122961CITY OF ATLANTIC BEACH
ti 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 122961800SEMINOLEROADN0.ATLANTIC BEACH, FLORIDA 32233-4445
WYOIGE INVOICE PURCHASE PROJECT ACCOUNT AMOUNT
DATE ORDER NO.NUMBER NUMBER
10371 02/29/2016 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.
4.; ;_ ;, Bank of America 63 n NO. 122961
y` CITY OF ATLANTIC BEACH Jacksonville,Florida 630
800 SEMINOLE ROAD Member FDIC
ATLANTIC BEACH,FLORIDA 32233-4445
J t'
VOID AFTER SIX MONTHS
PATE NET AMOUNT
5115 03/02/2016 8,000.00
EIGHT THOUSAND AND 00/100 DOLLARS xX -xx *... .Y.xxx* *#x-*xx ***************************
KOPELOUSOS, BRADELY & GARRISON P.A.NON-NEGOTIABLE**
PAY 1279 KINGSLEY AVENUE
AUTHORIZED SIGNATURE
TO THE SUITE 118 NON-NEGOTIALBE**ORDER OF ORANGE PARK FL 32073 AUTHORIZED SIGNATURE
CITY OF ATLANTIC BEACHi PURCHASE ORDER
PURCHASING
j to< PHONE (904) 247-5880vIFAX (904) 247-5819 rP.O. NUMBER DATE
160105 10/16/15
r ;itsl..;l
THIS P.O.NUMBER MUST APPEAR ON ALL INVOICES
PACKING SLIPS.LABELS.BILLS OF LADING AND
CORRESPONDENCE
VENDOR: SHIP TO:
KOPELOUSOS, BRADLEY & GARRISON CITY OF ATLANTIC BEACpD1279KINGSLEYAVENUEATTN: CITY MANAGER OFFI `:
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
TOTAL99'
16, 000. ed
I
l
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 k a - CI TN:ACCOUNTS PAYABLE CLERK
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
Kopelousos, Bradley & Garrison, P.A.
I9i t raou(N)s.e8 RAN.I.Y 1279 Kingsley Avenue
ht Alioamvs.)LAW Suite 118
Orange Park, FL 32003
Phone: 904-269-1111,Fax: 904-269-1115
Invoice submitted to: Invoice # 10371
Atlantic Beach
800 Seminole Rd
Invoice Date:02/29/16
Terms:COD
Atlantic Beach, FL 32233 Services Thru:02/29/16
Date By Type Service Summary Hours/Qty Rate Amount
In Reference To: Non Matter Related(Professional Services)
02/29/16 RCK Retainer Monthly retainer for February 2016. 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
PAI D
Total Amount Due: 8,000.00
Payments/Adjustments Detail
Date Transaction Type Description Amount
02/05/2016 Payment Monthly retainer. MAR 0 2 2016 8,000.00
CK # / z14 f
Acct # Req # PO # /G DAM—
Amount $ g, 4,. . op
Approval i Date it J'— 3 id i k.
Approval;Date tB 3/z/4,
Approval I Date
Approval i Date
RECEIVED
MAR 01 2016
A/P DE "/ARTMENT Page: I of I