Backup Documents 09/10/2019 Item #16F1-C (08/13/2019 in Absentia) RIGINAL DOCUMENH & ROUTING SLIP 1 6 F i C
Prd TO ACCOMPANY ALL TS ORIGINAL CECKLIST DOCUMENTS SENT TO
1 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.
2.
3. County Attorney Office County Attorney Office JAB 8/13/19
4. BCC Office Board of County ',-o‘1 ,\\ `/'/ l
Commissioners \ \S� /"1:1\kms
5. u ,A
Min tes and Records Clerk of Court's Office "l\\'S\' \ 1^3.
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. a
Name of Primary Staff Jennifer elpedio Facilities 239-252-8400
Contact/Department /Management
V Division v
Agenda Date Item was 8/13/19 '��c�-s'-tI- 342 .-4K-`CrN G Agenda Item Number -F6 "I\-c.XnG ( (1)
Approved by the BCC Q` <Akcit t F-\ - L �$V3`t91/4.
Type of Document Satisfaction and Release of Claim Number of Original 1 �'
Attached Documents Attached J�
PO number or account lir
44
number if document is V
S« o,'�c\te�,
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable col -, ' hever is Yes N/A(Not
appropriate. (Initial) Applicable) 0
1. Does the document require the chairman's original signatur= STAMP OK
2. Does the document need to be sent to another agency for additio . a res? If yes, NA
provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet. o
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAB
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney. p/
4. All handwritten strike-through and revisions have been initialed by the County Attorney's NA .44
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 JAB
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 JAB T
signature and initials are required. t
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. 9.1
Some documents are time sensitive and require forwarding to Tallahassee within a certain V
time frame or the BCC's actions are nullified. Be aware of your deadlines! q)
8. The document was approved by the BCC on 8/13/19 and all changes made during the JAB
meeting have been incorporated in the attached document. The County Attorney's
Office has reviewed the changes,if applicable. p
9. Initials of attorney verifying that the attached document is the version approved by 3
the BCC,all changes directed by the BCC have been made, and the document is
ready for the Chairman's signature. iD
4#
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9. .04,Revised 1.26.05,Revised 2.24.05 Revi��l,11/ 0/12 INP
* Please. a Iso Send O copy 01- Cl.ia;r S,9,1eed R€l coed
�o Co �r' t -F'; /� 9 L P doh 2 r3 1.(
16F1C
MEMORANDUM
Date: September 23, 2019
To: Jennifer Belpedio, Assistant County Attorney
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Satisfaction and Release of Claim — Case No. 2019-CP-208
Attached for your records is one (1) copy of the recorded document as referenced
above, (Item #16F1-C) adopted by the Board of County Commissioners on Tuesday,
September 10, 2019.
The original is being held in the Minutes & Records Department as part of the
Official Records.
If you have any questions, please feel free to contact me at 252-8411.
Thank you.
Attachment
I 6F1C
MEMORANDUM
Date: September 23, 2019
To: Barbara Flowers, Probate
From: Teresa Cannon, Senior Deputy Clerk
Minutes & Records Department
Re: Satisfaction and Release of Claim — Case No. 2019-CP-208
Attached for your records is one (1) copy of the recorded document referenced
above, (Item #16F1-C) approved by the Board of County Commissioners on
Tuesday, September 10, 2019.
The Board's Minutes and Records Department will keep the original as part of the
Board's Official Record.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachment
INSTR 5766669 OR 5674 PG 2649S 1 1 6 F 1 C
RECORDED 911712019 3.14 PM PAGE
CLERK OF
REC$10.00 THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
IN THE CIRCUIT COURT FOR COLLIER COUNTY,
FLORIDA PROBATE DIVISION
IN RE: ESTATE OF
File No. 2019-CP-208
LILLIAN C. WOLF
Division Probate
Deceased.
SATISFACTION AND RELEASE OF CLAIM
The undersigned, Board of County Commissioners, Collier County, Florida c/o Collier
County Utilities Division, 4420 Mercantile Avenue, Naples, FL 34102, has received full
payment of the claim which was filed in this proceeding by the undersigned against the above
estate for on or about March 18, 2019, or has otherwise settled or compromised said claim, and
this Satisfaction and Release of Claim is executed to acknowledge discharge of the claim and to
release the estate and the personal representative of the estate from all further liability with
respect thereto.
Signed on this it-\day of , 2019.
,-/' .4-
__1__. I
Approved in absentia per Resolution Willia //L. McDaniel,Jr. Chairman
2000-149 on August 1 2019 Authorized Agent for Board of County
Commissioners, Collier County,Florida c/o Collier
BY. ' ' C .00_County Utilities Division
. Leo . Ochs, Jr. , Co , r ager 4420 Mercantile Avenue,Naples, FL 34102
239-252-2380
..-* ' 611,.
*
4, ...,... .....AWEST
,f` *•, ,CRY. L K. KINZEL ERK Approved as to form and legality
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411
�� , As ant County Mut „ �j
-1 S test as to Chairman's °1
'e4• ..... eve,signature only.