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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 -LJ{,,-VIJ LJhpe\f(- Date \C'IJ-c!JC'L\ Business Address:l, ~) ~) 0 ( JC ({\ d ( ) e [1-, {: S c:s -,' 1=-(( t 1\.'\ lei) I F-C ,~~1 C 1- L1 s5 (p . Business Telephone ()~CD::2. ) ~ - ?)Cr:10 E-Mail (~Il-J L' t (' -t ( (;", 'I \ ,II f-t- NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: t). \) ()\ \ ('\ I-I, Ll ( , J').. \..1 C) \Jt'rlt' t\ o,{, Lc, Li ri- /,00, pit' '), r{ 3L1 \ (Y'~I 2). PLEASE ATTACH ADDITIONAL SHEETS IF NECESS c.~ Lobbyist Signature State of Florida County of Collier The for~oi1}g registration was sworn to and subscribed before me on this Z I sf day of LJeto~~ 2t1LD, by , who is personally known to me or has produce fLD L-- as identification and who did take anoaili CJ~ f Deputy Clerk/Notary Public 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 2007-2~. 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). ---' Receipt# 007114303 10/21/20108:28:47 AM Dwight E. Brock Clerk of the Circuit Court CQ)VVD@O([ln C-~@CG@DCQ)~ Customer DAVID WHEELER TR TRANSPORTATION CONSULTANTS, INC. 13881 PLANTATION RD STE 11 FORT MYERS, FL 33912- 4339 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# 1267 BALANCE DUE: AMOUNT $25.00 $25.00 ($25.00) $0.00 ((};@f}f}D@[f((};f}@[f[%o @@flilD Page 1 of 1