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2011-2012 Board Minutes & Records 3301 Tamiami Trail East Building F, 4th Floor Naples, FL 34112 Expires 'If /ZO I;)" BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name (Y) ; cha e.-I /l. (7J f fre Ii2 Date (~/~ ~/I / Business Address sor;9 hmIOn1,' ria:! g, /VCL tJ/e~ 1 FL- 3 if//3 . I Business TelephoneC~37) '-I) )-0 'XI? E-Mail/lJC-tr6f?/tS5dC @/'t-OL-,LOJ'Y\ NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED: 1). ;n I' c.J,.o e r J4, /?lq:re~ //::>6 '/Y)o rnl n5 '5/de.. Dr, u e.. Nc<-;,()Je-s I I~ 3t.J/{) 3 I I 2). /7jC(yt. L r/-. /l S~c..1 'a. Ie ~ Sa? 9 /C;h1laMI' "/rco I L; $6.. yJ/e 5 , /:::-L "39// 3 , / PLEASE ATTACH ADDITIONAL SHEETS IF NECESSARY State of Florida County of Collier .'l "f' I . om to and flbscribed beti>re me on this CjcA.;; I G Hy IYJ, (I\c;-(J f1( (p, who is personally known to C. DC; as identification and ; .I ,""'''' / \..J / /)q ~~-:'t'1J.Y"II~... JANET L. KLINE Y I "II . i.~.~ Notary Public. State of Florida BY: i ,.:J"j. /C- v \~i My Comm. Expir81 Jul 23. 2014 , " . ";:'l,,9r.t,\~~ Commission # DO 977542 Depu~y ClerkINotary Pubhc e annu regIstration fee is $25.00 per Lobbyist, accorMllg to CoUier 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). Dwight E. Brock Clerk of the Circuit Court Receipt# 007189401 9/26/2011 2:32:51 PM (Q)~~~'O (C~ 0 (sJ U [r;~ c~~e~x~~ H rV)G Customer MICHAEL MCGEE MCGEE & ASSOCIATES 5079 TAMIAMI TRL E NAPLES, FL 34113-4128 DeDutv Clerk BMR CASHIER MinutesandRecords@CollierClerk.co m 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 DESCRIPTION 1 BMR Lobbyist Registration UNIT COST $25.00 TOTAL AMOUNT DUE Check# 6079 BALANCE DUE AMOUNT $25.00 $25.00 ($25.00) $0.00 Note: Disclaimer: All transactions are subject to review/verification. The Clerk reserves the right to correct for clerical errors and to assess or refund charges as needed. @@DDD@o@D@~@@1Ji1i) Page 1 of 1