Backup Documents 04/26/2016 Item #16D13 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 D 13
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 Cawing n1 i-7
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the documents 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 JAB 0.
4/26/16
4. BCC Office Board of County -)F
Commissioners "11.5/ A\-z_--‘\‘‘c.
5. Minutes and Records Clerk of Court's Office '''7 ?))//1\i
412-1(he ark
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 Mandy Moodyc—,, Z_
Contact/ Department �v ec e _- Z.332
Agenda Date Item was 4/26/16 �/ Agenda Item Number 16D13 r�
Approved by the BCC
Type of Document Release of Declaration of Restrictions Number of Original One
Attached Documents Attached
PO number or account +wirrl -
number if document is ..l oc_Winos"(1-kc1030
to be recorded 3343A,
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 signat e STAMP OK JAB
2. Does the document need to be sent to another agency for u4gitional si res? If yes, JAB
provide the Contact Information(Name;Agency; Address; Rae on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAB
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 JAB
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 JAB
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 JAB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JAB
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 4/26/16 and all changes made during . • JAB
meeting have been incorporated in the attached document. The County Attorn• "s • .
Office has reviewed the changes,if applicable. •
9. � ,
Csn.N-rrF,v
C�V lr^G14-41 C.LS -
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
16 0 1 3 '
INSTR 5258469 OR 5266 PG 3777
RECORDED 4/28/2016 8:23 AM PAGES 1
Prepared by: Mandy Moody DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
Record and Return to: COLLIER COUNTY FLORIDA
Collier County Community&Human Services Division REC$10.00
3301 E.Tamiami Trail,Bldg H, Suite 211
Naples,FL 34112
THIS SPACE FOR RECORDING
RELEASE OF DECLARATION OF RESTRICTIONS
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA is the beneficiary of a certain
Declaration of Restrictions made by:
Immokalee Non-Profit Housing, Inc. A.K.A. Immokalee Housing & Family
Services
The Declaration of Restrictions was recorded on August 17, 2010 in Official Records Book
4596, Pages 0781 through 0784, inclusive in the Official Records of Collier County, State of
Florida as required by a subrecipient grant agreement with the County, dated September 15,
2009. The Declaration of Restrictions restricts the use of the property described:
The North one-half of the West one-half of the North one-half of the Southeast
one-quarter of the Northwest one-quarter of Section 32, Township 46 South
Range 29 East, Collier County, Florida.
Collier County Tax Folio Number 00082961109
2449 Sanders Pines Circle
Immokalee, FL 34142
Collier County, a political subdivision of the State of Florida, by execution of this Release of
Declaration of Restrictions, acknowledges cancelation of said Declaration of Restrictions in
accordance with the terms of the subrecipient grant agreement.
The Clerk of the Circuit Court is hereby directed to record this Release of Declaration of
Restrictions in the Official Records of Collier County, Florida, to acknowledge that the
Declaration of Restrictions ceases to exist.
ATTEST:
BOA' I OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, Clerk COL R COUNT , FLORIDA
By;))f ,� ;:� By:
'"Zh40
Attest as to Chairman's, Dp Cfe Donna Fiala, Chairman
signature only.
Approved for form and legality:
c_AA -
Je fer A. Belio
Assistant County Attorney �' \