Backup Documents 06/12/2018 Item #16F5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
��j TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 b F 5
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 1.1'k It‹., / ,
�t2-tl
4. BCC Office Board of County
Commissioners / / 44\`clO
5. Minutes and Records Clerk of Court's Office (0(Plitt) Sip''
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 0 Phone Number
Contact/ Department
Agenda Date Item was Agenda Item Number ff
Approved by the BCC (o\A)1\% b, • S
Type of Document ' Number of Original
Attached J cc_ .:-;�F N Documents Attached
PO number or account
number if document is t oi _ `-� G _ f(y
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Ap e li ableolumn, whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairma s original signature?
2. Does the document need to be sent to a e er agency for add' • al signatures? If yes,
provide the Contact Information(Name; Agenc , • .n -ss; Phone)on an attached sheet.
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 9Z c
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
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.
7. In most cases(some contracts are an exception),the original document and this routing slip
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 (enter date)and all changes made
during the meeting have been incorporated in the attached document. The County 0
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 •
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
16F5
MEMORANDUM
Date: June 25, 2018
To: Paula Fleischman, Impact Fee Coordinator
Business Management & Budget, CDES
From: Teresa Cannon, Sr. Deputy Clerk
Minutes & Records Department
Re: Collier County Impact Fees Charitable Organization Impact Fee
Deferral Program Agreement w/Neighborhood Health Clinic, Inc.
Enclosed please find a copy of the document referenced above (Agenda Item #16F5),
approved by the Board of County Commissioners on Tuesday, June 12, 2018.
The Minutes & Records Department has retained the original as part of the Board's
Official Records.
If you have any questions, please contact me at 239-252-8411.
Thank you.
Enclosure
Enclosure
16F5
MEMORANDUM
Date: June 25, 2018
To: Leslie Lascheild, CEO
Neighborhood Health Clinic, Inc.
From: Teresa Cannon, Sr. Deputy Clerk
Minutes & Records Department
Re: Collier County Impact Fees Charitable Organization Impact Fee
Deferral Program Agreement w/Neighborhood Health Clinic, Inc.
Enclosed please find a copy of the document referenced above (Agenda Item #16F5),
approved by the Board of County Commissioners on Tuesday, June 12, 2018.
The Minutes & Records Department has retained the original as part of the Board's
Official Records.
If you have any questions, please contact me at 239-252-8411.
Thank you.
Enclosure
Enclosure
16F5
INSTR 5572579 OR 5522 PG 2440
RECORDED
CLERK OF THE6/18/2018 CIRCUIT11:00 COURTAM ANDPAGES CO8
MPTROLL ER
Prepared by: COLLIER COUNTY FLORIDA
REC$69.50
Jeffrey A.Klatzkow
Collier County Att'y.
3301 Tamiami Trail East
Naples,FL 34112
This space for recording
AGREEMENT FOR DEFERRAL OF COLLIER COUNTY IMPACT FEES
CHARITABLE ORGANIZATION IMPACT FEE DEFERRAL PROGRAM
This Agreement for the Deferral of Impact Fees is entered into this j 4, day of
, 2018, by and between Collier County, a political subdivision of the State of
Florida, through its Board of County Commissioners, hereinafter referred to as "County," and
Neighborhood Health Clinic, Incorporated, hereinafter referred to as "Charitable Entity,"
collectively referred to as the "Parties."
RECITALS:
WHEREAS, Sec. 74-203(i) of the Collier County Consolidated Impact Fee Ordinance, as
amended, provides for deferrals of impact fees for qualified charitable organizations and
charitable trusts (hereinafter referred to as the "Charitable Organization Impact Fee Deferral
Program"); and
WHEREAS, Charitable Entity has applied for a deferral of $100,000 in impact fees as
authorized by the Charitable Organization Impact Fee Deferral Program. A copy of this request
is on file in the Impact Fee Administrator's office; and
WHEREAS, the County Manager, or his designee, has reviewed the Charitable Entity's
request and has found that it complies with the requirements for deferral of impact fees as
outlined in the Charitable Organization Impact Fee Deferral Program; and
WHEREAS, by signing this Agreement, the County hereby approves a deferral of impact
fees subject to the conditions set forth herein.
