Backup Documents 07/10/2018 Item #16E 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO I 6 E 1
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 routin: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 JAB 79ti98-
4. BCC Office Board of County
Commissioners t4�/
� y\n\V'
5. Minutes and Records Clerk of Court's Office
r\jitt) iirl 1 Ic6 iD:274)74
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 Ofeila Tallon Compensation 239-252-8715
Contact/Department Manager, Human
Resources
Agenda Date Item was 7/10/18 Agenda Item Number 16E1
Approved by the BCC
Type of Document 1 Resolution Number of Original T
Attached /a — 12--2.-'' Documents Attached C ir%r.____)
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 signatuSTAMP OK signatu --1-Air
Does the document need to be sent to another agency for aitional signatures? If yes, NA
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 JAB
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 NA
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 JAB
document or the fmal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's JAB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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 7/10/18 and all changes made during the JAB
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 JAB
BCC,all changes directed by the BCC have been made,and the document is ready fo the
Chairman's signature. f (z:4-}-17‘
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
16E 1
RESOLUTION NO. 2018 - 12 2
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, AUTHORIZING ITS CHAIR TO
EXECUTE INTERLOCAL AGREEMENTS WITH LOCAL
GOVERNMENTS, INDEPENDENT FIRE DISTRICTS AND OTHER
FIRST RESPONDER AGENCIES FOR RE-FUELING DURING
WILDFIRES WITHOUT FURTHER BOARD ACTION.
WHEREAS, the Board of County Commissioners (Board) serves as the provider of fuel
of last resort on the site of wildfires; and
WHEREAS, the attached standard form Interlocal Agreement for Re-fueling establishes a
mechanism and protocol to assure timely payment is made to Collier County for fuel used; and
WHEREAS, it is anticipated that local governments, independent fire districts and other
first responder agencies will be users of such fuel; and
WHEREAS, it is in the public's interest and to the public's benefit if the Board of County
Commissioners authorizes its Chair to administratively execute Interlocal Agreements for Re-
fueling as they are brought forward by Staff and approved by the County Attorney's Office for
form and legality without further Board approval or action after execution by first responder
agencies.
NOW, THEREFORE BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS, COLLIER COUNTY, FLORIDA, that:
1. The above recitals are adopted by the Board as being true and accurate and as such, are
hereby incorporated herein as if fully set out in in this Paragraph.
2. Its Chair is authorized to administratively execute Interlocal Agreements for Re-fueling
in substantially the form attached hereto as Exhibit "A" as they are brought forward by
Staff and approved by the County Attorney's Office for form and legality without further
Board approval or action after execution by first responder agencies.
1
0
16E I
THIS RESOLUTION ADOPTED after motion, second, and majority vote favoring
same this - day of Av\ , 2018.
ATTEST: CRYST K KINZEL, BOARD OF C• TY COMMISSIONERS
INTERtIM Cutix COLLIER UN ' , FLOR
BY� . r... B
�i y..
' A
Dep ty' ' ler- Andy Solis,Chairman
Attest as to Chairman's
signature only. -
Approved as to form and legality:
Jenni er A. Belpedio
Assistant County Attorney c4
2
0
1 6 E I
EXHIBIT "A"
STANDARD FORM
INTERLOCAL AGREEMENT FOR RE-FUELING
Between Collier County and
This Agreement for Re-fueling (Agreement) is made and entered into this , day of
, 20 (effective date) by and between Collier County, as the provider of
fuel of last resort, and ("User" or "Agency"), as the user of
fuel on the site of wildfire operations, collectively (the "Parties")
WITNESSETH 4
In consideration of these premises, the sum of Ten Dollars ($10.00), and other good and
valuable consideration, the receipt and sufficiency of which is hereby mutually acknowledged, it
is agreed by and between the Parties as follows:
1. This Agreement is entered into pursuant to the provisions of the Florida Interlocal
Cooperation Act of 1969, set forth in §163,01'
et seq.,Fla. Stat.,and is further authorized pursuant
to the parties' respective home rule powers"or other powers granted by the Florida Constitution or
general law.
2. Collier County shall lige a provider of fuel of last resort. User should make a good faith
effort to establish''commercial accounts to meet the needs"�of their jurisdiction as well as those of
incoming mutual-aid resources assisting the respective Independent Fire Districts.
z
3. Request for emergency refueling by Collier County shall be reported to the Collier County
Director of Emergency Management or designee. Request for Emergency Management assistance
after hours shall be made through the Collier County Sheriffs Office 911 Center. The Director of
Emergency Management or designee will evaluate the request and make contact with Collier
County's Fleet Management for deployment.
4. User is required to submit an open purchase order to Collier County's Department of
Emergency Management on March Pt annually of each year for fuel expenses against which fuel
expenses will be invoiced. The amount of the Purchase Order may be minimal, for example
$10.00, to provide a placeholder for an undeterminable future event.
5. Collier County will only charge for fuel at its wholesale or governmental entity cost.
Collier County will not charge for the services of the re-fueling vehicle or its operator. Fuel will
be commercial grade "regular unleaded" fuel as well as "red-dye" diesel.
