Backup Documents 12/10-11/2013 Item #16D 2ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURI
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the Coui
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attor
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 # 1 through #2, complete the checklist, and forward to the Coun Attorney Office.
A I
Route to Addressees (List in routing order)
Office
Initials
Date
1. Wendy Klopf
HHVS
*151�_
12/10/13
2. Jennifer Belpedio
County Attorney Office
Agenda Item Number.
1 L /L113
3. BCC Office
Board of County
Commissioners
Z �3
4. Minutes and Records
Clerk of Court's Office
Number of Original
1
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
dd sees above ma need to contact staff for additional or missin information
a res
Name of Primary Staff
Wendy Klopf/HHVS
Phone Number
252-2901
Contact / Department
Initial Applicable)
1.
Does the document require the chairman's original signature?
Agenda Date Item was
12/10/13
Agenda Item Number.
16.D.2
Approved by the BCC
provide the Contact Information Name; Agency; Address; Phone) on an attached sheet.
3.
Type of Document
Satisfaction of Mortgage -1
Number of Original
1
Attached
PDocurnents Attached
PO number or account
1 check #220499 for $10.00 made out to
NA
number if document is
the Clerk of Courts
5.
The Chairman's signature line date has been entered as the date of BCC approval of the
to be recorded
document or the final negotiated contract date whichever is applicable.
INCTRIICTIONS & CHECKLIST
1: 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
a ro riate.
Initial Applicable)
1.
Does the document require the chairman's original signature?
WK
2.
Does the document need to be sent to another agency for additional 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
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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
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
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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
NA
Looll
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 12/10/13 and all changes made during
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the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes, if applicable.
Initials of attorney verifying that the attached document is the version approved by the
9.
BCC, all changes directed by the BCC have been made, and the document is ready for
Chairman's signature.
1: 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
1602
INSTR 4925046 OR 4993 PG 110
RECORDED 12/17/2013 11:42 AM PAGES 1
DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
Prepared by: Wendy Klopf REC $10.00
Collier County
Housing, Human & Veteran Services
3339 E. Tamiami Trail
Naples, FL 34112
THIS SPACE FOR RECORDING
SATISFACTION OF MORTGAGE
KNOW ALL MEN BY THESE PRESENTS: That COLLIER COUNTY, whose post office address is
3299 E TAMIAMI TRAIL, NAPLES, FLORIDA 34112, the owner(s) and holder(s) of a certain
Mortgage executed by Maria Del Carmen Diaz to COLLIER COUNTY,
recorded on February26, 2010 in Official Records Book 4541 Page 127 of the Public
Records of Collier County, Florida, securing a principal sum of $ 3.920.00 and certain promises and
obligations set forth in said Mortgage, upon the property described in the aforementioned mortgage.
COLLIER COUNTY hereby acknowledges full payment and satisfaction of said Mortgage, and
surrenders the same as cancelled, and hereby directs the Clerk of said Circuit Court to cancel the same of
record.
This Satisfaction of Mortgage was approved by the Board of County Commissioners on -
,LgA I , 2013, Agenda Item Number % 6o ,b . .
ATTEST: .
DWIGHTE. BROCK,,C, .ERK
Approved for form and legality:
Jennifer A. Belpedio
Assistant County Attorney to
BOAF COUNTY COMMI SIONERS
OF C L R C/JUNTY, FL DA
I I /�
By:
A. HILLER, ESQ., CHAIRWOMAN