Backup Documents 12/09/2025 Item #16D 3C�{ ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 12/9/25 BCC MTc
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 Attm ney 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. 1 6 D 3
**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
a..tinn of the Chairman's signature draw a line thrnuvh rnntinu fines 91 thrnueh 42- complete the checklist, and forward to the County Attorney Office.
Route to Addressees (List in routing order)
Office
Initials
Date
1. Michelle Rubbo
Community and Human
Services
MR
12/4/25
2. County Attorney Office —
County Attorney Office
3. BCC Office
Board of County
Commissioners
/
4. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION v
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 ma need to contact staff for additional or missinp, information
Name of Primary Staff
Michelle Rubbo
Phone Number
(239) 252-6030
Contact / De artment
Agenda Date Item was
12/9/25
Agenda Item Number
16.D.3
Approved by the BCC
Type of Document
CWIF RELEASE OF LIEN
Number of Original
1
Attached
Documents Attached
PO number or account
1053.138791.649030.33907.1
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 STAMP OK
MR
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 final 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 above date and all changes made during
the meeting have been incorporated in the attached document. The County
Attorne 's Office has reviewed the changes, if applicable.
( y
9.
Initials of attorney verifying that the attached document is the version approved by the
BCC, all changes directed by the BCC have been made, and the document is ready for the
Chairman's signature.
�(
Prepared by: Michelle Rubbo
Collier County Community and Human Services
3339 E. Tamiami Trail, Building H, #211
Naples, FL 34112
------------
INSTR 6762387 OR 6534 PG 3249
RECORDED 12/11/2025 10:15 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
REC $10.00
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 Habitat for Humanity of Collier County,
Inc., to COLLIER COUNTY, recorded on 12/26/2024 in Official Records Book 6425, Page 681
of the Public Records of Collier County, Florida, in consideration of $12,676.32 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:
Kaicasa Phase One Lot 41
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 �� Agenda
Item Number 16.D. 3
ATTEST:
.., Cr$4j$�TAL K. KINZEL, CLERK
By:
c;l; , DEPUTY CLERK
'Attest as to Chairman's
signature only
and legality:
Jeffrey a. K_latzkow
Count Attorney 0 /36 f 235--
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
B R`r L. SAUNDERS, CHAIRPERSON