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STATE OF FLORIDA <br />INDIAN RIVER COUNTY <br />THIS IS TO CERTIFY THAT THIS IS <br />A TRUE AND CORRECT COPY OF <br />THE 05LRINAL ON FILE IN THIS <br />OFFI <br />FFRE�R. S I H, C RK <br />Attachment K sr <br />JUSTIFICATION FOR ADVANCE PAYMENT I <br />DATE <br />RECIPIENT: <br />If you are requesting an advance, indicate same by checking the box below. <br />[ ] ADVANCE REQUESTED <br />Advance payment of $ is <br />requested. Balance of payments will be made on a reimbursement <br />basis. These funds are needed to pay pending obligations for <br />eligible work. We would not be able to operate the program without <br />this advance. <br />If you are requesting an advance, complete the following chart and line item justification below. <br />BUDGET CATEGORY/LINE ITEMS <br />(list applicable line items) <br />20_-20_ Anticipated Expenditures for First Three Months <br />of Agreement <br />Example: PW#00001(0) <br />Contract Work $1,500,000.00 (provide detailed justification). <br />TOTAL EXPENSES <br />LINE ITEM JUSTIFICATION (For each line item, provide a detailed justification explaining the need <br />for the cash advance. The justification must include supporting documentation that clearly shows the <br />advance will be expended within the first ninety (90) days of the contract term. Support documentation <br />should include quotes for purchases, delivery timelines, salary and expense projections, etc. to provide the <br />Division reasonable and necessary support that the advance will be expended within the first ninety (90) <br />days of the contract term. Any advance funds not expended within the first ninety (90) days of the contract <br />term must be returned to the Division Cashier, 2555 Shumard Oak Boulevard, Tallahassee, Florida 32399, <br />within thirty (30) days of receipt, along with any interest earned on the advance). <br />86 <br />