Contract 2018-07 CLOSING AGREEMENT
In connection with the closing of the Contract for Sale and Purchase between the City of
Clermont, Florida, as Seller, and Performance Medical Partners, LLC, a Florida limited liability
company, as Buyer, with and Effective Date of October 10, 2017 ("Contract"), Seller and Buyer
acknowledge, agree, and represent and warrant to Nash Law Firm PA, as closing agent, and Old
Republic National Title Insurance Company, that, for the convenience of the Seller and Buyer,
the Seller and Buyer executed documents in connection with the closing of different dates, with
the Buyer executing them on January 23, 2018, that the Seller and Buyer agree that the proration
date shall remain the original closing date of January 16, 2018, and that the disbursement date
shall be the first business day following the date on which the Buyer's tender, JPMorgan Chase
Bank, N.A.,authorizes disbursement of loan funds.
BUYER:
Performance Medical Partners LLC, a Florida limited liability company
Date:January Z3, 2018
By Matthew .Casavant, Manager
Date: January 21, 2018
By J.,-p Kerps. k, Manager
SELLER:
City of Clermont,a Florida municipal corporation
ary
gr. Date: Janu ,) 2018
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LEGAL DESCRIPTION
(attach to Mortgage)
Lot 9,the West 47 feet of Lot 10,Lots 11, 12, 13, 14,15 and the East 1/2 of Lot 16,Block 91,
OFFICIAL MAP OF THE CITY OF CLERMONT,according to the map or plat thereof
as recorded in Plat Book 8,Page 17,Public Records of Lake County,Florida.
Closing Affidavit
(Buyer)
Before me,the undersigned authority,personally appeared Matthew S.Casavant and Joseph Kerpsack,as Managers of
PERFORMANCE MEDICAL PARTNERS LW,A FLORIDA LIMITED LIABILITY COMPANY,on behalf of the
Company,("Affiant"),who being by me first duly sworn,on oath,depose(s)and say(s)that:
I. Performance Medical Partners LLC,a Florida limited liability company("Buyer"),is purchasing the following
described property from City of Clermont,a Florida municipal corporation,to wit:
Lot 9,the West 47 feet of Lot 10,Lots 11,12,13,14,15 end the East 1/2 of Lot 16,Block 91,OFFICIAL
MAP OF THE CITY OF CLERMONT,according to the map or plat thereof as recorded in Plat Book 8,
Page 17,Public Records of Lake County,Florida.
2. The Buyer is of legal age and has never been adjudged incompetent. There are no matters pending against the Buyer
that could give rise to a lien that would attach to the property prior to the recording of the interests to be insured,and
Buyer has not and will not execute any instrument(nor permit any action to be taken)that would adversely affect
the title or interests to be insured. There are no judgments or liens against Buyer and no bankruptcy proceedings are
currently pending with respect to Buyer.
3. To the best of Buyer's knowledge, information, and belief: (a) within the past 90 days there have been no
improvements,alterations,or repairs to the above described property for which the costs thereof remain unpaid,and
that within the past 90 days there have been no claims for labor or material furnished for repairing or improving the
same,which remain unpaid;(b)there are no actual or potential mechanic's,materialmen's,or laborer's liens against
the property; (c)there are no tenancies, leases or other occupancies(oral or written)affecting the property; (d)no
other person or entity has any contract to purchase,option to purchase,right of first refusal,or other potential claim
of right to purchase the property.
4. Buyer knows of no violations of municipal ordinances pertaining to the property, or any action or proceeding
relating to the property which is pending in any court,nor does the Buyer know of any judgment,tax lien,or matter
of any nature whatsoever which could create a lien or charge upon the property. Buyer has no knowledge of any
matters that could or does create a cloud on the title to the subject property.
5. This affidavit is given for the purpose of clearing any possible question or objection to the title to the above
referenced property and, for the purpose of inducing Nash Law Firm P.A. and Old Republic National Title
Insurance Company to issue title insurance on the subject property, with knowledge that said title companies
relying upon the statements set forth herein.
6. Buyer certifies that the limited liability company is not one of a family or group of entities. Buyer certifies that the
managers authorized the transaction or executing the instruments to be insured are not debtors in bankruptcy and
have not been a debtor in bankruptcy since becoming a member or manager of the limited liability company. Buyer
certifies that the managers authorizing the transaction or executing the instruments to be insured have not become
dissociated pursuant to Sec. 605.0302(11), F.S., Secs. 605.0212, 605.0601 or 605.0602. nor did any persons
wrongfully cause dissolution of the company.
7. Buyer hereby holds Nash Law Firm P.A. and Old Republic National Title Insurance Company harmless and
fully indemnifies same(including but not limited to attorney's fees,whether suit be brought or not,and at trial and
all appellate levels, and court costs and other litigation expenses) with respect to the matters set forth herein.
"Affiant", "Seller" and "Buyer" include singular or plural as context so requires or admits. This affidavit is made
under the laws of the penalties of perjury. Buyer is familiar with the nature of an oath and with the penalties as
provided by the laws of the United States and the State of Florida for falsely swearing to statements made in an
instrument of this nature. Buyer has read,or heard read,the full facts of this Affidavit and understands its context.
Closing Affidavit(Buyer)-Page 1
File Number 17-0469
Further Affiant sayeth not.
