121592i CITY OF ATLANTIC BEACH
s, ' I' 800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233-4445
KOPELOUSOS, BRADELY & GARRISON P.A.
1279 KINGSLEY AVENUE
SUITE 118
ORANGE PARK FL 32073
CITY OF ATLANTIC BEACH 121592800SEMINOLEROADN0.ATLANTIC BEACH, FLORIDA 32233-4445
INVOICE INVOICE PURCHASE! PROJECT ACCOUNT AMOUNT
NUMBER DATE ORDER NO NUMBER NUMBER
10213 11/02/2015 160105 001-1004-514-31-02 8, 000 . 00
GROSS RETAINAGE DISCOUNT NET
8,000.00 8,000.00
5115 KOPELOUSOS, BRADLEY &GARRISON P.A.
Bank of America ' 63., NO. 121592
CITY OF ATLANTIC BEACH Jacksonville,Florida 630
1",Member FDIC
i ATLANTICNTIC BE ROADATLANTICBEACH, FLORIDA 32233-4445
ti—:Li)
VOID AFTER SIX MONTHS
NET AMOUNTVENDOtNUMBER :<::>av ::>::> DATE
5115 11/05/2015 8,000.00
EIGHT THOUSAND AND 00/100 DOLLARS K********************************************
KOPELOUSOS, BRADELY & GARRISON P.A.NON-NEGOTIABLE**
PAY 1279 KINGSLEY AVENUE
AUTHORIZED SIGNATURE
TO THE ORANGE PARK FL 32073 NON-NEGOTIALBE**
ORDER OF AUTHORIZED SIGNATURE
CITY OF ATLANTIC BEACH PURCHASE ORDERPURCHASING
PHONE (904) 247-5880I''I FAX (904) 247-5819 P.O. NUMBER DATE
160105 10/16/15
THIS P.O.NUMBER MUST APPEAR ONALL INVOICES
PACKING SLIPS.LABELS.BILLS OF LADING AND
CORRESPONDENCE \,
VENDOR: SHIP TO: POS1'Eiy
KOPELOUSOS, BRADLEY & GARRISON CITY OF ATLANTIC BEACH
1279 KINGSLEY AVENUE ATTN: CITY MANAGER OFFICE
SUITE 118 800 SEMINOLE ROAD
ORANGE PARK, FL 32073 ATLANTIC BEACH, FL 32233
VENDOR# DATE NEEDED TERMS REQUISITIONED BY
5115 09/30/16 NET YCALVERLEY
F.O.B CONTRACT NO.ACCOUNT NO. PROJECT REQ.NO. REQ.DATE
RFP14-05 00110045143102 95652 10/02/15
LINE QUANTITY UOM ITEM NO.AND DESCRIPTION UNIT COST EXTENDED COST
1 12 .00 MO PROFESSIONAL SERVICES - ANNUAL 8000. 00 96000. 00
RETAINER
SUB-TOTAL 96000.00
TOTAL 9600-&-.1 r
g o00• oa
NOTICE I CERTIFY THAT THE ABOVE PURCHASE IS NECESSARY FOR THE
PROPER OPERATION OF THE CITY OF ATLANTIC BEACH AND
PLEASE SEND INVOICE TO:
THE FUNDS ARE APPROPRIATED IN THE CURRENT BUDGET
CITY OF ATLANTIC BEACH i - 4 Ad(ATTN:ACCOUNTS PAYABLE CLERK o •800 SEMINOLE ROAD PURCHASING AGENT
ATLANTIC BEACH,FL 32233
THE LAWS OF THE STATE OF FLORIDA.U.5 A.SHALL GOVERN IN
CONNECTION WITH THE FORMATION.PERFORMANCE.AND THE
FEDERAL TAX ID#59-6000267
LEGAL ENFORCEMENT OF THIS PURCHASE ORDER
STATE TAX EXEMPT#85-8012740083C-8
re
3
Kopelousos, Bradley & Garrison, P.A.
7OtG
ARnI'
StN.BRADEEr 1279 Kingsley AvenuexGARRISCStn.'r..
A1, 1 ATTORNEYS tnw Suite 118
Orange Park,FL 32003
Phone: 904-269-1111,Fax: 904-269-1115
Invoice submitted to: Invoice # 10213
Atlantic Beach Invoice Date: 11/02/15
800 Seminole Rd Terms:con
Atlantic Beach,FL 32233 Services Thru: 11/02/15
Date By Type Service Summary Hours/Qty Rate Amount
In Reference To: Non Matter Related(Professional Services)
11/02/15 RCK Retainer Monthly retainer for October 2015. Flat 8,000.00
Total Labor: 8,000.00
Total Invoice Amount: 8,000.00
Previous Balance: 8,000.00
Payments/Adjustments: $-16,000.00
Total Amount Due: 0.00
Payments/Adjustments Detail Amount
Date Transaction Type Description
8mU n
10/09/2015 Payment Retainer Sept.2015
09/04/2015 Payment Monthly rctainer.
8000.00
PA I D
NOV 0 if 613
Acct # Req # eC—=2) CK # /' Z1-rZZ
Amount$ g 0o ,o
NOV022!
Approval/Date
Approval/Date t tApproval/Date
Approval;Dale_
RECEIVED
NOV 0 2 2015
AlP DEPARTMENT
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