Backup Documents 02/13/2018 Item #16E3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 L
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 afo 2/13/18
4. BCC Office Board of County pSb...k
Commissioners \r\S /g/ Z1 v3�vi,
5. Minutes and Records Clerk of Court's Office - 2' t 31 lag .34441
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 Kathy Heinri sberg Bureau of Emergency 239-252-3622
Contact/ Department Services
Agenda Date Item was 2/13/18 Agenda Item Number .J.611lQ g -b
Approved by the BCC
Type of Document Permit and Certification Number of Original One each
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 chairman's original signatur STAMP OK JAB
2. Does the document need to be sent to another agency for addi -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 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 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 JAB
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 JAB
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 2/13/18 and all changes made during the JAB
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 AB
BCC,all changes directed by the BCC have been made,and the document is ready for I,- (z,
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
16E3
MEMORANDUM
Date: February 14, 2018
To: Kathy Heinrichsberg, Executive Secretary
Bureau of Emergency Services
From: Teresa Cannon, Sr. Deputy Clerk
Minutes & Records Department
Re: COCPN Permit & Certification
Attached is an original document as referenced above, (Item #16E3) approved
by the Board of County Commissioners on Tuesday, February 13, 2018.
The Minutes & Records Department has a copy to be kept in the Board's Official
Records.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachment
1 6 E 3
COLLIER COUNTY FLORIDA
Renewal of Class "3" COCPN
This Permit is effective March 31, 2018 and
Expires March 30, 2019
Name of Service: North Collier Fire Control and Rescue District
Name of Owner: North Collier Fire Control and Rescue District
Principle Address of Service: 1885 Veterans Park Drive,Naples, FL 34109
Business Telephone: 239-597-3222
Description of Service: Non-Transport Advanced Life Support
Number of Ambulances: 17 Ground Units available.
See Attachment A for Description of Vehicles
This permit, as provided by Ordinance No. 2004-12, as amended, shall allow the above
named Non-transport ALS Service to operate within the North Collier Fire Control and
Rescue District response boundary and pursuant to the Collier County Fire Chiefs Local
Mutual Aid Agreement until the expiration date hereon, except that this permit may be
revoked by the Board of County Commissioners of Collier County at any time the service
named herein shall fail to comply with any local, state or federal laws or regulation
applicable to North Collier Fire Control and Rescue District.
Issued and approved this day of -4,10- ,e,c- 2018
ATTEST: BOARD ' CO TY C• i r IONERS
DWIGHT E. BICK,,CLE COLL R C! ►TY F !X
•
�a_
Attest as to Chaff ty Clerk A dy Solis, Chairman
signature only.
Approved as to form and legality:
Jennifer B 1 i
e e ped o fel, c6
Assistant County Attorney ir.
[18-EMG-00403/1389844/1]
GAS`
1 6 E 3
North Collier Fire Control and Rescue District Vehicles
Year Type VIN 14
2010 Pierce Quantum 4P1CU01E3AA010553 RE 45
2002 Pierce Quantum 4P1CT02S02A002256 PU 46
2004 Pierce Quantum 4P1CT02S93A003679 ENG 12
1998 Pierce Quantum 4P1CTO2S5WA000816 LA 48
2006 Pierce Quantum 4P1CU0I S36A006032 LA 46
2012 Ford 350 1FT8W3BT6CEC56211 SQ 40
2013 Pierce IMPEL 4PICJO1A8EA014108 ENG 44
2013 Pierce IMPEL 4PICJO1A8EA014125 ENG 43
2005 International MEDTEC 111TMNAAM6711460580 SQ 10
2005 Pierce Contender 4P1CC01M65A004732 PU44
2016 Pierce IMPEL 4P1BAAFF7GA015968 ENG 42
2006 Sutphen S2 1S9A1BLD261003097 PUll
2013 Ford F550 1FDOX5HTXDEA80905 AT 12
2015 Ford F550 1FDOX5HT2FEB71542 AT 10
2017 Ford F450 IFDUF4GT4HEC04205 SQ45
2017 Ford F440 1FDUF4GTXHDA02636 SQ44
2017 Ford f450 1FDUF46T111DA02637 SQ46
ATTACHMENT A
GI
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40,194 �$ ., .14 ,. ,9As . , i racy , .� .,� a,•,e.., :