Performance Medical Partners LLC,A Florida
limited liability company
By Matthew say nt,Manager
IIS
By Josg, Kerpsack,Manager
State of r` v �,b _
County of (A
n
The foregoing instrument was acknowledged before me this a-3 day of TAN JA ,20 ,by
Matthew S.Casavant and Joseph Kerpsack,as Managers of PERFORMANCE MEDICAL PARTNERS LLC,A
FLORIDA LIMITED LIABILITY COMPANY,on behalf of the Company,who U are personally known to me or CL
)have produced R,2 t>.L.` as identification.
(SEAL)
Notary ��� � ^
Printed Name: ^\ '1 / , 4 c^
My Commission Expires: J Z i Z 320
DANIEL F.MANT7JIRlS
{ *MY COMMISSION#17 982152
EXPIRES:July 2,2020
ar 14.°1.Bonded TTvu Bud*Notary ScriceS
ClosingAfdavie(Buyer)-Page 2
File Number: 17-0469
1
Buyer's Closing Statement
Page 1
FILE NUMBER: 052481
NAME OF BUYER: Performance Medical Partners LLC,a Florida limited liability company
Address of Buyer. 1900 Don Wckham Drive,*130,Clermont,Florida 34711
NAME OF SELLER: City of Clement,a Florida municipal corporation
Address of Softer: 685 West Montrose Street,Clermont,Florida 34711
NAME OF LENDER: JPMorgan Chase Bank,NA.
Address of Lender. 450 S.Orange Avenue, 10th Floor,Orlando,Florida 32801
PROPERTY LOCATION: 865 West Montrose Street,Clermont,Florida 34711
SETTLEMENT AGENT: Nash Law Firm PA
Placa of Settlement: PO Box 7644,Seminole,Florida 33775
SETTLEMENT DATE: 1/16/18 DISBURSEMENT DATE: 1/16/18
CHARGES: Amount
Contract sales price $785.000.00
Environmental tee(JPl4organ Chase Bank,N.A.) $250.00
Flood certifcatlon fee(JPMorgan Chase Bank,NA) $19.50
Future Release fee(JPMorgan Chase Bank,NA,) $10.00
Tax Transcript fee(JPMorgan Chase Bank,N.A.) $10.70
Settlement or dosing fee(Nash Law Firm PA) $200.00
Loan Closing fee(Nash Law Firm PA) $600.00
Overnight courier/wire fees(Nash Law Firm PA) $50.00
Title Insurance(Old Republic National Title Insurance Company/Nash Lav4 $240.00
8.1-100;19-424.00(Nash Law Firm PA) $524.00
Recording fees(Clerk of Court,Lake County) $190.00
City/county tax/stamps(Cierk of Court,Lake County) $1,656.00
State tax/stamps(Clerk of Court,Lake County) $2,898.00
Total Charges: $791,648.20
CREDITS: Amount:
Deposit or earnest money $25,000.00
Principal amount of new loari(s)(JPMorgan Chase Bank,N.A.) $828,000.00
Total Credits: $853,000.00
Cash due to buyer: $61,351.80
DoubleTlme®
Buyer's Closing Statement
Page 2
FILE NUMBER: 052481
THE UNDERSIGNED ACKNOWLEDGES RECEIPT OF A COPY OF THE FOREGOING SETTLEMENT STATEMENT,AGREES TO THE CORRECTNESS
THEREOF,AND AUTHORIZES AND APPROVES THE DISBURSEMENTS SET FORTH.
Performance Medic art ers LLC
a Florida li i d liab' ' ompany
By:
Matt ew S. Cas:vant
Manager/
By: '. �� .i
Jose. .sack
Manager
DoubNllme®
RESOLUTION
OF
THE MEMBERS
OF
PERFORMANCE MEDICAL PARTNERS,LLC
The undersigned, being all of the Members and Managers of Performance Medical Partners,
LLC, a Florida limited liability company ("Company"), acting pursuant to the laws of the State
of Florida and the Articles of Organization of the Company do hereby take, confirm, ratify,
consent and approve the following resolutions:
WHEREAS,the undersigned are all of the Members and Managers of the Company; and,
WHEREAS,the Company is in good standing with the State of the State of Florida; and,
WHEREAS,the Company does not have a written operating agreement: and,
WHEREAS, the Members and Managers desire that the Company ratify and confirm that certain
Contract for Sale and Purchase ("Agreement") between the Company and the City of Clermont,
Florida, a Florida municipal corporation ("Clermont"), dated effective October 10, 2017, under the
terms of which the Company agrees to purchase real estate described the Agreement ("Property")
for the price of$785,000.00.
NOW, THEREFORE, BE IT RESOLVED, that the Members and Managers unanimously
approve and ratify the Agreement;and,
RESOLVED, FURTHER, that the Company hereby authorize and empower Matthew Casavant
and Joseph Kerpsack, as Managers of the Company, acting jointly, to execute all loan and real
estate documents requested by the lender,the seller, the title insurance underwriter, and the closing
agent, and any and all documents relating thereto on behalf of the Company to consummate the
transactions contemplated under the Agreement;
RESOLVED, FURTHER, that Company hereby authorize Matthew Casavant and Joseph
Kerpsack, as Managers of the Company, acting jointly, to do all things and incur all expenses on
behalf of the Company in connection with the resolutions set forth herein;
RESOLVED, FURTHER, that the Company hereby authorize and empower Matthew Casavant
and Joseph Kerpsack, as Managers of the Company, acting jointly, to take such other and further
actions as are necessary to consummate the transactions described in the foregoing resolutions;
1
RESOLVED, FURTHER, that this Resolution may be signed in multiple counterparts, and if so
signed, it shall be effective as if all signatures appeared on one and the same document and this
Resolution may be transmitted by facsimile and the facsimile shall have the full force and effect as
if it were an original.
