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2016/2017 Collier County Clerk of Courts Expires 3299 Tamiami Trail E. (Clerk' Office Only) Suite 401, Bldg. F, 4th Floor Naples, Florida 34112 COLLIER COUNTY LOBBYIST REGISTRATION FORM Lobbyist Name 112&14---- --10-S Date Ij 3/is3- Business Name ").)a-C.kat 96-1/4-VWC/5 Business Address 11 s Ste- I 2) — City (jI/N State Zip Code 35603 Business Telephone( 337 (006-3 Contact Person It) 11/4 ZOS 166 Lobbyist/Contact E-mail +Odd 19A. t (614-4t44-( ot----- Noticefor Lobbyists: The annual registration fee is$25.00 per Lobbyist,per Collier County Ordinance No. 2003-53, as amended by Ordinance 2004-05, Ordinance 2007-24 and Ordinance 2013-39. Payments made out to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts(ADDRESS ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1. Name kik i - 2. Name Address N'35. lekk,..,1 Address Zol kit ritiAtela:44 It e.-1100 City I A 2 Zip Code 36 s" City IN/V94 Ft... 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 Lobby's Signature This registration was sworn (or affirmed) and subscribed before me this day of: , 20 17 , by 1 ioSLD ,0Z.41,4iv Personally Known BY: . X Produced ID Deputy Clerk/Notary Public' Type of ID Produced "a-- Revised:08/2014 Receipt#007748385 1/3/2017 12:43:57 PM Dwight E. Brock Clerk of the Circuit Court t%5' _ _ it Customer Deputy Clerk Clerk Office Location TODD JOSKO BMR CASHIER Collier County Govt. Center BALLARD PARTNERS MinutesandRecords@CollierClerk.co Building F, 4th Floor 1726 E 7THE AVE. SUITE 13- m 3299 Tamiami Trail East, Suite 15 239-252-2646 401 TAMPA, FL 33605 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 Cash Tendered ($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. ©gni CSQ NCI Page 1 of 1 Update iC5 Martha S. Vergara From: Lindsey Parks <lindsey@ballardfl.com> Sent: Friday, July 14, 2017 12:59 PM To: Minutes and Records Subject: Entity termination for lobbyist registration Good afternoon, Todd Josko, Partner at Ballard Partners is a registered lobbyist in Collier County. Please remove Mobilitie as a represented entity for Mr. Josko. We no longer represent that client. We do still represent HNTB. Please send confirmation and let me know if any additional information is required. Thanks, Lindsey BALLARD I PARTNERS Lindsey Parks Project Manager Ballard Partners—Tampa 1726 E. 7th Ave,Ste 13-15 Tampa, FL 33605 (813)374-6007 office (727)417-5533 cell Lindsev@ballardfl.com www.Ballard-Partners.com