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Attachment E <br />JUSTIFICATION OF ADVANCE PAYMENT <br />SUB -RECIPIENT: INDIAN RIVER COUNTY <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 and purchase 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.: Submit Attachment 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 />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 <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 work 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 />49 <br />