Parcel 1210FEE - Purchase Agreement PROJECT NO.: 60168 Vanderbilt Beach Road Ext.
PARCEL NO.: 1210FEE
FOLIO NO.: 37442960001
PURCHASE AGREEMENT
THIS PURCHASE AGREEMENT is made and entered into on this day of
14q . ,
2020, by and between ALFREDO MEDINA and YOHANKA
MEDINA, husband and wife, whose mailing address is 2760 4th Avenue SE, Naples, Fl
34117 (hereinafter referred to as "Seller"), and COLLIER COUNTY, a political subdivision
of the State of Florida, whose mailing address is 3299 Tamiami Trail East, do the Office
of the County Attorney, Suite 800, Naples, FL 34112 (hereinafter referred to as
"Purchaser").
WHEREAS, Purchaser desires to purchase a portion of Seller's property as
described on attached "Exhibit A"which is incorporated herein by reference, together with
all structures and improvements thereon (hereinafter referred to as "the Property"); and
WHEREAS, Seller has agreed to sell, and Purchaser has agreed to purchase the
Property subject to the terms and conditions that follow.
NOW THEREFORE, in consideration of these premises, the sum of Ten Dollars
($10.00), and other good and valuable consideration, the receipt and sufficiency of which
is hereby mutually acknowledged, it is agreed by and between the parties as follows:
1. AGREEMENT
In consideration of the purchase price and upon the terms and conditions hereinafter set
forth, Seller shall sell to Purchaser and Purchaser shall purchase from Seller the Property.
2. PURCHASE PRICE
The purchase price (the "Purchase Price") for the Property shall be Fifty-Two Thousand
Five Hundred and 00/100 DOLLARS ($52,500) (U.S. Currency) payable at time of
closing. The Purchase Price, subject to the apportionment and distribution of proceeds
pursuant to Paragraph 3D of this Agreement, shall be full compensation for the Property
conveyed, including all structures, improvements, fixtures, landscaping, trees, and
shrubs, located thereon, and shall be in full and final settlement of all claims against the
Purchaser, including all attorneys' fees, expert witness fees and costs as provided for in
Chapter 73, Florida Statutes. None of this Purchase Price is attributed to any personal
property.
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3. CLOSING
A. TIME IS OF THE ESSENCE. Therefore, the Closing (the "CLOSING DATE",
"DATE OF CLOSING", or "CLOSING") of the transaction shall be held on or before
one hundred twenty (120) days following execution of this Agreement by the
Purchaser or within thirty (30) days of receipt by purchaser of all fully executed
closing documents and documents necessary to convey marketable title free of any
liens, encumbrances, exceptions, or qualifications, whichever is later, unless
extended by mutual written agreement of the parties hereto. The Closing shall be
held at Collier County Growth Management Department, Transportation Engineering
Division, 2885 Horseshoe Drive South, Naples, Florida 34104. Purchaser shall be
entitled to possession at the time of Closing, unless otherwise provided herein.
B. Seller shall convey a marketable title free of any liens, encumbrances,
exceptions, or qualifications. Marketable title shall be determined according to
applicable title standards adopted by the Florida Bar and in accordance with law.
Within ten (10) days of the Effective Date of this Agreement, Seller shall provide
Purchaser with a copy of any existing title insurance policy and survey. Three (3)
weeks before the Closing, the Seller shall cause to be delivered to the Purchaser
any documents necessary to convey marketable title and the following documents
and instruments duly executed and acknowledged, in recordable form:
1. General Warranty Deed in favor of Purchaser conveying title to the
Property, free and clear of all liens and encumbrances other than:
(a) The lien for current taxes and assessments.
(b) Such other easements, restrictions or conditions of record.
2. Combined Purchaser-Seller closing statement.
3. A "Grantor's Non-Foreign, Taxpayer Identification & "Gap" Affidavit" as
required by Section 1445 of the Internal Revenue Code and as required by
the title insurance underwriter in order to insure the "gap" and issue the
policy contemplated by the title insurance commitment.
4. A W-9 Form, "Request for Taxpayer Identification and Certification" as
required by the Internal Revenue Service.
5. Such evidence of authority and capacity of Seller and its representatives to
execute and deliver this Agreement.
6. All other documents required to consummate this transaction, as reasonably
determined by Purchaser's counsel and/or title company.
