necessary for community development within its jurisdiction. The District is governed by a five-member Board of Supervisors. One Supervisor is elected on an at-large basis by the landowners of the District and four Supervisors are elected by qualified electors residing within the District. The District operates within the criteria established by Chapter 190. The Board has the responsibility for allocating and levying assessments, approving budgets, exercising control over facilities and properties, controlling the use of funds generated by the District, approving the hiring and firing of key personnel, and financing improvements.

The reporting entity for the District includes all functions of government in which the District's Board exercises oversight responsibility. Oversight responsibility includes, but is not limited to, financial interdependency, designation of management, significant ability to influence operations and accountability for fiscal matters. As required by GAAP, these financial statements present the Triple Creek Community Development District, (the primary government) as a stand-alone government.

Based upon the application of the above-mentioned criteria as set forth in Governmental Accounting Standards Board, the District has identified no component units.

Measurement Focus and Basis of Accounting

The basic financial statements of the District are composed of the following:

Government-wide financial statements

Fund financial statements

Notes to financial statements

- 16 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September 30, 2017

NOTE A - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)

Measurement Focus and Basis of Accounting (Continued)

Government-wide Financial Statements

Government-wide financial statements report all non-fiduciary information about the reporting government as a whole. These statements include the governmental activities of the primary government. The effect of interfund activity has been removed from these statements.

Governmental activities are supported by special assessments and interest. Program revenues are netted with program expenses in the statement of activities to present the net cost of each program.

Amounts paid to acquire capital assets are capitalized as assets, rather than reported as an expenditure. Proceeds of long-term debt are recorded as liabilities in the government­ wide financial statements, rather than as an other financing source.

Amounts paid to reduce long-term indebtedness of the reporting government are reported as a reduction of the related liability, rather than as an expenditure.

Fund Financial Statements

The underlying accounting system of the District is organized and operated on the basis of separate funds, each of which is considered to be a separate accounting entity. The operations of each fund are accounted for with a separate set of self-balancing accounts that comprise its assets, liabilities, fund equity, revenues and expenditures or expenses, as appropriate. Governmental resources are allocated to and accounted for in individual funds based upon the purposes for which they are to be spent and the means by which spending activities are controlled.

Fund financial statements for the primary government's governmental funds are presented after the government-wide financial statements. These statements display information about major funds individually.

- 17 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September 30, 2017

NOTE A - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)

2. Measurement Focus and Basis of Accounting (Continued)

b. Fund Financial Statements (Continued) Governmental Funds
The District has implemented the Governmental Accounting Standards Board Statement 54 - Fund Balance Reporting and Governmental Fund Type Definitions. The Statement requires the fund balance for governmental funds to be reported in classifications that comprise a hierarchy based primarily on the extent to which the government is bound to honor constraints on the specific purposes for which amounts in those funds can be spent.

The District has various policies governing the fund balance classifications.

Nonspendable Fund Balance - This classification consists of amounts that cannot be spent because they are either not in spendable form or are legally or contractually required to be maintained intact.

Restricted Fund Balance - This classification includes amounts that can be spent only for specific purposes stipulated by the state constitution, external resource providers, or through enabling legislation.

Assigned Fund Balance - This classification consists of the Board of Supervisors' intent to be used for specific purposes, but are neither restricted nor committed. The assigned fund balances can also be assigned by the District's management company.

Unassigned Fund Balance - This classification is the residual classification for the government's general fund and includes all spendable amounts not contained in the other classifications. Unassigned fund balance is considered to be utilized first when expenditure is incurred for purposes for which amounts in any of those unrestricted fund balance classifications could be used.

Fund Balance Spending Hierarchy - For all governmental funds except special revenue funds, when restricted, committed, assigned, and unassigned fund balances are combined in a fund, qualified expenditures are paid first from restricted or committed fund balance, as appropriate, then assigned and finally unassigned fund balances.

- 18 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September  30, 2017

NOTE A - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)

Measurement Focus and Basis of Accounting (Continued)

b. Fund Financial Statements (Continued) Governmental Funds (Continued)
Governmental fund financial statements are reported using the current financial
resources measurement focus and the modified accrual basis of accounting. Revenues are considered to be available when they are collected within the current period or soon thereafter to pay liabilities of the current period. For this purpose, the District considers revenues to be available if they are collected within 60 days of the end of the current fiscal period.

