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2014/2015 Collier County Clerk of Courts Expires Oq 2015 3299 Tamiami Trail E. (Clerk' office only) Suite 401,Bldg. F,4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name J E,stbs -561-05 Date l 13o))S Business Name TOLD SdU2i10105 LLC Business Address q )4 TIe-1Z2p■ X65 (A)t4-y City L£`5 State `FL- Zip Code 344 l 9 Business Telephone a 3q Q 4 7- ZOOO Contact Person 36-)\--N NE BOLaO5 Lobbyist E-mail J E.Ct r n e SOL.U 1-ton1S 0)0t-t Ov E C.Oty\ 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 C!O‘V1:IMU,l3rtt{ rotl.tvoPcno1) 2. Name 6rnu5612VANU( a• P20 tZIDA bF- C6 IL1 CO ULIO i( Address gi ,p -tar W I -re-Pk/L_0, Address 114x5 5ry mit -PM,,2t)E W1.44-9 - oOs City MA-p j 7=L Zip Code 3Lk 3 City Is p t E5 Ft. Zip Code 34.10. 3. Name U Nr i'M Al?r5 eoU Ill C f5F 4.Name C01-146e. CD►l,1JT5/ Address .a335 p-ni l -- >J Address City IJ q-p>z5 F L Zip Code-1003 City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier C ii obbyist Signature This registration was sworn(or affirmed) and subscribed before me this 30 day of, Lu ,20 l ,by 3e cis • Personally Known BY: ∎a1i�� SBA.% Produced ID ��8 O Deputy Clerk/Notary Public Type of ID Produced D y�, P,>k� 'h iJ F`""�►, c31ANNl►'AAR E HARP * * MY CO6gd #FF EXPIRES:ISSION Atxil 5,2019 217433 Revised:08/2011 4.44017:01 Banded Itru Budget Notify Sent* 11C{..CII.JI}f VV I JI VLV0 7/6/2015 2:13:59 PM ,,,. t. Dwight E. Brock y; ~, Clerk of the Circuit Court ��� o ffct- � ED ID) CR -E). (-7Th C=1 liy."Clf Customer Deputy Clerk Clerk Office Location JEANNE BOLDS BMR CASHIER Collier County Govt. Center BOLD SULUTIONS, LLC MinutesandRecords @CollierClerk.co Building F, 4th Floor 914 TIERRA LAGO WAY m 3299 Tamiami Trail East, Suite NAPLES, FL 34119-1800 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# 1312 ($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. ©®° 11D11® O® gOEla Page 1 of 1