2020/2021 Collier County Clerk of Courts Expires v /C99-I
3299 Tamiami Trail E. (Clerk'sflce only)
Suite 401, Bldg. F, 4th Floor
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Dan Waters, P.E. DateJuly 15, 2021
Business Name Peninsula Engineering
Business Address 2600 Golden Gate Parkway
City Naples State FL Zip Code 34105
Business Telephone 239.403.6700 Contact Person Dan Waters
Lobbyist E-mail dwaters@pen-eng.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, Ordinance 2007-24 and Ordinance
2013-39. Please make payment(s) to: Collier County Clerk of Courts & Comptroller.
(Mail to the address listed at the top of the form)
NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED:
1. Name See attached list 2. Name
Address Address
City/State Zip City/State Zip
3. Name 4. Name
Address Address
City/State Zip City/State A Zip
(ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY)
State of Florida -/
County of Collier 1
Lobbyis igna r re
This registration was sworn (or affirmed) and subscribed before me this 15th day of July
20 21 by Dan Waters
X Personally Known BY:
Produced ID epu clerk/NotaryPublic
„''�.,,, KIM D,DAVIDS h y
Type of ID Produced ;r�.` 1.`� ''e Notary Public-Stale of Florida
1 Commission tt GG 154782
( ,lii; My Comm.Expires Feb 19,2022
�� ';;"•p' Bonded Through National Notary Assn.
Revised:08/2019
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Receipt# 008426357
7/27/2021 11:26:51 AM
y Crystal K. Kinzel
Clerk of the Circuit Court and Comptroller
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Customer Deputy Clerk Clerk Office Location
J. ENGLISH, J. FRUTH, J. Martha S. Vergara Collier County Govt. Center
HARRELSON, D. HARTLEY, martha.vergara@collierclerk.com Building F, 4th Floor
D. HURST, C. SCOTT & D. 239-252-2646 3299 Tamiami Trail East, Suite
WATERS 401
PENINSULA ENGINEERING P.O. Box 413044
2600 GOLDEN GATE Naples, Florida 34101-3044
PARKWAY
NAPLES, FL 34105
1 Product
QUANTITY DESCRIPTION UNIT COST AMOUNT
7 BMR Lobbyist Registration $25.00 $175.00
TOTAL AMOUNT DUE $175.00
Check#016652 ($175.00)
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.
Co00o@TC0® coal Page 1 of 1