Backup Documents 12/14/2021 Item #16A14 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLID b A 1 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.
**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#I 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 CAK/rev 12/14/21
4. BCC Office Board of County 6ti �/�
Commissioners %'Y'0/
5. Minutes and Records Clerk of Court's Office
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 Michael Ossorio Phone Number 252-2440
Contact/ Department
Agenda Date Item was 12/14/21 ✓ Agenda Item Number 16A 14
Approved by the BCC
Type of Document Peter A. Atsales-Release& Satisfaction of Number of Original 1
Attached Lien Documents Attached
PO number or account 111-13 8911-64903 0
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)
I. Does the document require the chairman's original signature? No/CAK/rev
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 CAK
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 CAK
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 CAK
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 12/14/21 and all changes made during CAK/rev N/A is not
the meeting have been incorporated in the attached document. The County an option for
Attorney's Office has reviewed the changes, if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the CAK/rev N/A is not
BCC,all changes directed by the BCC have been made, and the document is ready for the an option for
Chairman's signature. this line.
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
16A14
INSTR 6176367 OR 6058 PG 769
RECORDED 12/16/2021 4:13 PM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
This Instrument Prepared By: REC$10.00
Colleen A. Kerins, Esquire
Collier County Attorney's Office
3299 E. Tamiami Trail-Suite 800
Naples, FL 34112
(239) 252-8400
RELEASE AND SATISFACTION OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA is the owner and holder of a certain lien against all real and
personal property owned by:
Peter A. Atsales,
Respondent
The lien was recorded on December 21, 2020, in Official Records Book 5864, Page 1235, in the
Official Records of Collier County, State of Florida. The lien secures the principal sum of twenty-
one thousand five hundred twenty-three dollars and fifty cents ($21,523.50), plus accrued interest
and penalties, if any, and imposes certain obligations against real property situated in Collier
County, Florida.
Collier County, a political subdivision of the State of Florida, by execution of this Release and
Satisfaction of Lien, acknowledges payment as approved by the Board of County Commissioners
as satisfaction of the lien and hereby cancels and releases said lien.
The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction of Lien in
the Official Records,of Collier County, Florida, to acknowledge that the lien ceases to exist.
ATTEST BOARD F COUNTY COMMISSIONERS
CRYSTAL J t,KI$ZEL, Clerk, COLLI NTY, FLORID
By: � ` Q �. By.
t as to at ;;le`'Suty Clerk Penny T or, Chairperson
Date: ` z[mottpiept Date: / /, /J /
Approved as to orm and legality
Colleen A. Kerins
Assistant County Attorney
[21-C E D-01617/1680644/1]