Backup Documents 06/23/2015 Item #16A 9 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIPI 6
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO �1
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
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 VeCar4o( l t
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the documet 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 KN 6/23/15
4. BCC Office Board of County 7\\C,
Th�5/ G`7`(S.
5. Minutes and Records Clerk of Court's Office
raw 25115 12:23
PRIMARYC ONTACT 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 Jeff E.Wri t,Code Enforcement Phone Number 252-6077
Contact/ Department
Agenda Date Item was 6/23/15 Agenda Item Number 16-A-9
Approved by the BCC
Type of Document Release and Satisfaction—Hubschman Number of Original One
Attached Documents Attached
PO number or account
number if document is 111-138911-649030
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? STAMP OK KN
2. Does the document need to be sent to another agency for additional signatures? If yes, KN
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 KN
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 KN
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 KN
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 KN
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip KN
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 6/23/15 and all changes made during the KN
meeting have been incorporated in the attached document. The County Attorney's
Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by t r- KN 1
BCC,all changes directed by the BCC have been made,and the document is ready 'r the
Chairman's signature. `, ceQ
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
Martha S. Vergara .£ ;
From: Martha S. Vergara
Sent: Wednesday, July 08, 2015 11:10 AM
To: Wright, Jeff
Cc: Adams, Kerry
Subject: Agenda Item #16A9 A10 receipt
Attachments: Jeff Wright.pdf
Attached for your records.
Martha Vergara, BMR Senior Clerk
Minutes and Records Dept.
Clerk of the Circuit Court
&Value Adjustment Board
Office: (239) 252-7240
Fax: (239) 252-8408
E-mail: martha.vergara@collierclerk.com
1
INSTR 5142134 OR 5169 P2
RECORDED 6/29/2015 4:14 PM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC $10.00
This Instrument Prepared By:
Jeff Wright
Code Enforcement Division 1 ¢; ,n '`
2800 North Horseshoe Drive U > a '
Naples, FL 34104
(239) 252-2440
RELEASE AND SATISFACTION OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA is the owner and holder of a certain lien against all real and
personal property owned by:
Sidney John Hubschman
Respondent
The lien was recorded on April 29, 2015, in Official Records Book 5145, Page 1135, in the
Official Records of Collier County, State of Florida. The lien secures the principal sum of one
thousand six hundred sixty-five dollars and twenty-eight cents ($1,665.28), plus accrued interest
and penalties, if any, and imposes certain obligations against real property situated in Collier
County, Florida.
Collier County, a political subdivision of the State of Florida, by execution of this Release and
Satisfaction of Lien, acknowledges payment as approved by the Board of County
Commissioners as satisfaction of the lien and hereby cancels and releases said lien.
The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction of Lien
in the Official Records of Collier County, Florida, to acknowledge that the lien ceases to exist.
ATTESTBOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK clerk COLLIER COUNTY, FLORIDA
/ er,l'asaGe_
By. .PP - ki / By:
Attest • • • a - ;,p=-'t Cler Tim Nance, Chairman
signattir0
ate: y' J::,..17
Date: (2,12., \1S
Approved as to form and legality
1 AI
Kevin Noell
Assistant County Attorney
CENA20140016288
INSTR 5142135 OR 5169 PG 2
RECORDED 6/29/2015 4:14 PM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC $10.00
This Instrument Prepared By:
Jeff Wright
Code Enforcement Division 1 6
2800 North Horseshoe Drive j '
Naples, FL 34104
(239) 252-2440
RELEASE AND SATISFACTION OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA is the owner and holder of a certain lien against all real and
personal property owned by:
Sidney John Hubschman
Respondent
The lien was recorded on July 16, 2014, in Official Records Book 5058, Page 1895, in the
Official Records of Collier County, State of Florida. The lien secures the principal sum of
thirteen thousand seven hundred eighty-nine dollars and eight cents ($13,789.08), plus accrued
interest and penalties, if any, and imposes certain obligations against real property situated in
Collier County, Florida.
Collier County, a political subdivision of the State of Florida, by execution of this Release and
Satisfaction of Lien, acknowledges payment as approved by the Board of County
Commissioners as satisfaction of the lien and hereby cancels and releases said lien.
The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction of Lien
in the Official Records of Collier County, Florida, to acknowledge that the lien ceases to exist.
ATTEST BOARD OF COUNTY COMMISSIONERS
DWIGHT E BROCK, Clerk COLLIER COUNTY, FLORIDA
By If C, /k\ By: / er,a...e.._
Attest as to Cha, an's Neep, Tim Nance, Chairman
Stgaate:UC c Date: (Q\Z3\\s
Approved as to form and legality
Kevin Noell
Assistant County Attorney
CEPM20130019061
INSTR 5142136 OR 5169 PG 24
RECORDED 6/29/2015 4:14 PM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC $10.00
This Instrument Prepared By:
Jeff Wright
Code Enforcement Division 1 6 A 1
2800 North Horseshoe Drive j'
Naples, FL 34104
(239) 252-2440
RELEASE AND SATISFACTION OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA is the owner and holder of a certain lien against all real and
personal property owned by:
Sidney John Hubschman
Respondent
The lien was recorded on May 23, 2014, in Official Records Book 5040, Page 2344, in the
Official Records of Collier County, State of Florida. The lien secures the principal sum of two
thousand two hundred sixty-four dollars and twenty-one cents ($2,264.21), plus accrued interest
and penalties, if any, and imposes certain obligations against real property situated in Collier
County, Florida.
Collier County, a political subdivision of the State of Florida, by execution of this Release and
Satisfaction of Lien, acknowledges payment as approved by the Board of County
Commissioners as satisfaction of the lien and hereby cancels and releases said lien.
The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction of Lien
in the Official Records of Collier County, Florida, to acknowledge that the lien ceases to exist.
ATTEST BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA
r`
By: +a v I B/ * _Attest as to Chairman's L D . , k -rlc Tim Nance, Chairman
cianatur //c- - 1
Date: r--) ' Date: (�,\2.7,V5
Approved as to form and legality
Kevin Noell
Assistant County Attorney
CENA20130019057