Candidate: DAVID F COLLINS

Office: LEE MEMORIAL HEALTH SYSTEM-3

Report Date: G4 (10/13/2012 - 11/1/2012)

Campaign Treasurer's Report – Itemized Contributions

Seq#	Date	Contributor	Entity	Occupation	Cont. Type	Amend	Amount
Seq# 1	Date 10/19/2012	Contributor Marjorie Starnes-Bilotti 14380 Riva Del Lago Dr #1504-S Fort Myers, FL 33907	Entity Individual	Occupation Retired	Contribution Type Check	Amend	Amount $100.00
Seq# 2	Date 10/28/2012	Contributor Eric Cohill 4674 Siesta Circle Fort Myers, FL 33901	Entity Individual	Occupation CEO	Contribution Type Check	Amend	Amount $100.00
Seq# 3	Date 10/27/2012	Contributor Trudy Doramus 10858 Tiberio Drive Fort Myers, FL 33913	Entity Individual	Occupation	Contribution Type Check	Amend	Amount $20.00
Seq# 4	Date 10/26/2012	Contributor John Potanovic 1715 Monroe Street Fort Myers, FL 33901	Entity Individual	Occupation Attorney	Contribution Type Check	Amend	Amount $100.00
Seq# 5	Date 10/26/2012	Contributor Elizabeth Bernstein 6767 Danah Court Fort Myers, FL 33908	Entity Individual	Occupation	Contribution Type Check	Amend	Amount $100.00
Seq# 6	Date 10/26/2012	Contributor Kendra Sutton 12450 Eagle Pointe Cir Fort Myers, FL 33913	Entity Individual	Occupation AdvertisingExec	Contribution Type Check	Amend	Amount $100.00
Seq# 7	Date 10/26/2012	Contributor Bob & Katie Bojarzin 19300 La Serena Dr. Fort Myers, FL 33967	Entity Individual	Occupation	Contribution Type Check	Amend	Amount $100.00
Seq# 8	Date 10/19/2012	Contributor John Agnew 1715 Monroe Street Fort Myers, FL 33901	Entity Individual	Occupation Attorney	Contribution Type Check	Amend	Amount $50.00
Seq# 9	Date 10/23/2012	Contributor Karen Johnson 832 North Town and River Drive Fort Myers, FL 33919	Entity Individual	Occupation CommercialRealEstate	Contribution Type Check	Amend	Amount $100.00
Seq# 10	Date 10/22/2012	Contributor Heather Fitzenhagen 1750 Marlyn Road Fort Myers, FL 33901	Entity Individual	Occupation attorney	Contribution Type Check	Amend	Amount $250.00
Seq# 11	Date 10/23/2012	Contributor Clifford and Christina Parker 12431 McGregor Woods Circle Fort Myers, FL 33908	Entity Individual	Occupation	Contribution Type Check	Amend	Amount $50.00
Seq# 12	Date 10/25/2012	Contributor Guy Whitesman 912 Robalo Drive Fort Myers, FL 33919	Entity Individual	Occupation Attorney	Contribution Type Check	Amend	Amount $50.00
Seq# 13	Date 10/26/2012	Contributor Richard and Cindy Harding 18000 Via Bellamare Lane Miromar Lakes, FL 33913	Entity Individual	Occupation Retired	Contribution Type Check	Amend	Amount $500.00
Seq# 14	Date 10/19/2012	Contributor Marilyn Stout 2907 SW 29th Ave Cape Coral, FL 33914	Entity Individual	Occupation	Contribution Type Check	Amend	Amount $25.00
Seq# 15	Date 10/22/2012	Contributor Richard Deboest 1750 Marlyn Road Fort Myers, FL 33901	Entity Individual	Occupation Attorney	Contribution Type Check	Amend	Amount $250.00
Seq# 16	Date 10/30/2012	Contributor Sandra Pavelka 2981 Styles Rd Alva, FL 33920	Entity Individual	Occupation CollegeProfessor	Contribution Type Check	Amend	Amount $100.00
Seq# 17	Date 10/30/2012	Contributor Law Office of Shawn Seliger 9990 Coconut Rd Ste 372 Bonita Springs, FL 34135	Entity Business	Occupation AttorneyPractice	Contribution Type Check	Amend	Amount $100.00
Seq# 18	Date 10/30/2012	Contributor Kelly L Fayer 12601 World Plaza Lane Fort Myers, FL 33907	Entity Individual	Occupation Attorney	Contribution Type Check	Amend	Amount $200.00
Seq# 19	Date 10/30/2012	Contributor Robert Todd Tooley 13736 Bald Cypress Circle Fort Myers, FL 33907	Entity Individual	Occupation realtor	Contribution Type Check	Amend	Amount $200.00
Seq# 20	Date 10/30/2012	Contributor Victoria S Black 5001 SW 10th Ave Cape Coral, FL 33914	Entity Individual	Occupation	Contribution Type Check	Amend	Amount $25.00
Seq# 21	Date 10/30/2012	Contributor Raimonda Childress 9594 Via Lago Way Fort Myers, FL 33912	Entity Individual	Occupation Executive Asst.	Contribution Type Check	Amend	Amount $100.00
Seq# 22	Date 10/30/2012	Contributor Jan-Erik Hustrulid 23751 Old Port Rd Apt 203 Bonita Springs, FL 34135	Entity Individual	Occupation BusinessDeveloperRealt	Contribution Type Check	Amend	Amount $150.00
Seq# 23	Date 10/19/2012	Contributor Mutual of Omha Bank 7331 College Parkway Fort Myers, FL 33907	Entity Other	Occupation	Contribution Type Interest	Amend	Amount $0.42
Seq# 24	Date 10/30/2012	Contributor Rob Glessner 2335 Tamiami Trail North Suite 403 Naples, FL 34103	Entity Individual	Occupation AccountExecutive	Contribution Type Check	Amend	Amount $100.00
Seq# 25	Date 10/30/2012	Contributor Kathy Toll 12497 Pebble Stone Court Fort Myers, FL 33913	Entity Individual	Occupation	Contribution Type Check	Amend	Amount $25.00
Seq# 26	Date 10/30/2012	Contributor Jenny MacDermott 2180 West First Street Suite 510 Fort Myers, FL 33901	Entity Individual	Occupation InsuranceSales	Contribution Type Check	Amend	Amount $100.00
Seq# 27	Date 10/31/2012	Contributor Jeff and Caryn Smith 12901 Village Gate Ct Fort Myers, FL 33913	Entity Individual	Occupation restaurant owners	Contribution Type Check	Amend	Amount $100.00
Seq# 28	Date 10/31/2012	Contributor Noelle M Melanson 1652 Carter Place Fort Myers, FL 33901	Entity Individual	Occupation Attorney	Contribution Type Check	Amend	Amount $50.00
Seq# 29	Date 11/1/2012	Contributor Jama Wyatt 8911 Brighton Lane Bonita Springs, FL 34135	Entity Individual	Occupation	Contribution Type Cash	Amend	Amount $50.00

