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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 requested, <br />budget data on which the request is based must be submitted. Any advance payment under this Agreement is <br />subject to s. 216.181(16), Florida Statutes. The amount which may be advanced shall not exceed the expected cash <br />needs of the Recipient within the initial three months of the Agreement. <br />[ X ] NO ADVANCE REQUESTED <br />No advance payment is requested. Payment <br />will be solely on a reimbursement basis. No <br />additional information is required. <br />ADVANCE REQUEST WORKSHEET <br />[ j ADVANCE REQUESTED <br />Advance payment of $ is requested. Balance of <br />payments will be made on a reimbursement basis. These funds <br />are needed to pay staff, award benefits to clients, duplicate <br />forms and purchase start-up supplies and equipment. We <br />would not be able to operate the program without this advance. <br />If you are requesting an advance, complete the following worksheet <br />1 First three months expenditures need only DC prUVIUCU 1U1 NIC YGAIJ M wmLLb ,Tv4 ival.awwv »u ».-. »++��• +-� �-- -- ---_ <br />have this information, call your consultant and they will assist you. <br />MAXIMUM ADVANCE ALLOWED CALULATION: <br />OW <br />Cell D3 <br />DEM Award <br />(Do not include any match) <br />.X <br />lu :. lu lu 1 <br />(A) <br />(B) <br />(C) <br />(D) <br />DESCRIPTION <br />FFY 2006 <br />FFY 2007 <br />FFY 2008 <br />Total <br />1 <br />INITIAL CONTRACT ALLOCATION <br />2 <br />FIRST THREE MONTHS CONTRACT <br />EXPENDITURES' <br />3 <br />AVERAGE PERCENT EXPENDED IN FIRST <br />THREE MONTHS <br />(Divide line 2 by line 1.) <br />._ <br />A <br />70...... d.. s...4 <br />1 First three months expenditures need only DC prUVIUCU 1U1 NIC YGAIJ M wmLLb ,Tv4 ival.awwv »u ».-. »++��• +-� �-- -- ---_ <br />have this information, call your consultant and they will assist you. <br />MAXIMUM ADVANCE ALLOWED CALULATION: <br />OW <br />Cell D3 <br />DEM Award <br />(Do not include any match) <br />.X <br />lu :. lu lu 1 <br />