2011/2012 Clerk to the Board,Minutes&Records Dept. Expires_1/12__ _
3299 Tamia rmi Trail East,Suite#401 (Staff use nail
Building F,4th Floor
Naples, FL 341 12
BOARD OF COUNTY COMMISSIONERS
LOBBYIST REGISTRATION FORM
Name Alissa Downing Date g' r 7 -
Business Address d o Nielsen Merksarner, et al.
2350 Kerner Blvd., Ste. 250, San Rafael, CA 94901
(415) 389-6800 jskeltan a�nmgovlav�r.cotrt
Business Telephone � E-Mail
NAME AND ADDRESS OF EACH PERSON OR ENTITY REPRESENTED:
1). Novartis Vaccines and Diagnostics
do Nielsen Merksamer, et al.
2350 Kerner Blvd., Ste. 250, San Rafael, CA 94901
2).
(PLEASE ATTACH ADDITIONAL SHEETS,IF NECESSARY)
__re._.—• — ____
Lobbyist Signa t
State of Florida
County of-Cel}ier cj,,,r-(D°4-.
The foregoing registration was -worn to and subscribed before me on this
day of _44 L'1 �o I ,by� , who is personally known to
me or has roduced � (1\,.e,l LN- as identification and
wit, . . ..
„S ""A V �
DEBRA A.H006HKIRK
s° •-�1«`- Notary
Public-State of Florida:N. i a•i My Comm.Expires Aug 18,2013 /L; 4,���s:� Commission#DD 918075 – — — gj
,of"�'� Bonded Through National Notary Assn.
"���", y Deputy Clerk/Notary Pu
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# 007272801
8/22/2012 9:48:28 AM
Dwight E. Brock
Clerk of the Circuit Court
f f
0 ffEj- cc}?) -
Customer Deputy Clerk Clerk Office Location
ALISSA DOWNING BMR CASHIER Collier County Govt. Center
NIELSEN, MERKSAMER, MinutesandRecords @CollierClerk.co Building F, 4th Floor
PARRINELLO, GROSS & m 3299 Tamiami Trail East, Suite
LEONI, LLP 239-252-2646 401
2350 KERNER BLVD STE 250 P.O. Box 413044
SAN RAFAEL, CA 94901-5596 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#6346 ($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.
�0�0b®Tg0g ❑g0EICI Page 1 of 1
FedEx Ship Manager-Print Your Label(s) , Page 1 of 1
AUG 22 201?
From: (415)389-6800 Origin ID:SRFA Ship Date:21AUG12
Rosy McCarthy . ActWgt:1.0 LB
r less CAD:103083785/INET3300 g ,k A —
2350 Kerner Blvd.,Ste 250
CI Delivery Address Bar Code
San Rafael,CA 94901 J12201207160325 I III III I 11 111111 IIII IIII 11111 1 I 11111 1 III
SHIP TO: (239)2522646 X 7240 BILL SENDER Ref# 8193.01 Collier County,FL
CLERK TO THE BOARD Invoice#
MINUTES AND RECORDS DEPT PO#
Dept#
3299 TAMIAMI TRL E
STE 401
NAPLES, FL 34112
WED - 22 AUG A4
TRK# 7987 9220 2485 PRIORITY OVERNIGHT
[0201
I
141 ! 34112
X H A P FA SW I
1 1,iiir
1 III 1 11110111
515G2.0C341AA44
^. - _
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