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2011/2012 Clerk to the Board, Minutes & Records Dept. Expires //o1-0/0---- 3299 Tamiami Trail East, Suite #401 (Staff use on Building F, 4th Floor Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Sandra L Bottcher Date 6/20/12 Business Address PO Box 2826 Bonita Springs, FL 34133 Business Telephone 239-250-3257 E-Mail sbottcher@comcast.net NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1) Sandra L. Bottcher, PE PO Box 2826 Bonita Springs, FL 34133 2). (PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY) (/) 6i11 ---- Lobbyist Signature State of Florida County of Collier The foregoing registration was sworn to and subscribed before me on this 2G fv' day of _J Y'& , by Sc tet ea._ a/- fr' - , who is personally known to me or has produced t-e-O .._ 133 2(,'7S'2 6 2 s---‹4/0 as identification and who did take an o .:,. .,. o; ; mycm: E:pi,esAug252oi3y:‘'-; 'P�a�,, JEREY L KUNBERGER� _* *�: Notary ublic-State of Florida ' s •P o , ��/ .v fi/ 9 FOF ( Commissin#DD 919904" " Bonded Throug National Notary Assn. P "Ti Receipt# 007260579 7/3/2012 8:24:55 AM Dwight E. Brock Clerk of the Circuit Court ffff- , D) Cc?7 Customer Deputy Clerk Clerk Office Location SANDRA L. BOTTCHER BMR CASHIER Collier County Govt. Center SLB CONSULTING OF SW MinutesandRecords @CollierClerk.co Building F, 4th Floor FLORIDA LLC m 3299 Tamiami Trail East, Suite P.O.BOX 2826 239-252-2646 401 BONITA SPRINGS, FL 34133 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# 1050 ($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. ©Qo 1:1111I®Lf VF@ ❑gg 11n11 Page 1 of 1