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2022/2023 Collier County Clerk of Courts Expires CA �a3 3299 Tamiami Trail E. (Clerk' office only) Suite 401, Bldg. F, 4th Floor Naples,Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name Ben Nelson Date 08/17/2022 Business Name Nelson Marine Construction Business Address 10923 Enterprise Ave. City Bonita Springs State FL Zip Code 34135 Business Telephone(239) 992-4443 Contact Person Lobbyist E-mail Ben@nelsonmaarine.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 Clerk of Court. (Mail to the address listed at the top of the form) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: 1. Name Stephen Buchalter 2. Name Address 493 Willet Ave Address City/State Naples Zip City/State FL Zip 34108 3. Name 4. Name Address Address City/State Zip C' /State Zip (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier Lobbyist Signature This registration was sworn (or affirmed) and subscribed before me this 17th day of, August , 20 22 , by Ben Nelson X Personally Known BY: Produced ID Deputy Clerk/Notary Public Type of ID Produced Revised:08/2019 Receipt# 008614927 9/1/2022 7:55:49 AM ,0vootc,,,,. Crystal K. Kinzel -�----4 Clerk of the Circuit Court and Comptroller fop, :cc 0 -C —E K _ _ am Cam o ER TyF.CIF‘„ Customer Deputy Clerk Clerk Office Location BEN NELSON BMR CASHIER Collier County Govt. Center NELSON MARINE MinutesandRecords@CollierClerk.co Building F, 4th Floor CONSTRUCTION m 3299 Tamiami Trail East, Suite 10923 ENTERPRISE AVE 239-252-2646 401 BONITA SPRINGS, FL 34135- P.O. Box 413044 6864 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# 35996 ($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. VOAR;IT©0(3g0E@ Page 1 of 1