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2014/2015 Collier County Clerk of Courts Expires (1 20 3299 Tamiami Trail E. (Clerk's fiee only) Suite 401, Bldg. F, 4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name D l0 41, O n-T�'7 Date // 7 /7 Business Name--D,Al.p•c-p A • )? -' ?i� Business Address be-4)Z) 7-1190//0// 7G Al 're 70._ City /0/1-P State " Zip Code 3 L/ Business Telephone °2 63-3660 Contact Person' O N ( ( '( Ix) Lobbyist E-mail / �-(� � caJ eq. r irk i< me- i 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 2. Name Address Address City ip C't Zip Code oeplrogircies00 3. Name 4. Name Address Address City Zip Code City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County Collier //r/ '/ /i /' 411 t3' �i � Lobbyist S gn.ture This registration was sworn(or affirmed) and subscribed before me this �v day of, NOra),Qfe, 20/' , by DOA)PrL-t Pr. QK-K 3O ( . Personally Known BY: Produced ID D„Y. y Clerk/Notary Public Type of ID Produced .41104,„� Commis on#FF NS :e. Commission#FF 049606 Expires December 29,2017 %ARf" Bonded Tlvu Troy Fain Hwurenoe8OD3&F70+e Revised:08/2011 Clients represented by Donald A. Pickworth, PA 1. Housing Finance Authority of Collier County c/o Donald A. Pickworth, General Counsel 5100 Tamiami Trail N STE 103 Naples, FL 34103 2. Collier County Health Facilities Authority c/o Donald A. Pickworth, General Counsel 5100 Tamiami Trail N STE 103 Naples, FL 34103 3. Collier County Educational Facilities Authority c/o Donald A. Pickworth, General Counsel 5100 Tamiami Trail N STE 103 Naples, FL 34103 4. Collier County Industrial Development Authority c/o Donald A. Pickworth, General Counsel 5100 Tamiami Trail N STE 103 Naples, FL 34103 5. City Gate Community Development District c/o Donald A. Pickworth, District Counsel 5100 Tamiami Trail N STE 103 Naples, FL 34103 r�cs.ciprirr vv I.wLU.�L 11/13/2014 12:32:17 PM ,,,;;�1��< rl Dwight E. Brock � Clerk of the Circuit Court � o C ` O fff \ _ �.n: _ -- /( / O Q /7!3 C IRS° Customer Deputy Clerk Clerk Office Location DON PICKWORTH BMR CASHIER Collier County Govt. Center 5100 TAMIAMI TRL N STE 103 MinutesandRecords @CollierClerk.co Building F, 4th Floor NAPLES, FL 34103-2810 m 3299 Tamiami Trail East, Suite 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# 6120 ($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. 00[1D11®Dvag gOGu�i Page 1 of 1 4 : - Martha S. Vergara From: Don Pickworth <picklaw @qm.net> Sent: Wednesday, April 22, 2015 1:11 PM To: Martha S. Vergara Subject: Lobbyist update This firm represents the following entities, which we believe were the same entities that were listed in the October 2014 registration. However, if they are not the same, please consider the following the current list: Housing Finance Authority of Collier County Collier County Health Facilities Authority Collier County Industrial Development Authority Collier County Educational Facilities Authority Thank you for your reminder emails. Please let us know if you need further information. Donald A. Pickworth Donald A. Pickworth PA 5100 Tamiami Trail North #103 Naples, Florida 34103 239.263.8060 I. ida-ks Martha S. Vergara From: Don Pickworth <Picklaw @sds.net> Sent: Tuesday, June 16, 2015 12:55 PM To: Martha S. Vergara Subject: Re: Lobbyist Update This firm represents the following entities, which we believe were the same entities that were listed in the first quarter update. However, if they are not the same, please consider the following the current list: Housing Finance Authority of Collier County Collier County Health Facilities Authority Collier County Industrial Development Authority Collier County Educational Facilities Authority Thank you for your reminder emails. Please let us know if you need further information. Donald A. Pickworth Donald A. Pickworth PA 5100 Tamiami Trail North #103 Naples, Florida 34103 239.263.8060 Donald A. Pickworth Donald A. Pickworth PA 5100 Tamiami Trail North #103 Naples, Florida 34103 239.263 .8060 On 6/16/2015 11:06 AM, Martha S. Vergara wrote: Morning All, If you haven't updated the Lobbyists/clients please do so prior to the end of this month. Attached below is a sample of an update: 1