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2021/2022
0 q Collier County Clerk of Courts Expires 3299 Tamiami Trail E. (Clerk's ffice only) Suite 401, Bldg. F, 4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name A I-)AP-t( 1-0AA((4 0 ) Date 3 2 22 Business Name 14 Oo 041?20 ) 9lQE' (-1- L„onn A4(-0D , PA - Business Address 3190 I�,� 1 R/} j L A.) ,S)-L- 261.- City (Vf1l.L > State L Zip Code 33101 Business Telephone (z $1) (`l/-(S I r Contact Person Lobbyist E-mail 2 LoM i5,4 20 P LG G C - 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 2. Name Address Address City/State Zip 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 Lobbyis ignat - 4* This registration was sworn (or affirmed) and subscribed before me this .�_' , day-of, , 20a , by Zs4. .. — • 0 Personally Known BY: Produced III Deputy Clerk/Notary u Iic,' Type of ID Produced ,,., ed.08/2019 Receipt# 008542133 3/24/2022 9:52:21 AM ",,,o,; Crystal K. Kinzel /LL } , \' Clerk of the Circuit Court and Comptroller _ T . I al _ J. 0 ,,_._ E E gig-@- _L:7 , - _-NE) ggc-D--7 _ -,09ER Customer Deputy Clerk Clerk Office Location ZACHARY W. LOMBARDO BMR CASHIER Collier County Govt. Center WOODWARD, PIRES AND MinutesandRecords@CollierClerk.co Building F, 4th Floor LOMBARDO, P.A. m 3299 Tamiami Trail East, Suite 3200 TAMIAMI TRL N STE 200 239-252-2646 401 NAPLES, FL 34103-4108 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 ZACHARY LOMBARDO Card: 2000 (Approval: 654c3d59-fac6-42a2-b82b-0cfe502edc88 ) ($25.00) BALANCE DUE $0.00 Note: 3/24/2022 9:52:21 AM BMR CASHIER:An additional card convenience fee of 3.5%was paid to nCourt LLC for a total card amount of: $25.88. Questions regarding processing fees should be directed to nCourt at(239)207-3731 or(800) 701-8560. Reference Invoice Number: 654c3d59-fac6-42a2-b82b-0cfe502edc88 and Item Number: 05320220324095149 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. ©®11[111QT@OQgOEfa Page 1 of 1