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Agenda 05/09/2023 Item #16A 2 (The Willough at Naples - Fire Line - Final Acceptance of utilities)16.A.2 05/09/2023 EXECUTIVE SUMMARY Recommendation to approve final acceptance of the potable water utility facilities and accept the conveyance of a portion of the potable water utility facilities and appurtenant utility easement for The Willough at Naples - Fire Line, PL20220000571. OBJECTIVE: To have the Board of County Commissioners, as Ex-Officio Governing Board of the Collier County Water -Sewer District, approve final acceptance and accept the conveyance of a portion of the potable water facilities and appurtenant utility easement, in accordance with the Collier County Utility Standards and Procedures, Ordinance No. 2004-31. CONSIDERATIONS: 1) The Developer has constructed the potable water facilities for The Willough at Naples - Fire Line, within dedicated easements to serve this development (see attached location map). A portion of the potable water facilities was offered for conveyance to the County, as described in Official Records (O.R.) Book 6241, Page (PG) 1354, together with appurtenant Deed of Utility Easement recorded in O.R. Book 6166, Page 3801, of the Public Records of Collier County, Florida. The remaining potable water facilities will be private. The value of these potable water utility facilities (assets) was $2,943.70. 2) Staff recorded all final acceptance documents associated with the potable water facilities conveyed to the County in the public records of Collier County, which were reviewed and approved by the County Attorney's office as to form and legality. The County acquired its interest in a portion of the potable water facilities by Warranty Deed and Bill of Sale recorded in Official Records Book 6241, on Page 1354 ("the Utilities Facilities Deed") of the Public Records of Collier County, Florida. 3) A final inspection to discover defects in materials and workmanship was conducted by public utility staff on August 16, 2022, and these facilities have been found to be satisfactory and acceptable. 4) Staff recommends final acceptance of the subject potable water utilities facilities in the amount of $2,943.70. Staff also recommends acceptance of the Utilities Facilities Deed and the facilities described in the Certification of Contributory Assets, which is attached to this Executive Summary. 5) This final acceptance is in accordance with Collier County, Ordinance No. 2004-31, as amended. 6) Staff is unaware of any issues that would serve to negate the recommendation to approve this final acceptance. FISCAL IMPACT: Approval of this Executive Summary will have no specific financial impact. However, approval of this Executive Summary will result in the Collier County Water -Sewer District receiving title to the potable water utility facilities, which has a total gross value of $2,943.70 (no depreciation applied). GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this action. LEGAL CONSIDERATIONS: This item has been approved as to form and legality and requires a majority vote for Board approval. -DDP RECOMMENDATION: To approve final acceptance