IN WITNESS WHEREOF,the undersigned have executed this Resolution as of the date first set
forth below.
This Resolution is effective as of October 10, 2017.
Matt ew Casav: •e :'r •,'d Manager
Joseph Kerp lir Member an i Manager
2
11
AFFIDAVIT OF JOSEPH KERPSACK
STATE OF FLORIDA
COUNTY OF LAKE
Before me, the undersigned authority, duly authorized and qualified in the State and County
aforesaid to administer oaths and take acknowledgments, this day personally appeared Joseph
Kerpsack,who,being by me first duly sworn,deposes and says:
I. The facts and matters contained and recited in this Affidavit are based upon the personal
knowledge of Affiant and Affiant is competent to testify to them.
2. I am a Member and Manager of Performance Medical Partners, LLC, a Florida limited
liability company("Company").
3. The only other Member and Manager of the Company is Matthew Casavant
("Casavant").
4. I am not a debtor in bankruptcy and have not been a debtor in bankruptcy since becoming
a member or manager of the Company.
5. Casavant in not a debtor in bankruptcy and has not been a debtor in bankruptcy since
becoming a member or manager of the Company.
6. The Company is not one of a family or group of entities.
FURTHER AFFIANT SAYETH NOT.
Joseph erpsack,Affiant
Sworn to an• bscribed before me this- day of U ,201'by Joseph Kerpsack,
who o ' persona : • •• to me,or roduced . Affiant did take an oath.
Mirill
pn,..,,,,,—. 4-2,,,,,.!
Notary Public, State of Florida
Commission No.: 11.----- JS?,My Commission Expires 6 lli Z! 2-3�0 2
,04.•,,4,. DAME F.LANTIARIS
4P° :, .WY COMtlISSION S FF 96157
9 Ti' y WIRES:July 2.2020
�'Eor AP-Bended INu Bodge!te 1.Berk 9
AFFIDAVIT OF MATTHEW CASAVANT
STATE OF FLORIDA
COUNTY OF LAKE
Before me, the undersigned authority, duly authorized and qualified in the State and County
aforesaid to administer oaths and take acknowledgments, this day personally appeared Matthew
Casavant,who,being by me first duly sworn, deposes and says:
1. The facts and matters contained and recited in this Affidavit are based upon the personal
knowledge of Affiant and Affiant is competent to testify to them.
2. I am a Member and Manager of Performance Medical Partners, LLC, a Florida limited
liability company("Company").
3. The only other Member and Manager of the Company is Joseph Kerpsack("Kerpsack").
4. I am not a debtor in bankruptcy and have not been a debtor in bankruptcy since becoming
a member or manager of the Company.
5. Kerpsack in not a debtor in bankruptcy and has not been a debtor in bankruptcy since
becoming a member or manager of the Company.
6. The Company is not one of a family or group of entities.
FURTHER AFFIANT SAYETH NOT. 7V14C2
Matthew Casavant, Affiant
Sworn to and sub ',ed before me this,,,,_2-32 day of ,2014,by Matthew Casavant,
who o is , •� . •.wn to me,or weed f1Pr" . Affiant did take an oath.
Print Name:'fit Z l 12417k_l
Notary Public, State of Florida
Commission No.:•t=Ftig')..(c),My Commission Expires:`1�j{ Z 2-620
%I OANfEL f.MANTZARIS
�' .Por�*MY COMMISSION.FF 982157
EXPIRES;July 2,2020
l'ror �9ond.d Tam Ltud0•t Notary Sirdo•a
Bill of Sale
This Bill of Sale, made on January l C) , 2018, between City of Clermont, a Florida municipal corporation
("Seller"),and Performance Medical Partners LLC,a Florida limited liability company("Buyer").
Witnesseth, that Seller, in consideration for the sum of TEN DOLLARS ($10.00) and other good and valuable
consideration paid to Seller by Buycr, receipt and sufficiency of which is hereby acknowledged, delivers, grants, bargains,
sells and transfers forever to Buyer the following goods and chattels,as-is and where is,to wit:
The personal property set forth in Exhibit A attached hereto.
Said property being located at:
Lot 9,the West 47 feet of Lot 10,Lots 11,12, 13,14,15 and the East l/2 of Lot 16,Block 91,OFFICIAL MAP
OF THE CITY OF CLERMONT,according to the map or plat thereof as recorded in Plat Book 8,Page 17,
Public Records of Lake County,Florida.
Also known as Alt Key No. 1614996,,FL
Seller covenants to Buyer that Seller is the lawful owner of the said goods and chattels;that they are free from all
encumbrances;that Seller has good right to sell that property,and that Seller will warrant and defend the sale of said
property,goods and chattels unto the Buyer against the lawful claims and demands of all persons whomsoever.
"Seller" and "Buyer" shall be used for singular or plural, natural or artificial, which terms shall include the heirs, legal
representatives,successors and assigns of Seller and Buyer whenever the context so requires or admits.
City of Cler.ont,a Florida municipal corporation
4k i A
By' ' " Man :er
State of C oVA
County of LAS
The foregoing instrument was acknowledged before me this 1 b — day of&AN U 1 CZ1/4.4 2018,by
Darren Gray,City Manages,ofthe CITY OF CLERMONT,A FLORIDA MUNICIPAL-CORPORATION,on behalf
of the Corporation,ghe is personally known tome or( )has produced as identification.
