Backup Documents 09/28/2021 Item #16C 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATUIL 6 C 1
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. County Attorney Office County Attorney
2. BCC Office Board of County b
Commissioners ,Stkict 16 SA
3. Minutes and Records Clerk of Court's Office
1:71 L I cA(4
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 Cindy M. Erb Phone Number 239-252-8917
Contact/ Department
Agenda Date Item was I / j Agenda Item Number / /1
Approved by the BCC 1 / Z9/ 202- / I V L-
Type of Document r�W �`� /�o///s ,� A Number of Original
Attached U/ r� / � �''C Documents Attached
PO number or account Account: Fund , Cost Center , Object
number if document is Code 649030, Project
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. (Initial) Applicable)
I. Does the document require the chairman's original signature?
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
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
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 N/A
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 N/A
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
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
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 of your deadlines!
8. The document was approved by the BCC on cl L /,Z.d,2 1 ,and all changes
made during the meeting have been incorporated in the attached document. The
County Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for the A
Chairman's signature.
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
Memorandum
I6Ci
TO: Minutes & Records
6..44
FROM: Cindy Erb, Property Acquisition Specialist, Sr., Real Property Management
DATE: September 28, 2021
RE: City Gate Blvd South - Utilities
This item was approved by the BCC on September 28, 2021, Agenda Item 16C1.
Please attest to Commissioner Taylor's signature as Chair on the Utility Facilities Warranty
Deed and Bill of Sale, and Owner's Affidavit.
Once attested, please advise so we can pick up ORIGINALS. These documents will
eventually go to the Growth Management department for processing.
Please contact me if you have any questions or comments at Extension 8917.
Thank you!
I6Ci
MEMORANDUM
Date: October 5, 2021
To: Cindy Erb, Property Acquisition Specialist, Senior
Real Property Management
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Utility Facility Warranty Deed and Bill of Sale—
Collier County Sports Complex and Events Center
Attached for further processing are original copies of the documents referenced
above, (Item #16C1) approved by the Collier County Board of County
Commissioners on September 28, 2021
Copies of the documents will be held in the Board's Minutes and Records
Department for the official record.
Thank you.
Attachment
i6C } '
This instrument prepared by
and return to:
Jennifer A. Belpedio, Assistant County Attorney.
Office of the County Attorney
3329 East Tamiami Trail. Suite 800
Naples, Florida 341 12-5749
Phone:(239)252-8400
Facsimile: (239)593-1309
UTILITY FACILITIES WARRANTY DEED AND BILL OF SALE
t�-
THIS INDENTURE made this 4.01 day of d?9knikr. 2021 by COLLIER COUNTY, A
POLITICAL SUBDIVION OF THE STATE OF FLORIDA, whose post office address is 3335 East
Tamiami Trail, Suite 101,Naples, Florida 34112, hereinafter referred to as "Grantor",and the BOARD
OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AS THE GOVERNING
BODY OF COLLIER COUNTY AND AS THE EX-OFFICIO GOVERNING BOARD OF THE
COLLIER COUNTY WATER-SEWER DISTRICT, whose post office address is 3335 East Tamiami
Trail,Suite 101,Naples, Florida 341 12, its successors and assigns, hereinafter referred to as"Grantee".
WITNESS ETH:
That said Grantor, for and in consideration of the sum of Ten Dollars ($10.00) and other good and
valuable consideration to said Grantor in hand paid by said Grantee, the receipt whereof is hereby
acknowledged,has granted, bargained and sold to the said Grantee,and Grantee's heirs, successors and
assigns forever, all potable water utility' facilities and/or system(s) or portion(s) thereof lying in, on,
over and under the following described land, for operation, relocation, installation, repair and/or
maintenance of said facilities, system(s)or portion(s)thereof,all situate and lying and being in Collier
County, Florida,to wit:
(See Exhibit "A" attached hereto and incorporated by reference herein.)
(See Exhibit 'B" attached hereto is a sketch or other graphic representation
that depicts the physical location of the utility systems being conveyed.)
and said Grantor does hereby fully warrant the title to said utility facilities and/or system(s)or portion(s)
thereof, be they realty, personalty, or mixed,and Grantor will defend such title against all claims of all
persons whomsoever. For the purposes of this conveyance. the utility facilities, system(s) and/or
portion(s)thereof conveyed herein shall not be deemed to convey any of the lands described in either
exhibit. Grantor and Grantee are used for singular or plural, as context allows. A sketch or other
Page 1 of 6
08.27.2021 CC to CCW&SD
0
I6Ci
graphic representation showing the location of the utility facilities, etc.. being conveyed is attached as
Exhibit B.
