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Backup Documents 02/28/2017 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 0 3 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 Att rney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP � � 3 Zi Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document 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. Elizabeth Hernandez Community and Human • Services ,'� a./a3/i7 2. Jennifer Belpedio County Attorney Office 3. BCC Office Board of County Commissioners 4. Minutes and Records Clerk of Court's Office P4286r7 3:4 , 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 Elizabeth Hernandez/CHS Phone Number 252-2338 Contact/ Department Agenda Date Item was _ Q_1Agenda Item Number Approved by the BCC �" b 16.D.3'�_ Type of Document Satisfaction of Mortgage Number of Original Attached Documents Attached 2 PO number or account Two $10 fees 123.155974.649030.32001.1 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? g c O y.„ .£ -- of ft- 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 EH 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 EH 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 EH 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 wlcVlines! 8. The document was approved by the BCC on4445121116 ktioN11 changes made during EH 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 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 3/6/2011603 57 OR 5368 PG 2546 RECORDED INSTR537437 9:24 AM PAGES 1 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT COLLIER COUNTY FLORIDA REC$10.00 Prepared by:Elizabeth Hernandez 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 Phania Alexis,A Single Person to COLLIER COUNTY, dated 03/19/2004 and recorded on 03/31/2004 in Official Records Book 3531 Page 2455 of the Public Records of Collier County, Florida, securing a principal sum of $2,500.00 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 - F b r i lk g\-y ;2-& , 2017,Agenda Item Number /G , D D.3 . ATTEST: ._ BOARD 1 ' CO Y COMMISSION• DWIGHT E.BROCK,,CLFI , OF CO 7 ' OUNTY,FLORIDA A11w�1 'a;t to tinainna s,DEPUT 1 E"t PennyTaylor,Ch.0.n r,.wo�0� signature oral . proval for form and legality: JeCk nn r A. Belped • Assistant County Atte -ey OVj 16 0 3 INSTR 5374358 OR 5368 PG 2547 RECORDED 3/6/2017 9:24 AM PAGES 1 DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT COLLIER COUNTY FLORIDA REC$10.00 Prepared by:Elizabeth Hernandez 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 Jennifer Bosch to COLLIER COUNTY, dated 08/27/1999 and recorded on 09/07/1999 in Official Records Book 2589 Page 1125 of the Public Records of Collier County, Florida, securing a principal sum of $5,000.00 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 - Fchr-u 19 r ,p-?' ,2017,Agenda Item Number /6, 0, 3 . ,1,-.0. ATTEST: BOARD 0 OUP. Y COMMISSIONE' DWIGHT E.BROCK, ,E'. OF COL i' • •LINTY,FLORIDA u:{l�i tI By: Attest as to L '41- .r t DO LE' s Penny Taylor,Chaim', ' • signature only. Approval for form and regality: Jenn er Belpedi Assistant County Att y \' a \(7"