2010/2011
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
Expires ~
BOARD OF COUNTY COMl\1ISSIONERS
LOBBYIST REGISTRATION FORM
Nameq,.0. ~h'6/"':- S Date /C> ~- /"w/c
/ /
Business Address /~ 020 8 (L .4R'F. 0 041:// 9;, c:2
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Business Telephone ~d 5> - %.s-- ~ E-Mail ~lQ"'.."..s1 ~~ @LO!AE/c /}vdv 6~c;
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1).
2).
PLEASE ATTACH ADDITIONAL SHEETS IF NECE ARY
State of Florida
County of Collier
The foregoing registration was sworn to and subscribed before me on this ~
day of ~""'i.. ~ ~ ~ , by-::p~ ~~~ \ \.:> ~ , who is personally known to
me or has produced /)1- ;.: L Ly ~~ 0 - r;.,//4 - ~LJ .- /)cf7-tA1s identification and
who did t
....rif.r....... DIANA COMPAGNONE
!..'f,Y-1s:.~:: MY COMMISSION # 00 952410
~.~.~f EXPIRES: March 23. 2014
....r......~~ Bonded Thru Notary Public UndeJwritefs
tP.fllf-i.
Deputy Clerk/Notary Publi
The annual registration fee is $25.00 per Lobbyist, according to Couter 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# 007118845
11/10/20103:10:15 PM
Dwight E. Brock
Clerk of the Circuit Court
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Customer
PETE QUASIUS
4523 E RIVERSIDE DR
FORT MYERS, FL 33905-
3013
Deputy Clerk
BMR CASHIER
Minutesand Records@CollierClerk.com
239-252-2646
Clerk Office Location
Collier County Govt. Center
Building F, 4th Floor
3299 Tamiami Trail East,
Suite 401
P.O. Box 413044
Naples, Florida 34101-3044
1 Product
QUANTITY
1
DESCRIPTION
BMR Lobbyist Registration
UNIT COST
$25.00
TOTAL AMOUNT DUE:
Check# 247
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
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