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Backup Documents 03/08/2016 Item #16E 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO "6 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 " COA � Complete routinglines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is alr dy cbm� ete with the P � 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 , 3 i i o I t L, 4. BCC Office Board of County �T" c Commissioners y .3\\l\\b 5. Minutes and Records Clerk of Court's Office TILL) Al(li V 'FYG( �' 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 Phone Number Contact/ Department Deborah Goodaker 252-8922 Agenda Date Item was Agenda Item Number Approved by the BCC March 8,2016 16E3 Type of Document Number of Original Attached Grant of Utility Easement w-Exhibit"A" Documents Attached i I PO number or account 35-0_ 14404-7-c-6/4/030 , number if document is to be recorded .537.S.0. a'6, 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 ,nature? *(-� 2. Does the document need to be sent to another agency for additional signatures? If yes, A J 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 1 � ) Office and all other parties except the BCC Chairman and the Clerk to the Board l'T 5. The Chairman's signature line date has been entered as the date of BCC approval of the i l document or the final negotiated contract date whichever is applicable. �1� 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's ;�1//� signature and initials are required. ,�.JJ�(-� 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 03/08/2016 and all changes made during the meeting have been incorporated in the attached document. The County d:QI 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 t•.- 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 16E 3 • ,or • Memorandum ()I ill'\ TO: Minutes & Records Management FROM: Deborah Goodaker Property Acquisition Specialist Real Property Management DATE: March 8, 2016 RE: Grant of Utility Easement for Collier EMS No. 76 Please find attached the original Grant of Utility Easement from Collier County to Comcast, which was approved by the BCC at the 3/8/16 Meeting, Agenda Item 16E3. Please attest to Chairman Fiala's signature. A recording form is attached to complete the transaction. Kindly contact Debi Goodaker (x8922) if you have any questions or comments. Thank you. RI NEScToRR5=339/81 50/2%5126590.3 P6 G3562 2GES 2 DVVIGHT E. BROCK, CLERK OF THE CIRCUIT COURT PROJECT: Collier EMS No. 76 PARCEL: 41820800009 COLLIER COUNTY FLORIDA DOC@ 70$0.70 REC$18.50 GRANT OF UTILITY EASEMENT 1 6 E 3 M-9 1(7.-/ This indenture made and executed this '.771" day of / , It__,. . , 2016, by and between COLLIER COUNTY, a political subdivision of the State of Florida, hereinafter referred to as GRANTOR and COMCAST CABLE COMMUNICATIONS MANAGEMENT, LLC, hereinafter referred to as GRANTEE. WITNESSETH That for and in consideration of the sum of Ten Dollars ($10.00) and other good and valuable consideration, receipt of which is hereby acknowledged, the GRANTOR hereby grants to GRANTEE, its successors or assigns, a non exclusive easement for the purpose of providing communications services by allowing Comcast's cable equipment to be placed into, over, under, across, and along the property as more particularly described on Exhibit "A" attached hereto and made a part hereof. TO HAVE AND TO HOLD the easement hereby granted unto said GRANTEE, its successors and assigns. GRANTEE, by acceptance of this easement agrees for itself, its successors and assigns, to maintain said easement and in no way interfere at any time with the right of ingress or egress of GRANTOR, its successors and assigns, or any other party requiring access to any of the property over which said easement is granted. GRANTEE further agrees that it will at all times use extreme care to restore all grounds to as good or better condition than found prior to construction, maintenance and repair. In the event GRANTEE, its successors or assigns, shall fail to use this easement for the purpose intended, then GRANTEE, its successors or assigns, shall vacate, cancel and annul said easement or relevant part thereof. GRANTOR, its successors or assigns, shall upon said vacation, have the right to require GRANTEE, its successors or assigns, to remove any structure or improvements which may affect the use of the property. GRANTEE hereby covenants and agrees to indemnify, save, protect and hold harmless GRANTOR against any loss, damage, injury, debt or expense (including attorney's fees) claimed or asserted by any person or entity, which claim relates to in any way, no matter how remote, or arises out of GRANTEE'S installation or use of GRANTEE'S facilities described above. IN WITNESS WHEREOF the GRANTOR has caused these presents to be executed in its name by its Board of County Commissioners acting by the Chairman of said Board, the day and year first above written. ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. 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