2009/2010
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
Ex pires
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRA nON FORM
Name 1v\4\\e,\L <;S1'EJ.)"pl'fd2.. ) 'C'S~~ Date 7 ("30' 10
Business Address lS(dz..I?-€;li?~ -+ tv \i AV.,.o fJ ' p.",
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Business Telephone 5.P \ -\oS$"- ';) L\ Lf Lf ___E-Mail~v.-M r II:-:~.e (2 hf0yOv'- pO\(~~f>f'
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!'lAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1). li MV\I\SlrJt;6 OF s:'CM-TH f'coi-!o-A INC /TGc-fI2f1NS, INC.
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25"1::' f'J!A) 39 Tl-t 5TT2'I;;,s.,T
M\ftM" fi... 33142
2).
PLEASE ATT ACH ADDITIONAL SHEETS IF NECESSARY
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Lobbyis~' Signature
State of Florida
County ofCelller ~,ddi B"o( 1-,
The foregoing registration was sworn to and subscribed before me on this 3xd
day of . uti v ~f ,0, by f.I fj " k::r .~ -) (",pk-,~ who is personally known to
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who did take an oath. 'MAR..........................nu...
GERY B. KOU<ER :
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The annual registration fee Is $25.00 per Lobbyist, according to Collier County
Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance 2007-24.
Please make payment and mall to: Collier County Clerk of Courts or
Dwight E. Brock, Clerk of Courts (at the address listed at the top of tbe form).
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Dwight E. Brock
Clerk of the Circuit Court
Receipt# 007098453
8/12/201012:13:00 PM
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Customer
BECKER & POLlAKOFF, PA
3111 STI RUNG RD
FT LAUDERDALE, FL
33312-6566
Deputy Clerk
BMR CASHIER
M inutesandRecords@CollierClerk,com
239-252-2646
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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
2
DESCRIPTION
BMR Lobbyist Registration
UNIT COST
$25.00
TOTAL AMOUNT DUE:
Check# 191662
BALANCE DUE:
AMOUNT
$50.00
$50.00
($50,00)
$0.00
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