1
E
6. In all cases the User, as the authority having jurisdiction, will be responsible for all costs
including those of its respective local district assets and resources as well as those costs associated
with all mutual aid resources assisting that authority having jurisdiction. No billing will be
conducted by Collier County to the in-county or out of county mutual aid organizations. Collier
County will not seek Fire Management Assistance Grants or the Stafford Act under the Federal
Emergency Management Agency's guidance and eligibility for reimbursement of future fuel
purchases except on behalf of Collier County owned assets. Terms are net 30 days to the
jurisdiction requesting re-fueling supplies and delivery resources.
7. Each User shall provide from the requesting fire department an officer at the re-fueling site
to co-sign each stamped fuel ticket and compile a corresponding fuel log, co-signed by either the
County fuel truck operator or a member of County Emergency Management staff. An invoice will
be generated from said stamped tickets and sent to the requesting fire department for payment in
full against the Purchase Order on file. Terms are net 30 days Sample Fuel Ticket and Sample
Fuel Log are attached. •
8. Should Collier County acquire the electronic capability to accept another governmental
agencies Purchasing Card, those services may be utilized as long as Collier County is not charged
any handling or fee charges for the use of such Purchasing Cards, Pump stamped tickets and a
corresponding fuel log as described above are still required. An invoice will be generated from
said stamped tickets and sent to the requesting fire department for both in-county and out-of-
county mutual aid resources without challenge with payment in full against the Purchase Order on
file. Terms are net 30 days.
9. Collier County may elect at its discretion the use of its automated pump and fuel dispensing
system at fixed sites,by the issuance of certain programmed key fob devices. Should those devices
be used, the Agency using those devices is responsible for payment for fuel dispensed to the
Agency or in-county or out-of-county mutual aid resource, without challenge. Terms are net 30
days.
10. This Agreement shall be valid for a period of three years with (3) one-year automatic
renewals, with a 60-day written notice of termination by either party.
11. If User is an Independent Fire District, rights to this Agreement may be transferred should
User merge or consolidate with a previously named Independent Fire District. However; an annual
purchase order must be submitted for fuel services to be rendered by Collier County.
12. Collier County shall not be liable,under any circumstance,for the failure or delay to deliver
fuel under the terms of this Agreement.
13. User shall indemnify and save harmless Collier County, from any loss or damages User
may suffer as a result of claims,suits,demands,damages,losses,fines,penalties,interest,expenses
2
1 6 E I
costs or judgments, including attorneys' fees and costs of litigation, arising out of User's use of
fuel as set forth in this Agreement.
14. All notices required under this Agreement shall be directed to the following offices:
For the County: Office of the County Manager
3301 East Tamiami Trail
Naples, Florida 34112
For the User:
15. This Agreement is solely for the benefit of the Parties hereto, and their successors in
interest, or assigns, and no right or cause of action shall accrue upon or by reason hereof, to or for
the benefit of any third party not a party hereto.
16. This Agreement shall be governedand construed under the laws of the State of Florida.
The parties further agree that all disputes shall be resolved exclusively in state or federal court in
having jurisdiction over Collier County.
17. This Agreement shall be binding upon the Parties hereto, and their successors and assigns.
18. This Agreement is the entire agreement g between the Parties and contains all the terms
agreed upon. This Agreement may only be changed by a writing signed by both parties. The
County may record this Agreement at its sole cost in the Public Records of Collier County.
IN WITNESS WHEREOF, the Parties have executed this Agreement on the date and
year first above written.
COUNTY:
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA
By: By:
, Deputy Clerk , CHAIRMAN
Approved as to form and legality:
Jennifer A. Belpedio
Assistant County Attorney
3
At
E
SAMPLE FUEL
TICKET 1 ,
BEI
S- „ 1 .1
Event Name .
j .
Authorized By
In . • or Out .. of County.flesource
Task Assignment
. Arrival or Departure •
Sold to : - Date 20
Name
Address
PHONE NO, TRUCK NO: ...
•
TIME ' • A.M. ttl� '" ,Z. • PAID ' . . .
_CHARGE
P.M gCEq� .
DISTRIBUTOR.SALESMAN- RECEIVED PAYMENT.
DELIVERY RECEIVED '
• ``.. _ CUSTOMER'SSIGNATURE
• YOUR SALE NO. , • ( END DELIVERY 110Ti9S
PREVIOUS SALE.NO. F. •START DELIVERY.
GALLONS DELIVERED . i .
i - - .PRODUCT.' 'G U.OMS PRICE. . AMOUNT, •
I I
AUTOMATICALLY-PRINTED. TAXi
•TO INSURE YOU OF ACCURACY - ''1'OTAL i
•INSERT FACEDOWN. " ' • THIS END'.FIRST
#4553 - GAO SOLUTIONS 828429-0640 - l
1. 6 E I
SAMPLE
Collier County Emergency Re-fueling Log
For Offic
Event Page Number
Fueling Team.
