Backup Documents 05/22/2018 Item #16C3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 C 3
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
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. County Attorney Office County Attorney
2. BCC Office Board of County AS b
Commissioners x0151 3"i)3'6
3. Minutes and Records Clerk of Court's Office },,, ,
Y 523115 l0.39 alik
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 Michael Dowling Phone Number 8743
Contact/ Department /
Agenda Date Item was May 22,2018 / Agenda Item Number 16 C 3
Approved by the BCC ✓✓✓
Type of Document Waiver of Right to File an Application for Number of Original 2
Attached the US Small Business Administration Documents Attached ✓
PO number or account
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? 0 , N/A
2. Does the document need to be sent to another agency for additiona -: es. If yes, N/A
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 n
signed by the Chairman,with the exception of most letters,must be reviewed and signed ' 10.13)
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
5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A
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 MD
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
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_5-22-2018 ,and all changes MD
made during the meeting have been incorporated in the attached document. The a # r o
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
BCC,all changes directed by the BCC have been made,and the document is ready for t # 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
16C 3
V q► P
• ' Memorandum
l 1 '10��1 1AAP
To: Minutes and Records
Clerk to the Board
From: Michael Dowling
Senior Property Management Specialist
Real Property Management
Date: May 22, 2018
Subject: Waiver of Right to File an Application for the US SBA
BCC: May 22, 2018
Item: 16 C 3
Please retain one original for your records and provide me with the other so that
I may provide the SBA with an original document.
Please contact me at extension 8743 with any questions.
Thank you and best regards,
Michael
16C 3
MEMORANDUM
Date: May 23, 2018
To: Michael Dowling, Property Acquisition Specialist
Facilities Management Department
From: Martha Vergara, Sr. Deputy Clerk
Boards Minutes & Records Department
Re: Waiver of Right to File an Application for the
US Small Business Administration (US SBA)
Attached is one (1) original waiver application as referenced above (Item
#16C3), approved by the Board of County Commissioners on Tuesday, May 22,
2018.
The Minutes & Records Department has kept an original agreement for the
Board's Official Records.
If you have any questions, please contact me at 252-7240.
Thank you.
Attachment
16C 3
Borrower: COLLIER COUNTY AGRICULTURAL FAIR&EXPOSITION, INC.
Loan No.: DLB 2263107001
WAIVER OF RIGHT TO FILE AN APPLICATION
I(We)BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA,with
intent
to be legally bound, declare that I(we)am an(are) owner(s) of the real tai-
property
located at: 751 39TH AVE NE,NAPLES, FL 34120.
I(We) hereby waive all rights which I(We)may have to file an application for a Disaster Loan
from the U.S. Small Business Administration, or receive such a loan in my(our)name(s),to repair
or replace the above described property as the result of damaged caused by the Hurricane Irma
disaster. The real property located at 751 39TH AVE NE,NAPLES, FL 34120 shall not be used as
security for Loan No.: DLB 2263107001 or otherwise used in any way that would give a right to a
claim of lien on the real property.
Dated: March 31, 2018
BOARD OF COUNTY 0 ISSION ' " ')F COLLIER
NI\ COUNTY, FLORID
STATE OF
)ss.
COUNTY OF ) By:
ANDY SOLIS, CHAIRMAN
A Notary Public''and for said County and State,do
hereby certify that
personally appeared before me this date and
acknowledged that they signed,delivered and executed
the foregoing instrument. ATTEST:
Witness my hand and notarial seal this the DWIGI-1T:E' ROCt<,Clerk
Approved as to form and legality 6
1140/
Attest
Signature as to Chairmanonly 's;
1Ck_ ,)
A Writ County Atu►"►,� .