TO HAVE AND TO HOLD the same unto the Grantee and its assigns, together with the right to enter
upon said land, excavate, relocate and/or take or introduce materials for the purpose of constructing,
relocating, operating, repairing and/or otherwise maintaining utility systems thereon. Grantor and
Grantee are used for singular or plural, as the context requires.
IN WITNESS WHEREOF, Grantor has caused these presents to be executed the date and year first
above written
Signed, sealed and delivered in the presence of:
ATTEST:
CRYSTAL K. KINZEL, Clerk of Court BOARD OF COUNTY COMMISSIONERS &
Comptroller in and for Collier County, Florida COLLIER COUNTY, FLORIDA
BY:
r _
i e CI, PENNY TAYL R, Chair
Attest as to Ch
si neture onI
Approved as to form and legality:
Jennifer A. Belpedio, A 'stant County Attorney. ())
Page 2 of 6
08.27.2021 CC to CCW&SD
0
I6C1 -
EXHIBIT"A"
Legal Description
The County Utility Easements (C.U.E.$) described on that certain Utility Easement dated May 12,
2020 and recorded on May 19, 2020,at Official Records Book 5764, Page 3429 of the Public Records
of Collier County, AND which abut the Plat of CITY GATE COMMERCE PARK, PHASE THREE
REPLAT NO. 4, recorded in Plat Book 68, Page 68 through 73, Public Records, Collier County,
Florida.
Page3of6 O
08.27.2021 CC to CCW&SD
EXHIBIT "B" i 6
SKETCH/GRAPHIC REPRESENTATION
DEPICTING THE PHYSICAL LOCATION OF THE
UTILITY SYSTEMS BEING CONVEYED.
"""1 Ji �i .o .... .._ 'r .. ... .,
11
r. , - .._ ._. ... _ ,_ .. ...._ , . _ . .. ; ' i LOT •
4 .
; I 11
Iy
.OT 8 . ' Np`" ,� 6"
_... +v ... � ma. .rn
�� n" �y „
qa cmmRvrwwAunr ,�
INNING I ',Al "'
� , Lid z0 I I
f, v. I
C.. I
1
•
T —
s, (P �I AC(P) I - — --- — — — ..
01.1MT %/A 111% t tnt 1T M art-rt.. 4 'el Intl'I",I rb nr .'
Page 4 of 6
08.27.2021 CC to CCW&SD 9
0
i6Ci _
CERTIFICATION OF CONTRIBUTORY ASSETS-COUNTY
PROJECT NAME: City Gate Commerce Perk Phase Three Replat No.4 #1
LOCATION: Collier County,FL
Real Property: Lot 26.City Gate Commerce Park Phase Three Replat No.2.Plat Book 67.Page 6 et seq.
NAME&ADDRESS OF OWNER: Board of County Commissioner of Collier County
3335 Tamiami Trail East,Suite 101
Naples,FL 34112
TYPE OF UTILITY SYSTEM:SANITARY SEWER(MATERIALS ONLY)
ITEM SIZE QUAN. UNIT COST TOTAL
N/A
TOTAL COST: $0.00
I do hereby certify that the Qua^titles of materals describes above are a true and accurate
representation of the system.
CERTIFYING:
,P.E.,Project Engineer
Name: Kevin Jensen Name: Jenne Woodward
Authorized Agent FOR
OF: Jensen Underground OF: Peninsula Engineering
5585 Taylor Rd 2600 Golden Gate Parkway
Naples,FL 34109 Naples,Florida 34105
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was signed and acknowledged before me this_day of
2021 by who is personally known to me and who did not take an oath.
SEAL:
Notary Public Signature
Page5of6
08.27.2021 CC to CCW&SD Q
ta.Ci -
#2
CERTIFICATION OF CONTRIBUTORY ASSETS-COUNTY
PROJECT NAME: City Gate Commerce Park Phase Three replat No.4
LOCATION: Collier County.FL
Real Property: Lot 26.City Gate Commerce Park Phase Three Replat No.2,Plat Book 67,Page 6 et seq.
NAME&ADDRESS OF OWNER: Board of County Commissioner of Collier County
3335 Tamiami Trail East,Suite 101
Naples.FL 34112
TYPE OF UTILITY SYSTEM:POTABLE WATER(MATERIALS ONLY)
ITEM SIZE QUAN. UNIT COST TOTAL
DR-1B PVC 12" 31 LF $
Poly Water Service 2" Ri I F $ -
Tapping Saddle and Gate Valve 14"x12" 1 EA $ -
TOTAL COST: $0.00
I do he'eby certify that the quantities of material and servaes described above are true arc
Jttu'ate repre_entahon of the as-nttalleo tort or the syr:em.
