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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />J.R. SMITH, CLERK <br />Attachment E <br />JUSTIFICATION OF ADVANCE PAYMENT <br />SUB -RECIPIENT: INDIAN RIVER COUNTY i <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 payments <br />will be -made on a reimbursement basis. These funds are needed to pay <br />staff, -award benefits to clients, duplicate forms andpurchase start-up <br />supplies and equipment. We would not be able .to operate the program <br />without this advance: <br />If you are requesting an advance, complete the following chart and line item justification below. <br />PLEASE NOTE: Calculate your estimated expenses at 100% of your expected needs for ninety <br />(90) days. SubmitAttachment'D with the cost share breakdown along with Attachment E and all <br />supporting, documentation. <br />.ESTIMATED;EXPENSES <br />BUDGET-CATEGORY/LINE ITEMS <br />20_=20_ Anticipated Expenditures for First Three <br />list applicable line items) <br />�� Months of Contract <br />f o.. example <br />ADMINISTRATIVE• COSTS <br />(Include Secondary Administration. <br />PROGRAM EXPENSES <br />TOTAL EXPENSES <br />LINE ITEM.JUSTIFICATION For each line item, provide a detailed justification explaining the <br />need'for the cash advance. The justification must include supporting documentation that clearly <br />shows the advance will be expended within the.first ninety (90) days of the contract term. Support <br />documentation should include quotes for purchases;; delivery timelines, salary and expense <br />projections, etc. to -provide the Division reasonable and necessary support that the advance will <br />be expended within -the first ninety (90) days of the contract term. Any advance funds not <br />expended within the first ninety (90) days of the contract term as evidenced by copies of Invoices <br />and cancelled checks as required by the Budget and, Scope of worts showing 100% of <br />expenditures for the 90 day period 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 <br />earned on the advance. <br />48 <br />