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Backup Documents 09/22/2015 Item #16A11 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 A 11 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 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. n ,, **NEW** ROUTING SLIP 1? I2 t1.1Y- I? 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 1. 2. 3. County Attorney Office County Attorney Office KNN \7-\. 9/22/15 4. BCC Office Board of County i Commissioners / c\\2:4-,c 5. Minutes and Records Clerk of Court's Office r\NO 1(22-// S 3:0(tell 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 Jeff E. Wright,C e Enforcement Phone Number 252-6077 Contact/ Department Agenda Date Item was 9/22/15 Agenda Item Number 16-A-11 Approved by the BCC Type of Document Release and Satisfaction—Fernandez 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 9/22/15 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 KN BCC,all changes directed by the BCC have been made,and the document is ready fo the 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 16A11 This Instrument Prepared By: iNSTR 5176204 OR 5198 PG M 908F' Jeff Wright RECORDED 9/26f201 9 RKOF IHEECIRCUIT LOUR i CCode Enforcement Division DWIGHT 1 E BROOK, COLLIER COUNTY FLORIDA 2800 North Horseshoe Drive REC$10.00 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: Frank Fernandez Respondent The lien was recorded on July 7, 2008, in Official Records Book 4376, Page 0281, in the Official Records of Collier County, State of Florida. The lien secures the principal sum of four thousand sixty-three dollars and ninety-nine cents ($4,063.99), 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. ," Attest as to Ch81fntan S r c eputy -rk Tim Nance, Chairman signatu, ° ate: r � 2, %` � Date: q\-7...2_,V• eye , . Approved as to form and legality Kevin Noell Assistant County Attorney 2006120290 ORIDOCUMENTS ROUTING TTLIP 16 A i lTOACOMANALL ORIGINAL DOCUMENTS SENT 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 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 1. 2. 3. County Attorney Office County Attorney Office KN 10/5/15 4. BCC Office Board of County � _ Commissioners /S/ lo`S\SS 5. Minutes and Records Clerk of Court's Office 7(1\ 10(5 15 (2!.1 t 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 Rosa Villarr al,Code Enforcement Phone Number 252-2444 Contact/ Department Agenda Date Item was 9/22/15 Agenda Item Number 16-A-11 Approved by the BCC Type of Document *IiEPL,A,EIT-Release and Number of Original One Attached Satisfaction—Fernandez Documents Attached PO number or account 001-10070-649030 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(taAMIa_attael)TK KN 2. Does the document need to be sent to another agency for addal turesyes, KN provide the Contact Information(Name;Agency;Address;Phone)osheet. 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 9/22/15 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 the KN BCC,all changes directed by the BCC have been made,and the document is ready for th• ,� ( Chairman's signature. V.N- •tia * 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 16A11 INSTR 5179579 OR 5201 PG 1084 RECORDED 10/5/2015 1'.18 PM PAGES 1 DWIGHT E. BROK, CLERK OF THE CIRCUIT COURT COLLIER COUNTY FLORIDA This Instrument Prepared By: REC$10.00 Jeff Wright Code Enforcement Division 2800 North Horseshoe Drive 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: Frank Fernandez Respondent The lien was recorded on July 7, 2008, in Official Records Book 4376, Page 0281, in the Official Records of Collier County, State of Florida. The lien secures the principal sum of four thousand sixty-three dollars and ninety-nine cents ($4,063.99), 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. BRQCK, CJerk COLLIER COUNTY, FLORIDA . By: I .►� � _� > l.� y 1 By. eputy erk Tim Nance, Chairman ate: C y� 1r r J; 40 J Date: 11Z.2�tc Attest as(o k.+nalrinan, signature only, Approved as to form and legality Kevin Noell Assistant County Attorney 2006120290 [15-CED-01053/1203569/1]