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Backup Documents 09/26/2017 Item #16A40 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 A4 0 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO '"t 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 9/26/17 4. BCC Office Board of County Commissioners 04-‘1Z `t `VI 5. Minutes and Records Clerk of Court's Office 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 Nancy Cardinale-Lower,Code Phone Number 252-2436 Contact/ Department Enforcement Agenda Date Item was 9/26/17 Agenda Item Number 16-A-,10 Approved by the BCC Type of Document Release and Satisfaction— De La Oo Number of Original �, Attached Documents Attached PO number or account 111-138911-649030 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? 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 9/27/17 and all changes made during the KN N/A is not meeting have been incorporated in the attached document. The County Attorney's an option for Office has reviewed the changes,if applicable. } this line. 9. Initials of attorney verifying that the attached document is the version approved by the KN ` A is not BCC,all changes directed by the BCC have been made,and the document is ready for t an ption for Chairman's signature. V'. thi line. [04-COA-01081/1344829/1]l: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 16A4fl INSTR 5435 PG 329 15 PM PAGES 1 DWIGHT5452506RECORDED 9/27/2017 4:E. BROCK,OR CLERK OF THE CIRCUIT COURT COLLIER COUNTY FLORIDA REC$10.00 This Instrument Prepared By: Marlene Serrano 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: YISLEN DE LA 0 AND ROESMEL RUA, Respondent The lien was recorded on June 15, 2015, Book 5163, Page 1323, in the Official Records of Collier County, State of Florida. The liens secure the principal sum of sixty two thousand two hundred ($62,200), 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 lip Y, FLORIDA By: NU,t/ V CYZ• B : // eputy Clerk Penny TaylV hairman, Date: Willi Date: \Z(,Ai1 Approved as to form and legality /17 Kevin Noell Assistant County Attorney D INSTRWIGHT 545E 25BR0007 ORK,5435 PG OF THE 330 RECORDED 9/27/2017 4 15 PM PA 1 COURT ikAO4 CLERK COLLIER COUNTY FLORIDA REC$10.00 This Instrument Prepared By: Marlene Serrano 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: YISLEN DE LA 0 AND ROESMEL RUA, Respondent The lien was recorded on June 14, 2016, Book 5283, Page 2690, in the Official Records of Collier County, State of Florida. The liens secure the principal sum of thirty three thousand four hundred ($33,400), 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 COLLIE' Cjj1frTY, FLORIDA By: ; (� BY /ij, ndt 2S 10eDut n S Jerk Penny Taylor hairm a , Date , e only. Date: ck`Z!o\\--"\ Approved as to form and legality .Y2/ / • Kevin Noell Assistant County Attorney