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2016/2017 Clerk to the Board, Minutes &Records Dept. Expires• JA 1 3299 Tamiami Trail East, Suite#401 (Staff use only) Building F, 4th Floor Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name (2 CzN; e \\ 0. S Date `\ Business Address a,1 , '\ \ Business Telephon `1.—Vac( E-Mail tlane_sc. CCr (2.e \0.,m,\pccry €5"--\Q�,,� cam\ NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). Y�LLiV)‘A at-1r SAU'e F->U� 1c6 CAV GC- \\) C , 2). (PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY) 4AALd AL.". Lobb ist Signatu e State of Florida County of Collier 7 el The foregoing registration was sworn to and subscribed before me on this -414vey t ot< day of A1QIIN;i ii ci , by Allqv.c-r C O n 1C2Lek , who is personally knot n to me or has produced as identification and who did take an oath. KATHRYN MTH NOTARY PUBLIC STATE OF FLORIDA BY: :.': COM*00029284 • • Expires 9/12/2020 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. Lowndes Drosdick Tl Doster NANCY CONICELLA Kantor & Associate Reed PA. nancy.conicella@lowndes-law.com 215 North Eola Drive,Orlando,Florida 32801-2028 ATTORNEYS AT LAW T: 407.418.62571 F: 407-843-4444 MAIN NUMBER: 407-843-4600 III MERITAS LAW FIRMS WORLDWIDE February 9, 2017 Clerk to the Board, Minutes & Records Department 3299 Tamiami Trail East Suite 401 Building F, 4th Floor Naples, FL 34112 Re: Lobbyist Registration Form Dear Clerk: Enclosed is my completed Board of County Commissioners Lobbyist Registration Form, together with our firm check in the sum of $25.00 in payment of the annual registration fee. Please proceed to complete the registration in Collier County so I may lobby on behalf of Walmart Stores. Please let me know if you need any further information. Sincerely, (I(' 601/(4,c C - I Nancy Conicella NC/rnlc Enclosures 0909051\173229\3407288v1 www.lowndes-law.com Receipt#007762156 2/16/2017 9:58:26 AM ; f O,ti Dwight E. Brock Clerk of the Circuit Court J . i� ) 1 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 PA 239-252-2646 401 215 N EOLA DR P.O. Box 413044 ORLANDO, FL 32801-2028 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#280127 ($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. ©OQQil@Q(gg0E10 Page 1 of 1 Update Collier County Clerk of Courts Expires gIf2 3299 Tamiami Trail E. (Clerk's oice Only) Suite 401, Bldg. F, 4th Floor Naples, Florida 34112 COLLIER COUNTY LOBBYIST REGISTRATION FORM Lobbyist Name Nancy Conicella Date 4/5/17 Business Name Lowndes, Drosdick, Doster, Kantor & Reed, P.A. Business Address 215 N. Eola Drivr City Orlando State FL Zip Code 32801 Business Telephone 407-843-4600 Contact Person Lobbyist/Contact E-mail nancy.conicella@lowndes-law.com Notice for Lobbyists: The annual registration fee is$25.00 per Lobbyist,per Collier County Ordinance No. 2003-53, as amended by Ordinance 2004-05, Ordinance 2007-24 and Ordinance 2013-39. Payments made out to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts(ADDRESS ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1.Name Walmart 2. Name Address 9885 Collier Boulevard Address City Naples Zip Code 34114 City Zip Code 3.Name 4.Name Address Address City Zip Code City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier Lob ist Signat re This registration was sworn (or affirmed) and subscribed before me this 5 "A day of 11411_, , 20 l 1 , by IVunc►/ Cance l/e . Personally Known BY: Produced ID KATHRYN SMITH De ity C _k/Notary Public Type of ID Produced . . ARY pUBUC �3 STATE OF FLORIDA .�.:•-4 Cane 03029204 • Expires 9/12/2020 Revised:08/2014 Receipt# 007781533 4/11/2017 8:21:41 AM Dwight E. Brock Clerk of the Circuit Court r� Customer Deputy Clerk Clerk Office Location NANCE 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 P.A. 239-252-2646 401 215 N EOLA DR P.O. Box 413044 ORLANDO, FL 32801-2028 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#281272 ($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. ©0D1Y1® 11® gQ[lL�fL Page 1 of 1