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Backup Documents 06/25/2024 Item #16D 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 16 D 6 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 'er-ora26 �xp Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete w th exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attomey 0fFice. Route to Addressee(s) (List in routing order) Office Initials Date 1. Michelle Rubbo Community and Human MR 06/21/2024 Services 2. County Attorney Office County Attorney Office G� 6 /ds ,/ 3. BCC Office Board of County CM kti / Commissioners i/ 6/a54Y 4. Minutes and Records Clerk of Court's Office 1,� (V` ).../ Ci 4?-5 aD to 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 Michelle Rubbo. Grants Support Specialist Phone Number 239-252-6030 Contact/ Depai intent II,Community and Human Services Agenda Date Item was June 25, 2024 Agenda Item Number 16.D.6 Approved by the BCC Type of Document Recommendation to approve and authorized Number of Original Attached the Chairman to sign One(1)mortgage Documents Attached satisfaction for the SHIP loan program...a. }�eJ . C - PO number or account number if document is 1077.138711.649030.50137.1 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) App icable) 1. Does the document require the chairman's original signature? 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 MR 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 MR 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 MR document or the foal negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's MR 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 nd all changes made during N/A is not the meeting have been incorporated in the atta ed document. The County (-C an.option for Attorney's Office has reviewed the changes,if a plicable. ) this line. 9. Initials of attorney verifying that the attached doc ent is the version approved by the is1/A is not BCC,all changes directed by the BCC have been ade, and the document is ready for the (5 toption for Chairman's signature. line. 0411 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 Receipt# 008870443 6/27/2024 8:58:54 AM &pi:� �ti f Crystal K. Kinzel Clerk of the Circuit Court and Comptroller 0 GIR � 0 0 Customer Deputy Clerk Clerk Office Location CLERK TO THE BOARD/MINS Anahi Ramirez Collier County Govt. Center & REC Recordinghelp@collierclerk.com Building LA, 2nd Floor 3299 TAMIAMI TRL E STE 401 (239)252-2646 3315 Tamiami Trl E Ste 102 NAPLES, FL 34112 Naples, Florida 34112-4901 2 Documents Recorded DOC TYPE INSTRUMENT BOOK PAGE AMOUNT Release 6563933 6374 1126 $10.00 Release 6563934 6374 1127 $10.00 TOTAL AMOUNT DUE $20.00 Clerk Account#: BCC ($20.00) BALANCE DUE $0.00 Note: 6/27/2024 8:58:54 AM Anahi Ramirez: Charge account: 1077 138711 649030 50137 1 Department: CHS- SHIP 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. ©QoAU ril®Ta®TrhoggiTA Page 1 of 1 606 INSTR 6563933 OR 6374 PG 1126 RECORDED 6/27/2024 8:58 AM PAGES 1 Prepared by:Michelle Rubbo CLERK OF THE CIRCUIT COURT AND COMPTROLLER Collier County Community and Human Services COLLIER COUNTY FLORIDA 3339 E.Taminml Trail,Building H,1121 1 REC$10.00 Naples,PL 34 112 TI:US 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 Janelly Del Ar_o, to COLLIER COUNTY, recorded on 06/28/2019 in Official Records Book 5653, Page 1686 of the Public Records of Collier County, Florida, in consideration of$8,015.82 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; DOCKSIDE OF NAPLES BLDG 4 UNIT 405 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 C9Ia5Io1i#,Agenda Item Numb er_1 b,D, (19 ATTEST: BOARD OF COUNTY COMMISSIONERS CRYSTAL K.,,KI L, CLERK COLLIER COUNTY,FLORIDA By; ,�;,,�i►'��/,/ By; Attest as to Chairman's Dip, �, CH HALL, CHAIRPER N • signature only • Approved for form and legality: b/ Der'el , Per y er.5 S/rq Assistant County Attorney (CAO) 16136 INSTR 6563934 OR 6374 PG 1127 RECORDED 6/27/2024 8:58 AM PAGES 1 Prepared by:tvilchelle Rubbo CLERK OF THE CIRCUIT COURT AND COMPTROLLER Collier County Community and Human Services COLLIER COUNTY FLORIDA 3339 B.Tanllami Trail,Building H,11211 REC$10.00 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 Mario dean Paul, to COLLIER COUNTY, recorded on 03/23/2010 in Official Records Book 4550, Page 644 of the Public • Records of Collier County,Florida, in consideration of$15,246,26 having met the term is hereby acknowledged does satisfy, remise, release, quitclaim, exonerate and discharge the Impact Fee • Lieu against the premises conveyed by said Impact Fee Lien and more particularly described as follows: LOT 67, LII3ERTY LANDING, ACCORDING TO THE PLAT THEREOF', AS RECORDED IN PLAT BOOK 47, PAGES 71 THROUGH 73, INCLUSIVE OF TIE PUBLIC RECORDS OF COLLIER COUNTY,FLORIDA The undersigned is authorized to and does hereby satisfy and release this Lieu 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 Calmly Commissioners on 4,Agenda Item Number16,D, Cp lr lr' - Al I F T` , ,,,. ' ; BOARD OF COUNTY COMMISSIONERS CRYSTAL I :KIN..I.,I.4,5,CLERK COLLIER COUNTY,FLORIDA By. By; Attest as to Chairman's;-DEMIT LE CH ALL, CIIAIRPERSO signature only fi Approved for form and legality: pi-,I7ere ,ferry CSS 5/(y Assistant County Attorney (CA c