NOW, THEREFORE, in consideration of the foregoing Recitals, and other good and
valuable consideration, the receipt and sufficiency of which is hereby mutually acknowledged,
the Parties covenant and agree as follows:
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16F5
1. The foregoing Recitals are true and correct and are incorporated by reference herein.
2. The address and legal description of the property which is the subject of this impact
fee deferral (hereinafter referred to as the "Subject Property") is attached as Exhibit "A."
3. The County hereby defers the sum of $100,000 in impact fees, which Charitable
Entity acknowledges would be otherwise due and owing. These deferred impact fees are
itemized in Exhibit"B."
4. These impact fees will be deferred for a period of ten years from the date of this
agreement, so long as the Charitable Entity utilizes the Subject Premises in the manner set forth
in the request. Should this stated use end for any reason whatsoever, or should the Charitable
Entity lose its status which qualified it for eligibility under the Charitable Organization Impact
Fee Deferral Program, then this deferral period will end, and the deferred impact fees will be due
and owing. Charitable Entity shall provide County within 30 days of written request with proof
of its continued eligible status on request, failing which County may terminate this deferral.
6. This Agreement is personal to the Charitable Entity, and as such, this Agreement may
not be assigned or otherwise transferred to anyone without County's prior written consent, which
consent may be freely withheld.
7. This Agreement and the deferral of impact fees will constitute a lien on the Subject
Property, which lien may be foreclosed upon in the event of non-compliance with the
requirements of this Agreement
8. Except as otherwise provided herein, this Agreement shall only be amended by
mutual written consent of the parties hereto or by their successors in interest. All notices and
other communications required or permitted hereunder shall be in writing and shall be sent by
Certified Mail, return receipt requested, or by a nationally recognized overnight delivery service,
and addressed as follows:
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16 F5
To County: To Charitable Entity:
Collier County Neighborhood Health Clinic, Inc.
Capital Project Planning, Impact Fees, and 121 Goodlette Road North
Program Management Division Naples, Florida 34102
Growth Management Department Attn: Leslie Lascheid,
2685 Horseshoe Drive South Chief Executive Officer
Naples, Florida 34104
Attn: Amy Patterson, Director
Notice shall be deemed to have been given on the next successive business day to the date of
the courier way bill if sent by nationally recognized overnight delivery service.
13. This Agreement shall be recorded by the County in the Official Records of Collier
County, Florida, within fourteen (14) days after the County enters into this Agreement. The
County shall provide a copy of the recorded document to Charitable Entity upon request.
14. In the event of a dispute under this Agreement, the parties shall first use the
County's then-current Alternative Dispute Resolution Procedure. Following the conclusion of
this procedure, either party may file an action for relief in the Circuit Court of Collier County to
enforce the terms of this Agreement, which shall be the sole venue for any such disputes.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
SIGNATURE PAGE TO FOLLOW
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16F5
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed
by their appropriate officials, as of the date first above written.
AS TO CHARITABLE ENTITY:
WITNESS: NEIGHBOIHOOD HE TH CL IC, INC.
/14(•0fliAa'e•V By: C �/l G� %
Print Name:L. Na/mss LD Print Name: # 'S//( %scIJ
Print Title: gea
WITNE
w'.AaNd
Print Name: -� - 4&l4- .4 17'jt.4.40
STATE OF FLORIDA
COUNTY OF COLLIER �(�.
The foregoing instrument was acknowledged_before me this (,b " , day of
kefi , , 2018, by US Ii L UOLSOV+ as GC O for Neighborhood Health
Clinic, Incorporated, who is personally known to me or has produced as
identification.
