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2009/2010
Board Minutes & Records Expires q)20140 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Aiiii E�'01�1 Date J ' 2 `T 0 Business Address MO C1 "^ N C IU f -t©q Business Telephone - c( $2.( ° E-Mail -7(;,e) 3 co VI\cor,Y( . p12.4- NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). r Jav 44E-1-"pW ° 0 9 N C 't. 14-tS/ EL e{-(®1 .1V21 A Z5c N a 99 rJ'lc ( 2). PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY Lobbyist Signature State of Florida County of Collier .,4 The foregoing registration was sworn to and subscribed before me on this °' day ofW1 JZil () by71,00•I r{' , who is pef onaify t It wnto me or has produced FL L L C, is identi i a�pn and who did take an oath. m —i 7 0 co BY: CUGU t� 0 IOi = Deputy Cle`�h •"t •ublic The annual registration fee is $25.00 per Lobbyist, according to Collier County Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance 2007-24. Please make payment and mail to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts (at the address listed at the top of the form). Receipt# 007062038 3/23/2010 9:01:41 AM teRC% Dwight E. Brock E, c1/10 Clerk of the Circuit Court myt GO �_ `1/ = G�THF01,0` O �f@Li O, � CC Customer Deputy Clerk Clerk Office Location JAMES BOUGHTON BMR CASHIER Collier County Govt. Center JBMB OF NAPLES MinutesandRecords @CollierClerk.com Building F, 4th Floor 760 CLAREDON COURT 239-252-2646 3301 Tamiami Trail East NAPLES, FL 34109 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 Cash Tendered: ($25.00) BALANCE DUE: $0.00 Page 1of1 CCu l® C©CC