2011/2012
Collier County Clerk of Courts
3299 Tamiami Trail E.
Suite 401, Bldg. F, 4th Floor
Naples, Florida 34112
Expires
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Name --- E r<E VV\ '1
Business Name C CoTo/'Jt E IV VI f?o 1Vrv1.. E>,.ftAL
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BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
(5, c;q '< Date 10 ) 6" / / I
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Business Address 2 501 6"1 t< LA/vQ IZ D
City
jJAPLES
State
FL
Zip Code 3Lf 117
Business Telephone ;}3Q-S-'75 - 4'1 :;21 Contact Person jEfZ.€tA-\. '--I S"IE/l-L<,
Lobbyist E-mail ji?re.M '-(@/ f (04 DOpe nV . (,oN\
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Notice for Lobbvists: The annual registration fee is $25.00 oer Lobbvist, per Collier County
Ordinance No. 2003-53, and amended by Ordinance 2004-05 and Ordinance 2007-24.
Payments made out to: Collier County Clerk of Courts or Dwi2ht E. Brock, Clerk of Courts
(ADDRESS LISTED ABOVE)
NAME AND ADDRESS OF EACH CLIENTIENTITY REPRESENTED:
1. Name C l"T'-j bA'Th D E'1lE'LQP/\.1Evr;- L-LC 2. Name
CG1J. LLC-
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Address / s-q MAIN ST ~TE. SCX)
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City Af?ILDN Zip Code 44509
Address J s-C; 111 Ll)V 5") S. TE' 5Z)O
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Cityf' fc-I2..0A) Zip Code L/ LJ 30 l3
3. Name O~fvvGerQ,Ef AS5cCui:\...-eS
4. Name
Address . YSOO bY cW7fV t D/2. S IE 1(0
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Address
City N~fLES Zip Code 3(i{11
(ATTACH ADDITIONAL CLJENT SHEETS, IF NECESSARY)
City
Zip Code
State of Florida
County of Collier
~-71.~~
Lobbtst Signa} re
This registration was sworn (or affirmed) and subscribed before me this
Oili~20-LL, by Jererry Gie-r L .
~sonally Known BY:
Produced ID
Type of ID Produced
5
day of,
TOCIA HAMUN
_ .. .. _ MY COMMISSION t EE 071084
~.'" ....~l EXPIRES: July 7, 2015
"~,~f.,y...<t>'. Bonded Thru Notwy Public Underwriters
Revised: 08/2011
Receipt# 007192847
10/6/2011 8:35:32 AM
Dwight E. Brock
Clerk of the Circuit Court
((Dafm Cs n c~J ,l ~~ C~X~X~) d [}DG
Customer Deputv Clerk
JEREMY STERK BMR CASHIER
ECOTONE ENVIRONMENTAL, MinutesandRecords@CollierClerk.co
INC. m
2809 GARLAND RD 239-252-2646
NAPLES, FL 34117-4008
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# 1003
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.
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