Backup Documents 11/13/2012 Item #11NORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP! I
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 #I 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 41 through #4, complete the checklist, and forward to Ian Mitchell (line #6).
Route to Addressee(s)
(List in routing order)
Office
Initials
Date
1.
appropriate.
(Initial)
Applicable)
2.
November 13, 2012
Agenda Item Number
1-6E� , 1
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4.
3` d Amendment to Contract
Number of Original
1
5. Commissioner Coyle
to the BCC
Board of Count Commissioners
y�
Documents Attached
6. Minutes and Records
Npe� 1j ikg5Fes 7
Clerk of Court's Office
f t �?p�f 2
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 Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff
Len Golden Price
Phone Number
8721
Contact
appropriate.
(Initial)
Applicable)
Agenda Date Item was
November 13, 2012
Agenda Item Number
1-6E� , 1
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
3` d Amendment to Contract
Number of Original
1
Attached
resolutions, etc. signed by the County Attorney's Office and signature pages from
Documents Attached
INSTRUCTIONS & CHECKLIST
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I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip, Revised 6 -15 -2011
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
1.
Original document has been signed/initialed for legal sufficiency. (All documents to be
Yes
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.
Is the Chairman's original signature required?
Yes
3.
All handwritten strike - throughs and revisions have been initialed by the County Attorney's
Yes
Office and all other parties except the BCC Chairman and the Clerk to the Board.
4.
The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date, whichever is applicable.
5.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
Yes
signature and initials are required.
6.
In most cases (some contracts are an exception), the original document and this routing slip
Yes
should be provided to Ian Mithchell 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!
7.
The document was approved by the BCC on 11/13/12 (enter date) and all
Yes
N/A is not
changes made during the meeting have been incorporated in the attached document.
an option
The County Attorney's Office has reviewed the changes, if applicable.
lbr4iuc6.
av
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip, Revised 6 -15 -2011
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THIRD AMENDMENT TO COLLIER COUNTY
EMERGENCY SERVICES MEDICAL CONSULTANT CONTRACT
THIS THIRD AMENDMENT to the Collier County Emergency Services Medical
Consultant Contract is made this 13th day of November, 2012, by and between Robert Boyd
Tober, Inc. ( "Consultant "), and Collier County, Florida ( "County ").
WHEREAS, by agreement dated September 1, 2001, the parties entered into a Collier
County Emergency Services Medical Consultant Contract, a copy of which is attached hereto,
together with the First Amendment dated October 14, 2008, and the Second Amendment dated
May 26, 2009 (collectively referred to as the "Agreement "); and
WHEREAS, at a regularly noticed public meeting on October 9, 2012, the Board of
County Commissioners directed that the Agreement be amended to provide for annual
performance evaluations; and
WHEREAS, certain clarifications are recommended as it relates to compensation upon
termination; and
WHEREAS, the parties believe that such amendments are in the interest of health, safety
and welfare of the citizens of the County.
NOW, THEREFORE, IN CONSIDERATION of the mutual promises and for other
good and valuable consideration, the receipt and sufficiency of which are acknowledged by the
parties, it is agreed that:
1. Paragraph 15 of the Agreement is hereby amended as follows:
15. PRO -RATIONS UPON T-ER A 1N A T -ION COMPENSATION UPON
TERMINATION:
In the event of the termination of this Contract, the
e ffeet ve date of the GefAfaet divi °a Consultant shall be paid only for services rendered
in accordance with this Contract. Compensation due for anv partial month's services will
be at a daily rate determined by dividing the annual contract rate by three hundred sixty -
five (365).
2. Paragraph 20 is hereby added to the Agreement as follows:
Words Strueli Thfough are deleted; Words Underlined are added
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20. ANNUAL PERFORMANCE EVALUATION
The Consultant will prepare a performance self - assessment along with proposed goals for
the next year on an annual basis and submit this evaluation to the Public Safety Authority
(PSA) no later than the first day of June. The PSA will review the Consultant's self -
assessment and will make an independent performance evaluation and recommendations,
which the PSA will forward to the Board of County Commissioners no later than the first
da of f July. The Commissioners will review both the Consultant's self - assessment and
the Public Safety Authority's performance evaluation and will prepare separate
performance evaluations and recommendations. The Consultant will forward the self -
assessment PSA review and recommendations and the individual Commissioners'
evaluations as an agenda item on the last regular meeting in n July. The Commissioners
will conduct the required evaluation, approve the proposed goals, and recommend any
additional areas of focus for the next evaluation period. An updated performance
evaluation plan may be developed in good faith between the Consultant and the County
and adopted by the County prior to October 1St of each year for implementation in the
next year.
