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Backup Documents 09/10/2013 Item #16D 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP D TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 4 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATU Print on pink paper. Attach to original document. The completed routing slip and original documents are to he 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 (yj 4.:;/` ra\toI► 3 4. BCC Office Board of County C 4 1 arl Commissioners �A\ 7:-A,�-F 5. Minutes and Records Clerk of Court's Office i,��y I PRIMARY CONTACT INFORMATION � -;t Loprti 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 Natali Betancur Phone Number 239-252-4059 Contact/ Department Agenda Date Item was 09/10/2013 Agenda Item Number Approved by the BCC b Type of Document Report/Invoice Number of Original 1 Attached Documents Attached PO number or account 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? NB / 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. I. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be NB ' 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 NB 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 NB signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip NB f✓ 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 09/10/13 and all changes made during NB v 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 NB BCC,all changes directed by the BCC have been made,and the document is ready for the d� 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 16041 Martha S. Vergara From: Betancur, Natali Sent: Monday, September 16, 2013 5:00 PM To: Martha S.Vergara Subject: 9/10/13 Item 16D4 Hi Martha, The FDEP invoice in the amount of $3,681.79 should be paid out of 001-156363-649010 and the address where the originals need to be mailed to is below: Department of Environmental Protection Receipts Section Post Office Box 3070 Tallahassee, FL 32315-3070 Thank you soo much for sending this! .Naafi 93etanccvi (9p viaticum ana&rp t J avdiis and J(eateatian 15000 .C'uuing ton 2aad .Nap1ei, 5.e 34109 239-252-4059 Stay connected with Collier County Parks and Recreation It Starts in Parks.,. Play, Connect and Discover http://www.collierparks.com/ `.,rr.er t v.d,c ..,e jai'r 'oresse s If you do not won':j.,rr e me l odds.ss eest,.! i 3 F;ob ectr-oroc moo to U s entry , steed t ).dL".111:s }rt=e by t leph iC 1 16D 4 MEMORANDUM Date: September 16, 2013 To: Natali Betancur Parks and Rec. Department From: Martha Vergara, Deputy Clerk Board Minutes & Records Department Re: Report/Invoice Cocohatchee River Park Attached for your records is a copy of the original document referenced above, (Item #16D4) adopted by the Board of County Commissioners on Tuesday, September 10, 2013. Per your e-mail the original invoice is being forwarded by Minutes and Records to DEP (Department of Environmental Protection). The invoice was also forwarded to the Finance Department. If you have any questions, please feel free to contact me at 252-7240. Thank you. Attachment County of Collier CLERK OF THE;CIRCUIT COURT Dwight E. Brock COLLIER COUNTY COORTHOUSE Clerk of Courts Clerk of Courts 3315 TAMIAMI TRL E STE 1024: P.O. BOX 413044 Accountant NAPLES, FLORIDA Y NAPLES, FLORIDA Auditor 34112-5324 34101-3044 Custodian of County Funds September 17, 2013 Florida Department of Environmental Protection Marjory Stoneman Douglas Building Division of State Lands/Bureau of Public Land Administration 3900 Commonwealth Boulevard, MS 130 Tallahassee, Florida 32399-6508 Re: 2013/2014 Sovereignty Submerged Lands Annual Lease Fee and Wet Slip Revenue Reporting— Cocohatchee River Park Transmitted herewith is a one (1) originals of the above referenced documents, as adopted by the Collier County Board of County Commissioners of Collier County, Florida on Tuesday, September 10, 2013, during Regular Session. Very truly yours, DWIGHT E. BROCK, CLERK ," 1 + Martha Vergara, Depu y C erk Enclosure Phone- (239) 252-2646 Fax- (239) 252-2755 Website- www.CollierClerk.com Email- CollierClerk@collierclerk.com 1604 DEPARTMENT OF ENVIRONMENTAL PROTECTION piO1EalON RECEIPTS SECTION POST OFFICE BOX 3070 TALLAHASSEE, FL 32315-3070 � e'id Bill To: COLLIER COUNTY FLORIDA 15000 LIVINGSTON ROAD INVOICE NAPLES, FL 34109 ** INVOICE / INSTRUMENT INFORMATION ** Invoice #: 70595 Instrument#: 110343885 Invoice Date: 05/31/2013 Expiration Date: 06/25/2015 Due Date: 06/30/2013 Extended Term Fee: NO Rate: BASE RATE Location: COCOHATCHEE RIVER PARK ** IMPORTANT REMINDERS ** If paying by mail, please return invoice with your payment to the above address. Online payment by check, credit card or debit card is available