Backup Documents 05/14/2013 Item #16C 4-TV Pec • j
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATI
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the flice
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 ater
than Monday preceding the Board meeting.
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 #I through #2, complete the checklist, and forward to the County Attorney Office.
Route to Addressees (List in routing order)
Office
Initials
Date
1.
appropriate.
(Initial)
Applicable)
2.
MAY 14, 2013
Agenda Item Number
16C4
3. County Attorney Office
County Attorney Office
N/A
4. BCC Office
Board of County
Commissioners
(j{�
b
1
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
SUE JIM ZIMMERMAN
Phone Number
252 -2622
Contact / Department
appropriate.
(Initial)
Applicable)
Agenda Date Item was
MAY 14, 2013
Agenda Item Number
16C4
Approved by the BCC
Does the document need to be sent to another agency for additional signatures? If yes,
N/A
Type of Document
UTILITY FACILITY WARRANTY DEED
Number of Original
1
Attached -
&BILL OF SALE
Documents Attached
PO number or acco
signed by the Chairman, with the exception of most letters, must be reviewed and signed
number if document is
-
to be
All handwritten strike- through and revisions have been initialed by the County Attorney's
N/A
INSTRUCTIONS & CHECKLIST
1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Origindl 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?
SJZ
2.
Does the document need to be sent to another agency for additional signatures? If yes,
N/A
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
SJZ
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
N/A
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
SJZ
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
SJ
signature and initials are required.
7.
In most cases (some contracts are an exception), the original document and this routing slip
N/A
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 May 14.2013 ( w w e and all
SJ
changes made during 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.
1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Origindl 9.03.04, Revised 1.26.05, Revised 2.24.05; Revised 11/30/12
INSTR 4842513 OR 4923 PG 2967 RECORDED 5/23/2013 8:39 AM PAGES 6
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT, COLLIER COUNTY FLORIDA
REC 552.50
16 C4
PROJECT: HHW BUILDING®COLLIER COUNTY LANDFILL
FOLIO NO.: 00298520004
UTILITY FACILITIES WARRANTY DEED AND BILL OF SALE
THIS INDENTURE made this •`hday of 2013,between COLLIER COUNTY,
a political subdivision of the State of Florida,whose ma Ing address is c/o 3335 Tamiami Trail E.,
Suite 101, Naples, FL 34112 (hereinafter referred to as"Grantor'.'), and the BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY,FLORIDA,AS THE GOVERNING BODY OF COLLIER COUNTY
AND AS THE EX-OFFICIO GOVERNING BOARD OF THE COLLIER COUNTY WATER-SEWER DISTRICT,its
successors and assigns,whose mailing address is c/o 3335 Tamiami Trail E.,Suite 101,Naples,FL
34112(hereinafter referred to as"Grantee").
WITNESSErH: •
That said Grantor,for and in consideration of the sum of Ten Dollars ($10.00) and other
good and valuable consideration to said Grantor in hand paid by said Grantee, the receipt
whereof is hereby acknowledged,has granted,bargained and sold to the said Grantee,and
Grantee's heirs,successors and assigns forever,all water,and/or utility facilities and/or system(s)
or portion(s)thereof lying in,on,over and under the following described land("Exhibit"A"),for
operation, relocation, installation, repair and/or maintenance of said existing and any future
facilities,system(s)or portion(s)thereof,all situate and lying and being in Collier County,Florida,
to wit:
(See Exhibit"A"attached hereto and Incorporated by reference herein.)
(Exhibit"B"attached hereto Includes a sketch or other graphic representation that
depicts the physical location of the utility systems being conveyed,together with a list of
contributory assets.)
and said Grantor does hereby fully warrant the title to said utility facilities and/or system(s) or
portion(s)thereof,be they realty,personalty,or mixed,and Grantor will defend such title against
all claims of all persons whomsoever. For the purposes of this conveyance,the utility facilities,
system(s)and/or portion(s)thereof conveyed herein shall not be deemed to convey any of the
lands described in either exhibit.Grantor and Grantee are used for singular or plural,as context
allows. A sketch or other graphic representation showing the location of the utility facilities,etc.,
being conveyed is attached as Exhibit"B",together with a list of those utility facilities.
TO HAVE AND TO HOLD the same unto the Grantee and its assigns,together with the
right to enter upon said land, excavate, relocate and/or take or introduce materials for the
purpose of constructing, relocating, operating, repairing and/or otherwise maintaining utility
systems thereon.Grantor and Grantee are used for singular or plural,as the.context requires.
IN WITNESS WHEREOF,Grantor has caused these presents to be executed the date and
year first above written. •
ATTEST 1 i BOARD' COUNTY CO MISSIONERS
DWIGHTO COLLIE'C`JI Y, LORI./A
n I
a.:: BY
• i ,t1 r Deputy Clerk GEC' IA 7 HILLER,ESQ.,Chairwoman
tastat t0�
signsture.onfy, r°.ti
Approyed‘O4itg,t6thi
and legal sufficiency;
AI ./ %•_
milt'Pepin,' This Conveyance Approved B
Assistant County Attorney The Board County --By
Commissioners
Collier County Florida,•-
Pursue To nla
Date:5JlyJf3 No: 142E4
•
OR 4923 PG 2968
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EXHIBIT
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OR 4923 PG 2969
16 C4
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• Page�.__of
OR 4923 PG 2970
16 C4
VERIFICATION OF FINAL COST - WATER .
