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Backup Documents 03/12/2019 Item #16A 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1JIt 6 A 6 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNAT Irk" Print on pink paper. Attach to original document. The completed routing slip and original documents are to he 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#I 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 Initials Date 1. 2. 3. County Attorney Office County Attorney Office `)�U/,n 4. BCC Office Board of County \ak_ / `] Commissioners < \\.Zl\c 5. Minutes and Records Clerk of Court's Office k3"- 3=03pm 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 Melissa Nute Phone Number x-2361 Contact/ Department Agenda Date Item was 3/12/2019 Agenda Item Number 16A6 Approved by the BCC Type of Document Plat Number of Original 1 Attached Documents Attached PO number or account number if document is to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A (Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? M +- 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name;Agency; Address; Phone)on an attached sheet. 3. 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. MN 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A 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 MN 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 MN signature and initials are required. 7. In most cases (some contracts are an exception),the original document and this routing slip should be provided to the County Attorney Office at the time the item is input into SIRE. cock 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 3/12/2019 and all changes made during the ' c meeting have been incorporated in the attached document. The County Attorney's § gi Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by tilf BCC, all changes directed by the BCC have been made, and the document is ready or the Chairman's signature. I: Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 16A6 FORM 8B MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS LAST NAME—FIRST NAME—MIDDLE NAME NAME OF BOARD,COUNCIL,COMMISSION,AUTHORITY,OR COMMITTEE Solis,Andrew I. Collier County Board of County Commissioners MAILING ADDRESS THE BOARD,COUNCIL.COMMISSION,AUTHORITY OR COMMITTEE ON 3299 Tamiami Trail East, Third Floor WHICH I SERVE ISA UNIT OF CITY COUNTY a ❑CITY ICOUNTY ❑OTHER LOCAL AGENCY Naples Collier NAME OF POLITICAL SUBDIVISION. Collier County DATE ON WHICH VOTE OCCURRED MY POSITION IS. March 12,2019 Of ELECTIVE 0 APPOINTIVE WHO MUST FILE FORM 88 This form is for use by any person serving at the county, city, or other local level of government on an appointed or elected board, council, commission, authority,or committee. It applies to members of advisory and non-advisory bodies who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes. Your responsibilities under the law when faced with voting on a measure in which you have a conflict of interest will vary greatly depending on whether you hold an elective or appointive position For this reason, please pay close attention to the instructions on this form before completing and filing the form. INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES A person holding elective or appointive county, municipal, or other local public office MUST ABSTAIN from voting on a measure which would inure to his or her special private gain or loss. Each elected or appointed local officer also MUST ABSTAIN from knowingly voting on a measure which would inure to the special gain or loss of a principal (other than a government agency) by whom he or she is retained (including the parent, subsidiary,or sibling organization of a principal by which he or she is retained);to the special private gain or loss of a relative; or to the special private gain or loss of a business associate. Commissioners of community redevelopment agencies(CRAs)under Sec. 163.356 or 163.357, F.S., and officers of independent special tax districts elected on a one-acre, one-vote basis are not prohibited from voting in that capacity. For purposes of this law, a "relative" includes only the officer's father, mother, son, daughter, husband, wife, brother, sister, father-in-law, mother-in-law, son-in-law, and daughter-in-law A"business associate' means any person or entity engaged in or carrying on a business enterprise with the officer as a partner,joint venturer, coowner of property, or corporate shareholder(where the shares of the corporation are not listed on any national or regional stock exchange). ELECTED OFFICERS: In addition to abstaining from voting in the situations described above, you must disclose the conflict: PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you are abstaining from voting;and WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing and filing this form with the person responsible for recording the minutes of the meeting,who should incorporate the form in the minutes. APPOINTED OFFICERS: Although you must abstain from voting in the situations described above. you are not prohibited by Section 112.3143 from otherwise participating in these matters. However, you must disclose the nature of the conflict before making any attempt to influence the decision, whether orally or in writing and whether made by you or at your direction. IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH THE VOTE WILL BE TAKEN: • You must complete and file this form(before making any attempt to influence the decision)with the person responsible for recording the minutes of the meeting,who will incorporate the form in the minutes. (Continued on page 2) CE FORM 8B-EFF.11/2013 PAGE 1 Adopted by reference in Rule 34-7.010(1)(f),F.A.0 i6A6 APPOINTED OFFICERS (continued) • A copy of the form must be provided immediately to the other members of the agency. • The form must be read publicly at the next meeting after the form is filed. IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING • You must disclose orally the nature of your conflict in the measure before participating. • You must complete the form and file it within 15 days after the vote occurs with the person responsible for recording the minutes of the meeting,who must incorporate the form in the minutes.A copy of the form must be provided immediately to the other members of the agency,and the form must be read publicly at the next meeting after the form is filed. DISCLOSURE OF LOCAL OFFICER'S INTEREST Andrew I. Solishereby disclose that on March 12 20 19 (a)A measure came or will come before my agency which(check one or more) inured to my special private gain or loss; inured to the special gain or loss of my business associate, • inured to the special gain or loss of my relative, inured to the special gain or loss of a client of my law firm , by whom I am retained;or inured to the special gain or loss of ,which is the parent subsidiary,or sibling organization or subsidiary of a principal which has retained me. (b)The measure before my agency and the nature of my conflicting interest in the measure is as follows On March 12,2019, the Board of County Commissioners will consider Agenda Item 16-A-6, a recommendation to approve for recording the minor final plat of LaMorada Parcel FD2. LaMorada at Naples Master Association, Inc., is a client of my law firm and in an abundance of caution, I will abstain from voting pursuant to Section 286.012, Fla. Stat.to avoid any perceived prejudice or bias. If disclosure of specific information would violate confidentiality or privilege pursuant to law or rules governing attorneys, a public officer, who is also an attorney, may comply with the disclosure requirements of this section by disclosing the nature of the interest in such a way as to provide the public with notice of the conflict. i March 12,2019 Date Filed Sign.t e alb NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES §112.317, A FAILURE TO MAKE ANY REQUIRED DISCLOSURE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT, REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY, REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED$10,000. CE FORM 88-EFF.11/2013 PAGE 2 Adopted by reference in Rule 34-7.010(1)(f),F.A.C.