Fire Official Emergency Mgmt Rep. Fief
Department Phone: Re-fueling
Date ;Tune ;Agency/Appratus Number BES Ticket# ,Mileage ;Unleaded i Diesel ;License Plate C me
iTotal
APPROVED: NOTES:
`i/
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO G
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 Veki9-tra,
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete h 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 O ice.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office � 'a1k`i
4. BCC Office Board of County VtsNco
Commissioners vway
5. Minutes and Records Clerk of Court's Office
b
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 Phone Number 252-3622
Contact/ Department Kathleen Heinrichsberg
Agenda Date Item was 7/10/18 Agenda Item Number V/
Approved by the BCC 16E1
Type of Document Number of Original 1
Attached City of Naples ILA Documents Attached
PO number or account -tea."`, z Qtrotkooe
number if document is
to be recorded 1t,CeoYaq
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 signatur . STAMP OI KH
2. Does the document need to be sent to another agency for additional signatures? 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 KH
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 NA
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 KH
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
mature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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 7/10/18 and all changes made during 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
BCC,all changes directed by the BCC have been made,and the document is ready for th= p
Chairman's signature. d
RETURN TO KATHLEEN HEINRICHSBERG IN EMERGENCY MANA T
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
16 E I
STANDARD FORM
INTERLOCAL AGREEMENT FOR RE-FUELING
Between Collier County and City of Naples
This Agreement for Re-fueling (Agreement) is made and entered into this 19, day of April
2018 (effective date) by and between Collier County, as the provider of fuel of last resort, and the
City of Naples ("User" or "Agency"), as the user of fuel on the site of wildfire operations,
collectively(the "Parties").
WITNESSETH
In consideration of these premises, the sum of Ten Dollars ($10.00), and other good and
valuable consideration, the receipt and sufficiency of which is hereby mutually acknowledged, it
is agreed by and between the Parties as follows:
I. This Agreement is entered into pursuant to the provisions of the Florida Interlocal
Cooperation Act of 1969, set forth in §163.01,et seq.,Fla. Stat.,and is further authorized pursuant
to the parties' respective home rule powers or other powers granted by the Florida Constitution or
general law.
2. Collier County shall be a provider of fuel of last resort. User should make a good faith
effort to establish commercial accounts to meet the needs of their jurisdiction as well as those of
incoming mutual-aid resources assisting the respective Independent Fire Districts.
3. Request for emergency refueling by Collier County shall be reported to the Collier County
Director of Emergency Management or designee. Request for Emergency Management assistance
after hours shall be made through the Collier County Sheriff's Office 91 I Center. The Director of
Emergency Management or designee will evaluate the request and make contact with Collier
County's Fleet Management for deployment.
4. User is required to submit an open purchase order to Collier County's Department of
Emergency Management on March 1 S`annually of each year for fuel expenses against which fuel
expenses will be invoiced. The amount of the Purchase Order may be minimal, for example
$10.00, to provide a placeholder for an undeterminable future event.
5. Collier County will only charge for fuel at its wholesale or governmental entity cost.
Collier County will not charge for the services of the re-fueling vehicle or its operator. Fuel will
be commercial grade "regular unleaded" fuel as well as"red-dye"diesel.
6. In all cases the User, as the authority having jurisdiction, will be responsible for all costs
including those of its respective local district assets and resources as well as those costs associated
with all mutual aid resources assisting that authority having jurisdiction. No billing will be
conducted by Collier County to the in-county or out of county mutual aid organizations. Collier
INSTR 5595572 OR 5540 PG 350
RECORDED 8/3/2018 4:18 PM PAGES 3
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
REC$27.00
16 E
County will not seek Fire Management Assistance Grants or the Stafford Act under the Federal
Emergency Management Agency's guidance and eligibility for reimbursement of future fuel
purchases except on behalf of Collier County owned assets. Terms are net 30 days to the
jurisdiction requesting re-fueling supplies and delivery resources.
7. Each User shall provide from the requesting fire department an officer at the re-fueling site
to co-sign each stamped fuel ticket and compile a corresponding fuel log, co-signed by either the
County fuel truck operator or a member of County Emergency Management staff. An invoice will
be generated from said stamped tickets and sent to the requesting fire department for payment in
full against the Purchase Order on file. Terms are net 30 days. Sample Fuel Ticket and Sample
Fuel Log are attached.
8. Should Collier County acquire the electronic capability to accept another governmental
agencies Purchasing Card, those services may be utilized as long as Collier County is not charged
any handling or fee charges for the use of such Purchasing Cards. Pump stamped tickets and a
corresponding fuel log as described above are still required. An invoice will be generated from
said stamped tickets and sent to the requesting fire department for both in-county and out-of-
county mutual aid resources without challenge with payment in full against the Purchase Order on
file. Terms are net 30 days.
9. Collier County may elect at its discretion the use of its automated pump and fuel dispensing
system at fixed sites,by the issuance of certain programmed key fob devices. Should those devices
be used, the Agency using those devices is responsible for payment for fuel dispensed to the
Agency or in-county or out-of-county mutual aid resource, without challenge. Terms are net 30
days.
10. This Agreement shall be valid for a period of three years with (3) one-year automatic
renewals, with a 60-day written notice of termination by either party.
11. If User is an Independent Fire District,rights to this Agreement may be transferred should
User merge or consolidate with a previously named Independent Fire District. However;an annual
purchase order must be submitted for fuel services to be rendered by Collier County.
12. Collier County shall not be liable,under any circumstance,for the failure or delay to deliver
fuel under the terms of this Agreement.