of the potable water facilities and accept the conveyance of a portion of the potable water utility facilities and appurtenant utility easement for The Willough at Naples - Fire Line, PL20220000571. Prepared by: Lucia S. Martin, Project Manager I, Development Review Division ATTACHMENT(S) 1. Location Map (PDF) 2. Assets Sheet (PDF) 3. Verification of Final Cost (PDF) 4. Deed of Utility Easement (PDF) 5. Warranty Deed and Bill of Sale (PDF) Packet Pg. 81 16.A.2 05/09/2023 COLLIER COUNTY Board of County Commissioners Item Number: 16.A.2 Doc ID: 25084 Item Summary: Recommendation to approve final acceptance of the potable water utility facilities and accept the conveyance of a portion of the potable water utility facilities and appurtenant utility easement for The Willough at Naples — Fire Line, PL20220000571. Meeting Date: 05/09/2023 Prepared by: Title: Technician — Development Review Name: Lucia Martin 03/29/2023 9:25 AM Submitted by: Title: Environmental Specialist — Growth Management and Community Development Department Name: Jaime Cook 03/29/2023 9:25 AM Approved By: Review: Water Pamela Libby Additional Reviewer Completed 03/29/2023 9:37 AM Water Howard Brogdon Additional Reviewer Completed 03/29/2023 9:40 AM Operations & Regulatory Management Michael Stark Additional Reviewer Completed 03/29/2023 11:41 AM Development Review Marcus Berman Additional Reviewer Completed 03/29/2023 11:43 AM Engineering & Natural Resources Jack McKenna Additional Reviewer Completed 03/29/2023 12:49 PM Engineering and Project Management Matthew McLean Additional Reviewer Completed 03/29/2023 1:49 PM Transportation Management Operations Support Evelyn Trimino Additional Reviewer Completed 03/29/2023 4:17 PM Engineering and Project Management Craig Pajer Additional Reviewer Completed 03/29/2023 5:19 PM Growth Management and Community Development Department Jaime Cook Division Director Completed 04/11/2023 1:04 PM Growth Management and Community Development Department Diane Lynch Growth Management DepartmentCompleted 04/11/2023 2:02 PM Growth Management and Community Development Department James C French Growth Management Completed 04/11/2023 5:18 PM County Attorney's Office Derek D. Perry Level 2 Attorney Review Completed 05/01/2023 1:42 PM Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 05/01/2023 1:46 PM Corporate Compliance and Continuous Improvement Megan Gaillard Additional Reviewer Completed 05/01/2023 2:02 PM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 05/01/2023 2:41 PM Office of Management and Budget Laura Zautcke Additional Reviewer Completed 05/01/2023 4:43 PM County Manager's Office Dan Rodriguez Level 4 County Manager Review Completed 05/02/2023 9:09 AM Packet Pg. 82 16.A.2 05/09/2023 Board of County Commissioners Geoffrey Willig Meeting Pending 05/09/2023 9:00 AM Packet Pg. 83 16.A.2. b CERTIFICATION OF CONTRIBUTORY ASSETS - COUNTY PROJECT NAME THE WILLOUGH PL # 20210000924 LOCATION: 9001 TAMIAMI TRAIL EAST, NAPLES, FL 34113 NAME & ADDRESS OF OWNER TYPE OF UTILITY SYSTEM: WILLOUGH HEALTHCARE INC. 9001 TAMIAMI TRAIL EAST NAPLES, FL 34113 POTABLE WATER (MATERIALS ONLY) ITEM SIZE QUAN. UNIT COST TOTAL 6" PVC Main (C-900, DR 18) 18 LF $12.15 $218.70 8"X6" HOT TAP 1 EA $1,875.00 $1,875.00 6" GATE VALVE 1 EA $850.00 $850.00 $2,943.70 I do hereby certify that the quantities of material described above are a true and accurate representation of the system being contributed to Collier County Utilities. CERTIFYING: M - PRESIDENT OF: I" BLUEWATER OF SOUTH FLORIDA, INC 534 PRODUCTION BLVD. NAPLES, FL 34104 STATE OF10p (b,i COUNTY OF C 6) (, The foregoing instrument was signed and acknowledged before me this 3(5 day of t 20,;�t by C14A I6 At. PVlc jGC 1,k wt who is personally known tome __X OR who produced identification _ Type of Identification Produced Notary Public Seal r(?X' "oaf Notary Public State of Florida Martha A Ward . My Commission GG 194770 Expires03/11r2022 Packet Pg. 85 16.A.2.c VERIFICATION OF FINAL COST PROJECT NAME: THE WILLOUGH PL # 20210000924 LOCATION: 9001 TAMIAMI TRAIL EAST, NAPLES, FL 34113 NAME & ADDRESS OF OWNER: WILLOUGH HEALTHCARE INC. 9001 TAMIAMI TRAIL EAST NAPLES, FL 34113 TYPE OF UTILITY SYSTEM: POTABLE WATER (MATERIAL AND SERVICES) ITEM SIZE QUAN. UNIT COST TOTAL Tapping Sleeve and Valve 8"X6" 1 EA $5,575.00 $5,575.00 6" PVC Main (C-900, DR 18) 6" 18 LF $57.60 $1,036.80 6" GATE VALVE 6" 1 EA $1,265.00 $1,265.00 PVC DR-18 WATER MAIN 6" 142 LF $57.60 $8,179.20 WATER MAIN DEFLECTION 6" 1 EA $1,625.00 $1,625.00 DDCA 6" 1 EA $10,453,00 $10,453.00 TOTAL COST $28,134.00 I do hereby certify that the quantities of material and services described above are a true and accurate representation of the as -installed cost of the system. CERTIFYING: CHAD M M, PRESIDENT OF: BLUEWATER OF SOUTH FLORIDA, INC. 534 PRODUCTION BLVD. NAPLES, FL 34104 STATE OF -C /0 R I l A - COUNTY OF 09.0 1 W P2— The foregoing instrument was signed and acknowledged before me this —C day of f"-�� r 203_%y Chad McKimm who is personally known to me OR who produced identification Type of Identification Produced U� Notary Public Seal: �u+r"41� :�artha:A ic Stale of Florila T Ward 1112'or 022my commission 00 194 a' Packet Pg. 86 INSTR 6300612 OR 6166 PG 3801 RECORDED 8/24/2022 3:43 PM PAGES 4 CLERK OF THE CIRCUIT COURT AND COMPTROLLER, COLLIER COUNTY FLORIDA DOC@.70 $0.70 REC $35.50 CONS $10.00 16.A.2.d DEED OF UTILITY EASEMENT THE UTILITY EASEMENT is granted and conveyed this 456% day of fi- t4A , 2022, by WILLOUGH,, AT CARE, INC., a Florida corporation as Grantor, to the BOARD OF COUNTY COMMISSIONERS�W COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF COLLIER COUNTY, AND AS T= X-OFFICIO GOVERNING BOARD OF THE COLLIER COUNTY WATER - SEWER DISTRICT, its suessors and assigns, GRANTEE. WITNESSETH: That the Grantor for and inconsideration of the sum often dollars ($10.00) and other valuable consideration paid by' Gntee, receipt of which by is hereby acknowledged by Grantor, hereby conveys, grants, bargains and sells `grantee, its successors and assigns, a perpetual, non-exclusive i easement, license, right and privilege t�ii(erupon and to install, relocate, repair and/or otherwise maintain utility system(s) and utility facilities, aay.partion(s) thereof, in, on, over and under the following described lands located in Collier County 4— 6i ta, `to