2009/2010
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
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Expires
Name
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
tit'r 1/ "V4/.'-6L
Date
c (11~o
Business Address
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Business Telephone ~q.> ) '%7( --ff-z.../ v
E-Mail f'\ ~G"', r1'"CI..- c..o> (. v So
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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PLEASE ATTACH ADDITIONAL SHEETS IF N
State of Florida
County of Collier
The fore 01 r~isp.:pti~n was ~I ~ ~ a
day of NIt.. &0 ID , by _ '. -_
me or has produced
who did take an oath. .....
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:.......'y;t6.MA'S.M~'AANKINE :
~ ,,\\~I~~jU~fl'/~ Comm# 000564995 i
~ {:" v. ~ Expires 8/6/2010 5 BY:
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: ~~l'Vf"." Florida Notary Assn.. inc :
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The annual registration fee is $25.00 per Lobbyist, accordin Collier County
Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance 2007-24.
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).
Dwight E. Brock
Clerk of the Circuit Court
Receipt# 007086523
6/22/20108:14:18 AM
Customer
MARK LEVITT
LIMOUSINES OF SOUTH
FLORIDA
2595 NW 38TH ST
MIAMI, FL 33142-5254
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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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