Backup Documents 10/10/2023 Item #16K 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 6
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 4
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.
** 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.
2. (Enter your Dept here)
3. County Attorney Office County Attorney Office
121.1* 1 v4/0/23
4. BCC Office Board of County RL by MB
Commissioners [s] l0/(7/2,3
5. Minutes and Records Clerk of Court's Office
10-fl- 3
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 Madison Bird Phone Number 2939
Contact/Department
Agenda Date Item was 10/10/23 Agenda Item Number 16.K.4
Approved by the BCC
Type of Document(s) Settlement- Hummer Number of Original 1
Attached Documents Attached
PO number or account
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 signature?(stamped unless otherwise stated) MB
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 legality. (All documents to be signed by MB
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 MB
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 MB
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 MB
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 uploaded to the
agenda. 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_10/10/23_and all changes made N/A is no
during the meeting have been incorporated in the attached document. The County 2 (I/ an option
Attorney 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 grT an option
jo
Chairman's signature. this lira
1:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04;Revised 1.26.05;2.24.05; 11/30/12;4/22/16;9/10/21
16K4
SETTLEMENT AC;RF E VIE:NT
THIS SE'fTl.FMENT AGREINEN"F (hereinafter referred to as the "Agreement") is
c'f?tNl't'iit irii�.> ,4?ci ma, ,?.•? tl7r' L ! s�::` 1,:' �jtP�YlY�kjO� 2,121. h' d bet"ct:n
CYNT}IEA HUMMER, hereinafter referred to as-Plaintiff.'and COLLIER COUNTY BOARD
OF COUNTY COMMISSIONERS, hereinafter referred to as-County."
WI F5VS ` FTFi:
WHEREAS. Plaintiff filed a Ito sun a 'aitist the (.(Kul() in the Circuit ( ire the
Twentieth Judicial Circuit in and for Collier County. Florida, in the case styled ()vireo flame»cr
r. Collier Urine)' &)w(I of( '( mntissioners, el al. Case No. 22-CA-I647 (hereinafter referred to
as the "Lawsuit" and
WHEREAS. Plaintiff and the fount)., v,ithout either party admitting any liahllit) or
fault, desires to settle the Lawsuit and am and all disputes that arise from. relate or refer in any
way. V,hether directly or indirectl\• known or unknown. accrued or unaccrued, to the incidents
described or'allegations made ill tll 0:1111piit!nt hiC't !i'. I'nC t ;i\\Stl:t.
WHEREAS, Plaintiff and the Count) desire to reduce the settlement to a writing so that
it shall he binding upon both parties' respective owners. principals. elected officials, officers.
employees. ex-Clnpio\cez,. ,thorn-\s. te1ncs nt.nivcs. the Count;.. suece s'rs.
assigns.heirs,departments, and agencies.
NOW, THEREFORE. in consideration of the mutual covenants. promises and
consideration set forth in this A►rreernent. and with the intent to he legally hound. Plaintiff and
Count) ciw'rce as 105;'1v.s'
I` Plaintiff and the County adopt and incorporate the foregoing recitals. sometimes
referred to as"Whereas Clauses." by reference into this Agreement.
�. In consideration of the rest lution of all di:puies nr chums ,:wising front or
referring or relating in an. was. whether directly or inditeetl',. to the Lawsuit. and litr and in
consideration of the sum of nine thousand nine hundred dollars and no cents ($9,900.00) and
other valuable consideration, the receipt and adequacy of which is hereby acknowledged by
hl'Ati1l5tt. t�ialS\l'•,(t a .ve'C� i.o di.smis' the L'su1L 111.11 L iciLid C' .1s it relit." h' .
3. In consideration of the resolution of the Lawsuit, and for other good and valuable
consideration, the receipt and adequacy of which is hereby acknowledged, Plaintiff. on behalf of
herself. her attorne\s. agents. representatives. heirs. successors and assigns. hereby expressly
16K4
releases and forever discharges the County. as well as its owners, principals. elected officials,
officers. employees. cx-employees, agents. attorneys. contractors. representatives. successors.
;,,.suer.,: +)} !ii ' I. oi1111\. llt.'llh. JCaart111Ct)t • aril iktienCle . Cron; an> and all claims.
demands. causes of actions. damages. costs, liens. attorneys fees. expenses. medial hills and
obligations of any kind or nature \\hatsoever, that she has asserted or could have asserted in the
i.a\\suil or dial atke from tir relate or refer in an\ %.\a\. «hether directly or in.lirectl . accrued or
unacerued. known or unknot\n. to the L;tu'Suit or:ul\ int .i lrnt, e\rut or allegation rclerrL':'; to in
the complaint in the Lawsuit.
d, Notwithstanding anything that may he to the contrary in Paragraph 3 of this
Agreement. Plaintiff tmJ the C 011nl thal either o lli' nl t11`, \\eh as U11 other persons or
entities intended to he hound) shall. in the event of any breach, rc1 nn the right to enforce the
terms and conditions of this Agreement.