Expenditures generally are recorded when a liability is incurred, as under accrual accounting. Interest associated with the current fiscal period is considered to be an accrual item and so has been recognized as revenue of the current fiscal period.

Under the current financial resources measurement focus, only current assets and current liabilities are generally included on the balance sheet. The reported  fund balance is considered to be a measure of "available spendable resources". Governmental fund operating statements present increases (revenues and other financing sources) and decreases (expenditures and other financing uses) in net current assets. Accordingly, they are said to present a summary of sources and uses of "available spendable resources" during a period.

Because of their spending measurement focus, expenditure recognition for governmental fund types excludes amounts represented by non-current liabilities. Since they do not affect net current assets, such long-term amounts are not recognized as governmental fund type expenditures or fund liabilities.

Amounts expended to acquire capital assets are recorded as expenditures in the year that resources were expended, rather than as fund assets. The proceeds of long-term debt are recorded as an other financing source rather than as a fund liability.

Debt service expenditures are recorded only when payment is due.

Basis of Presentation

Governmental Major Funds

General Fund - The General Fund is the District's primary operating fund.  It accounts for all financial resources of the general government, except those required to be accounted for in another fund.

- 19 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September 30, 2017

NOTE A - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)

Basis of Presentation (Continued)

Governmental Major Funds (Continued)

Debt Service Fund 200 - This Debt Service Fund accounts for the debt service requirements to retire Series 2012 special assessment bonds which were used to finance the construction of District infrastructure improvements and finance certain additional improvements. The bond series is secured by a pledge of debt service special assessment revenues in any fiscal year related to the improvements. A lien is placed on all benefited land in relationship to the debt outstanding.

Debt Service Fund 201 - This Debt Service Fund accounts for the debt service requirements to retire Series 2017 special assessment bonds which were used to finance the construction of certain infrastructure improvements. The bond series is secured by a pledge of debt service special assessment revenues in any fiscal year related to the improvements, A lien is placed on all benefited land in relationship to the debt outstanding.

Capital Projects Fund 300 - This Capital Project Fund accounts for financial resources to be used for the acquisition or construction of major infrastructure within the District financed by the Series 2012 bonds.

Capital Projects Fund 301 - This Capital Project Fund accounts for financial resources to be used for the acquisition or construction of major infrastructure within the District financed by the Series 2017 bonds.

Non-current Governmental Assets/Liabilities

GASS Statement 34 requires that non-current governmental assets, such as land and buildings, and non-current governmental liabilities, such as special assessment bonds, be reported in the governmental activities column in the government-wide Statement of Net Position.

- 20 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September  30, 2017

NOTE A - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)

Assets, Liabilities and Net Position or Equity

Cash and Investments

Florida Statutes require state and local governmental units to deposit monies with financial institutions classified as "Qualified Public Depositories," a multiple financial institution pool whereby groups of securities pledged by the various financial institutions provide common collateral from their deposits of public funds. This pool is provided as additional insurance to the federal depository insurance and allows for additional assessments against the member institutions, providing full insurance for public deposits.

The District is authorized to invest in those financial instruments as established by Section 218.415, Florida Statutes. The authorized investments consist of:

Direct obligations of the United States Treasury;
The Local Government Surplus Funds Trust or any intergovernmental investment pool authorized pursuant to the Florida lnterlocal Cooperative Act of 1969;
Interest-bearing time deposits or savings accounts in authorized qualified public depositories;
Securities and Exchange Commission, registered money market funds with the highest credit quality rating from a nationally recognized rating agency.

Receivables and Payables

Activities between funds that are representative of lending/borrowing arrangements outstanding at the end of the fiscal year are referred to as "due to/from other funds". Any residual balances outstanding between the governmental activities and business­ type activities are reported as "internal balances".

Net Position

Net position is the difference between assets and deferred outflows of resources less liabilities and deferred inflows of resources. Net position in the government-wide financial statements are categorized as net investment in capital assets, restricted, or unrestricted. Net investment in capital assets represents net position related to infrastructure and property, plant and equipment. Restricted net position  represents the assets restricted by the District's bond covenants and  other  contractual restrictions. Unrestricted net position consists of the net position not meeting the definition of either of the other two components.

- 21 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September 30, 2017

NOTE A - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)

4. Assets, Liabilities and Net Position or Equity (Continued)

Capital Assets

Capital assets, which include construction in progress, land and improvements, infrastructure, buildings and equipment are reported in the applicable governmental activities column.

