2012/2013 Clerk to the Board, Minutes & Records Dept. Expires G(J`Zj
3299 Tamiami Trail East, Suite #401 (Staff use on y)
Building F, 4th Floor
Naples, FL 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
NameAmber Crooks Date 9/19/12
•
Business Address 1450 Merrihue Drive
Naples, FL 34102
Business Telephone 239 262-0304 E-Mail amberc @conservancy.org
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1). Conservancy of Southwest Florida
1450 Merrihue Drive
Naples, FL 34102
2).
(PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY)
CD C
Lobbyist Signature
State of Florida
County of Collier
The foregoing registration was sworn to and subscribed before me on this 1 9th
day of September,2012 , by Amber Crooks , who is personally known to
me or-has-produced and
who did take an oath.
KATHLEEN P.ADAMS
MY COMMISSION#DD 940461 1
js EXPIRES:November 27,2013 BY \\ � \ !! • 11,
,.'FO Bcnded Thor Budget Notary Services
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 and Ordinance 2007-24.
Please make payment and mail to: Collier County Clerk of Courts or
Dwight E. Brock, Clerk of Courts (at the address listed at the top of the form).
Receipt# 007283406
10/4/2012 2:19:56 PM
4; 16ri; Dwight E. Brock
Clerk of the Circuit Court
1 i X _
izI O 0 O
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Customer Deputy Clerk Clerk Office Location
ANDERSON, CROOKS, BMR CASHIER Collier County Govt. Center
FRANTZ, HECKER, MinutesandRecords @CollierClerk.co Building F, 4th Floor
JOHNSON, MCELWAINE & m 3299 Tamiami Trail East, Suite
POLGAR 239-252-2646 401
CONSERVANCY OF SW P.O. Box 413044
FLORIDA Naples, Florida 34101-3044
1450 MERRIHUE DR
NAPLES, FL 34102-3449
1 Product
QUANTITY DESCRIPTION UNIT COST AMOUNT
7 BMR Lobbyist Registration $25.00 $175.00
TOTAL AMOUNT DUE $175.00
Check#7610 ($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.
@ODOOargil®G'CZ❑gOEri Page 1 of 1
Up (do
es
Martha S. Vergara
From: Minutes and Records
To: kathy adams
Subject: RE: Conservancy of Southwest Florida Lobbyist
Thanks, will update the information after lunch
Martha
From: kathy adams [mailto:kathva@conservancy.org]
Sent: Friday, January 11, 2013 10:54 AM
To: Minutes and Records
Subject: Conservancy of Southwest Florida Lobbyist
No changes to our lobbyist client list
gat*3'Xiain2.4
Administrative Assistant for Environmental Policy & Science
Conservancy of Southwest Florida
1450 Merrihue Drive /Naples, FL 34102 &(6�Phone (239)403-4232 r ,
Fax(239) 262-5872 �
kathya(a�conservancY.org ���
www.conservancy.org ot
Please consider the environment before printing this e-mail
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