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2012/2013 Collier County Clerk of Courts Expires 9 2013 3299 Tamiami Trail E. (CLce.r of't«c only) Suite 401,Bldg. F,4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Alissa. Downinn Date 11/20/12 . Business Name Novartis Vaccines and Diagnostics Business Address do Nielsen Merksamer. et al._ 2350 Kerner Blvd. Ste. 2.50 City San Rafael State CA Zip Code 94901 Business Telephone 415) 389-6800 Contact Person _Jennie Unger Skelton Lobbyist E-mail jskcitonr'nm2ovaw.corn ,'notice for Lobbyists: The annual registration fee is 525.00 per Lobbyist,per Collier County Ordinance No. 2003-53,and amended by Ordinance 2004-05 and Ordinance 2007-24. Payments made out to: Collier County Clerk of Courts or Dwight E. Brock,Clerk of Courts (ADDRESS LISTED ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1.Name Novartis Vaccines and Diagnostics- 2.Name Address _c/o Nielsen Merksamer. et al. 235() Kerner Blvd., Ste. 250 Address City San Rafael Zip Code 94901 Cite Zip Code 3. Name 4. Name Address Address City Zip Code Cite -. Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier Lem f Lo twist Signa re This registration was sworn (or affirmed) and subscribed before me this 'L day o Iw il;Iyi r20 12 - by lcl__r�siz c,(,, t -th _ 7 Personally Known k ✓ ) Produced I D _ �",'. NANCY J SABO 1 epu p erk/ ulJlte T -7 �tn Type of ID Produced t L l�'t�l ' :; .'.�T•i2��Vo_tary Public -State of Florida ` 1 _ My Comm.Expires Jan 25,2015 ,/ .����a' Commission # EE 58598 ( Revised 0812011 °°1, t ,,, Bonded Through National Notary Assn. 0 / � _ ∎. Receipt# 007295913 11/28/2012 9:03:12 AM ,R,,„ Dwight E. Brock Clerk of the Circuit Court DD I‘C-:*",Qj ( U L_ ( C-7 L _1\<\CPMCc-±±7(-c-S-)F --FDJ Customer Deputy Clerk Clerk Office Location ALISSA DOWNING BMR CASHIER Collier County Govt. Center NOVARTIS VACCINES & MinutesandRecords @CollierClerk.co Building F, 4th Floor DIAGNOSTICS m 3299 Tamiami Trail East, Suite 2350 KERNER BLVD STE 250 239-252-2646 401 SAN RAFAEL, CA 94901-5596 P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 1 BMR Lobbyist Registration $25.00 $25.00 TOTAL AMOUNT DUE $25.00 Check#6402 ($25.00) BALANCE DUE $0.00 Note: Disclaimer:All transactions are subject to review/verification.The Clerk reserves the right to correct for clerical errors and to assess or refund charges as needed. ©00111h1T©lk;Aog ni Page 1 of 1