2010/2011
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
EXPires~t I
Name
BOARD OF COUNTY COMl\1ISSIONERS
LOBBYIST REGISTRATION FORM
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Date
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Business Address
Business Telephone Ce,L/3 -7 crJ...L E-Mail b (..0 f I'\et( @ ~, I ,'e... 4vclf;'~M.. o~
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY
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State of Florida
County of Collier
The for~~ registration was sworn t9-'!!ld subs~ril>ed before fi.l,' "~"'",,",o,,n, tl1i.,~;}~~
day of ~r. , bf'(\( . l...()Y"~ , who11~,~er~~~l1v.~tro~I(~~,
me or ~as produced <'~\, /~"t.~~Rc,.hon a~ .
who dId take an oath.;. ,.,if ;.....: ~;, '. .
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BY: ...(2;~:
l<,
Deputy CI rkIN
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# 007108882
9/28/2010 10:35:46 AM
Dwight E. Broek
Clerk of the Circuit Court
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Customer
BRADLEY CORNELL
1020 8TH AVE S STE 2
NAPLES, FL 34102-6959
Deputy Clerk
BMR CASHIER
M inutesand Records@CollierClerk.com
239-252-2646
Clerk Office Location
Collier County Govt. Center
Building F, 4th Floor
3301 Tamiami Trail East
P.O. Box 413044
Naples, Florida 34101-3044
1 Product
QUANTITY
1
DESCRIPTION
BMR Lobbyist Registration
UNIT COST
$25.00
TOTAL AMOUNT DUE:
Check# 2022
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
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