Backup Documents 10/22/2019 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 3
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
I°I 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 Initi is Date
1. Susan Golden Community and Human 9
Services 1 b '1�
2. Jennifer Belpedio County Attorney Office D-016 i a'
3. BCC Office Board of County LJLtab�
Commissioners \r$4/ tc\- \�
4. Minutes and Records Clerk of Court's Office 0 I 113I tcl -ZpPill
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 ` /
Approved by the BCC V
Type of Document SHIP Satisfaction of Mortgage Number of Original 1
Attached Documents Attached V
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. mtial) Applicable)
1. Does the document require the chairman's original signature? 5\vk 5\v - a .&4 h Stamp
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 aware o our deadlines! /
8. The document was approved by the BCC 10/22/2019.a d all changes made during the N/A is not
meeting have been incorporated in the attached document. The County Attorney's l/ 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 N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for t QQ7 an o tion for
Chairman's signature. p� th' 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 5781702 OR 5687 PG 3857
RECORDED 10/24/2019 12:46 PM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
Prepared by: Susan Golden REC$10.00
Collier County
Community and Human Services a
3339 E.Tamiami Trail 1 D
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 Nose R.Portillo and Rhina E.Diaz,a married couple COLLIER COUNTY,dated
August 18,2011 and recorded on August 29,2011 in Official Records Book 4714 Page 531 of the Public
Records of Collier County, Florida, securing a principal sum of $4,500.00 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 obex- Z2
2019, Agenda Item Number \�t -3 .
ATTEST: BOARD • • !* Y CO • SION RS
CR. At:,K.,1<A1 , CLERK Q OF 0 •); Y, FLORI tA�'
Att St l 8thirCmLE1SK W / IAM L. MCDANIEL,JR.,C'AIRMAN
a, d
l• sIgnaltr Only
/*oval flis,fo to and legality:
„ft.1):A
Jenna er A. Belpedio
Assistant County Attorney c•-e05)7
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