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2012/2013
Collier County Clerk of Courts Expires q 3299 Tamiami Trail E. (Clerk's office only) Suite 401,Bldg. F,4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Jeffrey A. Straw Date October 24, 2012 Business Name GeoSonics, Inc. Business Address 4313 S. W. 64 Avenue City Davie State FL Zip Code_33314 Business Telephone_954-327-7882 Contact Person Jeffrey A. Straw Lobbyist E-mail jstraw @geosonics.com 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_Alico Land Development, Inc._ 2.Name_Collier Aggregates/Streak Investments Address Suite 100, 10700 Daniels Interstate CT Address_Suite 348, 1415 Panther Lane City_Ft. Myers Zip Code_33913_ City Naples Zip Code_34109_ 3.Name_CEMEX Construc. Matls, FL, LLC 4.Name Address_1501 Belvedere Road Address City_West Palm Beach_Zip Code_33406 City iip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Broward o .y st i l l Ire This registration was sworn(or affirmed) and subscribed be'sre me this_25th day of, October_, 2012_, by Jeffrey A. Straw _x_Personally Known BY Produced ID Deputy Clerk/Notary Public Type of ID Produced o�"`::TN4, CYNTHIABE)ETMIILOVA * � , * MY COMMISSION I EE 015115 T: EXPIRES:August 19,2014 +r 4 4'o i n e. Bonded itw W e t WI Swiss Revised:08/2011 Receipt# 007289742 10/31/2012 10:50:26 AM Dwight E. Brock Clerk of the Circuit Court / (-miff g rc ash/N (`l J C \ 1 r 11 Customer Deputy Clerk Clerk Office Location JEFFREY STRAW BMR CASHIER Collier County Govt. Center GEOSONICS, INC MinutesandRecords @CollierClerk.co Building F, 4th Floor 4313 SW 64TH AVE m 3299 Tamiami Trail East, Suite DAVIE, FL 33314-3435 239-252-2646 401 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#3119 ($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. ©OriDhh @0 ltll Page 1 of 1