2015/2016 Clerk to the Board, Minutes&Records Dept. Expires 1 C(
3299 Tamiami Trail East, Suite#401 (Staff use only)
Building F, 4th Floor
Naples, FL 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Jessica Crane Date 9-14-15
Business Address 1495 Smith Preserve Way
Naples Florida 34102
Business Telephone 239-262-0304 E-Mail Cola p�COnS @rvanCy.Org
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1). Conservancy of Southwest Florida
1495 Smith Preserve Way
Naples, Florida 34102
2).
(PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY)
obbyist Signature
State of Florida
County of Collier
The foregoing registration was sworn to and subscribed before me on this I -f
day of 3t., VOIS ,by 74 sS■ co Oren . , who is personally known to
me or has produced as identification and
who did talkofttidlballi -
.e ,7",„s,„ MARGARET ANN DMD18
's Notary PubNC•$1#M Da r$cd4a
3• `My Comm.Expires Nov 12,2017 C L
' , �'.� commis:Ion•ff 48794 BY: c, ,`��
„a ''d v' Bonded Through National Notary Asst. 0
Deputy Clerk/Notary Public
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.
INGVCI`JLft WV I,.JV I IVY
9/16/2015 3:40:45 PM
Dwight E. Brock
Clerk of the Circuit Court
Customer Deputy Clerk Clerk Office Location
M. CARROZZO, J. CRANE, A. BMR CASHIER Collier County Govt. Center
CROOKS, J. HECKER, R. MinutesandRecords @CollierClerk.co Building F, 4th Floor
MOHER, L. PEMBERTON & C. m 3299 Tamiami Trail East, Suite
WEBER 239-252-2646 401
CONSERVANCY OF SW P.O. Box 413044
FLORIDA Naples, Florida 34101-3044
1495 SMITH PRESERVE WAY
NAPLES , FL 34102
1 Product
QUANTITY DESCRIPTION UNIT COST AMOUNT
7 BMR Lobbyist Registration $25.00 $175.00
TOTAL AMOUNT DUE $175.00
Check# 14500 ($175.00)
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.
Cg[1[111g1TagiltagaM Page 1 of 1