Backup Documents 07/09/2019 Item #16C13 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 C13
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. Jennifer A. Belpedio, Asst. County Atty. County Attorney DO) (1S I 14
County Attorney's Office I
2. BCC Office Board of County
Commissioners v S —t\\b\\ck
3. Minutes and Records Clerk of Court's Office
') tAt kl:1
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in t e event one of the
addressees above,may need to contact staff for additio al or missing information.
Name of Primary Staff Toni A. Mott Phone Number 239-252-87 0
Contact/ Department
Agenda Date Item was July 9,2019 Agenda Item Number 16.C.13
Approved by the BCC
Type of Document Utility Easement Number of Original 1
Attached Documents Attached
PO number or account Account: Fund 414, Cost Center 263614, RECORDING FORM
number if document is Object Code 649030, Project 70103.4.3 ATTACHED
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? Sk'qu,--r <
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 v
by the Office of the County Attorney.
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 N/A
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 TAM
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
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 July 9,2019,and all changes made TAM
during the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the D
04.4
BCC,all changes directed by the BCC have been made,and the document is ready for the
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
16013
INSTR 5741437 OR 5653 PG 2811
RECORDED 7/19/2019 10:21 AM PAGES 2
PROJECT: MASTER PUMP STATION AT HERITAGE BAY CLERKCOLLIER OF THECOUNTY CIRCUITFLORIDA COURT AND COMPTROLLER
DOC@.70$0.70 REC $18.50
UTILITY EASEMENT
THIS EASEMENT, made and entered into this 11 day of , , 2019, by COLLIER
COUNTY, A POLITICAL SUBDIVISION OF THE STATE OF FLORIDA, whose st office address is 3335
Tamiami Trail East, Suite 101, Naples, Florida 34112, hereinafter referred to as "Grantor", to the BOARD OF
COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF
COLLIER COUNTY AND AS EX-OFFICIO THE GOVERNING BOARD OF THE COLLIER COUNTY
WATER-SEWER DISTRICT, whose post office address is 3335 Tamiami Trail East, Suite 101, Naples, Florida
34112, its successors and assigns, hereinafter referred to as "Grantee".
WITNESSETH:
Grantor, for and in consideration of TEN DOLLARS ($10.00) and other valuable consideration paid by the
Grantee, the receipt and sufficiency of which is hereby acknowledged, hereby conveys, grants, bargains and
sells unto the Grantee, its successors and assigns, a perpetual, non-exclusive easement, license, and
privilege for utility purposes, and access, on the following described lands located in Collier County, Florida, to
wit:
See attached Exhibit "A" which is
incorporated herein by reference.
Subject to easements, restrictions, and reservations of record.
THIS IS NOT HOMESTEAD PROPERTY.
TO HAVE AND TO HOLD the same unto the Grantee together with the right to enter upon said land,
excavate, and place or remove materials, including, but not limited to, sewer lines and pipes, service and
pump stations, and other equipment or improvements appurtenant thereto or thereunder for the purpose of
constructing, operating, and maintaining utility facilities thereon. The easement granted herein shall constitute
easements running with the land and shall burden the lands described above.
IN WITNESS WHEREOF, the Grantor has caused these presents to be executed the date and year
first above written.
ATTEST: ,. % _ r BOARD OF COUNTY COMMISSIONERS
Crystal.F izel, CLERK COLLIER COUNTY, FLORIDA
149 ',.,,,4,4,
Aapo
rF`.,-- ' , . - C°1- , 010
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# ;0. z/poi- k . iam L. McDaniel, Jr., Ch firman
Attestoi �
ignat o skt,i, ' ;
Approved as t or, ' 1.
legality:
Jenn erA. Belpedio 092gip\
Assistant County Attorney S\
16C13
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