C. At the time of Closing, the Purchaser, or its assignee, shall cause to be delivered
to the Seller a County Warrant or wire transfer in an amount equal to Net Cash to
Seller on the Closing Statement. No funds shall be disbursed to Seller until there is
verification that there has been no adverse change to the state of the title to the
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Property since the date of the last title commitment, referenced in Paragraph 5 "Title
Defects" below, and the title company is irrevocably committed to issue the Owner's
title policy to the Purchaser in accordance with the commitment.
D. Purchaser shall pay all fees to record any curative instruments required to clear
title, and all Warranty Deed recording fees. In addition, Purchaser may elect to pay
reasonable processing fees required by mortgagees in connection with the
execution and delivery of a Release or Satisfaction of any mortgage, lien or other
encumbrance recorded against the Property; provided, however, that any
apportionment and distribution of the full compensation amount in Paragraph 2
which may be required by any mortgagee, lien-holder or other encumbrance-holder
as payoff, paydown, or for the protection of its security interest, or as consideration
due to any diminution in the value of its property right, shall be the responsibility of
the Seller, and shall be deducted on the Closing Statement from the compensation
payable to the Seller per Paragraph 2. County shall have sole discretion as to what
constitutes "reasonable processing fees."
E. There shall be deducted from the proceeds of sale all prior year ad valorem
taxes and assessments levied against the parent tract property which remain unpaid
as of the date of Closing.
4. IRRIGATION SYSTEM AND MISCELLANEOUS IMPROVEMENTS
A. Seller agrees to relocate any existing irrigation system (if any) located on the
Property including any irrigation lines, electrical wiring and sprinkler valves, etc.,
prior to the construction of the project without any further notification from Purchaser.
Seller assumes full responsibility for the relocation of the irrigation system (if any) on
the remainder property and its performance after relocation. Seller holds Purchaser
harmless for any and all possible damage to the irrigation system in the event owner
fails to relocate the irrigation system prior to construction of the project.
B. If Seller elects to retain any improvements and/or landscaping ("Improvements")
located on the Property, the Seller is responsible for their retrieval prior to the
construction of the project without any further notification from Purchaser. Seller
acknowledges that Purchaser has compensated Seller for the value of the
improvements located on the Property, and yet Purchaser is willing to permit Seller
to salvage said improvements as long as their retrieval is performed before
construction and without interruption or inconvenience to Purchaser's contractor. All
Improvements not removed from the Property prior to construction of the project
commences shall be deemed abandoned by Seller.
This provision shall survive Closing and is not deemed satisfied by conveyance of
title.
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5. TITLE DEFECTS
Upon execution of this Agreement by both parties or at such other time as specified within
this Section, Purchaser and/or Seller, as the case may be, shall perform the following
within the times stated, which shall be conditions precedent to the Closing:
A. Within forty-five (45) days after the Effective Date hereof, Purchaser shall
obtain as evidence of title an ALTA Commitment for a Title Insurance Policy with
Florida Modifications covering the Property, together with hard copies of all
exceptions shown thereon. Purchaser shall have thirty (30) days, following receipt
of the title insurance commitment, to notify Seller in writing of any objection to title
other than liens evidencing monetary obligations, if any, which obligations shall be
paid at closing. If the title commitment contains exceptions that make the title
unmarketable, Purchaser shall deliver to the Seller written notice of its intention to
waive the applicable contingencies or to terminate this Agreement.
B. Upon notification of Purchaser's objection to title, Seller shall have thirty (30)
days to remedy any defects in order to convey good and marketable title, except for
liens or monetary obligations which will be satisfied at Closing. Seller, at its sole
expense, shall use its best efforts to make such title good and marketable. In the
event Seller is unable to cure said objections within said time period, Purchaser, by
providing written notice to Seller within seven (7) days after expiration of said thirty
(30) day period, may accept title as it then is, waiving any objection, or may terminate
the Agreement.
6. TERMINATION AND REMEDIES
A. If Seller shall have failed to perform any of the covenants and promises
contained herein, which are to be performed by Seller, within fifteen (15) days of
written notification of such failure, Purchaser may, at its option, terminate this
Agreement by giving written notice of termination to Seller. Purchaser shall have the
right to seek and enforce all rights and remedies available at law or in equity to a
contract vendee, including the right to seek specific performance of this Agreement.
