2009/2010
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
EXPires~
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name /!//!/qA4 7 i?oa//f1(~ Date21fo
Business Address !OfV N /kf; Icy 13ft! q ~ 100
7etYIjJQ FL .33(., (j
Business Telephone 0 b/3 - 221/tt&4-Mail ;;bOw'f//Ct1@I1!ir'/cl.i(!o/rJcf:
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NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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2).
PLEASE A'ITACH ADIlITlONAL SHUTS IF NECM; /"
1A-~
Lobbyist Signature
State of Florida
County of ColIler
The foregoing registration was sworn to and subscribed before me on this 1+'1
day of ~Y4, '2()ID ,by , who is ~~softllllY'\qJown to
me or has produced / _,, as identific~t'ilJlJ and
who did take an oath. .C ",. ...... ", .
'. ,
L.lt R _. I
i ,"I \. -.
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De~uty l;::lerkINotary Pu
The anoual registration fee is 525.00 per Lobbyist, accordin~ t~' C~lii~r Edllri
Ordinance No. 2003-53, as amended by Ordinance 2004-05 and O;;niiance 20
Please make payment and mail to: ColIler County Clerk of CourtS,9!:."..",'--
Dwight E. Brock, Clerk of Courts (at the address listed at the top of the form).
Receipt# 007050680
2/4/20109:04:01 AM
Dwight E. Brock
Clerk of the Circuit Court
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Customer
WilLIAM T. BOWMAN
TINDAL OLIVER
1000 N ASHLEY DR STE
100
TAMPA, FL 33602-3719
Deputy Clerk
BMR CASHIER
MinutesandRecords@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:
Cash Returned:
BALANCE DUE:
AMOUNT
$25.00
$25.00
($40.00)
$15.00
$0.00
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