2004/2005B•�3ioa
4/03
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#: 3358727 10101/4M04
When Validated
CHECK: 25.00
BY: LINDA HO MC AMT PAID: 25.00
DEPUTY CLERK
RECEIPT: 4349666 DESCRIPTION AMOUNT
NAME DANIEL W. BRUNDAGE LOBBYIST=====----------------=----25 00
PAYOR: DANIEL W. BRUNDAGE
REFNC: LAH
DEPT: BOARD MINUTES AND RECORDS
TOTAL• DUE : 25.00
Page 01 of 01
COLLIER COUNTY
3301 Tamiami Trail East
Naples, Florida 34112
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Daniel W. Brundage, P.E. DATE September 27, 2004
BUSINESS ADDRESS Agnoli, Barber & Brundage, Inc.
7400 Tamiami Trail North, Suite 200
Naples, FL 34108
NAMES AND BUSINESS ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1) Person or entity would depend on Project.
2)
ATTACH ADDITIONAL SHEETS
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing registration was jylbto
September, 2004 by
known to me ouvl3e ham prnducPd_
did take an oath.
s YVONNE L. OGDEN
1.:
Notary Public, State of Florida
r
`'
My Comm. expires Aug. 26, 2007
,,,
Comm. No. DD245024
before me on this the 27 day of
who is personally
as identification and who
B
Deputy Clerk/Not Public
Please Note: 1) Failure to renew this registration by the renewal date of October I" 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.