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2017/2018 Collier County Clerk of Courts Expires gIf2 3299 Tamiami Trail E. (Clerk's oice Only) Suite 401, Bldg. F, 4th Floor Naples, Florida 34112 COLLIER COUNTY LOBBYIST REGISTRATION FORM Lobbyist Name Nancy Conicella Date 4/5/17 Business Name Lowndes, Drosdick, Doster, Kantor & Reed, P.A. Business Address 215 N. Eola Drivr City Orlando State FL Zip Code 32801 Business Telephone 407-843-4600 Contact Person Lobbyist/Contact E-mail nancy.conicella@lowndes-law.com Notice for 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 Walmart 2. Name Address 9885 Collier Boulevard Address City Naples Zip Code 34114 City 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 Lob ist Signat re This registration was sworn (or affirmed) and subscribed before me this 5 "A day of 11411_, , 20 l 1 , by IVunc►/ Cance l/e . Personally Known BY: Produced ID KATHRYN SMITH De ity C _k/Notary Public Type of ID Produced . . ARY pUBUC �3 STATE OF FLORIDA .�.:•-4 Cane 03029204 • Expires 9/12/2020 Revised:08/2014 Receipt# 007781533 4/11/2017 8:21:41 AM Dwight E. Brock Clerk of the Circuit Court r� Customer Deputy Clerk Clerk Office Location NANCE CONICELLA BMR CASHIER Collier County Govt. Center LOWNDES, DROSDICK, MinutesandRecords@CollierClerk.co Building F, 4th Floor DOSTER, KANTOR & REED, m 3299 Tamiami Trail East, Suite P.A. 239-252-2646 401 215 N EOLA DR P.O. Box 413044 ORLANDO, FL 32801-2028 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#281272 ($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. ©0D1Y1® 11® gQ[lL�fL Page 1 of 1