at http://www.fldepportai.com/go/pav-invoices/. Late payments are subject to a 12% Interest fee pursuant to FAC 18-21.011(1)(b)11. INFORMATION ANNUAL LEASE FEE DATA Description Memo Object Net Square Rate Discount Extended *Amount Feet Term Fee ANNUAL LEASE FEE 021017 22,577 0.163077 N/A Y $3,681.79 2013/2014 Subtotal $3,681.79 Sales Tax (0.0%) $0.00 County Tax (0%) $0.00 Note: PLEASE COMPLETE THE ENCLOSED INCOME REPORTING FORMS Total $3,681.79 AND RETURN WITH YOUR REMITTANCE Invoice Balance Due $3,681.79 Instrument/Lease $3,681.79 Balance Due ANNUAL LEASE FEE FORMULA = BASE FEE* - DISCOUNT + EXTENDED TERM FEE *BASE FEE= Base Rate x Net Square Feet OR *BASE FEE= Minimum Rate DISCOUNT= Base Fee x Discount Percentage EXTENDED TERM FEE = Base Fee x Extended Term Fee Percentage For any questions concerning this invoice,please call the Division of State Lands at(850) 245-2720. 1604 4 2012/2013 Wet Slip Information Form Lessee: 4 //i ( 41. AM-717 Instrument No: //33' 3 g85 I. INFORMATION ON WET SLIPS LOCATED ON STATE-OWNED LANDS 1. Number of Temporary Slips -Slips that are not rented and are used as fuel docking, launching or removing boats, restaurants, or store purchases. O These slips should be Non revenue generating slips. 2. Number of Transient Slips-Slips that are rented on a short term basis. / 3. Number of Public Slips-open to the public on a "first come,first served" basis. -Rental term shall be no longer than one year and with no /6 automatic renewal rights or conditions. 4. Number of Slips Not Usable-Slips that are silted in or are in low water. 5. Number of Slips Sold, Subleased, Licensed,Assigned, etc. -Attach a copy of the document which represents the sale, sublease, license or assignment. The document should include the sublessee's name, unit o number, the slip number, and the amount of the transaction. 6. Number of Private Slips, not rented to the public-Slips used for O personal mooring, Association common area, etc. Total Number of Slips on State-Owned l agd ,Add h eal rough f .. ,,,rt alp. ,, �.. ,. , . ti�,.,. .�, .�,. _ �. . ...A. . �: �._.�. _. .�. Is your facility a Pier with Admission Fees? YES dZIO Circle One Boating has a tremendous economic impact on the State of Florida each year. In an effort to learn if boaters have an adequate number of slips around the state, we are requesting information on wet slips that are not within a state-owned submerged land lease. No income generated from these slips is to be reported. II. INFORMATION ON WET SLIPS LOCATED ON PRIVATELY-OWNED LAND 1. Number of Slips Sold, Subleased, Licensed,Assigned, etc: 2. Number of Public Slips-open to the public on a "first come,first served" basis. 3. Number of Private Slips, not rented to the public-Slips used for personal mooring, Association common area, etc. Total Number of Slips on Privately-Owned Lands,Add lines 1 thr"ough 3 Yr ' �;� 1604 4 2012/2013 GROSS INCOME REPORTING FORM Lessee: eV/W'' (..1�� Instrument #: //0393875 Month Year Direct Income Indirect Income The beginning month is the All income received directly by Lessee from All income received by someone other than Anniversary month of your lease. transactions within the lease boundary.* the Lessee for transactions involving the use of state-owned submerged land within the Lessee's lease boundary. June 2012 $ g:5, 00 $ o July 2012 $ `'/� 73Z, / $ o August 2012 $ 3, 4/3 7, 5o $ o September 2012 $ Iq.5 - / 7 $ D October 2012 $ �"� '• BO $ 0 November 2012 $ 0, 7 7 7, z/S $ C December _2012 $ 3' 1 ''3, 33 7 $ of January 2013 $ J Cj 7r 8 ? $ l February 2013 $ .-3'o /, to $ -7r 2Z / . / Z March 2013 $ Z/ 3, 57 $ / // &06. &.3 April 2013 $ 157, 6T $ 3� 7 8/, 5 a May 2013 $ ZA7 7 6 $ bj / e', 51 TOTALS s ze 6- S'1 2 7 $ 2'1' So,,�� Every month must be filled out evenif income for the month is zero. "Enter Zero if slips are non-revenue generating or generated$0.00" * Income is defined in chapter 18-21.003,Florida Administrative Code,as the gross revenue derived directly or indirectly from the use of state-owned submerged lands such as slip rental,lease or sublease fees,dock or pier admission fees,club membership,stock ownership or equity interest in activities where increased revenue is attributable to the use of the submerged land.However,gross revenue shall not include pass-through fees such as fees for utility services,sale of the facility or sales of products not occurring on sovereignty submerged lands. Gross revenue shall include all future payments made for the transfer of the interest in a slip originally obtained from the Board's lessee,including transfer of slip rights by slip sublessee's,slip"sellers",slip interest transfers,new club