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2020/2021 Collier County Clerk of Courts Expires CY1 9-0 3299 Tamiami Trail E. (Clerk' office only) Suite 401,Bldg.F,4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Marina Guirguis Date July 22, 2021 — Business Name Johnson Engineering,Inc. Business Address 2350 Stanford Court City Naples State FL Zip Code 34112 Business Telephone (239)334-0046 Contact Person Lobbyist E-mail mguirguis@johnsoneng.com Notice for Lobbyists: The annual registration fee is$25.00 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 CLIEN'T/ENTITY REPRESENTED: I. Name Bayshore Gateway Triangle CRA 2. Name _Collier Countty_Housing Division ddress 3339 Tamiami Trail East, Suite 211 Address '329 Tamiami Trail E,Building F, Suite 103`� — City Naples Zip Code 34112 City Naples Zip Code 34112 3. Name Immokalee CRA 4. Name Address 750 South Fifth Street Address City Immok_alee _ Zip Code 34142 City_ Zip Code (ATTACH ADDITIONAL CLIENT SIWETS,IF NECESSARY) State of Florida AMANDA MAE MARTIN • County of Collier. NOTARY PUBLIC STATE OF FLORIDA Lob ist Signature NO.GG218010 y �' MY COMMISSION EXPIRES JUN.19,2022 This registration was /, in or a, firmed)and subscribed before me this __.f day of,a-, , 20 ?.l. , by Marina(: tirrxuis X _Personally Knovvi BY: 2-MA_ .l � / "'CL.�� �/ Produced ID Deputy Clerk/Notary Public Type o1'1t) Produced Revised:08/2018 Receipt# 008430987 8/5/2021 10:45:54 AM 0,,, rf Crystal K. Kinzel Clerk of the Circuit Court and Comptroller Gig— o 0 0 >AF'CIItC @ :DER Customer Deputy Clerk Clerk Office Location LAURA DEJOHN & MARINA Martha S. Vergara Collier County Govt. Center GURIGUIS martha.vergara@collierclerk.com Building F, 4th Floor JOHNSON ENGINEERING, 239-252-2646 3299 Tamiami Trail East, Suite INC. 401 2350 STANFORD CT P.O. Box 413044 NAPLES, FL 341 1 2-481 3 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 2 BMR Lobbyist Registration $25.00 $50.00 TOTAL AMOUNT DUE $50.00 Check#42414 ($50.00) 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. CCA[Ild®Ta®ITBZogODM Page 1 of 1