2009/2010
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COLLIER COUNTY
330 I Tamiami Trail East
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
NAME b~tf\orJ :b~~s
DATE
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BUSINESS ADDRESS
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NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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JONeS ~l"'Y\~Co. N:tple: t FL- !>"tnt,
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ATTACH ADDITIONAL SHEETS AS MAY BE NECE
byist Signature
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STATE OF FLORIDA
COUNTY OF COLLIER
The dJore~Oing registration was sworn'/) and subsgjbed before me on this the / '("'day of
ct7JhL/ ' 2009, by fJrJufYl UO/1€A who is personally known to
me or who has produced as identification and who did take an
oath.
lutU,U/II'l...rp...t
:u,uuu".ILiSAIr,\NDRV i
: comm# 000683323 :
i,if ._ Expires 61112011 i BY:
: ~$ :
;; .f F'orida Notary Assn.,lnc :
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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 mail to: Collier County Clerk of Courts or
Dwight E. Brock, Clerk of Courts (at the address listed at the top ofthe form).
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Receipt# 007028241
10/20/2009 2:22:04 PM
Dwight E. Brock
Clerk of the Circuit Court
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Customer
DAMON JONES
COLLIER AGGREGATES,
LLC
PO BOX 990099
NAPLES, FL 34116-6059
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# 1741
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
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