(SEAL)
3
�ti►R� uc DANIEL F.MAN1ZARIS Notary Pu• IC
* : • *MY COMM ISSiON N FF 962157
e, EXPIRES:.My 2,2020 �
�reor rt°� Bonded u Budget Notary 9ervic8a l
Nu Name: `1•1 1 F ANT2.(-)Q\S
My Commission Expires:�v 2 2ti2_o
Fik Number:17-0469
EXHIBIT A TO BILL OF SALE
7L�9R�?��1�Y+�fil�f�bif�il3�
ROOM Q1Y ITEM SIZE
DIVISION COMMANDER OFFICE#1 2 BOOK SHELVES 28 X 60
1 CABINET-FILE-2 DRAWER 31X30
1
CABINET-STORA(F-4 DRAWER 35.5 X 71
2 CHAIR-OFFICE
1 CHAIR-SWIVLE
1 WHITE BOARD 36 X 47.5
1 WHIITE BOARD •
36 X 24
DIVISION COMMANDER OFFICE#2 1 DESK-COMPUTER-W/SHELVES- 2 DRAWER 61 X 59.5
1 DESK-OFFICE-5 DRAWER 645 X 29
2 BOOK SHELF 30 X 71
1 TABLE t ROUND) 42 WIDTH
4 CHAIR-DESK
] CHAIR-SWIVIF
1 PLASTIC CHAIR MAT 44X55.5
1 WHITE BOARD 35.5X48
CHIEFS OFFICE 1 DESK-OFFICE-7 DRAWER 71.5 X 35
1 DESK-COMPUTER 59)t 385
1 CABINET-2 DRAWER 29.5X20
1 CABINET-6 DRAWER-2SNELVES 66X20
1 CABINET-2 DRAWER-3 SHELVES 29.5 X 20 X 76.5
2 CHA4R-()MEI
1 CHAIR-SWIVLE
1 PHONE-DESK-NEC BRAND
1 PAPER SHREDDER-FELLOW BRAND
1 ACCESSORY RACK(BATHROOM) 10X 10 X 23
1 PLASTIC CHAIR MAT 44 X 55.5
CHIEFS SECRFTMIY 1 DESK- NO DRAWERS 72 X 30
1 CABINET-FILE -5 DRAWER 71.5X20
1 TABLE-PRINTER ADJUSTABLE 36 X 70
1 CABINET-2 DRAWER WITH BOOK SHELF 38 X 19 X 65
1 CHAIR-SWIVLE
3 PLASTIC LETTER HOLDER-WALL MOUNT)
1 PLASTIC CHAIR MAT 44 X 55.5
ROOM 108 5 CABINET-METAL- 4 DRAWER 16 X26.5 X52
1 BOOK SHELF 36.5 X 12 X 62
1 PLASTIC LETTR HOLDE--WALL MOUNT
RECORDS 1 DESK-7 DRAWERS 65.5 X 295
1 DESK-2 FILES DRAWERS 715 X 20
4 CABINET-METAL- 4 DRAWERS 96 X 19.5 X 67
1 CABINET METAL 4 DRAWERS 15 X 26.5 X 52
1 PLASTIC FLOOR MAT(BLACK)() 48 X 38
1 PLASTIC FLOOR MAT(CLEAR) 71 X 59-5
1 CABINET-METAL- 2 DRAWERS 14X18X25
1 BULUTEN BOARD 48X 48
RECORDS REVIEW 1 CABINET-STORAGE 36X 18X71.5
2 CRUTCHES
ROOM 109 1 CABINET-FILE 36 X 19 X 67
2 CABINET-FILE 36X18X64.5
1 KEY BOX-METAL 12X6
1 APC SURGE ARRESTOR
DETECTIVE DIVISION OFFICE 4 DESK-COMPUTER-4 DRAWERS-4 SHELVES 86 X 85 X 65
2 DESK-COMPUTER-2 DRAWERS-2 SHELVES 60 X 24 X 65
1 TABLE-PRINTER-METAL FRAME 30 X 20
1 TABLE PRINTER-WITH WHEELS
1 DESK-OFFICE-4 DRAWERS 60X20
3 CABINET-FILE-METAL-4 DRAWERS 18 X 25 X 52
1 CABINET-FILE-METAL-2 DRAWERS 18X25X29
1 CABINET-FILE-METAL-2DRAWERS 14X18X25
2 PLASTIC LETTER HOLDER-WALL MOUNT
1 LOUROF ELECTRONICES AUDIO BASE STATION
INTERVIEW ROOM KII 1 DESK-FILE-2 DRAWERS 71 X 24
1 BULLETIN BOARD 48X48
1 WHITE BOARD 23.5 X 35.5
INTERVIEW ROOM R 2 1 DESK COMPUTER-7 DRAWERS-L SHAPE 66X74
2 CHAIR-OFFICE-SWIVLE
1 BOOK SHELF 36 X 14 X 48
1 CABINET FILE-METAL-4 DRAWER 18 X 26.5 X 52
1 BULLETIN BOARD 72 X 46
1 PLASTIC LETTER HOLDER-WALL MOUNT
1 PLASTIC FLOOR MAT 44 X 55.5
INTERVIEW ROOM N 3 2 CHAIR-OFFICE
1 TABLE-METAL 48X23.5
ROOM 110 1 CABINET-STORAGE-METAL 36 X 18 X 713
1 BOOKSHELF 33 X 11 X 55.5
6REAK ROOM 7 CHAIR-FOLD UP-METAL
1 TABLE-ROUND 47 WIDTH
1 TABLE-ROUND 36 WIDTH
i CHAIR-OFFICE-SWIVLE
7 BULLETIN BOARD 51 X 31
WEIGKTROOM 1 SCI FIT PRO SPORT EXERCISE MACHINE
1 SCI FIT SXT 7000 EXERCISE MACHINE
1 EVERLAST HEAVY BAG WITH STAND
1 WEIGHT BENCH
3 MIRRORS VARIOUS
