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ATTACHMENT <br />ADVANCE PAYMENT ]USTIFICATON FORM <br />Use of this form is not required unless the advance requested requires the prior approval of the Comptroller. For advance <br />requests that are equal to or less than the purchasing threshold of category two as defined in Section 287.017, Florida <br />Statutes, and meet one of the advance payment requirements identified in Section 215.422(14), Florida Statutes, use of <br />this form is waived. However, the purchase requisition or contract review form must clearly identify the criteria being met <br />under 215.422(14), Florida Statutes that allows the advance to be made without prior Comptroller approval. <br />Name/Address of the Vendor/Recipient: <br />Contact Person/Phone No.: <br />Agreement No./Purchase Order No. (if known): <br />LP6822 <br />Commodities/Services/Project Description: <br />Organizational Structure <br />i.e. local ov't non-profit corporation, etc. <br />Value of Purchase or Grant: <br />Advance Payment Amount Requested: <br />Period Advance Payment to Cover: <br />❑ 90 days startup <br />❑ Quarterly <br />❑ Full Contract Period <br />❑ Other (specify): <br />Indicate Statutory Authority: <br />❑ 215.422, F.S ❑ 216.181, F.S. <br />GAA Year and Line Item Info: <br />SFY: <br />Line Item: <br />1. Reason advance payment is required: <br />2. The following information required for advances requested pursuant to 215.422, Florida Statues <br />(and the Comptroller's Voucher Processing Handbook) which exceed the purchasing threshold of <br />category two as defined in 287.017 Florida Statues. <br />A. Document, if applicable, the cost savings to be incurred as a result of an advance payment that are equal or <br />greater than the amount the State would earn by investing the funds and paying in arrears. Include the percent <br />(%) savings to be realized. In calculating the percent savings as compared to the percent that can be earned by <br />the State, information may be obtained from the Department of Insurance, Division of Treasury at 850/413-2776 <br />or SunCom 293-2776 regarding the current Treasury earnings rate. <br />B. Document, if applicable, how the goods or services are essential to the operation of the Department and why <br />they are available only if advance payment is made: <br />DEP Agreement No. LP6822, Attachment F, Page 1 of 3 <br />