B. If the Purchaser has not terminated this Agreement pursuant to any of the
provisions authorizing such termination, and Purchaser fails to close the transaction
contemplated hereby or otherwise fails to perform any of the terms, covenants and
conditions of this Agreement as required on the part of Purchaser to be performed,
provided Seller is not in default, then as Seller's sole remedy, Seller shall have the
right to terminate and cancel this Agreement by giving written notice thereof to
Purchaser, whereupon $500 shall be paid to Seller as liquidated damages, which
shall be Seller's sole and exclusive remedy, and neither party shall have any further
liability or obligation to the other. Notwithstanding anything to the contrary herein
contained, the Purchaser shall have the right to terminate this agreement without
cause, in which event the liquidated damages provisions of this Section 1.B shall
equally apply, and Seller's sole remedy shall be a claim for payment of $500 as
liquidated damages. The parties acknowledge and agree that Seller's actual
4
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damages in the event of Purchaser's default or termination without cause are
uncertain in amount and difficult to ascertain, and that said amount of liquidated
damages was reasonably determined by mutual agreement between the parties,
and said sum was not intended to be a penalty in nature.
C. The parties acknowledge that the remedies described herein and in the other
provisions of this Agreement provide mutually satisfactory and sufficient remedies
to each of the parties and take into account the peculiar risks and expenses of each
of the parties.
7. SELLER'S AND PURCHASER'S REPRESENTATIONS AND WARRANTIES
A. Seller has full right and authority to enter into and to execute this Agreement
and to undertake all actions and to perform all tasks required of each hereunder.
Seller is not presently the subject of a pending, threatened or contemplated
bankruptcy proceeding.
B. Seller has full right, power, and authority to own and operate the Property, and
to execute, deliver, and perform its obligations under this Agreement and the
instruments executed in connection herewith, and to consummate the transaction
contemplated hereby. All necessary authorizations and approvals have been
obtained authorizing Seller and Purchaser to execute and consummate the
transaction contemplated hereby. Prior to Closing, and upon the request of
Purchaser or the Title Company, certified copies of such approvals shall be delivered
to Purchaser or the Title Company.
C. The warranties set forth in this paragraph are true on the Effective Date of this
Agreement and as of the date of Closing. Purchaser's acceptance of a deed to the
said Property shall not be deemed to be full performance and discharge of every
agreement and obligation on the part of the Seller to be performed pursuant to the
provisions of this Agreement.
D. Seller and Purchaser agree to do all things which may be required to give effect
to this Agreement immediately as such requirement is made known to them or they
are requested to do so, whichever is the earlier.
E. Seller represents that it has no knowledge of any actions, suits, claims,
proceedings, litigation or investigations pending or threatened against Seller, at law,
equity or in arbitration before or by any federal, state, municipal or other
governmental instrumentality that relate to this agreement or any other property that
could, if continued, adversely affect Seller's ability to sell the Property to Purchaser
according to the terms of this Agreement.
F. No party or person other than Purchaser has any right or option to acquire the
Property or any portion thereof.
G. Until the date fixed for Closing or as long as this Agreement remains in force
and effect, Seller shall not encumber or convey any portion of the Property or any
5
rights therein, nor enter into any agreements granting any person or entity any rights
with respect to the Property or any part thereof, without first obtaining the written
consent of Purchaser to such conveyance, encumbrance, or agreement which
consent may be withheld by Purchaser for any reason whatsoever.
H. Seller represents that Seller has no knowledge that any pollutants are or have
been discharged from the Property, directly or indirectly into any body of water.
Seller represents the Property has not been used for the production, handling,
storage, transportation, manufacture or disposal of Hazardous Materials as defined
herein, or any other activity that would have toxic results, and no such Hazardous
Materials are currently used in connection with the operation of the Property, and
there is no proceeding or inquiry by any authority with respect thereto. Seller
represents that Seller has no knowledge that there is ground water contamination
on the Property or potential of ground water contamination from neighboring
properties. Seller represents no storage tanks for gasoline or any other Hazardous
Materials are or were located on the Property at any time during or prior to Seller's
ownership thereof. Seller represents none of the Property has been used as a
sanitary landfill.
I. Seller has no knowledge that the Property, and/or that Seller's operations
concerning the Property, are in violation of any applicable Federal, State or local
statute, law or regulation, or of any notice from any governmental body has been
served upon Seller claiming any violation of any law, ordinance, code or regulation
or requiring or calling attention to the need for any work, repairs, construction,
alterations or installation on or in connection with the Property in order to comply
with any laws, ordinances, codes or regulation with which Seller has not complied.
J. There are no unrecorded restrictions, easements or rights of way (other than
existing zoning regulations) that restrict or affect the use of the Property, and there
are no maintenance, construction, advertising, management, leasing, employment,
service or other contracts affecting the Property.
