2010/2011
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
Expires
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BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name_~ Q6;'1 ~e /'() ;;, HI ~ Date~
Business Address 31 01 CxLA flU '/v'7\, 1 n e('11 ~I f1 _ J':t Pi7
Business Telephone ~ C, If -ld. \.j~
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY
State of Florida
County of CoJUer
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Lobbyist Signature
Deputy Clerk/Notary Pu lie
The 8nnua] registration fee is $25.00 per Lobbyist, according to ColUer Coon
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# 007121045
11/22/201010:09:28 AM
Dwight E. Brock
Clerk of the Circuit Court
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Customer
ROBIN DEMATTIA
ROBIN DEMATTIA
CONSULTING, INC.
3707 EXUMA WAY
NAPLES, FL 34119-1620
Deputy Clerk
BMR CASHIER
MinutesandRecords@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# 121
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
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