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Attachment E <br /> JUSTIFICATION OF ADVANCE PAYMENT <br /> Zecipient : <br /> ndicate by checking one of the boxes below, if you are requesting an advance. If an advance payment is requested ; budget <br /> lata on which the request is based must be submitted . Any - advance payment under this Agreem nt is subject to s . <br /> • 16 . 181 ( 16) (a) (b) , Florida Statutes . The amount which may be advanced shall not exceed t e expected cash needs of the <br /> ,ecipient within the initial three months . <br /> [ ] NO ADVANCE REQUESTED [ ] ADVANCE REQUESTED <br /> Advance payment of $ is reque ted . Balance of <br /> No advance payment is requested . Payment payments will be made on a reimbursement bas ' s . These funds are , <br /> will be solely on a reimbursement basis . No needed to pay staff, and purchase start-up supplies and equipment. We <br /> additional information is required . would not be 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 /> FFY 2002 FFY 2003 F1 Y 2004 Total <br /> DESCRIPTION <br /> 1 INITIAL CONTRACT ALLOCATION <br /> 2 FIRST THREE MONTHS CONTRACT <br /> EXPENDITURES ' <br /> 3 AVERAGE PERCENT EXPENDED IN <br /> FIRST THREE MONTHS <br /> (Divide line 2 by line 1 . <br /> 'irst three months expenditures need only be provided ort the years in which you requested an advance. If you do not havi <br /> information , call your consultant and they will assist you . <br /> MAXIMUM ADVANCE ALLOWED CALULATION : <br /> X $ _ <br /> Cell D3 EMPA Award MAXIMUM <br /> (Do not include match) ADV NCE <br /> REQUEST FOR WAIVER OF CALCULATED MAXIMUM <br /> ] Recipient has no previous EMPA contract history. Complete Estimated Expenses chart and Explanation of <br /> Circumstances below. <br /> ] Recipient has exceptional circumstances that require an advance greater than the Maximum Advance calculated <br /> above. <br /> 31 <br />