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2011/2012 &p. q/~/~ Clerk of the Board, Minutes & Records Dept. 3299 Tamiami Trail East, Suite #401 Building F, 4th Floor Naples, Florida 34112 Expires: / J) /, It z.. BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM 2011-2012 $ILL hNN'P DATE 9/1v/;1 1Jr~~/ Sv l.,e ~PO NAME BUSINESS ADDRESS jo,atJ ~441 ss ~/z'j>t7M 7C F/oJt!.(~ g$ 32.3' E-Mail bl//.le.Ai#()(i!.. j / hOAleJ .c..>AA..... NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 71f/UU-A#As As ~/)4Ares .:z:, ?t-L-P 1) By: ~,e.laA~))S c,EAJP.I'I-J!.. ~~"PM7'D,,0/ C;~t... ?~"-/4A- 2) ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY ~~ybe STATE OF FLORIDA COUNTY OF COLLIER egis ation was sworn to and subscribed , 20LL by $1I( ~IJN() BY: Deputy Clerk/Notary 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# 007190126 9/29/2011 9:00:46 AM Dwight E. Brock Clerk of the Circuit Court (g)lrHij ((-~ D C:l) 0 ~-~ (~CI~~ (~) 0 lPy~ Customer BILL FENNO GL HOMES, PARKLANDS ASSOCIATES I, LLLP 1600 SAWGRASS CORPORATE PKWY STE 400 SUNRISE, FL 33323-2890 DeDutv Clerk BMR CASHIER MinutesandRecords@CollierClerk.co m 239-252-2646 Clerk Office Location Collier County Govt. Center Building F, 4th Floor 3299 Tamiami Trail East, Suite 401 P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION 1 BMR Lobbyist Registration UNIT COST $25.00 TOTAL AMOUNT DUE Check# 0234 BALANCE DUE AMOUNT $25.00 $25.00 ($25.00) $0.00 Note: Disclaimer: All transactions are subject to review/verification. The Clerk reserves the right to correct for clerical errors and to assess or refund charges as needed. @@DD~@a@D@~@@[[fi) Page 1 of 1