Laserfiche WebLink
Attachment K <br />JUSTIFICATION FOR 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 <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 />STATE OF FLORIDA <br />INDIAN RIVER COUNTY <br />THIS IS TO CERTIFY THAT THIS IS <br />A TRUE AND CORRECT COPY OF <br />THE ORIGINAL ON FILE IN THIS <br />OFFICE. <br />EFFR R. St917FI CLERK <br />BY �7, ye , D.C. <br />DATE P4 <br />/ <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#00009(0) <br />Contract Work $9,500,000.00 (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, as defined in 2 C.F.R. §200.305 and as applicable section 216.181(16), Florida <br />Statutes. Any advance funds not expended within the first ninety (90) days of the contract term must be <br />returned to the Division Cashier, 2555 Shumard Oak Boulevard, Tallahassee, Florida 32399, within thirty <br />(30) days of receipt, along with any interest earned on the advance). <br />53 <br />