Backup Documents 11/15/2016 Item #16A27 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNA U Q 7
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to Co ty ffice
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 11/15/16
4. BCC Office Board of County c
Commissioners \ /6/ \\\\CVb
5. Minutes and Records Clerk of Court's Office 11 i5
t '5�I a 3, 4-,
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 Trinity Scott,T sportation Planning Phone Number 252-5832
Contact/Department
Agenda Date Item was 11/15/16 Agenda[tem Number 16-A-27
Approved by the BCC
Type of Document Right of Entry—FDOT Number of Original 'TW
Attached 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 JAK
2. Does the document need to be sent to another agency for additional signatures? If yes, JAK See-note Sew._c- c \
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. bcluw 9rn k‘x
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAK
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 11/15/16 and all changes made during JAK
the 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 - Or-%
BCC,all changes directed by the BCC have been made,and the document is ready for hq e
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
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 16 A 2 7
RIGHT OF ENTRY AGREEMENT
ITEM/SEGMENT NO.: 435040-1-52-01
MANAGING DISTRICT: District One
F.A.P. NO: Not Applicable
STATE ROAD NO.: SR 45
COUNTY: Collier
STATE OF FLORIDA
COUNTY OF COLLIER
THIS AGREEMENT, made and entered into on the 'e`° day of `rC.Y-rk\ocsr' ,?—U\!�
By and between Collier County hereinafter called the "OWNER" and the State of Florida Department of Transportation,
hereinafter called the "DEPARTMENT."
WITNESSETH:
WHEREAS,the DEPARTMENT intends to construct certain improvements to State Road 45; and
WHERAS, as a part of the intended improvements the DEPARTMENT agrees to construct roadway and sidewalk
modifications.The OWNER desires and the DEPARTMENT agrees to enter the OWNER'S property to mill and resurface,
construct sidewalk and drainage beyond the right of way line without cost to the OWNER.The OWNER agrees to allow
onto their property activities associated with the construction of the roadway and sidewalk improvements.This right of
entry shall allow the DEPARTMENT, its agents and contractors the right to ingress, egress and move construction
vehicles and equipment onto the OWNER'S land as necessary for the purpose of constructing the roadway, sidewalk
connections, drainage and milling and resurfacing.This right of entry terminates upon the completion of this work; and
WHERAS,the OWNER has no objection to the entry onto its property to perform these construction activities on
OWNER'S land.
NOW,THEREFORE, in consideration of the above stated premises,the OWNER herby grants to the DEPARTMENT
and its agents or assigns a right of entry to enter upon the OWNER'S lands for the purpose of performing the activities
described above. It is further understood and agreed to the DEPARTMENT and/or its duly authorized representative will
restore the remaining disturbed lands to a safe and sanitary condition after the construction of the improvements.The
DEPARTMENT agrees that the OWNER'S right to access to the property during the construction shall be maintained.
COLLIER CO Y, FLORIDA: DEPARTMENT:
STATE OF FLORIDA
DEPARTMENT OF TRANSPORTATION
BY: �K3'f tMr11Q \Q-�c�.� tY' yr-1 BY:
Name(Please Print or Type) ' Name(Please Print or Type)
Signature Signature
Approlt to form nd legality
1 f
Jeffrey A.;[Ulakow,County Attorney
• ; . _.'
IOC
espas,'tN'' 1�
signature only.
,Y� 1 b A 2 7
Colin of (oilier
CLERK OF THEICIR UIT COURT
Dwight E. Brock COLLIER COUI@Y COi11THOUSE Clerk of Courts
Clerk of Courts 3315 TAMIAMI TRL E STE 102 P.O. BOX 413044 Accountant
NAPLES,FLORIDA ` I NAPLES,FLORIDA CustodianAuditor
of CountyFunds
34112-5324 _I- ;34101-3044
November 17, 2016
Justin R. Reck, Project Manager
Florida Department of Transportation District #1
801 N. Broadway Avenue, MS 1-29
Bartow, FL 33830
Re: Right-of-Entry between FDOT and Collier County for the construction of
roadway and sidewalk improvements and drainage connections along US 41
Item/Segment: 435040-1-52-01
Mr. Reck,
Attached for further processing are two original copies of the agreement referenced
above, approved by Collier County Board of County Commissioners November 15, 2016.
After the agreements have been signed, please return one of the original copies of the
agreement to the Collier County Minutes and Records Department, that serves as
Clerk to the Board, thereby providing a fully executed document for the Official Record.
I have included a label to facilitate mailing.
If you require further information from our office, please feel free to contact me at
239-252-8406.
Thank you.
DWIGHT E. BROCK, CLERK
QC
Ann Jenner o ,
Deputy Clerk
Attachment
Phone- (239) 252-2646 Fax- (239) 252-2755
Website- www.CollierClerk.com Email- CollierClerk@collierclerk.com
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16A27
FDOTA ,
Florida Department of Transportation
RICK SCOTT 801 N.Broadway Avenue JIM BOXOLD
GOVERNOR Bartow,Florida 33830 SECRETARY
November 21, 2016
Ann Jennejohn
Deputy Clerk
Collier County Government
3299 Tamiami Trail E. Suite#401
Naples, FL 34112
RE: Right-of-Entry Agreement
FPID: 435040-1-52-01
US 41 from N. of Pine Ridge Road to S. of Pelican Bay Blvd.