[NOTARIAL SEAL]
S nat re f Notar Publ i - tate f Florida)
""""• CYNTHIA GONZALEZ
1 Y �•., ' Print, Type, or Stamp
4 1 ..�'� Notary Public-State of Florida Commissioned Name of Notary Public)
Commission#�FF 914069
-� �;� My Comm.Expires Nov 15,2019
4 ,,, Bonded through National Notary Assn.
Page 4
1 6 F 5
BOARD OF COUNTY COMMISSIONERS
ATTEST: , - COLLIER CO TY, FLO ' DA
DWIGHT E. BROCK, CLERK
. I
...:..
s Thth, ' C.,Ce-YVWSV----By: iligi . .
-,Dleputy lrl(
Arrest as w unairman's AntrrolisnrAIRMAN
signature only.
A
,_tcrfrorm..
Appre et and legality:
Jeffrey)ik..' 41,atzkow, County Attorney
1
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16F5
EXHIBIT "A"
LEGAL DESCRIPTION OF CHARITABLE ENTITY ADDRESS
Folio # 14360000024
Address: 122 Goodlette-Frank Road North,Naples, Florida 34102
A PARCEL OF LAND LYING IN AND BEING A PART OF THE NORTHWEST 1/4 OF
SECTION 3, TOWNSHIP 50 SOUTH, RANGE 25 EAST, COLLIER COUNTY, FLORIDA,
BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS:
COMMENCING AT THE INTERSECTION OF THE CENTERLINE OF FIRST AVENUE SOUTH
WITH THE SOUTHERLY EXTENSION OF THE EAST LINE OF THE SEABOARD DOWNTOWN
SUBDIVISION, AS RECORDED IN PLAT BOOK 13, PAGES 61 AND 62, PUBLIC
RECORDS OF COLLIER COUNTY; FLORIDA; THENCE ALONG SAID EAST LINE; NORTH
785.02 FEET TO AN INTERSECTION WITH THE EASTERLY EXTENSION OF THE SOUTH
LINE OF FIRST AVENUE NORTH AND THE POINT OF BEGINNING OF THE HEREIN
DESCRIBED LANDS; THENCE CONTINUE NORTH 204.16 FEET TO THE NORTHEAST
CORNER OF LOT 9 OF SAID SEABOARD DOWNTOWN SUBDIVISION; THENCE ALONG
THE NORTH LINE OF SAID LOT 9 AND THE WESTERLY EXTENSION OF SAID NORTH
LINE, WEST 145.00 FEET; THENCE SOUTH 155.86 FEET; THENCE N83'27'09" E
51.85 FEET; THENCE SO6'32'51"E 64.50 FEET TO A POINT ON THE EASTERLY
EXTENSION OF THE SOUTH LINE OF FIRST AVENUE NORTH; THENCE ALONG SAID
EASTERLY EXTENSION, N83'27'09't 86.71 FEET TO THE POINT OF BEGINNING;
TOGETHER WITH AN EASEMENT FOR INGRESS AND EGRESS OVER AND ACROSS THE
FOLLOWING DESCRIBED LANDS:
COMMENCING.AT THE INTERSECTION OF THE CENTERLINE OF FIRST AVENUE SOUTH
WITH THE SOUTHERLY EXTENSION OF THE EAST LINE OF THE SEABOARD DOWNTOWN
SUBDIVISION, AS RECORDED IN PLAT BOOK 13, PAGES 61 AND 62, PUBLIC
RECORDS OF COLLIER COUNTY, FLORIDA; THENCE ALONG SAID EAST LINE NORTH
785.02 FEET TO AN INTERSECTION WITH THE EASTERLY EXTENSION OF THE SOUTH
LINE OF FIRST AVENUE NORTH; THENCE ALONG SAID EASTERLY EXTENSION
S83'27'09"W 86.71 FEET; THENCE NO6'32'S1"W 52.50 FEET TO THE POINT OF
BEGINNING OF THE HEREIN DESCRIBED EASEMENT; THENCE S83'27'09"W 53.22
I-LET; !HENCE NOR IH 12.0/ FEET; THENCE
