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OM8 APPROVAL NO. PAGE OF <br /> REQUEST FOR ADVANCE ~ o34s-0oo4 1 2 PAGES <br /> a. '7C"one crboth boxes 2. BASIS OF REQUEST <br /> OR REIMBURSEMENT 1. ? AwANCE ? REIMBURSE- <br /> TYPE OF MENT ? CASH <br /> PAYMENT b. '7C"theapplrcabte box <br /> (See instructions on back) REOUesTED 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 HAF051M07 1 <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 August 31, 2005 February 6, 2006 <br /> 9. RECIPIENT ORGANIZATION 10. PAYEE (Where check Is to be sent if dlflerent 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 ZIP Code: <br /> 11. ~ COMPUTATION OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED <br /> (a) (6I (o) <br /> PROGRAMS/FUNCTIONSlACTIVITIES ? <br /> Botanical Assistance TOTAL <br /> a. Total program (As of date) <br /> outlays to date $ 43,900.00 $ $ $ 43,900.00 <br /> b. Less: Cumulative rogram income 0.00 0.00 <br /> c. Net program outlays (Line a minus [}3,900.00 0.00 0.00 43,900.00 <br /> line b) <br /> d. Estimated net cash outlays for advance O.OO <br /> eriod <br /> e. Total (sum otlines c & d) 43,900.00 0.00 0,00 43,900.00 <br /> f. Non-Federal share of amount on line a 0.00 0.00 <br /> g. Federal share of amount on line a 43,900.00 43,900.00 <br /> h. Federal pa ments reviously requested O.OO 0.00 <br /> i. Federal share now requested (Line g <br /> minus line h) 43,900.00 0.00 0.00 43,900.00 <br /> <br /> 1• Advances required by <br /> month, when .requested 1st month 0.00 <br /> by Federal grantor 0.00 <br /> agency for use in making 2nd month <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 $ 0.00 <br /> b. Less: Estimated balance of Federal cash on hand as of be innin of advance eriod <br /> $ 0.00 <br /> <br /> c. Amount re nested (Line a minus line b) <br /> <br /> AUTHORIZED FOR LOCAL REPRODUCTION (Continued on Reverse) STANDARD FORM 270 (Rev. 7-97) <br /> Prescribed by OMB Circulars A-102 and A-110 <br /> <br />