2004/2005County of Collier
CLERK OF THE CIRCUIT COURT
COLLIER COUNTY COURTHOUSE
3301 TAMIAMI TRAIL EAST
P.O. BOX 413044
NAPLES, FLORIDA 34101-3044
ORIGINAL
OFFICIAL RECEIPT
When Validated
BY: LINDA HO
DEPUTY CLERK
RECEIPT: 4349673
NAME : DOMINICK J. AMICO
PAYOR: DOMINICK AMICO
REFNC: LAH
DEPT: BOARD MINUTES AND RECORDS
iR 33500
9.lds
V#: 3358731 10/01/2004
CHECK: 25.00
MC AMT PAID: 25.00
DESCRIPTION AMOUNT
LOBBYIST25 00
TOTAL - DUE: 25.00
Page 01 of 01
I
COLLIER COUNTY
3301 Tamiami Trail East
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Dominick J. Amico Jr. P.E. DATE September 27, 2004
BUSINESS ADDRESS Anoli Barber & Brundage Inc
7400 Tamiami Trail North Suite 200
Naples, FL 34108
NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1) Person or entity would depend on project.
2)
ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY
w4°0
Lobbytist Signatttfe
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing registration was s rn to ands scri before =on this the 27 day of
September, 2004 by ��.. who is personally
known to me o �rvheas »r�d�ced-�S identi ,c + nn ?nd who
did take an oath.
Fix
YVONNE L.OGDEN
zNotary Public, State of Florida
My comm. expires Aug. 26, 2007,q,,,, F Comm. No. DD245024 Deputy Clerk/Notaf Public
Please Note: 1) Failure to renew this registration by the renewal date of October I' will result in the placement of
this registrant on a "status unknown" list. 2) If one wishes to revoke this registration, a "Lobbyist Withdrawal" form
must be filed with the clerk to the Board. 3) annual Registration Fee is $25.00 per Lobbyist according to Ordinance
99-22.