1 EXERCISE TIMER-WALL MOUNT
IRAMIMO MICE 2 DESK-OFFICE-8DRAWERS 71X24
1 CABINET-STORAGE-METAL 48X 24 X 78
1 CABINET-STORAGE-METAL 31X18X67
1 CABINET-FILE-METAL-4 DRAWER 1B X 25 X 52
1 CABINET-FILE-METAL-4 DRAWER 16X26.5X52
1 CABINET-ELLE-METAL-2 DRAWER 18 X 25 X 29
1 CABINET-FILE-METAL-2 DRAWER 14X18X25
1 CHAIR-OFFICE-SWIVLE
1 BULLETIN BOARD 48X48
2 PLASTIC MAIL HOLDER-WALL MOUNT
PATROL COMMANDERS OFFICE 3 DESK-OFFICE-7 DRAWER 60 X 30
1 DESK-OFFICE-7DRAWER-LSHAPE 60X73
1 TABLE 60X30
1 BOOKSHELF 28K12X71.5
1 CABINET-STORAGE-METAL 24X9X39
S CABINET-FILE-METAL-4 DRAWER 15X26K52
3 CABINET-FILE-METAL-2 DRAWER 18 X 26.5 X 29.5
4 CHAIR-OFFICE-SWIVLE
2 CHAIR-OFFICE
1 CHAIR-FOLD UP-METAL
1 PAPER SHREDDER-NOVTECH BRAND
1 KFYBOX- METAL 8X12
1 FILE CASE PORTABLE
1 2 INCH BALL HITCH
5 MAG LIGHT CHARGERS
SQUAD ROOM 4 TABLE-FOLD UP-METAL 96X30
3 LOCKERS-3 TOGETHER 36 X 18 X 78
1 TABLE-ROUND 48 INCH WIDTH
1 TABLE 72X30
1 CHAIR-OFFICE-SWIVLE
1 CHAIR-OFFICE
20 CHAIR-FOLD UP-METAL
1 PROJECTION SYSTEM W/SCREEN-TOSHIBA
1 DVD PLAYER-GO VIDEO
1 AM/FM RECIEVER-SHERWOOD
1 TFI FVLSION-CRT TYPE-MAGNOVOX 27 INCH
1 WHITE BOARD 71 X 48
1 BULLETIN BOARD 48X48
1 CAMERA-DUNK
2 SPEAKER FOR PROJECTION SYSTEM
1 PROJECTOR-OVER HEAD-APOLLO BRAND
2 PLASTC MAIL HOLDER-WALL MOUNT
ROOM 103 1 CABINET-STORAGE 48X12 X72
ROOM101 1 DESK-OFFICE-5 DRAWER 61X30
1 DESK-OFFICE-7 DRAWER-LSHAPE 66X74
1 BOOK SHELF 35 X 14 X48
2 CHAIR-OFFICE
7 CHAIR-OFFICE-SWIVLE
4 CABINET-FILE-METAL-4 DRAWER 15 X25 X52
1 LETTER HOLDER-DESKTOP
4 CHAIR-FOLOUP-METAL
25 PHONE-DESK TOP-NEC BRAND
2 COMPUTER-GATEWAY
2 MONITOR-COMPUTER-ENVISION 18 INCH
3 MONITOR-COMPUTER-DELL 19 INCH
7 KEY BOARD-COMPUTER-DELL
2 SURGEARRESTOR-APC
1 PRINTER-COMPUTER-BROTHER-ML30
2 SPEAKER-WIRELESS-LOGI TECH
3 POWER SUPPLY-COMPUTER-DELL
1 TELEVISION-CRT TYPE-SHARP 19 INCH
1 BULLETIN BOARD 48 X 48
3 PLASTIC MAIL HOLDER-WALL MOUNT
1 MAIL HOLDER-DESK TOP
ROOM 102 1 CHAIR-OFFICE
1 CABINET-FILE-METAL-4 DRAWER 18 X 26.5 X 52
1 CABINET-FILE-METAL-2 DRAWER 18X25X29
4 PLASTIC MAIL HOLDER-WALL MOUNT
ENTRANCE 2 CHAIR/BENCH-3 SEATS TOGETHER
1 BOOKSHELF 28X12X30
22 STUFFED ANIMALS VARIOUS
1 BULLLETIN BOARD 48 X 48
COMMUNITY AFFAIRS ROOM 1 TABLE-MEETING 93 X 48
9 CHAIR-OFFICE
4 CHAIR-FOLD UP-METAL
2 TREE-FICUS-FAKE
1 PICTURE-CLERMONTARIEL VIEW 103 X 52
OOMMUNIIY AFFAMS OFFICE 1 DESK-OFFICE-5 DRAWER 64 X 29.5
1 TABLE 48 X 20
1 TABLE-9RUN-SLR 48 X 24
1 BOOKSHELF 30X12 X71
2 CHAIR-OFFICE
1 CHAIR-OFFICE-SWIVLE
2 MONITOR-COMPUTER-DELL 18 INCH
1 SURGE ARRESTOR-APC
1 PHONE DESK-NEC BRAND
1 SPEAKER-COMPUTER-DELL
1 WHITE BOARD 94 X48
CELL BLOCK 1 TABLE-FOLD UP 46 X 24
6 CHAIR-FOLD UP-METAL
2 SURGE ARRESTOR-APC
2 KEY BOARD-COMPUTER-DELL
1 PHONE-DESK-NEC BRAND
1 CAMERA-D LINK
1 RACK-STORAGE-METAL 29X12X60
LOCKER ROOM-MEM 1 LOCKER-METAL-3 ATTACHED TOGETHER 12X12X66
4 LOCKER-METAL-6 ATTACHED TOGETHER
3 TOP OVER 3 ON BOTTOM 12X18X66
LOCKER ROOM•WOMENS 1 CABINET-FILE-METAL 2 DRAWER 15 X 18 X 28
ROOM 106 2 TABLE-FOLD UP•METAL 92X30
1 CHAIR-FOLD UP-METAL
1 BOX CABLES-ASSORTED TYPES
Prevared by and return to:
Nash Law Firm P.A.
