2018/2019 Clerk to the Board, Minutes &Records Dept. Expires se 0
3299 Tamiami Trail East, Suite#401 (Staff use only)
Building F, 4th Floor
Naples, FL 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Nancy Conicella Date June 29, 2017
Business Address Lowndes, Drosdick et al, 215 N. Eola Drive,
Orlando, FL 32801
E-Mail nancy.coniceIIa@lowndes law.com
Business Telephone 407-843-4600
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1) Walmart, 9885 Collier Boulevard, Naples, FL 34114
2).
(PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY)
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Lobbyist Signature
State of Florida
County of Colliei
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The foregoing registration was sworn to and subscribed before me on this
day of tJ Ot, , by Nancy Conicella , wh is persaaal l�known to
,tree or has produced as identification and
who di. - anitaVaRyN g
' NOTARY PUBUC
lt.4,�_STATE OF FLORIDA BY:
._ . Cam*00028284
Expires 9/1212020 Dep,ty 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.
Receipt# 007813746
7/11/2017 8:26:10 AM
,H ,t Dwight E. Brock
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Customer Deputy Clerk Clerk Office Location
NANCY CONICELLA BMR CASHIER Collier County Govt. Center
LOWNDES, DROSDICK, MinutesandRecords@CollierClerk.co Building F, 4th Floor
DOSTER, KANTOR & REED m 3299 Tamiami Trail East, Suite
215 N EOLA DR 239-252-2646 401
ORLANDO, FL 32801-2028 P.O. Box 413044
Naples, Florida 34101-3044
1 Product
QUANTITY DESCRIPTION UNIT COST AMOUNT
1 BMR Lobbyist Registration $25.00 $25.00
TOTAL AMOUNT DUE $25.00 1
Check#282986 ($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.
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