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2010/2011 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 Expires: 1 /~I/ I BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name: . lane E Eichhorn Date: 4-70-:W11 Business Address: 7400 Tamiami Trail N Naples, Florida 334108 Business Telephone: ~~ ')J, ,)6!! Emall: eicbba[D@abbinc earn NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: PLEASE ATTACH ADDITIONAL SHEETS IF NECESw W~( (/t/tbvK ) O"lJt SIgnature State of Florida County of Collier The foregoing registration was svv~~n to and subscribed before me on this day of ~;'A.'./ 02//1 ,y~ ~ ~~ or:JJ_~_s..pr~--.-_______- 07/ , who is personally known to me ...... an oath. __..iiS-idel,tiril.dLiO'II and who did take l BY: The annual registration fee is $25.00 per Lobbyist, according to Collier county Ordinance No. 2003-53,as amended by Ordinance 2004-05 and Ordinance 2007-24. Please make payment and mail to:Collier County Clerk of Courts or Dwight E. Brock, clerk of Courts (at the address listed at the top of the form). Receipt# 007156045 4/28/2011 9:31:17 AM Dwight E. Brock Clerk of the Circuit Court @v110CC30([)O ~C~C~@DlrDQ Customer JANE EICHHORN AGNOLl, BARBER, & BRUNDAGE, INC. 7400 TAMIAMI TRL N NAPLES, FL 34103-3712 Deputy Clerk BMR CASHIER M inutesand Records@CollierClerk.com 239-252-2646 Clerk Office Location Collier County Govt. Center Building F, 4th Floor 3299 T amiami Trail East, Suite 401 P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY 1 DESCRIPTION BMR Lobbyist Registration UNIT COST $25.00 TOTAL AMOUNT DUE: Check# 13894 BALANCE DUE: AMOUNT $25.00 $25.00 ($25.00) $0.00 (0@uuo @[f(0u @[f~o (9;@[f[f[) Page 1 of 1