memberships,and other similar transactions. PLEASE ATTACH A LIST OF ANY SLIP TRANSFERS AS DEFINED ABOVE INCLUDING THE SLIP NUMBER, AMOUNT OF INCOME RECEIVED,SUBLESSEE'S NAME AND UNIT NUMBER, IF APPLICABLE. FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION DIVISION OF STATE LANDS/BUREAU OF PUBLIC LAND ADMINISTRATION 3900 COMMONWEALTH BOULEVARD, MS#130 TALLAHASSEE, FLORIDA 32399-3000 (850)245-2720 1604 6 4 40Notegoom Tff IMINMENIM SOVEREIGNTY SUBMERGED LANDS LEASE ANNUAL WET SLIP REVENUE REPORT As a submerged lands lessee,you are required to report annually to the Division of State Lands all income derived directly or indirectly from the lease area,to report the number and type of wet slips and to certify that all information provided is correct. This includes reporting any income collected by you or someone else. The three attached forms must be completed and returned by all lessees. Directions for completing forms WET SLIP INFORMATION FORM-This form is for reporting the number and type of wet slips. Please enter the correct number of each type of wet slip at the lease facility and total. GROSS INCOME REPORTING FORM-This form is for reporting direct and indirect income that has been generated within the lease boundary during the timeframe specified. This is required under the terms of your lease and under subsection 18- 21.011(1)(a)2. Florida Administrative Code. Please enter the amount of both direct and indirect income generated by month within the lease boundary. The definition of income can be found at the bottom of the form. CERTIFICATION FORM-This form is the lessee's confirmation that all information provided is true and correct. This form must be notarized. General Lease Fee Information Income is defined in Rule 18-21.003, Florida Administrative Code,as the gross revenue derived directly or indirectly from the use of state-owned submerged lands such as slip rental, lease or sublease fees,dock or pier admission fees,club membership,stock ownership or equity interest in activities where increased revenue is attributable to the use of the submerged land. However,gross revenue shall not include pass-through fees for utility services,sale of the facility or sales of products not occurring on sovereignty submerged lands. Gross revenue shall include all future payments made for the transfer of the interest in a slip originally obtained from the Board's lessee, including transfer of slip rights by slip sublessee,slip"sellers",slip interest transfers, new club memberships, and other similar transactions. If you are required to pay 6%of the income generated on the lease area,you will receive a supplemental invoice for any additional fees owed. To view Chapter 18-21 Florida Administrative Code,on Sovereignty Submerged Lands Management in its entirety go to: http://www.flrules.org/gateway/ChapterHome.asp?Chapter=18-21 FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION DIVISION OF STATE LANDS/BUREAU OF PUBLIC LAND ADMINISTRATION 3900 COMMONWEALTH BOULEVARD, MS 130 TALLAHASSEE, FLORIDA 32399-3000 (850)245-2720 CERTIFICATION 1 6 © 4 Instrument No. //C31-/3 o K Lessee Name: 6//717-(, /4 y c-42/7�� Billing Address /67ac7 G/1//ll ,957 /1 Rd. City/State/Zip /C/q���j /C�• 3 / Telephone:) Z Z �7O2o 2 (Please provide area code) Facility Address: ��/ �� J/ /2 2 /b/�� /j City/County/Zip: A. €/ • _3-70¢ I, being first duly sworn, hereby certify under penalty of perjury that the following statements are true: (1)To the best of my knowledge and belief,the information contained on the Wetslip Information Form and the Gross Income Reporting Form is true and correct; (2) I have read and understand the terms and conditions of the sovereignty submerged lands lease, and the facility is in full compliance with all the terms and conditions of the sovereignty submerged lands lease; (3) I am authorized to execute this certification on behalf of the lessee; and (4) I am aware that any intentional false statement herein will be grounds for cancellation the sovereignty submerged lands lease. ignature of Lessee ATTE fis' �� �e3R.G►A A . t-a ► LLf—Z , ESQ. 0 I T _-QROCK; Clerk Printed Name of Signature R MAN) C� . Title Attest as to n s� G�+o113 signaturaortlY.,; Date STATE OF F COUNTY OF C_. \\. Sworn to or affirmed and subscribed before me the\ k \ day ofS-- e-sm X20 \2 , by Ger.3Y-��a . ��\\°r- ; nary VIRGINIA eipor+ea • �+ My Comm. Expires Jun 23,2017 Personally Known V",---soli Commission•Ff 11� d`•', Bonded Through MOW Mary Assn. (SEAL) OR Produced Identification Type of identificaiton produced / Approved as to form and legality Notary Signature !� �c-� C�-/ ..?_ Commission Expires b Z �r��-� Assistant County A rney