2013/2014 Clerk to the Board,Minutes&Records Dept. Expires pq (c)Olt-
3299 Tamiami Trail East, Suite#401 (Staff use only)
Building F,4th Floor
Naples,FL 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Terrence R. Holihen Date 6-6-2014
Business Address 4500 PGA Boulevard,Suite 400, Palm Beach Gardens, FL 33418
Business Telephone 561-624-4000 E-Mail tholihen @kitsonpartners.com
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1). Kitson &Partners
4500 PGA Boulevard,Suite 400
Palm Beach Gardens, FL 33418
2).
(PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY)
Lobbyist Signature
State of Florida
County of J611i 'Palm Beach
The foregoing registration was sworn to and subscribed before me on this
day ofl&: , ,who is personally known to
me or41wradcxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxiascxdentifintion and
who did take an oath.
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Deputy Clerk/Notary Public E..... .y'%r
The annual registration fee is$25.00 per Lobbyist,according to Collier County ‘P°�0 Jay 20?,-lq!p\
Ordinance No.2003-53,as amended by Ordinance 2004-05,Ordinance 2007-24 = � N
and Ordinance 2013-39. _*: •"'''
Please make payment to: Collier County Clerk of Courts or i2; 00560
Dwight E. Brock,Clerk of Courts and mail to the address listed at the top of the fori# 9 �s e� �;.� �'
f����iitiaLfCSTP.....�,
Receipt# 007463128
6/25/2014 3:51:25 PM
Dwight E. Brock
Clerk of the Circuit Court
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.
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