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2020/2021
Collier County Clerk of Courts Expires 09Jd0c} I -9 - 3299 Tamiami Trail E. (Clerk'sce only) Suite 401, Bldg. F, 4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NameChris Scott, AICP DateJuly 15, 2021 Business Name Peninsula Engineering Business Address 2600 Golden Gate Parkway Cif Naples State FL Zip Code 34105 Business Telephone 239.403.6700 Contact Person Chris Scott Lobbyist E-mail cscott@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 Zip (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier Lob yist Signature This registration was sworn(or affirmed) and subscribed before me this 15th day of July 20 21 by Chris Scott I X Personally Known BY: - G' t Produced ID I ;.tiP„Y',',;;•,•• KIM D.DAVIDSON eput Clerk/Notary Public Type of ID Produced `11 _ Notary Public-Slate of Florida Commission#GG 154782 9' �+ <vs My Comm.Expires Feb 19,2022 ,F.b;.cN;,+ .,, Bonded Through National Notary Assn. Revised:08/2019 nnnnnnnnnnnn co 0 Z 0 0 0 Z 0 Z O °n < n n n n o o n n nm > D C O z co C K y 0 D a < C C d q < < Dp ,A V w ,-. 1 .+ .. ^. 1 •.. 1 C o < w x 2 p D A i C x a p p m n p O 2 t<i, D 0 1 1 .+. 3- ro ro D ,n o s .o.. • j j j ..I 0 a ro p 1 D z �c 2 F C C o A F'' ro z ro ro ro m ro Z m _c O1 < O n F 'n p m E F x m 2 r'o 3 Z •_•• 00 '_" m - o p ,�i, 3 O O O O O. 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" F+ tD A I- I- . W N N N N t0 N 0 F+ F+ 0 F+ F+ N I- N A O 0M, ON N t00 I 00 N O, w 000 t0D w o N CCO N O, A l00 00 O 01 N N w t00 tOD tD O W 000 000 00 t0 A w tCn N O, A 000 00 00 -0<r" - $ / S ¥ § ! k ` � § - 0 , = 0 > = 7 � R � � «, gt ` 25 22 / ® > ° 1 ° > -0r-> §CD $ n z o � z / & 2co - 0 \ j / r „ ® 2 * « / § \ � 0 > 0 W m \ � e , ; zK ! £ ; or - a ; ) z rl283g9, Q ; a -< 0 r)z \ ( / % � > § zt0 > < { § \ ( \ k ( \ � _ } - & § ] ) f « ` 6a 2 0 # o k ¢ 22 z / § 11 E . ( = ; 3 -I { o 00 \ ) q ) 00oV 77 ƒ [f § Vt2Vt < 55 z \ ! / r- oo0 � - 5 ! ; O ` Receipt# 008426357 7/27/2021 11:26:51 AM __A:1.\\arl Crystal K. Kinzel Clerk of the Circuit Court and Comptroller ''k", s'k))." a a — o `?:,_.%-h-,- 0 07— g — c, ''- .-, c— ELTh -iDER „7 , 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. ©0110M® gl® ggn Page 1 of 1