Backup Documents 10/16/2021 Item #16A 5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP +
TO ACCOMPANY ALL ORIGINAL DOCUMENT'S SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original doeumCMS are to be forwarded to the('01111i3 Attorney Office
at the lime the item is placed on the agenda. All completed routing slips and original doe um en is must be received in the('ouuty Allorne3 Office no laic:
than i1londay preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. lithe 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 fi>rward to the County Attorney(Mice.
Route to Addressee(s) (List in routing order) Office
1 Initials Date
2.
3. County Attorney Office County Attorney Office
4. BCC Office Board of County
Commissioners
5. Minutes and Records Clerk of Court's Office I /
(}
PRIMARY CONTACT INFORMATION `,�'1 �� 2.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 Lucia S. Martin Phone Number
Contact/ Department x 2279
Agenda Date Item was 10/26/21
Approved by the BCC Agenda Item Number 16.A.5
Type of Document Plat
Attached Number of Original 1
PO number or account Documents Attached
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is
appropriate. Yes N/A (Not
1. Does the document require the chairman's original signature? (Initial) Applicable)
LM
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.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's LM 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 LM
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 LM
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 10/26/21 and all changes made during
the meeting have been incorporated in the attached document. The Count
Attorney's Office has reviewed the changes, if applicable. Y 09 P
9. Initials of attorney verifying that the attached document is the version a PP Y roved b the ' VS
°t.
BCC,all changes directed by the BCC have been made,and the document is ready for the 0 0 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