PROJECT NAME: Collier County Landfill
LOCATION: 3750 Landfill Boulevard,Naples,Florida
NAME AND ADDRESS OF OWNER: Collier County Board of County Commissioners
3299 Tamiami Trail E.Ste 303
• Naples,FL 34112
TYPE OF UTILITY SYSTEM: Potable Water
IITEM SIZE QUANT. UNIT COST TOTAL
Tapping Sleeve 8"x 6" 1 EA $ 1,425.00 $1,425.00
Tapping Valve 6" 1 EA $ 960.00 $ 960.00
Hydrant Assembly N/A 1 EA $ 2,330.00 $2,330.00
SDR 11 Directional Drill 4" 60 LF $ 32.00 $ 1,920.00
Polytube Water Service 1.5" 70 EA $ 8.00 $ 560.00
SDR 11 Directional Drill(IRR) 4" 60 LF $ 32.00 $ 1,920.00
Polytube Irrigation Service 1.5" 70 - EA $ 7.20 $ 504.00
TOTAL COST $9,619.00
I do hereby certify that the quantities of material and services described above`a���p►>NJ cl
accurate representation of the as-installed cost of the system. `�� p►1�Ns�4/47/1/, j
CERTIFYING: it 1 •.6i / _* '
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•
18 2.011
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was signed and acknowledged before me this day of 144✓a`,
2013 b Chad MM��cKimm• who is personally know to me and who did not take an oath.
Name: PYIEt d.44-t-'-` SEAL:
EXHIBIT OEBRAS.FiJMI
Of 1-� f't = MYCOMMSS!ONIEEB59181
_ EXPIRES:Dexmber t7.2ote
Page — Brded nNewr
OR 4923 PG 2971
16 C4
Certification of Material — Private Potable
PROJECT NAME: Collier County Landfill
LOCATION: 3750 Landfill Boulevard, Naples,Florida
NAME AND ADDRESS OF OWNER: Collier County Board of County Commissioners
3299 Tamiami Trail E.Ste 303
Naples,FL 34112
TYPE OF UTILITY SYSTEM: Potable Water
ITEM SIZE QUANT. UNIT COST TOTAL
SDR 11 Directional Drill 4" 60 •LF $ 16.00 $960.00
Polytube Water Service 1.5" 70 EA $ 2.75 $ 192.50
SDR 11 Directional Drill 4" 60 IF $ 16.00 $960.00
Polytube Irrigation Service 1.5" 70 EA $ 2.45 $171.50
TOTAL COST $2,284.00
��11I I/!////,
I do hereby certify that the quantities of material described above are a true and ate Pt;AN ,�
representation of the as-installed material cost of the system. ,` : ��ceN //
CERTIFYING: t �'
/' . *,
,� 1 r• • �� �,' .%'•;• Ft„op:` ∎
OF: ,. 44120
�t ,,,a4c►r of t kcv,d c. iYts, . "Yv5c MAR 18 2013
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was signed and acknowledged before me this J day of papal,
2013 by Chad McKimm who is personally know to me and who did not take an oath.
I SEAL:
Name: 1�1ti
EXHIBIT 6 • 55 �� ;6
Page -2 of use
*** OR 4923 PG 2972 ***
16 C4
Certification of Contributory Assets —Potable Water
PROJECT NAME: Collier County Landfill
LOCATION: 3750 Landfill Boulevard, Naples,Florida
NAME AND ADDRESS OF OWNER: Collier County Board of County Commissioners
3299 Tamiami Trail E.Ste 303
Naples,FL 34112
TYPE OF UTILITY SYSTEM: Potable Water
ITEM SIZE QUANT. UNIT COST TOTAL
Tapping Sleeve 8"x 6" 1 EA $ 745.00 $ 745.00
Tapping Valve 6" 1 EA $ 580.00 $ 580.00
Hydrant Assembly N/A 1 EA $ 1,680.00 $ 1,680.00
TOTAL COST $3,005.00
I do hereby certify that the quantities of material described above are a true anti yrptig1
representation of the material cost of the system as installed. \\�� p t.AN 1/�//�
a ,/1,�o
CERTIFYING: No
OF: 4v KC vry .• •
.D(u.1�.,akrcP -c)(11-11 �1�,-�a� �35Sa'�s r� ' 3' ;1.,`��.
n w�1 f6+�Tiint����i 88 zni:
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing Instrument was signed and acknowledged before me this day of Ala.-ck,
2013 by Chad McKimm who is personally know to me and who did not take an oath.
Name: SEAL:
1DEBRA s.FUMI
4 MY COMMA EE 859151
EXHIBITS
Page f' of I'
•