Backup Documents 04/26/2016 Item #16E 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16E �.
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 Off e no later
than Monday preceding the Board meeting. ii''
**NEW** ROUTING SLIP ;AV 7 Z
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already com ' to ith the
exception of the Chairman's stature,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
4. BCC Office Board of County b--k
Commissioners /6 j e-A2S\kb
5. Minutes and Records Clerk of Court's Office
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 SUE JIM ZIMME AN Phone Number 239-252- 622
Contact/ Department
Agenda Date Item was APRIL 26,2016 Agenda Item Number 16E1
Approved by the BCC
Type of Document UTILITY EASEMENT and Number of Original 2
Attached UTILITY FACILITIES WARRANT/DEED Documents Attached
&BILL OF SALE
PO number or account FUND 490/144(0'
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? sJz
2. Does the document need to be sent to another agency for additional signatures? f 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 ,JZ,
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 sJz
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 5JZ
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 4/26/16 (enter date)and all changes sJz
made during 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 z
Chairman's signature.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 224.05;Revised 11/30/12
16E 1
.0,A
, /'
Memorandum
r•
_rel -Ny
TO: Minutes & Records Management
Zfe-71
FROM: Sue Zimmerman
Sr. Property Acquisition Specialist
Real Property Management
DATE: April 26, 2016
RE: EMS #76 —4/26/16 BCC Item 16E1
Attached are the original Utility Easement and Utility Facilities Warranty Deed and Bill of Sale
approved by the Board under Agenda Item 16E1 at today's Board Meeting. Please be kind
enough to attest to the Chairman's signature and then process for recording.
The originals are to be returned to your office for safe keeping. We will deliver copies of the
recorded documents to Melissa Alvarez at Growth Management for the utility conveyance
process.
These documents pertain to EMS #76 which was renumbered and formerly known as EMS
#73. For reference, you have an existing folder for EMS No. 73 with the property's
Conservation Easement in it. On March 8, 2016 Item 16E3 (Grant of Utility Easement to
Comcast Cable Communications Management, LLC) was approved by the Board pertaining
to this same EMS #76, but I am not sure where that has been filed in your records.
Please contact me if you have any questions or comments at Extension 2622. Thank you.
16E 1
•
PROJECT: EMS #76 (fka#73)
FOLIO NO.: 41820800009 INSTR 5259609 OR 5267 PG 3339
RECORDED 5/2/2016 8:34 AM PAGES 2
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC$18.50
UTILITY EASEMENT
THIS EASEMENT, made and entered into this -
day of 2016, by
COLLIER COUNTY, A POLITICAL SUBDIVISION OF THE STATE OF FLORIDA, whose post office
address is c/o 3335 Tamiami Trail E, Naples, Florida 34112, hereinafter referred to as
"Grantor", to the BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA,
AS THE GOVERNING BODY OF COLLIER COUNTY AND AS THE EX-OFFICIO GOVERNING
BOARD OF THE COLLIER COUNTY WATER-SEWER DISTRICT, whose post office address is
3339 Tamiami Trail E, 3rd Floor, Naples, Florida 34112, its successors and assigns,
hereinafter referred to as "Grantee".
WITNESSETH:
Grantor, for and in consideration of TEN DOLLARS ($10.00) and other valuable
consideration paid by the Grantee, the receipt and sufficiency of which is hereby
acknowledged, hereby conveys, grants, bargains and sells unto the Grantee, its
successors and assigns, a perpetual, non-exclusive easement, license, and privilege for
utility purposes, on the following described lands located in Collier County, Florida, to
wit:
See attached Exhibit "A"which is
incorporated herein by reference.
Subject to easements, restrictions, and reservations of record.
TO HAVE AND TO HOLD the same unto the Grantee together with the right to
enter upon said land, excavate, and place or remove materials for the purpose of
constructing, operating, and maintaining utility facilities thereon. Grantor and Grantee
are used for singular or plural, as the context requires.