do Sandy Davis
Attorney Closing Services LLC
5850 TG Lee Boulevard,Ste.435
Orlando,FL 32822
File Number. 17-0469/052461
(Space Abovt This Lim Fos Rteordiag bats)
Special Warranty Deed
This Special Warranty Deed made this I tp day of January, 2018, between City of Clermont, a Florida
municipal corporation, whose post office address is 685 West Montrose Street, Clermont, FL 34711, grantor, and
Performance Medical Partners LLC, a Florida limited liability company whose post office address is 1900 Don
Wickham Drive,#1130,Clermont,FL 34711,grantee:
(Whenever used herein the terms grantor and grantee include all the parties to
this instrument and the heirs, legal representatives, and assigns of individuals,
and the successors and assigns of corporations, trusts and trustees)
Witnesseth, that said grantor,for and in consideration of the sum of SEVEN HUNDRED EIGHTY FIVE THOUSAND
AND 00/100 DOLLARS(U.S.$785,000.00)and other good and valuable considerations to said grantor in hand paid by said
grantee,the receipt whereof is hereby acknowledged,has granted,bargained,and sold to the said grantee,and grantee's heirs
and assigns forever,the following described land,situate,lying and being in the Lake County,Florida,to-wit:
Lot 9,the West 47 feet of Lot 10,Lots 11,12,13,14,15 and the East 1/2 of Lot 16,Block 91,OFFICIAL MAP
OF THE CITY OF CLERMONT,according to the map or plat thereof as recorded in Plat Book 8,Page 17,
Public Records of Lake County,Florida.
Parcel Identification Number: 2422250100-091-00900
Subject to taxes for 2018 and subsequent years; covenants, conditions, restrictions, easements, reservations and
limitations of record,if any,and further subject to the following restrictions and buy back provision:
Grantee warrants and agrees that the initial use of the Property by Grantee shall be for medical and/or professional
office purposes and further that Grantee shall exert all reasonable efforts to timely renovate the improvements on the
Property and redevelop the Property for the above-stated purposes. In the event that Grantee has not received a
Certificate of Occupancy for the renovated and redeveloped Property as set forth herein on or before the expiration
of SEVEN HUNDRED AND THIRTY(730)days of from the date of this Deed,Grantor,at Grantor's sole option,
shall have the right to buy back the Property, including any and all improvements, development plans, surveys,
environmental studies, plans, drawings, architectural plans, permit approvals, and all other documents and things
related to the Property and development thereof, for the buy-back purchase price of SEVEN HUNDRED AND
EIGHTY-FIVE THOUSAND DOLLARS ($785,000), Upon the failure of Grantee to timely obtain the required
Certificate of Occupancy, and upon thirty (30) days written notice from Grantor at Grantor's option, with
opportunity to cure during said thirty (30)day period,Grantee shall transfer the Property to Grantor by executing a
Special Warranty Deed delivering marketable title to the Property to Grantor, free and clear of all liens,
encumbrances, and taxes, except for all matters contained on the Plat of Official Map of the City of Clermont, as
recorded in Plat Book 8, Page 17,Public Records of Lake County,Florida. The transaction and delivery of title as
contemplated herein shall be in exchange for SEVEN HUNDRED AND EIGHTY-FIVE THOUSAND DOLLARS
($785,000) paid by Grantor to Grantee and shall be completed by a closing agent as selected by Grantor. At the
closing pursuant to this buy back provision,Grantee shall pay for state documentary stamps as may be required to be
Spuria!Warronry Deed-Pap 1
affixed to the Special Warranty Deed,any taxes or assessments prorated as of the date of closing,the premium for
the owner's title insurance policy to be issued insuring title, the cost of recording any and all other documents
necessary to deliver good and clear title,any document preparation fees,the cost of recording the Special Warranty
Deed and any and all costs associated with the recording of any satisfaction or release of any note,mortgage, lien,
encumbrance, and security agreement attached to the Property. Grantee and Grantor shall each hear its own
attorneys' fees in connection with the buy back and closing thereof. In the event that Grantee has timely met the
conditions set forth above, Grantor shall, upon written request from Grantee, execute and deliver to Grantee a
Release of Buy Back Interest.Notwithstanding the foregoing,in the event that the Certificate of Occupancy referred
to herein is not issued or delayed,solely due to the inaction or omission of Grantor, the time to perform hereunder
shall be extended for a period to be agreed-upon by the parties.
Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining and all of
grantor's interest in all the phosphate, minerals, metals and petroleum that are or may be in, on, or under the said land, it
being the intent of the grantor to disclaim all interest in the foregoing as would otherwise be reserved if not herein transferred
and disclaimed pursuant to Florida Statute 270.11(1).