wit: See attached Exhibit "A," iV , ich-is corporated herein by reference. TO HAVE AND TO HOLD the same unto the right and privilege to enter upon said land to successors and/or assigns, together with the te.and/or take and/or introduce materials for the purpose of constructing, operating, relocating, repairitiand4,qr-otherwise maintaining the subject utility facilities and/or system(s) or portion(s) thereof, in, on, over and/bi`u tder the easement area. Grantor and Grantee are used for singular or plural, as the context allows. [Signature Page to Follow] [22-EIS-04621/1697485/1] Page I of 2 Packet Pg. 87 OR 6166 PG 3802 16.A.2.d IN WITNESS WHEREOF, the Grantor has caused these presents to be executed the date and year first above written. WITNESSES: WILLOUGH HEALTHCARE, INC. By: o✓i� ......... . l--E <- Robert M. Cohen, Chairman STATE OF F IDA' COUNTY F HILLSBOROUGH BE IT REMEMBERE6,.th „ova this day of F- rua- , 2022, before me, by physical presence, a Notary Publi n q d,for said County and State, cam Robert M. Cohen, who is the Chairman of the Board of WiUo' ugb. Healthcare, Inc., a Florida corporation, and is personally known to me to be the same person,`c *ham gned the herein instrument, and such person duly acknowledged the signing of the same, s the act and deed of the corporation. IN WITNESS WHEREOF, I have er ' nto subscrib d my name and affixed my official seal the day and year last above written.,w,,. expires:,gf s Prepared by: Macfarlane, Ferguson & McMullen, P N' JelmNbr JMM J. Paul Raymond, Esq. " St��blic ' � Florida COMW HH1W928 PO Box 1669 ftires 5/5/2025 Clearwater, FL 33756 [22-EIS-04621/1697485/11 Page 2 of 2 Packet Pg. 88 OR 6166 PG 3803 EXHIBIT "A99 A proposed 20' x 3 0' County Utility Easement, described as: A PARCEL OF LAND LYING IN THAT PART OF TRACT "J"OF LELY GOLF ESTATES ST. ANDREWS WEST AS RECORDED IN PLAT BOOK 10, PAGE 93, SAID PARCEL LIES WITHIN THOSE LANDS RECORDED IN O.R. BOOK 1077, PAGE 1630 OF THE PUBLIC RECORDS PF,/CQLLIER COUNTY FLORIDA, BEING DESCRIBED AS FOLLOWS: COMMENCING AT ' THE SOUTHERLY MOST CORNER OF SAID LANDS, RUN 1 1, N39-04'38"W ALON(4 THE NORTHEASTERLY RIGHT-OF-WAY LINE OF TAMIAMI TRAIL EAST (U.S.41)\FQR`A, DISTANCE OF 160.00 FEET TO THE POINT OF BEGINNING. THENCE CONTINUE N39*04'38"W ALONG SAID NORTHEASTERLY RIGHT-OF-WAY LINE FOR A DISTANCE OF 39.00 FEET; THENCE LEAVING sAm 11!PW-OF-WAY LINE N50*55*22"E FOR A DISTANCE OF 20.00 FEET; THENCE S39004'38"E F06 A DISTANCE OF 30.00 FEET; THENCE S50('5522"W FOR ('A-',,OISTANCE OF 20.00 FEET TO THE POINT OF BEGINNING. THE ABOVE DESCRIBES APPROXIMATELY 600 SQUARE FEET OF LAND. TOGETHER WITH J I An existing County Utility Easement recorded at,,w A paroid—, pk, 11i" ilk tb* smut '�* d1v' SO fkMth, #Aft9ft 26 Satt COIL I 1030, Page 924, described as: of soctlaft 19, ,. FIor$4&. Was 0womancing *Vtba t of 1"Inning of L&lY Golf I St. Auftew West, ai€uAdivision as recorded in'4! Page 93 of the at of Collier comty"r., Point also being thecorner of Section 1! A "n— 24 fit: �A ce 0`39*06120* W a dista,, foots tbexw* S S*05311404��,' , foot to the northeasterly, right-*f-vay line of S.R.I3 r thence N 31*"*26-'w t along said right-of-vay Una A thence N SO-53-40- Z 20. 