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Backup Documents 05/14/2019 Item #16D 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 0 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE 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 VV 4 Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is alr .ii, 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 Cou,, Attorney Office. illi Route to Addressee(s) (List in routing order) Office Initials Date 1. JASON RUMMER Community and Human P7 05.10.19 Services 2. Jennifer Belpedio County Attorney Office - .5113 ll`� 3. BCC Office Board of County W Commissioners VA/ S,\S\`c\ 4. Minutes and Records Clerk of Court's Office i\kl) IISG� 3'�/ 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 JASON RUMIVE CHS Phone Number 252-5505 Contact/ Department Agenda Date Item was 05.14.2019 Agenda Item Number 16.D.1 Approved by the BCC Type of Document Satisfaction of Mortgage DE LA CRUZ Number of Original 1 Attached Documents Attached PO number or account 123-155974-649030-32000.1 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? 5-c►p d�___ // NA 2. Does the document need to be sent to another agency for additional signatures? If yes, NA 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 JNR 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 JNR 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 JNR 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 05/14/2019 and all changes made during the N/A is not meeting have been incorporated in the attached document. The County Attorney's an option for Office has reviewed the changes,if applicable. line. 9. Initials of attorney verifying that the attached document is the version approved by the �` ` Nl is not BCC,all changes directed by the BCC have been made,and the document is ready for the f an option for Chairman's signature. 's line. 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 11/30/12 16 0 1 INSTR 5713654 OR 5630 PG 3103 RECORDED 5/16/2019 1:16 PM PAGES 1 CLERK OF THE CIRCUIT COURT AND COMPTROLLER Prepared by:Jason Rummer COLLIER COUNTY FLORIDA Collier County REC$10.00 Community and Human Services 3339 E.Tamiami Trail Naples,FL 34112 THIS SPACE FOR RECORDING SATISFACTION OF MORTGAGE' 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 Mortgage executed by FRANCISCA DE LA CRUZ to COLLIER COUNTY, dated AUGUST 2001 and recorded on 08/30/2001 in Official Records Book 2884 Page 0178 of the Public Records of Collier County, Florida, securing a principal sum of$2,500.00 of SHIP: and certain promises and obligations set forth in said Mortgage, upon the property described in the aforementioned mortgage. COLLIER COUNTY hereby acknowledges satisfaction of said Mortgage, and surrenders the same as cancelled, and hereby directs the Clerk of said Circuit Court to cancel the same of record. This Satisfaction of Mortgage was approved by the Board of County Commissioners on MAY 14,2019, Agenda Item Number 6, /�, t. ATTEST: BOARD OF CO ' Yr SIONERS CRYSTAL K. KINZEL, CLER OFC L e• ►v TY FLORID • • By: �I �dk _ By: C��� Attest as to Cairiiri • 5' WIL /, M L.MCD L,JR.,C AN signature only: , 4 Approval for form and legality: Jenni er A.Belped "'� Assistant County Attorney 2' V'l