Backup Documents 04/23/2019 Item #16A 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 A 3
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#I 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.
2.
3. County Attorney Office County Attorney Office 'sok; (drys!I I`1
4. BCC Office Board of County ,
Commissioners \ ,4 / (A-?Akc`
5. Minutes and Records Clerk of Court's Office t0c ' '3 3
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 Jodi Hughes Phone Number x-5744
Contact/ Department
Agenda Date Item was 4/23/19 1/ Agenda Item Number 16A3 1
Approved by the BCC
Type of Document Plat and Mortgagee's Joinder and Consent Number of Original 2
Attached Documents Attached
PO number or account
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?
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
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
signed by the Chairman, with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney. JH
4. 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
5. The Chairman's signature line date has been entered as the date of BCC approval of the JH
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 JH
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
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 on 4/23/19 and all changes made during r;1'
the meeting have been incorporated in the attached document. The County Pa
Attorney's Office has reviewed the changes,if applicable. at2
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 the 4/
Chairman's signature. 111
ee -
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05, ' ised 2.24.05;,Revls d`1/30/12
16A3
MEMORANDUM
Date: June 24, 2019
To: Jodi Hughes, Project Manager
Development Review
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Plat— Landings at Bear's Paw, Lot 10 Replat
Attached is a copy of the aforementioned document as referenced above, (Item
#16A3) approved by Board of County Commissioners on Tuesday, April 23,
2019.
If you need anything further, please feel free to contact me at 252-8411.
Thank you.
Attachment
16A3
MORTGAGEE'S JOINDER AND CONSENT
Mutual of Omaha Bank, authorized to transact business in the state of Florida, hereby certifies
that it is the holder of a mortgage and security agreement recorded in O.R. Book 5045, Page 55
of the Public Records of Collier County upon the property described therein and does hereby join
in and consent to the dedication of the property by the owner pursuant to the plan entitled
"Landings at Bear's Paw Lot 10 Replat" and agrees that its mortgage shall be subordinated to the
dedications shown thereon.
MUTUAL OF OMAHA BANK
BY; __.52-- -
PRINT NAME Bemetra Simmons
TITLE: Senior Vice President
MORTGAGEE'S ACKNOWLEDGEMENT
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH
THE FOREGOING MORTAGEE'S JOINDER AND CONSENT WAS ACKNOWLEDGED
$Y ME THI / DAY OF ill 19, BY 0 f'rlL� A. sl 'Y7 f 7'' , AS
1 0 Y \I(1 C`�I OFUTUAL OF OMAHA BANK, HO IS
VP RSONALLY KNOWN ME OR HAS PRODUCED (1 licr AS
IDENTIFICATION.
NOY la/ — STATE OF FLORIDA 4
,__,,,
u , Lt vm &grill
NAME PRINTED
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COMMISSION # MY COM ISSI(J)N EXPIRES
AGy.!;`,4:;,,„,
c« � JILL M.SMITH
' ?.' °.1 Notary Public-State of Florida
:N,° Il:`,34 Commission#FF 929376
oFf..�'� My Comm.Expires Oct 20,2019',..