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2011/2012 Collier County Clerk of Courts Expires 9/V /;' 3299 Tamiami Trail E. (Clerla office only) Suite 401, Bldg. F, 4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Paul K. Owen Date October 14, 2011 Business Name W. Dexter Bender& Associates, Inc. Business Address 4470 Camino Real Way, Suite 101 City Fort Myers State FL Zip Code 33966 Business Telephone 239-334-3680 Contact Person Paul K. Owen Lobbyist E-mail owen i dexbender.com Notice for Lobbyists: The annual registration fee is $25.00 ner 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: Mr. David Jackson 1. Name Collier Co. Business& Economic Development 2. Name Address 4069 Bayshore Drive Address City Naples Zip Code 34112 City Zip Code 3. Name 4.Name Address Address City Zip Code City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier Lobbyist Sign ure This registration was sworn(or affirmed) and subscribed before me this /'Y day of, Oct. , 20 // , by -Pak k * O01(A) Personally Known / 44f Produced ID .rRY°�, Notary Public State of Florida Deputy Clerk/Notary Public Type of ID Produced : Linda Gonsalves r u •u u •n DD811970 40i Expires 10/17/2012 Revised:08/2011 Receipt# 007195605 10/17/2011 3:32:25 PM v,,;_s9es , Dwight E. Brock Clerk of the Circuit Court ')-0,,oz,"\''' -0 0j- (-- - , E3:, - -nQ ____ c-) _ _ , __; _1_57 ,_____7 0 J Customer Deputy Clerk Clerk Office Location PAUL K. OWEN BMR CASHIER Collier County Govt. Center W. DEXTER BENDER & MinutesandRecords @CollierClerk.co Building F, 4th Floor ASSOCIATES, INC. m 3299 Tamiami Trail East, Suite 4470 CAMINO REAL WAY 239-252-2646 401 STE 101 P.O. Box 413044 FORT MYERS, FL 33966-1119 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 1 BMR Lobbyist Registration $25.00 $25.00 TOTAL AMOUNT DUE $25.00 Check# 14778 ($25.00) 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. @g[1111®r?©0®112ftoggIM Page 1 of 1