1233811kV- CITY 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
800 SEMINOLE ROAD NO, 123381
ATLANTIC BEACH, FLORIDA 32233-4445
INVOICE INVOICE PURCHASE PROJECT ACCOUNT AMOUNT
NUMBER DATE ORDER NO NUMBER NUMBER
10426 04/01/2016 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.
e.70? •. j-r' ."' Bank of America 3 63 4 NO. 123381
I' " A ;> CITY OF ATLANTIC BEACH Jacksonville, Florida 630
k,-; '--,. — t 800 SEMINOLE ROAD Member FDIC
ATLANTIC BEACH,FLORIDA 32233-4445
VOID AFTER SIX MONTHS
VENDOR NUMBER DATE NET AMOUNT
5115 04/06/2016 8,000.00
EIGHT THOUSAND AND 00/100 DOLLARS .YYXX./ X..X .YYYYY;YYYY X XXx „ x Yx „ XYXXY „YYY . )YY ;lxYY • Y
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 BEACH PURCHASE ORDER
PURCHASING
PHONE (904) 247-5880IFAX (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
r(
I ST) n
VENDOR: SHIP TO: U
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
i 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
t SUB-TOTAL 96000. 00
TOTAL up-Q-8-71z-
g(W
NOTICE I CERTIFY THAT THEABOVE PURCHASE 15 NECESSARY FOR THE
PROPER OPERATION OFTHE CITY OF ATLANTIC BEACH AND
PLEASE SEND INVOICE TO:
THE FUNDS ARE APPROPRIATED IN THE CURRENT BUDGET
CITY ACCOUNTSATLANTIC BEACHCIATTN:OF ATLANTICPAYABLE CLERK
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
LEGAL ENFORCEMENT OF THIS PURCHASE ORDER
FEDERAL TAX ID#59-6000267
STATE TAX EXEMPT#85-8012740083C-8
I
Kopelousos, Bradley & Garrison, P.A.NIKUritOUS(.).S.1 RADIFY
s GARRISON.r., 1279 Kingsley Avenue
I AITOxNtYS..tnw Suite 118
Orange Park, FL 32003
Phone: 904-269-1111, Fax: 904-269-1115
Invoice submitted to: Invoice # 10426
Atlantic Beach
800 Seminole Rd Invoice Date: 04/01/16
Atlantic Beach,FL 32233 Terms: COD
Services Thru: 04/01/16
Date By Type Service Summary Hours/Qty Rate Amount
In Reference To: Non Matter Related(Professional Services)
03/31/16 RCK Retainer Monthly retainer for March 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
Total Amount Due: 8,000.00
Payments/Adjustments Detail
Date Transaction Type Description Amount
03/04/2016 Payment Retainer for February 8,000.00
Acct # Req # PO # 142)/4f— PA 1 D
Amount$ gI pvo • 00
APR 0 6 2016
CK # /z338/Approval/Dare 14)— c.l- 6./k.
Approval/Dale
Approval/Date
Approval/Dale
RECEIVED
APR 052016
A/P DEPARTMENT
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