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2009/2010 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name <Nz"t Mss~ G/-t' Date Fylo Business Address /6' cl 2- Vh;~ 14~/ A pL h/f-f /t(1/./!~7) J:-L 3;;'/27// . T I h -7 (7 J2 '7 ~6;? b 6 E M 'I / 6 / ,:,> I Busmess e ep one ?- 5 / ~ ~ - aJ U-- f? ~4' fU?'/R( ~?:V a tJ . CO /-if NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: I). e.?s-f 4/r?~ ;:""4/ ;;;;~A~ 2). PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY ~~ d,ub"~ture State of Florida County of Collier The foregoing registration was sworn to and subscribed before me on this day of , by , who is personally known to me or has pro ed '\J as identification and who did take an oath. ~ ~ 4~ uty Clerk/Notary Public The annual registration fee is 525.00 per Lobbyist, according to Comer County Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance 2007-24. Please make payment and mail to: Collier County Clerk or Courts or Dwight E. Brock, Clerk of Courts (at the address listed at the top of the form). Receipt# 007098454 8/12/2010 12:14:39 PM Dwight E. Brock Clerk of the Circuit Court @VVD@D([l~ ~@@@D~G Customer SOUTHERN BIOMES, INC 1602 WOODFORD AVE FORT MYERS, FL 33901- 2426 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: Check# 5977 BALANCE DUE: AMOUNT $25.00 $25.00 ($25.00) $0.00 ~@u U o@rr~u@rr~o @@[f[f[) Page 1 of 1 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 -Q)Cf' Cft 10 Expires BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name 6ez~ M=s04: ~'i / Date ;/;(;0 Business Address /6 CI 2- Vh~ ~ h /.-~ A pL hAf /tfl/L~.:;r) Pc 35727// . (' 3:.,1 9 ~6"? b (; . BusmessTelephone 2-.57~~ E-Mail ;;f!~~f~/:.WatJ!cc'/--q NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). eL?5f.4/~., &4/ /:'70AY 2). PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY ~~ gnature State of Florida County of Collier The foregoing registration was sworn to and subscribed before me on this 4~ day of -?tV~' , by t , who is personally known to me or has pro ed 'Of \ V Q.. '{"IS ""~. .,. as identification and who did take an oath. ~ ~ uty ClerkiNotary Public The annual registration fee is $25.00 per Lobbyist, according to Comer County Ordinance No. 2003-53, as amended by Ordjnance 2004-05 and Ordinance 2007-24. Please make payment and mail to: CoJUer County Clerk of Courts or Dwight E. Brock, Clerk of Courts (at the address listed at the top of the form). Receipt# 007098454 8/12/201012:14:39 PM \)fU2('I~~~ (.~r .~"\ / .~.~"\ J \:-'\. \ '\ I \ I'; ",I ,) ~,I'-i ~\ \.. ~I J~! ~1"- ~//.CI 0/>_ '_ ___<<"'... ffJl~ eiR('- Dwight E. Brock Clerk of the Circuit Court (rl '\\1' ~,-!{J:iFI (/(~~' !,~II C~:I D ~\"j) Ii !, \J71 roll ___-- ..., L _' ____..._/ '._ ~_._.-----'~.._, Customer SOUTHERN BIOMES, INC 1602 WOODFORD AVE FORT MYERS, FL 33901- 2426 Deputy Clerk BMR CASHIER M inutesand Records@CollierClerk.com 239-252-2646 I' -', r~J ~1 ") "" ~--, G - I r'y, -~) C~ \( -,_~ n\I': (\ \ :1 !\.'" Qj' \,C=J ':;51_J J)~J Clerk Office Location Collier County Gov!. 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# 5977 BALANCE DUE: AMOUNT $25.00 $25.00 ($25,00) $0.00 :?,:, n t7 (1".c' c-p0 !7r;'~ c-p! i-?=r;-~ r-;Y' \~:!J!QjL/LiUI,,-S5lj 1&// ~%'L( L(\1L,I llJ~/tflIlj Page 1 of 1