2017/2018 Clerk to the Board,Minutes& Records Dept. Expires 0q 2 L V
3299 Tamiami Trail East, Suite#401 (Staff use only)
Building F,4th Floor
Naples, FL 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Steven J. Adamczyk Date 4/10/2018
Business Address Goede, Adamczyk, DeBoest & Cross, PLLC
8950 Fontana Del Sol Way Ste 100 Naples, FL 34109
Business Telephone 239-331-5100 E-Mail sadamczyk@gadclaw.com
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1) Glades Golf and Country Club, Inc.
174 Teryl Road, Naples, FL 34112
2).
(PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY)
4 / l
i
Lobbyist Signature
State of Florida
County of Collier
The foregoing registration was sworn to and su scribed before me on this 0�h
day of , by S\ t' \ ho isrs nay nown
me or has produced -- s-id ntiflcatton and
who did take an oath.
.o`"::(•Z1 ,c, LAURA C.STEADMAN ,1�
MY COMMISSION#8 145837 �►��i�, AA i
* lam) * `��
u i EXPIRES:July 28,2018 BY: t, i
''l91•FOF RoP Bonded Thru Budget Notary Services W '
Deputy Clerk/Notary Public
The annual registration fee is $25.00 per Lobbyist,according to Collier County
Ordinance No.2003-53, as amended by Ordinance 2004-05,Ordinance 2007-24
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# 007911140
4/13/2018 3:25:25 PM
�tiy�tiK� tr Dwight E. Brock
� ^ Clerk of the Circuit Court
n, F
•f`� 0as C a aaECEI-� a
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Customer Deputy Clerk Clerk Office Location
STEVEN J. ADAMCZYK BMR CASHIER Collier County Govt. Center
GOEDE, ADAMCZYK, MinutesandRecords@CollierClerk.co Building F, 4th Floor
DEBOEST & CROSS, PLLC m 3299 Tamiami Trail East, Suite
8950 FONTANA DEL SOL 239-252-2646 401
WAY, 1ST FLOOR P.O. Box 413044
NAPLES, FL 34109-4419 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# 18872 ($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.
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