2003/2004 o'/
County of Collier
CLERK OF THE CIRCUIT COURT
COLLIER COUNTY COURTHOUSE
3301 TAMIAMI TRAIL EAST
P.O. BOX 413044
NAPLES, FLORIDA 34101-3044
ORIGINAL
OFFICIAL RECEIPT
When Validated
BY: _ANN J
DEPUTY CLERK
RECEIPT: 4064477 DESCRIPTION AMOUNT
NAME : JARED R. BROWN, P . E . LOBBYIST 25 . 00
PAYOR: JARED R. BROWN, P . E .
REFNC : APJ
DEPT: BOARD MINUTES AND RECORDS TOTAL DUE : 25 . 00
Page 01 of 01
_ . Q 75980
• -`COLLIER COUNTY
3301 Tamiami Trail North
Naples, FL 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
NAME: Jared R. Brown, P. E. DATE: October 2, 2003
BUSINESS : WilsonMiller, Inc.
3200 Bailey Lane, Suite 200
Naples, Florida 34105
NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1 . Collier County Housing Authority, 1800 Farm Worker Way, Immokalee,
Florida 34142
2 . Collier County Airport Authority, 2003 Mainsail Drive, Naples,
Florida 34114
3 . Seminole Tribe of Florida, 6300 Stirling Road, Hollywood, Florida
33024
4 . Collier County Public Works, 3301 E. Tamiami Trail, Naples, Florida
34112
5. Habitat for Humanity of Collier County, 11550 E. Tamiami Trail,
Naples, Florida 34112
ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY.
Vy "."5.1---_gnature t
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing registration was sworn to and subscribed before me on
this the 2nd day of October, by Jared R. Brown, who is personally
known to me or who has produccd as idcntification and
who did take an oath.
•'Y'' m Kennedy
�s fir'% Pa
?, i :ka MY COMMISSION# DD008069 EXPIRES BY:
;., .% June 10,2005 Clerk/Notar Public
'T, o`‘ BONDED THRU TROY FAIN INSURANCE INC. Y
Please Note: 1) Failure to renew this registration by the renewal date
will result in the placement of this registrant on a "status unknown"
list . 2) If one wishes to revoke this registration, a "Lobbyist
Withdrawal" form must be filed with the Clerk to the Board.
0/2/2003-128640 Ver.011-SGUAJARD
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