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2010/2011 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 EXPires~ BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name~~L ~SS/e.r Date /0" i/ - /0 Business Address Sty'S 4ft: J'l-ree.::r- ~a:rkl j FL 3 i/D Y Business Telephone239- ulbul.. (pJi 7 E-Mai~L. /<:es-s /~~/lJarkhq/2.7: (j1<1 NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: l)'~I'~f ~,er /1.sS~6i~/7~Ai .stf s / /HfK.. 07";: ee-r Nc"f'~ I ~L ...3 Y/D >-- 2). PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY ~Z/ ~---/ ~bbYiSI Signature State of Florida County of Collier The for~oipg re~s~~ion was sworn to and subscribed before m. ~ on.~~~,"" ". ~ day of ~'l ~JU , by , Wh~;~!~P.f\{~~tWtY'lo.1()fll to me or ~as produced ~L- JX.-.:.;:~..."~:)r&idea4~~j~d who did take an oath""t~~<;-{!!fi~:~f-;< "~ BY:' ':,..;. ..~~~iet. .J? ary~: ~. 'J,,<'EH "'''T-i'.' r' The annual registration fee is 525.00 per Lobbyist, accor~ifcrCdJi~'fCftn Ordinance No. 2003-53, as amended by Ordinance 2004-05 and Ordinance 2 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). Dwight E. Brock Clerk of the Circuit Court Receipt# 007110331 10/4/20103:13:26 PM Customer JOEL KESSLER NAPLES ART ASSOCIATION, INC. 585 PARK ST NAPLES, FL 34102-6611 @UUD@D~JrJ [Jz~C~@@DCQ)1J 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# 31023 BALANCE DUE: AMOUNT $25.00 $25.00 ($25.00) $0.00 ~@!J!J o@rr~O@rrfko @@[![f[J Page 1 of 1