Backup Documents 07/13/2021 Item #16A12 AZto
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 6 A 12
(Alto THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. I he 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.
2. l
3. County Attorney Office County Attorney Office CAK 7-13-21
4. BCC Office Board of County PT by JH/s/ 7-13-21
Commissioners
5. Minutes and Records Clerk of Court's Office C, Ada-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 Illiana Burgos/Code Enforcement Phone 239-252-6865
Contact/ Department
Agenda Date Item was July 13,2021 Agenda Item Number 16Al2
Approved by the BCC
Type of Document Code enforcement lien,with an accrued value of Number of Original 1
Attached $62,600 for payment of$700 in the code Documents Attached
enforcement action titled Board of County
Commissioners v.Chad Barancyk
PO number or account 111-138911-649030
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?STAMP OK N/A
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 IB
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 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 IB
document or the fmal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's IB
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 13,2021 and all changes made IB N/A is not
during the meeting have been incorporated in the attached document. The County an option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the an option fug
Chairman's signature. this 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
16Al2
MEMORANDUM
Date: July 23, 2021
To: Illiana Burgos, Operations Supervisor
Code Enforcement
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Release and Satisfaction of Lien — Barancyk
Attached is a scanned copy of the document referenced above, (Item #16Al2) approved by
the Board of County Commissioners on Tuesday, July 13, 2021.
The original agreement has been kept by the Minutes and Records Department as part of the
Board's Official Record.
If I can be of any further assistance, please feel to call me at 252-8411.
Thank you.
Attachment
16Al2
INSTR 6097998 OR 5983 PG 3915
RECORDED 7/20/2021 8'44 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
This Instrument Prepared By: COLLIER COUNTY FLORIDA
REC$10 00
Colleen A. Kerins, Esquire
Collier County Attorney's Office
3299 E. Tamiami Trail-Suite 800
Naples, FL 34112
(239) 252-8400
RELEASE AND SATISFACTION OF LIEN
KNOW ALL MEN BY THESE PRESENTS: That the BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA is the owner and holder of a certain lien against all real and
personal property owned by:
CHAD BARANCYK,
Respondent
The lien was recorded on March 20, 2020, in Official Records Book 5742, Page 257, in the
Official Records of Collier County, State of Florida. The lien secures the principal sum of sixty-
one thousand nine hundred nineteen dollars and forty cents ($61,919.40), plus accrued interest
and penalties, if any, and imposes certain obligations against real property situated in Collier
County, Florida.
Collier County, a political subdivision of the State of Florida, by execution of this Release and
Satisfaction of Lien, acknowledges payment as approved by the Board of County Commissioners
as satisfaction of the lien and hereby cancels and releases said lien.
The Clerk of the Circuit Court is hereby directed to record this Release and Satisfaction of Lien in
the Official Records of Collier County, Florida, to acknowledge that the lien ceases to exist.
ATTEST BOAR , OF COUNTY COMMISSIONERS
CRYSTAL,-K. K[N2tL2,-Clerk COLL UNTY, FLO
By. . 14tegga:
5t� ha ' By.
- y Clerk Penny T lor, Chairperson
ig tyre.0li}•
,
,
Date: r '# Date: l 0 o'Z I
Approved as to form and le lity
ve)
Colleen A. Kerins
Assistant County Attorney
[21-CED-01566/1634549/1]