Campaign Treasurer's Report – In-Kind Contributions

Seq#	Date	Contributor	Entity	Occupation	In-Kind Description	Amend	Amount
Seq# 1	Date 10/19/2012	Contributor Kurt Maurillo 505 NW 25th Terrace Cape Coral, FL 33993	Entity Individual	Occupation FinancialPlanner	In-Kind Description Dinner ticket and Golf hole sign at golf tournament	Amend	Amount $250.00
Seq# 2	Date 10/25/2012	Contributor Patrick and Susan Sweeney 3391 BRANTLEY OAKS DR Fort Myers, FL 33905	Entity Individual	Occupation Realtors	In-Kind Description Food and beverages for Meet and Greet Fundraiser	Amend	Amount $150.00
Seq# 3	Date 10/25/2012	Contributor Lee Meyers 12491 Verandah Blvd Fort Myers, FL 33905	Entity Individual	Occupation CPA	In-Kind Description Food and beverages for Meet and Greet Fundraiser	Amend	Amount $150.00
Seq# 4	Date 10/23/2012	Contributor Muni Designs 7091 College Parkway #16 Fort Myers, FL 33907	Entity Business	Occupation	In-Kind Description party supplies for meet and greet fundraiser	Amend	Amount $100.00
Seq# 5	Date 10/30/2012	Contributor Foster 's Grill 9903 Gulf Coast Main Street Fort Myers, FL 33913	Entity Business	Occupation resturant	In-Kind Description food and beverage and supplies for meet and greet	Amend	Amount $450.00

