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Attachment E <br />JUSTIFICATION OF ADVANCE PAYMENT <br />RECIPIENT: <br />If you are requesting an advance, indicate same by checking the box below. <br />[ ] ADVANCE REQUESTED <br />Advance payment of $ is requested. Balance of <br />payments will be made on a reimbursement basis. These funds are <br />needed to pay staff, award benefits to clients, duplicate forms and <br />purchase start-up supplies and equipment. We would not be able to <br />operate the program without this advance <br />If you are requesting an advance, complete the following chart and line item justification below. <br />ESTIMATED EXPENSES <br />A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />J.R. SMITH, CLERK <br />BUDGET CATEGORY/LINE ITEMS <br />(list applicable line items) <br />20-20 <br />Anticipated Expenditures for First Three Months of <br />Contract <br />For example <br />ADMINISTRATIVE COSTS <br />(Include Secondary Administration.) <br />For example <br />PROGRAM EXPENSES <br />TOTAL EXPENSES <br />LINE ITEM JUSTIFICATION (For each line item, provide a detailed justification explaining the need for the cash <br />advance. The justification must include supporting documentation that clearly shows the advance will be expended <br />within the first ninety (90) days of the contract term. Support documentation should include quotes for purchases, <br />delivery timelines, salary and expense projections, etc. to provide the Division reasonable and necessary support that <br />the advance will be expended within the first ninety (90) days of the contract term. Any advance funds not expended <br />within the first ninety (90) days of the contract term shall be returned to the Division Cashier, 2555 Shumard Oak <br />Boulevard, Tallahassee, Florida 32399, within thirty (30) days of receipt, along with any interest earned on the advance) <br />32 <br />