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2023/2024 Collier County Clerk of Courts Expires 2 0,2_0 3299 Tamiami Trail E. (Cler 's office only) Suite 401, Bldg. F,4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NameMatthew R. Holliday DateJUly 12, 2023 Business Name NCH Healthcare System, Inc. Business Address 350 7th Street North City Naples State FL Zip Code 34102 Business Telephone 239-826-7864 Contact Person same Lobbyist E-mail matthew.holliday@nchmd.org 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 NCH Healthcare System, Inc. 2. Name Address 350 7th Street North Address City/State Naples, FL 34102 tY Zip City/State ip 3. Name 4. Name Address Address City/State Zip City/State Zip (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier 7/i ‘4 /' a'shier Lobbyist Signature This registrati w worn(or aj fi ed) and subscribed before me this OS day of l�` 20(33 y y • ' Personally Known BY. Produced ID DepXrd otary Public �(! Type of ID Produced yl// Gsei-eE � '4\L.: LYNN A.LEWIS 4-r ` ': Notary Public-State of Florida .pCommission#HH 024528 ;ov rtiFr,-. My Comm.Expires Jul 27,2024 Revised:08/2019 Bonded through National Notary Assn. Receipt# 008750689 8/18/2023 1:55:32 PM `o(���R�o�T Crystal K. Kinzel L Clerk of the Circuit Court and Comptroller r 11 F. �GFTHE cia���� 1 Customer Deputy Clerk Clerk Office Location MATTHEW R HOLIDAY BMR CASHIER Collier County Govt. Center NCH HEALTHCARE SYSTEM, MinutesandRecords@CollierClerk.co Building F, 4th Floor INC. m 3299 Tamiami Trail East, Suite 350 7TH STREET NORTH 239-252-2646 401 NAPLES, FL 34102 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 Check# 102182878 ($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. ©0111TUT©U®ITBZoggpila Page 1 of 1 Lobbyist: H NCH Health System Name: Matthew R. Holliday E-Mail: matthew.holliday@nchmd.org Date Received Details 8/6/2020 New Registration - Exp. 09/2021 3/15/2021 Update - Jan 3/26/2021 Update - April 6/29/2021 Update - July 9/22/2021 Registration Renewal - Exp. 09/2022 1/3/2022 Update - Jan 4/1/2022 Update - April 7/5/2022 Update - July 9/1/2022 Registration Renewal - Exp. 09/2023 1/9/2023 Update- Jan 7/21/2023 Registration Renewal - Exp 09/2024