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Backup Documents 02/27/2024 Item #16F 3
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 F 3 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. 2. 3. County Attorney Office County Attorney Office z/z7/zY 4. BCC Office Board of County Commissioners CH VS/ 2/27/ Y 5. Minutes and Records Clerk of Court's Office ( 4x/.9t. 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 Kathy Heinrichsberg Phone Number 252-3622 Contact/ Department Agenda Date Item was February 27,2024 Agenda Item Number Minute Traq Item Approved by the BCC 27906 J ., F, 3 Type of Document Permit and Certificate Number of Original 2 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 original signature? NA 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 KH 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 NA 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 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 KH signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip NA 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 February 27,2024,and all changes made KH " #: ix during the meeting have been incorporated in the attached document. The County :,N U ' Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the JAK BCC,all changes directed by the BCC have been made,and the document is ready for the r*� _ Chairman's signature. : Please return to K. Heinrichsberg once recorded. 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 16F3 COLLIER COUNTY FLORIDA Renewal of Class "3" COCPN This Permit is effective March 30, 2024, and Expires March 30, 2025 Name of Service: North Collier Fire Control and Rescue District Name of Owner: North Collier Fire Control and Rescue District Principle Address of Service: 1885 Veterans Park Drive, Naples, FL 34109 Business Telephone: 239-597-3222 Description of Service: Non-Transport Advanced Life Support Number of Ambulances: 29 Ground Units available. See Application for Description of Vehicles This permit, as provided by Ordinance No. 2004-12, as amended, shall allow the above named Non-transport ALS Service to operate within the North Collier Fire Control and Rescue District response boundary and pursuant to the Collier County Fire Chiefs Local Mutual Aid Agreement until the expiration date hereon, except that this permit may be revoked by the Board of County Commissioners of Collier County at any time the service named herein shall fail to comply with any local, state or federal laws or regulation applicable to North Collier Fire Control and Rescue District. Issued and approved this 27+4 day of Februgry 2024. ATTEST: BOARD OF COUNTY COMMISSIONERS Crystal K.KinzeVeterk of Courts COLLIER COUNTY, FLORIDA , By: By: Attest a , ept'tty Clerk Chr al , Chairman sign fi on Approv 3s t¢ f rm and legality: Jeffrey . 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