The District defines capital assets as assets with an initial, individual cost of $5,000 or more and an estimated useful life in excess of two years. The valuation basis for all assets is historical cost.

The costs of normal maintenance and repairs that do not add to the value of the asset or materially extend its useful life are not capitalized.

Major outlays for capital assets and improvements are capitalized as projects are constructed.

Depreciation of capital assets is computed and recorded by utilizing the straight-line method. Estimated useful lives of the various classes of depreciable capital assets are as follows:

Furniture and equipment Infrastructure Stormwater management Buildings

5 years 15/20 years 25 years
30 years

Unamortized Bond Discounts

Bond discounts associated with the issuance of revenue bonds are amortized according to the straight line method of accounting. For financial reporting, unamortized bond discounts are netted against the applicable long-term debt.

Budgets

Budgets are prepared and adopted after public hearings for the governmental funds, pursuant to Chapter 190, Florida Statutes. The District utilizes the same basis of accounting for budgets as it does for revenues and expenditures in its various funds. The legal level of budgetary control is at the fund level. All budgeted appropriations lapse at year end. Formal budgets are adopted for the general and debt service funds. As a result, deficits in the budget variance columns of the accompanying financial statements may occur.

- 22 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September 30, 2017

NOTE A - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED)

4. Assets, Liabilities and Net Position or Equity (Continued)

Use of Estimates

The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, and disclosure  of  contingent assets and liabilities at the date of the financial  statements,  and  the  reported  amounts of revenues and expenditures during the period. Actual results could differ from those estimates.

NOTE B - CASH AND INVESTMENTS

All deposits are held in qualified public depositories and are included on the accompanying balance sheet as cash and investments.

Custodial Credit Risk - Deposits

Custodial credit risk is the risk that in the event of a bank failure, the District's deposits may not be returned to it. The District does not have a formal deposit policy for custodial credit risk, however, they follow the provisions of Chapter 280, Florida Statutes regarding deposits and investments. As of September 30, 2017, the District's bank balance was $178,939 and carrying value was $174,064. Exposure to custodial credit risk was as follows. The District maintains all deposits in a qualified public depository in accordance with the provisions of Chapter 280, Florida Statutes, which means that all deposits are fully insured by Federal Depositors Insurance or collateralized under Chapter 280, Florida Statutes.

As of September 30, 2017, the District had the following investments and maturities:

 	Investment	

Federated Govt Obligation Tax-Managed	Maturity	 	Fair Value		
Fund #636	46 days*	$	283,303	
Federated Govt Obligation Institutional Shares	35 days*	16,143,652	
Total		$16,426,955	

*Maturity is a weighted average maturity.

- 23 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September 30, 2017

NOTE B - CASH AND INVESTMENTS (CONTINUED)

Custodial Credit Risk - Deposits (Continued)

The District categorizes its fair value measurement within the fair value hierarchy established by generally accepted accounting principles. The fair value is the price that would be received to sell an asset, or paid to transfer a liability, in an orderly transaction between market participants at the measurement date. The hierarchy is based on the valuation inputs used to measure the fair value of the asset. The District uses a market approach in measuring fair value that uses prices and other relevant information generated by market transactions involving identical or similar assets, liabilities, or groups of assets and liabilities.

Assets or liabilities are classified into one of three levels. Level 1 is the most realizable and is based on quoted price for identical assets, or liabilities, in an active market. Level 2 uses significant other observable inputs when obtained quoted prices for identical or similar assets, or liabilities, in markets that are not active. Level 3 is the least reliable and uses significant unobservable inputs that uses the best information available under the circumstances which includes the District's own data in measuring unobservable inputs.

Based on the criteria in the preceding paragraph, the investment listed above is a Level 1 asset.

Interest Rate Risk

The District does not have a formal investment policy that limits investment maturities as a means of managing its exposure to fair value losses arising from increasing interest rates.

Credit Risk

The District's investments are limited by state statutory requirements and bond compliance. The District has no investment policy that would further limit its investment choices. As of September 30, 2017, the District's investment in both of the Federated Govt Obligations noted above were rated AAAm by Standard & Poor's.