Campaign Treasurer's Report – Itemized Expenditures

Seq#	Date	Vendor	Purpose	Exp. Type	Amend	Amount
Seq# 1	Date 10/15/2012	Vendor Paper Fish Printing, Inc 17251 Alico Center Road suite 5 Fort Myers, FL 33967	Purpose Bumper Stickers	Expenditure Type Monetary	Amend	Amount $87.98
Seq# 2	Date 10/15/2012	Vendor Grafix Alliance 5565 Lee Street Unit 5 Lehigh Acres, FL 33971	Purpose Campaign Signs	Expenditure Type Monetary	Amend	Amount $754.19
Seq# 3	Date 10/15/2012	Vendor Grafix Alliance 5565 Lee Street Unit 5 Lehigh Acres, FL 33971	Purpose Campaign Signs	Expenditure Type Monetary	Amend	Amount $159.00
Seq# 4	Date 10/16/2012	Vendor Lamar of Fort Myers 14580 Global Parkway Suite 104 Fort Myers, FL 33913	Purpose Campaign Billboards	Expenditure Type Monetary	Amend	Amount $2,375.00
Seq# 5	Date 10/23/2012	Vendor La Trattoria Cafe Napoli 12377 South Cleveland Ave Fort Myers, FL 33907	Purpose food and beverages for meet and greet	Expenditure Type Monetary	Amend	Amount $394.32
Seq# 6	Date 10/30/2012	Vendor Grafix Alliance 5565 Lee Street Unit 5 lehigh Acres, FL 33971	Purpose Campaign signs	Expenditure Type Monetary	Amend	Amount $848.00
Seq# 7	Date 10/23/2012	Vendor La Trattoria Cafe Napoli 12377 South Cleveland Ave Fort Myers, FL 33907	Purpose additional food for meet and greet fundraiser	Expenditure Type Monetary	Amend	Amount $90.10
Seq# 8	Date 10/30/2012	Vendor Foster 's Grille 9903 Gulf Coast Main Street Fort Myers, FL 33913	Purpose Tips for wait staff at meet and greet	Expenditure Type Monetary	Amend	Amount $50.00
Seq# 9	Date 11/1/2012	Vendor Davd Collins 6458 Griffin Blvd Fort Myers, FL 33908	Purpose Loan repayment	Expenditure Type Monetary	Amend	Amount $300.00
Seq# 10	Date 11/1/2012	Vendor Priority Payment Systems P.O.Box 246 Alpharetta, GA 30009	Purpose credit card fees	Expenditure Type Monetary	Amend	Amount $64.76
Seq# 11	Date 10/31/2012	Vendor Lamar of Fort Myers 14580 Global Parkway suite 104 Fort Myers, FL 33914	Purpose campaign billboard	Expenditure Type Monetary	Amend	Amount $250.00
Seq# 12	Date 10/17/2012	Vendor Imaginarium Group 2000 Cranford Ave Fort Myers, FL 33916	Purpose ticket for 2012 history maker of the year	Expenditure Type Monetary	Amend	Amount $50.00
Seq# 13	Date 10/30/2012	Vendor Robert McDonald 1335 SE 44th Street Cape Coral, FL 33904	Purpose Music and Audio DJ for meet and greet fundraiser	Expenditure Type Monetary	Amend	Amount $100.00
Seq# 14	Date 11/1/2012	Vendor News-Press 2442 Dr. Martin Luther King Jr. Blvd. Fort Myers, FL 33901	Purpose Newspaper Advertising	Expenditure Type Monetary	Amend	Amount $1,575.00
Seq# 15	Date 11/1/2012	Vendor Grafix Alliance 5565 Lee Street Suite 104 Lehigh Acres, FL 33913	Purpose campaign signs	Expenditure Type Monetary	Amend	Amount $79.50
Seq# 16	Date 11/1/2012	Vendor David Collins 6458 Griffin Blvd Fort Myers, FL 33908	Purpose Petty cash expenditures	Expenditure Type Monetary	Amend	Amount $87.50

Campaign Treasurer's Report – Fund Transfers

Seq#	Date	Institution	Transfer Type	Nature of Account	Amend	Amount

Campaign Treasurer's Report – Distributions

Seq#	Date	Vendor	Purpose	Expenditure Related Exp.	Amend	Amount