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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 /> [ ] ADVANCE REQUESTED <br /> [ ] NO ADVANCE REQUESTED <br /> Advance payment of $ is requested . Balance of <br /> No advance payment is requested . Payment payments will be made on a reimbursement basis . These funds <br /> will be solely on a reimbursement basis . No are needed to pay staff, award benefits to clients, duplicate <br /> additional information is required , forms and purchase start-up supplies and equipment . We <br /> 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 /> DESCRIPTION FFV 20_ FFV 20_ FFV 20_ 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 by line 1 .) <br /> First three months expenditures need only be provided for the years in which you requested an advance. If you do not <br /> have this information , call your consultant and they will assist you . <br /> MAXIMUM ADVANCE ALLOWED CALULATION : <br /> X $ _ <br /> Cell D3 DEM Award MAXIMUM ADVANCE <br /> ( Do not include any match ) <br /> 22 <br />