S83'27'09"W 110.04 FE:ET TO THE EAST LINE OF 12TH STREET NORTH AS
DESCRIBED IN DEED BOOK 22, PAGE 346, PUBLIC RECORDS OF COLLIER COUNTY,
FLORIDA; THENCE ALONG SAID EAST LINE, NO1'38'38'W 20.07 FEET; THENCE
N83'27'09"E 100.56 FEET; THENCE NORTH 166.88 FEET; THENCE EAST 32.56 FEET
TO A POINT ON THE NORTHEASTERLY LINE OF LOT 9 OF SAID SEABOARD
DOWNTOWN SUBDIVISION; THENCE 37.46 FEET ALONG THE ARC OF A CURVE TO
THE RIGHT, HAVING A RADIUS OF 431.24 FEET AND SUBTENDED BY A CHORD
WHICH BEARS S36'47'37"E 37.44 FEET TO THE' SOUTHWEST CORNER OF LOT 4 OF
SAID SEABOARD DOWNTOWN SUBDIVISION; THENCE
WEST 45.00 FEET; THENCE SOUTH 155.86 FEET; THENCE N83'27'09"E 51.85 FEET;
THENCE SO6'32'51 "E 12.00 FEET TO THE POINT OF BEGINNING.
SUBJECT TO AN EASEMENT FOR INGRESS AND EGRESS OVER AND ACROSS THE
WEST 10 FEET THEREOF;
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16F5
Folio #14360000040
Address: 100 Goodlette-Frank Road North,Naples, Florida 34102
A PARCEL OF LAND LYING IN SECTION 3, TOWNSHIP 50 SOUTH, RANGE
25 EAST, COLLIER COUNTY, FLORIDA AND A PORTION OF LOT 5 SEABOARD
DOWNTOWN SUBDIVISION AS RECORDED IN PLAT BOOK 13. PAGE 61 . BEING MORE
PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCING AT THE INTERSECTION OF THE
CENTERLINE OF FIRST AVENUE SOUTH WITH THE SOUTHERLY EXTENSION OF THE
EAST LINE OF THE SEABOARD DOWNTOWN SUBDIVISION. AS RECORDED IN PLAT
BOOK 13 PAGE 62 OF THE PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA:
THENCE NORTH 634.04 FEET ALONG SAID EAST LINE TO AN INTERSECTION WITH A
LINE 150.00 FEET SOUTH AND PARALLEL WITH THE EASTERLY EXTENSION OF THE
SOUTH RIGHT—OF—WAY LINE OF FIRST AVENUE NORTH, SAID POINT BEING THE
POINT OF BEGINNING: THENCE CONTINUE NORTH ALONG SAID EAST LINE 150.98
FEET TO AN INTERSECTION WITH THE EASTERLY EXTENSION OF THE SOUTH
RIGHT—OF—WAY LINE OF FIRST AVENUE NORTH; THENCE SOUTH 83'27'09" WEST
ALONG SAID EASTERLY EXTENSION 254.13 FEET TO AN INTERSECTION WITH THE
EAST RIGHT—OF—WAY LINE OF TWELFTH STREET NORTH. AS RECORDED IN DEED
BOOK 22, PAGE 346 OF THE PUBLIC RECORDS OF COLLIER COUNTY. FLORIDA
THENCE SOUTH 01 '38'38" EAST ALONG SAID EAST RIGHT—OF—WAY LINE 150.55
FEET TO AN INTERSECTION WITH A LINE 150.00 FEET SOUTH END PARALLEL WITH
THE EASTERLY EXTENSION OF THE SOUTH RIGHT—OF—WAY LINE OF FIRST AVENUE
NORTH: THENCE NORTH 83'27'09" EAST ALONG SAID PARALLEL LINE 249.78 FEET
TO THE POINT OF BEGINNING.
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16 F5
EXHIBIT "B"
DEFERRED IMPACT FEE BREAKDOWN
Type of Impact Fee Amount
Road Impact Fee $100,000.00
TOTAL DEFERRED IMPACT FEES $100,000.00
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