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ATTACHMENT B ADVANCE PAYMENT JUSTIFICATON FORM Use of this form is not required unless the advance requested requires the prior approval of the State Chief Financial Officer. For advance requests that are equal to or less than the purchasing threshold of $35,000 .00 , category two as defined in Section 287 .017, Florida Statutes, and meet one of the advance payment requirements identified in Section 215 .422( 14), Florida Statutes, use of this form is waived. However, the purchase requisition or contract review form must clearly identify the criteria being met under Section 215 .422( 14), Florida Statutes which allows the advance to be made without prior approval of the State Chief Financial Officer. Name/Address of the Vendor/Recipient: Contact Person/Phone No. : Agreement No ./Purchase Order No. if known) : Commodities/Services/Project Description: Organizational Structure i.e. local ov 't, non-profit corporation, etc. Value of Purchase or Grant: Advance Payment Amount Requested: Period Advance Payment to Cover: 90 days startup Full Contract Period ❑ Quarterly ❑ Other (specify): Indicate Statutory Authority : Ll 215 .422, F. S Lj 216. 181 , F. S. GAA Year and Line Item Info : SFY: Line Item : 1 . Reason advance payment is required : 2. The following information required for advances requested pursuant to 215.422, Florida Statues (and the Reference Guide for State Expenditures) which exceed the purchasing threshold of category two as defined in 287.017 Florida Statutes. A. Document, if applicable, the cost savings to be incurred as a result of an advance payment that are equal or greater than the amount the State would earn by investing the funds and paying in arrears. Include the percent (%) savings to be realized. In calculating the percent savings as compared to the percent that can be earned by the State, information may be obtained from the Department of Financial Services, Division of Accounting and Auditing, Bureau of Auditing at 850/4104194 or SunCom 2104194 regarding the current Treasury earnings rate. B. Document, if applicable, how the goods or services are essential to the operation of the Department and why they are available only if advance payment is made : DEP Agreement No . 14IR2 , Attachment B , Page 1 of 3