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Lobbyist_2016_R_Ken Spiker and Associates, Inc_012016 Date Stamp City of Long Beach RECEIVED LOBBYIST RENEWAL FORMCITY CLERK i 0T44, 13-ACHE CA 16 JAN 261 '!I!! '!1°r' "" INSTRUCTIONS 1. Fill out form 2. Sign and date 3. File with: Long Beach City Clerk's Office 333 W. Ocean Blvd. Long Beach, CA 90802 Tel. 562 570-6101 O This is the Renewal Registration Report due January 15 for: Lobbyist Name: Ken Spiker And Associates, Inc. Filer ID Number: 10-004 Renewal for Calendar Year: 2016 Registration Fees: Persons subject to the registration requirements of this ordinance shall pay an annual fee of one hundred dollars($100.00).The applicable fee is due at the time of registration renewaL Payment will be deemed delinquent thereafter.Late Fees will be assessed on a per day basis in accordance with Long Beach Municipal Code 2.80,and the most recent Fee Schedule approved by Long Beach City Council. http://www.lonpbeach.eov/finance/fees and charges/ ➢ Annual Registration Fee: $ 100.00 ➢ Late Fee Total(if applicable) $ ➢ Total submitted $ Payment Method: ❑ Cash El Check No: 131 Verification of Person Responsible for Report Preparation: Print Name: Greg Spiker Title: President Address: I have used all reasonable diligence in preparing this report. I have reviewed all the sections and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: January 20, 2016 Signature: City of Long Beach Lobbyist Renewal Report Form—10/2012 Page 1 of 1