On December 29, 2020 a
Final Bill Appeal Preparation fees pending in amount of:
was filed
involving a dispute between
Functional Evaluation Testing Of Florida, Inc.,
and
Progressive Select Insurance Company,
for Appeal (County Court)
in the District Court of Broward County.
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**** FILED: BROWARD COUNTY, FL Brenda D. Forman, CLERK 2/1/2021 3:21:57 PM.****
Brenda D. Forman - CLERK
CIRCUIT COURT COUNTY COURT
17™ Judicral Crrcuit
Inand for Broward County
Fort Lauderdale, FL 33301
201 Southeast 6" Street
Broward County Courthouse
Fort Lauderdale, Flonda 33301
CIVIL APPEAL DIVISION FINAL INVOICE/ROOM 4140
Date: February 1, 2021
To: Chad A. Barr, Esquire
Style of Case: Functional Evaluation Testing of FL, Inc. vs. Progressive Select
Insurance Company
L.T. Court Numbers: COWE 20-18504 and CACE 20-21926
Appeal Case Number: 4D21-0570
Please be advised that the amount shown below represents the balance due for the
preparation of the appeal record on the above styled case.
1, _19 INSTRUMENTS @ 3.50 EACH Sl $ 66.50
2. ___ PAGES COPIED (INDEX & PROGRESS REPORT)
MULTIPLIED BY #OF ATTORNEYS: 7 $
3. CERTIFICATE OF CLERK FEE = $ 7.00
4. FILING FEE: (INCLUDED IN PRE-BILL) = $281.00
5. INDIGENT APPLICATION FEE ($25 fee, if applicable) = $
6. TOTAL COST OF RECORD PREPARATION (1 THRU 5) = $354.50
7. PREVIOUSLY PAID / ESTIMATED INVOICE (CREDIT) = $340.50
8. TOTAL AMOUNT NOW DUE (#6 minus #7) = $14.00
**PAYMENT IS DUE WITHIN (10) BUSINESS DAYS**
Upon receipt of your payment, the record on appeal in this case will be sent to the Fourth District Court of
Appeal. Our payment types include cash, cashier’s check, money order or attorney’s firm check made
payable to Clerk of the Court. If you have any questions regarding this invoice, please contact the appeal
division at 954-831-5699
BRENDA D. FORMAN
Clerk of the Court
By: JACQUIE SHELLMAN
As Deputy Clerk
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**** FILED: BROWARD COUNTY, FL Brenda D. Forman, CLERK 2/1/2021 3:21:57 PM.**** Brenda D. Forman - CLERK CIRCUIT COURT COUNTY COURT 17™ Judicral Crrcuit Inand for Broward County Fort Lauderdale, FL 33301 201 Southeast 6" Street Broward County Courthouse Fort Lauderdale, Flonda 33301 CIVIL APPEAL DIVISION FINAL INVOICE/ROOM 4140 Date: February 1, 2021 To: Chad A. Barr, Esquire Style of Case: Functional Evaluation Testing of FL, Inc. vs. Progressive Select Insurance Company L.T. Court Numbers: COWE 20-18504 and CACE 20-21926 Appeal Case Number: 4D21-0570 Please be advised that the amount shown below represents the balance due for the preparation of the appeal record on the above styled case. 1, _19 INSTRUMENTS @ 3.50 EACH Sl $ 66.50 2. ___ PAGES COPIED (INDEX & PROGRESS REPORT) MULTIPLIED BY #OF ATTORNEYS: 7 $ 3. CERTIFICATE OF CLERK FEE = $ 7.00 4. FILING FEE: (INCLUDED IN PRE-BILL) = $281.00 5. INDIGENT APPLICATION FEE ($25 fee, if applicable) = $ 6. TOTAL COST OF RECORD PREPARATION (1 THRU 5) = $354.50 7. PREVIOUSLY PAID / ESTIMATED INVOICE (CREDIT) = $340.50 8. TOTAL AMOUNT NOW DUE (#6 minus #7) = $14.00 **PAYMENT IS DUE WITHIN (10) BUSINESS DAYS** Upon receipt of your payment, the record on appeal in this case will be sent to the Fourth District Court of Appeal. Our payment types include cash, cashier’s check, money order or attorney’s firm check made payable to Clerk of the Court. If you have any questions regarding this invoice, please contact the appeal division at 954-831-5699 BRENDA D. FORMAN Clerk of the Court By: JACQUIE SHELLMAN As Deputy Clerk