Backup Documents 10/12/2021 Item #16A 8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP A 8
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.
2. Risk-Management Risk-Management
3. County Attorney Office County Attorney Office CAK 10-12-21
4. BCC Office Board of County PT by JH/s/ 10-12-21
Commissioners
5. Minutes and Records Clerk of Court's Office
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 October 12,2021 Agenda Item Number 16A8
Approved by the BCC
Type of Document Release of Lien Number of Original 1
Attached Documents Attached
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 final 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 October 12,2021 and all changes made IB
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 ,
BCC,all changes directed by the BCC have been made,and the document is ready for the ' r1t�4)
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
6 A 8
Ann P. Jennejohn
From: Ann P. Jennejohn
Sent: Thursday, October 28, 2021 4:30 PM
To: Burgoslliana
Subject: Item n#16A8 (10-12-21 BCC Meeting)
Attachments: Item #16A8 10-12-21 BCC Meeting.pdf
Hi Iliavta,
Please see ethe attacked recorded release avid
satisfactiovt of lievt for your records.
Thavtk you!
Ann Jenne,jolin
>3MR Sevtior Deputy Clerk II
ttaTtot*, Clerk to the Value Adjustwtevtt Board
�.'" `•�, Office: 239-252-8406
Fax: 239-252-8408 (if applicable)
AvuA.Jevtvtejohvt@CollierClerk.cowt
r
'*'< Office of the Clerk of the Circuit Court
& Comptroller of Collier Couvtty
32qq Taw.avvti Trail, Suite #401
Naples, FL 34112-5324
www.CollierClerk.cowt
i
16A8
INSTR 6148819 OR 6031 PG 3075
RECORDED 10/26/2021 9:08 AM PAGES 1
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
COLLIER COUNTY FLORIDA
REC$10 00
This Instrument Prepared By:
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:
Peter A. Helff,
Respondent
The lien was recorded on March 20, 2013, in Official Records Book 4898, Page 2916, in the
Official Records of Collier County, State of Florida. The lien secures the principal sum of two
thousand seven hundred sixty-two dollars and three cents ($2,762.03), 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 BOARD of •UNTY COMMISSIONERS
CRYSTAL_ K. KINZEL,'Clerk COLLI 'O•NTY, FLORI
By: �,cC� By:
1 '"% - t Clerk PennyTayor, Chairperson
�6( y p
Date: 1,11.94VIN Date: 10"i)- p!
Approved as to for 'and legality
r
een A. Kerins
Assistant County Attorney
[21-C E D-01597/1661573/1]