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2013/2014
Clerk to the Board,Minutes&Records Dept. Expires ©-1 laiDitit 3299 Tamiami Trail East, Suite#401 (Staff use only) Building F,4th Floor Naples,FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name John Broderick Date May 23, 2014 Business Address 17837 Murdock Circle, Port Charlotte, FL 33948 Business Telephone 941-235-6900 E-Mail jbroderick@akitsonpartners.com NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). Kitson& Partners, 17837 Murdock Circle, Port Charlotte, FL 33948 2). (PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY) Lobbyist Signature State of Florida County of Collier o The foregoing registration was sworn to and subscribed before me on this a-5 (° - day of a y , a'o i ,by -S0-1,n 6(ode K ,who is personally known to mns or has produced as identification and who did take an oath. 49"'''''°4 ".•--,THERESA 4■NN JURC ��' " MY COMMISSION#FF087445 I. BY: `.+�.��e;= EXPIRES April 2, 2018 (ao7)398-0153 FlorldallotaryService.com Deputy Clerk/Notary he 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# 007463128 6/25/2014 3:51:25 PM Dwight E. Brock Clerk of the Circuit Court k ; - , i _ Z LI .. Customer Deputy Clerk Clerk Office Location KITSON EVERGREEN LLC BMR CASHIER Collier County Govt. Center 4500 PGA BLVD STE 400 MinutesandRecords @CollierClerk.co Building F, 4th Floor PALM BEACH GARDENS, FL m 3299 Tamiami Trail East, Suite 33418-3995 239-252-2646 401 P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 5 BMR Lobbyist Registration $25.00 $125.00 TOTAL AMOUNT DUE $125.00 Check# 12226 ($125.00) 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. ©CID EIMCgETC1b7Pzogalif0 Page 1 of 1