Backup Documents 01/10/2017 Item #16D1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 6
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 JAB 1/18/17
4. BCC Office Board of County �F
Commissioners \ 441 / 1\V'AkA
5. Minutes and Records Clerk of Court's Office �nl 'W' ` �;�,�/i'1,A„
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 Tanya Williams, Library Director Phone Number 593-3511
Contact/Department
Agenda Date Item was 1/10/17 / Agenda Item Number 16-D-1
Approved by the BCC
Type of Document Certification of Credentials 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 chauuian's original signatu STAMP OK ) JAB
2. Does the document need to be sent to another agency for ad ' 1 sigtua es? If yes, JAB
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 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 1/10/17 and all changes made during the JAB m b�
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 •
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
1 6 0 1
MEMORANDUM
Date: January 19, 2017
To: Tanya Williams,
Collier County Public Library
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Certification of Credentials
Attached for your records is a copy of the document as referenced above, (Item
#16D1) adopted by the Board of County Commissioners on Tuesday, January
10, 2017.
The original has been kept by the Minutes & Records Department as part of the
Board's Official Records.
If you have any questions, please contact me at 252-7240.
Thank you.
Attachment
______
16t3 1
FLORIDA DEPARTMENT OF STATE
DIVISION OF LIBRARY AND INFORMATION SERVICES
STATE AID TO LIBRARIES GRANT APPLICATION
Certification of Credentials -Single Library Administrative Head
The Collier County Board of County Commissioners
governing body for the Collier County Public Library
hereby certifies that the incumbent single library administrative head,
Tanya R. Williams
(Name of incumbent)
• Has completed a library education program accredited by the American Library
Association; and
• Has at least two years full-time paid professional experience, after completing the
library education program, in a public library that is open to the public for a
minimum of 40 hours per week.
BOARD OF COUNTY COMMISSIONERS,
COLLI R COUNTY FLORIDA
By:X al-241,0
•
Donna Fiala, Chairman
ATTEST
DWIGHT E. BROCK, Clerk
By _, .:
Deputy Clerk = �,
Attest as to u airman s
signature only. -
Approved as to form and legality:
c (-) '.2-) ____________ilt ,,,\\\(0
Jennifer A. Belpedio
Assistant County Attorne _
% �
State Aid to Libraries Grant Certification of Credentials, Form#DLIS/SA03
Chapter 1 B-2.011(2)(a), Florida Administrative Code, Effective 4-10-2012 C9®