2016/2017 Clerk to the Board, Minutes &Records Dept. Expires q11;1017
3299 Tamiami Trail East, Suite#401 (Staff use onl )
Building F, 4th Floor
Naples, FL 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Kathleen Curatolo Date11 /22/16
Business AddressCBIA, 3200 Bailey Ln., Suite 110 Naples FL 34105
Business Telephone 239-436-6100 E-Mailkathy@cbia.net
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1). Collier Building Industry Association
2).
(PLEASE ATTACH ADDITIONAL SHE CESSA,tY)
Lobbyist Signature
State of Florida
County of Collier
The foregoing regi tration was sworn to and subscribed before me on this c).�
day of ,J O -sor , by 1 1Alten Cur 1-o 1 , who i ersonally known o
n e..or has produced as identi ication and
who did take ano aatth. __,,,,,
siy : MICHAEL PUCHALLA
MY COMMISSION#FF 223784
./ ,
EXPIRES:May 1,2019 BY: i�,i, `�
~'d,;R �' Bonded Thru Notary Puble Underwriters
wwwwwwwwwwwwwwwwwwwwwwwwwwwww 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# 007749404
1/5/2017 3:29:35 PM
Dwight E. Brock
Clerk of the Circuit Court
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Customer Deputy Clerk Clerk Office Location
KATHLEEN CURATOLO BMR CASHIER Collier County Govt. Center
CBIA MinutesandRecords@CollierClerk.co Building F, 4th Floor
3200 BAILEY LN STE 110 m 3299 Tamiami Trail East, Suite
NAPLES, FL 34105-8524 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
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.
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