13. User shall indemnify and save harmless Collier County, from any loss or damages User
may suffer as a result of claims,suits,demands,damages,losses,fines,penalties,interest,expenses
costs or judgments, including attorneys' fees and costs of litigation, arising out of User's use of
fuel as set forth in this Agreement.
14. All notices required under this Agreement shall be directed to the following offices:
2
16 E I
For the County: Office of the County Manager
3301 East Tamiami Trail
Naples, Florida 34112
For the User: City of Naples
735 8m Street South
Naples, Florida 34102
15. This Agreement is solely for the benefit of the Parties hereto, and their successors in
interest, or assigns, and no right or cause of action shall accrue upon or by reason hereof,to or for
the benefit of any third party not a party hereto.
16. This Agreement shall be governed and construed under the laws of the State of Florida.
The parties further agree that all disputes shall be resolved exclusively in state or federal court in
having jurisdiction over Collier County.
17. This Agreement shall be binding upon the Parties hereto, and their successors and assigns.
18. This Agreement is the entire agreement between the Parties and contains all the terms
agreed upon. This Agreement may only be changed by a writing signed by both parties. The
County may record this Agreement at its sole cost in the Public Records of Collier County.
IN WITNESS WHEREOF, the Parties have executed this Agreement on the date and
year first above written.
COUNTY:
ATTEST: `+•CRYSTAL`K..,KI NZEL, BOARD O O TY COM ' "IINERS
ta. CLERK-, COLLIE CO TY, FLO'� r
• •
By: X0011kj;, By •�
Attest as to airrria 5 E.- ty Oler A Sees , CHAIRMAN
signature only. •
Approved as to form and 1-:.lity:
Jenn r A. Belpedi
Assistant County Atto ey 92 \C->
CITY OF NAPLES Approved as to form and legality:
a/tat/74
By: +� )
A. William Moss,City Manager Robert Pritt, City Attorney
3
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 E .
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. �` W2-4**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is alrealy 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 Attomey Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office JAB $'
4. BCC Office Board of County (;Sb
Commissioners \ A/ --t‘k.c1.\\*q>
5. Minutes and Records Clerk of Court's Office INA/ 1111117 frY-251-PN
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 Ofeila Tallon Phone Number 252-8715
Contact/Department
Agenda Date Item was 7/10/18 ,r= Agenda Item Number 16-E-1
Approved by the BCC
Type of Document Re-Fueling Interlocal—Pursuant to Number of Original
Attached Resolution 2018-122 \,,,a)- \ke- Documents Attached z,
PO number or account n/a
number if document is
I 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 JAB
2. Does the document need to be sent to another agency for additional signatures? If yes, JAB
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 JAB
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 JAB
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 JAB
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 JAB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JAB
should be provided to the County Attorney Office at the time the item is input into
MinuteTraq. 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 7/10/18 and all changes made during the JAB N/Ais not_
meeting have been incorporated in the attached document. The County Attorney's ego tion'for
Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the 4
BCC,all changes directed by the BCC have been made, and the document is ready forth 1 pa •n or
Chairman's signature. . 1
[04-COA-01081/1344830/1]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
16E -„tanavor.‘c, oe 1
Coun`y
p►PR �� STANDARD FORM
INTERLOCAL AGREEMENT FOR RE-FUELING
tv�een Collier County and ,,v%•,,D' Q..A RYdt C:bv ra �1 S4 tc4
This Agreement for Re-fueling (Agreement) is made and entered into this , day of
t\-kpy' , 20 1 (effective date) by and between Collier County, as the provider of
fuel of last resort, andZwr b halon eb btkett Iisiri ftUser" or "Agency"), as the user of
fuel on the site of wildfire operations, collectively(the"Parties").
WITNESSETH
In consideration of these premises, the sum of Ten Dollars ($10.00), and other good and
valuable consideration, the receipt and sufficiency of which is hereby mutually acknowledged, it
is agreed by and between the Parties as follows:
1. This Agreement is entered into pursuant to the provisions of the Florida Interlocal
Cooperation Act of 1969, set forth in §163.01, et seq., Fla. Stat., and is further authorized
pursuant to the parties' respective home rule powers or other powers granted by the Florida
Constitution or general law.
2. Collier County shall be a provider of fuel of last resort. User should make a good faith
effort to establish commercial accounts to meet the needs of their jurisdiction as well as those of
incoming mutual-aid resources assisting the respective Independent Fire Districts.
3. Request for emergency refueling by Collier County shall be reported to the Collier
County Director of Emergency Management or designee. Request for Emergency Management
assistance after hours shall be made through the Collier County Sheriff's Office 911 Center. The
Director of Emergency Management or designee will evaluate the request and make contact with
Collier County's Fleet Management for deployment.
4. User is required to submit an open purchase order to Collier County's Department of
Emergency Management on March 1st annually of each year for fuel expenses against which fuel
expenses will be invoiced. The amount of the Purchase Order may be minimal, for example
$10.00, to provide a placeholder for an undeterminable future event.
5. Collier County will only charge for fuel at its wholesale or governmental entity cost.
Collier County will not charge for the services of the re-fueling vehicle or its operator. Fuel will
be commercial grade "regular unleaded" fuel as well as "red-dye"diesel.