Except as expressly provided herein, the Agreement, as amended, remains in full force
and effect according to the terms and conditions contained therein.
IN WITNESS WHEREOF, the Consultant and the County have executed this Third
Amendment to Collier County Emergency Services Medical Consultant Contract as of the date
first written above.
s '
ATTEST:
DWft"HT. B. BRf3CC�, Clerk
By- ,-i,(%
!t *,test -.as to `.
WITNESSES:
Print Name:
Print Name:
A *pL ;d-tM form and legal sufficiency:
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: �� ) C."
FRED W. COYLE, CHAIRM
ROBERT BOYD TOBER, INC.
By:
Robert Boyd f ober, resident
IN "1
COLLIER COUNTY EMERGENCY SERVICES
MEDICAL CONSULTANT CONTRACT
THIS MEDICAL CONSULTING CONTRACT made this --j-1 14- day of
� 2001 by and between ROBERT BOYD TOBER, INC., hereinafter referred to as
Consultant, and COLLIER COUNTY, FLORIDA, hereinafter referred to as the County.
WITNESSETH
WHEREAS, the County is responsible for emergency services in COLLIER COUNTY,
Florida; and
WHEREAS, Emergency Medical Services, (hereinafter "EMS "), are a Iogical extension
of existing health care services performed by the County in the above described geographic area;
and
WHEREAS, Consultant ROBERT TOBER, M.D., a duly licensed physician in the State
of Florida who is specially trained in the field of emergency medicine; and
WHEREAS, the County and Consultant have previously entered into a Medical
Consulting Contract dated June 18, 1996 which provides for automatic renewal pursuant to
certain conditions; and
WHEREAS, said conditions have been met for renewal of the contract and the parties
hereto manifest their mutual desire to renew same with certain chances contained herein; and
NOW THEREFORE, in consideration of the promises and the mutual covenants
hereinafter set forth, the parties hereto agree as follows:
1. LICENSE: ROBERT TOBER, M.D. is at the present time a duly licensed
physician in the State of Florida and he has agreed to maintain his license in full force and effect
during the term of this contract. If for any reason during the term of this Contract, the County no
longer contracts with DR. TOBER, or if DR. TOBER should lose his license to practice
medicine, this contract shall immediately become null and void.
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'2• GENERAL DUTIES: Consultant shall be an independent contractor and shall
be directly responsible to the Division Administrator of the Emergency Services Division for the
Performances of services as Medical Director as more specifically defined in this agreement and
as set forth in Section 401.265, Florida Statutes. The Consultant shall be responsible for the
implementation of such planning and coordination as may be necessary to deliver advanced life
support by Paramedics (including EMS and Fire District personnel) trained to the level of
advanced and basic medical technicians, which may require intravenous administration of
emergency resuscitative drags and the performance of sophisticated technical emergency
procedures.
3. TERM OF CONTRACT: The initial term of this contract shall be from October
1, 2000 to September 30, 2001. The parties agree that the term of the Contract shall be
automatically renewed on a yearly basis from October 1, through September 30 with the same
terms, conditions and obligations as set forth herein, unless terminated by County upon sixty (60)
days written notice to Consultant.
4. COMPENSATION: The County shall pay to the Consultant the sum of
$50,000 per annum, as full compensation for the services rendered herein and no other
compensation. The County will pay the cost of the professional liability insurance. The Medical
Director shall not be eligible for any employee benefits other than this compensation. This sum
shall be paid to the Consultant in twelve (12) equal monthly payments commencing with the
effective date of the Contract, with each monthly payment being payable by the 10`h of each
month. The Consultant will be entitled to a 5% annual increase beginning October 1, 2001 upon
written notification by the Emergency Services Administrator by September 15`h of each year,
beginning on September 15, 2001, and upon approval by the Board of County Commissioners.
5. PATIENT RECORDS: The County shall make available, within two days of
request, any and all medical records, reports, documents and other relevant materials, including
IN
audio and visual tapes requested by the Consultant. This includes all run reports, medical test
results, recordings on tape and any other reasonably available similar information.
b. CONFIDENTIAL COMMUNICATIONS: Except as may be provided by
general law, the County agrees to keep all medical records confidential and allow no
communication of records or patient information without a written release from the patient or the
Consultant.
7. REPORT: The County agrees to give the Consultant full and detailed reports
regarding any case which it reasonably believes has the potential for legal action against the
County or its employees pertaining to EMS.
