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2022/2023 Collier County Clerk of Courts Expires 09 (90033 3299 Tamiami Trail E. (Clerk' office only) Suite 401, Bldg. F, 4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NameBen Smith Date7/14/2022 Business Name Morris-Depew Associates, Inc. Business Address 2914 Cleveland Ave i Fort Myers State Florida Zip Code 33901 Business Telephone 2393373993 Contact Person Ben Smith Lobbyist E-mail bsmith@m-da.com 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, Ordinance 2007-24 and Ordinance 2013-39. Please make payment(s) to: Collier County Clerk of Courts & Comptroller. (Mail to the address listed at the top of the form) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: Mediterra Community Association, Inc. 1. Name 2. Name Address 15735 Corso Mediterra Circle Address City/State Naples / Florida Zip 34110 City/State Zip 3. Name 4. Name Address Address City/State Zip City/State Zip (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier , Efte mot- �� gist S' re This registra ' n was sworn (or affirmed) and subscribed before me this /g day of JI-t'Cy 20 2Z by Den Srn l i/Personally Known B Produced ID e ty Clerk/Notary Public Type of ID Produced 0 • ' *Wen Abraham Notary Public Revised:08/2019 W �1 State of Florida • •••,.0 Comm#HH102345 Expires 3/9/2025 Receipt# 008614929 9/1/2022 8:01:44 AM Crystal K. Kinzel Clerk of the Circuit Court and Comptroller mP�Of TNFC10.�J`�`O Or � _ - 0 [R Customer Deputy Clerk Clerk Office Location BEN SMITH BMR CASHIER Collier County Govt. Center MORRIS-DEPEW MinutesandRecords@CollierClerk.co Building F, 4th Floor ASSOCIATES, INC m 3299 Tamiami Trail East, Suite 2914 CLEVELAND AVE 239-252-2646 401 FORT MYERS, FL 33901-6003 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#5520 ($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. @O1:1D11QTgl® g'griM Page 1 of 1