Backup Documents 05/14/2013 Item #16A15l
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 OJ ire no later
than Monday preceding the Board meeting. �1i7 6
* *NEW ** ROUTING SLIP
Complete routing lines #1 through #2 as appropriate for additional signatures, dates, and/or information needed. Ifthe document is already complete witrMe A ,
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 Addressees (List in routing order)
Office
Initials
Date
1.
appropriate.
(Initial)
Applicable)
2.
5/14/13
Agenda Item Number
16 -A -15
3. County Attorney Office
County Attorney Office
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5/14/13
4. BCC Office
Board of County
Commissioners
1etc�G�u��
S 30 3
5. Minutes and Records
Clerk of Court's Office
Documents Attached
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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, C de Enforcement
Phone Number
252 -2444
Contact / Department
appropriate.
(Initial)
Applicable)
Agenda Date Item was
5/14/13
Agenda Item Number
16 -A -15
Approved by the BCC
Does the document need to be sent to another agency for additional signatures? If yes,
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Type of Document
Release and Satisfaction of Lien —
Number of Original
One
Attached
Hernandez and Fults
Documents Attached
PO number or account
111 - 138911- 649030
number if document is
by the Office of the County Attorney.
to be recorded
All handwritten strike- through and revisions have been initialed by the County Attorney's
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INSTRUCTIONS & CHECKLIST
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
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?
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2.
Does the document need to be sent to another agency for additional signatures? If yes,
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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
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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
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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
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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
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signature and initials are required.
7.
In most cases (some contracts are an exception), the original document and this routing slip
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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 5/14/13 and all changes made during the
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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 th
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BCC, all changes directed by the BCC have been made, and the document is ready f the
Chairman's signature.
V-
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
This Instrument Prepared By:
Jen Baker
Code Enforcement Department
2800 North Horseshoe Drive
Naples, FL 34104
(239) 252 -2440
16A15
INSTR 4846708 OR 4927 PG 713
RECORDED 6/3/2013 9:36 AM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC $10.00
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:
Terry Hernandez and Brian K. Fults,
Respondents
The lien was recorded September 5, 2012 in Official Records Book 4832 Page 1989, in
the Official Records of Collier County, State of Florida. The lien secures the principal
sum of Forty Five Thousand ten dollars and eighty 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 UNIT 3 BLK 88 LOT 5
270047 TH Terrace SW Naples, 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
DWIGHT E. BROCK, Clerk
y:
Veputy Clerk
Approved as to form and legal sufficiency
Jeff rig t
Assist County Attorney
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, F4ORIDA
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ME