Backup Documents 11/14/2023 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. County Attorney's Office County Attorney
Attn. Derek D. Perry, Esq.
File: 23-RPR-03702
2. BCC Office Board of County Commissioners 0 P •_ 4412y
3. Minutes and Records* Clerk of Court's Office r /�J�t, •
*NOTE TO MINUTES AND RECORDS: (�
Please return an electronic copy of the document(s) to vivian.rodriguez@colliercountyfl.gov
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 Vivian Rodriguez/Real Property—Facilities Phone Number 239-252-8402
Contact/Depat intent Management
Agenda Date Item was November 14,2023 Agenda Item Number 16.F.3
Approved by the BCC
Type of Document Lake Trafford Memorial Gardens Cemetery Number of Original 1
Attached Quit Claim Deed Certificate—Heriberto Santiago Documents Attached
PO number or account
number if document is 0001000000-122370-649030
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)
�l 1. Does the document require the chairman's original signature? N/A
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 (_ f
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 VR
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 VR
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 the above date,and all changes made VR N/A is not
during the meeting have been incorporated in the attached document. The County 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 ,fl an option for
Chairman's signature. V this line.
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
Quit Claim Deed Certificate
Lake Trafford_Memorial Carden
This Quit Claim Deed Certificate made this 22-1`14 day of JaZt.uady ,2943,is made between
Heriberto Santiago,whose mailing address is HC 3 Box 53403,Hatillo,Puerto Rico,00659-6138,the part of the first
part, and the BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY,a Political Subdivision of the State of
Florida, whose mailing address is 3355 Tamiami Trail East, Suite 101, Naples, Florida 34112-5746, party of the
second part.
liVitnesseth, that the party of the first part,for and in consideration of the sum of$1.00 and other good and
valuable consideration paid by the party of the second part,receipt of which is hereby acknowledged,hereby grants,
bargains,sells,conveys,and confirms unto the party of the second part,for the sole purpose of burial rights only,the
following described property situated in Collier County,Florida.
Ground Space described as the South 1/2 of Lot 1 in Block B-38 of Lake Trafford
Memorial Gardens,as recorded in Plat Book 8,Pages 32 through 40 and Page 88
of the Public Records of Collier County,Florida.
To have and to hold said property,subject to conditions and limitations set forth in the Policies and Procedures
now in existence,or which may hereafter be adopted by the Board of County Commissioners of Collier County,for
the administration,maintenance,and development of Lake Trafford Memorial Gardens.
The party of the first part shall not be liable for loss or damage caused by an act of God,common enemy,thieves,
vandals,strikers,malicious mischief makers,unavoidable accidents,riots or order of any military authority.
n 'Witness 'Whereof,the undersigned has caused,these presents to be signed the day and year first above
writt n. 33_ i ,a i-,,
BY:
-�� Witness HERIBERTO SANTIAGO
Print Name V(>.
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11��C.CXtalc- eaorol.S INSTR 6577728 OR 6385 PG 3421
RECORDED 8/2/2024 8:23 AM PAGES 1
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/� Wi ss/ CLERK OF THE CIRCUIT COURT AND COMPTROLLER
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Print Name oar (_7 ✓ COLLIER COUNTY FLORIDA
3835 zrkcaz,e44-4.7"KL) ,f h p(� ,jSt//z, DOC@.70$2.80 REC$10.00
CaMM /_" /R fit CONS$375.00
OTY/COUNTY of &Wi(_'.!-
The foregoing was acknowledged before me by means of m'physisal presence or❑online notarization this — 1�day
of %-i-aiLt.CGZ (Li ,2023,by Heriberto Santiago whoti its personally known to me;a has produced his current
driver's license;or produced a.t. as Identification ,.,
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Notary . I, : '••fyre DEBOf,I`, K.G�•
Print Na '•;• ,•, ':': MY Ci ISSION#HH136883 I
Approved as to form an legality: Commis EXPIRE4444,2025
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O(,+ 1)A E1'�E7C E2/y, Assistant County Attorn y(\\P
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