2009/2010
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Receipt# 007011023
8/6/2009 10:12:46 AM
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Dwight E. Brock
Clerk of the Circuit Court
Customer
CRAIG DAVISSON
LIFE CARE SERVICES
1301 RIVERPLACE BLVD
JACKSONVILLE, FL 32207-
9047
Deputy Clerk
BMR CASHIER
M inutesand Records@CollierClerk.com
239-252-2646
Clerk Office Location
Collier County Govt. Center
Building F, 4th Floor
3301 Tamiami Trail East
P.O. Box 413044
Naples, Florida 34101-3044
1 Product
QUANTITY
1
DESCRIPTION
BMR Lobbyist Registration
UNIT COST
$25.00
TOTAL AMOUNT DUE:
Cash Tendered:
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
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Page 1 of 1
b 03/VD
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
Expires
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
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Business Address /~ / ;(/y~~
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Business Telephone fJ;f; ~~. tb~~ E-Mail ~V""~.on ~;'/,.,~~ h
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NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY
State of Florida
County of Collier
BY: .
Deputy ClerkIN tar):.
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The annual registration fee is $25.00 per Lobbyist, according to Collier County:.. ',~ ...'.
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Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance2001~2~f,' ..'
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).