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Attachment E <br /> JUSTIFICATION OF ADVANCE PAYMENT <br /> Recipient : <br /> Indicate by checking one of the boxes below, if you are requesting an advance. If an advance payment is <br /> requested , budget data on which the request is based must be submitted . Any advance payment under this <br /> Agreement is subject to s. 216. 181 ( 16) (a) (b) , Florida Statutes . The amount which may be advanced shall not <br /> exceed the expected cash needs of the recipient within the initial three months. <br /> [ ] NO ADVANCE REQUESTED ; ; [ ] ADVANCE REQUESTED ' <br /> ' No advance payment is requested . Payment I PAdvance payment of $ is requested . Balance of <br /> , will be solely on a reimbursement basis . No . payments will be made on a reimbursement basis . These funds are <br /> additional information is required . ; ; needed to pay staff, and purchase start-up supplies and equipment. We ; <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' would not be able to operate the program <br /> without this advance_ ' <br /> - - - - <br /> ADVANCE REQUEST WORKSHEET <br /> If you are requesting an advance, complete the following worksheet <br /> DESCRIPTION (A) (B) (C) (D) <br /> FFY 2003 FFY 2004 FFY 2005 Total <br /> 1 INITIAL CONTRACT ALLOCATION <br /> 2 FIRST THREE MONTHS CONTRACT <br /> EXPENDITURES ' <br /> 3 AVERAGE PERCENT EXPENDED IN <br /> FIRST THREE MONTHS <br /> ivide line 2 by line 1 . <br /> First three months expenditures need only be provided for the years in which you requested an advance. If you do <br /> not have this information , call your consultant and they will assist you . <br /> MAXIMUM ADVANCE ALLOWED CALULATION : <br /> X $ _ <br /> Cell D3 EWA Award MAXIMUM ADVANCE <br /> (do not include match) <br /> REQUF..4T FOR WAIVER OFC',4L CULA TED MAX7M771N <br /> [ Recipient has no previous EMPA contract history. Complete Estimated Expenses chart and Explanation of <br /> Circumstances below. <br /> [ ] Recipient has exceptional circumstances that require an advance greater than the Maximum Advance <br /> calculated above. <br /> Complete estimated expenses chart and Explanation of Circumstances below. Attach additional pages if <br /> needed . <br /> 32 <br />