To Have and to Hold,the same in fee simple forever.
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the
grantor has good right and lawful authority to sell and convey said land;that the grantor hereby fully warrants the title to said
land and will defend the same against the lawful claims of all persons claiming by,through or under grantors.
In Witness Whereof,grantor has hereunto set grantor's hand and seal the day and year first above written.
Signed,sealed and delivered in our presence:
City of Clermont,a Florida municipal corporation
LrDinAL, M. /,A . A
First Witness Si ture B,a;� ray,Cl Manager
Printed Name: ( eIra 01. ,4 j')4 C
l -
Secon' itness Signature
Printed Name:/5'eAdQC772 /
State of l k 9A
County of LA
The foregoing instrument was acknowledged before me this Ito day of CS'ANV fW 2018,by
Darren Gray,City Managprof the CITY OF CLERMONT,A FLORIDA MUNICIPAL CORPORATION,on behalf
of the Corporation,he L is personally known to me or( )has produced as identification.
(SEAL)
601.V.PVeq, DANIEL F.AINITZAAIS
*MYCOMMiSSION FF 992157 i
EXPIRES:July 2020 Notary • .icc f� (�,�
�e0F rk° Bonded u Budget Notary SWAM Printed Name:)A7(�.1 1((_ F 1(` i l a..S
My Commission Expires: 2.l �O�0
Special Warnanry Deed-Page 2
AFFIDAVIT OF NO LIENS
STATE OF FLORIDA
COUNTY OF LAKE
Before me,the undersigned authority,on this day personally appeared: Darren Gray,City Manager of the City of
Clermont,a Florida municipal corporation,who,upon being by me first duly sworn,deposes and says:
The affiant(s)is/are the owners of the following described real property
Lot 9,the West 47 feet of Lot 10,Lots 11,12,13,14,15 and the East 1/2 of Lot 16,Block 91,OFFICIAL
MAP OF THE CITY OF CLERMONT,according to the map or plat thereof as recorded in Plat Book
8,Page 17,Public Records of Lake County,Florida.
The affiant(s)is/are in full and exclusive constructive or actual possession of the above described premises and have
no knowledge of any claim or assertion of title to those premises,other than N/A.
There are no delinquent taxes or outstanding assessments or pending assessments of any kind against the property
for street paving,sewer,lighting or water services in respect to said property.
There are no unpaid bills or claims for labor or services performed or material furnished or delivered to said
property.
The affiant(s) is/are not involved in any court proceedings affecting the above described real property, or in any
proceedings in which a money judgement might be entered against them, and that the affiant(s)owe to the United
States no money for overdue unpaid taxes.
The affiant(s)have not and will not execute any instrument or do any act whatsoever which would or might in any
way affect the title to the foregoing property to the detriment of the purchasers.
All of the statements and representations set forth above are made in order to induce Performance Medical
Partners LLC,a Florida limited liability company to purchase or complete the purchase of the foregoing property
and to induce the title insurance company to issue title insurance in relation to said property.
AFFIANT(S) KNOW THAT IF ANY OF THESE STATEMENTS AND
REPRESENTATIONS ARE FALSE THEN AFFIANT(S) IS/ARE
OBTAINING MONEY UNDER FALSE PRETENSES.
Seller:
Ci o ?P ont,a Florida municipal corporation
474
/�. ►
By 1''*"ijr,y,City anager
Sworn to an. '.scn. .•fore me this / day of January,
2018 �!':.",�,� DANK f.AtANT1AtiIS
$1464,7
MYCOMMISSION AFP/12167
EXPIRES: 2,2020
Notary '�m4''of re'Bonded nvu Budget No WAN,
Printed Nae: MZA2 t S
My Commission Expires: \,.j v t t Z L020
(Seal)
File Number: 17-0469
Affidavit No Liens/Cash Sale
LEGAL DESCRIPTION
(attach to Mortgage)
Lot 9,the West 47 feet of Lot 10,Lots 11, 12,13, 14, 15 and the East 1/2 of Lot 16,Block 91,
OFFICIAL MAP OF THE CITY OF CLERMONT,according to the map or plat thereof
as recorded in Plat Book 8,Page 17,Public Records of Lake County,Florida.
Closing Affidavit
(Seller)
Before me,the undersigned authority,personally appeared Darren Gray,City Manager of the CITY OF
CLERMONT,A FLORIDA MUNICIPAL CORPORATION,on behalf of the Corporation the undersigned("Affiant"),
who being by me first duly sworn,on oath,depose(s)and say(s)that:
1. City of Clermont, a Florida municipal corporation ("Seller"), is the owner of and is selling the following described
property,to wit:
Lot 9,the West 47 feet of Lot 10,Lots 11,12,13,14,15 and the East 1/2 of Lot 16,Block 91,OFFICIAL
MAP OF THE CITY OF CLERMONT,according to the map or plat thereof as recorded in Plat Book 8,
Page 17,Public Records of Lake County,Florida.
2. The above described property is free and clear of all liens,taxes,encumbrances and claims of every kind,nature and
description of record whatsoever,except for mortgage or mortgages,if any,described in the Deed and except for real
estate and personal property taxes for the year 2018,which are not yet due and payable.
3. There have been no improvements,alterations,or repairs since acquisition by the Seller to the above described property for which the costs thereof
remain unpaid,that there arc no claims for labor or material furnished for repairing or improving the same,which remain unpaid since the acquisition
by Seller,and that there are no mechanic's,materialmen's or laborer's liens since acquisition by Seller against the above described property.
