Backup Documents 11/08/2011 Item #16A 2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP '' '1‘4--
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 0-0 9)
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
c(Cl
Print on pink paper.Attach to original document.Original documents should be hand delivered to the Board Office.The completed routing slip and gin
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP e
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 Sue Filson(line#5).
Route to Addressee(s) Office Initials Date
(List in routing order)
1. Judy Puig GMD Planning & 11),y1
Regulation/Operations
2.
3.
4.
5 Ian Mitchell, Supervisor, BCC Office Board of County ii t 9 i��
Commissioners
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 Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.) Phone Number 252-2487
Name of Primary Staff Marlene Serrano
Contact
Agenda Date Item was November 8,2011 Agenda Item Number 16A2
Approved by the BCC
Type of Document Partial Release of Lien Number of Original 1
Attached Documents Attached
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
(Initial) Applicable)
appropriate.
1. Original document has been signed/initialed for legal sufficiency.(All documents to be
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 1?h9
Chairman and Clerk to the Board and possibly State Officials.) N/A
2. All handwritten strike-through and revisions have been initialed by the County Attorney's
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
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 CM
signature and initials are required.
5. In most cases(some contracts are an exception),the original document and this routing slip
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 11/08/11 (enter date) and all
changes made during the meeting have been incorporated in the attached document. 1.
The County Attorney's Office has reviewed the changes,if applicable.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05
1642
INSTR 4625091 OR 4735 PG 676
RECORDED 11/9/2011 4:05 PM PAGES 1
This Instrument Prepared By: DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Marlene Serrano COLLIER COUNTY FLORIDA
Code Enforcement Department REC$10.00
2800 North Horseshoe Drive
Naples, FL 34104
(239) 252-2440
PARTIAL RELEASE 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:
Joseph H. Deroma Living Trust Ltd, Owner ("Respondent")
The lien was recorded on 07/01/2010 in Official Records Book 4581, Page 3480, in the
Official Records of Collier County, State of Florida. The lien secures the accrued sum of
One Hundred Thousand and Four Hundred dollars (representing $4,000 as stated on
lien instrument, plus accrued penalties).
Collier County, a political subdivision of the State of Florida, by execution of this Partial
Release of Lien, acknowledges partial payment and hereby cancels and releases the
lien in relation to the following property only:
824 96th Avenue North, Unit B, Naples, Florida
Folio No. 62769800000
The Board of County Commissioners hereby acknowledges that the lien ceases to exist
as to the above described property only, and that the lien shall remain in full force and
effect with respect to all other real and personal property owned by Respondent.
IN WITNESS WHEREOF, the Board of County Commissioners of Collier County,
Florida, acting through its Chairman directs execution and recording of this Partial
Release and Satisfaction of Lien, by action of the Board on this ' day of
1J , Ve %vs Q , 2011.
ATTEST BOARD OF COUNTY COMMISSIONERS
DWIGHT E:BROK clerk COLLIER COUNTY, FLORIDA
II 4a�J By:
'tekiuty Clerk Fred W. Coyle, Chair n
'+,1 aa':ura 4ftt
Approved as to form,and legal sufficiency
Item# I!(0 1-2
Je f Wr)ght Agenda 111 (�I
As-• tint County Attorney Date
Date it I15 1
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