6. In all cases the User, as the authority having jurisdiction, will be responsible for
all costs including those of its respective local district assets and resources as well as those costs
INSTR 5602917 OR 5545 PG 1618
RECORDED 8/22/2018 8:43 AM PAGES 5
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
REC$44 00
1 6 E 1
14. All notices required under this Agreement shall be directed to the following offices:
For the County: Office of the County Manager
3301 East Tamiami Trail
Naples, Florida 34112 ,, '9k_pp
For the User: Z''Mak�� Firt C.6 r.` -bisktira-
50141./.. tkt- siLd G..
�w►Moko►`.e,e !-L 34442,
15. This Agreement is solely for the benefit of the Parties hereto, and their successors in
interest, or assigns, and no right or cause of action shall accrue upon or by reason hereof, to or
for the benefit of any third party not a party hereto.
16. This Agreement shall be governed and construed under the laws of the State of Florida.
The parties further agree that all disputes shall be resolved exclusively in state or federal court in
having jurisdiction over Collier County.
17. This Agreement shall be binding upon the Parties hereto, and their successors and
assigns.
18. This Agreement is the entire agreement between the Parties and contains all the terms
agreed upon. This Agreement may only be changed by a writing signed by both parties. The
County may record this Agreement at its sole cost in the Public Records of Collier County.
IN WITNESS WHEREOF, the Parties have executed this Agreement on the date and
year first above written.
COUNTY:
Immokalee Fire Control District
ATTEST:
By: ,,, � _ By:
Attest as t, C airman' �'
pep, ty �' , C4AI1VN
signature only,
Approved as to fo .nd legality:
BOARD OF • COMMIS '•►' ••
COLLIER 0 ' ', I: oat
Jenn - A. e pedio 11111
Assistant County Attorney BY: A
ANDY SOLIS, CHAIRMAN
3
SAMPLE FUEL TICKET 16E
•
BES- 8851
I Event Name -
I. Authorized By.
In or.Out___:.of Corn fy Resource
�.. Task Assignment..
Arrival or Departure
Sold to late t7
Name
Address
• EV"r
I
A.IA ��CE; • , •
DISTRIBUTORSALESMAN.. RECEIVEQpAYMENT. ..
DELIVERY RECEIVED
`\, CusrOmeR'S•sOP 'JRE
YOUR-SALE NO. . ENO DELIVERY GOTHS,
t START PELNERY 1
I ,:'_PREVIC�U'9$AIEJdO... r .
1 GALLONS DEUVEREA '• •, • • r
GfLLONS PRICE.' WOUNT
II . i
T' f
AUTOMATICALLY P.RiNTED '. _ '
••TO INSURE YOU OR ACCURACY 1tOTAL i
1r
_ INSERT'FACEDOWN '! '". CHIS END FIRST
f 4553 : ONG SO4Ur1ONS 828429.0640 .
SAMPLE 1 6 E
Collier County Emergency Re-fueling Log
For OfflG
Event Page Number
Fueling Team.
Fire Official Emergency Mgmt Rep. Flet
Department Phone: Re-fueling.
Date jTunc, lAgency/Appratus;Number: BES Ticket t _`Mileage - `Unleaded 1Diesel • #lacense..PlateCosnnies
APPROVED: NOTES:
0
1 6 E
STANDARD FORM
INTERLOCAL AGREEMENT FOR RE-FUELING
Between Collier County and North Collier Fire Control and Rescue District
This Agreement for Re-fueling (Agreement) is made and entered into this JL, day of
April , 20 18 (effective date) by and between Collier County, as the provider of fuel of last
resort, and North Collier Fire Control and Rescue District ("User" or "Agency"), as the user of
fuel on the site of wildfire operations, collectively (the"Parties").
WITNESSETH
In consideration of these premises, the sum of Ten Dollars ($10.00), and other good and
valuable consideration, the receipt and sufficiency of which is hereby mutually acknowledged, it
is agreed by and between the Parties as follows:
1. This Agreement is entered into pursuant to the provisions of the Florida Interlocal
Cooperation Act of 1969, set forth in §163.01,et seq., Fla. Stat.,and is further authorized pursuant
to the parties' respective home rule powers or other powers granted by the Florida Constitution or
general law.
2. Collier County shall be a provider of fuel of last resort. User should make a good faith
effort to establish commercial accounts to meet the needs of their jurisdiction as well as those of
incoming mutual-aid resources assisting the respective Independent Fire Districts.
3. Request for emergency refueling by Collier County shall be reported to the Collier County
Director of Emergency Management or designee. Request for Emergency Management assistance
after hours shall be made through the Collier County Sheriff's Office 911 Center. The Director of
Emergency Management or designee will evaluate the request and make contact with Collier
County's Fleet Management for deployment.
4. User is required to submit an open purchase order to Collier County's Department of
Emergency Management on March lannually of each year for fuel expenses against which fuel
expenses will be invoiced. The amount of the Purchase Order may be minimal, for example
$10.00, to provide a placeholder for an undeterminable future event.
5. Collier County will only charge for fuel at its wholesale or governmental entity cost.
Collier County will not charge for the services of the re-fueling vehicle or its operator. Fuel will
be commercial grade"regular unleaded" fuel as well as"red-dye"diesel.