K. Seller acknowledges and agrees that Purchaser is entering into this Agreement
based upon Seller's representations stated herein and, on the understanding, that
Seller will not cause the zoning or physical condition of the Property to change from
its existing state on the effective date of this Agreement up to and including the date
of Closing. Therefore, Seller agrees not to enter into any contracts or agreements
pertaining to or affecting the Property and not to do any act or omit to perform any
act which would change the zoning or physical condition of the Property or the
governmental ordinances or laws governing same. Seller also agrees to notify
Purchaser promptly of any change in the facts contained in the foregoing
representations and of any notice or proposed change in the zoning, or any other
action or notice, that may be proposed or promulgated by any third parties or any
governmental authorities having jurisdiction of the development of the property
which may restrict or change any other condition of the Property.
6
L. Seller represents, warrants and agrees to indemnify, reimburse, defend and hold
Purchaser harmless from all costs (including attorney's fees) asserted against the
Purchaser by reason or arising out of the breach of any of Owner's representations
under Paragraph 7. This provision shall survive Closing and is not deemed satisfied
by conveyance of title.
8. ENTIRE AGREEMENT
A. This Agreement and the exhibits attached hereto contain the entire agreement
between the parties, and there are no promises, representations, warranties or
covenants by or between the parties not included in this Agreement. No modification
or amendment of this Agreement shall be of any force or effect unless made in
writing and executed and dated by both Purchaser and Seller.
B. No waiver of any provision of this Agreement shall be effective unless it is in writing
signed by the party against whom it is asserted, and any waiver of any provision
of this Agreement shall be applicable only to the specific instance to which it is
related and shall not be deemed to be a continuing or future waiver as to such
provision or a waiver as to any other provision.
C. This Agreement is governed and construed in accordance with the laws of the
State of Florida.
D. Should any part of this Agreement be found to be invalid, then such invalid part
shall be severed from the Agreement, and the remaining provisions of this
Agreement shall remain in full force and effect and not be affected by such
invalidity.
E. The Effective Date of this Agreement will be the date of execution of this
Agreement by the last signing party.
9. PUBLIC DISCLOSURE.
If the Seller holds the Property in the form of a partnership, limited partnership,
corporation, trust or any form of representative capacity whatsoever for others, Seller
shall make a written public disclosure, according to s. 286.23, Fla. Stat., under oath,
subject to the penalties prescribed for perjury, of the name and address of every person
having a beneficial interest in the Property before Property held in such capacity is
conveyed to Collier County. (If the corporation is registered with the Federal Securities
Exchange Commission or registered pursuant to Chapter 517, Florida Statutes, whose
stock is for sale to the general public, it is hereby exempt from the provisions of Chapter
286, Florida Statutes.)
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the
date first above written.
411t
AS TO PURCHASER:
DATED: 9) 3/2t (9 )
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. KINZEL, Clerk of the COLLIER COUNTY, FLORIDA
• Circuit Court & Co troller
S , BY:
•eputy t as to Chairman s BURT L. SAUNDERS, Chairman
-signature only.
AS TO SELLER:
DATED: cc 13 \20� O
WITNESSES:
//
By:
(Signature) Alfredo Medina
) 4. OreV)
(Printed Name)
ignature)
Sd i1h rn. Pt
(Printed Name) _!
8
WITNESSES:
By:
(Signature) Yoh ka Medina
(Printed Name)
lucttaln f_buci
(Signature)
in PO
(Printed Name) J
Approved as to form and legality:
Jennifer A. Belpedio a�'/
��
Assistant County Attorney (. 0j
9
• EXHIBIT - A
VANDERBILT BEACH ROAD
7P.
100'
L PROPOSED
PARCEL 1210 FEE
18,000 SQ. FT.
TRACT 39
WEST 180' OF TRACT 55
TRACT 42
JAKE.CHRtSTOPHER WWSON,MONICA 1EDINA MYREM a YCHNMA , ^ ASILEY,S1EVFN a AMAIOA PECUCH.DALE&M.
OR 5604/2720 OR 5197/360 OR 5008/17455 , OR 4921/3259 OR 2741/1597
37442760007 37442800006 37442960001 37444010001 37444000008
180'
TRACT 42
GOLDEN GATE ESTATES
UNIT 17
PUT BOOK 7 DACE 5
10TH AVENUE N.E.
