121938CITY OF ATLANTIC BEACH
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 121938800SEMINOLEROADNO.
ATLANTIC BEACH, FLORIDA 32233-4445
INVOICE INVOICE PURCHASE PROJECT ACCOUNT AMOUNT
NUMBER DATE ORDER NO NUMBER NUMBER
10249 11/30/2015 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 4 NO. 121938
FCITY OF ATLANTIC BEACH Jacksonville, Florida 630
800 SEMINOLE ROAD Member FDIC
f ATLANTIC BEACH,FLORIDA 32233-4445
VOID AFTER SIX MONTHS
NET AMOUNTVENDOR,NUMBER ??:`>:<:::::>::;::::<:><::<:::>:::::;: , s-...
5115 12/02/2015 8,000.00
EIGHT THOUSAND AND 00/100 DOLLARS **********************************************
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 BEACHi PURCHASE ORDERiPURCHASING
fr t``t PHONE (904) 247-5880
t, FAX (904) 247-5819 P.O. NUMBER DATE
160105 10/16/15
THIS P.O.NUMBER MUST APPEAR ON ALLINVOICES
PACKING SLIPS.LABELS.BILLS OF LADING AND
CORRESPONDENCE
VENDOR: SHIP TO: 4/1.4
KOPELOUSOS, BRADLEY & GARRISON CITY OF ATLANTIC BEACH W V TL •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
I SUB-TOTAL 96000.00
TOTAL 9.6-690-00
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
ACCOUNTSCOUNTS
BEACH lATTN:A000UNTS PAYABLE CLERK
800 SEMINOLE ROAD PURCHASING AGENTATLANTICBEACH,FL 32233
THELAWS OF THE STATE OF FLORIDA.U.S.A.SHALL GOVERN IN
CONNECTION WITH THE FORMATION.PERFORMANCE.AND THE
LEGAL ENFORCEMENT OF THIS PURCHASE ORDER
FEDERAL TAX ID#59-6000267
STATE TAX EXEMPT#85-8012740083C-8
Kopelousos, Bradley & Garrison, P.A.K(artux vu».1 I&AuI.t rk -i itxist t.., 1279 Kingsley Avenue
1 ArrOR:vtr.:•,I.Aw Suite 118
Orange Park, FL 32003
Phone: 904-269-1111,Fax: 904-269-1115
Invoice submitted to: Invoice # 10249
Atlantic Beach
800 Seminole Rd Invoice Date: 11/30/15
Terms:CODAtlanticBeach, FL 32233
Services Thru: 1 1/30/15
Date By Type Service Summary Fiours/Qty Rate Amount
In Reference To: Non Matter Related(Professional Services)
11/30/15 RCK Retainer Monthly retainer for November 2015. Flat 8.000.00
Labor: 8,000.00
Invoice Amount: 8,000.00
Total Labor: 8,000.00
Total invoice Amount: 8,000.00
Previous Balance: 8,300.00
Payments/Adjustments: 8,300.00
Total Amount Due: 8,000.00
Payments/Adjustments Detail
Date Transaction Type Description Amount
11/30/2015 Payment Litigation Payment 300.00
11/09/2015 Payment 8000.00
PA 1 D
Acct # Req # PO # 1640/0S' DEC 1 2 613
Amount$ gj pep • .9 49 •
CK # 1_ z/ Jg
DEC 0 1 2015
Approval I Date a—1i. It Li {
Approval I Date _ICJ 12(-ipRECEIVEDApproval1Date
DEC O1 2015
Approval!`Date
NP DEPARTMENT
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