Backup Documents 03/08/2016 Item #16D12 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
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 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. County Attorney Office County Attorney Office C y' ` ' +I V
4. BCC Office Board of County Fes`
Commissioners 13\( \k6
5. Minutes and Records Clerk of Court's Office
*10 ifar/%t
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 Tanya Williams Phone Number X5391
Contact/ Department
Agenda Date Item was 3/8/2016 Agenda Item Number 16.D.12
Approved by the BCC
Type of Document Pschibul Revocable Trust Number of Original 2 documents,4 pages
Attached Documents Attached total
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. (I iti ) Applicable)
1. Does the document require the chairman's original signature?
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
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 34
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 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 3/8/2016 (enter date)and all �.
changes made during the meeting have been incorporated in the attached document. ah option for
The County Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not
BCC, all changes directed by the BCC have been made, and the document is ready for the an option for
Chairman's signature. this line.
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
1601 2
Martha S. Vergara
From: Martha S. Vergara
Sent: Thursday, March 10, 2016 9:51 AM
To: Williams,Tanya
Subject: Agenda Item#16D12 from the 3/8/16 BCC Meeting (Pschibul Revocable Trust)
Attachments: Tanya Williams.pdf
Hi Tanya,
Attached is a copy of the doc that went out to Kathi Young w/Raymond James Trust, N.A. for your records.
Thanks,
Martha Vergara, BMR Senior Clerk
Minutes and Records Dept.
Clerk of the Circuit Court
& Value Adjustment Board
Office: (239) 252-7240
Fax: (239) 252-8408
E-mail: martha.vergara(a�collierclerk.com
1
16012
r--
(Mk
Count-of Collier
CLERK OF THE CIICU COURT
COLLIER COUNTY Cc JRTHO SE
Dwight E.Brock-ClerI Circu`�it Court P.O. BOX 413044
3315 TAMIAMI TRL E STE 102 pf, A
NAPLES,FL 34112-5324ice ' NAPLES,FL 34101-3044
Clerk of Courts • Comptroller • Auditor • C'usfodian of County Funds
March 9, 2016
Raymond James Trust, N.A.
Attn: Kathi Young
880 Carillon Parkway
St. Petersberg, Florida 33716
Re: Pschibul Revocable Trust
Transmitted herewith is the original of the above referenced document for further
execution, as adopted by the Collier County Board of County Commissioners of Collier
County, Florida on Tuesday, March 8, 2016, during Regular Session.
Please forward/e-mail a copy once the Notice is fully executed to
(martha.vergara@collierclerk.com) for the Boards Official Records.
Very truly yours,
DWIGHT E. BROCK, CLERK
Martha Vergara, epu y C erk
Enclosure
Phone- (239)252-2646 Fax- (239)252-2755
Website- www.CollierClerk.com Email-CollierClerk@collierclerk.com
RAYMOND JAMES' Trust Release, Waiver & 16 a 12
Refunding Agreement
Name of Account: Franz Pschibul Revocable Trust of 1996, dated May 15, 1996 as
amended on March 31, 1998 & October 29, 2009 ("Trust").
Trustee: RAYMOND JAMES TRUST, N.A. ("Trustee")
Beneficiaries: Todd Wertalik, Janine Gregor, Claudia Mogendorf, Andreas Maier,
Children's Museum of Naples, Inc., Collier County Public Library
and Florida Gulf Coast University Foundation, Inc.,
("Beneficiaries")
The undersigned, as Beneficiaries of the Trust, in consideration of the mutual covenants
set forth below,hereby:
1. Acknowledge that they are entitled to an account of the Trustee's acts as Trustee
of the Trust, that the Trustee may file a judicial accounting and petition for
discharge in the appropriate court seeking approval of its accounting and granting
its petition for discharge from any further responsibility of the Trust;
2. Agree to execute this Agreement in lieu of such judicial accounting and discharge
and waive all right to any such account in order to expedite the distribution of the
Trust and avoid the expense attendant thereon;
3. Accept all periodic statements of the Trust heretofore made by Trustee and
received by the undersigned in connection with the administration of the Trust
and does hereby release the Trustee from any and all liability for all matters
disclosed in such periodic statements of account;
4. Acknowledge that they are aware of the amounts and assets which shall be
transferred upon execution of this Agreement, subject to any applicable market
fluctuation and payment of fees and expenses, and accepts same as accurate;
5. Release and discharge the Trustee, as trustee and in its corporate capacity, its
predecessors, successors, affiliates and directors and employees of the Trustee or
its affiliates, of and from any and all liability or claims whatsoever that they or
any other person or entity may now have or may have in the future against the
Trustee by reason of any act done or omitted to be done by the Trustee in
connection with the administration of the Trust;
6. Agree that, if any claims, charges or expenses (including but not limited to taxes,
court costs, attorneys' fees and fiduciary compensation) become properly payable
by the Trustee out of the property hereby delivered, the undersigned will,
Page 1 of 3
RAYMOND JAMFS® Trust Release, Waiver &
16 D12
Refunding Agreement
immediately upon demand, pay over the amount thereof to the Trustee, or
retransfer and redeliver to the Trustee, for sale and liquidation, such part of the
assets delivered herewith as said Trustee may demand. Said refund shall not
exceed the value of the assets received from the Trust.
