Backup Documents 10/11/2011 Item #16D316U 3
ORIGINAL DOCUMENTS CHECKLIST &ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
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
excevtion of the Chairman's signature, draw a line through routine lines # 1 through #4. complete the checklist. and forward to Ian Mitchell (line #5).
Route to Addressee(s)
List in routing order
Office
Initials
Date
1. Priscilla Doria
Housing, Human & Veteran
Services Department
PD
10/04/2011
2.
Original document has been signed/ initialed for legal sufficiency. (All documents to be
PD
for Dick u
3.
September 27, 2011
Agenda Item Number
16.D.3
4. Ian Mitchell, Executive Manager
Board of County Commissioners
/
5. Minutes and Records
Clerk of Courts Office
Number of Ori final
1
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 Ian Mitchell, needs 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
Priscilla Doria Housing, Human and
Phone Number
252 -5312
Contact
Veteran Services
Initial
Please call or e-mail
1.
Original document has been signed/ initialed for legal sufficiency. (All documents to be
PD
for Dick u
Agenda Date Item was
September 27, 2011
Agenda Item Number
16.D.3
Approved by the BCC
by the Office of the County Attorney. This includes signature pages from ordinances,
'
Type of Document
One (1) Release of lien.
Number of Ori final
1
Attached
Signature needed on all documents.
Documents Attached
INSTRUCTIONS & CHECKLIST
I: Forms/ County Forms/ BCC Fors/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
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
PD
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
PD
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
PD
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
PD
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
PD
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 09/27/2011 (enter date) and all changes
PD
made during the meeting have been incorporated in the attached document. The
County Attorney's Office has reviewed the changes, if applicable.
I: Forms/ County Forms/ BCC Fors/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
16
INSTR 4617069 OR 4728 PG 936
Prepared by: RECORDED 10/18/2011 10:18 AM PAGES 1
Priscilla Doria DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Collier County COLLIER COUNTY FLORIDA
Housing,Human&Veterans Services Dept REC$10.00
3339 E.Tamiami Trail,Building H,#211
Naples,FL 34112
THIS SPACE FOR RECORDING
RELEASE OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That Collier County, whose post office address is 3301 E.
Tamiami Trail, Naples, Florida 34112, the owner(s) and holder(s) of a certain Impact Fee Agreement
executed by Lazaro J. Rodriguez and Diana B. Cruz to Collier County, recorded on 5/17/2006 in
Official Records Book 4038, Page 2018, of the Public Records of Collier County, Florida, hereby does
remise, release, quitclaim, exonerate and discharge from the lien and operation of the said agreement,that
certain portion of the premises conveyed by said lien,more particularly described as follows:
Unit 205, Building 6, Botanical Place, A Condominium, according to the Declaration of
Condominium thereof recorded in O.R. Book 3933, Page 2655, of the Public Records of Collier
County,Florida.(4450 Botanical Place Circle,#6205,Naples,FL 34112)
The undersigned is authorized to and does hereby release this Lien with res ct to the above-
named property, and consents to this Lien being forever discharged of record with respect to said
property.
Dated this o.`J day of Stp-k n b f , 2011.
ATry5`
,dPC BOARD OF COUNTY COMMISSIONERS
f ' ilT. .BR(IK,Clerk COLLIER COUNTY, FLORIDA
By:
ma`' . ' cp 00 Clerk FRED W. COYLE, CHA AN 9/cr7140!1
Approved as to form and
legal su ,iency:
Jeff right
Assistant County Attorney