Backup Documents 11/12/2019 Item #16D 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 0 6
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
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 eceived in the County Att rney Office no later
than Monday preceding the Board meeting. �d� ')�
**NEW** ROUTING SLIP I1 19
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is i kady 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. Susan Golden Community and Human 10/25/19
Services
2. Jennifer Belpedio County Attorney Office
•S'- o till -II
3. BCC Office Board of County
Commissioners
4. Minutes and Records Clerk of Court's Office �,��
' VA h Hill I(=?tel
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 11/12/2019 ✓ Agenda Item Number I6.D. 6
Approved by the BCC
Type of Document 2 - SHIP Satisfaction of Mortgage(Leiva& Number of Original 2 C'� I e p,c.- -.) ✓
Attached Chase) �/ Documents Attached
PO number or account 791-138791-649030-33613.1
number if document is
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. itiafj-' plicable)
1. Does the document require the chairman's original signature? STAMP
�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 aware o our deadlines!
8. The document was approved by the BCC 11/12/2019 d all changes made during the SG 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 SGtt�1 N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the �O✓. an option for
Chairman's signature. this line.
CY—
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 c:?
1606
INSTR 5790365 OR 5695 PG 888
RECORDED 11/14/2019 9:58 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Prepared by: Susan Golden COLLIER COUNTY FLORIDA
Collier County REC$10.00
Community and Human Services
3339 E.Tamiami Trail
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 Christine Chase, a single woman, to COLLIER COUNTY, dated 07/09/2007 and
recorded on 07/11/2007 in Official Records Book 4256 Page 0881 of the Public Records of Collier County,
Florida, securing a principal sum of$29,250.00 of SHIP and certain promises and obligations set forth in
said Mortgage, upon the property described in the aforementioned mortgage.
COLLIER COUNTY hereby acknowledges 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 -
1 1 12 , 2019,Agenda Item Number t(, D G
A,
ATTEST: BOA:. • 111, OMMI ON '
CRYSTAL K. KINZEL, CLERK OF (O ' ' � ►' ,F •RID •
Arir /7 C• i
v.
By: { r`AIWA rim- y.Attest as to ,C ' a WI / IAM L.MCDANIEL,JR.,CHAIRMAN
signature only.
A�.rova1 for form ..d legality:
Jennifer A. BelpedioOs??
Assistant County Attorn-
16o6
INSTR 5790364 OR 5695 PG 887
RECORDED 11/14/2019 9:58 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Prepared by:',Susan Golden COLLIER COUNTY FLORIDA
REC$10.00
Collier County
Community and Human Services
3339 E.Tamiami Trail
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 Maria A. Leiva, a single woman to COLLIER COUNTY, dated 07/15/2011 and
recorded on 08/03/2011 in Official Records Book 4707 Page 1680 of the Public Records of Collier County,
Florida, securing a principal sum of$4,208.00 of SHIP and certain promises and obligations set forth in
said Mortgage, upon the property described in the aforementioned mortgage.
COLLIER COUNTY hereby acknowledges 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 -
\I a • , 2019, Agenda Item Number 1(0 £
ATTEST: O BOA I + IMMIS 4NE' ij
,'.0
CRYSTAL K, KINZELLERK OF CQ ,,, • k '� FL'RID•
•
aka (', By�
'MTV( LE'l I •
WILL M L.MCDANIEL,JR.,CHAIRMAN
Attest as to Ch
signatl:re only.
Approval for form and legality:
Jenna er A. Belpedi
Assistant County Attorney
O
0