Ms. Jennejohn,
Attached is one original executed copy of the agreement for the above referenced project which
has been signed by Department staff on November 21, 2016.
If you require any further information, please feel free to contact me at 863.519.2502.
Thank you,
J stin R. Reck
Project Manager
Attachment
www.fdot.gov
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 1 6 M)i 27
RIGHT OF ENTRY AGREEMENT
ITEM/SEGMENT NO.: 435040-1-52-01
MANAGING DISTRICT: District One
F.A.P. NO: Not Applicable
STATE ROAD NO.: SR 45
COUNTY: Collier
STATE OF FLORIDA
COUNTY OF COLLIER
THIS AGREEMENT, made and entered into on the e��� day of\`\ic `re k\re.\c— ,2-0\lo
By and between Collier County hereinafter called the "OWNER" and the State of Florida Department of Transportation,
hereinafter called the "DEPARTMENT."
WITNESSETH:
WHEREAS, the DEPARTMENT intends to construct certain improvements to State Road 45; and
WHERAS, as a part of the intended improvements the DEPARTMENT agrees to construct roadway and sidewalk
modifications. The OWNER desires and the DEPARTMENT agrees to enter the OWNER'S property to mill and resurface,
construct sidewalk and drainage beyond the right of way line without cost to the OWNER.The OWNER agrees to allow
onto their property activities associated with the construction of the roadway and sidewalk improvements.This right of
entry shall allow the DEPARTMENT, its agents and contractors the right to ingress, egress and move construction
vehicles and equipment onto the OWNER'S land as necessary for the purpose of constructing the roadway, sidewalk
connections, drainage and milling and resurfacing. This right of entry terminates upon the completion of this work; and
WHERAS, the OWNER has no objection to the entry onto its property to perform these construction activities on
OWNER'S land.
NOW, THEREFORE, in consideration of the above stated premises, the OWNER herby grants to the DEPARTMENT
and its agents or assigns a right of entry to enter upon the OWNER'S lands for the purpose of performing the activities
described above. It is further understood and agreed to the DEPARTMENT and/or its duly authorized representative will
restore the remaining disturbed lands to a safe and sanitary condition after the construction of the improvements.The
DEPARTMENT agrees that the OWNER'S right to access to the property during the construction shall be maintained.
COLLIER CO IJ Y, FLORIDA: DEPARTMENT:
STATE OF FLORIDA
cc \ DEPARTMENT OF TRANSPORTATION
BY: `n.r� -\Q..\c►x CV--o.�\---t,--<3...)rc BY: Ayylv C. glair 'fvr N i C O Z in; 11S
Name(Please Print or Type) I Name(Please Print or Type)
Signature Sig ure
Approved ra, toy``oii alad legality
II!
I
:.., IE.D!� s�
_ ,tG :; K
Jeffrey A.1.la f i kow,County Attorney
Y J . _ a 111C
rdb
signature only.
FDOT ,
16A27
Florida Department of Transportation
RICK SCOTT 801 North Broadway Ave. JIM BOXOLD
GOVERNORBartow,Florida 33830 SECRETARY
MEMORANDUM
DATE: October 26,2016
TO: Amy E. Blair, P.E.,Project Management Engineer Supervisor III
Richard E. Lilyquist, P.E.,Project Management Engineer Supervisor III
FROM: Nicole E. Mills,P.E., District Consultant Project Management Enginee
COPIES: File
SUBJECT: Delegation of Authority for Nicole E. Mills,P.E.
You are delegated signature and approval authority anytime during my absence from the office.
Signature should be made "in your name for the District Consultant Project Management
Engineer". This delegation rescinds any prior delegations.
This delegation will remain in effect until rescinded by me.
Please ensure all documents requiring signature/or approval under this delegation are forwarded
to my office for proper coordination prior to signing and also provide a reading file copy of any
documents you sign.
NEM/clw
www.dot.state.fl.us
www.dot.state.fl.us
1 6 A 27
Ann P. Jennejohn
From: Ann P.Jennejohn
Sent: Monday, November 28, 2016 3:13 PM
To: Scott, Trinity
Subject: 11-15-16 Item #16A27 (Right of Entry Agreement FPID 435040-1-52-01)
Attachments: Backup Documents 11_15_2016 Item #16A27.pdf
Hi Trinity,
A copy of the (sigvted) Right-of-Entry Agreement with
FDOT for improvemevtts ovt US 41- (from N. Pine Ridge
to S. of Pelican Bay Boulevard) that was approved by the
Board on November 15, 2016, is attached for you.
Thank you!
Ann Jennejohn, Deputy Clerk
Clerk of the Circuit Court
Clerk to the Value Adjustment Board
Collier County Board Mivtutes & Records Dept.
239-252-8406 Fax 239-2.52-8408
1