6. In all cases the User, as the authority having jurisdiction, will be responsible for all costs
including those of its respective local district assets and resources as well as those costs associated
INSTR 5602926 OR 5545 PG 1655
RECORDED 8/22/2018 8 47 AM PAGES 6
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
REC$52.50
16E1
with all mutual aid resources assisting that authority having jurisdiction. No billing will be
conducted by Collier County to the in-county or out of county mutual aid organizations. Collier
County will not seek Fire Management Assistance Grants or the Stafford Act under the Federal
Emergency Management Agency's guidance and eligibility for reimbursement of future fuel
purchases except on behalf of Collier County owned assets. Terms are net 30 days to the
jurisdiction requesting re-fueling supplies and delivery resources.
7. Each User shall provide from the requesting fire department an officer at the re-fueling site
to co-sign each stamped fuel ticket and compile a corresponding fuel log, co-signed by either the
County fuel truck operator or a member of County Emergency Management staff. An invoice will
be generated from said stamped tickets and sent to the requesting fire department for payment in
full against the Purchase Order on file. Terms are net 30 days. Sample Fuel Ticket and Sample
Fuel Log are attached.
8. Should Collier County acquire the electronic capability to accept another governmental
agencies Purchasing Card,those services may be utilized as long as Collier County is not charged
any handling or fee charges for the use of such Purchasing Cards. Pump stamped tickets and a
corresponding fuel log as described above are still required. An invoice will be generated from
said stamped tickets and sent to the requesting fire department for both in-county and out-of-
county mutual aid resources without challenge with payment in full against the Purchase Order on
file. Terms are net 30 days.
9. Collier County may elect at its discretion the use of its automated pump and fuel dispensing
system at fixed sites,by the issuance of certain programmed key fob devices. Should those devices
be used, the Agency using those devices is responsible for payment for fuel dispensed to the
Agency or in-county or out-of-county mutual aid resource, without challenge. Terms are net 30
days.
10. This Agreement shall be valid for a period of three years with (3) one-year automatic
renewals, with a 60-day written notice of termination by either party.
1 I If User is an independent Fire District, rights to this Agreement may be transferred should
User merge or consolidate with a previously named independent Fire District. However;an annual
purchase order must be submitted for fuel services to be rendered by Collier County.
12. Collier County shall not be liable, under any circumstance, for the failure or delay to deliver
fuel under the terms of this Agreement.
13. User shall indemnify and save harmless Collier County, from any loss or damages User
may suffer as a result of claims,suits,demands,damages,losses, fines,penalties, interest,expenses
costs or judgments, including attorneys' fees and costs of litigation, arising out of User's use of
fuel as set forth in this Agreement.
2
16E 1
14. All notices required under this Agreement shall be directed to the following offices:
For the County: Office of the County Manager
3301 East Tamiami Trail
Naples, Florida 34112
For the User: North Collier Fire Control and Rescue District
Attn: Fire Chief
1885 Veterans Park Drive
Naples, Fl_, 34109
15. This Agreement is solely for the benefit of the Parties hereto, and their successors in
interest,or assigns, and no right or cause of action shall accrue upon or by reason hereof, to or for
the benefit of any third party not a party hereto.
16. This Agreement shall be governed and construed under the laws of the State of Florida.
The parties further agree that all disputes shall be resolved exclusively in state or federal court in
having jurisdiction over Collier County.
I 7. This Agreement shall be binding upon the Parties hereto, and their successors and assigns.
18. This Agreement is the entire agreement between the Parties and contains all the terms
agreed upon. This Agreement may only be changed by a writing signed by both parties. The
County may record this Agreement at its sole cost in the Public Records of Collier County.
IN WITNESS WHEREOF, the Parties have executed this Agreement on the date and
year first above written.
COUNTY:
CRYSTAL k..,KINZEL,
ATTEST: BOARD OF C TY COMMIS •NIRS
�ITER[M CLERK .
COLLIER it UN ['LORI►
,f
By. 190 'I By:
Attest as o a► >DTu,, gl5 Andy Solis, Chairman
signature only.
Approved as to form and le' ty:
Jennifer A. Belpedio
Assistant County Atto q.\�
Ar`
3
0
1 6 E I
NORTH COLLIER FIRE.CONTROL AND RESCUE DISTRICT:
CHAIRMAN
.M r
J. Christopher Lombardo
Printed Name
4
0
SAMPLE FUEL TICKET 1 6E
1
BES 435.
j Event Name
Authorized By
In :: or Out _T •sof County Resource
Task Assignment
'Arrival or Departure
Sold to .: • bate** ;
Name
1. Address
•
PHONE NO, .: :TRUCK NO•.
l. 'TIME . • A:� ��,. �4 - .
DISTRIBLITOR'SALESMAN" � RECEIVED PAYMENT• .
DELIVERY RECEIVED•
`"‹ CUSTOMER'S SIGNAPJRE .
YOUR-SALE NGf -EN)DELIVERY: :E•SALE:NO... I. START DELIVERY
.PRODUCT'.' ::'GAU.ON PRS• AMOU r:"•,.