EX5T1NG ROADWAY EASEMENT
PER P8 7. PC S
SQ. FT.- SQUARE FEET TE - ROW
FEE - FEE SIMPLE PARCEL N
OR - OFFICIAL RECORDS (BOOK/PAGE) APR 2 9 ZOZO
PROPOSED FEE PARCEL W � E
S
LEGAL DESCRIPTION FOR PARCEL 1210 FEE
A PORTION OF TRACT 42, GOLDEN GATE ESTATES UNIT 17, AS RECORDED IN PLAT BOOK 7, PAGE 1Q5BLIC
RECORDS OF COLLIER COUNTY, FLORIDA, LYING IN SECTION 35, TOWNSHIP 48 SOUTH, RANGE`2,7% T. JrL R,,COUNTY,
FLORIDA, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: \G
`�_A .****GC'•!!
.
THE NORTH 100 FEET OF THE WEST 180 FEET OF SAID TRACT 42. •`• eCtlfICa
CONTAINING 18,000 SQUARE FEET, MORE OR LESS. Cy*
ro � Sao' o•,
0 Bo 120 240 .l �
SKETCH & DESCRIPTION ONLY l_.____.I i BY.rICWID arz�"-,�-`81 l57°r
ri J1 eA+
NOT A BOUNDARY SURVEY SCALE:1'-120' �'
APPEAANiC ON DOCUWINT WAS
FOR: COLLIER COUNTY GOVERNMENT BOARD OF COUNTY COMMISSIONERS THE
A 010O a2er IMC14413..A wu0.ns
VANDERBILT BEACH ROAD EXTENSION
SKETCH & DESCRIPTION OF: PROPOSED FEE SIMPLE PARCEL1Y*1341 88t0 Willow Park De.Suite 200
Naples,Florida 34109
PARCEL 1210 FEE Phone:(239)597-0575 FAX.(239)597-057s
LB N9.•8352
COLLIER COUNTY, FLORIDA ENGINEERING
JOB NUMBER REVISION SECTION TOWNSHIP RANGE SCALE DATE DRAWN BY FILE NAME SHEET
060119.06.00 1 35 485 27E 1' 120' 04-28-20 MAW SK1210FEE 1 OF 1
PROJECT NO.: 60168 Vanderbilt Beach Road Ext.
PARCEL NO.: 1210FEE
FOLIO NO.: 37442960001
STATE OF FLORIDA
COUNTY OF COLLIER
GRANTOR'S NON-FOREIGN TAXPAYER IDENTIFICATION & "GAP" AFFIDAVIT
The undersigned, ALFREDO MEDINA and YOHANKA MEDINA, husband and wife
(collectively, "Grantor"), after being duly sworn, deposes and says:
1. Grantor is the fee simple owner and the only owner of the property located in
Collier County and described in Exhibit "A" attached hereto ("Property").
2. Grantor's Legal Name is: ALFREDO MEDINA and YOHANKA MEDINA
3. Grantor's address is: 2760 4TH Avenue SE, Naples, Fl 34117
4. Section 1445 of the Internal Revenue Code requires a transferee of a U.S. real
property interest to withhold tax if the transferor is a foreign person. For U.S. tax
purpose (including Section 1445), the owner of a disregarded entity having legal
title to a U.S. real property interest under local law will be the transferor of the
property and not the disregarded entity. To inform Collier County, as transferee,
that withholding of tax is not required upon disposition of the Property, Affiant
affirms that the following is true:
a. Grantor is not a non-resident alien (if individual) or a foreign corporation,
foreign partnership, foreign trust or foreign estate (as those terms are defined
by the Internal Revenue Code and Income Tax Regulations) for purposes of
U.S. income taxation.
b. Grantor is not a disregarded entity as defined in s.1.1445-2(b)(2)(iii). (NOTE:
A disregarded entity for these purposes means an entity that is disregarded
as an entity separate from its owner under s.301.7701-3, a qualified REIT
subsidiary as defined in s. 856(i), or a qualified subchapter S subsidiary under
s.1361(b)((3)(B).
5. For purposes of reporting this Transaction to the Internal Revenue Service on
Form 1099-S, the Property is Grantor's (check one)
Principal Residence X Other real estate
6. Grantor is in sole constructive or actual possession of the Property, and there is
no other person or entity that has any possessory right in the Property.
7. Grantor has full authority to convey the Property.
8. There are no existing contracts for sale or mortgage commitments other than
those being closed affecting the Property.