8. DISCIPLINARY ACTIONS: The County agrees to give the Consultant a full
written report of any and all Emergency Medical Services personnel who are known to have
violated any standing or verbal orders. Consultant shall be given full support for removal of any
program participant as provided for in State regulations governing Advanced Life Support
Providers.
9. DUTIES AND RESPONSIBILITIES OF THE CONSULTANT:
a. He shall be from a broad -based medical specialty such as emergency medicine,
internal medicine, anesthesiology; or other surgical specialty, with demonstrated
experience in pre- hospital care and hold an ACLS certificate of successful course
completion or be board certified in emergency medicine.
b. He shall demonstrate and have available for review documentation of active
participation in a regional or statewide physician group involved in pre - hospital care.
c. He shall supervise and accept direct responsibility for the medical performance of
the paramedics working for Collier County EMS.
d. He shall develop medically correct standing orders or protocols relating to life
support system procedures when communication cannot be established with a
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supervising physician or when any delay in patient care would potentially threaten the
life or health of the patient.
e. He shall issue standing orders and protocols to Collier County EMS to ensure that
it transports each of its patients to facilities that offer a type and level of care
appropriate to the patient's medical condition if available within the service region.
f. He or his appointee shall provide continuous 24 -hour- per -day, 7- day - per -week
medical direction which shall include, in addition to the development of protocols and
standing orders, direction to Collier County EMS personnel as to the availability of
"off- line" service to resolve problems, system conflicts, and provide services in an
emergency as that term is defined by section 252.34 (3), Florida Statutes.
g. He shall establish a quality assurance committee to provide for quality assurance
review of all paramedics operating under his supervision.
h. He shall audit the performance of system personnel by use of a quality assurance
program that includes but is not limited to a prompt review of patient care records,
direct observation, and comparison of performance standards for drugs, equipment,
system protocols and procedures. He shall be responsible for participating in quality
assurance programs that may be developed by the department.
i. He shall ensure and certify that security procedures of the Collier County EMS
for medications, fluids and controlled substances are in compliance with chapters 401,
499 and 893, Florida Statutes, and chapter 10D-45 of the Florida Administrative
Code.
j. He shall create, authorize and ensure adherence to, detailed written operating
procedures regarding all aspects of the handling of medications, fluids and controlled
substances by the EMS personnel and comply with all requirements of chapters 401,
499 and 893, Florida Statutes.
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k. He shall notify the Florida Department of Health, (hereinafter the "Department ")
in writing when the use of telemetry is not necessary.
L He shall notify the department in writing of each substitution by Collier County
EMS of equipment or medication.
m. He shaII assume direct responsibility for the use by a Collier County paramedic of
an automatic or semi- automatic defibrillator and the performance of esophageal
intubation, and on routine interfacility transports, the monitoring and maintenance of
non - medicated I.V.s. He shall ensure that the paramedic is trained to perform these
procedures; shall establish written protocols for the performance of these procedures;
and shall provide written evidence to the department documenting compliance with the
provisions of this paragraph.
n. He shall ensure that all paramedics are trained in the use of the trauma scorecard
methodologies as provided in sections 64E -2.017 of the F.A.C., for adult
trauma patients and 64E- 2.0175, F.A.C., for pediatric trauma patients.
o. He shall participate as a crewmember on an EMS vehicle for a minimum of 10
hours per year and complete a minimum of 10 hours per year of continuing medical
education related to pre - hospital care or teaching or a combination of both.
p. He shall ensure that all Collier County paramedics have all proper certifications
and receive all training necessary to maintain their certification.
10. ADDITIONAL DUTIES: Consultant shall also be responsible for assisting in
the following additional duties:
a. Consultation in the planning for Emergency Medical Services Department to be
provided by the County, including the design of vehicles, equipment, supplies,
distribution resources, emergency medical services personnel training and medical
policy, protocol, planning and development.
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b. Consultation in the coordination of training of paramedical personnel, including
the determination of training criteria for certification.
c. Organizing, coordinating and participating as an instructor in the in- service
education programs and quality control of the patient care in day - to-day delivery of
emergency medical services by the County.
& Serving as a liaison between the County and the appropriate community hospitals,
medical societies, practicing physicians and training facilities in the area.
e. Providing such assistance as may be required in the preparation and administration
of any grant programs for the establishment and improvement of the system.
f. All duties outlined in Rule 64 -E Florida Administrative Code for Emergency
Medical Services Medical Director that are not specifically set forth herein and as may
be changed from time to time by the department..
g. He shall keep adequate records and supporting documentation, which concern or
reflect his services under this Contract.
h. Consultant represents that it presently has no interest and shall acquire no interest,
either direct or indirect, which would conflict in any manner with the performance of
services required hereunder.
