Loading...
2016/2017 Collier County Clerk of Courts Expires 6 1 -• .011 3299 Tamiami Trail E. (Clerk's office only) Suite 401,Bldg. F,4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name CiZx.k( Cj."-.eft, Date tit (106 Business Name W'Q t Bt....4(k)— + Ji-550+c,.1 5, �K Business Address 4 4 10 CtiO4,4,0 Pea t..0,1 'S J.1t l L l City Fe. 4 .4143-Lr, State FL Zip Code 33u1' Business Telephone A 3q-331-36 20 Contact Person CrekS:��'f Lobbyist E-mail C y - f (ail ct eac1:70,c L-s Lc e., 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 A/&—Ftes tkillev. 2. Name Address « tom'•k et A kr Address City 1"ts Zip Code 31 It Z- City Zip Code 3. Name 4. Name Address Address City Zip Code City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida o�e�`Ek►I4I+rico,; County of Collier q..• - Lobbyist Signature >,'`- fa+•• °•. • This reais_tr_ation was sworn(or affi ed) subscrib d before me this- � 'c: c'- Personally Known BY: j_t,4A 1I.,r z':' Produced ID , Deputy C1et. • y A' blip Type of ID Produced , LA Revised'08/2011 Receipt# 007733570 11/17/2016 8:43:45 AM Dwight E. Brock / Clerk of the Circuit Court 1 Customer Deputy Clerk Clerk Office Location CRAIG SMITH BMR CASHIER Collier County Govt. Center W. DEXTER BENDES & MinutesandRecords@CollierClerk.co Building F, 4th Floor ASSOCIATES, INC. m 3299 Tamiami Trail East, Suite 4470 CAMINO REAL WAY 239-252-2646 401 STE 101 P.O. Box 413044 FORT MYERS, FL 33966-1119 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. ©OQQ11gD(@Q@ ❑@Co (Dj] Page 1 of 1 Update D.R. Horton Homes 10541 Six Mile Cypress Pkwy., Suite 100 Fort Myers, FL 33966 Neal Communities 5800 Lakewood Ranch Blvd. Sarasota, FL 34240 Eagle Ready Mix, LLC 16576 Gator RD Fort Myers, FL 33912 Stock Development 2647 Professional Circle, Suite 1201 Naples, FL 34119 PulteGroup, Inc. 24311 Walden Center Drive, Suite 300 Bonita Springs, FL 34134