Backup Documents 04/24/2012 Item #16A 5ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip an o6al A
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #I through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
A„rin„ .,fthe chni cio t, r ,t— a line thm„gh routing lines #1 through #4- cmmnlete the checklist. and forward to Sue Filson (line #5).
Route to Addressee(s)
(List in routing order)
Office
Initials
Date
1. Judy Puig
GMD Planning &
Regulation/Operations
(Initial)
`� I f
`1 �`I f
2.
April 24, 2012
Agenda Item Number
16.A.5
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4.
Lien
Number of Original
1
5 Ian Mitchell, Supervisor, BCC Office
Board of County
Commissioners
Documents Attached
/
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. 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, including Sue Filson, need to contact staff for additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item )
Name of Primary Staff
Jennifer Baker
Phone Number
252 -2444
Contact
appropriate.
(Initial)
Applicable)
Agenda Date Item was
April 24, 2012
Agenda Item Number
16.A.5
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
Lien
Number of Original
1
Attached
resolutions, etc. signed by the County Attorney's Office and signature pages from
Documents Attached
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
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
I.
Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
n
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.)
2.
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
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable.
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Ian Mitchell in the BCC office within 24 hours of BCC approval.
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!
6.
The document was approved by the BCC on 4/24/2012 (enter date) and all changes
made during the meeting have been incorporated in the attached document. The
W
County Attorney's Office has reviewed the changes, if applicable.
I 11W
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
This Instrument Prepared By: INSTR 4688190 OR 4792 PG 1468
Jen Baker RECORDED 502012 11:34 AM PAGES 1
Code Enforcement Department DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
2800 North Horseshoe Drive COLLIER COUNTY FLORIDA
Naples, FL 34104 REC $10.00
(239) 252 -2440
RELEASE AND SATISFACTION OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That
COMMISSIONERS OF COLLIER COUNTY, FLORIDA i s
certain lien against all real and personal property owned by
Maria D. and Sergio Gomez,
Respondents
the BOARD OF COUNTY
the owner and holder of a
The lien was recorded on February 10, 2011 in Official Records Book 4651, Page 515,
in the Official Records of Collier County, State of Florida. The lien secures the principal
sum of Nine Thousand four hundred eighty one dollars and fifteen 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:
GOLDEN GATE UNIT 4 BLK 145 LOT 7
4983 170 Avenue SW Naples, 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
DWIGHT E.,BROCK, Clerk
Deputy Clerk
iI1t�1M'l etN�� '
Fir ,
Approved as to form and legal sufficiency
Jeff righ
Assis nt ounty Attorney
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By: .� W. - C'j,
Fred W. Coyle, CharimaiT