2010/2011
Board Minutes & Records
3301 Tamiami Trail East
Building F, 4th Floor
Naples, FL 34112
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Expires:
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name: liJu (,.:> lG\.Lr-r-h
Business Address: l.\4l-O S +-/...
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Date:
1J. !O\}10
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Business Telephone: ;)"'3.'" -450 - S S"'1 Email: --'l k ~{ ~ e ~ IV'-"; \. (of'\-..
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
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PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY
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State of Florida
County of Collier
The foregoing registration was sworn to and subscribed before me on this
ZDID
day of 'lJe/1'J/f7f2r_ ,by f)U/T) KuV+h
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, who is personally known to me
or has produced
as identification and who did take
an oath.
KB.I. Y LEWIS
'" MYCOMMlSSlONtDD744154
. EXPIRES: FobnJ8ty 28. 2012
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BY:
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# 007122956
12/1/20103:15:22 PM
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Dwight E. Brock
Clerk of the Circuit Court
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Customer
QUIN KURTH
4470 5TH AVE NW
NAPLES. FL34119-1512
Deputy Clerk
BMR CASHIER
M inutesand Records@CollierClerk.com
239-252-2646
Clerk Office Location
Collier County Gov!. 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# 144
BALANCE DUE:
AMOUNT
$25.00
$25.00
($25.00)
$0.00
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