IN WITNESS WHEREOF, the Grantor has caused these presents to be executed the
date and year first above written.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK COLLIER C NTY, FLORIDA
4,,si:Otlivkil BY: i-m-1-!✓' art. .-
Ast as to Cha�tnka, Knut✓y' lerk DON A FIALA, Chairman
a
signature only.
Approved as to form and legality:
C.K��� his Board
Co Approved By
The Of County
Commissioners�� }�c��}xy,�,I FoF�ir"e",-,
Jenn r A. Belped •, P �� Collier County Florida,an.,iaa �'d'' i,x r
Assistant County At o noy n� Pursuant o Ag�en is
�\ Date: 4l,?t31i� -Item No: 1bei
Of)
C
16E 1
S -1 D n ` 2 0 W N l Z o co
0 mo oop°O Dss '�
pm P. r�r 0 (m� li c�12pp f.' Q5858--I c m9covmim ? ,z). c)v_z Ac c „ 22a-o .C1
O 7C Co-I o Z C)0 O
"' O o mn moZN Z ��W�� m Z E- rn z m D. A cprnm 'p
co T rn 0 .9 y� m Nm N f Z G) �� Oz O mmt.- 00 fA*1Z r- xi
m
A { m Z 020M-1 fOz/f z o o 'Nj OzA D�O O �� ZZA�D o°-
:C LI fztn= In cO-KOcn Na m Z ,4-I O0oom"'"� m
it m v oR8 -o
,0R. o cNs O*m� p v o(Tpcm n? rip nop0 �Z�o m
Cn
m (ri) > QRZ�1 n=om = N,�==_ > z0 JU'mD V U c�z - O Om C)0 0
`� fS ON yO mi-,,,mm m OmfOcr, m Z•'m;� Dy0�z '--
VIInOr OZf�TI m mr mNm --� Z�� oco ".�* tnZtD0
m�DO yz O -D_-IZ mm �-1 m NO 'O-Si Imo O� 04'2z
O :7 0=o0 �l o`�A z0 mDmn DO mElL77cn o-A m'"� Z
'n z.D m zCDm zm MO O2� 0_41�A N2
�" .�., �• =Q'm� 2 arm m P(n 8 4 cil0 y O f. z 0 m- z • z t�j,.9
v 6 tncrmicz -Dm+ZOA 1� o� D�i$�{ oDU,0 vo�o
CrJ Z��O N (n pO (TI(�ni -0m o= Z O X100 m o m-
74 Ctl (^l ZO�Z C trail D� fn n Oo O c r m� pm cep=G7
Vi o �1 ' G)mOo -izn� - 2 IoG5=o ' m0
cp 0 to D-I DO m N ?S M0 z0r- n U, o
N CP O mN -°ntn O rno'4 ZZZO-4 Ovm
W UCZ Cuj 13 c�7< u)D CN c CD c0 10 0 z m-m c Z
-- np� • Z O Cmf�'i f�T1 co =v�**+ =O OmOm mc) n-D1
�7 • 00Q o Zm"C c� mrn.-NiD�r m O rn yZ)m
n
��n mgo zoo ^'�MDo�o mow m0u)
A s Cr 20 O f,) IV 1 mm--1 r- OD
~'� n coZrm-n * Cz-=�o 0-I0x� °'tv Neil
-+ Et N OO m npL m m 1 -i mm O-
G. cn m m n o°D= n (Tl m
Om m N (n S o A '{ V I m r O Z m UDl n z
• C h..j O�- = mmD� D �c00(�100 ora*miOj'D -'off
rd r-
C �QQ' co
=1 3. m -o{ 'm m ,Da, z '9-V)
mpio
�•.' O Z 0p.'O O OS-1� DONO Z� pOt�O Z_ o
Z O O n n
GP Z; cocn $gym ?r IN m-'rnm ��', mOcoOr t mocu
N -SOD Zf-iTl O �c..4 co m nirz OZDD
mtUnZv ccnmmm -n.7.-, . Dm:, z na23. m
• N
'C a
v m
0 a)
.1 J j '0
n b
CI) co
�' al W LOGANBOULEVARD
o ,
0
• n N2°46'31"E
m w r- 174.97'
"110r-4 a N EAST RIGHT-OF-WAY
o Co = S 2°46'31"W
g d ,a o
L i co - 166.88'
'0 c., 0.>
IV N `� o CD TRACT 19 Z Cl)
Cb in = < n
a 8 n a m 0 00 03
C N = °' O ,- o� c cA °
'1" O� CD U) m AZO 2
Cji Gil
O g �� > NO m
,..P..m 2
o m
0:il
wm
wo n
u
o Z -+
U) co
m
0
--Ib
0
zi
z o As
0 o 0
r-< my N h
Z �0lo m N ta
m� �DO 0 N
C� r W m- 2 0
O O Qo o,
CC4'Z O��Z 0 I m n
Z �0 c,D� g Do at
-< OZ Dtm»-1 0 m N 0
co
