Backup Documents 05/28/2019 Item #16D2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP16 D 2
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
Complete routing lines#1 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 County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Elizabeth Hernandez Community and Human 4,3//9
Services
2. Jennifer Belpedio County Attorney Office S /eA�
3. BCC Office Board of County \. 3o
Commissioners WA/ ABEAlck
4. Minutes and Records Clerk of Court's Office
keS 61301°1 y-D -
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 Elizabeth Herna ez/CHS Phone Number 252-2903
Contact/ Department
Agenda Date Item was 5/28/2019 Agenda Item Number 16.D.2. ' f
Approved by the BCC �I
Type of Document Release of Lien Number of Original
Attached Documents Attached 1
PO number or account One Letter of Authorization to use Habitat
number if document is for Humanity Recording account.
to be recorded
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. Does the document require the chairman's original signature? '.i liiTT
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 EH
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 EH
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 EH
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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 05/28/2019 and all changes made during the
meeting have been incorporated in the attached document. The County Attorney's � �(�j # }
Office has reviewed the changes,if applicable. ��?''""�
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 e
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
1 6 D 2
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Executive Committee October 17,2018
Rev.Lisa Lefkow
CEO
Nick Kouloheras
President Clerk of the Circuit Court
John Cunningham
Chairperson Attn: Recording Department
Ed Hubbard
VC Operations PO Box 413044
Craig Jilk
VC-Development
Naples, FL 34101-3044
Doug Peterson
VC-Family Support
Stanard Swihart,M.D.
VC-Family Selection
Rick Deal RE:Satisfaction of Mortgage or Lien
Treasurer
L.Michael Mueller
Secretary
Directors To Whom It May Concern:
Douglas L.Rankin,Esq.
Assistant Secretary
Penny Allyn
Kathleen Doar Please withdraw the necessary funds from our Deposit Account to record this Satisfaction
Tom Fahey of Mortgage or Lien.
Gene Frey
Curt Gillespie
Robert Gurnitz
Bill Hall Sincerely,
Patricia Jilk
Kathy Kircher
Tom Messmore
John Paalman
David Pash,Esq. Bill Shade
Tom Pollak
Robert Rice Director of Finance
John Sampson
Barbara Sill
Bill Stephenson
Aileen Tostrud
George Wainscott
Karl Wyss
I:•;..
Orr Habitat for Humanity 11145TamiamiTrail East•Naples, FL 34113
of Collier County 239-775-0036•Fax:239-775-0477•www.HabitatCollier.org
602
INSTR 5721101 OR 5636 PG 3176
RECORDED 6/3/2019 2:31 PM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Prepared by:Elizabeth Hernandez COLLIER COUNTY FLORIDA
Collier County REC$10.00
Community&Human Services Division
3339 E.Tamiami Trail,Building H,#211
Naples,FL 34112
THIS SPACE FOR RECORDING
RELEASE OF LIEN
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 Impact
Fee Agreement executed by Habitat for Humanity of Collier County, Inc. to Collier County,
recorded on 03/02/1999 in Official Records Book 2518 Page 1003, of the Public Records of
Collier County, Florida, in consideration of$3,929.52 receipt of which is hereby acknowledged
does remise, release, quitclaim, exonerate and discharge from the lien and operation of the said
agreement, that certain portion of the premises conveyed by said lien, more particularly
described as follows:
LOT 31,BLOCK B, SEMINOLE SUBDIVISION IN IMMOKALEE,
ACCORDING TO THE PLAT BOOK THEREOF,AS RECORDED
IN PLAT BOOK 1,AT PAGE 31,OF THE PUBLIC RECORDS
OF COLLIER COUNTY,FLORIDA.
The undersigned is authorized to and does hereby release this Lien with respect to the above-
named property, and consents to this Lien being forever discharged of record with respect to said
property.
This Release of Lien was approved by the Board not County Commissioners on -
5/20-017 ,2019,Agenda Item Number /6 D. ' , .
ATTEST: BOARD OF C i► • • A ISSIONERS
CRYSTAL K.KTNZEL', CLERK OFt," 14 Y,FLO' n
� � � .r_ �.�
By: LMM I q_� -
By:
/did CI a r _. WI/
IAM L.M NIEL,JR., ' 'IRMAN
Approval for form and legality:
Je er A.Belpedio
Assistant County Att y