7. Acknowledge that (i) this Agreement is a legal document; (ii) they have been
advised to have this Agreement reviewed by their attorney(s); and (iii) they have
had the Agreement reviewed by such attorney(s) or voluntarily chose to execute it
without a review by such attorney(s);
8. Understand that the provisions of this Agreement are severable, and if any part of
it is found to be unenforceable, the other provisions shall remain fully valid and
enforceable;
9. Agree that the provisions of this Agreement shall bind and inure to the benefit of
them and their heirs, successors and assigns and the successors and assigns of the
Trustees; and
10. Agree that this Agreement may be signed in counterparts, each of which shall be
an original and all of which together shall constitute one Agreement.
Dated:
Todd Wertalik, Individually and as Beneficiary of the
Franz Pschibul Revocable Trust on 1996, dated
May 15, 1996 as amended on March 31, 1998 &
October 29, 2009
Dated:
Claudia Mogendorf, Individually and as Beneficiary of the
Franz Pschibul Revocable Trust on 1996, dated
May 15, 1996 as amended on March 31, 1998 &
October 29, 2009
Dated:
Andreas Maier, Individually and as Beneficiary of the
Franz Pschibul Revocable Trust on 1996, dated
May 15, 1996 as amended on March 31, 1998 &
October 29, 2009
Page 2 of 3
RAYMOND JAMIES® Trust Release, Waiver &
16012
Refunding Agreement
, Dated: __
Janine Gregor, Individually and as Beneficiary of the
Franz Pschibul Revocable Trust on 1996, dated
May 15, 1996 as amended on March 31, 1998 &
October 29, 2009
ik ,--rmAl , Dated: \-Aavc'.tZ ISI Zolb
Collier C unty Public Library,
Individually and as Beneficiary of the
Franz Pschibul Revocable Trust on 1996, dated
May 15, 1996 as amended on March 31, 1998 &
October 29, 2009
BY: DONNA FIALA, CHAIRMAN, COLLIER COUN'T'Y BOARD OF COUNTY COMMISSIONERS
, Dated:
Florida Gulf Coast University Foundation, Inc.,
Individually and as Beneficiary of the
Franz Pschibul Revocable Trust on 1996, dated
May 15, 1996 as amended on March 31, 1998 &
October 29, 2009
, Dated:
Children's Museum of Naples, Inc.,
Individually and as Beneficiary of the
Franz Pschibul Revocable Trust on 1996, dated
May 15, 1996 as amended on March 31, 1998 &
October 29, 2009
.4,i"i EST
DWIGHT E. BR•eK Cler:Ak
,A4„1,..f
ey.--:laQik- ' '
Attest as to Chairman's
signature nn(y.
A(; _&i"
v ' to form and le ality
-XI 4 l'J f
Assistant County Atto Page 3 of 3
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ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 0 2
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 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. County Attorney Office County Attorney Office CMG 3/21/16
4. BCC Office Board of County
Commissioners \K/ 3\Z`\\
5. Minutes and Records Clerk of Court's Office ('\/,4j I
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 Valerie Kocin,Library Director 593-3511
Contact/ Department
Agenda Date Item was 3/8/16 . Agenda Item Number 16-D-12(Receipt)
Approved by the BCC l/
Type of Document Franz Pschibul Trust Donation-Receipt Number of Original One
Attached Documents Attached
PO number or account n/a
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 CMG
2. Does the document need to be sent to another agency for additional signatures? If yes, CMG
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 CMG
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 CMG
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 CMG
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 CMG
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip CMG
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 3/8/16 and all changes made during the CMG N/A is not
meeting have been incorporated in the attached document. The County Attorney's an option for
Office has reviewed the changes,if applicable. t me.
9. Initials of attorney verifying that the attached document is the version approved by the c .ic /A not
BCC,all changes directed by the BCC have been made,and the document is ready for he opt on for
Chairman's signature. \('4e this l' e.
PLEASE CALL VALERIE KOCIN (593-3511)WHEN READY
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
.,r.. <,.cwNNe,OM, .r4#pv r .00, —,..,,,,,<..—,,.r„:�...,,.m>,. woo; r,; as e,a ??.. »;u_, ob .r R•: ,A .,,. rw,. ,
x`s.{
County-of
Collier
CLERK OF THE CIR.CURl��' COURT
COLLIER COUNTY CQ=<,IRTHOUSE
3315 TAMIAMI TRL E STE 102 Dwight E. Brock-Cler1 `pf Circuit Court
P.O.BOX 413044
NAPLES,FL 34112-5324 f
NAPLES,FL 34101-3044
Clerk of Courts • Comptroller • Auditor • Custodian of County Funds
March 22, 2016
Raymond James Trust, N.A.