0 = mC� o m q coZ
AZ m 4. A m J`/
0 Zcn=I c0 Z N o Z D Ul C)
tD
CD CS)
D (Z O > N m v_ q
M coCP m
m
IV o(7 o 0
m c °° US
�m Cn
O O D
fn AOZ (] _ . o C)
--I �' 9 cn m o
g �i o-z� ~` o L1
O v, z o„- "', o
r R/' (n tAr�O
z II
0n --- z N�Z D
,r4, MI/‘ O Z�� Q
D
�v ='tn Do m
01 _ 1;t ) m0 O
:0:
Cx)
G:\SURVEY\PROJECT SURVEY 2014\133 - EMS 73\SURVEY\14-133-WATERLINE SLDWGX H IT
Parra I „t 1
16E 1
INSTR 5259610 OR 5267 PG 3341
PROJECT: EMS#76(fka#73) RECORDED 5/2/2016 8:34 AM PAGES 4
FOLIO NO.: 41820800009 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC$35.50
UTILITY FACILITIES WARRANTY DEED AND BILL OF SALE
THIS INDENTURE made this.rQcnfk day of AFn ' I , 2016, between COLLIER COUNTY,
a political subdivision of the State of Florida, whose ailing address is c/o 3335 Tamiami Trail E.,
Suite 101, Naples, FL 34112 (hereinafter referred to as "Grantor"), and the BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF COLLIER COUNTY
AND AS THE EX-OFFICIO GOVERNING BOARD OF THE COLLIER COUNTY WATER-SEWER DISTRICT, its
successors and assigns, whose mailing address is 3339 Tamiami Trail E., Suite 301, Naples, FL 34112
(hereinafter referred to as"Grantee").
WITNESSETH:
That said Grantor, for and in consideration of the sum of Ten Dollars ($10.00) and other
good and valuable consideration to said Grantor in hand paid by said Grantee, the receipt
whereof is hereby acknowledged, has granted, bargained and sold to the said Grantee, and
Grantee's successors and assigns forever, all wastewater, water, and/or utility facilities and/or
system(s) or portion(s) thereof installed by Grantor during the construction of EMS Station #76 in
the property located at 790 Logan Boulevard North and in the Vanderbilt Beach Road right-of-
way at or near the intersection of Vanderbilt Beach Road and Logan Boulevard North as shown
on the graphic, "Exhibit "A" attached, for operation, relocation, installation, repair and/or
maintenance of said existing and any future utility facilities, system(s) or portion(s) thereof, all
situate and lying and being in Collier County, Florida, to wit:
(See Exhibit"A"attached hereto and incorporated by reference herein.)
and said Grantor does hereby fully warrant the title to said utility facilities and/or system(s) or
portion(s) thereof, be they realty, personalty, or mixed, and Grantor will defend such title against
all claims of all persons whomsoever. For the purposes of this conveyance, the utility facilities,
system(s) and/or portion(s) thereof conveyed herein shall not be deemed to convey any of the
lands described in either exhibit. Grantor and Grantee are used for singular or plural, as context
allows. A list of the utility facilities, etc., being conveyed is attached as Exhibit "B".
