2011/2012 Board Minutes & Records
3301 Tamiami Trail East C7-1-1114 Expires: / aWal---Building F, 4th Floor
Naples, FL 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name: �J(t- ✓,(/ L / „ fz/<< if Date: /0 -4 //
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Business Address: /6 `/0 4-cec d(e /71 e— " -u \
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Business Telephone:Piz )6, 51/4)9 y/p 7 Email: (f ay ./ L;-7 L"�//,,'s z°o. C v9
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY
641/4/
Lobbyist Sign-1 re
State of Florida
County of Collier
The foregoing registration was sworn to and subscribed before me on this
day of NG bew ' by 't1A1,1 L. 1 T ja f-t , who is personally known to me
or has produced as identification and who did take
an oath. CAMILLE PICKENS
1`"' cowl*DD0745897
Expires 1/312012 BY: 'Ic y '%ce_ii..„,__ .
Florida Notary Assn.,Inc Deputy Clerk/Notary Public
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#007200724
11/8/2011 8:08:02 AM
,z<<> Dwight E. Brock
Clerk of the Circuit Court
Customer Deputy Clerk Clerk Office Location
DAVID L. TETZLAFF BMR CASHIER Collier County Govt. Center
NAPLES ZOO, INC. MinutesandRecords @CollierClerk.co Building F, 4th Floor
1590 GOODLETTE-FRANK m 3299 Tamiami Trail East, Suite
ROAD 239-252-2646 401
NAPLES, FL 34102 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# 15008 ($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.
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