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ATTACHMENT B <br /> ADVANCE PAYMENT JUSTIFICATON FORM <br /> Use of this form is not required unless the advance requested requires the prior approval of the Comptroller. For advance requests that are equal <br /> to or <br /> less than the purchasing threshold of category two as defined in Section 287 . 017 , Florida Statutes, and meet <br /> one of the advance payment <br /> requirements identified in Section 215 .422 ( 14), Florida Statutes, use of this form is waived . However, the purchase requisition or <br /> contract review <br /> form must clearly identify the criteria being met under 215 .422 ( 14) , Florida Statutes that allows the advance to be made without <br />prior Comptroller <br /> approval . <br /> Name/Address of the Vendor/Recipient : <br /> Contact Person/Phone No . : <br /> Agreement No ./Purchase Order No . if known) : <br /> Commodities/Services/Project Description : <br /> Organizational Structure <br /> i . e . local ov ' t, non-profit corporation, etc. <br /> Value of Purchase or Grant: <br /> Advance Payment Amount Requested : <br /> Period Advance Payment to Cover: ❑ 90 days startup ❑ Full Contract Period <br /> ❑ Quarterly ❑ Other (specify) : <br /> Indicate Statutory Authority: I ❑ 215 .4229 F . S ❑ 216 . 181 , F. S . <br /> GAA Year and Line Item Info : SFY: Line Item: <br /> 1 . Reason advance payment is required : <br /> 2 . The following information required for advances requested pursuant to 215.422, Florida Statutes (and the Comptroller' s Voucher <br /> Processing Handbook) which exceed the purchasing threshold of category two as defined in 287.017 Florida Statutes. <br /> A. Document, if applicable, the cost savings to be incurred as a result of an advance payment that are equal or greater than the <br /> amount the State <br /> would earn by investing the funds and paying in arrears . Include the percent (%) savings to be realized . In calculating the <br />percent savings as <br /> compared to the percent that can be earned by the State, information may be obtained from the Department of Insurance, Division of <br /> Treasury at <br /> 850/413 -2776 or SunCom 293 -2776 regarding the current Treasury earnings rate. <br /> This section not applicable. <br /> B . Document, if applicable, how the goods or services are essential to the operation of the Department and why they are available only if <br />advance <br /> payment is made : <br /> This section not applicable. <br /> Attachment B , DEP Agreement No . H5IR1 , Page 1 of 3 <br />