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2014/2015 Clerk to the Board, Minutes&Records Dept. Expires 09 MP 3299 Tamiami Trail East, Suite#401 (Staff use only Building F, 4th Floor Naples, FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Laura Pemberton Date 9-14-15 Business Address 1495 Smith Preserve Way Naples Florida 34102 Business Telephone 239-262-0304 E-Mail caep @conservancy.org NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1) Conservancy of Southwest Florida 1495 Smith Preserve Way Naples, Florida 34102 2). (PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY) A4416 A t c�, Lobbyist Signature State of Florida County of Collier The foregoing registration was sworn to and subscribed before me on this 144-U day of .t.g;t, _.,.0 t S , by L Q t.A ca P e AN r+n , who is personally known to me or has pr d ced _ _ _ . . _ _ _ _ _ as identification and who did tak ;4l ,, MARGARET ANN DARDIS e 1. Notary Public-State of Florida •: IrCL.CIIJL1r vv I J.7/Vv-, 9/16/2015 3:40:45 PM Dwight E. Brock Clerk of the Circuit Court Customer Deputy Clerk Clerk Office Location M. CARROZZO, J. CRANE, A. BMR CASHIER Collier County Govt. Center CROOKS, J. HECKER, R. MinutesandRecords @CollierClerk.co Building F, 4th Floor MOHER, L. PEMBERTON & C. m 3299 Tamiami Trail East, Suite WEBER 239-252-2646 401 CONSERVANCY OF SW P.O. Box 413044 FLORIDA Naples, Florida 34101-3044 1495 SMITH PRESERVE WAY NAPLES , FL 34102 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 7 BMR Lobbyist Registration $25.00 $175.00 TOTAL AMOUNT DUE $175.00 Check# 14500 ($175.00) 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. ©01:1 rig0@gg L1 Page 1 of 1