Concentration of Credit Risk

The District places no limit on the amount it may invest in any one fund. The investment in Federated Govt Obligations Tax Managed Fund represented 2% of the District's total investments and Federated Govt Obligations Fund represented the remaining 98%.

The types of deposits and investments and their level of risk exposure as of September 30, 2017 were typical of these items during the fiscal year then ended. The District considers any decline in fair value for certain investments to be temporary.

- 24 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September 30, 2017 NOTE C - SPECIAL ASSESSMENT REVENUES
Assessments are non-ad valorem assessments imposed on assessable lands located within the District. Assessments may be levied on property to pay for the operation and maintenance of the District, as well as to pay for debt service on the District's Bonds. The fiscal year for which annual assessments may be levied begins October 1 with discounts available for payments through February 28 and become delinquent on April 1. For debt service assessments, amounts collected as advance payments are used to prepay a portion of the Bonds outstanding. Otherwise, assessments are collected annually to provide funds for the debt service on the portion of the Bonds which are not paid with prepaid assessments.

Assessments and interest associated with the current fiscal period are considered to be susceptible to accrual and so have been recognized as revenues of the current fiscal period. The portion of assessments receivable due within the current fiscal period is considered to be susceptible to accrual as revenue of the current period.

NOTE D - CAPITAL ASSETS

Capital Asset activity for the year ended September 30, 2017 was as follows:

Balance	Balance
October 1,	September 30,
    2016	Additions	Dis12osals	2017	
 Governmental  activities:	

Capital assets, not being depreciated
Land	$		$		50,000	$	$	50,000 Construction in progress		341 212		712791873			716211085

Total capital assets, not being depreciated	341 212	713291873	7 671 085
Capital assets, being depreciated:
Building	1,290,129	1,290,129
Infrastructure	1,218,872	1,218,872
Stormwater management	1,946,854	1,946,854
Equipment	91 116	91 116

Total capital assets, being depreciated	41546,971	4 546 971
Less accumulated depreciation for:
Building	(103,403)	(43,004)	(60,399)
Infrastructure	(157,621)	(81,259)	(76,362)
Stormwater management	(323,881)	(77,874)	(246,007)
Equipment	{341610)	{131958)	{20,652)

Total accumulated depreciation	{619,515)	{2161095)	{4031420)

Total capital  assets being depreciated, net		319271456		{2161095)					3 711 361 Governmental  activities capital assets, net	$    4,268,668	$7,113,778	ll!		$	11,382,446 
Depreciation of $216,095 was charged to physical environment.

- 25 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September 30, 2017

NOTE E - LONG-TERM DEBT

In June 2012, the District issued $3,180,000 of Special Assessment Bonds, Series 2012 maturing on November 1, 2043 with a fixed interest rate ranging from 5.625% to 6.75%. The bonds were issued to finance the acquisition and construction of certain improvements for the benefit of the District. Interest is to be paid semiannually on each May 1 and November 1. Principal is to be paid serially commencing November 1, 2014 through November 1, 2043. The balance outstanding at September 30, 2017 was $3,055,000.

In February 2017, the District issued $9,850,000 Series 2017A Special Assessment Bonds maturing on November 1, 2046 with fixed interest rates ranging from 5.25% to 6.125%. These bonds were issued to finance a portion of the cost of acquisition, construction, installation, and equipping of the Series 2017 Project. The balance outstanding on the Series 2017A Bonds at September 30, 2017 was $9,850,000.

In February 2017, the District issued $12,760,000 Series 2017B Special Assessment Bonds maturing on November 1, 2029 with a fixed interest rate ranging from 5.75% to 6.125%. These bonds were issued to finance a portion of the cost of acquisition, construction, installation, and equipping of the Series 2017 Project. The balance outstanding on the Series 2017B Bonds at September 30, 2017 was $9,560,000.

