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Backup Documents 11/09/2010 Item #16D 1ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP16 D l 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 and original documents are to be forwarded to the Board Office only after the Board has taken action on the item.) ROUTING SLIP Complete routing lines #1 through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the f th Chairman's si ature draw a line throuah routino lines #1 throu-ah #4 com lete the checklist, and forward to Sue Filson (line #5). exce on o e Route to Addressee(s) (List ' outing order) Office Initials Date Contact ! (Initial) ` l Agenda Date Item was 2. Agenda Item Number Approved by the BCC signed by the Chairman, with the exception of most letters, must be reviewed and signed 3. Type of Document by the Office of the County Attorney. This includes signature pages from ordinances, Number of Original 4. Attached h Documents Attached 5' Ian Mitchell, Executive Manager Board of County Commissioners 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 contactstaff 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 W., Name of Primary Staff �� /'A Phone Number /,,Q / OrL r r. Contact ! (Initial) Agenda Date Item was / Agenda Item Number Approved by the BCC signed by the Chairman, with the exception of most letters, must be reviewed and signed Type of Document by the Office of the County Attorney. This includes signature pages from ordinances, Number of Original Attached h Documents Attached INSTRUCTIONS & CHECKLIST 1: Fors/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS 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) 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 V �Q 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 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 1 should be provided to Sue Filson in the BCC office within 24 hours of BCC approval. Some documents are time sensitive and require forwarding to Tallahassee within a certain OLV time frame or the BCC's actions are nullified. Be aw of your deadlines! 6_ -.. _. T- he- documentwasappr-oved -b-y- the-BCGon ..- — (enter - date) -and- all- ehanges made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 1: Fors/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05 161 Release, Waiver of Liability, and Indemnity Agreement for the Donation of Skate Park Ramps This Agreement is between The Greater Marco Family YMCA, Inc. and Board of County Commissioners of Collier County, Florida, hereinafter respectively called "YMCA" and "COUNTY ". This Agreement provides for donation of (10) ten skate park ramps by YMCA to the COUNTY. IN CONSIDERATION of being granted possession and ownership of the skate park ramps currently located at the YMCA, the COUNTY releases all liability of such use of, construction and/or, transportation of said skatepark ramps only to the extent permitted by Section 768.28, Florida Statutes. THE COUNTY HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the YMCA, its directors, officers, employees, and agents (hereinafter referred to as "releasees ") from all liability to the COUNTY, its employees, agents, personal representatives, assigns, heirs, and next of kin for any loss or damage, and any claim or demands therefore on account of injury to person or property or resulting in death of the COUNTY, whether caused by the negligence of the releasees or otherwise while the COUNTY or its employees, clients, agents, or representatives are in, upon, or about the premises. IN WITNESS WHEREOF, the parties hereto have signed and sealed this Agreement as set forth below. The Greater Marco Family _YMCA, Inc. Signature /Y7� Lpve- Printe Name ey Title Zi2l /z /v Date si ed Witness Signature Witness Printed Name N. Witness Signature Page 1 of 2 Witness Printed Name ATTEST" ;,a �^ DWIGj1 E 3ROCK,'CCERK i i-patu a on. J;4 Approval for form and legal, Sufficiency: Jennifer White Assistant County Attorney 1601' BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA iuk (/J. By: _ FRED W. COYLE, CHAI Date k �2 ZDI1 Page 2 of 2