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2005/2006County of Collier CLERK OF THE CIRCUIT COURT COLLIER COUNTY COURTHOUSE 3301 TAMIAMI TRAIL EAST P.O. BOX 413044 NAPLES, FLORIDA 34101-3044 Dwight E. Brock Clerk BY: ANN J DEPUTY CLERK RECEIPT: 4660379 NAME : DANIEL BRUNDAGE PAYOR: DANIEL W. BRUNDAGE REFNC: APJ ORIGINAL OFFICIAL RECEIPT When Validated DEPT: BOARD MINUTES AND RECORDS �e)3100 oxp-g4o iffy SPAT IA ina 1C DESCRIPTION AMOUNT LOBBYIST=====-----------------�--_25 00 TOTAL. DUE: 25.00 Page 01 of 01 COLLIER COUNTY 3301 Tamiami Trail East Naples, Florida 34112 BOARD OF COUNTY COMMISSIONE LOBBYIST REGISTRATION FORM NAME: Daniel W. Brundage, P.E. DATE September 27, 2005 BUSINESS ADDRESS Name of Business: Agnoli, Barber & Brundaae 7400 N. Tamiami Trail, Suite 200 Naples, FL 34108 NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1) Person or Entity would depend on project. ATTACH ADDITIONAL SHEETS AS MA STATE OF FLORIDA COUNTY OF COLLIER The foregoing registration was sworn to and subscribed before me on this the 27 day of, September. 2005 by Drw1EL hi.BRutiDA& who is personally known to me r who has produced as identification and who did take an oath. NOTARY PUBLIC -STATE OF FLORIDA June Miller Lehmann BY: ` v CommiWon # DD451197 Deputy Clerk/Notary Public Fapim: APR. 24, 2006 Bonded Thtu Atlantic eondint Co., Inc. Please Note. 1) Failure to renew this registration by the renewal date of October Vt will result in the placement of this registrant on a "status unknown, list. 2) If one wishes to revoke this registration, a "Lobbyist Withdrawal' form must be filed with the Clerk to the Board. 3) Annual Registration Fee is $25.00 per Lobbyist according to Ordinance 99-22