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2012/2013
.irrt O( Collier County Clerk of Courts Expires 9 2°15 3299 Tamiami Trail E. (Clerk' office only) Suite 401,Bldg. F,4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name EMI L 0 <</7/o% U Date ,(96% 7/c 0".3 Business Name / O U Arv17 �SSoC fA/� crJ L • L. C-• Business Address / 9¢© C' 1(-AM/. iS ,0/ZI(J�. City MA d SL AA)/J State b2,OF Zip Code .5+4'' Business Telephone Z7� ��8COO Contact Person• IUO ✓. Lobbyist E-mail e/R Q Reo Notice for Lobbyists: The annual registration fee is$25.00 per Lobbyist, per Collier County Ordinance No.2003-53, and amended by Ordinance 2004-05 and Ordinance 2007-24. Payments made out to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts (ADDRESS LISTED ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1.Name Alievt.a4 axes pl-44440&,(2. Name /5/7x2 //k40/4/146307- Address ZI 1712.O;-tPec-r" /2dL Address 3Z Z /. 44/e- MAZY 30i> City /04/9( /f Zip Code 39 - City (1/L,t A40a41 Zip Code 377 3.Name P t.- fitoll t9(IAC 4.Name l-/ 4474-,5 ,$tr E Address 3Z3 Cite MAP/ LL/(7 Address 3Z3Z r AiLt' /1101241 4 V/? City LAW-P__, /'`?12Y Zip Code 3i" '1 O City J MAW(z i Zip Code 3z 7 p (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier 4' I 16°€C---(---- Lobbyist Signature • This registration was sworn(or affirmed) and subscribed before;t t)11S �\7Y1e. , 20 13,by EIh{L'o 'IDbi -v PI Personally Known BY, ;;4 ._ /At'? A1' Produced ID ;� "city �`pr •er ' + 'c �� Type of ID Produced L �� Revised:08/2011 Receipt#007347512 6/7/2013 3:44:45 PM , :h { Dwight E. Brock Clerk of the Circuit Court D-2 C_C) ( LM i.. J Customer Deputy Clerk Clerk Office Location EMILIO ROBAU BMR CASHIER Collier County Govt. Center ROBAU AND ASSOCIATES, MinutesandRecords @CollierClerk.co Building F, 4th Floor LLC m 3299 Tamiami Trail East, Suite 940 CAXAMBAS DR 239-252-2646 401 MARCO ISLAND, FL 34145- P.O. Box 413044 5908 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#2509 ($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. ©®01:111®TglgenKoggn Page 1 of 1