00 foot to the Point of ftgi a 39606*20* W 20.00 IN SO*S3*40'0 Z 20 f 39*06*200 120.00 f"tt thence feats thence S 50PS3440* W 20.00 ot"Toint of Beginning. [22-EIS-04621/1697450/11 Page I of 1 C* Cz C* 10, to (Said hip so Exhibit "A" E w 0 E I Packet Pg. 89 1 *** OR 6166 PG 3804 *** 16.A.2.d EXHIBIT "A" r�+ a 96 IDS � r W iR "U ,d�'-�� :., zz Gl `> C� j w z Uw tip dC in tu A'`�: a 7 n 0 �2U U � Eli 0- .7 ii u slit.` m ilk �y ° w m C, w C7 fl € z t$ m w E 000 0 Qtn �� E y W ¢o 8p ziw w�a as Ewa L7wl ru wkm 0 Z5 o 20 ul 0 g [22-EIS-04621/1697485/ I ] Page 2 of 2 Packet Pg. 90 INSTR 6395861 OR 6241 PG 1354 E-RECORDED 4/28/2023 4:15 PM PAGES 7 CLERK OF THE CIRCUIT COURT AND COMPTROLLER, COLLIER COUNTY FLORIDA Doc@.70 $0.70 REC $61.00 CONS $10.00 16.A.2.e THIS CORRECTIVE UTILITY FACILITIES WARRANTY DEED AND BILL OF SALE IS BEING RECORDED TO CORRECT THE EXHIBITS ATTACHED THERETO IN THAT CERTAIN UTILITY FACILITIES WARRANTY DEED AND BILL OF SALE RECORDED IN OFFICIAL RECORDS BOOK 6166, PAGES 3805 THROUGH 3811, UNDER INSTRUMENT NUMBER 6300613 OF THE PUBLIC RECORDS OF COLLIER COUNTY, FLORIDA. UTILITY FACILITIES WARRANTY DEED AND BILL OF SALE THIS INI tdTI " made this 84- day of -+ 2022, between WILLOUGH IiEALTHCA , 1. `, Florida corporation (hereinafter referred to as "Grantor"), and the BOARD OF COUNTY COM S91 RS OF COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF COLLIER COI)NTY)�1rTHE EX-OFFICIO GOVERNING BOARD OF THE COLLIER COUNTY WATER -SEWER DISTRICT, it successors and assigns, (hereinafter referred to as "Grantee"). W ITNESSETH: That said Grantor, for and in constd' ratio,.' of the sum of Ten Dollars (S 10.00) and other good and valuable consideration to said Grantor in hanidvpyAatd Grantee, the receipt whereof is hereby acknowledged, has granted, bargained and sold to the sat ant v, and Grantee's heirs, successors and assigns forever, all the personal property and utility faciiii I e,06 n� the property specifically described therein as not included) lying in, on, over and under the foi 'win'-- §cribed land, for operation, relocation, installation, repair and/or maintenance of said facilities, syst 4s} o �ion(s) thereof, all situate and lying and being in Collier County, Florida, to wit: ' See Exhibit "A" attached hereto and i Exhibit "B" attached hereto is a sketch or other gr< location of the utility systems being conveyed and Exhibit "C" attached hereto ("Certification of utility systems being conveyed. Exhibit "D" attached hereto ("Certification of Material — Pril the utility systems NOT being conveyed (and not part of this herein. ntation that depicts the physical ' ription thereof. an itemized list of the an itemized list of and said Grantor does hereby fully warrant the title to said utility facilities ana,/0',: s) or portion(s) thereof, be they realty, personalty, or mixed, and Grantor will defend such title againsla.11,claims of all „ s and/4 persons whomsoever. For the purposes of this conveyance, the utility facilities, s ste ` ' or portion(s) s P P P Y Y Y P () thereof conveyed herein shall not be deemed to convey any of the lands described in either exhibit. Grantor and