The following is a summary of activity for long-term debt of the District for the year ended September 30, 2017:

Long-term debt at October 1, 2016	$	3,100,000	
Bond proceeds	22,610,000	
Principal payments	(3,245,000)	
Long-term debt at September 30, 2017	22,465,000	
Less bond discount, net	 	(527,576)	

Total long-term debt, September 30, 2017

Developer advance at October 1, 2016 Principal Payments

Developer advance at September 30, 2017

$	21.937.424

$	309,472
(207,583)

$	101.889

- 26 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September 30, 2017 NOTE E - LONG-TERM DEBT (CONTINUED)
The annual requirements to amortize the principal and interest of bonded debt outstanding as of September 30, 2017 are as follows:

Year Ending
Seetember 30,	
Princieal	
Interest	
Total	
2018	$	335,000	$	1,607,412	$	1,942,412	
2019	185,000	1,343,519	1,528,519	
2020	200,000	1,333,216	1,533,216	
2021	205,000	1,322,378	1,527,378	
2022	220,000	1,311,006	1,531,006	
2023-2027	1,280,000	6,342,406	7,622,406	
2028-2032	11,260,000	4,471,681	15,731,681	
2033-2037	2,275,000	2,409,338	4,684,338	
2038-2042	3,090,000	1,570,422	4,660,422	
2043-2047	 	3,415,000	506,763	3,921,763
Totals	 $	22,465,000	 $	22,218,141	 $	44,683,141 

Summary of Significant Bonds Resolution Terms and Covenants
The District levies special assessments pursuant to Section 190.022, Florida Statutes and the assessment rolls are approved by resolutions of the District Board. The collections are to be strictly accounted for and applied to the debt service of the bond series for which they were levied. The District covenants to levy special assessments in annual amounts adequate to provide for payment of principal and interest on the bonds. Payment of principal and interest is dependent on the money available in the debt service fund and the District's ability to collect special assessments levied.

The Series 2012 Bonds are subject to redemption prior to maturity, in whole on any date, or in part at any time on or after November 1, 2032 and the Series 2017A Bonds may be redeemed at anytime after November 1, 2030, at the redemption price of par, together with accrued interest to the date of redemption. The Series 20178 Bonds are not subject to redemption at the option of the District. The Series 2012 and Series 2017 Bonds are subject to extraordinary mandatory redemption prior to their selected maturity date in the manner determined by the Bond Registrar if certain events occurred as outlined in the Bond Indenture.

The bond indenture provides for Debt Service Reserve Funds, which shall be held by the Trustee separate and apart from all other funds. The following is a schedule of reserve requirements and balances in the reserve accounts at September 30, 2017:

	Reserve
 	Balance		Reserve
Requirement	
Series 2012	$	124,165	$	123,372	
Series 2017A	$	639,986	$	639,174	
Series 20178	$	576,447	$	437,658	

- 27 -

Triple Creek Community Development District NOTES TO FINANCIAL STATEMENTS
September 30, 2017 NOTE E-LONG-TERM DEBT (CONTINUED)
Developer Advance

During fiscal year 2016 the District entered into an agreement with the Developer to fund certain construction expenditures totaling $309,742 . The District made a payment to the Developer of
$207,583 in the current year. The balance outstanding as of September 30, 2017 is $101,889.

NOTE F - ECONOMIC DEPENDENCY

The developer owns a significant portion of the land in the District. The District's activity is dependent upon the continued involvement of the Developer, the loss of which could have a material adverse effect on the District's operations.

NOTE G - INTERFUND ACTIVITY

The interfund activity as of and for the year ended September 30, 2017 was as follows:

 	Due To	
Series 2017
 Due From	Capital Projects
General Fund	$	175

 Transfers Out	
Series 2017 Capital Projects

Transfers In Series 2012 Capital Projects
$	12,493

The due to/due from relates to Capital Projects 2017 Fund repaying the General Fund for construction costs and Transfer between funds relates to prior year accrued construction supplement.

NOTE H - RISK MANAGEMENT

The District is exposed to various risks of loss related to torts; theft of, damage to and destruction of assets; errors and omissions; natural disasters; and environmental remediation. The District has obtained commercial insurance from independent third parties to mitigate the costs of these risks; coverage may not extend to all situations. The District has not filed any claims under the commercial insurance coverage over the last three years.

- 28 -

tt Berger, Toombs, Elam,
....o,,	Gaines & Frank
Certified Public Accountants	PL
600 Citrus Avenue
Suite 200
Fort Pierce, Florida 34950
772/461-6120 II 461-1155
FAX: 7721468-9278

INDEPENDENT AUDITOR'S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS

To the Board of Supervisors
Triple Creek Community Development District Hillsborough County, Florida	·

We have audited, in accordance with the auditing standards generally accepted in the United States of America and the standards applicable to financial audits contained in Government Auditing Standards issued by the Comptroller General of the United States, the financial statements of Triple Creek Community Development District, as of and for the year ended September 30, 2017, and the related notes to the financial statements, and have issued our report thereon dated March 23, 2018.