9. Grantor knows of no defects in the Property's title and, except for real estate
taxes for the current year and those items identified on Exhibit "B" attached
hereto, there are no liens, encumbrances, mortgages, claims or demands on or
against the Property
10. There are no unrecorded labor, mechanics', material men's liens or "Notices of
Commencement" against the Property; no material has been furnished to or labor
performed upon the Property within the past ninety (90) days which has not been
paid for in full; no notices to owner have been delivered to or received by the
Grantor.
11. There are no bills, liens or assessments for sanitary sewers, paving or other
public utilities, or improvements made by any governmental instrumentality,
which are now unpaid, against the Property. Further, Grantor acknowledges
responsibility for water, sewer and electrical consumption charges through date
of closing or occupancy by Grantor, whichever first occurs. If any bills, liens or
assessments are found which relate to the period of Grantor's possession,
Grantor will pay same upon demand. Grantor shall obtain any release
documents needed which relate to bills, liens or assessments not paid at the time
of closing.
12. No notice has been received of any public hearing regarding future or pending
zoning changes or assessments for improvements by any governmental
instrumentality.
13. Grantor knows of no violations of local or state laws or private covenants,
restrictions or conditions which pertain to the Property.
14. There are no judgments, orders or decrees which have been entered in any state
or federal court against the Property or Grantor, and there are no civil or
administrative actions pending against Grantor or which involve the Property in
any way, including no action for dissolution of marriage or bankruptcy.
15. The Property and all uses of the Property have been and presently are in
compliance with all Federal, State and Local laws, regulations and ordinances,
including environmental laws, and that the Grantor has no knowledge of any spill
or environmental law violation on any property contiguous to or in the vicinity of
the Property; and that Grantor has not received notice and otherwise has no
knowledge of a) any spill on the Property, b) any existing or threatened
environmental lien against the Property or c) any lawsuit, proceeding or
investigation regarding the generation, storage, treatment, spill or transfer of
hazardous substances on the Property. This provision shall survive closing
and/or acceptance and is not deemed satisfied by conveyance of title.
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16. Grantor shall indemnify, defend and hold Collier County harmless against and
from any and all damages, claims, liabilities, actions, expenses, penalties, fines
and costs (including attorney's fees and expenses) incurred by or asserted
against Collier County by reason of or arising out of the breach of Grantor's
representations under Paragraph 15 above, irrespective of whether Affiant was
negligent in the making of these representations.
17. There are no unrecorded deeds, judgments, liens, mortgages, easements or
rights of way for users, claims, boundary line or other disputes, or demands of
any nature asserted against or affecting the Property.
18. There are no matters pending against Grantor that could give rise to a lien that
would attach to the Property, or cause a loss of title, or impair title between the
effective date of the title insurance commitment (or title search showing
ownership and encumbrances) and the time of recording of the instruments
evidencing the County's fee simple or other interests in the Property; and that
Grantor has not executed and will not execute any instrument that would
adversely affect the title to the Property from the date of this Affidavit forward.
19. If the conveyance is of fee simple and by purchase, Grantor agrees that in the
event the current real and personal property taxes vary in amount from the
figures used in making the prorations used in closing the conveyance of the
Property to County, then a new proration and a correct and proper adjustment
shall be made upon demand. Grantor understands that all taxes, maintenance
charges and assessments due from Grantor for which a bill is rendered prior to
closing will be charged against Grantor on the closing statement.
20. If the Property is improved property, then Affiant is the owner of said property,
and there are no claims, liens, security interests, claims or demands of any kind
against the furniture, equipment, fixtures and personal property located on the
Property and being sold as part of this transaction.
21. If the subject Property hereto is rental property, Grantor hereby represents that
Grantor has paid all sales taxes due to the State of Florida to date and will pay
any remaining taxes due in respect to said premises before due and will
indemnify and hold harmless Collier County from Grantor's failure to do so.
22. Grantor agrees to fully cooperate with Collier County when necessary to correct
an error discovered after closing and, in doing so, to execute, without delay, any
corrective instrument(s) needed in order to effectuate the intent of the parties to
this transaction. This provision shall survive closing.
23. Grantor understands that this certification may be disclosed to the Internal
Revenue Service by Collier County and that any false statements made here
could be punished by fine, imprisonment, or both. Grantor further authorizes the
submission of this affidavit if and when required.
