Backup Documents 11/15/2016 Item #16D 2 12cz ' lly
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIT 602
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. Wendy Klopf Community and Human
Services 0, 1 tS i
2. County Attorney Office County Attorney Office
3. BCC Office Board of County �
Commissioners \<-1,S
/5
4. Minutes and Records Clerk of Court's Office 11 ht (1:(61,0
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 Wendy Klopf/CHS Phone Number 252-2901
Contact/ Department
Agenda Date Item was 11.15.16 Agenda Item Number 16D2 +�
Approved by the BCC
Type of Document Satisfaction of Mortgage 1 V Number of Original 1
Attached Documents Attached
PO number or account 705-138705-882100-33480.1
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? s+ c) � N 1,12k
2. Does the document need to be sent to another agency for additional signatures‘? If yes, NA
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 WK
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 NA
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 WK
document or the fmal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's WK
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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 11.15.20nd all changes made during WK
the meeting have been incorporated in the attached'document. The County + y
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 037
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
INSTR 5339301 OR 5337 PG 3981
16U2
RECORDED 11/30/2016 10:27 AM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
Prepared by:Wendy Klopf REC$10.00
Collier County
Community and Human Services
3339 E.Tamiami Trail
Naples,FL 34112
THIS SPACE FOR RECORDING
SATISFACTION OF MORTGAGE
KNOW ALL MEN BY THESE PRESENTS: That COLLIER COUNTY, whose post office address is
3299 E TAMIAMI TRAIL, NAPLES, FLORIDA 34112, the owner(s) and holder(s) of a certain
Mortgage executed by Carlos Vallejo to COLLIER COUNTY, recorded
on 11/15/2011 In Official Records Book 4736 ,Page 3087 , of the Public Records of
Collier County, Florida, securing a principal sum of$7,198.67 and certain promises and
obligations set forth in said Mortgage,upon the property described in the aforementioned mortgage.
COLLIER COUNTY hereby acknowledges full payment and satisfaction of said Mortgage, and
surrenders the same as cancelled, and hereby directs the Clerk of said Circuit Court to cancel the same of
record.
This Satisfaction of Mortgage was approved by the Board of County Commissioners on
- Novc)i-e...ocv- \S , 2016,Agenda Item Number 1 b -Z.
ATTEST: BOA NI, OF COUNTY OMMISSIONERS
DWIGHT E.BRICK,CLERK OF r p LIER COUN ,FLORIDA
By; K a :fir By:
Attest aS_ 01i Jl'�' Chairman Donna Fiala,District 1 Commissioner
AprielOalkingi `galgy:
Jenni-r A Belpe.to
Assistant County Atto `:L