Backup Documents 03/26/2013 Item #10CORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATtW 0
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 #I 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 #I through #2, complete the checklist, and forward to the County Attornev Office.
Route to Addressee(s ) (List in routing order)
Office
Initials
Date
1.
appropriate.
(Initial)
Applicable)
2.
3/26/13
Agenda Item Number
10 -C
3. County Attorney Office
County Attorney Office
JA
3/26/13
4, BCC Office
Board of County
Commissioners
*�
One
5. Minutes and Records
Clerk of Court's Office
Documents Attached
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
Jeffrey A. Klatzkow, County Attorney
Phone Number
252 -8400
Contact / Department
appropriate.
(Initial)
Applicable)
Agenda Date Item was
3/26/13
Agenda Item Number
10 -C
Approved by the BCC
Does the document need to be sent to another agency for additional signatures? If yes,
JAK
Type of Document
Resolution — Appointment to Public Safety
Number of Original
One
Attached
Authority
Documents Attached
PO number or account
n/a
number if document is
&V
to be recorded
All handwritten strike - through and revisions have been initialed by the County Attorney's
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INSTRUCTIONS & CHECKLIST
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
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?
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2.
Does the document need to be sent to another agency for additional signatures? If yes,
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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
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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
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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
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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
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signature and initials are required.
7.
In most cases (some contracts are an exception), the original document and this routing slip
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should be provided to the County Attorney Office at the ti e the item is input into SIRE.
Some documents are time sensitive and require forwardin to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be awar of your deadlines!
8.
The document was approved by the BCC on 3/26/13 and all changes made during the
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ur
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 b e
JAKIP
1
BCC, all changes directed by the BCC have been made, and the document is read for the
:04
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
RESOLUTION NO. 2013 - 8 0
10C .1
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, APPOINTING JOSEPH BERNARD TO
THE COLLIER COUNTY PUBLIC SAFETY AUTHORITY.
WHEREAS, on June 26, 2012, the Board of County Commissioner (Board) adopted
Ordinance No. 2012 -23 establishing the Collier County Public Safety Authority to assume the duties
and responsibilities of the former Collier County Emergency Medical Services Policy Advisory
Board; and
WHEREAS, Ordinance No. 2012 -23 sets forth the appointment process for the Public Safety
Authority and the categories of professional expertise required of its membership; and
WHEREAS, Ordinance No. 2012 -23 also provides that Public Safety Authority shall include
three citizen representatives; and
WHEREAS, there is currently one vacant, unexpired term on the Public Safety Authority for
a hospital administration representative from the Physicians Regional Hospital organization; and
WHEREAS, the Public Safety Authority has provided the Board of County Commissioners
with its recommendation for appointment.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that JOSEPH BERNARD, Chief
Operating Officer of Physicians Regional Healthcare System, is hereby appointed to the Collier
County Public Safety Authority to fulfill the remainder of this unexpired term, said term to expire on
July 2, 2016.
THIS RESOLUTION ADOPTED after motion, second and majority vote on this the 26th day
of March, 2013.
ATTEST. , "`` °' airy' BOA F COUNT COMMISSIONERS
DWIGHT' E. BROCI�,'C��rk' COL. C UNTY FLORIDA
l.�J�-
By� �-� - � By:
ttES aS Clerk O IA A. HILLER, ESQ.
�,r C I OMAN
Appr b�t'm and
lei i ncv: