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2016/2017 Clerk to the Board, Minutes &Records Dept. Expires e)?/2-677 3299 Tamiami Trail East, Suite#401 (Staff use on! Building F,4th Floor Naples,FL 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Michael R Ramsey Date 10 Jan 2017 Business Address 2631 4th St NW, Naples, FL, 34120 2395641660 RAMSEY.INC@EMBARQMAIL.COM . . Business Telephone E-Mail NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). Joe Huber 3645 SR 982 Latrobe, PA PA 15650 2) Walter Kulbcki 7677 Colonial Ct Naples, FL 34112 (PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY) Lobbyist Signature State of Florida County of Collier d r1 The foregoing registration was sworn to and subscribed before me on this day of Jqe,✓Ce;.f 2.)1 7 ,by R Q kixim 5 ,who is Personally known to me or has produced idunflfi.pation and who did take an oath. _ BY / !' ti Deputy Clerk/Notary ' blic The annual registration fee is $25.00 per Lobbyist, according to Collier Co ty Ordinance No. 2003-53, as amended by Ordinance 2004-05, Ordinance 2007- and Ordinance 2013-39. Please make payment to: Collier County Clerk of Courts or Dwight E. Brock, Clerk of Courts and mail to the address listed at the top of the form. Receipt# 007750406 1/10/2017 9:02:00 AM k ,l Dwight E. Brock Clerk of the Circuit Court Customer Deputy Clerk Clerk Office Location MICHAEL R. RAMSEY BMR CASHIER Collier County Govt. Center RAMSEY INC. MinutesandRecords@CollierClerk.co Building F, 4th Floor 2631 4TH ST. SW m 3299 Tamiami Trail East, Suite NAPLES, FL 34120 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#2677 ($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. ©CDUEIMW©11®ffihoggE10 Page 1 of 1