Backup Documents 10/22/2013 Item #16A 1ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLI16A I.
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 rprd1D /Zq
Complete routing lines #1 through #2 as appropriate for additional signatures, dates, and/or information needed. If the d ument is already complete with the
exce tion of the Chairman's signature draw a line through routing lines # 1 through #2, complete the checklist, and forward to the Count Attorney Office.
Route to Addressee (s) (List in routing order)
Office
Initials
Date
1.
appropriate.
(Initial)
Applicable)
2.
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Agenda Item Number
16 -A -1
3. County Attorney Office
County Attorney Office
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10/22/1
4. BCC Office
Board of County
Commissioners
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5. Minutes and Records
Clerk of Court's Office
Documents Attached
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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
Marlene S-11hrano, Code Enforcement
Phone Number
252 -2487
Contact / Department
appropriate.
(Initial)
Applicable)
Agenda Date Item was
-r07Eft3 V
Agenda Item Number
16 -A -1
Approved by the BCC
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Type of Document
Release and Satisfaction of Lien -
Number of Original
One
Attached
Hernandez
Documents Attached
PO number or account
signed by the Chairman, with the exception of most letters, must be reviewed and signed
number if document is
111 - 138911- 649030
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
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 t Tallahassee within a certain
time frame or the BCC's actions are nullified. Be awarj2f your deadlines!
8.
The document was approved by the BCC on 10/22/13 and all changes made during
the meeting have been incorporated in the attached document. The County
Attorne 's Office has reviewed the char es, if a licable.
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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
This Instrument Prepared By:
Marlene Serrano
Code Enforcement Department
2800 North Horseshoe Drive
Naples, FL 34104
(239) 252 -2487
16A
INSTR 4907277 OR 4979 PG 69
RECORDED 10/29/2013 3:41 PM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
REC $10.00
RELEASE AND SATISFACTION OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA is the owner and holder of a
certain lien against all real and personal property owned by:
Emilio and Emma Hernandez,
Respondents
The lien was recorded on January 23, 2013 in Official Records Book 4878, Page 2046,
in the Official Records of Collier County, State of Florida. The lien secures the principal
sum of Sixty Seven Thousand, Three Hundred and Twelve Dollars and Fifty Six Cents,
plus accrued interest and penalties, if any, and imposes certain obligations against real
property situated in Collier County, Florida, which property is described as follows:
PEARCE SUBD BLK 2 LOT 27 & N '/2 LOT 26
40612 th Street SE, FL
Collier County, a political subdivision of the State of Florida, by execution of this Release
and Satisfaction of Lien, acknowledges payment as approved by the Board of County
Commissioners as satisfaction of the lien and hereby cancels said lien.
The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction
of Lien in the Official Records of Collier County, Florida, to acknowledge that the lien
ceases to exist.
ATTEST BOR OF COUNT COMMISSIONERS
DWIGHT E. BRO.CK; Clerk CQLLI R FOUTTY FLORIDA
11 n '
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.By. By. ,\ v
epu y lerk Georgia A. Hiller, Esq.,
Attest as to Chairman s Chairwoman
signature only.
Approved as to form and legality
Kevin Noell
Assistant County Attorney
14