Grantee are used for singular or plural, as context allows. [22-EIS-04621/1697469/1] Page I of 2 Packet Pg. 91 OR 6241 PG 1355 16.A.2.e TO HAVE 41,p . O HOLD the same unto the Grantee and its assigns, together with the right to enter upon said land, eav elocate and/or take or introduce materials for the purpose of constructing, relocating, <„ operating, repaid ar otherwise maintaining utility systems thereon. Grantor and Grantee are used for singular or pliir tlit`ontext requires. IN WITNESS WHER50F, Grantor has caused these presents to be executed the date and year first above written. t ',.'Y WILLOUGH HEALTHCARE, INC. r 4� Robert M. Cohen, Chairman STATE OF FLO,AIDA COUNTY OF HILLSBOROUG.H BE IT REMEMBERED, that on this physical presence, a Notary Public in and for said C is the Chairman of the Board of Willough 1w. known to me to be the same person who signed the N acknowledged the signing of the same as the act and deed IN WITNESS WHEREOF, I have hereunto subsc seal the day and year last above written. /1 )tary Public I y appointment Prepared by: Macfarlane, Ferguson & McMullen, P. A. J. Paul Raymond, Esq. PO Box 1669 Clearwater, FL 33756 [22-EIS-04621/1697469/11 Page 2 of 2 3 t` i , 2022, before me, by caRobert M. Cohen, who corporation, and is personally lment, and such person duly e and affixed my official ` ennsar e Of FkUres S/S Packet Pg. 92 OR 6241 PG 1356 16.A.2.e EXHIBIT "A" A proposed 20' x 30' County Utility Easement, described as: A PARCEL OF LAND LYING IN THAT PART OF TRACT "J" OF LELY GOLF ESTATES ST. ANDREWS WEST AS RECORDED IN PLAT BOOK 10, PAGE 93, SAID PARCEL LIES WITHIN THO E LANDS RECORDED IN O.R. BOOK 1077, PAGE 1630 OF THE PUBLIC RECOR F POLLIER COUNTY FLORIDA, BEING DESCRIBED AS FOLLOWS; COMM ENCTNP'ATTHE SOUTHERLY MOST CORNER OF SAID LANDS, RUN 1V39°04'38"WALOI GJHIE NORTHEASTERLY RIGHT-OF-WAY LINE OF TAMIAMI TRAIL EAST (U.S.41) RA DISTANCE OF 160.00 FEET TO THE POINT OF BEGINNING. THENCE CONTINUE N39'04'38"W ALONG SAID NORTHEASTERLY RIGHT-OF-WAY LINE FOR A DISTANCE 'OF 0.00 FEET; THENCE LEAVING SAKD -' HT -OF -WAY LINE N50°55'22"E FOR A DISTANCE OF 20.00 FEET; THENCE S39004'38"E FOR A STANCE OF 30.00 FEET; THENCE S50°55'22"W FO , A:)DISTANCE OF 20.00 FEET TO THE POINT OF BEGINNING, THE ABOVE DESCRIBES APPR.QX'hMATELY 600 SQUARE FEET OF LAND. TOGETHER WITH An existing County Utility Easement 1030, Page 924, described as: A parcel of %,awl lying in the souttigait%'iu4rter of Section 19. StnraeTFip 50 South, Range 26 East, Coil r Ceunty, Florida, being described as folic : Commencing at/the Point of ,'Beginning of Lely "Ccilf Estates. � a St. Andrews Meet. , ya subdivision as recorded in at< go<)k 10, 4n � A Page 93 of the Public Records of Collier County, liar a,, said Point also being the youthe"t corner of Section 19# "T'GwrAhilp so South, Range 26 Last: thehee N 39006'20" W a distance of- 359:182 feet] thence S 50•531'400, '473.3$ feet to the northeasterly, right-of-way line of S.R. 90 Rt S. 41), thence N 35•06`20' 1F along said right-of-way line 169,.