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2010/2011 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 Expires 9/ .:2b1/ BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name J~\l-\Q r ~ CA..C ~e (0 Date <1 / I '-i jd-.O \ Q Business Address~ \ >~ S -\ \\J\6-C\ P \0\ ( e I '\ h ~ r.\ f \ 00 ( (\JG\ flee, I f\()~-\d<A- ) ~ \0,8 Business Telephone d-~q - ')<=\ ~ - ~ C\ ~ X E-Mail -:J PAC I+~co@fo R-1E-rZW~ \ Cr H T . Co IV\ NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). _M (. \)0 i\V- \ ~ T 10- A \ '\ \- A 5SOC-\ '^ + e \ ;If\C s~o() 5~~~ 5~p \\ \)r\V~ )u~~~ \l-S- " / , F () C' -\- ~J 0 ('l-~ T e><CA S "1 b \ -?) T J 2). PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY State of Florida County of Collier BY: ~.t0~ fLtt,el5T1-v~ 1"/. /5/f'TE5" Deputy ClerkINotary Public 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 mail to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts (at the address listed at the top of the form). Receipt# 007105716 9/14/20109:00:39 AM Dwight E. Brock Clerk of the Circuit Court @VVO@O([lO ~@@@O~U Customer JAVIER PACHECO PORTER, WRIGHT, MORRIS & ARTHUR 9132 STRADA PLACE, THIRD FLOOR NAPLES, FL 34108 Deputy Clerk BMR CASHIER Minutesand 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: Check# 1956 BALANCE DUE: AMOUNT $25.00 $25.00 ($25.00) $0.00 ~@[} [} O@[f~[} @[f[%o @@[f[JjJ Page 1 of 1