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2007/2008County of Collier CLERK OF THE CIRCUIT COURT COLLIER COUNTY COURTHOUSE 3301 TAMIAMI TRAIL EAST P.O. BOX 413044 NAPLES, FLORIDA 34101-3044 Dwight E. Brock Clerk BY: TERESA D DEPUTY CLERK RECEIPT: 5280118 NAME : DANIEL BRUNDAGE PAYOR: DANIEL W. BRUNDAGE REFNC: TLD ORIGINAL OFFICIAL RECEIPT When Validated DEPT: BOARD MINUTES AND RECORDS Vc 4268518 10/02/2007 CHECK: 25.00 CT AMT PAID: 25.00 DESCRIPTION AMOUNT LOBBYIST25 00 TOTAL DUE: 25.00 Page 01 of 01 '�3_-73( 60 COLLIER COUNTY 3301 Tamiami Trail East Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM NAME DANIEL W. BRUNDAGE, P.E. DATE SEPT. 27,2007 BUSINESS ADDRESS: AGNOLI BARBER & BRUNDAGE, INC. 7400 TAMIAMI TRAIL N. SUITE 200 NAPLES FL 34108 NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1) Person or Entity would depend on project. ATTACH ADDITIONAL SHEETS AS MAY BE NECESSARY STATE OF FLORIDA COUNTY OF COLLIER The foregoing registration of September, 2007 by, ------------- 1IYOMIR40YOtM 00"Pok•aft M"Wft wOMMWIM�fyMA1�� WOW" t Ob pl11 before me on this the c,�77_ day who is personally known to me er- ifn and who did take an oath. 'Deputy Clerk/NotaryPublic Please Note: 1) Failure to renew this registration by the renewal date of October 1st 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 $25.00 per Lobbyist according to Ordinance 99-22.