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ATTACHMENT B <br /> "Wow <br /> ADVANCE PAYMENT JUSTIFICATON FORM <br /> Use of this form is not required unless the advance requested requires the prior approval of the State Chief Financial Officer. For advance requests <br /> 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 <br /> the advance payment requirements identified in Section 215.422(14),Florida Statutes,use of this form is waived. However,the purchase requisition <br /> 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 <br /> without prior approval of the State Chief Financial Officer. <br /> Name/Address of the Vendor/Recipient: <br /> Contact Person/Phone No.: <br /> Agreement No./Purchase Order No. if known): <br /> Commodities/Services/Project Description: <br /> Organizational Structure <br /> i.e.local ov't, non-profit corporation,etc. <br /> Value of Purchase or Grant: <br /> Advance Payment Amount Requested: <br /> Period Advance Payment to Cover: ❑ 90 days startup ❑ Full Contract Period <br /> ❑ <br /> Quarterly ❑ Other(s ci : <br /> Indicate Statutory Authority: ❑215.422,F.S ❑ 216.181,F.S. <br /> GAA Year and Line Item Info: SFY: Line Item: <br /> 1. Reason advance payment is required: <br /> -wr+ <br /> 2. The following information required for advances requested pursuant to 215.422, Florida Statues (and the Reference Guide for State <br /> Expenditures)which exceed the purchasing threshold of category two as defined in 287.017 Florida Statutes. <br /> 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 <br /> would earn by investing the funds and paying in arrears. Include the percent (%) savings to be realized. In calculating the percent savings as <br /> compared to the percent that can be earned by the State, information may be obtained from the Department of Financial Services, Division of <br /> Accounting and Auditing,Bureau of Auditing at 850/410-4194 or SunCom 210-4194 regarding the current Treasury earnings rate. <br /> 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 <br /> payment is made: <br /> DEP Agreement No. 14IR2,Attachment B,Page I of 3 <br /> 44 <br />