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Attachment C <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 <br /> requested , budget data on which the request is based must be submitted . Any advance payment under this <br /> Agreement is subject to s. 216. 181 ( 16), Florida Statutes. The amount which may be advanced shall not exceed <br /> the expected cash 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 <br /> FFY 20 FFY 20 FFY 20 Total <br /> INITIAL CONTRACT <br /> 1 <br /> ALLOCATION <br /> 2 FIRST THREE MONTHS <br /> CONTRACT EXPENDITURES' <br /> 3 AVERAGE PERCENT EXPENDED <br /> IN FIRST THREE MONTHS <br /> (Divide line 2 byline 1 .) <br /> ' First three months expenditures need only be provided for the years in which you requested an advance. If <br /> you do not have this information , call your consultant and they will assist you. <br /> MAXIMUM ADVANCE ALLOWED CALULATION : <br /> 47 <br />