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2009/2010 Receipt# 007046915 1/19/20104:14:22 PM Dwight E. Brock Clerk of the Circuit Court @VVD@O([}O ~@@@D~U Customer DAVID FARMER KEYSTONE DEVELOPMENT ADVISORS, LLC 12355 COLLIER BLVD STE B NAPLES, FL 34116-6027 Deputy Clerk BMR CASHIER M inutesand Records@CollierClerk.com 239-252-2646 Clerk Office Location Collier County Gov!. 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: Cash Tendered: BALANCE DUE: AMOUNT $25.00 $25.00 ($25.00) $0.00 (Q;@O 0 o@rr(Q;O@rr[};ro @@!J[f[J Page 1 of 1 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 Expires: 2007-10-08 BOARD OF COUNTY COMMISSIONE~ LOBBYIST REGISTRATION FORM Name: David Farmer Date: January 19, 2010 Business Address: Kevstone Develooment Advisors. LLC 12355 Collier Blvd Suite B Naoles. Florida 34116 Business Telephone: +1 (239) 263-1100 Email: dave@keystonellc.net NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1. Rich Yvanovich 435-3535 2. Bruce Anderson for Jack Sullivan 649-2708 PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY JO~ Lobbyist Signature "'" ~- State of Florida County of Collier The foregoing registration was sworn to and subscribed before me on this i ,\\,"HHr::,,.. :\\ ",, ,':'I'" ,/ fi; ,'" ;ry-'rll,o' ~,..... o~. .~ '... ~ " day OLbY)\)lIyj/LoIO or has produced ~- . BY: .~. i' .L;,I r. dr,' .~, ':'. , who i~ pe'fo~l~t .~f~~nf' me =. to (.::' i>) :,'" (;;,9.:" : as idenencation and' whQ)tlid:t<lke ..~~;:.. ..... ' l'f.... ~ .~. '" " " , by F L 'J::L an oath. The annual registration fee is $2S.00 per Lobbyist, according to Collier county Ordin n No. 2003-S3,as amended by Ordinance 2004-0S 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).