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Backup Documents 09/28/2010 Item #16D13ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATU ROUTING SLIP j/hh/� Complete routing lines #I through #4 as appropriate for additional signatures, dates, and/or information needed If the document is already co et{f�e exception of the Chairman's signature, draw a line throu routing lines 41 through 44, complete the checklist, and forward to Ian Mitchell line #5). iii Route to Addressee(s) List in routing order Office Initials Date 1. Frank Ramsey HHS Initial) 9/29/10 2. Original document has been signed/ initialed for legal sufficiency. (All documents to be PD for pick u 3. September 28, 2010 Agenda Item Number 16D13 4. Ian Mitchell, Executive Manager Board of County Commissioners 1O�19 fo 5. Minutes and Records Clerk of Courts Office Number of Ori inal 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 Frank Ramsey and/or Priscilla Doria Phone Number 252 -5312 Contact Housing, Human and Veteran Services Initial) Please call or e-mail 1. Original document has been signed/ initialed for legal sufficiency. (All documents to be PD for pick u Agenda Date Item was September 28, 2010 Agenda Item Number 16D13 Approved by the BCC by the Office of the County Attorney. This includes signature pages from ordinances, Type of Document One (1) Amendment to Lien Agreement Number of Ori inal 1 Attached Signature needed on document. Documents Attached INSTRUCTIONS & CHECKLIST 1: Forms/ County Forms/ BCC Forms / Original Documents Routing Slip W WS Original 9.03.04, Revised 126.05, 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 ACC 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 our deadlines! 6. document was approved by the BCC on 9/28/2010 (enter date) and all changes PD 1The made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 1: Forms/ County Forms/ BCC Forms / Original Documents Routing Slip W WS Original 9.03.04, Revised 126.05, Revised 2.24 05 16013 INSTR 4487090 OR 4616 PG 57 RECORDED 10/2012010 10 -.03 AM PAGES 2 Prepared by DWIGHT E. BROCK OF THE CIRCUIT COURT Frank Ramsey COLLIER COUNTY CLERK Collier County REC $18.50 Ileasing and Human Services 3301 Ii. "tamami Trail Naples, FI, 34112 THIS SPACE FOR RECORDING AMENDMENT TO LIEN AGREEMENT FOR DEFERRAL OF 100% OF COLLIER COUNTY IMPACT FEES FOR OWNER OCCUPIED AFFORDABLE HOUSING DWELLING UNITS This Amendment to Lien Agreement for Deferral of 100% of Collier County Impact Fees For Owner Occupied Affordable Housing Dwelling Units (hereinafter "Amendment") is entered into this day of &p4tm 6K , 2010, between Collier County, a political subdivision of the State of Florida (hereinafter "COUNTY ") and Rebeca Gordon Silot (hereinafter "OWNER ") collectively stated as the "Parties ". NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which is mutually acknowledged, the Parties agree as follows: 1. LIEN AGREEMENT. OWNER has given to the COUNTY a lien agreement recorded on November 18, 2009 at OR Book 4511 Page 197, of the Public Records of Collier County, Florida (hereinafter "Agreement'). OWNER warrants that it is still the owner of the property. COUNTY warrants that it is still owner and holder of said Agreement. Parties warrant they have good right and authority to enter into the Amendment. 2. MODIFICATION. In consideration of the mutual covenants herein and other good and valuable considerations, the Parties agree that this Agreement is modified. The additions to the existing language in the Agreement are shown herein by underlining and deletions from the Agreement are shown by sirfis as follows: Page Four, Exhibit "A ": Legal Description Let 92 Lot 79, Trail Ridge, according to the plat thereof, as recorded in Plat Book 44, Pages 71 through 77, inclusive, of the Public Records of Collier County, Florida. Page Four, Exhibit "A ": Street Address: -13605 13593 Koinonia Drive, Naples, Florida 34114 3. OTI IER TERMS. Notwithstanding anything to the contrary herein or in the Agreement, the lien and operation of the Agreement shall continue in full force and effect except as modified by this Amendment. All other terms of said note and mortgage remain unchanged. 4. COMPLIANCE. The OWNER covenants and agrees to perform, comply with, and abide by each and every one of the provisions of the Agreement, as modified hereby. Pae,e I ur2 16D 13 5. AGREEMENT BINDING. This Amendment shall be binding upon and inure to the benefit of the heirs, legal representatives, and assigns of the OWNER and to the successors and assigns of the COUNTY. 6. RECORDING. The County, at its own expense, will record the Amendment with the Clerk of Courts. IN WITNESS WHEREOF, the Parties have executed this Amendment to be executed as of the date first above written. Attest: �r DWIGHT;V.. .VI , -Clerk i'�f,W; ttre'fe9't� Clerk brfvooiure 06 J. j Signature U Print Name: E 1 On �gnature Print Name: I M UA p— rv.,j STATE OF FLORIDA COUNTY OF COLLIER COUNTY: BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA, By. _ f c r, _� S 9Id8'I2o1U FRED W. COYLE, CHAIRMAN OWNER: , By: R , GORDON SILOT The forgoing instrument was acknowledged before me this .14 day of A 1 2010, by Rebeca Gordon Silot, as OWNER, who is personally known to me or has #reduced Approved as to f -K' .t , and legal sufficiency. Jenni erB. OWhite kll�� Assistant County Attorney / drliw �vJ,ocw Si n ture of Notar Public yj o(.� � -Tra%U Print Name of Notary Public Recommended Apprqval: a cy Krumbme Director — Housing, Human and Veteran Services Pagc 2 of [NOTARY SEA;: t -, Approved as to f -K' .t , and legal sufficiency. Jenni erB. OWhite kll�� Assistant County Attorney / drliw �vJ,ocw Si n ture of Notar Public yj o(.� � -Tra%U Print Name of Notary Public Recommended Apprqval: a cy Krumbme Director — Housing, Human and Veteran Services Pagc 2 of