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Palmer, Ali (3) PAR Date 01/12/16 CITY OF PARKLAND c 6600 UNIVERSITY DRIVE ° PARKLAND FL 33067 (954) 753-5040 FAX (954) 341-5161 LOBBYIST REGISTRATION STATEMENT Lobbyist Information Lobbyist Name PALMER ALESSANDRIA("Ali") (Please print) Last First Middle Lobbyist Address (Residence)2223 Arterra Court Royal Palm Beach FL 33411 City State Zip Code Business Name(Company/Firm) URBAN DESIGN KILDAY STUDIOS Business Address 610 Clematis Street,Suite CU-02 City: W Palm Beach State:FL Zip Code 33401 Telephone 561-366-1100 Fax 561-366-1111 Nature of Lobbyist Business, Occupation or Profession:LAND PLANNING/LANDSCAPE ARCHITECTURE Name of Principal BENNETT NELSON Last First Middle Business Name WCI COMMUNITIES,LLC Business Address 24301 Walden Center Drive,Bonita Springs,FL 34134 City State Zip Code Subject matter that Lobbyist seeks to influence (Ordinance/Resolution etc. describe in detail) PARKLAND BAY(f/k/a Bishop Pit) Please state the extent of any business association by the lobbyist with any current elected or appointed official or employee of the City of Parkland. For the purposes of this article, the term "direct business association" shall mean any mutual endeavor undertaken for profit or compensation. NONE Note: Appropriate authorization from the group, association, or organization that the lobbyist is representing must be attached. (Applicable minutes, motion, or other documentation of action) Page I 1 I understand that I am required to file, on an annual basis, a registration statement for each employer on whose behalf he or she lobbies before the city commission, board or city employee or official and to notify the City of any changes to the information contained herein. Further, I understand that each person who withdraws as a lobbyist for a particular person shall file a notice of withdrawal as a lobbyist with the city clerk. Annual Registration Fee of$150.00 to be included CERTIFICATION I do solemnly swear or affirm that all the foregoing facts are true and correct and that I have read the City of Parkland Code, Chapter 2.5 or Ordinance No. 2011-02, and that I am aware of the requirements for periodic filing and submission of other statements A , Yf �A'al _ Signature STATE OF FLORIDA COUNTY OF BROWMMPA�rittili4c On this 1,--2 day of S iq , 20/6, before me, the undersigned Notary Public of the State of Florida, personally appeared ALE sANDRIA PALMER whose name(` re subscribed and acknowledged that he le xecuted it. �))6 G� o ublic Notary Seal: Cr. ? E.R.>� ! �"' . X Personally known to me ,. Gommissa Produced Identification X lYOS NOU0 Fain Insow"6e ainInsnraace Page 2