Backup Documents 09/10/2019 Item #16D 9 ) 9,?.,1-,-At?
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 9
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
Cl 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. Elizabeth Hernandez Community and Human
Services 9/s-//7
2. Jennifer Belpedio County Attorney Office 2 n `' tokEk
3. BCC Office Board of County 1,43
1-.1tA
Commissioners U�(6/ 9\\��\`
4. Minutes and Records Clerk of Court's Office 0, 9 /II bq 3' -v
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
Contact/Department Elizabeth Hernand z/CHS Phone Number 252-2903
Agenda Date Item was
Approved by the BCC 09/10/2019 Agenda Item 16.D.9 /7.-
Number
Type of Document Release of Mortgage Number of Original
Attached Documents Attached 2
PO number or account $10 fee 791-138791-649030-33569.1 SHIP
number if document is $10 fee 705-138705-649030-33580.1 CDBG
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whic • Yes N/A(Not
appropriate. . itial) Applicable)
1. Does the document require the chairman's original signature E
2. Does the document need to be sent to another agency for additi 1 signatures? f yes, NA
provide the Contact Information(Name;Agency;Address; Phone)o attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be EH
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 EH
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 EH
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 09/10/2019 and all changes made during EH 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 the H N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for th an option for
Chairman's signature. ��this line.
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
INSTR 5764971 OR 5673 PG 1320
RECORDED 9/12/2019 4:38 PM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
Prepared by: Elizabeth Hernandez REC$10 00
Collier County
Community and Human Services
3339 E.Tamiami Trail L O
Naples,FL 34112 (�
THIS SPACE FOR RECORDING
RELEASE 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 Elnora Miller & Samuel Miller, husband and wife to COLLIER COUNTY,
dated March 10,2004 and recorded on 05/17/2005 in Official Records Book 3799 Page 3487 of the Public
Records of Collier County, Florida, securing a principal sum of $11,684.75 and certain promises and
obligations set forth in said Mortgage, upon the property described in the aforementioned mortgage.
COLLIER COUNTY hereby acknowledges release 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 Release of Mortgage was approved by the Board of County Commissioners on -
--Zift.Mtt e•it• /0 , 2019, Agenda Item Number /6. D. 9 •
A E rr'D es3,r► BOARD OF CO ' • SIONERS
k17 AL . .L, CLERK OFC L E r• FLORID •,
; ,t ^; �.;1 K WIL�AM L. MCD• 'IEL, JR., C MAN
Qt •
•
sign +, 'y •
Apytign and legality:
�� _ $ d moo\
Jennt er A.Belpedio �p O`
Assistant County Attorney
^��
1609
INSTR 5765047 OR 5673 PG 1597
RECORDED 9/13/2019 8:41 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Prepared by:1 Elizabeth Hernandez COLLIER COUNTY FLORIDA
Collier County REC$10.00
Community and Human Services
3339 E.Tamiami Trail
Naples,FL 34112
THIS SPACE FOR RECORDING
RELEASE 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 1Samuel Miller & Elnora Miller, husband and wife l to COLLIER COUNTY,
dated July 29, 2002 and recorded on 08/13/2002 in Official Records Book 3090 Page 0031 of the Public
Records of Collier County, Florida, securing a principal sum of $15,000.00, and certain promises and
obligations set forth in said Mortgage, upon the property described in the aforementioned mortgage.
!COLLIER COUNTY hereby acknowledges release 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 Release of Mortgage was approved by the Board of County Commissioners on -
eirt.sdeAt /o , 2019, Agenda Item Number /6,1), 9 .
r ,• baton
-\ . ATTE T: BOARD OF C•I Y CO SIONERS
C' `•L'.Kt:,KINZ _ CLERK r OFS�, L�I�'1 , FLORI9
11 It•
amiiity _ .
• •
�D' ERK By.WIL/ AM,L. MCDANIE`R., C • IRMAN
le.4' 's fe only.
Approval for form and egality:
C�1 A
Jen r A. Belpedio 0-
Assistant County Attorney CD p\
0