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2013/2014 Clerk to the Board, Minutes & Records Dept. Expires Y 3299 Tamiami Trail East, Suite#401 (Staff use o ,y) Building F, 4th Floor Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Steven C. Hartsell, Esq. Date 09-26-2013 Business Address Pavese Law Firm, P.O. Drawer 1507 Fort Myers, FL 33902-1507 Business Telephone 239-336-6244 E-Mailstevehartsell@paveselaw.com NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). ULI Southwest Florida 12355 Collier Blvd. , Suite B Naples, FL 34116 2). (PLEASE ATTACH ADDITIONAL SHEETS,IF NEC ARY) L Lobbyist Signature State of Florida County of Collier The foregoing registration was sworn to and subscribed before me on this Avl day of 4w , by 64-wry Q. apc„...4-c,i who is sersona a known to me or has produced as '4 e 'fie. an an • •i• a - .n o.t . Notary Public State of Florida / 1 Sandra H Smith My Commission FF 008313 B, „���r - a pd� Expires 0612712017 :. - otary Public The annual registration fee is $25.00 per Lobbyist, according to Collier County Ordinance No. 2003-53, as amended by Ordinance 2004-05, Ordinance 2007-24 and Ordinance 2013-39. Please make payment to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts and mail to the address listed at the top of the form. Receipt# 007381787 9/30/2013 2:57:25 PM j�,u<,,;,\J\ Dwight E. Brock } Clerk of the Circuit Court k 0 r7YF,aRC •, ( 0 ffgo W (-' (— ° TR Customer Deputy Clerk Clerk Office Location STEVEN HARSELL & BMR CASHIER Collier County Govt. Center KATHLEEN OPPENHEIMER- MinutesandRecords @CollierClerk.co Building F, 4th Floor BERKEY m 3299 Tamiami Trail East, Suite PAVESE LAW FIRM 239-252-2646 401 PO BOX 1501 P.O. Box 413044 FORT MYERS, FL 33902-1501 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 2 BMR Lobbyist Registration $25.00 $50.00 TOTAL AMOUNT DUE $50.00 Check# 123456 ($50.00) 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. ©©[1[1171®ITChrdhoggal Page 1 of 1