24. Under penalties of perjury, I, the undersigned affiant, state that I have examined
this affidavit and to the best of my knowledge and belief it is true, correct and
complete as of the date of execution hereof; that I am authorized to execute this
affidavit as or on behalf of Grantor and to bind Grantor thereby; that I will
immediately notify Collier County of any change to the representations contained
herein and that, in the absence of such notification, Collier County may rely on
the representations contained herein on the day of closing; that Grantor intends
for Collier County, its agents and attorneys, the title company issuing the title
policy (if title insurance is to be issued), its underwriter and its employees, any
escrow/settlement agent and other parties and their attorneys participating in this
transaction, to rely on these representations, and Grantor will indemnify said
parties for all damages, loss, liability, claims, cost and expenses, including
attorney fees, which arise out of or result from their reliance upon these
representations, irrespective of whether I was negligent in making these
representations or executing this Affidavit.
WITNESSES:
t `> BY:
(S11igllnatur Alf edo Medina
(Print Name)
ignature) l
7r/4. ► lY fA i(f
(Print Name) J
0
STATE OF: FLORIDA
COUNTY OF: COLLIER
Sworn to and subscribed before me by means of Rphysical presence or ❑ online
notarization this 3r day of Sepjtm h - , 2020, by ALFREDO MEDINA a
married man, who is:
personally known to me,
OR,
1 who has produced 2as proof of
identity.
(affix notarial seal)
"ignature of Notary/Public)
(JtAdA in {:ail.
(Print Name of No ary Public)
11 ' .c:µr'i;i;;;„ JUDITH M.PUIG
/.`A,, 4:' Notary mmissic-Slat of rida Serial / Commission # (if any):
!), Commission If GG 194244
�,;,f�^:' My Comm.Expires May 20,2022
} Bonded through National Notary Assn.
a-. My Commission Expires: �/�?d/a o2a
WITNESSES:
. .._N. BY, anka c_cite,&
(Sign�at�urre) Y Medina
/t- errini-jp-, -
(Print Name)
litti,411, flAi'
ignature) Pull*
(Print Name) j
STATE OF: FLORIDA
COUNTY OF: COLLIER
Sworn to and subscribed before me by means of ilphysical presence or ❑ online
notarization this :if d day of p. pbV , 2020, by YOHANKA MEDINA a
married woman, who is:
personally known to me,
OR,
V who has produced as proof of
identity.
(affix notarial seal)
ignature of Notary Public)
PUS!{
tipav'n�B., JUDITH M.PUIG (Print Name of NoJry Public)
Notary Public-State of Florida
'779;. Commission q GG 194244 '
,.',,`;;TV):`rMy Cornet.Expires May 20,2022
4 Hondcd through National NotaryAssn. 0 Serial / Commission # (if any):
My Commission Expires: 5/:))0/Zd-,-).
Approved as to form and legality:
�Qa
Jennifer A. Belpe to
Cb\
Assistant County Attorney
0
. EXHIBIT - A
a.
VANDERBILT BEACH ROAD
1 I
100'
i
/PROPOSED
PARCEL 1210 FEE
18,000 SQ. FT.
TRACT 39 TRACT 55
WEST 180' OF
TRACT 42
JRKE,CHRISTOPHER HWSON,MONICA MEDMA A1FRE(A&WHOM Y 7 $^ ASREY,MEN&Nagel PIECUCH,DALE k W
OR 5604/2720 OR 5197/360 OR 5008/17455 Q, OR 4921/3259 OR 2741/1597
37442760007 37442800006 37442960001 1X Y 37444010001 37444000008
180' -
TRACT 1-2
GOLDEN GATE ESTATES
UNIT 17
PUT BOOK 7 SAGE 5
10TH AVENUE N.E.
COSTING ROADWAY EASEMENT
PER P8 7, PG 5
SQ. FT.- SQUARE FEET TE - R O W
FEE - FEE SIMPLE PARCEL N
OR - OFFICIAL RECORDS (BOOK/PAGE) APR 2 9 2020
1 I PROPOSED FEE PARCEL W !sil�- E
S
LEGAL DESCRIPTION FOR PARCEL 1210 FEE
A PORTION OF TRACT 42, GOLDEN GATE ESTATES UNIT 17, AS RECORDED IN PLAT BOOK 7, PAGE _5;,,QI sr PUBLIC
RECORDS OF COLLIER COUNTY, FLORIDA. LYING IN SECTION 35. TOWNSHIP 48 SOUTH, RANGE 7 EAS`.1888CG0'[I IER,COUNTY,
FLORIDA. BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: • �,\G ,Q 'L.,
THE NORTH 100 FEET OF THE WEST 180 FEET OF SAID TRACT 42. �� �Ctifia ?f�•� ,;, -
CONTAINING 18,000 SQUARE FEET, MORE OR LESS. CS.
