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2011/2012 Receipt#007221022 2/6/2012 5:11:55 PM Dwight E. Brock Clerk of the Circuit Court Li aaa_ t/ e c + F F11 ClR ` / - a aa O a Customer Deputy Clerk Clerk Office Location ANTHONY SOLOMON BMR CASHIER Collier County Govt. Center TWIN EAGLES MinutesandRecords @CollierClerk.co Building F, 4th Floor DEVELOPMENT m 3299 Tamiami Trail East, Suite 3185 HORSESHOE DR S 239-252-2646 401 NAPLES, FL 34104-6164 P.O. Box 413044 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#2077 ($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. ©01:10a® @U® ho©®liaD Page 1 of 1 Collier County Clerk of Courts Expires 9 1/ 3299 Tamiami Trail E. (Clerk's lee only) Suite 401,Bldg.F,4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name 4A/1-4-1M/11 SPL0MDAI Date 02. . �2- Business Name -n//,f EAG- € S 4 &le so, � LLL Business Address 3/ 575 Dirjw_s/10 L Del V c City A/A-tai_.“ State f L- Zip Code f 9/0 `f Business Telephone j3 9 G v.9- 3/ Contact Person A/✓ A/f Je74-0 A-io Lobbyist E-mail t�c,o.,c.,a.J ,4 & ed.,1-i-0 • CvM 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 Twin/E.46-L4s A-R.. Sou_rg, LLc.. 2.Name Address 3/SS Ave s. slfoC. Do?ivq S. Address City A(40.-c s Zip Code 39/o 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 Lobbyi t Signature s registration was sworn(or affirmed)and subscribed before me this o2. day of, itbruar ,201a. ,by ATvi ions( P . Solomon . /Personally Known n elawt, t Produced ID .,. KAREN E.wEUCS s -puty Clerk/Notary Public Type of ID Produced i • MY COMMISSION#DD 829713 �, ; - - -.February 9,2013 ;1 ; Bonded Thru Notary Public Underwriters Revised:08/2011