Backup Documents 02/12/2013 Item #16A 5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO e-
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATU1 6 A .,
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 JW
z\%z\v3
4. BCC Office Board of County
Commissioners
5. Minutes and Records Clerk of Court's Office —Pm 2 (5fi
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 Jen Baker,Code Enforcement Phone Number 252-2444
Contact/ Department J /
Agenda Date Item was 2/12/13 / Agenda Item Number 16-A-5 ,v/
Approved by the BCC v
Type of Document Releases of Liens Number of Original Two separate
Attached Documents Attached
PO number or account
number if document is t (`r-ag1,‘-1L030
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? JW
2. Does the document need to be sent to another agency for additional signatures? If yes, JW
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 JW
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 JW
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 JW
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 JW
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JW
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 o Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware your deadlines!
8. The document was approved by the BCC on 2/12/13 nd all changes made during the JW
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. .21,3
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
16A5
INSTR 4801222 OR 4887 PG 1534
This Instrument Prepared By: RECORDED 2/18/2013 4:20 PM PAGES 1
Jen Baker DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Code Enforcement Department COLLIER COUNTY FLORIDA
2800 North Horseshoe Drive REC$10.00
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:
Elvis Camacho,
Respondents
The lien was recorded on August 19, 2011 in Official Records Book 4712, Page 460, in
the Official Records of Collier County, State of Florida. The lien secures the principal
sum of Thirteen Thousand one hundred twelve dollars and fifty six cents, plus accrued
interest and penalties, if any, and imposes certain obligations against real property
situated in Collier County, Florida, which property is described as follows:
GOLDEN GATE EST UNIT 29 S 150FT OF TR 12, LESS THE W 45FT
2725 70TH STREET SW, FL
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 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 0 NTY COMMISSIONERS
DWIGHT E0 BROCK, Clerk COLLI-°, lb U TY, FLORIDA
B �• i
y By
Atest -•Vfy Clerk rgia A. Hiller, Esq.,
\�� irwoman
•
Approved as to form and legal sufficiency
Jeff F•ht
Ass nt County Attorney
INSTR 4801223 OR 4887:01:35 This Instrument Prepared By: RECORDED 2/18/2013 4: M PAGES 1
Jen Baker DWGHT EBROKCLE16A5
THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
Code Enforcement Department REC$10.00
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:
Elvis Camacho,
Respondents
The lien was recorded on August 19, 2011 in Official Records Book 4712, Page 466, in
the Official Records of Collier County, State of Florida. The lien secures the principal
sum of Forty Two Thousand eight hundred sixty two dollars and fifty six cents, plus
accrued interest and penalties, if any, and imposes certain obligations against real
property situated in Collier County, Florida, which property is described as follows:
GOLDEN GATE EST UNIT 29 S 150FT OF TR 12, LESS THE W 45FT
2725 70TH STREET SW, FL
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 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 • edi�fi Y COMMISSIONERS
DWIGHT E. BROCK,,Clerk COLL 'i , FLORIDA
0 "
B wf :.� �� '. ® !. C . By
yi i Wig- •uty Clerk e-orgia A. Hiller, Esq.,
1 3 airwoman
Approved as to form and legal sufficiency
•
J- ight
As. ant County Attorney