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2016/2017 Clerk to the Board, Minutes &Records Dept. Expires oQ 1, 3299 Tamiami Trail East, Suite#401 (Staff use only) Building F, 4th Floor Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NameAshley D. Lupo, Esq. Date 10/13/16 Business Address c/o Roetzel & Andress, 850 Park Shore Drive Third Floor, Naples, FL 34103 Business Telephone 239-649-6200 E-Mailalupo@ralaw.com NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1) CC-Naples, Inc. (Vi), 7100 South Wacker Drive Suite 900, Chicago, IL 60606 2) Villages at Stella Maris Condominium Association, 2300, 285 Cays Drive, Suite 2303, Naples, FL 34114 (PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY) 'lam ftridi° Lobbyist Signature,,,. State of Florida County of Collier The foregoing registration was frworn to and subsc ibed before me on this 1 L\ day of ' - t 3 + ,by �� " ° ' ,who is personally known to me o - •au es _ _ _ ' as identification and who ( d,tt ' i oath. TRINA SHATTO 4 �,�. Notary Public-State of Florida My Comm. Expires Jun 21,2017 Commission# EE 881236 BY; Bonded Through National Notary Assn. �1 Deputy 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. Villages at Stella Maris Condominium Association 2800, Inc. 385 Stella Maris Drive North Naples, FL 34114 Receipt#007722641 10/17/2016 2:44:28 PM Dwight E. Brock Clerk of the Circuit Court �A. Customer Deputy Clerk Clerk Office Location ASHLEY D. LUPO BMR CASHIER Collier County Govt. Center ROETZEL & ANDRESS MinutesandRecords@CollierClerk.co Building F, 4th Floor 850 PARK SHORE DR m 3299 Tamiami Trail East, Suite NAPLES, FL 34103-3587 239-252-2646 401 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 Check# 1028205 ($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. ©Q11111® Q® gg[g] Page 1 of 1