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2009/2010 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 Expires q I dolo I BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name At-Jar> Jf!/P~11SP 7 'Ie ~ '~' ~ Business Address 2631 - It..sf A/{...,j G-tfc f~ ~c ') cAJ{jIZ'/~5 I It. 0~ /20 / I I - BusinessTelephone ;;!o '7.%,/, /610 E-Mail /l!,~iue/.I2.J1~~ -r.-" RQI11S7--Htc~ ~( NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). /-::; !/ftMOlile.... LLCl.. t!ctA I /l1ut)II~1 J- ,I)~cyc)~ ~C-, / ()UlI iy A<,-;J, flJ';;t:/fu"1 ;Uffi.:;. felL'Ll, 2). ::;;-F ;::; 11M '3 1.10.. I Sign~' -- State of Florida County of Collier The fo~ng re-ttration was sworn to and subscribed before me on this d~ day of :t' " c '1 , by , who is personally known to me or has produced fL ~L_ as identification and who did take an oath. BY: Deputy Clerk/Notary Pyblic The annual registration fee is $25.00 per Lobbyist, according toCoUlerCoun Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordjilan~ec 200'-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 tbe form). Receipt# 007028088 10/20/200910:34:27 AM Dwight E. Brock Clerk of the Circuit Court @VVO@O([)o ~@@@o~Q Customer MICHAEL R. RAMSEY RAMSEY, INC. 2631 4TH ST NW NAPLES, FL 34120-1306 Deputy Clerk BMR CASHIER M inutesandRecords@CollierClerk.com 239-252-2646 Clerk Office Location Collier County Govt. Center Building F, 4th Floor 3301 Tamiami Trail East P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY 1 DESCRIPTION BMR Lobbyist Registration UNIT COST $25.00 TOTAL AMOUNT DUE: Cash Tendered: BALANCE DUE: AMOUNT $25.00 $25.00 ($25.00) $0.00 ~@[j [j !j(~!l~O &J!l!ko @@[f[ffJ Page 1 of 1