2009/2010
Receipt# 007015782
8/28/2009 10:36:00 AM
BOYLA MENTAL
CONSULTANTS, INC.
11000 METRO PKWY STE 4
FORT MYERS, FL 33966-
1210
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itl1i:a1 Si!l114l'hfZtpeputy Clerk Clerk Office Location
BMR CASHIER Collier County Govt. Center
MinutesandRecords@CollierClerk.com Building F, 4th Floor
239-252-2646 3301 Tamiami Trail East
P.O. Box 413044
Naples, Florida 34101-3044
Dwight E. Brock
Clerk of the Circuit Court
1 Product
QUANTITY DESCRIPTION
1 BMR Lobbyist Registration
UNIT COST
$100.00
TOT AL AMOUNT DUE:
Check# 9468
BALANCE DUE:
AMOUNT
$100.00
$100.00
($100.00)
$0.00
Page 1 of 1
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BOqrd Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
Expires:
6 I ~~VC()
Cl~Ql[L_-
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Date: 2009-08-24
Name: Kimberly Schlachta
Business Address:
Boylan Environmental Consultants. Inc.
11000 Metro Parkway. suite 4
Fort Myers. Florida 33966
+1 (239) 418-0671
Email: kims@boylanenv.com
Business Telephone:
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1.Kimberly;;;hlachta
Bo~~n Envi nm~nt~1 Consultants. Inc.
~L_O Metro Parkway, Suite 4
Fort Myers, Florida 33966
PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY
State of Florida
County of -CGlli~r L-(L
The foregoing registration was sworn to and subscribed before me on this twenty fourth
b Kimberly Schlachta ~--_.-.
day of August, 2009 ' Y , who iS~~~)wn to m~
as identification and who did take
an oath.
~~ OOIJ~ Notary PubliC State of Florida
. . Judy C Perrella
: (~, ; My commission 00778200
...;~o~ ExpIres 05/11/2012
'\
By:~~Ld)UJt ~
Deput Clerk/Notary Public
or has produced
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 a
the top of the form).