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Backup Documents 10/26/2021 Item #16K 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 K .4 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 received in the County Attorney Office no later than Monday preceding the Board meeting. ** 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 routingzlines#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. 2. 3. County Attorney Office County Attorney Office JAK 10/26/21 4. BCC Office Board of County b Commissioners S js 5. Minutes and Records Clerk of Court's Office I toiX(Dal Pitit 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 Wanda Rodriguez,ACP Phone Number 252-8123 Contact/Department Office of the County Attorney Agenda Date Item was 10/26/21 Agenda Item Number 16-K-I f Approved by the BCC Type of Document(s) Resolution appointing 3 members to the Number of Original one Attached Black Affairs Advisory Board Documents Attached PO number or account N/A c7110.2/—AP--5 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. (Initial) Applicable) 1. Does the document require the chairman's original signature(instead of stamp)? N/A 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 legality. (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 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 JAK document or the fmal negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's l JAK signature and initials are required. J 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 uploaded to the agenda. 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 10/26/21 and all changes made during JAK the meeting have been incorporated in the attached document. The County Attorney 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 (-re\ Chairman's signature. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04;Revised 1.26.05;2.24.05;11/30/12;4/22/16;9/10/21 16K 4 RESOLUTION NO. 2021 - 2 2 5 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA APPOINTING DARNELL JOHNSON, DEBORAH B. WILLIAMS, AND JEAN PAUL, TO THE BLACK AFFAIRS ADVISORY BOARD. WHEREAS, Collier County Ordinance No. 91-38 established the Black Affairs Advisory Board to provide periodic reports to the Board of County Commissioners that identify and evaluate problems unique to the black community and recommend ways to ensure open communication between minorities and Collier County Government; and WHEREAS, Ordinance No. 91-38, as amended, provides that the Advisory Board shall consist of nine members; and WHEREAS,there are currently three vacancies on this Advisory Board; and WHEREAS, the Board of County Commissioners previously provided public notice soliciting applications from interested parties; and WHEREAS, staff has provided the Board of County Commissioners with its recommendation for appointment. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that DARNELL JOHNSON, DEBORAH B. WILLIAMS, and JEAN PAUL, are hereby appointed to the Black Affairs Advisory Board, each to serve a four-year term expiring on June 25, 2025. THIS RESOLUTION ADOPTED after majority vote on the 26t"day of October, 2021. ATTEST: BOARD OF COUNTY COMMISSIONERS CRYSTAL K. KINZEL, Clerk COLLIER TY, FLORIDA AL 'R�. By:a 0 hal11181Wep Cl- PE TA , CHAIR signature only. Approve, .. I form . egality: (IL Jeffrey County A o -y