Backup Documents 10/23/2018 Item #16D 9 a)174
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP II,
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 0 A
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE 7
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 Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 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#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office
,iLti.!_ls,,c4x, Date
1. Hilary Halford Community and Human . 'p 10/16/18
Services A
2. Jennifer Belpedio County Attorney Office
(\ '3 10 A0.C
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3. BCC Office Board of County �S ,
Commissioners Y f kn`ZSkk�
4. Minutes and Records Clerk of Court's OfficeRCM 10V8 Z;0
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 Hilary Halford/CHS Phone Number 252-2670
Contact/ Department
Agenda Date Item was 10/23/2018 j Agenda Item Number6G'
.�
Approved by the BCC `
Type of Document 3 Lien Releases for execution and Number of Original 3
Attached recording. Documents Attached
PO number or account 111-138759-649030
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever' Yes N/A(Not
appropriate. Initial) Applicable)
1. Does the document require the chairman's original signature? N. 13
2. Does the document need to be sent to another agency for additional si u atures? If yep, NA
provide the Contact Information(Name;Agency;Address;Phone)on 01` attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All doc r la e HH I
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 NA
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 HH
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 HH
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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 10/23/2018 and all changes made during HH _ i 4'
the meeting have been incorporated in the attached document. The County e 11.0 kiVi Icir
Attorney's Office has reviewed the changes,if applicable. a , .o
9. Initials of attorney verifying that the attached document is the version approved by the HH _ 4..�
BCC,all changes directed by the BCC have been made,and the document is ready for the o� _ ++, • i
Chairman's signature. ° 'i
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12I
± 609
INSTR 5630535 OR 5566 PG 3004
RECORDED 10/30/2018 8:15 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Prepared by:Hilary Halford COLLIER COUNTY FLORIDA
Collier County Community and Human Services 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
3299 E. Tamiami Trail, Naples, Florida 34112, the owner(s) and holder(s) of a certain Lien
Agreement for Deferral of 100% of Collier County Impact Fees for Owner Occupied Affordable
Housing Dwelling Units (the "Impact Fee Lien") executed by Rubi L. Castro Mendez, recorded
on 01/20/2011 in Official Records Book 4644,Page 2077,of the Public Records of Collier County,
Florida, in consideration of $15,246.26 plus interest, receipt of which is hereby acknowledged
does satisfy, remise, release, quitclaim, exonerate and discharge the Impact Fee Lien against the
premises conveyed by said Impact Fee Lien.
The undersigned is authorized to and does hereby satisfy and release this Lien with respect to the
above-named property, and consents to this Lien being forever discharged of record with respect
to said property.
This Release of Lien was approved by the Board of County Commissioners on -
ctatir , 2018,Agenda Item Number
ATTEST: BOARD OF 'OUN . COMMI . P I/
CRYSTAL K. KINZEL, OF COL . R C• i ` , •
CLERK
By:
By: LL A A..-(.. `
• C . •_
SOLIS,CHAIRMAN
D �4 �'
Attest as to
signature only.
Approval for form and legality:
Jennifer A.Belpedio
Assistant County Attorn y �' 'j(\1
\O
C
1609
INS T R 5630536 OR 5566 PG 3005
RECORDED 10/30/2018 8:15 AM PAGES 1
PrepareAl.y:Hilary Halford CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
Collier County Community and Human Services 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
3299 E. Tamiami Trail, Naples, Florida 34112, the owner(s) and holder(s) of a certain Lien
Agreement for Deferral of 100% of Collier County Impact Fees for Owner Occupied Affordable
Housing Dwelling Units (the "Impact Fee Lien") executed by Latoya Rene Shipman to Collier
County,recorded on 01/17/2008 in Official Records Book 4321,Page 2621, of the Public Records
of Collier County, Florida, in consideration of $12,442.52 plus interest, receipt of which is
hereby acknowledged does satisfy,remise,release, quitclaim, exonerate and discharge the Impact
Fee Lien against the premises conveyed by said Impact Fee Lien.
The undersigned is authorized to and does hereby satisfy and release this Lien with respect to the
above-named property, and consents to this Lien being forever discharged of record with respect
to said property.
This Release of Lien was approved by the Board of County Commissioners on -
CD C 14610-QA— ,2018,Agenda Item Number .
ATTEST: ;. BOARD • CO ' Y COM • 'S
CRYSTAL K. KINZEL; OF CO IER 'i• , - r '.
CLERK. a, ,71
•
By: i
By: , , l •
LI L ANDY SOLIS,CHAIRMAN
Attest : '� I
�
signature only.
Ap royal for form and legality:
Jenni er A.Belpedi PAssistant County Att ey
1509
INSTR 5630537 OR 5566 PG 3006
RECORDED 10/30/2018 8:15 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Prepared by:Hilary Halford COLLIER COUNTY FLORIDA
Collier County Community and Human Services 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
3299 E. Tamiami Trail, Naples, Florida 34112, the owner(s) and holder(s) of a certain Lien
Agreement for Deferral of 100% of Collier County Impact Fees for Owner Occupied Affordable
Housing Dwelling Units (the "Impact Fee Lien") executed by Lazaro Rua, Jr. to Collier County,
recorded on 01/17/2008 in Official Records Book 4321,Page 2603,and Subordination Agreement
on 3/11/2008 in Official Record Book 4337, Page 2765 of the Public Records of Collier County,
Florida, in consideration of $19,411.65 plus interest, receipt of which is hereby acknowledged
does satisfy, remise, release, quitclaim, exonerate and discharge the Impact Fee Lien.
The undersigned is authorized to and does hereby satisfy and release this Lien with respect to the
above-named property, and consents to this Lien being forever discharged of record with respect
to said property.
This Release of Lien was approved by the Board of County Commissioners on -
0e```` tt cas. , 2018,Agenda Item Number `b .
/ . fl
ATTEST: BOARD 0 0 COMM ' ' ' S
CRYSTAL K. KINZEL, OF COL R C' - iA /
CLERK •
By � .� A
By: ._0 `I •C ► SOLIS,C AIRMAN
P
Attest as to' 0,ir't1Ta ii.4 RK
signature only.
Approval for form and legality:
Jennifer .Be pedio \�
Assistant County Attorney
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