Attn: Kathi Young
880 Carillon Parkway
St. Petersberg, Florida 33716
Re: Franz Pschibul Trust Settlement—Final Distribution
Receipt of Beneficiary - Charity
Transmitted herewith is a certified copy of the original of the above referenced document
for further execution, as adopted by the Collier County Board of County Commissioners
of Collier County, Florida on Tuesday, March 8, 2016, during Regular Session.
If you have any concerns or questions feel free to contact us anytime.My e-mail is
martha.vergara(c;collierclerk.com.
Very truly yours,
DWIGHT E. BROCK, CLERK
)1\-70,_L - ' '--- ,
Martha Vergara, Dep Cler
Enclosure
Phone- (239) 252-2646 Fax- (239) 252-2755
Website- www.CollierClerk.com Email-CollierClerk@collierclerk.com
RAYMOND JAMES®
16012
March 10, 2016
Collier County Public Library
Attn: Val Kocin,Division Director
2385 Orange Blossom Dr.
Naples, FL 34109
Re: Franz Pschibul Trust Settlement
Final Distribution
Dear Ms.Kocin:
Please find enclosed final distribution representing the Collier County Public Library share of the
above referenced Trust.
For our files, please sign and return the enclosed Receipt as acknowledgement of the enclosed
final distribution proceeds entitled to the Collier County Public Library from this Trust. A self-
addressed envelope is enclosed for your convenience.
Thank you for your attention in this matter.
Si erely,
atk J
athi Young
t—d..---I
Associate Trust Officer
Encl.
Raymond JamesTrust N.A.
880 Carillon Parkway Saint Petersburg,FL 33716
T 727.567.2300 T 800 248 8863 x72300? F 727.567.8738 (raymondjames.com
16012
RAYMOND JAMES" BankofAmerica�i, No. T 244878 6 1278
1.L�1 i N . A .1 � Atlanta,GA
TRUST NATHIS CHECK BECOMES VOID AFTER 180 DAYS
RAYMOND JAMES TRUST NA
880 CARILLON PARKWAY PHONE(727)567-4888
ST.PETERSBURG,FL 33716
ACCT.NO. 1033630400 DATE 03/04/2016
PAY Two Hundred Ninety—Five Thousand Two AMOUNT $*****295,264.82
Hundred Sixty-Four DOLLARS AND Eighty—Two CENTS
TO THE COLLIER COUNTY PUBLIC LIBRARY 1 V
ORDER ATTN: VAL KOCIN, DIV. DIRECTOR �„�%�,
OF 2385 ORANGE BLOSSOM DR. f //� f�t/e/L.
NAPLES, FL 34109 �/, n/
AUTHORIZED'SIGNATURE
PLEASE DETAC EFverire DEPOSITING CHECK
No. T 244878
A/C NAME FRANZ PSCHIBUL TRUST DATE 03/04/2016
REMITTANCE AMOUNT
ACCT. NO. 1110111111111111111111111111x 40 INCOME PRINCIPAL;
OFFICER NO. 3317 TAX CODE 850 $**********0.00 $****295,264.82
DISBURSEMENT APPROVED TO FOR
COLLIER COUNTY PUBLIC LIBRARY
ATTN: VAL KOCIN, DIV. DIRECTOR
2385 ORANGE BLOSSOM DR.
NAPLES, FL 34109
FINAL DISTRIBUTION PER TRUST
DOCUMENT(KY)
12/30/2015
16 0 1 2
RAYMOND JAMES TRUST N.A.
IN RE: FRANZ PSCHIBUL TRUST SETTLEMENT
1033630400
RECEIPT OF BENEFICIARY - CHARITY
The undersigned, being a beneficiary of the Trust, hereby acknowledges having received
from the Trustee of the above Trust the following final distribution:
Distribution in the amount of: $295,264.82 check#244878 Final Distribution
This distribution represents final distribution of the Collier County Public Library Trust's
beneficial interest in the Trust.
In consideration of the distribution of the aforesaid property, the undersigned does hereby
agree to assume and pay any and all taxes and other liabilities for which the Trustee may
hereafter be personally liable if said taxes and other liabilities would have been taken
from the above assets or funds had such property remained in the possession of the
Trustee. This indemnification shall include any and all costs of the Trustee in collecting
any funds due, including but not limited to reasonable attorney fees, including any and all
judicial proceedings. The amount of this indemnification, exclusive of costs, shall not
exceed the amount of this distribution.
The endorsement and negotiation of the distribution check acknowledges agreement to
this indemnification.
Dated this Z I s�- day of cx -cv.\, , 2016
By:
Collier C my Public Library
Chairman of the Board of County Comnissioners, Collier County, Florida
Print Your Name Donna Fiala
tti • Approved as to form and legality
ATTEST!' Ce-X012A,1170 MO4A1Z--
[3 CHT E. = ^• , irk Assistant County Attorney
By: v Yta
Attest ask)Chairman's IP
cinnatum nnly