Backup Documents 02/14/2012 Item #10MORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
10M TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #1 through #4 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 #4, complete the checklist, and forward to Ian Mitchell pine #5).
Route to Addressee(s)
List in routing order
Office
Initials
Date
1.
2/14/12
Agenda Item Number
(16F3) IOM
2.
Original document has been signed/initialed for legal sufficiency. (All documents to be
JBW
3.
North Naples Fire Control & Rescue
Number of Original
2
4. Jennifer B. White, ACA
County Attorney's Office
JBW
2/14/12
5. Ian Mitchell, BCC Office
Supervisor
Board of County Commissioners
Z
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. 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, including Sue Filson, need to contact staff for additional or missing
information. All original documents needing the BCC Chainnar►'s signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.
Name of Primary Staff
Contact
Dan Summers
Phone Number
N/A (Not
Agenda Date Item was
2/14/12
Agenda Item Number
(16F3) IOM
Approved by the BCC
Original document has been signed/initialed for legal sufficiency. (All documents to be
JBW
Type of Document
North Naples Fire Control & Rescue
Number of Original
2
Attached
District — Certificate of Public Convenience
Documents Attached
& Necessity - Permit & Certificate
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
apprOlDriate.
Initial
Applicable)
1.
Original document has been signed/initialed for legal sufficiency. (All documents to be
JBW
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.
2.
All handwritten strike- through and revisions have been initialed by the County Attorney's
N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
JBW
document or the final negotiated contract date whichever is applicable.
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
JBW
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
N/A
should be provided to Ian Mitchell in the BCC office within 24 hours of BCC approval.
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!
6.
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 Attorney's Office has reviewed the changes, if applicable.
10M
MEMORANDUM
Date: February 15, 2012
To: Orly Stolts, Fire Chief
North Naples Fire Control & Rescue District
CC: Dan Summers, Director
Bureau of Emergency Services & Management
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: COCPN & Permit
Mr. Stolts: Attached please find one (1) ORIGINAL of the COCPN & PERMIT
referenced above, (Agenda Item #16F3) approved by the Collier County
Board of County Commissioners on Tuesday, February 14, 2012.
Mr. Summers: North Naples came and picked up their COCPN & PERMIT.
Attached is a copy of the original documents for your records.
The Minutes and Records Department has retained a copy of the documents to be
kept in the Board's Official Records, as North Naples Fire & Rescue is required to
maintain these documents on site.
If you have any questions, please call me at 252 -7240.
Thank you.
COLLIER COUNTY FLORIDA
Renewal of Class 3 COPCN
This Permit Expires February 27, 2013
Name of Service: North Naples Fire Control and Rescue District
Name of Owner: North Naples Fire Control and Rescue District
Principle Address of Service: 1885 Veterans Park Drive,. Naples FL 34109
Business Telephone: 239 -597 -3222
Description of Service: Non - Transport Advanced Life Support
Number of Vehicles: 10 Ground Units available
See Attachment "A" for description of vehicles. The County recognizes that in addition to the vehicles described in
Attachment "A ", other vehicles may be permitted by the State of Florida pursuant to section 401.26, Florida
Statutes, to provide non - transport ALS services within its boundaries. The District shall provide within (10) ten
days a notification to the County of any additional vehicles permitted by the State. The District shall also
provide the County notification when a vehicle listed on attachment "A" is no longer permitted by the State.
This permit, as provided in Collier County, Florida, Ordinance 04 -12, as amended, shall allow North Naples Fire
Control and Rescue District to provide emergency response but not provide emergency transportation within
Collier County North Naples Fire Control and Rescue District, as delineated in the Boundary Map attached
hereto as Attachment "B" and described in the Laws of Florida Chapter 99 -450, excluding the property known
as Moorings Park and the property known as Hole -in -Wall Golf Course, and pursuant to mutual -aid agreement
until the expiration date hereon, except that this permit may be revoked by the Board of County Commissioners
of Collier County at any time the service named herein shall fail to follow the protocols of the Collier County
Medical Director, or comply with any applicable local, state or federal laws or regulations.
North Naples Fire Control and Rescue District shall also:
1. Fully cooperate in a timely manner with the filing of quarterly response -time and statistical care reports in a
form jointly approved by the County Medical Director and the North Naples Fire Department District Medical
Director.
2. Fire District shall ensure that all efforts are faithfully committed to ensure continunity of patient care by
having its paramedics ride -in to the hospital when joint policy, procedure, and ALS procedures initiated by
North Naples Fire Control personnel exist.
Issued and approved this 1 �`' day of 2012
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ATTESTQ.s,I Ok
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AP � i[".."land i legal sufficiency:
Jennifer . White, Assistant County Attorney
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
Fred W. Coyle, Chairman
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ATTACHMENT "A"
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2007 Ford MO
➢
2005 Ford F250
D
2006 Ford Expedition
➢
2005 Ford F250
D
2006 Ford Expedition
D
1998 Pkm Quantum
D
2000 Plerco Quantum
➢
1998 Pkzw Quantum
D
1998 Plem Quantum
D
2002 Plem Quantum
➢
2004 Pierce Quantum
D
1998 Pierce Quantum
2006 Pierce Quantum
9
2005 Ford F450
VIN 0 1FTSW`11P67EA47402
VIN 01FTMIPOSBC07402
VIN It IFMPUI6516LA6403I
VIN 01FTSW21P25EC07403
VIN # 1FMPU16506LA97619
VIN 9 4PiClWS4WA000600
VIN 0 4PICrO236YA00078Q
VIN 0 4PICT02S9WA000592
VIN # 4PICIMI WA000604
VIN # 4P1 C7 2SO2AO02256
VIN # 4P1C WS93AO03679
VIN # 4P1 CT02SSWA000816
VIN # 4P 1 CDO 1 S36AO06032
VIN 0 1FDAF56P95ED24543
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