Backup Documents 10/22/2019 Item #16C 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 C - 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.
f_etralkiiiA (t 1**NEW** ROUTING SLIP U1.
13
Complete routing lines 41 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is alr ady complete with the
exception of the Chairman's signature,draw a line through routing lines 41 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 w,)i3. to p6119
4. BCC Office Board of County lA m 1�
Commissioners lel k t ` 1 .t
5. Minutes and Records Clerk of Court's Office
nAki 11,1411 I;Ai(ll'1
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 Phone Number _ 7
Contact/ Department ` t\D ) e`r'� 25 2 ^
Agenda Date Item was , Agenda Item Number
Approved by the BCC )6) 22-1 2.0 \p1 I C. 3
Type of Document • \ umber of Original
Attached U`�--)'1; P Yr•p V1� Documents Attached (
PO number or account
number if document is C%l. QC
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? • ("e'
2. Does the document need to be sent to another agency for additional signatures? If yes,
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 C;Ph't
by the Office of the County Attorney.
4. 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 Ai
5. 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. LAt
. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's Cm tsignature 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. WP/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 IDiP- i1 enter date)and all changes made E,lt./=`ililt- _-_
t.
during the meeting have been incorporated in the attached document. The County ..a;Sul°.•"It. =—
Attorney's Office has reviewed the changes, if applicable. si i-7,
9. Initials of attorney verifying that the attached document is the version approved by the 6, t 2
BCC,all changes directed by the BCC have been made, and the document is readyfor the �1' 9 _�_,
0 a...,::,.:%s.
Chairman's signature. VrA 3°
1: Forms/County Forms`BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 126.05,Revised 2.24.05;Revised 11/30/12
16C3
Memorandum
TO: Minutes & Records (:;iv-c)LAA.
FROM: Cindy Erb, Property Acquisition Specialist, Sr., Real Property Management
DATE: October 22, 2019
RE: New Tamiami Well #39
This item was accepted by the BCC on October 22, 2019, Agenda Item 16C3.
Please attest to Commissioner McDaniel's signature as Chairman on the Utility Easement.
Once attested, please forward the Utility Easement to the Recording Department for
recordation. A recording form is attached.
Please contact me if you have any questions or comments at Extension 8917.
Thank you!
PROJECT: New Tamiami Well#39
FOLIO: 00219440008 1 6 C 3
INSTR 5790454 OR 5695 PG 1102
RECORDED 11/14/2019 11 06 AM PAGES 3
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
REC$27.00
UTILITY EASEMENT
THIS EASEMENT, made and entered into this day of ! 1 _ , , 2019, by
COLLIER COUNTY, a political subdivision of the State of Florida, whose mailing address is
3335 East Tamiami Trail, 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
mailing address is 3335 East Tamiami Trail, 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, 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 for the purpose of constructing,
operating, and maintaining utility facilities thereon. Grantor and Grantee are used for singular
or plural, as the context requires.
IN WITNESS WHEREOF, the Grantor has caused these presents to be executed the
date and year first above written.
w t''")
'i ATTEST: BOARD OF COUNTY COMMIS 1ONERS
i1 CRYSTAL K. KINZEL, Clerk COLLIER C"cUNJTY LORID'
D►r w Z
pi ibla ��
W s
< � f BY: - . _ S
Attest as to Chairman's ,Deputy Clerk WI 'LIAM L. MCDANIEL,+.-., Chairman
WI'0 signature only,
t41 H n Approved as to form and legality:baithis Conveyance Approved By
f.i YY� pp
— t 0. The Board Of Countq
Commissioners
n e+ J\ Collier County Florida,
-' W ) / Pursuant To A en is
5 Jennifer A. Belpedio, Asss tsi rrt ounty Attorney el? gg �;
a \( . Date..;,)-9.2./,11 Item No. 1/.;,.L
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