Backup Documents 10/23/2012 Item #16A 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO ( 0���
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 and origin
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP 3
Complete routing lines#1 through#4 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#4,complete the checklist,and forward to Sue Filson(line#5).
Route to Addressee(s) Office Initials Date
(List in routing order)
1. Judy Puig GMD Planning &
Regulation/Operations 101 2-311Z
2.
3.
4.
5 Ian Mitchell, Supervisor, BCC Office Board of County ��
Commissioners
6. Minutes and Records Clerk of Court's Office 7 (0(23112-
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
Agenda Date Item was October 23,2012 Agenda Item Number 16.A.3
Approved by the BCC
Type of Document Lien — ( L 2446 _ Number of Original 1
d
Attache J� Documents Attached
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. 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,
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. �Q
5. In most cases(some contracts are an exception),the original document and this routing slip VV��
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! {/►J
6. The document was approved by the BCC on 10/23/2012 (enter date)and all
changes made during the meeting have been incorporated in the attached document.
The County Attorney's Office has reviewed the changes,if applicable.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05
16A3
This Instrument Prepared By: INSTR 4755297 OR 4848 PG 3148
Jen Baker RECORDED 10/24/2012 3:23 PM PAGES 1
Code Enforcement Department DWIGHT E. BROCK, CLERK OF THE CIRCUIT COURT
COLLIER COUNTY FLORIDA
2800 North Horseshoe Drive
REC$10.00
Naples, FL 34104
(239) 252-2440
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:
Edward A. Kaulbars & Paula L. Kaulbars,
Respondents
The lien was recorded on November 8, 2010 in Official Records Book 4621, Page 2468,
in the Official Records of Collier County, State of Florida. The lien secures the principal
sum of Seventeen Thousand eight hundred eleven dollars and twenty 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:
STERLING OAKS PHASE 3A BLOCK A LOT 20
1579 Whispering Oaks Circle 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 r� BOARD OF COUNTY COMMISSIONERS
DWIGItT� :BRC OK, Clerk COLLIER COUNTY, FLORIDA
a� f1-Il-�GC By: .
"CA4i�yClerk Fred W. Coyle, Charima
est to
tr=
•
Approved as to form and legal sufficiency
I
Je Wri•ht
Ass .t- t County Attorney