Backup Document 06/14/2022 Item #16D7 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 0 1
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 06/09/2022
Services
2. Derek D. Perry County Attorney Office p 115)LZ
3. BCC Office Board of County Commissioners Lai iy/v /'f 6//7/2 Z
4. Minutes and Records Clerk of Court's Office
cc6 (Anz7- to-- -t
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/ Department Specialist/CHS Division
Agenda Date Item was June 14,2022 Agenda Item Number 16.D.7
Approved by the BCC
Type of Document Release of Lien-CWIF: Garcia Number of Original 1
Attached Documents Attached
PO number or account
number if document is 001-155930-369620
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? 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 6/14/2022 and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County P 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 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.
** 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 a
Ann P. Jennejohn
From: Ann P. Jennejohn
Sent: Tuesday, July 5, 2022 1:23 PM
To: 'BardalesKarina'
Subject: Release of Lien - CWIF (6/14/2022 Item #16D7)
Attachments: Backup Document 06_14_2022 Item #16D7.pdf
For your records.
*receipt ivtcluded**
Thavtk you agaivt,
Ann Jenne,jotin
13MR Sevtior Deputy Clerk II
,Ksttc ,,pl Clerk to the Value Adjustvvtevtt Board
f",
Office: z3q-zsz-84o6
Fax: 239-252-8408 (if applicable)
AtAtA.JemAejolAK@CollierClerk.com
r¢i ' Office of the Clerk of the Circuit Court
(ttr.,i-4-.`"'` & Comptroller of Collier Couvtty
3299 Tawtiawti Trail, Suite #401
Naples, FL 34112-5324
www.CollierClerk.com
i
16D7
INSTR 6272991 OR 6144 PG 1953
RECORDED 6/22/2022 5:24 PM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
Prepared by:Karina 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 Deferral of 100% of Collier County Impact Fees for Owner Occupied Affordable
Housing Dwelling(the "Impact Fee Lien")executed by Alejandro Caleb Garcia and Fantaja Felicia
Foreus Garcia, to COLLIER COUNTY, recorded on 04/03/2020 in Official Records Book 5747,
Page 2053 of the Public Records of Collier County, Florida, in consideration of $9,078.91
($8,253.55 plus $825.36 in interest) having met the term is hereby acknowledged does satisfy,
remise, release, quitclaim, exonerate and discharge the Impact Fee Lien against the premises
conveyed by said Impact Fee Lien and more particularly described as follows:
Unit No. 505 of Dockside of Naples A Condominium according to the Declaration of Condominium recorded
in OR Book 5622, Page 3364, as amended in OR Book 5629, Page 2092; OR Book 5629 Page 2102; OR Book
5688,Page 828; OR Book 5702 Page 3175 and OR Book 5718 Page 344 of the Public Records of Collier County,
Florida.
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 urct--ICI) 2622_
Agenda Item Number I (,p .D. `, .
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL IZINZEL, CLERK COLLIER COUNTY, FLORIDA
kk.,, 61) v..•
By; :.�:. =. _ _ C. By:
Attest 71 1V eputy Clerk Wil ' m L. McDaniel Jr., Chairman
signature.nne
Approved for form and legality:
Derek D. Perry
Assistant County Attorney `ti
[22 GRC-01354/1717223/1] G\ Page 1 of 1
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