�00 feet, thence N 500531401 Z rl 20.00 feet to the Point of Beginning; thence N 39`06'20" W 20.00 fi feet$ thence N 50`53`40' E 20 feetz.,thence.S .39`06'20" 8 20.00 feet] thence S 50•53'40" W 20.00 feet to ttW Point of Beginning. [22-EIS-04621/1697450/1] Page 1 of 1 Exhibit "A" Packet Pg. 93 OR 6241 PG 1357 16.A.2.e EXHIBIT "B" (SKETCH OR OTHER GRAPHIC REPRESENTATION THAT DEPICTS THE PHYSICAL LOCATION OF THE UTILITY SYSTEMS BEING CONVEYED AND THE LEGAL DESCRIPTION THEREOF) [22-E1S-04621l1697450l1] Page I of 2 Exhibit "B" Packet Pg. 94 Best Avai e OR 6241 PG 1358 EXHIBIT 441199 (SKETCH OR OTHER GRAPHIC REPRESENTATION THAT DEPICTS THE PHYSICAL LOCATION OF THE UTILITY SYSTEMS BEING CONVEYED AND THE LEGAL DESCRIPTION THEREOF) Zo 7 s tu -7 0 z 0 w z C) WZ :r > 0 Lil Z) < Cl (0 uj W w (0 u- < 0 (50 20 VW) < 0 Z < F- W Lm IL .0 tna C0 F-1 z! WA w lu UJAL tu 0" W ZIE X W N 0 < 1 08 6 9- �w -to "n. 06 0 Z,w z _-3 0 w 4;7 gx� 000 3� z u 9 z W, W." E2 w n. hP4ii Uix 0 C; —10 re j u (22-EIS-0462111697450111 Page 2 of 2 Exhibit "B" . I Packet Pg Best Ava ,_L�!; OR 6241 PG 1359 16.A.2.e EXHIBIT 44C11 (ITEMIZED LIST OF THE UTILITY SYSTEMS BEING CONVEYED) CERTIFICATION OF CONTRIBUTORY ASSETS - COUNTY PROJECT NAME THE WILLOUGH PL a 2021000()924 LOCATION` 9001 TAMIAMI TRAIL EAST, NAPLES. FL 34113 NAME 8 AODR TYPE OF UTILITY SYSTLIM,. WILLOUGH HEALTHCARE INC. 9001 TAMIAMI TRAIL EAST NAPLES, FL 34113 POTABLE WATER N1ATERIALS ONLY, 6' F'V(; ma',, IC A06. T)R !Ai 18 LF $ .2 15 $218 70 8' x6- rtpT TAP t FA Si 8%S OC' $1.875 Ci0 5 (;Ail VAl'lt: 1 LA $850.J0 $850.00 „ TOTAL COST $2 943 70 .. i do hereby a UTy that Ine t)uariuueS are a true and accurate tepresentaticn or the system being contributed tc Collier Cuunty U:,'Ities CERTIFYING: u ." N CHAR PRESIDENT OF 4111, HLUEWATER OF SOUTH FLORIDA, INC y 634 PRODUCTION BLVD NAPLES, FL 34104 STATE OF by e �� ` _ COUNTY OF .0_�C,_{ T,nn11et rfAomgo rg tn%trumant was sgned ano acknowiedged ,7etere me tht5 Jt'$#day OF L.r.ti it. t+4'�-•I•K+�t who s pervonai,y known to me _F OR who IXbc,7u Type of Identification Produced Seal NoUry Public [22-EIS-04621/1697450/1] Page I of I 20,L1 by fiC�ttor+ _ *AAGha t AA Exhibit "C" Packet Pg. 96 *** OR 6241 PG 1360 *** EXHIBIT "W" (ITEMIZED LIST OF THE UTILITY SYSTEMS NOT -BEING CONVEYED AND NOT PART OF THIS CONVEYANCE). Certification of Material — Private Potable PRDJE,CTNAM- The Willough I DCATIdrq Vl�mfarni Trail East. Naples, FL 34113 r NAME ANd.1,Ab0AE9,50F OWNER Willough Healthcare. Inc. 9001 Tamiami Trail Last Naples. Ft 34113 TYPE OF UTILITY SY5TEIVII: Po,,ble Water ITEM SIZE QUANT. UNIT Los[ TOTAII, PVC DR-18 Water Main 142 LF S 12.15 S 1,72530 Water Main Deflection FA 1.; 725,00 5 725 00 DDCA EA S 6.525.00 5 6,525,00 I do hereby certify That the quantttles of materliptIe"41. representation of the as -installed material Cost ()"![I CERTIFYING: Chad M. McKimm - President OF: BLUEWATER OF SOUTH FLORIDA, INC. 53-4 PRODUCTION BLVD. NAPLES, FL 34104 STATE OF FLOR!DA COUNTY OF COLDER} TOTAL COST S 9,97S.30 area true and accurate The foregoing instrument was signed and acknowledged before me th.s day of 202.1 by 4 ti is 0-* - Al, i, AN who is personally know to me and who did net take an oath, �14 -47 1*" V 1,AW SWO V Name: f, A SEAL - NIC [22-EIS-04621/169745011] Page I of I Exhibit "D" Packet Pg. 97