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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 Fneeded <br /> EQUESTED <br /> No advance payment is requested . of $ <br /> s rto ceque7en <br /> ; lents , iciate for <br /> Payment will be solely on a ns <br /> made on a reimbursement basicate forms <br /> reimbursement basis. No additional rt up suppl s and ff award equipmts to lent. <br /> information is required . <br /> able to operate the program without this advance. <br /> ADVANCE REQUEST WORKSHEET <br /> If you are requesting an advance , complete the following worksheet. <br /> (A) (B) (C) (D) <br /> FFY 2004 FFY 2005 FFY 2006 Total <br /> DESCRIPTION <br /> 1 INITIAL CONTRACT ALLOCATION <br /> 2 FIRST THREE MONTHS CONTRACT <br /> EXPENDITURES' <br /> 3 AVERAGE PERCENT EXPENDED IN FIRST <br /> THREE MONTHS <br /> (Divide line 2 b line 1 .) <br /> First three months expenditures need only be provided for the years in which you requested an advance. <br /> If you do not have this information, call your consultant and they will assist you . <br /> MAXIMUM ADVANCE ALLOWED CALULATION : <br /> X $ MAXIMUM <br /> Cell D3 HMGP Award ADVANCE <br /> (Do not include match) <br /> REQUEST FOR WAIVER OF CALCULATED MAXIMUM <br /> [ ] Recipient has no previous HMGP contract history . Complete Estimated Expenses chart <br /> and Explanation of Circumstances below . <br /> [ ] Recipient has exceptional circumstances that require an advance greater than the Maximum <br /> below. Attach additional pages iComplete eedetimated expenses chart and Explanation of Circumstances <br /> 31 <br />