5. Plaintiff and the Counn acknowledge and agree that this Agreement is intended
to and shall he binding upon their' resp ecu\ ;piinc'Ira't;• cticcic3 nllr't s. ctl4ccr�.
employees. ex-employees. agents. attorneys, representatives. insurers of the County. successors.
assigns.and heirs.
f+. Plaintill and III,: Count\ reco 11... oleo ackno\\ledge that tit;.. ,\S;recinc1l
memorializes and states a settlement at disputed claims and r1othin in this .1`rcenient Trail be
construed to he an admission of any kind. whether of fault. liability. or of a particular polio or
procedure. on the part of either Plaintiff or the County.
tll:ltPdltr, atui the Ci111ur\ .lcsnu\\i,:dr.e and agree that this .\LreC111Cl11 is Mc'
product of mutual negotiation and no doubtful or ambiguous language or provision in this
Agreement is to he construed against any party based upon a claim that the party drafted the
ambiguous pro\isiolt or language or tl;;it the party \ya,3 intended to he benefited by the
ambiguous iiro\ision or
R. 'I his Agreement may he amended only by a written instrument specifically
referring to this Agreement and executed with the same formalities as this Agreement.
gym, In the e'\ctit ut an allceed hrea'h il! this .'ttrecllle11t. Plaintiff and the fount\
agree that all underlying causes of action or claim; ill Plainul I against the t euntl\ ha‘e been
extinguished by this Agreement and that the sole remedy for breach of'this Agreement shall be
for specitie performance of the terms and conditions of this Agreement. In this regard. Plaintiff
6K
and the t'ounty further agree that the ;tile cue for any such action shall be in th.' l \\entieth
Judicial Circuit in and ibr (.otlicr Loom\. 1' i)1'lu t to
10. Plaintiff agrees to use the proceeds of the settlement funds for the pay meat and
satisfaction of all liens. past and future medical hills. attorney fees. and all other expenses, costs.
debts. o1' losses \111i11S14''\l'I'. aliSillt1 Old id.Or ill ;l'n \\;i\ connected to the incident described in
the 1.1\tsuit, which Plaintiff brought or Collin ha\e brought in the :stlflte:t Lawsuit l he Pli.i.ilitrfi
agrees to be solely responsible for complete payment of all other obligations out of the
settlement proceeds. including any fuldre medical bills
I I. lit' r' lai/0,Q ;mi.] bold halmicss lion; any
and all claims and/or liens and!or subrogatcd interests. including but not limited to Worker's
compensation liens, health insurance liens, Medicaid Medicare liens. Social Security and any
and all attorney lions and ehar_ing lions Iteieio.
12• I his Agreement shall b;: go erued ;1\ tit{ l;.\+ ;it! the Sulic oil lot'idil
IN WITNESS WHEREOF. Plaintiff and the County hest\-c signed and sealed this
Agreement and t'efcase as set 1'60(l
Cynthea Ilumn er. Plaintiff
l_'t)L\11' OF ('OLLi1..R
ro Ward
I he foregoing instrument was acknowledged before me by means of physical
t,. S.epimbef-_presence or - online notarization. this Z� �a\ of 2023. by ()Althea
Hummer.
yS�/
Notary Public Slate of Florida 1 ...._ ---- - .-_4 Scott Scott Torres I (Signature of Notary Public-State of.V lorida
1111 My Commission HH 305505 /
4 Expire' 6129/2020 CO..1 t o r�'e
. . . .. �. _..
(Prim. Ict?C, (. ornmissioners
o
/ f✓
Personally Known OR Produced Identification
Type of identification Produced:
1 6 K 4
AS TO C.OLIN I Y:
ATTE„,SI: .
( RYS I AI K. KIN7.1--.1_:-..Clerl: Fit). R1.)()I: ( ()I ...VrY (. ON1VIISS1()Nt-.Rs
. Attest as to Chairman's (.It (.01 I II. ' ' \ I si'. Fi oRiDA
,.. 1 ", signature only
..,
B.‘, ' ..: IVC• B;: i '
,. Rick LoCastro. Chairperson
1);.iic [0—11- -
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1
Aprt7d as to to n anti cpin
Xttoil•=y1 -- (-tat
Assistant County Attorne;
i 22-CA-16.47-1817773M 4