2009/2010
Board Minutes & Records
3301 Tamiami Trail East
Building F. 4th Floor
Naples, FL 34 t t 2
Expires__ q - 30 - 20 lO
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name J;t, '1 fflc? ,"'e 7 W- Date. ? rr' ;J-J;.)-. v P?
Business Address )-J-O t,.//~ '~?,-e.. .tf'1......-.f: ~_u
J1/V'-i / eJ Pi- _5 H /P )..--
Business Telephone .:2-37:~H.y--I.s-s-C?
E-Mail -Ie.r e 7 ..5" "-' .., c;:,; ?i?.... &:- h-J r~ -? e /
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY
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~JObbYist Signature
State of Florida
County of Collier
The foregoing registration was sworn to and subscribed before me on this __ c::<'!~\
day of Sect ,;( DO 1 . by',.hh VI F So veI.-l , ~ho is pers?nally k~()wn ~~
~ or has produced _____ _ , r as IdentIfication and
who did take an oath.
:........................ ~1 ~
s 8>' CAMIllE PiCKENS..........: BY'. /~ A I'L' / Cf' Ii ( /6: Ii }--.
: ~ Comm# 000745897 S 1St- . ~ <- __ _
i' . :811312012 ! Deputy ClerkiNotary Public
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J ne an n1lnPg'tS't'l"Mion fee is $25.00 per I..obbyist, according to Collier County
Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance 2007-24.
Please make payment and mail to: Collier County Clerk of Courts or
Dwight E. Brock, Clerk of Courts (at the address listed at the top of the form).
Receipt# 007023367
10/1/2009 11 :11 :51 AM
Dwight E. Brock
Clerk of the Circuit Court
CQ)uUD(~DCIDD ~@CC~X~l'~Q
Customer
JOHN F. SORREY III
220 GULF SHORE BLVD N
NAPLES, FL 34102-8450
Deputy Clerk
BMR CASHIER
M inutesand Records@CollierClerk.com
239-252-2646
Clerk Office Location
Collier County Govt. Center
Building F, 4th Floor
3301 Tamiami Trail East
P.O. Box 413044
Naples, Florida 34101-3044
1 Product
QUANTITY
1
DESCRIPTION
BMR Lobbyist Registration
UNIT COST
$25.00
TOTAL AMOUNT DUE:
Check# 665
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
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