Backup Documents 04/09/2013 Item #10D ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP n
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO UU 0
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 JAK 4/9/13
4. BCC Office Board of County G1� ■ 1\1
Commissioners k\ 2\\aD
5. Minutes and Records Clerk of Court's Office 7m 4/„-1/` th
PRIMARY CONTACT INFORMATION 1�
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 Jeffrey A. atzkow, County Attorney Phone Number 252-8400
Contact/ Department
Agenda Date Item was 4/9/13 Agenda Item Number 10-D Ni
Approved by the BCC
Type of Document Resolution—Public Safety Authority Number of Original One
Attached Documents Attached
PO number or account n/a
number if document is 94)
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? JAK
2. Does the document need to be sent to another agency for additional signatures? If yes, JAK
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 JAK
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 JAK
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 JAK
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 JAK
signature and initials are required.
7. In most cases(some contracts are an exception),the on inal document and this routing slip JAK
should be provided to the County Attorney Office at t time the item is input into SIRE.
Some documents are time sensitive and require forw ding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be, are of your deadlines!
8. The document was approved by the BCC on 4/9/13 and all changes made during the JAK
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 e JAK kai
BCC,all changes directed by the BCC have been made,and the document is read for the
Chairman's signature. �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
ion
MEMORANDUM
Date: April 12, 2013
To: Dinny Neet, Paralegal Assistant
County Attorney's Office
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Resolution 2013-89: Appointment to the Public Safety Authority
Attached for your records is a copy of the Resolution referenced above, (Item
#10D) adopted by the Board of County Commissioners on April 9, 2013.
If you have any questions, please call me at 252-8411.
Thank you.
Attachment
100
RESOLUTION NO. 2013 - 8 9
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, APPOINTING DR. MATT EVERETT TO
THE COLLIER COUNTY PUBLIC SAFETY AUTHORITY.
WHEREAS, on June 26, 2012, the Board of County Commissioner (Board) adopted
Ordinance No. 2012-23 establishing the Collier County Public Safety Authority to assume the duties
and responsibilities of the former Collier County Emergency Medical Services Policy Advisory
Board; and
WHEREAS, Ordinance No. 2012-23 sets forth the appointment process for the Public Safety
Authority and the categories of professional expertise required of its membership; and
WHEREAS, Ordinance No. 2012-23 also provides that Public Safety Authority shall include
three citizen representatives; and
WHEREAS, there is currently one vacant, unexpired term on the Public Safety Authority for
an active Emergency Department physician representing the collective campuses of the Physicians
Regional Healthcare System Medical Center organization; and
WHEREAS, Physicians Regional Medical Center has provided the Board of County
Commissioners with its recommendation for appointment.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that Dr. Matt Everett, an active
Emergency Department physician for the Physicians Regional Healthcare System, is hereby
appointed to the Collier County Public Safety Authority to fulfill the remainder of this unexpired
term, said term to expire on July 2, 2016.
THIS RESOLUTION ADOPTED after motion, second and majority vote on this the 9th day of
April, 2013.
ATTEST: BOA' 11F COUNT COMMISSIONERS
DWKGIT;E..,BROOK, Clerk COLL ' C 1 UNT , FLORIDA
.31 4'461 �► . ' m By
its 'as. . "iiiIi 'tty Clerk G+ i 'v IA A. HILLER, ESQ.
sn .�,�. C • IRWOMAN ,. � .
=Appro est as-t+, • - . Itch f 0 1
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Jeffrey A. '1 a ko Data t, ( c l
County Att+ , Rec'd
Deputy Clerk