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2014/2015 Clerk to the Board, Minutes & Records Dept. Expires !2J 3299 Tamiami Trail East, Suite#401 (Staff use only Building F, 4th Floor Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Kristina Johnson Date 12-3-14 Business Address 1605 Hendry Street Fort Myers FL 33901 Business Telephone 239-418-0691 E-Mail Kristina @DeLisiFitzgerald.com NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). RaceTrac Petroleum, Inc. 3225 Cumberland Boulevard, Suite 100 Atlanta GA 30339 2). (PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSAR Lobbyist Sit ature State of Florida County of Collier The foregoing re istration was sworn to and subscribed before me on this (EA day of rz06y bfil & ,)„11()So1-) , who is personally known to me or has produced as identification and who did take an oath. � o`''a�`V; CRYSTAL A FITZGERALD BY. '+ MY COMMISSION#FF024856 -k„,,op.:' EXPIRES June 6,2017 Deputy Clerk/Notary Public (007)398-0153 FloridallotaryService.com 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. I ., l F.J Iff V V I.JV Q ) I 12/8/2014 2:17:27 PM Kt.,.. Dwight E. Brock ` Clerk of the Circuit Court 1 1 �: 1 x` gggc- ED 0 rr+t':ciK �C- p Customer Deputy Clerk Clerk Office Location KRISTINA JOHNSON BMR CASHIER Collier County Govt. Center DELISI FITZGERALD MinutesandRecords @CollierClerk.co Building F, 4th Floor 1605 HENDRY ST m 3299 Tamiami Trail East, Suite FORT MYERS, FL 33901-2909 239-252-2646 401 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# 5000 ($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. g [Iri®° Er© ° ggIU Page 1 of 1 A t Martha S. Vergara From: Kristina Johnson <kristina @delisifitzgerald.com> Sent: Wednesday, April 22, 2015 11:50 AM To: Martha S. Vergara Subject: RE: Lobbyist Updates Martha, For the lobbyist form renewal please find my information listed below: Lobbyist Info: Kristina Johnson, DeLisi Ftizgerald, Inc. 1605 Hendry Street Fort Myers FL 33901 Entity Represented: RaceTrac Petroleum, Inc. 3225 Cumberland Boulevard, Suite 100 Atlanta GA 30339 Does this satisfy the quarterly renewal requirement? Thanks, Kristina Johnson, P.E., LEED AP DELIS! FITZGERALD, IC. Planning-Engineering-Project Management 1605 Hendry Street Fort Myers, FL 33901 P: (239)418-0691 F: (239)418-0692 kristina @delisifitzgerald.com www.delisifitzgerald.com From: Martha S. Vergara [mailto:Martha.Vergara@collierclerk.com] Sent: Wednesday, April 22, 2015 11:15 AM To: 'anderson @abbinc.com'; 'ktaylor @cecifl.com'; 'jmbswte @msn.com'; 'karenbishop @pmsnaples.com'; 'bcornell @audubonwe.org'; 'jorgec @primegroupus.com'; 'kathy @cbia.net'; 'Idejohn @johnsoneng.com'; jskelton @nmgovlaw.com'; 'cpanczykowski @mcguiredevelopment.com'; 'pam @jrevansengineering.com'; Kristina Johnson; 'dkirby @kiterealty.com'; 'jkorn @cohenlaw.com'; 'frankm @hglsaw.com'; 'timothyr @hgslaw.com'; 'mcgeeassoc @aol.com'; 'jmorey @bsk.com'; 'picklaw @earthlink.net'; 'ryovanovich @cyklawfirm.com' Subject: Lobbyist Updates Hello All, As a final reminder prior to Friday's deadline for January's update. Starting Monday, April 27th, 2015 if you haven't updated you will be dropped from the Lobbyist list and will be required to re-register along with paying the lobbying fee again. The annual fees and quarterly updates are due as follows: Renewal Due Quarterly Update Due Quarterly Update Due Quarterly Update Due Oct.1 - registration January (e-mail) April (e- mail) July (e-mail) form & fee For the updates all we are asking for is an e-mail with all of your lobbyist listed and any additions/deletions to your client list that they lobby for. If you have any questions feel free to call. Thanks, Martha Vergara, BMR Senior Clerk Minutes and Records Dept. Clerk of the Circuit Court & Value Adjustment Board Office: (239) 252-7240 Fax: (239) 252-8408 E-mail: martha.vergara(a�collierclerk.com Please visit us on the web at www.collierclerk.com This electronic communication is confidential and may contain privileged information intended solely for the named addressee(s). It may not be used or disclosed except for the purpose for which it has been sent. If you are not the intended recipient,you must not copy,distribute or take any action induced by or in reliance on information contained in this message. Unless expressly stated, opinions in this message are those of the individual sender and not of the Office of the Clerk of the Circuit Court of Collier County. If you have received this communication in error, please notify the Clerk's Office by emailing helpdesk@collierclerk.com quoting the sender and delete the message and any attached documents.The Collier County Clerk's Office accepts no liability or responsibility for any onward transmission or use of emails and attachments having left the CollierClerk.com domain. Under Florida Law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request,do not send electronic mail to this entity. Instead, contact this office by telephone or in writing. 2