Backup Documents 07/08/2014 Item #16F1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO Afi F 1
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNAT
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 At rney 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 documen s alrea y 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 JAK 7/25/14
`A
4. BCC Office Board of County �'�
`_�'�
Commissioners 7c5/ $A`` VI\
5. Minutes and Records Clerk of Court's Office
Q(ct (I� 12.:24p1
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 Amy Patte son,It Fees Phone Number 252-5721
Contact/ Department
Agenda Date Item was 7/8/14 Agenda Item Number 16-F-1
Approved by the BCC
Type of Document Termination of Agreement and Release of Number of Original One
Attached Lien Documents Attached
PO number or account
number if document is Yes- 107-138920-649030.
to be recorded
ONS & 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? JAK
2. Does the document need to be sent to another agency for additional signatures? If yes, JAK
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 JAK
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 JAK
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 JAK
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 JAK
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JAK
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 7/8/14 and all changes made during the JAK
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 JAK b
BCC,all changes directed by the BCC have been made,and the document is ready for 'e y[' J
/ J
Chairman's signature. 1V
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
16F 1
INSTR 5018232 OR 5066 PG 3056
RECORDED 8/12/2014 3:20 PM PAGES 2
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC$18.50
TERMINATION OF AGREEMENT AND RELEASE OF LIEN
KNOWN ALL MEN BY THESE PRESENTS: That Collier County, whose post office
address is 3301 East Tamiami Trail, Naples, Florida, 34112, the owner(s) and holder(s) of a
certain Amended and Restated Impact Fee Agreement executed by Ospreys Landing, Ltd. to
Collier County, on December 6, 1994, and recorded on December 20, 1994, in Official
Records Book 2012, Page 2265, of the Public Records of Collier County, Florida, such
Agreement having amended the agreement executed by Ospreys Landing, Ltd. to Collier
County, on November 9, 1993, and recorded on April 14, 1994, in Official Records Book
1935, Page 817, of the Public Records of Collier County, Florida, and re-recorded on April
22, 1994, in Official Records Book 1938, Page 1481, of the Public Records of Collier
County, Florida, hereby does terminate the aforesaid Agreement and release the real property
described in Exhibit "A" (attached) from the aforesaid Agreement.
The undersigned is authorized to and does hereby release this lien as to the whole of the
described real property and consents to this lien being discharged of record.
Dated this Sk--\--N day of __Jc \LA , 2014.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COLLIER COUNTY, FLORIDA
By:
4.___...-- Byi--...._701Z .
,i. `.,,A,a' " Deputy Clerk TOM HENNING/
Attest as to Chai .n'ss. CHAIRMAN
Si!neat Mrly;'.
Appro;ed :;s,°: orm and legality:
Jeffrey ll I: i % `
County ( ey
1
16F 1
Exhibit"A"
The East Half of the West Half of the Southeast Quarter of Section 6, Township 50
South, Range 26 East, Collier County, Florida, less and excepting the South 75 feet thereof,
previously deeded to Collier County for road purposes.
2