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r <br /> OMB APPROVAL NO. PAGE OF <br /> REQUEST FOR ADVANCE o34$-0004 1 2 PAGES <br /> a. ~C'one a both boxes 2. BASIS OF REQUEST <br /> OR REIMBURSEMENT ? ADVANCE ~ REIMBURSE- <br /> TYPE OF MENT ?CASH <br /> PAYMENT b. ?C"the applicable box <br /> (See instntcttions on back) REQUESTED ~ FINAL ? PARTIAL ®ACCRUAL <br /> 3. FEDERAL SPONSORING AGENCY AND ORGANIZATIONAL ELEMENT TO 4. FEDERAL GRANT OR OTHER 5. PARTIAL PAYMENT REQUEST <br /> WHICH THIS REPORT IS SUBMITTED IDENTIFYING NUMBER ASSIGNED NUMBER FOR THIS REQUEST <br /> BY FEDERAL AGENCY <br /> U.S. Bureau of Land Management HAF031 M02 2 <br /> 8. EMPLOYER IDENTIFICATION 7. RECIPIENTS ACCOUNT NUMBER 8. PERIOD COVERED BY THIS REQUEST <br /> NUMBER OR IDENTIFYING NUMBER FROM (month, day, year) TO (month, day, year) <br /> 93-6002160 1536-0031-8601 July 14, 2003 June 15, 2005 <br /> S. RECIPfENT ORGANIZATION 10. PAYEE (lNhere checkls to be sentlldi//etgnf than ttem 9) <br /> Name: City of Eugene Name: <br /> Number Number <br /> and street: 777 Pearl Street and sneer: <br /> clry, state Eu ene, OR 97401 city, state , <br /> and ZIP Code: g and ZIP Code: <br /> 11. COMPUTATION OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED <br /> (a) (b) (c) <br /> PROGRAMS/FUNCTIONS/ACTIVITIES ? <br /> June 15, 2005 TOTAL <br /> a. Total program (Asordate) $ 773,000.00 $ $ $ 773,000.00 <br /> outla to date <br /> b. less: Cumulative ram income 0.00 0'00 <br /> c. Net program outlays (Line a minus 773,000.00 0.00 0.00 773,000.00 <br /> ine b) <br /> d. Estimated net cash outlays for advance 0.00 <br /> rfod <br /> e. Total (sum otunes c s d) 773,000.00 0.00 0.00 773,000.00 <br /> f. Non-Federal share of amount on line a 0.00 <br /> . Federal share of amount on line a 773,000.00 773,000.00 <br /> h. Federal ments reviousl re nested 758,877.92 758,877.92 <br /> I. Federal share now requested (Line g 14 122.08 0.00 0.00 14,122.08 <br /> minus Nne h ~ <br /> 1• Advances required by <br /> nanth, when requested 1st month 0.00 <br /> by Federal grantor <br /> agency for use in making 2nd month 0.00 <br /> prescheduled advances 3rd month 0.00 <br /> 12. ALTERNATE COMPUTATION FOR ADVANCES ONLY <br /> a. Estimated Federal cash outla that will be made duri eriod covered b the advance $ 0.00 <br /> b. Less: Estimated balance of Federal cash on hand as of be Innin of advance eriod <br /> Amount re nested Une a minus line b) $ 0.00 <br /> <br /> AUTHORIZED FOR LOCAL REPRODUCTION (Continued an Reverse) STANDARD FORM 270 (Rev. 7-97) <br /> Prescribed by OMB Circulars A-102 and A-110 <br /> <br />