TO HAVE AND TO HOLD the same unto the Grantee and its assigns, together with the
right to enter upon said land, excavate, relocate and/or take or introduce materials for the
purpose of constructing, relocating, operating, repairing and/or otherwise maintaining utility
systems thereon. Grantor and Grantee are used for singular or plural, as the context requires.
IN WITNESS WHEREOF, Grantor has caused these presents to be executed the date and
year first above written.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK,j!t F-k- COLLIER COUNTY, FLORIDA
• /i f /.1 BY: 4/1''4."1"" Le:6"
A •
+ _ • , D-pu+ erk DONNA FIALA, Chairman
signature only,
Approved as to form and legality:
Chis Conveyance Approved By
The Board Of County
Commissioners
Jennife A. Belpedio, $.o Collier County Florida,
Assistant County Attorn -b\ Pura IA oA en is
� Datej1 to Item No: IL, El
16 E 1
, I
I I
I 3
I 1 i
I I
E%.LOGAN BLVD IPU9UC RO/ q I , I
1.
P t I I
S a 4 S f 3
` z' � it i�r , NI�i 1if ii rj �;�� 1 1 j
t.
$E L rt— — t•
_ 3 '� ' r 1� , --,I
�g if �s��j _ , -Hyl ,
, 14, Hi 11 ' `':^_mil /_ i�� $
1:1 li1 11,
A c t NI t II, k
111 a .ate . 1I I i 1 1
nw •us 5.t q, , it I I
,,, , oii, TTimearammiar_
�t I. ; ii r� pp ����
._La'
r� I 1�I 1 Y 7 1
y 4 7 a ^g
O iA+• 11 l 11 ;I 1 ti j 71 i.
�^ I
I 1 , Y A a
FSf t , - A , I III 11 ii I A
% Rte• ' I II I' A t/ HI II
faa ft j: n: if IL1 1
1 13
rer
:+os-#t i€ '„..qy D :� -1'0 a i l ;1 Ir 1 b ''d I�
, - E I ,L�. 1 �1
ffi, 1 i I I1 11 1 F a I
iFt i 1 r , ' ,III �9
Q r k c, .
y i •! 1
4. 1
FF :.r l'1 I '1X,i < �.;
1 . t ? `�`- _______ I 11{11.1 4 '-�
13
5Id I R
6 dy Yt 1 a
Ia t 1 III 1
♦ 11
b 1= a m , 1
L :r&
6 14i2 al
a 1IL-'.. 0.,
0_ 11 R
_ �anr ncal. f1 1 Y
�� O� I
.Iii
xg 3 ( I i i ' 1
a 'p
e ..d
Al 5
o i t. .._... .... ._.,_... ...
111
a •_ 5� y � I I 791 T 18- Y.
1) ' I 1 1 •a
i I 1 $
t LI
(1 ,
s R ; 1, i ' i'i R
if ' IS '
Ili la 'ti
1=
16 E 1
VERIFICATION OF FINAL COST
PROJECT NAME: Collier County EMS#76
LOCATION: Section 4 Township 48 South Range 26 East
Collier County,Florida
NAME&ADDRESS OF OWNER: Collier County BOCC
3301 East Tamiami Trail
Naples,FL 34112
TYPE OF UTILITY SYSTEM: SANITARY SEWER
!Item Size 9uantity Units Cost Tota!)
