Backup Documents 06/11/2019 Item #16D 9 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 9
c2, 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. JASON RUMMER Community and Human 06/05/2019
Services
2. Jennifer Belpedio County Attorney Office61-7111
3. BCC Office Board of County
Commissioners '(k /57 (o\\<\\V
4. Minutes and Records Clerk of Court's Office
hiVV/
� itI I `1 S.3irk
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 JASON RUMMER S Phone Number 252-5505
Contact/ Department
Agenda Date Item was 06/11/2019 Agenda Item Number /�' ?D: �'
Approved by the BCC
Type of Document SHIP Satisfaction of Mortgage Number of Original 1
Attached Documents Attached
PO number or account 123-155974-649030-32000.1
number if document is
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? NA
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 JNR
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 JNR
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 JNR
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 II and all changes made during the meeting /A is not
have been incorporated in the attached document. The County Attorney's Office has n option for
reviewed the changes,if applicable. of// J/ is line.
9. Initials of attorney verifying that the attached document is the version approved by the '/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the option for
Chairman's signature. his line.
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
1609
INSTR 5726864 OR 5641 PG 2759
RECORDED 6/14/2019 10:10 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
Prepared by:Jason Rummer COLLIER COUNTY FLORIDA
Collier County REC$10.00
Community and Human 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 HICKEL BLAISE AND WITNIE GARCON, A HUSBAND AND WIFE to
COLLIER COUNTY, dated APRIL 2, 2007 and recorded on 04/27/2007 in Official Records Book 4220
Page 1882 of the Public Records of Collier County, Florida, securing a principal sum of$20,250.00 of
SHIP and certain promises and obligations set forth in said Mortgage, upon the property described in the
aforementioned mortgage.
COLLIER COUNTY hereby acknowledges 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 JUNE 11, 2019,
Agenda Item Number /6, a
_ _
ATTEST: BOARD OF COU �i! • SIONERS
,CRYSTAL K. KINIU, CLERK OF CaLIIE� �� FLORID
•
est as :
Q-01\4‘011By: C• :�_ 0.400� filliO>�S ` ' — 'r AN
�y.l_ � 1RK WILL L. MCD• � .,
' only.
„F�Yh.^flim
Approval for form and legality:
Jenn A.Bel edio O
p o- �
Assistant County Attorney S`