Backup Documents 12/09/2014 Item #16E8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 E 8 I
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.
**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 JAK 1-2- j 01 '14-
4. BCC Office Board of County 1172=k4
Commissioners V\\171/4/ i?....V AV\
5. Minutes and Records Clerk of Court's Office
n
` �I VU VI It I I IZ•
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 p 1 ^ Phone Number
Contact/ Department Gr,/5 (f -;Agenda Date Item was 7 Agenda Item Number
Approved by the BCC `o
Type of Document „` i . - .'„"�i��� , Number of Original _�— J
Attached rr r� / rt- Documents Attached
PO number or account I CO PC 0
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?
PP
2. Does the document need to be sent to another agency for additional signatures? If yes, I V
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. Ss]
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 '
Office and all other parties except the BCC Chairman and the Clerk to the Board 'v
5. The Chairman's signature line date has been entered as the date of BCC approval of the V-
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 '
signature and initials are required. "Y
7. In most cases(some contracts are an exception),the original document and this routing slip ir
should be provided to the County Attorney Office at the time the item is input into SIRE. iv,
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 14712713 and all changes made during i
the meeting have been incorporated in the attached ment. The County lb. I-/ option for
Attorney's Office has reviewed the changes,if applicable. ? l 2 q /
// . th s line.
9. Initials of attorney verifying that the attached document is the version approved b�y the r N A is not
BCC,all changes directed by the BCC have been made,and the document is ready for • ii, ? a option for
Chairman's signature. , 4 -• tis line.
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
16 E 8
MEMORANDUM
Date: December 11, 2014
To: Pat Pochopin, Administrative Assistant
Collier County Administrative Services
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Renewal of Class "3: COCPN & Permit
Attached is one (1) original of the document referenced above, (Item #16E8) adopted
by the Board of County Commissioners on Tuesday, December 9, 2014.
If you have any questions, please feel free to contact me at 252-7240.
Thank you
.___.,..::: _ ____„--N , ___,_ 6 E
iii LIrP' r „ 41,61 1 41, •,;w1• i lr 1 ..1rrr J.1 'Ir%' 111 r// rp
���/. � ��.fJw,...:,___..,,_.:4-0.1\w„,,,,,_,..__.:_.,6Yu'u/ s"" r .l•.:�:'uA uu.:u5••l'^�� 'r•",s'A � "u. u\,.,..+�'• mss. .i'•• uuv auu'iielyy. .✓ •1.A .�/d!d'• ; � 1` ,W6u::.u• • ''A1
\� � Y"" `\ /�u,ndYG.yG.,,�,� `\ �, � � 114'' �•:i � s. li. /'."u,'�� .". ,\ /i� 1"'. �. i:✓'\ `\ 1! /"� �1 II
446101v, Pokiiii
ARIL .044. ii.lii
lot
�. /� • i•+
..�.,. :n,..,., ..Y�,: '..... •:��::: �:�.r�,. .fir,��, :_
' ''''
.,..it,,,:,..:,
:11,,,,,,,:411C:::
r" �.• ui...;'.,„:„..„:,...,:, :\fa t
.,. ., , „.), ..,
. ,
i.,, ,.
�. �. uo;R ++ �� S S S
\\
(`�/ y �• vQ ;�'tom Gtr cn 411\..'„
......1111 ,...., D e'
I
`iDn cm Dm Dn
J ° W
o
(� p '" N m m N N i�D Z ti
to r S to O
:;I/rr i�D , m ai
s F , ' m rs cu t? O m O 1
•
1 m a �, r., m • �• ° o a 2 m n, z 111,
' �b� 7C Vf' fl1 N to Vf N m N (C (� �' 'F
• H O A m ° m m 0- ,- (D2( 2 ?I
•
"r m V1
d G O to O m v, O m ` n O ' ► rS
rr m d h �' '7+ m O r^ S
• 'J_ ° arD °i ° ° „ ° °t r" =
Fri
7 O nr ar F. n' l7 ;�
V
''\lt 1
�
� m � O Q z
� +1/ '\
I, ...,LAI.i
f i 1 birm A ' C O `v _j NS m m O
ll ! UH m't
\\ ?./' I X md O t f 2-
r- D o N ° to Z
O m Ov (D mCU O T -*, n., vii N m mrr'/ .1).ra
OO f* C O O mo H tojt10
• r+ C 7 O r+ a 7 O O ° O C/1 n
0 rt yr D t1 D f
r .rr'��J414' Wp
,,... 4
h+,
a fili.:----..„ p
vb
�,
O Domc1n eOr+ n aufi
CM
rD '
4
7 1rp 77
n m
m `^
co
3r+ —rv ..n) °
O v, V^ a
' ? n Yrr/,,r
- ap
Ft Au
t'r 114
1:1� ' I
` �r 13e
wo
bb
.
•: iii: �.. • : •• , „ .i.,J� •.. 'GtiS4G G,.G♦Xv,}},♦G.GYi:45;QYORFAX[dddW6 tt .. ..:
Aikeira . '
��/ / a ' i -u11
I, l �iS'1 � t 'Ili. R' ...,1r .r�•. .;r �h.f" r� V1. i,�, 111
16E 8
COLLIER COUNTY FLORIDA
Renewal of Class "3"COCPN
This Permit is Effective January 1,2015 and
Expires December 31, 2015
Name of Service: North Collier Fire Control and Rescue District
Name of Owner: North Collier Fire Control and Rescue District
Principle Address of Service: 1885 Veterans Park Drive, Naples, FL 34109
Business Telephone: 239-597-3222
Description of Service: Non-Transport Advanced Life Support
Number of Ambulances: 18 Ground Units available
See Application for Description of Vehicles
This permit, as provided by Ordinance No. 2004-12, as amended, shall allow the above named Non-
transport ALS Service to operate within the North Naples Service Delivery response boundary and
pursuant to the Collier County Fire Chiefs Local Mutual Aid Agreement until the expiration date hereon,
except that this permit may be revoked by the Board of County Commissioners of Collier County at any
time the service named herein shall fail to comply with any local, state or federal laws or regulation
applicable to North Collier Fire Control and Rescue District.
Issued and approved this 1 day of C.9.tc[ ,k...* A 2014
ATTEST: " BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROOK ELERK COLLIER COUN , FLORIDA
4;1I
Aft t a$to:Chai CI Tom Henning, Chair t .n
signature .1"
Approved as to form and legality:
Jen er A. Belpe i p�J') `�L\e
Assistant County Attorney �
S