Backup Documents 12/14/2021 Item #16D16 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 D 1 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 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. Karina Bardales Community and Human KB 12/10/2021
Services
2. Jennifer Belpedio County Attorney Office I , 1 L{ Z�
3. BCC Office Board of County T 6G
Commissioners '� ,,32//v/�i
4. Minutes and Records Clerk of Court's Office
/
110 I i : 4k
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 Karina Bardales,Grants Support Phone Number 239-252-2338
Contact/ Depai tusent Specialist/CHS Division
Agenda Date Item was December 14,2021 , Agenda Item Number 16.D.16
Approved by the BCC
Type of Document DRI Release of liens: Becerra and Frias Number of Original 2
Attached Ramirez Documents Attached
PO number or account
number if document is 791-138791-649030-33686.1
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. (Initial) Applicable)
1. Does the document require the chairman's original signature? `J 0►,C KB
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 KB
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 KB
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 KB
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 above date and all changes made during KB 4a ire i1
the meeting have been incorporated in the attached document. The County of
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the KB `I, : t. rug
BCC, all changes directed by the BCC have been made,and the document is ready for the 0LA �< +r! 7
Chairman's signature. kr�F {-qt.;.
** Please e-mail a recorded copy to Karina.Bardales@colliercountyfl.gov**
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
1 6 D 1 6
Ann P. Jennejohn
From: Ann P. Jennejohn
Sent: Tuesday, December 28, 2021 11:31 AM
To: 'Karina.Bardales@colliercountyfl.gov'
Subject: Item #16D16 (12-14-21 BCC Meeting)
Attachments: Backup Documents 12_14_2021 Item #16D16.pdf
Please see the attached recorded Release of Lievts
(Itewt #i-(l)16) from the December 14, 2021 13CC Meetivtg.
Thavtk you!
Ann Jenne,jotin
13MR Sevtior Deputy Clerk II
01.7 tit RI Clerk to the Value Adjustment 13oard
Office: 239-2s2-s406
tr
Fax: 239-z5z-s4os (if applicable)
Arui..Jepunejoka@CollierClerk.com
r � Office of the Clerk of the Circuit Court
ff�k ,`e" '` & Comptroller of Collier Couvtty
3299 Tawtiavvti Trail, Suite #401
Naples, FL 34112-5324
www.CollierClerk.cowt
i
16fl16
INSTR R 68 PG 474
RECORDED6176279 12/16O/202105 3:26 PM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Prepared by:Karina Bardales COLLIER COUNTY FLORIDA
Collier County Community and Human Services REC$10.00
3339 E.Tamiami Trail,Building H,#211
Naples,FL 34112
THIS SPACE FOR RECORDING
RELEASE OF LIEN
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 Lien
Agreement for Disaster Recovery Initiative (the "DRI Lien") executed by Beverly and Jaime
Frias Ramirez to Collier County, recorded on March 5tt', 2010 in Official Records Book 4543
Page 531, of the Public Records of Collier County, Florida, in consideration of $143,578.63,
receipt of which is hereby acknowledged does satisfy, remise, release, quitclaim, exonerate and
discharge the Disaster Recovery Initiative Agreement against the premises conveyed by said DRI
Lien and more particularly described as follows:
The undersigned is authorized to and does hereby satisfy and release this Lien with respect to the
above-named property, and consents to this Lien being forever discharged of record with respect
to said property.
This Release of Lien was approved by the Board of County Commissioners on 12/ /41Z02-I
Agenda Item Number 16.D. /
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. KINZEL, CLERK OF COLLIE OUNTY, FLORIDA
tb.�q,fie•... t
By: to 1 �a l/1,CO C . By:
",D.41Ir , t' ERK PENNY TAYLO , CHAIRPER ON
•st as to ;0' a 4..
Iattire only'
Approvapr orm'and•legality:
Jenn er A. Belpedio C)97 2-•
Assistant County Attorn 9 �>
RINESCORR DE7D62 1820/O602051
16a1 b
83:2'6GP4M75PAGES
1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Prepared by:Karim COLLIER COUNTY FLORIDA Bardales REC$10.00
Collier County Community and Human Services
3339 E.Tamiami Trail,Building H,#211
Naples,FL 34112
THIS SPACE FOR RECORDING
RELEASE OF LIEN
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 Lien
Agreement for Disaster Recovery Initiative (the "DRI Lien") executed by Danny Becerra to
Collier County, recorded on March 5th, 2010 in Official Records Book 4543 Page 529, of the
Public Records of Collier County, Florida, in consideration of$138,401.02 receipt of which is
hereby acknowledged does satisfy,remise,release,quitclaim,exonerate and discharge the Disaster
Recovery Initiative Agreement against the premises conveyed by said DRI Lien and more
particularly described as follows:
The undersigned is authorized to and does hereby satisfy and release this Lien with respect to the
above-named property, and consents to this Lien being forever discharged of record with respect
to said property.
This Release of Lien was approved by the Board of County Commissioners on _/Z-//Y/Zol/ ,
Agenda Item Number 16.D. ! (,'
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. K ZEL, CLERK OF COLLIE OUNTY, FLORIDA
By:0 h d•-.. By:
PENNY TAYLO , CHAIRPER ON
Si(a Qtll •• ''�t'
Approval for form and legality:
503;�nr7
Jen r A. Belpe 1 c��'
Assistant County Atto ZZZI/l
7®