122393f_. CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 322334445
KOPELOUSOS, BRADELY & GARRISON P.A.
1279 KINGSLEY AVENUE
SUITE 118
ORANGE PARK FL 32073
CITY OF ATLANTIC BEACH 122393800SEMINOLEROADNO.
ATLANTIC BEACH, FLORIDA 32233-4445
INVOICE INVOICE PURCHASE PROJECT ACCOUNT AMOUNT
NUMBER DATE ORDER NO NUMBER NUMBER
10315 01/05/2016 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.
i ``
Bank of America 63 4 NO. 122393
4 •..=
800
r CITY OF ATLANTIC BEACH Jacksonville,Florida 630
i is.,. . 800 SEMINOLE ROAD Member FDIC
l ••s'.. ATLANTIC BEACH,FLORIDA 32233-4445
VOID AFTER SIX MONTHS
NET AMOUNTVENDORNUM8,1i;A'I" : ...'
5115 01/13/2016 8,000.00
EIGHT THOUSAND AND 00/100 DOLLARS *********************************************
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KOPELOUSOS, BRADELY & GARRISON P.A.NON-NEGOTIABLE**
PAY 1279 KINGSLEY AVENUE
AUTHORIZED SIGNATURE
TO THE ORANGE PARK FL 32073 NON-NEGOTIABBE**
ORDER OF AUTHORIZED SIGNATURE
CITY OF ATLANTIC BEACH
PURCHASING PURCHASE ORDER
0 2' PHONE (904) 247-5880
t'I FAX (904) 247-5819 P.O. NUMBER DATE
160105 10/16/15
THIS P.O.NUMBER MUST APPEAR ON ALL INVOICES
PACKING SLIPS.LABELS.BILLS OF LADING AND
CORRESPONDENCE
VENDOR: SHIP TO:
ay IN
KOPELOUSOS, BRADLEY & GARRISON CITY OF ATLANTIC BEACH \, P C1279KINGSLEYAVENUEATTN: CITY MANAGER OFFICE 1 d,
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
Dec. e9E)
NOTICE I CERTIFY THAT THE ABOVE PURCHASE 15 NECESSARY FORTHE
PROPER OPERATION OF THECITY OF ATLANTIC BEACH AND
PLEASE SEND INVOICE TO: THE FUNDS ARE APPROPRIATED IN THE CURRENT BUDGET
CITY OF ATLANTIC BEACH
7(e i -,,, 9`/ 4ATTN:ACCOUNTS PAYABLE CLERK 1/.-• i l414,
800 SEMINOLE ROAD PURCHASING AGENT
ATLANTIC BEACH,FL 32233
THE LAWS OF THE STATE OF FLORIDA.U.S.A.SHALL GOVERN IN
CONNECTION WITH THE FORMATION.PERFORMANCE,AND THE
FEDERAL TAX ID#59-6000267
LEGAL ENFORCEMENT OF THIS PURCHASEORDER
STATE TAX EXEMPT#85-8012740083C-8
Kopelousos, Bradley & Garrison, P.A.
yrjI
Kt±L L:ult`So .lI&AoL.L.Y
t L >t N ;.1279 Kingsley Avenue
kik AI IC)RNLYS m LAW Suite 118
Orange Park,FL 32003
Phone: 904-269-1111,Fax: 904-269-1115
Invoice submitted to: Invoice # 10315
Atlantic Beach
800 Seminole Rd Invoice Date:01/05/16
Atlantic Beach, FL 32233
Terms:COD
Services Thru:01/05/16
Date By Type Service Summary Hours/Qty Rate Amount
In Reference To: Non Matter Related(Professional Services)
01/05/16 RCK Retainer Monthly retainer for December 2015. Flat 8,000.00
Total Labor: 8,000.00
Total Invoice Amount: 8,000.00
Previous Balance: 8,000.00
Payments/Adjustments: 8,000.00
Total Amount Due: 8,000.00
Payments/Adjustments Detail
Date Transaction Type Description Amount
12/07/2015 Payment Nov.Retainer 8,0(X1.00
Acct # Req # PO # /4.e/04— I
Amount$ 8, 000. oo
JAN 1 3 2015
JAN 11 2015 II CK # /Z$
Approval/Date Ito—1. i
Approval i Date ._—Q VI 04
Approval/Date
Approval!Date
RECEIVED
JAN 11 2016
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