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2018/2019
Collier County Clerk of Courts Expires cq( zocci 3299 Tamiami Trail E. (Clerk's oce only) Suite 401,Bldg. F,4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name ap,(Z c "" FX RG J) ate e C l L/) 070 ( Business Name Lb/0 B 1.1, (-6 Bo y Business Address 3 115 Im i4CT O ('I t PnAi D Pei U C City / - / �- State - Zip Code 3V Business Telephone23q`0291Z c?C7G Contact Person G-/tr er Lobbyist E-mail 6"-c ,- 13 o 7 46 L 0 0 Notice for Lobbyists: The annual registration fee is 525.00 per Lobbyist, per Collier County Ordinance No. 2003-53, and amended by Ordinance 2004-05 and Ordinance 2007-24. Payments made out to: Collier County Clerk of Courts or Crystal K. Kinzel, Clerk of Courts (ADDRESS LISTED ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1. Name L 'q-t"°7-"t n C (r(3t) y` 2. Name Address 5 4vL'E "ppf-z. S Address City Zip Code City Zip Code 3. Name FAy GHQ 4. Name Address 311`; /1 `( A- et)vJn Address City 1U,'l,' - Zip Codel'C 7:3L- /CCity Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida ' s�. R '' County of Collier I`/L��L _/�. .� /: obb rt Signatur'• yf�" This registration as swor i(• lrmed) and s .scribed before me this -1•101111�4,ay�of; _;eiker; 20 \ 5, by JV, Personally Known BY: 1 ✓u--_*: } ,.,,_ Abk Produced ID •eputy CIeik/Nota'- Public Type of ID Produced y �` Revised:08/2018 12/14/2018 1:29:44 PM Crystal K. Kinzel Clerk of the Circuit Court and Comptroller o icDER Customer Deputy Clerk Clerk Office Location GARRETT F.X. BEYRENT BMR CASHIER Collier County Govt. Center LONG BOW LOBBY MinutesandRecords@CollierClerk.co Building F, 4th Floor 3115 MAGNOLIA POND DR m 3299 Tamiami Trail East, Suite NAPLES, FL 34116-8308 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 Cash Tendered ($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. ©C0 00a@Q® ❑ cgQoj] Page 1 of 1 Lobbyist Registration Quarterly Update 7'co 71 „ Lobbyist Registration Quarterly Update -, / 7--------7 , , - C4,, \ : , I 9 AN PL-eAe- �v rt w etIzD i U c l -y s T-ft- < N z 1 L c ew-r- T-0 levx7 '&;1-- F reePt, l L. s� F Pz S r1 POt( eSolek1ti1 Or._ r HA 5veam-p- A Procicrio,\J I N ,\4^ ' C0 L Sof'F / A1) ROf A ScNte eL . Lobbyist Registration Quarterly Update