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OMB APPROVAL NO. PAGE OF <br /> i <br /> REQUEST fOR ADVANCE o34s-ooo4 1 2 PAGES <br /> a. '7C" one or both boxes ~ 2. BASIS OF REQUEST <br /> OR REIMBURSEMENT ? ADVANCE ® REIMBURSE- <br /> TYPEOF MENT ? CASH <br /> PAYMENT b. the applicable box <br /> (See insfnlc6ons on back) REQUESTED m 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 HEF051 M11 1 <br /> 6. 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 September 12, 2005 January 20, 2006 <br /> 9. RECIPIENT ORGANIZATION 10. PAYEE (Where check is to be sent /f different than item 9) <br /> Name: City of Eugene Name: <br /> Number Number <br /> and Street: 777 Pearl Street and Street: <br /> City, State Eu ene, OR 97401 City, State <br /> and ZIP Code: g and Z/P Code: <br /> 11. COMPUTATION OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED <br /> (a) (bJ (cJ <br /> PROGRAMS/FUNCTIONS/ACTIVITIES ? <br /> Botanical Assistance TOTAL <br /> a. Total program (AsotdateJ $ 5,000.00 $ $ ~ 5 000.00 <br /> outla s to date <br /> b. Less: Cumulative ro ram income 0.00 0.00 <br /> c. Net program outlays (Line a minus 5,000.00 0.00 0.00 5,000.00 <br /> line b) <br /> d. Estimated net cash outlays for advance 0.00 <br /> eriod <br /> e. Total (sum otlines c & d) 5,000.00 0.00 0.00 5,000.00 <br /> f. Non-Federal share of amount on Tine a 0.00 0.00 <br /> . Federal share of amount on line a 5,000.00 5,000.00 <br /> h. Federal a ments reviously re uested 0.00 0.00 <br /> i. Federal share now requested (Line g 5,000.00 0.00 0.00 5,000.00 <br /> minus line h) <br /> 1• Advances required by <br /> month, when requested 1st month O.OO <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 s that will be made Burin eriod covered b the advance $ O.OO <br /> b. Less: Estimated balance of Federal cash on hand as of be inning of advance eriod <br /> $ 0.00 <br /> c. Amount re uested (Line a minus line b) <br /> AUTHORIZED FOR LOCAL REPRODUCTION (Continued on Reverse) srartDARD FORM 2~0 (Rev. ~-s7) <br /> Prescribed by OMB Circulars A-102 and A-11.0 <br /> <br /> _ _ _ _ <br /> <br />