11. LIABILITY AND REMEDIES IN BREACH OF CONTRACTS: It is
recognized that the provision of advanced life support services requires that the County have a
Medical Director. Accordingly, the Consultant shall not refuse to perform these services during
the terms of this Contract so long as it is able to so perform, and the County shall have the right
to specific performance of the provisions of this contract. In addition, the Consultant shall be
liable to the County for his unreasonable failure or refusal to perform the services required
hereunder.
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No modification, or change in this Agreement shall be valid or binding upon the parties,
unless in writing, and executed by the party or parties intended to be bound by it.
Unless otherwise specified, the laws, rules and regulations of the State of Florida shall
govern this Agreement. Any suit or action brought by either party to this Agreement against the
other party relating to or arising out of this Agreement must be brought in the appropriate Florida
State Court in Collier County, Florida.
12. CONFLICTING EMPLOYMENT OR CONTRACTUAL RELATIONSHIP:
Nothing in this Contract shall be interpreted as preventing the Consultant from operating
any other business or being similarly employed with any other emergency medical service that is
lawfully licensed by the County (within Collier County, Florida) and the State. However the
Consultant shall not accept any employment or enter into any contractual relationship that would
create a conflict between such interest and the performance of its duties hereunder.
Nothing in this Contract shall be interpreted as preventing the Consultant, a contractual
employee of the County, from being employed in any other capacity, including, but not limited
to the operation of a medical practice, the employment as a staff member of any hospital, or the
serving as a medical director for any other emergency medical service which is lawfully licensed
by the County (if located within Collier County) and the State.
13. SUCCESSOR: The Contract shall be binding upon the successors of the County_
This Contract shall not be assignable by the Consultant.
14. TERMINATION: This Contract may be terminated by either party, with or
without cause, upon sixty (60) days written notice to the other party of such party's intention to
terminate the Contract.
15. PRO - RATIONS UPON TERMINATION: In the event of the termination of
this Contract, the Consultant's compensation due under Paragraph 4 shalt bq prorated on the basis
7
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of the number of days elapsed from the effective date of the Contract, divided by three hundred
sixty -fivo (355).
lb. MANUALS: All manuals of procedure and instructional material, which are
created or prepared by the Consultant, shall be and remain the property of the Consultant.
17. ADDITIONAL LICENSES: Consultant agrees to obtain and maintain
throughout the period of this Agreerrient, all such licenses as are required to do business by the
Consultant in the State of Florida and in Collier County, Florida, including, but not limited to, all
licenses required by any State Boards or other Governmental agencies responsible for regulating
and licensing the professional services to be provided and performed by the Consultant, pursuant
to this Agreement.
18, INSURANCE:
The County shall, pay for, and maintain, during the life of this agreement, professional liability
insurance. Collier County shall be named as an additional insured on the certificate of insurance
for the policy.
M.
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IN WITNESS WHEREOF, the parties have executed this agreement as of the date first
written above.
AT IZST:
DWIGHT E. BROCK, CLERK
.of'Cburt,s
Attat K• to Cha #r=,,
signstw* only.
Witnessed b
r mac.._
Approved as to form and
Legal Sufficiency:
WCQLiELE HUBBARD ROBINSON
sistant I1N County Attorney
H/IackiJEMS Contm=/t'ober
Medical Contract 2061 -Revised
BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA
ROBERT BOYD TOBER, INC.
BY: i1119 K6�w
ROBERT BOYD TOBER, PRESIDENT
Contract ( "Amendment ") is made this 14th day of October, 2008, by and between Robert Boyd
Tober, Inc. ( "Consultant'), and Collier County, Florida ( "County ").
WHEREAS, by agreement dated September 1, 2001, the parties entered into a Collier
County Emergency Services Medical Consultant Contract ( "Agreement "), a copy of which is
attached to this Amendment; and
WHEREAS, at a regularly noticed public meeting on September 23, 2008, the Board of
County Commissioners directed that the Agreement be amended to authorize the Consultant to
be directly responsible to the Board of County Commissioners; and
WHEREAS, the parties believe that such an amendment is in the interest of health,
safety and welfare of the citizens of the County.