Grinder Pump Station 1 EA $36,924.55 $36,924.55
SDR 26 6" 50 LF $17.13 $856.50
Cleanout Assembly 6" 2 EA $409.96 $819.92
HDPE DR 11 4" 195 LF $13.10 $2,554.50
HDPE Directional Bore 4" 160 LF $84.55 $13,528.00
Check Valve 4" 1 EA $3,223.95 $3,223.95
Air Release Valve 2 EA $5,561.78 $11,123.56
Back Tap 16"x 4" 1 EA $6,565.40 $6,565.40
TOTAL COST $75,596.38
I do hereby certify that the quantities of material and services described above are true and an accurate
representation of the as-installed system.
CERTIFYING: t•t,r (�
11A 10.(kI Dt
Name and Title of Engineer Certifying
OF: Grady Minor
3800 Via Del Rey
Bonita Springs,FL 34134
I do hereby certify that the quantities of material and services described above are true and an accurate
representation of the as-installed cost of the system.
CERTIFYIN
Kevin Jeisen,Pc ident
OF: JENSEN UNDERGROUND UTILITIES,INC.
5585 Taylor Road
Naples,Florida 34109
STATE OF FLORIDA )
SS:
COUNTY OF COLLIER )
The foregoing Instrument was signed and acknowledged before me this 19th day of November,2015 by
Kevin Jensen ,who Is personally known to me and who did not take an oath.
• I it► AI SEAL:
.onna L.Ventre , otary Public DONNA L.VENTRE
:gyp
•.- MY COMMISSION 1 FF 206604
�`' EXPIRES:Juno 1,2019
Bonded Tbru Notuy Pubtic Uncle:lotus
EXHIBIT
Page / of
16 E 1
VERIFICATION OF FINAL COST
PROJECT NAME: Collier County EMS#76
LOCATION: Section 4 Township 48 South Range 26 East
Collier County,Florida
NAME&ADDRESS OF OWNER: Collier County BOCC
3301 East Tamiami Trail
Naples,FL 34112
TYPE OF UTILITY SYSTEM: POTABLE WATER
Item Size Quantity Units Cost Total
DR 18 C-900 8" 295 LF $18.21 $5,371.95
DR 14 C-900 8" 40 LF $20.79 $831.60
Gate Valve 6" 1 EA $907.69 $907.69
Fire Hydrant Assembly 1 EA $3,921.02 $3,921.02
Automatic Flush Device 1 EA $5,680.38 $5,680.38
Saddle&Valve 8"x 1.5" 1 EA $681.62 $681.62
Water Meter Assembly 1.5" 1 EA $836.48 $836.48
Backflow Assembly 1.5" 1 EA $1,691.80 $1,691.80
Poly Tube 2" 70 LF $8.34 $583.80
DR 14 C-900 6" 170 LF $16.29 $2,769.30
Fire Backflow Preventer Assembly 6" 1 EA $7,668.67 $7,668.67
Fire Department Connection 1 EA $2,016.26 $2,016.26
Saddle&Valve 8"x 1" 1 EA $616.00 $616.00
Meter Assembly 1" 1 EA $836.48 $836.48
Backflow Assembly 1" 1 EA $1,344.51 $1,344.51
TOTAL COST $35,757.56
I do hereby certify that the quantities of material and services described above are true and an accurate
representation of the as-installed system.
CERTIFYING:
Name and Title of Engineer Certifying
OF: Grady Minor
3800 Via Del Rey
Bonita Springs,FL 34134
I do hereby certify that the quantities of material and services described above are true and an accurate
representation of the as-installed cost of the system.
CERTIFYING:
Kevin Jengen, ident
OF: l JENSEN UNDERGROUND UTILITIES,INC.
5585 Taylor Road
Naples,Florida 34109
STATE OF FLORIDA )
SS:
COUNTY OF COLLIER )
The foregoing instrument was signed and acknowledged before me this 19th day of November,2015 by
Kevin Jensen ,who is personally known to me and who did not take an oath.
:�•ry'•. DONNA L 4ENTRE
SE^ +; �iY�NMISSION f 7 200604
D nna L.Ventre , otary Public /f J EXPIRES;June 1,2019
[londed Tin Notary Public Undonvalers
Page ok of �,