Backup Documents 03/28/2017 Item #16K11 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP J
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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 KN 3/28/17
4. BCC Office Board of County
Commissioners V N/:S 31Z`tk1`1
5. Minutes and Records Clerk of Court's Office
1)0 -512810 3'-3fta
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 Kevin Noell,Assistant County Attorney Phone Number 252-8400
Contact/Department
Agenda Date Item was 3/28/17 Agenda Item Number 16-K-11 1/
Approved by the BCC v
Type of Document Settlement Agreement and Mutual Release- Number of Original One
Attached Jimenez 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 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 3/28/17 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. r
9. Initials of attorney verifying that the attached document is the version approved by the KI\S
BCC, all changes directed by the BCC have been made, and the document is ready for he
e � 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
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MEMORANDUM
Date: March 29, 2017
To: Kevin Noell, Assistant County Attorney
County Attorney's Office
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Settlement Agreement and Mutual Release - Jimenez
Attached is a copy of the document referenced above, (Item #16K11) approved by the
Board of County Commissioners on Tuesday, March 28, 2017.
The original document is being held in the Minutes & Records Department as
part of the Board's Official Record.
If you have any questions, please contact me at 252-8411.
Thank you.
SETTLEMENT AGREEMENT AND MUTUAL RELEASE
THIS SETTLEMENT AGREEMENT AND MUTUAL RELEASE (hereinafter referred
2 13-44—t
to as the "Agreement and Release") is entered into and made on this- d" day of
1_ , 2017, by and between PHILIP P. JIMENEZ, (hereinafter referred to as
"Plaintiff') and Collier County(hereinafter referred to as the "County").
WITNESSETH:
WHEREAS, Plaintiff filed a lawsuit against the County in the Circuit Court for the
Twentieth Judicial Circuit in and for Collier County, Florida, styled Philip P. Jimenez v. Collier
County, a political subdivision of the State of Florida, Case No. 16-01014-CA (hereinafter
referred to as the "Lawsuit"); and
WHEREAS, Plaintiff and the County, without either party admitting any liability or
fault, desires to settle the Lawsuit and any and all disputes that arise from, relate or refer in any
way, whether directly or indirectly, known or unknown, to the incidents described or allegations
made in the Complaint filed in the Lawsuit; and,
WHEREAS, Plaintiff and the County desire to reduce the settlement to a writing so that
it shall be binding upon both parties' respective owners, principals, elected officials, officers,
employees, ex-employees, agents, attorneys, representatives, insurers, spouses, successors,
assigns, heirs and affiliates.
WHEREAS, the Plaintiff agrees and covenant to fully comply with all applicable
Medicare laws and liens specifically including 42 USC § 1395y.
NOW, THEREFORE, in consideration of the mutual covenants, promises and
consideration set forth in this Agreement and Release, and with the intent to be legally bound,
Plaintiff and the County agree as follows:
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1. Plaintiff and the County adopt and incorporate the foregoing recitals, sometimes
referred to as "Whereas Clauses", by reference into this Agreement and Release.
2. This settlement agreement and mutual release is contingent upon approval by the
Board of County Commissioners of Collier County, Florida.
3. In consideration of the resolution of all disputes or claims arising from or
referring or relating in any way, whether directly or indirectly, to the Lawsuit, and for and in
consideration of the sum of Ten Thousand Dollars and 00/100 ($10,000.00) and other valuable
consideration, the receipt and adequacy of which is hereby acknowledged by Plaintiff, Plaintiff
agrees to dismiss the Lawsuit with Prejudice.
4. In consideration of the resolution of the Lawsuit, and for other good and valuable
consideration, the receipt and adequacy of which is hereby acknowledged, Plaintiff, on behalf of
himself, his attorneys, agents, representatives, insurers, heirs, successors and assigns, hereby
expressly releases and forever discharges the County, as well as its elected officials, officers,
employees, ex-employees, agents, attorneys, representatives, successors, assigns, insurers and
affiliates from any and all claims, demands, causes of actions, damages, costs, liens, attorney's
fees, expenses and obligations of any kind or nature whatsoever that he has asserted or could
have asserted in the Lawsuit or that arise from or relate or refer in any way, whether directly or
indirectly, to the Lawsuit or any incident, event or allegation referred to or made in the
Complaint in the Lawsuit.
5. Notwithstanding anything that may be to the contrary in Paragraph 4 of this
Agreement and Release, Plaintiff and the County agree that either of them (as well as any other
persons or entities intended to be bound) shall, in the event of any breach, retain the right to
enforce the terms and conditions of this Agreement and Release.
[16-1014-CA/1327777/2] 2
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6. Plaintiff agrees and covenant to fully comply with all applicable Medicare laws
and liens specifically including 42 USC § 1395y.
7. Plaintiff and the County acknowledge and agree that this Agreement and Release
is intended to and shall be binding upon their respective owners, principals, officials, officers,
employees, ex-employees, agents, attorneys, representatives, insurers, successors, assigns,
spouses, heirs, and affiliates.
8. Plaintiff and the County recognize and acknowledge that this Agreement and
Release memorializes and states a settlement of disputed claims and nothing in this Agreement
and Release shall be construed to be an admission of any kind, whether of fault, liability, or of a
particular policy or procedure, on the part of either Plaintiff or the County.
9. Plaintiff and the County acknowledge and agree that this Agreement and Release
is the product of mutual negotiation and no doubtful or ambiguous language or provision in this
Agreement and Release is to be construed against any party based upon a claim that the party
drafted the ambiguous provision or language or that the party was intended to be benefited by the
ambiguous provision or language.
10. This Agreement and Release may be amended only by a written instrument
specifically referring to this Agreement and Release and executed with the same formalities as
this Agreement and Release.
11. In the event of an alleged breach of this Agreement and Release, Plaintiff and the
County agree that all underlying causes of action or claims of Plaintiff have been extinguished
by this Agreement and Release and that the sole remedy for breach of this Agreement and
Release shall be for specific performance of its terms and conditions or any damages arising
from the breach. In this regard, Plaintiff and the County further agree that the sole venue for any
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such action shall be in the Twentieth Judicial Circuit in and for Collier County, Florida in
Naples, Florida.
12. This Agreement and Release shall be governed by the laws of the State of Florida.
13. Plaintiff agrees to reimburse Medicare and pay for any and all Medicare liens or
any other liens arising out of, or anyway connected to, injuries and/or damages suffered from the
incident described in the Lawsuit, out of the proceeds of the settlement monies.
IN WITNESS WHEREOF, Plaintiff, and the County have signed and sealed this
Agreement and Release as set forth below.
AS TO COUNTY:
ATTEST:
DWIGHT E. BROCK,'Clerk BOARD OF COUNTY COMMISSIONERS
OF COL I OUNTY, FLORIDA
AV
it.L.A. Q....04,4\.6.41/Lcz._
By: /1
Attest as to ChaMINY Clerk PENNY T OR, Cha�y''�n
signature nY°a.
Approved as to form and legality: AS TO PLAINTIFF:
B (� c .
y' i
Kevin L. Noell PHILIP P. J' Z, Plaintiff
Assistant County Attorney
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was acknowledged before me this 20 day of
/tLze_rcAn , 2017, by PHILIP P. JIMENEZ, who is ( e) personally known to me or ( )
produced as identification.
SHARON ORZECH _ (Sign re of Notary Public - State of Florida)
Zs° `�= Notary Public-State of Florida 1
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� P`= Commission#FF 014636
�O o" Bonded Through National Notary Assn. ( (Print, Type, or Stamp
Commissioned Name of Notary Public)
Commissioner Expires 7/-3 7
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