Backup Documents 11/12/2024 Item #16A 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 A 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 recei in the County Attorney Office no later
than Monday preceding the Board meeting.
** ROUTING SLIP** 1q
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is alrea plete iththe
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 RTT 9/25/24
4. BCC Office Board of County
Commissioners jJ� I t IIz'Z�
5. Minutes and Records Clerk of Court's Office ( rr ''
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 Iliana Burgos Phone Number 252-6865
Contact/Department
Agenda Date Item was 11/12/24 Agenda Item Number 16A- 3
Approved by the BCC
Type of Document(s) Matthew D. Williams, LLC- Releases& Number of Original 1
Attached Satisfaction of Lien Documents Attached
PO number or account DO NOT RECORD,PLEASE RETURN
number if document is TO CODE FOR FURTHER
to be recorded PROCESSING t
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(instead of stamp)? No/
RTT/rev
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 RTT/rev
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 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 RTT/rev
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 RTT/rev
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 I L and all changes made RTT/rev
during the meeting have been incorporated in t e attached document. The County "_ , or
Attorney Office has reviewed the changes,if applicable. '.
9. Initials of attorney verifying that the attached document is the version approved by the RTT/rev •s
BCC,all changes directed by the BCC have been made,and the document is ready for the fati
Chairman's signature.
PLEASE SEND ORIGINAL BACK TO CODE ENFORCEMENT!
I: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
16A 3
This Instrument Prepared By:
Ronald T. Tomasko, Esquire
INSTR 6616824 OR PG
Collier County Attorney's Office RECORDED 11 6//202471:20 PM34 PAGES 1
3299 E. Tamiami Trail-Suite 800 CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Naples, FL 34112 COLLIER COUNTY FLORIDA
(239) 252-8400 REC$10.00
RELEASE AND SATISFACTION OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA is the owner and holder of a certain lien against all real and
personal property owned by:
MATTHEW D. WILLIAMS,
Respondent
The lien was recorded on June 25, 2013, in Official Records Book 4936, Pages 3976-3977, in
the Official Records of Collier County, State of Florida. The lien secures the principal sum of ten
thousand two hundred fifty dollars and twenty-nine cents ($10,250.29), plus accrued interest and
penalties, if any, and imposes certain obligations against real property situated in Collier County,
Florida.
Collier County, a political subdivision of the State of Florida, by execution of this Release and
Satisfaction of Lien, acknowledges payment as approved by the Board of County Commissioners
as satisfaction of the lien and hereby cancels and releases said lien.
The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction of Lien in
the Official Records of Collier County, Florida, to acknowledge that the lien ceases to exist.
ATTEST , �, BOARD OF COUNTY COMMISSIONERS
CRYSTAL. K..k1t ZEL, Clerk COLLIER UNTY, FLORIDA
V
YBy:
.*'`. eputy lerk hris Hall, Chairpers n
Date: U Is:1 •2 b . Date: Ulm/Zy
Appr v as to form and legality
b'>7 tip4Vevy
R nald T. Tomasko
Assistant County Attorney
[24-CED-01841/1893885/1]
16A 3
This Instrument Prepared By:
Ronald T. Tomasko, Esquire INSTR 6616825 OR 6417 PG 2735
RECORDED 11/26/2024 1.20 PM PAGES 1
Collier County Attorney's Office CLERK OF THE CIRCUIT COURT AND COMPTROLLER
3299 E. Tamiami Trail-Suite 800 COLLIER COUNTY FLORIDA
Naples, FL 34112 REC$10.00
(239) 252-8400
RELEASE AND SATISFACTION OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA is the owner and holder of a certain lien against all real and
personal property owned by:
MATTHEW D. WILLIAMS,
Respondent
The lien was recorded on January 23, 2013, in Official Records Book 4878, Pages 2052-2054,
in the Official Records of Collier County, State of Florida. The lien secures the principal sum of
twenty-two thousand seven hundred forty-two dollars and twenty-nine cents ($22,742.29), plus
accrued interest and penalties, if any, and imposes certain obligations against real property
situated in Collier County, Florida.
Collier County, a political subdivision of the State of Florida, by execution of this Release and
Satisfaction of Lien, acknowledges payment as approved by the Board of County Commissioners
as satisfaction of the lien and hereby cancels and releases said lien.
The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction of Lien in
the Official Records of Collier County, Florida, to acknowledge that the lien ceases to exist.
ATTEST BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. KINZEL, Clerk COLLIER COUNTY, FLORIDA
By: By:
D uty erk ris Hall, Chairpers
fr
Date: [1 Date: 111(217,44
App,o, `as to form and legality
11-" )9(4/1 A 1
Ronald T. Tomasko
Assistant County Attorney
[24-CE D-01841/1893882/1I