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Backup Documents 10/22/2019 Item #16D 2 Al2-41/4-4-441). ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP n TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 D 2 qv/ 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 In'tials Date 1. Susan Golden Community and Human 9/ 9 Services ci.. 2. Jennifer Belpedio County Attorney Office 3. BCC Office Board of County WV.t-k Commissioners \l-N /St \o\23Vzk 4. Minutes and Records Clerk of Court's Office Cle IC kr/ 1-1:41°1 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 Susan Golden/CHS Phone Number 252-2336 Contact/ Department Agenda Date Item was 10/22/2019 Agenda Item Number 16.D a ✓ Approved by the BCC Type of Document SHIP Satisfaction of Mortgage Number of Original 1 .1/ Attached Documents Attached PO number or account number if document is 123-155974-649030-32001.1 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. Inti Applicable) 1. Does the document require the chairman's original signature? S 411�.__f Cl4.s1 Stamp 1 OK 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 SG 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 SG 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 SG 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 awarerour deadlines! 8. The document was approved by the BCC 10/22/2019 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. this line. 9. Initials of attorney verifying that the attached document is the version approved by the -"- /A is not BCC,all changes directed by the BCC have been made,and.the document is ready for th an` ption for Chairman's signature. thiline. 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 5781694 OR 5687 PG 3849 RECORDED 10/24/2019 12:42 PM PAGES 1 CLERK OF THE CIRCUIT COURT AND COMPTROLLER Prepared by:Mason Rummer COLLIER COUNTY FLORIDA Collier County REC$10.00 Community and Human Services 3339 E.Tamiami Trail 16 0 2 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 Alipio A. Marrero and Maria L. Jimenez, Husband and Wiff COLLIER COUNTY,dated June 28,2004 and recorded on July 8,2004 in Official Records Book 3602 Page 3569 of the Public Records of Collier County,Florida,securing a principal sum of$2,500.00 and certain promises and obligations set forth in said Mortgage, upon the property described in the aforementioned mortgage. (COLLIER COUNTY hereby acknowledges and 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 2019, Agenda Item Number l -A -2 • • ' . . 4tErrt r %. BOARD 0 4 if TY CO SION 'S E R .%T IC.. ► CLERK OF '0 ' Y, FLORI►A fas tONERK WI i IAM L. MCDANIEL JR., C AIRMAN srgnalur only Ap royal for form d legality: Jennifer .Belpedio Assistant County Attorney C1110 q\