Backup Documents 05/13/2014 Item #16D 8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 6 08
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.
2.
3. Colleen Greene County Attorney Office
4. BCC Office Board of County
Commissioners \,r �S> a\tb L`k
5. Minutes and Records Clerk of Court's Office
s 0,401
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 Natali Betancur Phone Number 239-252-40 9
Contact/ Department
Agenda Date Item was 05/13/14 Agenda Item Number 16D8
Approved by the BCC
Type of Document Liability and Release Form Number of Original
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? NB
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 NB
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 NB
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 NB
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 NB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NB
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 05/13/14 and all changes made during NB
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
Chairman's signature. IP
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revi : ! , •evised 11/30/12
1608
MEMORANDUM
Date: May 19, 2014
To: Natali Betancur, Operations Analyst
Park & Recreation— Beach & Water
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Facility Liability and Publicity Release
Attached for your records is a copy of the agreement referenced above, (Item #16D8)
approved by the Board of County Commissioners on Tuesday, May 13, 2014.
The original is being held in the Minutes and Records Department for the Official
Record.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachment
1608
_ The
June 20,2014
Worlds Largest
vissow Swimming Lesson''
World's Largest Swimming Lesson
Host Facility Liability and Publicity Release
Aquatic Facility Name: North Collier Regional Park-Sun-N-Fun Lagoon
15000 Livingston Road
Address:
City: Naples State: FL Zip: 34105
Main Phone:
239-252-4000 Direct Phone: 239-252-4074
Facility Representative (Name): Rich Degalan
Title: Aquatics Supervisor
By registering to participate in this event, our facility acknowledges that:
1. Abbey's Hope,American Red Cross(ARC),Aquatics International,Amusement Today, Association of
Aquatic Professionals(AOAP),Association of Pool&Spa Professionals(APSP),Australasian Leisure
Management;AUSTSWIM,Blooloop, Canadian Red Cross(CRC),Centers For Disease Control&
Prevention, Colin's Hope,CPSC's Pool Safely,Drowning Prevention Foundation, Euro Professional
Amusement Magazine, INATI, International Swimming Hall of Fame(ISHOF), International Swim
Instructors Association (ISIA), Independent Pool&Spa Service Association (IPSSA), InterPark Magazine,
Jeff Ellis&Associates, National Aquatic Safety Company(NASCO),National Drowning Prevention
Alliance (NDPA), Notional Recreation&Park Association (NRPA),Park World Magazine,SPLASH!
Magazine, Starfish Aquatics Institute, Swim For life Foundation,The C.L.A.Y.Foundation,The Zac
Foundation, United States Swim School Association, USA Swimming,Water Safety Products,World
Waterpark Association (WWA),and others who may be added later and are posted on the World's
Largest Swimming Lesson website, including all National Supporting Organizations,State Level
Supporting Organizations and Media Partners,have joined together to act as Presenting Organizations
for the World's Largest Swimming lesson (WLSL),which will occur simultaneously at numerous facilities
on Friday,June 20, 2014.
The Presenting Organizations have not inspected or tested any of the host facilities and will not be present
at the facilities during or prior to the WLSL Lesson.The design,construction,operation and maintenance
of the facilities and the instruction and supervision of all facility staff,participants and their parents or
guardians in attendance shall be the sole responsibility of each facility as per local, state and federal pool
and spa regulations and no Presenting Organization or their parents,partners,stockholders,affiliates,
subsidiaries,advertising and promotion agencies and their respective directors,officers, employees,
licensees, ("Releasees"), and all others associated with the development and execution of this event shall
be liable for the safety of any employees,instructors,participants or their parents and guardians or for is
any acts or omissions on the part of any facility in connection with this event. Canter Cott rt1 s (Aa(ot salt'
2. By participating in the WLSL event, I hereby give Releasees and Guinness World Records full permission OF i i) a 2g
and authority to use, publish and display our facility,employees and local WLSL event attendee names,
voices, photographs or other likeness in connection with this event and any events that are scheduled in Flo.Std.)
connection therewith including,without limitation for advertising,publicity and trade purposes in any and cia'S
all media worldwide in perpetui without an ••ditional compensation payable. sove ye�t ,��,•
Whm
Appn°vedit Date: 5/13/14 : „ t" S
, •ctLA
,II r/ IJ �� TOM HENNING, C i� 'N ATTEST: r
- 't your signed release form/a fax to (1-800-403 _ a ,
Assistant a Attorney or scan and email to bbuda@wIsl.org.
i' L
Attest as to Chairman's