4. There have been no documents recorded in the Public Records of Lake County,subsequent to 12/7/2017,which affect
title to the Property and Seller has not entered into any contracts for the sale,disposition or leasing of the Property since
said date except as may have been disclosed to Nash Law Firm P.A.in writing,and Seller has no knowledge of any
matter affecting title to the Property.
5. The personal property contained in the building of said property,or on the said premises,and which,if any,is being sold
free and clear of all liens, encumbrances, claims and demands whatsoever. The Seller knows of no violations of
Municipal or County Ordinances pertaining to the above described property. No judgment or decree has been entered in
any court in this State or in the United States against said Seller which remains unsatisfied. There are no persons other
than Seller in possession of the above described property.
6. Seller agrees that in the event the current real estate or personal property taxes vary in amount from the figures used in
making the prorations used in closing the transfer and conveyance of the above described property to said buyers,then a
new proration and a correct and proper adjustment will be made upon demand.
7. Seller understands that Section 1445 of the Internal Revenue Code provides that a Buyer of a United States real property
interest must withhold tax if the Seller is a foreign person. To inform the Buyer that withholding of tax is not required
upon purchase of the above described property Seller certifies the following:
a. Seller is not a nonresident alien individual,foreign corporation,foreign partnership,foreign trust or foreign estate for
purposes of United States federal income taxation.
b. Seller's Tax Identification Number is 5(7-60 00 q d
c. Seller's address is: 685 West Montrose Street,Clermont,FL 34711
Closing Affidavit(Seller)-Page 1
File Number: 17-0469
Seller understands that this certification may be disclosed by Buyer to the Internal Revenue Service and that any false
statement made by Seller could be punished by fine,imprisonment,or both. Under penalties of perjury Seller declares that to
the best of his knowledge and belief the certification contained herein is true, correct and complete, and that Seller has
authority to sign this affidavit as either individual Seller or on behalf of an entity Seller.
8. This affidavit is given for the purpose of clearing any possible question or objection to the title to the above referenced
property and,for the purpose of inducing Nash Law Firm P.A.and Old Republic National Title Insurance Company
to issue title insurance on the subject property, with the knowledge that said title companies are relying upon the
statements set forth herein. Seller hereby holds Nash Law Firm P.A. and Old Republic National Title Insurance
Company harmless and fully indemnifies same(including but not limited to attorney's fees,whether suit be brought or
not,and at trial and all appellate levels,and court costs and other litigation expenses)with respect to the matters set forth
herein. "Affiant","Seller"and"Buyer"include singular or plural as context so requires or admits. This affidavit is made
under the penalties of perjury. Seller further states that he/she is familiar with the nature of an oath and with the
penalties as provided by the laws of the United States and the State of Florida for falsely swearing to statements made in
an instrument of this nature. Seller further certifies that he/she has read,or heard read,the full facts of this Affidavit and
understands its context.
Further Affiant sayeth not.
City of Clermont,a Florida municipal corporation
AS& i �
y, ity anager
State of o kc)
County of LA �
The foregoing instrument was acknowledged before me this I L — day of TA N J ,2018,by
Darren Gray,City Manager f the CITY OF CLERMONT,A FLORIDA MUNICIPALCORPORATION,on behalf
of the Corporation,he is personally known to me or(J has produced as identification.
(SEAL)
•
ro�,Rr •
P• � DANIEL F WQ7T7AR1S Notary =,.
*0,14• *FAV COMMISSION tFF 902157 •
EXPIRES:July 2,2020 Printed Name t�L m r+l 72 LS
14 o,,JBcn4 d Nu Budget Notary Sen 3
My Commission Expires: . s)`�j c 2-J20
Closingffidavit(Seller)-Page 2
File Number 17-0469
Seller's Closing Statement Page 1
FILE NUMBER: 052481
NAME OF BUYER: Performance Medical Partners LLC,a Florida limited liability company
Address of Buyer: 1900 Don Wickham Drive,#130,Clermont,Florida 34711
NAME OF SELLER: City of Clermont,a Florida municipal corporation
Address of Seller. 685 West Montrose Street,Clermont,Florida 34711
PROPERTY LOCATION: 865 West Montrose Street,Clermont,Florida 34711
SETTLEMENT AGENT: Nash Law Firm PA
Place of Settlement: PO Box 7844,Seminole,Florida 33775
SETTLEMENT DATE: 1/16/18 DISBURSEMENT DATE: 1/18/18
CREDITS: Amount
Contract sales price $785,000.00
Total Credits: $785,000.00
CHARGES: Amount:
Settlement or closing fee(Nash Law Firm PA) $200.00
Abstract or title search(Attorneys'Title Fund Services,LLC) $275.00
Overnight courier/wire fees(Nash Law Firm PA) $50.00
Attorney's Fees(DSK Law) $500.00
Title Insurance(Old Republic National Title Insurance Company/Nash Law) $4,000.00
State tax/stamps(Clerk of Court,Lake County) $5,495.00
Total Charges: $10,520.00
Cash due to seller. $774,480.00
THE UNDERSIGNED ACKNOWLEDGES RECEIPT OF A COPY OF THE FOREGOING SETTLEMENT STATEMENT,AGREES TO THE CORRECTNESS
THEREOF,AND AUTHORIZES AND APPROVES THE DISBURSEMENTS SET FORTH.
City of Clermont ' •
a Florid- . . 4/orporation
By: A. l i A
,:'4110. ..*.4W ,, 't1; - _c- ay, ity Manager
SCorporate Seal}
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