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2010/2011 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 Expires: 2007-10-08 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name: Carol A. licko Date: October 12, 2010 Business Address: Hogan Lovells US LLP 1111 Brickell Avenue. Suite 1900 Miami. Florida 33131 Business Telephone: +1 (305) 459-6612 Email: carol.licko@hoganlovells.com NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1. Jackson Laboratorv 600 Main Street Bar Harbor. ME 04609 PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY C~(] L<,lu Lobbyist Signature State of Florida. ' , \ I} Countyof'" "~~-D,~ The foregoing registration was sworn to and subscribed before me on this day of O~ ';;o/<i' by C~ ,4 ~du ' who is personally known to me /,;? K or t'ld~ t-'Ioeh::le:cd as identification and who did take an oath. l~\'~'.!~, PATRICIA A. COURTNEY ,,,"1;;.",,, Commission DO 70n66 ~~jf Expires September 19, 2011 "',1l'r.,f,\'*" Bar1ciedThNTroyF<<inl~"'7019 The annual registration fee is $25.00 per Lobbyist, according to Collier county Ordinance No. 2003-53,as amended by Ordinance 2004-05 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). Receipt# 007112628 10/13/20102:32:25 PM \.\~fC{jl::V" 27;/. ~~" / '~-'\_>:_<" \.. I' -'I .~. I, 'I ~, ',I. fi-, 0;:\ \;j!2 ~1;"-. 'i; ,;0 -'/"iTii::f.:\;t;,'\\\ Dwight E. Brock Clerk of the Circuit Court r;~\{. ,CJ (-2[:1 __ C \' II ell (c-'" \,--~)) L I LJ I '\\~7 (..;c-;\',Il. (0 ' '''-___--'''---.\ '-'-..1 ---'\ c: ( l ?) (Q\ i~ ~o (oj 'I ~I r;:;\ I" J[ !\",~'?5''=7\,-'> 1/), J Clerk Office Location Collier County Govt. Center Building F, 4th Floor 3301 Tamiami Trail East P.O. Box 413044 Naples, Florida 34101-3044 Customer HOGAN LOVELLS 1111 BRICKELL AVE STE 1900 MIAMI, FL 33131-3142 Deputy Clerk BMR CASHIER M inutesand Records@CollierClerk.com 239-252-2646 1 Product QUANTITY 1 DESCRIPTION BMR Lobbyist Registration UNIT COST $25.00 TOTAL AMOUNT DUE: Check# 7103 BALANCE DUE: AMOUNT $25.00 $25.00 ($25.00) $0.00 Page 1 of 1