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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 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 /> rA NO ADVANCE REQUESTED I ] 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 /> 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 /> ' 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 <br /> (Do not include any match) ADVANCE <br /> 39 <br />