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2007/2008County of Collier CLERK OF THE CIRCUIT COURT COLLIER COUNTY COURTHOUSE 3301 TAMIAMI TRAIL EAST P.O. BOX 413044 NAPLES, FLORIDA 34101-3044 Dwight E. Brock Clerk BY: TERESA D DEPUTY CLERK RECEIPT: 5280115 NAME : DOMINICK AMICO PAYOR: DOMINICK AMICO REFNC: TLD ORIGINAL OFFICIAL RECEIPT When Validated DEPT: BOARD MINUTES AND RECORDS V#: 42685:6 1Cj,02 2nn- CHECk<: 25.00 CT AMT PAID: 25.li0 DESCRIPTION AMOUNT LOBBYIST25 00 TOTAL DUE: 25.00 Page 01 of 01 COLLIER COUNTY 3301 Tamiami Trail East Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NAME DOMINICK J. AMICO JR., P.E. DATE SEPT. 27,2007 BUSINESS ADDRESS: AGNOLL BARBER & BRUNDAGE INC. 7400 TAMIAMI TRAIL N. SUITE 200 NAPLES FL 34108 NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1) Person or Entity would depend on project. ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY STATE OF FLORIDA COUNTY OF COLLIER The foregoing registration of September, 2007 by` weary Pews - w. of RV* yscerer h"ewwx,xn 4Vw4Wd14z44V- LobbyisfSignatufe before me on this the L.)? 7 day _, who is personally known to me er- c�at�rr�and who did take an oath. Public Please Note: 1) Failure to renew this registration by the renewal date of October 15r 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. 3) Annual Registration Fee is $25.00 per Lobbyist according to Ordinance 99-22.