Internal Control Over Financial Reporting

In planning and performing our audit, we considered Triple Creek Community Development District's internal control over financial reporting to determine the audit procedures that are appropriate in the circumstances for the purpose of expressing our opinions on the financial statements, but not for the purpose of expressing an opinion on the effectiveness of Triple Creek Community Development District's internal control. Accordingly, we do not express an opinion on the effectiveness of Triple Creek Community Development District's internal control over financial reporting.

A deficiency in internal control exists when the design or operation of a control does not allow management or employees, in the normal course of performing their assigned functions, to prevent, or detect and correct misstatements on a timely basis. A material weakness is a deficiency, or combination of deficiencies, in internal control, such that there is a reasonable possibility that a material misstatement of the entity's financial statements will not be prevented, or detected and corrected on a timely basis. A significant deficiency is a deficiency, or a combination of deficiencies, in internal control that is less severe than a material weakness, yet important enough to merit attention by those charged with governance.

Our consideration of internal control over financial reporting was for the limited purpose described in the first paragraph of this section and was not designed to identify all deficiencies in internal control that might be material weaknesses or significant deficiencies. Given these limitations, during our audit we did not identify any deficiencies in internal control that we consider to be material weaknesses. However, material weaknesses may exist that have not been identified.

Member AICPA

Fort Pierce I Stua,rt
- 29 -
Member AICPA Division For CPA Firms
Private Companies Practice Section

Member FICPA

fti"-'" t  Berger, Toombs,  Elam,
-.OJ Gaines & Frank
Celt.lAed f'ublk: Acmunta.nts Pl

Board of Supervisors
Triple Creek Community Development District Hillsborough County, Florida

Compliance and Other Matters

As part of obtaining reasonable assurance about whether Triple Creek Community Development District's financial statements are free of material misstatement, we performed tests of its compliance with certain provisions of laws, regulations, contracts, and grant agreements, noncompliance with which could have a direct and material effect on the determination of financial statement amounts. However, providing an opinion on compliance with those provisions was not an objective of our audit, and accordingly, we do not express such an opinion. The results of our tests disclosed no instances of noncompliance or other matters that are required to be reported under Government Auditing Standards.

Purpose of this Report

The purpose of this report is solely to describe the scope of our testing of internal control and compliance and the results of that testing, and not to provide an opinion on the effectiveness of the  entity's  internal  control  or on compliance.	This report is an integral part of an audit · performed in accordance with Government Auditing Standards in  considering  the  entity's internal control and compliance. Accordingly, this communication is not suitable for any other purpose.

J!lUIJ

J>4 JamJotY	fl/Jill,
OXJaiuJ
Berger, Toombs, Elam, Gaines & Frank
Certified Public Accountants Fort Pierce, Florida

March 23, 2018

- 30 -

tt Berger, Toombs, Elam,
,OJ Gaines & Frank
Certified Public Accountants	PL

600 Citrus Avenue
Suite 200
Fort Pierce,  Florida 34950
772/461-6120 II 461-1155
FAX: 7721468-9278

MANAGEMENT LETTER

To the Board of Supervisors
Triple Creek Community Development District Hillsborough County, FL
Report on the Financial Statements

We have audited the financial statements of the Triple Creek Community Development District as of and for the year ended September 30, 2017, and have issued our report thereon dated March 23, 2018.

Auditor's Responsibility

We conducted our audit in accordance with auditing standards generally accepted in the United States; the standards applicable to financial audits contained in Government  Auditing Standards, issued by the Comptroller General of the United States and Chapter 10.550, Rules of the Florida Auditor General.

Other Reports and Schedule

We have issued our Independent Auditor's Report on Internal Control over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial Statements Performed in Accordance with Government Auditing Standards and our Independent Auditor's Report on an examination conducted in accordance with AICPA Professionals Standards, AT-C Section 315 regarding compliance requirements in accordance with Chapter 10.550, Rules of the Auditor General. Disclosures in that report, which is dated March 23, 2018, should be considered in conjunction with this Management Letter.
Prior Audit Findings

Section 10.554(1)(i)1., Rules of the Auditor General, requires that we determine whether or not corrective actions have been made to address findings and recommendations made in the preceding financial audit report. There were no findings or recommendations made in the preceding financial audit report.

