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2011/2012 Collier County Clerk of Courts Expires I' �/� 3299 Tamiami Trail E. (Cler s office only) Suite 401,Bldg.F,4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name THOMAS F. MULLIN Date 10/13/11 Business Name ROSE, SUNDSTROM & BENTLEY, LLP Business Address 950 PENINSULA CORPORATE CIRCLE, SUITE 2020 City BOCA RATON State FL Zip Code 33487 Business Telephone (561) 984 7114 Contact Person BERNICE TORRES Lobbyist E-mail TMULLIN @RSBATTORNEYS.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: 1.Name BAREFOOT BEACH HOA, INC. 2.Name Address 259 BAREFOOT BEACH BLVD. Address City BONITA SPRINGS Zip Code 34134 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 Colli, 4pv'" "O Notary Public State of Florida AO Bernice Torres i c c` My Commission DD931590 .bbyist Signatur ?or e? Expires 10/07/2013 This registration was sworn(or affirmed) and subscribed before me this 13th day of, October , 20 11 ,by Thomas F. Mullin X Personally Known B . . 41111 ' Produced ID Deputy C k/Notary Public Type of ID Produced Revised:08/2011 Receipt# 007200726 11/8/2011 8:12:06 AM (0i Dwight E. Brock Clerk of the Circuit Court Customer Deputy Clerk Clerk Office Location THOMAS F. MULLIN BMR CASHIER Collier County Govt. Center ROSE, SUNDSTROM & MinutesandRecords @CollierClerk.co Building F, 4th Floor BENTLEY, LLP m 3299 Tamiami Trail East, Suite 950 PENINSULA 239-252-2646 401 CORPORATE CIR STE 2020 P.O. Box 413044 BOCA RATON, FL 33487-1389 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#45496 ($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. ©®11[1LJQ17COQggEID Page 1 of 1