Laserfiche WebLink
Attachment E <br /> JUSTIFICATION OF ADVANCE PAYMENT <br /> RECIPIENT : <br /> Indicate by checking one of the boxes below, if you are requesting an advance . If an advance payment is <br /> requested , budget data on which the request is based must be submitted . Any advance payment under this <br /> Agreement is subject to s . 216 . 181 ( 16)(a)(b) , Florida Statutes . The amount which may be advanced shall not <br /> exceed the expected cash needs of the recipient within the initial three months . <br /> [ ] NO ADVANCE REQUESTED [ ] ADVANCE REQUESTED <br /> No advance payment is requested . Advance payment of $ is requested . Balance of <br /> Payment will be solely on a payments will be made on a reimbursement basis . These funds <br /> reimbursement basis . No additional are needed to pay staff, award benefits to clients , duplicate forms <br /> information is required . and purchase start-up supplies and equipment. We would not be <br /> able to operate the program without this advance. <br /> ADVANCE REQUEST WORKSHEET <br /> If you are requesting an advance , complete the following worksheet. <br /> (A) (B) (C) (D) <br /> DESCRIPTION FFY 2004 FFY 2005 IFFY 2006 Total <br /> 1 INITIAL CONTRACT ALLOCATION <br /> 2 FIRST THREE MONTHS CONTRACT <br /> EXPENDITURES' <br /> 3 AVERAGE PERCENT EXPENDED IN FIRST <br /> THREE MONTHS <br /> (Divide line 2 b line 1 .) <br /> First three months expenditures need only be provided for the years in which you requested an advance. <br /> If you do not have this information, call your consultant and they will assist you . <br /> MAXIMUM ADVANCE ALLOWED CALULATION : <br /> X $ _ <br /> Cell D3 HMGP Award MAXIMUM <br /> (Do not include match ) ADVANCE <br /> REQUEST FOR WAIVER OF CALCULATED MAXIMUM <br /> [ ] Recipient has no previous HMGP contract history. Complete Estimated Expenses chart <br /> and Explanation of Circumstances below . <br /> [ ] Recipient has exceptional circumstances that require an advance greater than the Maximum <br /> Advance calculated above. Complete estimated expenses chart and Explanation of Circumstances <br /> below. Attach additional pages if needed . <br /> 31 <br />