Backup Documents 06/11/2019 Item #16D10 ri orck ?`[(e(L'J
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP r�
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 6 01 U
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
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 Initials Date
1. Don Luciano Community and Human DL 08/12/19
Services
2. County Attorney Office County Attorney Office i 1 0°1
3. BCC Office Board of County ti) g )14_ 16?
Commissioners '1k}
4.
Minutes and Records Clerk of Court's Office
3'.3f P1
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 Don Luciano,Grants Coordinator, Phone Number 239-252-250
Contact/ Department Community and uman Services
Agenda Date Item was June 11,2019 Agenda Item Number 16 D 10
Approved by the BCC
Type of Document '- = - . - • ;.'" Number'.p Number of Original 1
Attached �- f�a�Q o�u.„n Documents Attached
PO number or account
number if document is -Nies CS_c7,Vyi
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? 3 4, 0 K DL
2. Does the document need to be sent to another agency for additional signatures1 If yes, DL
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 DL
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 DL
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 DL
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 DL
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip DL
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 06/11/19 and all changes made during N"A is not
the meeting have been incorporated in the attached document. The County an option for
Attorney's Office has reviewed the changes, if applicable. this line:
9. Initials of attorney verifying that the attached document is the version approved by theA is not
BCC, all changes directed by the BCC have been made, and the document is ready for the O`"_' a option for
Chairman's signature. 00,:s; ine.
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
1 6 D 1 U
INSTR 5754542 OR 5664 PG 1069
RECORDED 8/19/2019 11:13 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
REC$10.00
Prepared by:IDon Luciano
Collier County
Community and Human Services
3339 E.Tamiami Trail
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
Mortgage executed by James & Filornena Poole, husband & wife to COLLIER COUNTY, dated
07/30/2002 and recorded on 08/13/2002 in Official Records Book 3090 Page 0059 of the Public Records
of Collier County, Florida, securing a principal sum of $15,000.00 of SHIP and certain promises and
obligations set forth in said Mortgage,upon the property described in the aforementioned mortgage.
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!June 102019,Agenda Item
Number{ i(.Q ID 1.
ATTEST„ t B&14+J9,0 BOARD F O09 TY COM SION t S
CRYSTI,K.KINZEL LERK • 0 n Y,FLOR1 r,A 01110
By. ,". C • By. � ..�Arr _ _ r►
Ait
�St`a -sail LLIAM L.MCDANIEL,JR.,C •IRMAN
SI ature or
Appro 1,for form,a ¢I. ity:
Jenne-A.Belpedio
Assistant County Attorney \`
511\