2004/20051-4 - a Lq 8o0
q/os
County of Collier
CLERK OF THE CIRCUIT COURT
COLLIER COUNTY COURTHOUSE
3301 TAMIAMI TRAIL EAST
P.O. BOX 413044
NAPLES, FLORIDA 34101-3044
ORIGINAL
OFFICIAL RECEIPT V#: 3356983 09/29/2004
When Validated
CHECK: 25.00
BY: LINDA HO MC AMT PAID: 25.00
DEPUTY CLERK
RECEIPT: 4347865
NAME : GEORGE HERMANSON
PAYOR: GEORGE H. HERMANSON
REFNC: LAH
DEPT: BOARD MINUTES AND RECORDS
DESCRIPTION AMOUNT
LOBBYIST ---- ----25 00
TOTAL DUE: 25.00
Page 01 of 01
HOLE MONTES, INC.
Vendor ID" ' 1317 COLLIER CTY CLERK OF CIRCUIT COURT
Check Amount: 25.00
Invoice # Date Invoice Amount Gross Payment Discount
Hermanson04 09/17/2004 $25.00
$25.00
Check #: 30543 30543
Date : 09/17/2004
Net Payment Notes
$25.00 George Hermanson - Lobbyist Registration
a L4 C)
COLLIER COUNTY
3301 Tamiami Trail East F-4
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
NAME George H. Hermanson, P.E. DATE September 17, 2004
BUSINESS ADDRESS Hole Montes Inc.
950 Encore Way
Naples, FL 34110
NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1) See attached
2)
ATTACH ADDITIONAL SHEETS AS MAY BE
Signature
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoin registration was sworn to and subscribed before me on
this the ► day of S Qom,`{ by eke a V�
who is personally known to me or who has produced
'•"• entification and who did take an oath.
awaarr��
�MrM1100e� BY
e�—Cle—r*M�MPublic
4..... „.Mryin°.i
Please Notes 1) Failure to renew this registration by the renewal
date of October Vt will result in the placement of this registrant on
a "status unknown■ list. 2) If one wishes to revoke this
registration, a ■Lobbyist Withdrawal■ form must be filed with the
Clerk to the Board. 3) Annual Registration Fee is $2S.00 per
Lobbyist according to Ordinance 99-22