Financial Condition

Section 10.554(1)(i)5.a. and 10.556(7), Rules of the Auditor General, requires us to apply appropriate procedures and communicate the results of our determination as to whether or not Triple Creek Community Development District has met one or more of the conditions described in Section 218.503(1), Florida Statutes, and to identify the specific conditions met. In connection with our audit, we determined that the Triple Creek Community Development District did not meet any of the conditions described in Section 218.503(1), Florida Statutes.

Member AICPA

Fort Pierce I Stuart
- 31 -
Member AICPA Division For CPA Firms Private Companies Practice Section

Member FICPA

tt

Berger, Toombs, Elam,

,OJ Gaines & Frank

To the Board of Supervisors
Triple Creek Community Development District

Pursuant to Sections 10.554(1)(i)5.c. and 10.556(8), Rules of the Auditor General, we applied financial conditions assessment procedures as of September 30, 2017 for the Triple Creek Community Development District. It is management's responsibility to monitor the Triple Creek Community Development District's financial condition; our financial condition assessment was based in part on the representations made by management and the review of the financial information provided by the same.

Section 10.554(1)(i)2., Rules of the Auditor General, requires that we communicate any recommendations to improve financial management. In connection with our audit, we did not have any such recommendations. ·

Annual Financial Report

Section 10.554(1)(i)5.b. and 10.556(7), Rules of the Auditor General, requires that we apply appropriate procedures and communicate the results of our determination as to whether the annual financial report for the Triple Creek Community Development District for the fiscal year ended September 30, 2017, filed with the Florida Department of Financial Services pursuant to · Section 218.32(1)(a), Florida Statutes, is in agreement with the annual financial audit report for the fiscal year ended September 30, 2017. In .connection with our audit, we determined that these two reports were in agreement.

Additional Matters

Section 10.554(1)(i)3., Rules of the Auditor General, requires us to communicate noncompliance with provisions of contracts or grant agreements, or abuse, that have occurred, or are likely to have occurred, that have an effect on the financial statements that is less than material but which warrants the attention of those charged with governance. In connection with our audit, we did not note any such findings.

Purpose of this Letter

Our Management Letter is intended solely for the information and use of the Legislative Auditing Committee, members of the Florida Senate and the Florida House of Representatives, the Florida Auditor General, Federal and other granting agencies, the Board of Supervisors, and applicable management, and is not intended to be and should not be used by anyone other than these specified parties.
J>JMµ, JamKxY	fitJIPv
Ox5tuiuJ .._ J1tdW
Berger, Toombs, Elam, Gaines & Frank
Certified Public Accountants PL Fort Pierce, Florida

March 23, 2018

- 32 -

tt Berger, Toombs, Elam,
.....o,,	Gaines  & Frank
Certified Public Accountants	PL
600 Citrus Avenue
Suite 200
Fort Pierce, Florida  34950
772/461-6120 II 461-1155
FAX: 7721468-9278

INDEPENDENT ACCOUNTANT'S REPORT/COMPLIANCE WITH SECTION 218.415, FLORIDA STATUTES

To the Board of Supervisors
Triple Creek Community Development District Hillsborough County, Florida

We have examined Triple Creek Community Development District's compliance with Section 218.415, Florida Statutes during the year ended September 30, 2017. Management is responsible for Triple Creek Community Development District's compliance with those requirements. Our responsibility is to express an opinion on Triple Creek Community Development District's compliance based on our examination.

Our examination was conducted in accordance with attestation standards established by the American Institute of Certified Public Accountants and, accordingly, included examining, on a test basis, evidence about Triple Creek Community Development District's compliance with those requirements and performing such other procedures as we considered necessary in the circumstances. We believe that our examination provides a reasonable basis for our opinion. Our examination does not provide a legal determination on Triple Creek Community Development District's compliance with the specified requirements.

In our opinion, Triple Creek Community Development District complied, in all material respects, with the aforementioned requirements during the year ended September 30, 2017.
JJJ/d}Jfi, JoonkxY	f'irJlrL
OiJtUixv) 4	Jll
Berger, Toombs, Elam, Gaines & Frank
Certified Public Accountants PL Fort Pierce, Florida

March 23, 2018

Member AICPA

Fort Pierce I Stuc1rt
-  33 -
Member AICPA Division For CPA Firms Private Companies Practice Section

Member FICPA