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2013/2014 Collier County Clerk of Courts Expires (.t/6 3299 Tamiami Trail E. (Cler 's otlice ) Suite 401,Bldg.F,4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Michael Herrera Date 9/30/13 Business Name J.R.Evans Engineering,P.A. Business Address 23150 Fashion Drive,Suite 242 City Estero State FL Zip Code 33928 Business Telephone 239-405-9148 Contact Person Michael Herrera Lobbyist E-mail michael @jrevansengineering.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 See attached list 2. Name Address Address City Zip Code 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 Collier ." Lobbyist Signature This registration was sworn (or affirmed) and subscribed before me this 30 day of, ut 20 13 ,by Michael Herrera `��T—✓ Personally Known BY: - �_.. Produced ID Deputy Clerk/Notary Pub"c Type of ID Produced SABINA E.HARDY Revised:08/2011 SMY rye MY COMMISSION#EE 022300 EXPIRES:0etober 28,2014 Bonded Thru Notary Public UndS flt5rs J,R, EVANS ENGINEERING LOBBYIST REGISTRATION LIST OF PERSONS OR ENTITIES REPRESENTED 9.30.13 PULTE HOMES COLLIER ENTERPRISES MANAGEMENT AVE MARIA DEVELOPMENT WALDROP ENGINEERING FOREST GLEN GOLF&COUNTY CLUB COLLIER'S RESERVE COUNTY CLUB DON STEVENS THE LUTGERT COMPANIES BENDERSON DEVELOPMENT QUARRY CDD COASTAL RESOURCE GROUP FLOODZONE REVISIONS, LLC KMF ENVIRONMENTAL CONSULTING THE CHURCH OF JESUS CHRIST OF LDS FIFTH THIRD BANK JCS REALTY GROUP KMK CAPITAL HEADWATERS DEVELOPMENT LIMITED LIABILITY PARTNERSHIP, LLLP BB&T DAVID ALBIN ARGENT MANAGEMENT WALSH COMPANIES CAMERATTA COMPANIES LENNAR HOMES, LLC WILLIAMS FARMS, INC. CENTEX PMP MANAGEMENT SRS ENGINEERING OUTSIDE PRODUCTIONS RCMA KITSON PARTNERS AMERICAN FARMS ARGO LAND 23'S' wash;_., Drive, Ste. 242. Estero: FL 33928 P . �5.9I1 • F 239.2H.2537 V vai.!Se!`_jt ieeiin CQfI' Receipt# 007382764 10/2/2013 1:25:45 PM Dwight E. Brock Clerk of the Circuit Court rrre zit � 21R Customer Deputy Clerk Clerk Office Location A. JENKINS, M. HERRERA, J. BMR CASHIER Collier County Govt. Center EVANS, E. FOUNTAIN & D. MinutesandRecords @CollierClerk.co Building F, 4th Floor HARTLEY m 3299 Tamiami Trail East, Suite J.R. EVANS ENGINEERING 239-252-2646 401 23150 FASHION DR STE 242 P.O. Box 413044 ESTERO, FL 33928-2568 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 5 BMR Lobbyist Registration $25.00 $125.00 TOTAL AMOUNT DUE $125.00 Check# 1270 ($125.00) 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. &DU rGITagriBCCD@CM Page 1 of 1