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2015/2016 Collier County Clerk of Courts Expires v 3299 Tamiami Trail E. (Clerk's race only) Suite 401,Bldg. F,4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Ma-\-wv,,,.) FI,p,Ces' Date 1113110 Business Name uJ,o.tscsrc. ,�,re \_nenkooroz, Business Address Z*2sZc 7pcmoc6 �(-DA , Zc City \oete s State F L Zip Code 3LW S Business Telephone CoSS4 Contact Person P.7j , c\ ,06- Lobbyist E-mail Nt-Nrets @(11,ie,5.1 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 ( S, (9tr✓tk. 2. Name A&, y�c. Address t 'lstod. Address ZS Qort R ecsA City Vkissw, I • Zip Code I,Z,s3--\ City }-\s,n tJ■ Zip Code tZS 3ra 3.Name-0146 cA.,ce d 4.Name'gp►t� fin. Z+we�.wes , l,>rG Address \I( �r, ,\ 'Q . Address 011{j Cc�e Mares rNC. ZQ4(o • City 4uM6,H , S�, Zip Code Zcez c City Awes 1s\c�,d, �(, Zip Code 34W5 (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier Lobbyist Signa ire This registration was sworn(or affirmed)and subscribed before me this S day of, 1.173,30047E4 20 l ,by 1N4" •��,V a..S - ---Personally Known BY: Produced ID TIPp"*y clink/Nat 'Pxliic Type of ID Produced ter PG'., NOEL A HOWSTER *: ,,' : ;. c*= MY COMMISSION#EE 164786••rv� EXPIRES:March 23,2016 •��of ti Bonded Thru Notary Public Undenfitlemised:08/2011 RG{rG1FJVI' VV/V 1YJJU 11/9/2015 2:45:46 PM 4t_,,,,:c,;,,„,„.,,,,,,,,, Dwight E. Brock \ Clerk of the Circuit Court 'I o ffcI ER Customer Deputy Clerk Clerk Office Location MARK WOODWARD & BMR CASHIER Collier County Govt. Center MATTHEW P. FLORES MinutesandRecords @CollierClerk.co Building F, 4th Floor WOODWARD, PIRES & m 3299 Tamiami Trail East, Suite LOMBARDO, P.A. 239-252-2646 401 3200 TAMIAMI TRL N STE 200 P.O. Box 413044 NAPLES, FL 34103-4108 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 2 BMR Lobbyist Registration $25.00 $50.00 TOTAL AMOUNT DUE $50.00 Check#4010 ($50.00) 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. ©00111111g0g @0EID Page 1 of 1