Backup Documents 03/24/2015 Item #16H1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIPk6
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATU
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#1 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
l.
2.
3. County Attorney Office County Attorney Office JAK 3/24/15
4. BCC Office Board of County
Commissioners V (%/ , S\ZSoVS
5. Minutes and Records Clerk of Court's Office
Wi) rr5 3,
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 ditional or missing information.
Name of Primary Staff Wanda Ro iguez,ACP Phone Number 252-8123
Contact/ Department Office of t e County Attorney
Agenda Date Item was 3/24/15 Agenda Item Number 16-H-1
Approved by the BCC
Type of Document Resolution appointiAg member to the Public Number of Original one
Attached Safety Authority nets�'.- Documents Attached
PO number or account N/A
number if document is
to be recorded
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? N/A
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
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 N/A
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 N/A
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 3/24/15 and all changes made during the
meeting have been incorporated in the attached document. The County , rney's
Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version proved by the = ,
BCC, all changes directed by the BCC have been made,and the docu ent is ready for th&snZaskyNN
Chairman's signature. 'e�� .1&
1:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Re * d 1.26.05,Revised 2.2, Revised 11/30/12
16H I
RESOLUTION NO. 2015 - 58
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, APPOINTING RONALD KEZESKE 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 is a vacancy on this Advisory Committee; and
WHEREAS, the Board of County Commissioners has provided public notice soliciting
applications from interested parties; and
WHEREAS, the Authority has provided the Board of County Commissioners with its
recommendation for appointment.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that RONALD KEZESKE is hereby
appointed to the Collier County Public Safety Authority to a four-year term to expire on March
24, 2019.
THIS RESOLUTION ADOPTED upon majority vote on the 24th day of March, 2015.
ATTEST:.. ? BOARD OF COUNTY COMMISSIONERS
DWIGHT E.*BROOK, Clerk COLLIER COUNTY, FLORIDA
B • By:
Attest as to Chairman
et. Cl TIM NANCE, CHAIRMAN
signature on 'b af:)?J'
Ap. ov-• .. o form an legality:
Jeffrey A. Klatzkow
County Attorney