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2013/2014 Collier County Clerk of Courts Expires / 20/4' 3299 Tamiami Trail E. (Cler 's office only) Suite 401, Bldg. F, 41h Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name John J. Mulvena hi Date 9-16-2013 Business Name Naples Zoo Business Address 1590 Goodlette Frank Rd City Naples State FL Zip Code 34102 Business Telephone 239-262-5409 X 107 Contact Person Jack Mulvena Lobbyist E-mail jack(cr�napleszoo.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 and Ordinance 2007-24. Payments made out to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts (ADDRESS LISTED ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1. Name Naples Zoo, Inc. 2. Name Address 1590 Goodlette Frank Rd Address City Naples Zip Code 34102 City Zip Code 3. Name 4. Name Address Address City Zip Code City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier Lobby st S u i ature This registration was sworn (or affirmed),and subscribed before me this / day of, Jet , 20 / , by \J c/ J ''lu/ve/7<< l V . X Personally Known NeY: �! T-ti C i� �— y CAMILLE PICKS iARY AS Produced ID �� soy,NOTARY PUBLIC Deputy Clerk/Notary Public °f Type of ID Produced STATE OF FLORIDA yid =Comm#EE145095 S/NCE 191'1 Expires 1/3/2016 Revised: 08/2011 Receipt# 007379454 9/23/2013 3:18:04 PM C�1<J Dwight E. Brock Clerk of the Circuit Court 10 _e:_a D 0 FR Customer Deputy Clerk Clerk Office Location JOHN J. MULVENA IV BMR CASHIER Collier County Govt. Center NAPLES ZOO MinutesandRecords @CollierClerk.co Building F, 4th Floor 1590 GOODLETTE RD N m 3299 Tamiami Trail East, Suite NAPLES, FL 34102-5260 239-252-2646 401 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#2593 ($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. ©®11M kg o O Lf (l Page 1 of 1