NOW, THEREFORE, the parties hereby amend Paragraph 2 of the Agreement as
follows:
"Consultant shall be an independent contractor and shall be directly
responsible to the
Board of County Commissioners of Collier County, Florida for the performances
of services as Medical Director as more specifically defined in this agreement and
as set forth in Section 401, Florida Statutes... "
Except as specifically set forth herein, all other terms and conditions of the Agreement
remain in full force and effect.
IN WITNESS THEREOF, the parties have executed this First Amendment to the
Agreement as of the date first written above.
Page 1 of 2 e--.
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FIRST AMENDMENT TO COLLIER COUNTY EMERGENCY SERVICES
MEDICAL CONSULTANT CONTRACT
c.a
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This First Amendment to the Collier County Emergency Services Medical Consultant
Contract ( "Amendment ") is made this 14th day of October, 2008, by and between Robert Boyd
Tober, Inc. ( "Consultant'), and Collier County, Florida ( "County ").
WHEREAS, by agreement dated September 1, 2001, the parties entered into a Collier
County Emergency Services Medical Consultant Contract ( "Agreement "), a copy of which is
attached to this Amendment; and
WHEREAS, at a regularly noticed public meeting on September 23, 2008, the Board of
County Commissioners directed that the Agreement be amended to authorize the Consultant to
be directly responsible to the Board of County Commissioners; and
WHEREAS, the parties believe that such an amendment is in the interest of health,
safety and welfare of the citizens of the County.
NOW, THEREFORE, the parties hereby amend Paragraph 2 of the Agreement as
follows:
"Consultant shall be an independent contractor and shall be directly
responsible to the
Board of County Commissioners of Collier County, Florida for the performances
of services as Medical Director as more specifically defined in this agreement and
as set forth in Section 401, Florida Statutes... "
Except as specifically set forth herein, all other terms and conditions of the Agreement
remain in full force and effect.
IN WITNESS THEREOF, the parties have executed this First Amendment to the
Agreement as of the date first written above.
Page 1 of 2 e--.
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ROBERT BOYD TOBER, INC.
ROBERT BOYD TOBER, PRESIDENT
AT)�iT ";'`' BOARD OF COUNTY COMMISSIONERS
�WIGHT.E._BRQCK, CLERK OF COLLIER OUNTY FLORIDA
-B ..
�-7 By. ..
. �� Deputy Clerk TOM ANNINC, CHAIRMA
`il1�f�At".s,
Approval as to form
and legal sufficiency:
Jeffrey A. ICY�tzkow
County Attorney
08 -COA- 00127/2
Page 2 of 2
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Item #
Agenda
Date O Q�
Date
Rec' L
erk
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SECOND AMENDMENT TO COLLIER COUNTY EMERGENCY SERVICES MEDICAL CONSULTANT
CONTRACT
This Second Amendment to the Collier County Emergency Services Medical Consultant
Contract ( "Amendment ") is made this _�iay of Nk&j4 2009, by and
between Robert Boyd Tober, Inc. ( "Consultant ") and Collier Co y, Florida ( "County ").
WHEREAS, by Agreement dated September 1, 2001, the parties entered into a Collier
County Emergency Services Medical Consultant Contract ( "Agreement "), a copy of which is
incorporated herein by reference; and
NOW, THEREFORE, the parties hereby amend the Agreement to add Item 19,
EXPENSES, as follows:
19. EXPENSES. County shall pay expenses for Dr. Tober, and /or his assistant related to County
business, to include, but not be limited to, mailings, office supplies, training, education,
seminars, lodging (actual cost of lodging at single occupancy rate with a cap of no more than
$150.00 per night), air travel (actual ticket cost limited to tourist or coach class fare), and
rental car (actual rental cost limited to compact or standard -size vehicles).
Except as specifically set forth herein, all other terms and conditions of the Agreement remain
in full force and effect.
IN WITNESS WHEREOF, the parties have executed this Second Amendment to the Agreement
as of the date first written above.
CONSULTANT:
Type /Print Name
SE ITN ES
Type /Print Name
ROBERT BOYD TZFT BfRC�
By:
Robert Boyd Tober, President
11N 1
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Date: mog tar Z gnq OWNER:
ATTEST: BOARD OF COUNTY COMMISSIONERS OF
DWIGHT E., <, COLLIER COUNTY FLORIDA
CLERK OkCOURTS ,
By r
Dated 2- '" BY:
($,FAQ VDonna Fiala, Chairman
Attest It. C Ift" e
signature ooh-t
Approved As To Form a d L al Sufficiency:
AsskAaW County Attorney
oeift
Print Name: S47? 7`ee4n
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