2011/2012
Clerk to the Board, Minutes & Records Dept.
3299 Tamiami Trail East, Suite #401
Building F, 4th Floor
Naples, FL 34112
Expires 1 ( :;0 I J -
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Brian Barnes
Date September 30, 2011
Business Address 1388 Colonial Blvd.
Fort Myers, Florida 33907
Business Telephone (239) 829-7004
E-Mail brian.barnes~cardno.com
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1). See attached list.
2).
(pLEASE ATTACH ADDITIONAL SHEETS, IF NECESSARY)
~~i--~
Lobbyist S~ure
State of Florida
County of Collier Lee
The foregoing registration was sworn to and subscribed before me on this 30th
day of September , by Brian Barnes , who is personally known to
me or has produ e p. r 0 as identification and
who did take GITANA N. GIBSON
! \ Nolary Public - Slate of Florida
i. . i My Comm. Expires Jan 1,. 2015
\U; 9!l Commission * EE 36143
"'i,l"w,r.',"'" Bonded Through National Notary Ass .
otary
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# 007192490
10/5/2011 8:54:13 AM
~:: ',', J I I J,
Dwight E. Brock
Clerk of the Circuit Court
Customer
ANDREW MCTHENIA, BRIAN
BARNES
CARD NO ENTRIX
1388 COLONIAL BLVD
FORT MYERS, FL 33907-1015
Deputv Clerk
BMR CASHIER
Minutesand Records@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
2
DESCRIPTION
BMR Lobbyist Registration
UNIT COST
$25.00
TOTAL AMOUNT DUE
Check# 143427
BALANCE DUE
AMOUNT
$50.00
$50.00
($50.00)
$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.
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