X.� 5,30) 0A:
.*t:: ...*?0,Poriel:.*:t .-
0 60 120
SKETCH & DESCRIPTION ONLY i—__ I` L-_ _ t SIGHING OA c: _ E/rid t k 8,51'‘'
NOT A BOUNDARY SURVEY SCAMS:1'-120' i{THE SF.AL TA t
FOR: COLLIER COUNTY GOVERNMENT BOARD OF COUNTY COMMISSIONERS At,riw,mm z er WHAM.A WARDON .Pis
VANDERBILT BEACH ROAD EXTENSION
SKETCH & DESCRIPTION OF: PROPOSED FEE SIMPLE PARCEL1,BILIA\I 6610 WNilloaplea.w ParkFb rD:darne34109.Su!le 200
PARCEL 1210 FEE Phone(239) FAX.(239)59J-0578
l8 No.:8952
COLLIER COUNTY. FLORIDA ENGINEERING
JOB NUMBER REVISION SECTION TOWNSHIP RANGE SCALE DATE DRAWN BY FILE NAME ISHEET
060119.06.00 1 35 48S 27E 1" = 120' 04-28-20 MAW SK1210FEE 1 1 OF 1
EXHIBIT �u
Page of
Taxes for the year 2020 and subsequent years, which are not yet due and payable.
Encroachments, overlaps, boundary line disputes, and any other matters which would be
' disclosed by an accurate survey and inspection of the premises.
3 Oil, Gas and Sulphur Lease by and between Lee County Land Company, a Delaware
corporation, Tamiami Land Development Company, a Delaware corporation, Tamiami Trail
Estates, Inc., a Florida corporation, Deep Lake Company, a Florida corporation,
Caloosahatchee Tropical Company, a Florida corporation, Florida Timber Lands Corporation, a
Delaware corporation, Empire Land Company, a Delaware corporation, Gulf Coast Realties
Corporation, a Delaware corporation, Lessors, and Peninsular Oil and Refining Company, a
Florida corporation, Lessee, dated December 3, 1940 and recorded December 28, 1940 in
Deed Book 9, Page 560, of the Public Records of Collier County, Florida, as thereafter
amended. Note: Exception will be deleted upon receipt of Schedule B-i, #12 requirement.
Oil, Gas and Mineral Lease by and between Miles Collier and Barron Collier, Jr., joined by their
respective wives, Isabel Collier and Barbara Collier, Lessors, and Humble Oil & Refining
Company, Lessee, dated July 1, 1952 and recorded August 6, 1952 in Deed Book 24, Page
385; Assignment of Overriding Royalty recorded in Deed Book 29, Page 341, both of the Public
Records of Collier County, Florida. Note: Exception will be deleted upon receipt of Schedule B-
1, #13 requirement.
Reservation of oil, gas and mineral rights as set forth in that certain deed from Barron Collier,
Jr. and Miles Collier, joined by Barbara M. Collier, wife of Barron Collier, Jr., and Isabel U.
Collier, wife of Miles Collier, to Anchor Investment Corporation, a Florida corporation, dated
September 29, 1953 and recorded October 5, 1953 in Deed Book 30, Page 86, of the Public
Records of Collier County, Florida.
Restrictions, conditions, reservations, easements and other matters as set forth on the Plat of
Golden Gate Estates Unit 17 as recorded in Plat Book 7, Page 5, of the Public Records of
Collier County, Florida.
Request for Taxpayer
Form _9 Give Form to the
(Rev.October2018) Identification Number and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information.
on your income tax return).Name is required on this line;do not leave this line blank.
Alfredo Medina d Yohanka Medina
Dr„atl disregarded entity name,if different from above
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to
(a following seven boxes. certain entities,not individuals;see
a
✓ Individual/sole proprietor or ❑ C Corporationinstructions on page 3):
p ❑ p p' ❑ S Corporation 0Partnership ❑Trust/estate
csingle-member LLC Exempt payee code(if any)
❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)►
`p .22 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
c rn LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code(if any)
another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that
n o is disregarded from the owner should check the appropriate box for the tax classification of its owner.
instructions)
Other❑ (see ► (Applies to accounts maintained outside the U.S.)
y 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional)
cn 2760 4th Avenue SE
6 City,state,and ZIP code
Naples, Fl 34117
7 List account number(s)here(optional)
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid I Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a _ - / _
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a
TIN,later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
Part II Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later.
Sign Signature of
Here U.S.person► Date O.
General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross
noted.
proceeds)
Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)