Backup Documents 01/13/2015 Item #16H3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT T
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIG11j�T
al 3
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines 41 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office JAK 1/13/15
4. BCC Office Board of County '11,C
Commissioners \ /5/ k`MS` S
5. Minutes and Records Clerk of Court's Office Rm It5f 4:8N1
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Wanda Rodriguez,ACP Phone Number 252-8123
Contact/ Department Office of th County Attorney
Agenda Date Item was 1/13/15 V Agenda Item Number 16-H-3
Approved by the BCC
Type of Document Resolution vlappointing member.to the Number of Original one
Attached Public Safety Authority Documents Attached
PO number or account N/A
number if document is
to be recorded ab6-13
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A" in the Not Applicable column, whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? JAK
2. Does the document need to be sent to another agency for additional signatures? If yes, JAK
provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's JAK
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the JAK
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's JAK
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JAK
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 1/13/15 and all changes made during the
meeting have been incorporated in the attached document. The County Attorney's
Office has reviewed the changes,if applicable. 1
9. Initials of attorney verifying that the attached document is the version approved by th _�
BCC,all changes directed by the BCC have been made,and the document is ready for e1.
Chairman's signature.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
16H3
RESOLUTION NO. 2015 - 1 3
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, APPOINTING LAVIGNE ANN
KIRKPATRICK TO THE COLLIER COUNTY PUBLIC SAFETY
AUTHORITY.
WHEREAS, on June 26, 2012, the Board of County Commissioner (Board) adopted
Ordinance No. 2012-23, establishing the Collier County Public Safety Authority (Authority) to
address issues affecting pre-hospital emergency medical services in Collier County; and
WHEREAS, on October 14, 2014, the Board adopted Ordinance No. 2014-37 which
reduced the membership of the Authority to a five member citizens committee; and
WHEREAS, there are two vacancies on this Advisory Committee; and
WHEREAS, the Board of County Commissioners has provided public notice soliciting
applications from interested parties.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that LAVIGNE ANN
KIRKPATRICK is hereby appointed to the Collier County Public Safety Authority to four-year
terms to expire on December 31, 2018.
THIS RESOLUTION ADOPTED upon majority vote on the 13th day of January, 2015.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA
By ,,�;; pc By
a Clerk TIM NANCE, CHAIRMAN
A est as t0
si.. . • 1y.
Appro ; o'orm and legality:
4,111 ti v
Jeffrey •I :tzkow item#
County • ttS`;��I ey Agenda _tZ�l�
Date �— =
Date `� LS-t5
Recd —