Backup Documents 01/13/2015 Item #16A 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 A 6
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATUR
Print on pink paper. Attach to original document. The completed routing slip and original documents are to he 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 M1londay preceding the Board meeting.
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 a/ /►S
4. BCC Office Board of County
Commissioners 4\(:, Z-ks\`S
5. Minutes and Records Clerk of Court's Office -�^ 2,b+tS V :5-t Q
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 John Houldsworth Phone Number x-5757
Contact/ Department
Agenda Date Item was January 13,2015 Esplanade at Hacienda Agenda Item Number 16-A6
IV
Approved by the BCC Lakes Amenity Center
Type of Document Plat Number of Original One-Plat
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? oxvip Q�L.
2. Does the document need to be sent to another agency for additional signatures? If yes, JH
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 JH
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 JH
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
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
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 January 13,2015 and all changes made if
during the meeting have been incorporated in the attached document. The County ,
Attorney's Office has reviewed the changes, if applicable.
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 fi ,'
Chairman's signature. ' -
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
16116
MEMORANDUM
Date: February 5, 2015
To: John Houldsworth, Senior Engineer
Engineering Services Department
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Plat— Esplanade at Hacienda Lakes Amenity Center
Attached for your records are copies of the Agreement and LOC referenced
above, (Item #16A6) approved by the Board of County Commissioners on
January 13, 2015.
If you need anything further, please feel free to contact me at 252-8411.
Thank you.
Attachment