•
p 1
AUTOMATICALLY PRINTED , TAXy '
:TO INSURE VOU OF ACCURACY - TOTAL
INSERT FACE• OWN.: - ' T111S:END FIRS •
Y a353' :: GNC SOLUT1DNS 828429.0640
•
SAMPLE
Collier County Emergency Re-fueling Log
Toc offic
Event Page Number
Fueling Team
Fire Official Emergency Mgmt Rep. Flet
Department Phone: Re-fueling
Date.: . :. ;-.Tii e., . :� :enaA iatua•Numbe% +.jSE Ticket#":.`Ivtilea.e t nleaded. ... :,jD�ese1; . .. aense:PllYe'._, Comtuel
•
•
•
Tot-4•V;::•::.• •• : t _
APPROVED: NOTES:
020
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
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 €' { iYi Si1:2
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is alread plate with the
exception of the Chairman's signature,draw a line through routinlines#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
4. BCC Office Board of County
Commissioners � /S/ .8r" Zo'
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 Phone Number 252-3622
Contact/ Department Kathleen Heinrichsberg
Agenda Date Item was 7/10/18 Agenda Item Number
Approved by the BCC 16E1
Type of Document Number of Original 1
Attached City of Marco Island ILA 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?STAMP OK KH
2. Does the document need to be sent to another agency for additional signatures? 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 KH
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 NA
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 KH
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 NA
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 7/10/18 and all changes made during 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
BCC,all changes directed by the BCC have been made,and the document is ready for the '
Chairman's signature. �J
RETURN TO KATHLEEN HEINRICHSBERG IN EMERGENCY MANAN(.7 '► I'
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 ‘C::)�
16E I
HeinrichsbergKathy
From: BelpedioJennifer
Sent: Wednesday, July 11, 2018 10:52 AM
To: HeinrichsbergKathy
Cc: SummersDan; NeetVirginia; HayesJessica
Subject: Item 16E1 -Refueling
Kathy,
I routed the refueling resolution and also the agreement with Immokalee Fire Control District. As you receive
agreements,they may be routed for Chairman signature without further Board action if the template on the
resolution is used.
I am starting vacation tomorrow and returning to the office on Tuesday, July 17`h. If you have any questions
about routing contact Dinny or Jessica at CAO.
For legal questions, contact Jeff and he will either assist or assign an attorney.
Regards,
Je,vt.vt,{,f ge r A. 6elpeol i,o-
Assistant County Attorney
Collier County, Florida
Direct Dial: (239)252-8194
Under Florida Law, e-mail addresses are public records. If you do not want your e-mail address released in response to a
public records request, do not send electronic mail to this entity. Instead, contact this office by telephone or in writing.
1
INSTR 5602912 OR 5545 PG 1571
RECORDED 8/22/2018 8:40 AM PAGES 6
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
REC$52 50
1 6 E
EXHIBIT"A"
STANDARD FORM
INTERLOCAL AGREEMENT FOR RE-FUELING
Between Collier County and City of Marco Island
This Agreement for Re-fueling (Agreement)is made and entered into this 18th, day of June
2018(effective date)by and between Collier County,as the provider of fuel of last resort,and City
of Marco Island ("User" or "Agency"), as the user of fuel on the site of wildfire operations,
collectively(the"Parties").
WITNESSETH
In consideration of these premises, the sum of Ten Dollars ($10.00), and other good and
valuable consideration,the receipt and sufficiency of which is hereby mutually acknowledged,it
is agreed by and between the Parties as follows:
1. This Agreement is entered into pursuant to the provisions of the Florida Interlocal
Cooperation Act of 1969,set forth in§163.01,et seq.,Fla. Stat.,and is further authorized pursuant
to the parties'respective home rule powers or other powers granted by the Florida Constitution or
general law. 1
2. Collier County shall be a provider of fuel of last resort. User should make a good faith
effort to establish commercial accounts to meet the needs of their jurisdiction as well as those of
incoming mutual-aid resources assisting the respective Independent Fire Districts.
3. Request for emergency refueling by Collier County shall be reported to the Collier County
Director of Emergency Management or designee. Request for Emergency Management assistance
after hours shall be made through the Collier County Sheriff's Office 911 Center. The Director of
Emergency Management or designee will evaluate the request and make contact with Collier
County's Fleet Management for deployment
4. User is required to submit an open purchase order to Collier County's Department of
Emergency Management on March 1St annually of each year for fuel expenses against which fuel
expenses will be invoiced. The amount of the Purchase Order may be minimal, for example
$10.00,to provide a placeholder for an undeterminable future event.
5. Collier County will only charge for fuel at its wholesale or governmental entity cost.
Collier County will not charge for the services of the re-fueling vehicle or its operator. Fuel will
be commercial grade"regular unleaded"fuel as well as"red-dye"diesel.
1
1 6 E
6. In all cases the User,as the authority having jurisdiction,will be responsible for all costs
including those of its respective local district assets and resources as well as those costs associated
with all mutual aid resources assisting that authority having jurisdiction. No billing will be
conducted by Collier County to the in-county or out of county mutual aid organizations. Collier
County will not seek Fire Management Assistance Grants or the Stafford Act under the Federal
Emergency Management Agency's guidance and eligibility for reimbursement of future fuel
purchases except on behalf of Collier County owned assets. Terms are net 30 days to the
jurisdiction requesting re-fueling supplies and delivery resources.
