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2011/2012 Collier County Clerk of Courts Expires 0°4=1-- 3299 Tamiami Trail E. (Clerk's office only) Suite 401, Bldg. F,4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Dean S. Ziegler Date 10/27/11 Business Name Banks Engineering Business Address 12653 SW County Road 769, Suite B City Lake Suzy State Florida Zip Code 34269 Business Telephone (941) 625-1165 Contact Person Dean S. Ziegler Lobbyist E-mail dziegler( bankseng.com Notice for Lobbyists: The annual registration fee is $25.00 per Lobbyist,per Collier County Ordinance No. 2003-53, and amended by Ordinance 2004-05 and Ordinance 2007-24. Payments made out to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts (ADDRESS LISTED ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1. Name Collier County Community 2. Name Bayshore Gateway Triangle Community Redevelopment Agency Redevelopment Agency Address 3301 Tamiami Trail East Address 4069 Bayshore Drive City Naples Zip Code 34112 City Naples Zip Code 34112 3. Name The Pizzuti Companies 4. Name Address Two Miranova Place, Ste. 800 Address City Columbus, OH Zip Code 43215 City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida t County of CollierDesoto Lob r ist `ign/r=/ This registration was sworn (or affirmed) and subscribed before me this 27th day of, October , 20 11 ,by Dean S. Ziegler. X Personally Known - — — — — — — — —: ��_ /L AA. HEATHER . •OL - � 4 A.4 Produced ID .�«a� o - ��;; Notary Public-state of FloridD •uty Clerk/Notary Public Type of ID Produced N/A ' ',. My Commission Expires Jan 8,2012 Commission# DD 746989 ,q, ;,,,, Bonded Through National Notary Assn. Revised:08/2011 Receipt# 007200728 11/8/2011 8:15:55 AM Dwight E. Brock Clerk of the Circuit Court Customer Deputy Clerk Clerk Office Location DAVID R. UNDERHILL, JR.; BMR CASHIER Collier County Govt. Center JONATHAN HAGAN; DEAN S. MinutesandRecords @CollierClerk.co Building F, 4th Floor ZIEGLER; TODD R. REBOL m 3299 Tamiami Trail East, Suite BANKS ENGINEERING 239-252-2646 401 12653 SW COUNTY ROAD P.O. Box 413044 769 STE B Naples, Florida 34101-3044 LAKE SUZY, FL 34269-5907 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 4 BMR Lobbyist Registration $25.00 $100.00 TOTAL AMOUNT DUE $100.00 Check# 17501 ($100.00) BALANCE DUE $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. C 0[I[In®IT©[1®UtoggNtu Page 1 of 1