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Backup Documents 03/08/2022 Item #16A13 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 A 13 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 Attor y Office no later than Monday preceding the Board meeting. 1-^w < f' **NEW** ROUTING SLIP F- Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is r ady 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. 2. 3. County Attorney Office County Attorney Office CAK/rev 3/3/22 4. BCC Office Board of County `� Commissioners W/i1�. Alb I 31 Z/ZZ 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 3/8/2022 Agenda Item Number 16A 13 Approved by the BCC Type of Document William Forte-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) 1. 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/rev 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/rev 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/rev 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 3/8/22 and all changes made during the CAK/rev IAA isn+ meeting have been incorporated in the attached document. The County Attorney's #iltr Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the CAK/rev it itoi BCC,all changes directed by the BCC have been made, and the document is ready for the 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 16A13 Receipt# 008535914 3/10/2022 12:25:48 PM Crystal K. Kinzel Clerk of the Circuit Court and Comptroller O 1 � :DER Customer Deputy Clerk Clerk Office Location PICK UP Donna A Rutherford Collier County Govt. Center MINUTES & RECORDS Donna.Rutherford@CollierClerk.com Building LA, 2nd Floor 3331 TAMIAMI TRL E (239) 252-7242 3315 Tamiami Trl E Ste 102 NAPLES, FL 34112-4901 Naples, Florida 34112-4901 1 Document Recorded DOC TYPE INSTRUMENT BOOK PAGE AMOUNT Release 6217717 6095 3124 $10.00 TOTAL AMOUNT DUE $10.00 Clerk Account#: BCC ($10.00) BALANCE DUE $0.00 Note: 3/10/2022 12:25:48 PM Donna A Rutherford: CHARGE ACCT 111-138911-649030 CODE ENFORCEMENT Disclaimer: All transactions are subject to review/verification. The Clerk reserves the right to correct for clerical errors and to assess or refund charges as needed. ©CD[I0rl®Ta® ggplia Page 1 of 1 161113 INSTR 6217717 OR 6095 PG 3124 RECORDED 3/10/2022 12" 5 PM PAGES 1 This Instrument Prepared By: CLERK OF THE CIRCUIT COURT AND COMPTROLLER Colleen A. Kerins, Esquire COLLIER COUNTY FLORIDA Collier County Attorney's Office REC$10 00 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: William J. Forte Jr., Respondent The lien was recorded on January 29, 2019, in Official Records Book 5593, Page 3654, in the Official Records of Collier County, State of Florida. The lien secures the principal sum of sixty- four thousand six hundred twenty-three dollars and ninety-five cents ($64,623.95), 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 OF CO TY COMMISSIONERS CRYSTAL 4%K4#N 'Et9, jerk COLLIER COAT. • , DA (2) , . ilikfr Attes a. 0 r:, + P�" Ni erk Willi.- L. McDaniel, Jr.,.� ep Chairperson Date?1��EJRL 't• �', Date: 3f 4 Z2 Approved as to form and legality (011( -' Colleen A. Kerins Assistant County Attorney [22-CE D-01631/1694282/1]