7. Each User shall provide from the requesting fire department an officer at the re-fueling site
to co-sign each stamped fuel ticket and compile a corresponding fuel log, co-signed by either the
County fuel truck operator or a member of County Emergency Management staff. An invoice will
be generated from said stamped tickets and sent to the requesting fire department for payment in
full against the Purchase Order on file.Terms are net 30 days.
8. Should Collier County acquire the electronic capability to accept another governmental
agencies Purchasing Card,those services may be utilized as long as Collier County is not charged
any handling or fee charges for the use of such Purchasing Cards. Pump stamped tickets and a
corresponding fuel log as described above are still required. An invoice will be generated from
said stamped tickets and sent to the requesting fire department for both in-county and out-of-
county
mutual aid resources without challenge with payment in full against the Purchase Order on
file. Terms are net 30 days.
9. Collier County may elect at its discretion the use of its automated pump and fuel dispensing
system at fixed sites,by the issuance of certain programmed key fob devices. Should those devices
be used, the Agency using those devices is responsible for payment for fuel dispensed to the
Agency or in-county or out-of-county mutual aid resource, without challenge. Terms are net 30
days.
10. This Agreement shall be valid for a period of three years with (3) one-year automatic
renewals,with a 60-day written notice of termination by either party.
11. If User is an Independent Fire District,rights to this Agreement may be transferred should
User merge or consolidate with a previously named Independent Fire District. However;an annual
purchase order must be submitted for fuel services to be rendered by Collier County.
12. Collier County shall not be liable,under any circumstance,for the failure or delay to deliver
fuel under the terms of this Agreement.
13. User shall indemnify and save harmless Collier County, from any loss or damages User
may suffer as a result of claims,suits,demands,damages,losses,fines,penalties,interest,expenses
2
1
16E I
costs or judgments, including attorneys' fees and costs of litigation, arising out of User's use of
fuel as set forth in this Agreement.
14. All notices required under this Agreement shall be directed to the following offices:
For the County: Office of the County Manager
3301 East Tamiami Trail
Naples, Florida 34112
For the User: City of Marco Island
50 Bald Eagle Drive
Marco Island,Fl 34145
I
15. This Agreement is solely for the benefit of the Parties hereto, and their successors in
interest,or assigns,and no right or cause of action shall accrue upon or by reason hereof,to or for
the benefit of any third party not a party hereto.
i
16. This Agreement shall be governed and construed under the laws of the State of Florida.
The parties further agree that all disputes shall be resolved exclusively in state or federal court in s
having jurisdiction over Collier County.
17. This Agreement shall be binding upon the Parties hereto,and their successors and assigns.
i
18, This Agreement is the entire agreement between the Parties and contains all the terms
agreed upon. This Agreement may only be changed by a writing signed by both parties, The
County may record this Agreement at its sole cost in the Public Records of Collier County.
IN WITNESS WHEREOF, the Parties have executed this Agreement on the date and
year first above written.
COUNTY:
Attest: BOARD OF 0 04 CO : 4'41* ERS l
Crystal. K. Kinzel, Clerk COLLIE' 0 ►' ,FLO'
l
L 0 ' AwA"
B :
1
Attest as to Chairman r'' , ` ,,,4 ,� y SO1 S >CHAIRMANSig' Qiprov'6d as to form and legality: ,.
\` 1
Jenn-1 A. Belpedia_ 40 �_ \
rn �
Assistant County Atto -y
1 i
i
i
3
I
3
6E 1
CITY OF MARCO ISLAND
ii
ATTEST: CITY OF MARCO LLAND {{I
i
hi<
By.
Laura M.Litzan ' 'ty Clerk dare} rifon' Chai an
Approved as to form and legal sufficiency:
I
Alan L.Gabriel,City Attorney
4
16E1
BES- 8851
Event Name
Authorized By
In or Out of County Resource
Task Assignment
Arrival or Depeutwe
Sold to Date
Name
Address Address
PIONS NO l MEDI MO
II 01
TOO A.M. r 0 AP s
R. P AO COIR NK
4cso.
Down=WAWA Is
ATolMT O Mrrorr
aILnlaY WOAD
cu roausvolan.s
.auN`IALE Na I DO NOW(
P! MUS SALIM I MAT 011LAIIM
PriCOVelr GOuow - Mita , 'MOLYIT-
t i
.
.
• S
Y '
AUTOMATICALLY PANTED TAX
10 WWI!YOU CIF ACCURACY TOTAL.
NOWT FAC!DOWN 'i' THIS END FIRST
r+ CNC IouA10NO
16E i
.,.....
Collier County Emergency Re-fueling Log
OrOillo AT•011y
Gant Page Nandrr Date
fowl Ther
Fueling Teasel
file Meld _ tnn/mly Neat Pep hat Operator
Deportment Phar: Itis dielWolia W
:ser rUr rlawtlytAstya•Mlaaar ilrtildwe ++oleos. .molal Db.d tkr•otlloo (arwe.., Woolealde Tooitidlie
r-- .__.-�.._...__ .... �......_............—......,..._.... ..,__.........�_..._.._�__ .}_,._._. ...,.__. .—.�.-
Teed .
aid
APPROVED.
ta=1
Under Florida Law,e-mail addresses ars public records.If you do not want your to-mall address released in response to a public records request,do not send
electronic mail to this entity.Instead,contact this office by tatephone or in writing.