CERTIFYING:
•P.E..Project Engineer
Name Kevin Jensen Name: Jenne Woodward
Authorized Agent FOR
OF: Jensen Underground OF: Peninsula Engineering
5585 Taylor Rd 2600 Golden Gate Parkway
Naples,FL 34109 Naples,Florida 34105
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was signed and acknowledged before me this_day of
2021 by who is personally known to me and who did not take an oath.
SEAL:
Notary Public Signature
Page 6 of 6 Q
08.27.2021 CC to CCW&SD
It C
PROJECT: Sports Complex&Event Center—Utilities—City Gate Blvd South
Prepared by:
Jennifer A. Belpedio,Assistant County Attorney
Office of the County Attorney
3329 East Tamiami Trail,Suite 800
Naples,Florida 34112-5749
(239)252-8400
OWNER'S AFFIDAVIT
STATE OF FLORIDA
COUNTY OF COLLIER
BEFORE ME, the undersigned authority, personally appeared PENNY TAYLOR, who
to me is well known, and having been duly sworn and under oath, deposes and
states:
1. My name is PENNY TAYLOR, I am over the age of twenty-one (21) years, am sui
juris, and have personal knowledge of the facts asserted herein.
2. COLLIER COUNTY is the owner of said real property located at 3920 City Gate
Blvd N and known as the Sports Complex and Events Center, and described on
Exhibit A, which shows the location of the subject utility facilities being conveyed.
3. All persons, firms, and corporations, including the general contractor, all laborers,
subcontractors and sub-subcontractors, materialmen and suppliers who have
furnished services, labor or materials according to plans and specifications, or extra
items; used in the construction, installation and/or repair of potable water and
wastewater utility system(s) or portion(s) thereof on the real estate hereinafter
described, have been paid in full and that such work has been fully completed and
unconditionally accepted by the current owner of such facilities.
4. No claims have been made to the owner, nor is any suit now pending on behalf of
any contractor, subcontractor, sub-subcontractor, supplier, laborer or material-men,
and no chattel mortgages or conditional bills of sale have been given or are now
outstanding as to the subject utility system(s) or portion(s) thereof placed upon or
installed in or on the aforesaid premises.
5. Title to the subject utility system(s) or portion(s) thereof and/or easement(s), if any,
being conveyed to the County is not encumbered by any recorded mortgage,
recorded assignment of rents or profits, by any recorded Uniform Commercial Code
Financing Statement, or by any other recorded document that imposes a security
interest that could negatively affect conveyance of marketable title to the utility
system(s) or portion(s) thereof and/or any easement being conveyed to the County.
6. As and on behalf of the owner of the subject utility system(s) or portion(s) thereof,
does for valuable consideration hereby agree and guarantee, to hold the Board of
County Commissioners of Collier County, Florida, as the governing body of Collier
County and as the Ex-Officio Governing Board of the Collier County Water-Sewer
District harmless against any lien, claim or suit by any general contractor,
subcontractor, sub-subcontractor, supplier, mechanic, material-man, or laborer, and
against chattel mortgages, security interests or repair of the subject utility system(s) or
portion(s) thereof by or on behalf of Owner. Affiant is used as singular or plural, as
the context requires.
f xi,kl
Owner's Affidavit
7. The utility system(s) or portion(s) thereof referred to herein are located within the ' 6 C 1
real property described in the attached Exhibit "A".
FURTHER AFFIANT SAYETH NAUGHT.
st't
DATED this t—c day of S-T , 2021.
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. KINZEL, Clerk COLLIER CO NTY, FLORIDA
•
BY: Sg114.
asto Chi erk PENNY TAYL R, Chair
signeltureonly.
Approved as to form and legality:
Jenrai'AwBelpedio,Assi t County Attorney
A\
Owner's Affidavit %.1
16 c
EXHIBIT"A"
Legal Description
The County Utility Easements (C.U.E.$) described on that certain Utility Easement dated May 12, 2020 and
recorded on May 19, 2020, at Official Records Book 5764, Page 3429 of the Public Records of Collier County,
AND which abut the Plat of CITY GATE COMMERCE PARK, PI IASE THREE REPLAT NO. 4, recorded in
Plat Book 68, Page 68 through 73, Public Records. Collier County, Florida.
Obo
Owner's Affidavit