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2010/2011 COLLIER COUNTY 3301 Tamiami Trail East Naples, Florida 34112 liP q I ;)0// BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NAME Dominick J. Amico. Jr.. P.E. DATE OCTOBER 1. 2010 BUSINESS ADDRESS: AGNOLl. BARBER & BRUNDAGE. INC. 7400 TAMIAMI TRAIL N.. SUITE 200 NAPLES. FL 34108 NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 3) Person or Entitv would depend on proiect. ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY ~jLk. LobbyisC-S ignatu re I' STATE OF FLORIDA COUNTY OF COLLIER 'bed before me on this the 80 day I who is personally known to me.er-- d who did take an oath, 0) YVOfML.OGDIN NoIIrr PuIlIc . .... of ,..... . . lire... .Ullr...._..28t , , , ,,' C4IO\fI\Inllll . DO I1'IOM u" Please Note: 1) Failure to renew this registration by the renewal date of October 1st 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. Receipt# 007111334 10/7/20103:26:48 PM Dwight E. Brock Clerk of the Circuit Court @)VVDCC5uCIDD ~@@@D~~ Customer FREDERICK T. BARBER, DANIEL W. BRUNDAGE, DOMINICK J, AMICO, JAMES A. CARR, EDWARD G. TRYKA, STEVEN A AGNOLl, BARBER & BRUNDAGE, INC. 7400 TAMIAMI TRL N STE 200 NAPLES, FL 34103-3712 Deputy Clerk BMR CASHIER M inutesand Records@CollierClerk.com 239-252-2646 Clerk Office Location Collier County Govt. Center Building F, 4th Floor 3301 Tamiami Trail East P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY 7 DESCRIPTION BMR Lobbyist Registration UNIT COST $25,00 TOTAL AMOUNT DUE: Check# 13373 BALANCE DUE: AMOUNT $175.00 $175.00 ($175,00) $0.00 ~@O 0 D@[f~O@[f!ko (tg@[J[J1J Page 1 of 1