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2011/2012 Collier County Clerk of Courts Expires 4_101°Q---3299 Tamiami Trail E. only) Suite 401,Bldg. F, 4th Floor Naples, Florida 34112 BOARD OF COUNTY COMMISSIONERS LOBBYIST REGISTRATION FORM Name W. TERRY COLE Date /lj/y/// Business Name HOLE MONTES, INC. Business Address 950 ENCORE WAY City NAPLES State FL Zip Code 34110 Business Telephone 239-254-2000 Contact Person Lobbyist E-mail terrycole @hmeng.com Notice for Lobbyists: The annual registration fee is 525.00 per Lobbyist, 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 Dwight E. Brock, Clerk of Courts (ADDRESS LISTED ABOVE) NAME AND ADDRESS OF EACH CLIENT/ENTITY REPRESENTED: (See Attached List) 1. Name 2. Name Address Address City Zip Code City Zip Code 3. Name 4. Name Address Address City Zip Code City Zip Code (ATTACH ADDITIONAL CLIENT SHEETS,IF NECESSARY) State of Florida County of Collier Wit/. ignature This registration was sworn or affirmed) and sus cribed before me this 414/ day of, 2011, by --�^1 - • Olek 4 7 4 Personally Known ='ft, �;- Nor ,„► ;�.�; i Produced ID I. = My Comm.Expire p>�,goQ -rk/Notar 'ublic T e of ID Produced ";; -c# Commission dr 0 U L.,t(� 4,7r4. Bonded Through National Notary Assn. Revised:08/2011 Receipt#007195585 10/17/2011 3:14:48 PM cam,,-1,_,c >, , Dwight E. Brock 1 Clerk of the Circuit Court i^ Ail _ 1„ - „ .:,,,, n , D'e .c,_, ,;'01Tixo` -, ) Ur- .-\_ -----7 -----7 pr-1 Customer Deputy Clerk Clerk Office Location W. TERRY COLE BMR CASHIER Collier County Govt. Center HOLE MONIES, INC. MinutesandRecords @CollierClerk.co Building F, 4th Floor 950 ENCORE WAY m 3299 Tamiami Trail East, Suite NAPLES, FL 34110-9176 239-252-2646 401 P.O. Box 413044 Naples, Florida 34101-3044 1 Product QUANTITY DESCRIPTION UNIT COST AMOUNT 1 BMR Lobbyist Registration $25.00 $25.00 TOTAL AMOUNT DUE $25.00 Check#47186 ($25.00) BALANCE DUE $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. ©COQ[1® OQgOIED Page 1 of 1