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2011/2012 Clerk to the Board, Minutes & Records Dept. 3299 Tamiami Trail East, Suite #401 Building F, 4th Floor Naples, FL 34112 Expires (Jq I ()[J / d- (Staff use only) BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Christopher J. Thornton, Esq. Date B. Add Becker & Poliakoff, P .A. usmess ress 999 Vanderbilt Beach Road, Suite 501, Naples, FL 34108 Business Telephone 239-552-3200 '1 cthornton@becker-poliakoff.com E-Mal NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). SEE ATTACHED 2). (PLEASE ATTACH ADDITIONAL SHEETS, IF NECESS.;\RY) ., Lobbyist Signature State of Florida County of Collier The foregoing registration was sworn to and subscribed before me on this 2-'8 ~ day of ~M~ ' by CH-a..1~Tt>~ l~ who is personally known to me or has pro uced as identification and who did take an oath. STARAo.MOLINSKI NOTARY PUBLIC STATE OF FLORIDA . . Comm#EE123665 , Expires 8/2912015 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). NAME AND ADDRESS OF EACH PERSON OF ENTITY REPRESENTED: 1.) Limousines of South Florida, Inc. 2595 Northwest 38th Street Miami, FL 33142 2.) Tectrans, Inc. 6053 W. Century Boulevard, 9th Floor Los Angeles, CA 90045 3.) Casa Grande on Vanderbilt Beach Condominium Association, Inc. 9653 Gulf Shore Dr. Naples, FL 34108 4.) Grace Place for Children and Families, Inc. 4300 21 sl Avenue SW Naples, FL 34116 5.) Germain Properties of Columbus, Inc. 13315 N. Tamiami Trail Naples, FL 34110 6.) Germain Real Estate Company, LLC 4250 Morse Crossing Columbus, OH 43219 7.) Naples Land Yacht Harbor, Inc. 2801 Palm Street Naples, FL 34112 8.) Capt. Ron's, Inc. 1930 Indian Hill Marco Island, FL 34145 Receipt# 007190292 9/29/2011 2:51 :43 PM Dwight E. Brock Clerk of the Circuit Court (QXI~rD (~~ 0 ?~l 0 C-~ (~~(r~~C~~ U Ui)lt Customer CHRISTOPHER THORNTON BECKER & POLlAKOFF, P .A. 3111 STIRLING RD FORT LAUDERDALE, FL 33312-6566 Deputv Clerk BMR CASHIER Minutesand Records@CollierClerk.co m 239-252-2646 Clerk Office Location Collier County Govt. Center Building F, 4th Floor 3299 Tamiami Trail East, Suite 401 P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY 1 DESCRIPTION BMR Lobbyist Registration UNIT COST $25.00 TOTAL AMOUNT DUE Check# 203533 BALANCE DUE AMOUNT $25.00 $25.00 ($25.00) $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. @@DD~@U@D@ufuo@@[JiJU Page 1 of 1