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The construction of the medieval basilica on a pre-existing early Christian building is not confirmed. According to tradition, during the papacy of Urban II (1088-1099), the relics of various saints from Palermo were transferred from the Basilica of S. Ninfa in Palermo to S. Maria in Monticelli. The first certain mention of the church, which still exists today, is found in the Liber Pontificalis from the year 1100/01, when Pope Paschal II (1099-1118) consecrated it. It is believed that the basilica was built around 1100, using a heterogeneous set of spolia columns and capitals. All that remains of the 12th-century basilica are the outer walls and the five-storey bell tower, while all that remains of its rich furnishings is a mosaic fragment in the apse depicting the face of Christ and a few other decorative remains. In 1580, there was still a Cosmatesque floor. During the excavation of the pillars of the nave in 1715, a floor was discovered 55 cm below the existing level, made of fragments of serpentine, porphyry, granite, marble, alabaster and breccia, similar to those found in other Roman basilicas. Part of this ancient floor has been preserved near the entrance to the church. During the renovation of the church in 1715/16, traces of frescoes were found in the upper parts of the nave.