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2014/2015 Clerk to the Board, Minutes &Records Dept. Expires Ns-- 3299 Tamiami Trail East, Suite #401 (Staff use only) Building F,4th Floor Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Terrence R. Holihen Date 01/29/2015 Business Address4500 PGA Boulevard, Suite 400 Palm Beach Gardens, FL 33418 Business Telephone 561 -624-4000 E-Mail tholihen @kitsonpartners.com NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). KE Talis Park Properties, LLC 16990 Livingston Road Naples, FL 34110 2) Talis Park Community Development District do Governmental Management Services-South Florida, LLC 5385 North Nob Hill Road, Sunrise, FL 33351 (PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY) Lobbyist Signature State of Florida County of Collier The foregoing registration was sworn to and subscribed before me on this day of January ,by Terrence R.Holihen ,who is personally known to me 13 tvidgazidxx a oxxx.... ...,.,;:. .:.. .:.. ;.....:....;...:.. •....z ielartificstlim and who did take an oath. � �O�vk Deputy Clerk/Notary Public \`�00.1E R e...... N,1S 2►O h 4.0":9 The annual registration fee is$25.00 per Lobbyist,according to Collier County i yo�y �o Ordinance No.2003-53, as amended by Ordinance 2004-05, Ordinance 2007-24= : cn and Ordinance 2013-39. — �� Please make payment to: Collier County Clerk of Courts or SW. 4FF056031 Q Dwight E. Brock, Clerk of Courts and mail to the address listed at the top of the ean .� : INC{..CIiJbf WSJ/JLVVVV 2/6/2015 2:27:12 PM y ; ;r �; <<;1 Dwight E. Brock Clerk of the Circuit Court l 4 O D)CC@CM[I]— O Customer Deputy Clerk Clerk Office Location KITSON EVERGREEN LLC BMR CASHIER Collier County Govt. Center 4500 PGA BLVD STE 400 MinutesandRecords @CollierClerk.co Building F, 4th Floor PALM BEACH GARDENS, FL m 3299 Tamiami Trail East, Suite 33418-3995 239-252-2646 401 P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 2 BMR Lobbyist Registration $25.00 $50.00 TOTAL AMOUNT DUE $50.00 Check# 12938 ($50.00) 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. @a0�@Q@Qig g Ea Page 1 of 1