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OMB APPROVAL NO. PAGE OF <br /> REQUEST FOR ADVANCE 0348-0004 1 1 PAGES <br /> a. X-onaorbothboxes 2. BASIS OFREOUEST <br /> OR REIMBURSEMENT ?ADVANCE 0 REIMBURSE- <br /> nrPEOF MENT ? CASH <br /> PAYMENT b. 9C'theapplkablebox <br /> (See instrucBons on back) Rc-ciuESTED ? FINAL 0 PARTIAL ? ACCRUAL <br /> 3. FEDERAL SPONSORING AGENCY AND ORGANIZATIONAL ELEMENTTO 4. FEDERAL GRANTOR OTHER 5. PARTIAL PAYMENT REQUEST <br /> WHICH THIS REPORT LS SUBMrfiEO IDENTIFYING NUMBER ASSIGNED NUMBER FOR THIS REQUEST a <br /> BY FEDERAL AGENCY <br /> FEMA EMS-2004-GR-0035 1 <br /> 8. EMPLOYER IDENTIFICATION 7. RECIPIENTS ACCOUNT NUMBER 8. PERIOD COVERED BY THIS REQUEST <br /> NUMBER OR IDENTIFYING NUMBER FROM (month, dey, year) TO (month, dey, year) <br /> 93-6002160 _ 10/1 /04 4-27-07 <br /> 9. RECIPIENT ORGANIZATION - 10. PAYEE (Whe/9 Check/S t0 be Selitlrtl!lfer@ntThan Item 9) -YE <br /> x. <br /> Name: CITY OF EUGENE- PW-ENGINEERING Name: SAME <br /> Number Number <br /> and street: 244 E. BROADWAY and Street: <br /> u <br /> City, State EUGENE,OR. 97401 City, State' <br /> and ZIP Code: and ZIP Code: <br /> 11. COMPUTATION OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED <br /> (a) lb) (c) <br /> PROGRAMS/FUNCTIONS/ACTIVITIES ? <br /> CTP-97-045 TOTAL <br /> a. Total program (as of date) $ 232 303.14 $ $ $ 232 303.14 <br /> outla to date > > <br /> b. Less: Cumulative ro ram income 0.00 <br /> c. Net program outlays (Line a minus <br /> lineb 232,303.14 0.00 0.00 232,303.14 <br /> d. Estimated net cash outlays for advance <br /> eriod 0.00 0.00 i. <br /> 232 303.14 0.00 ~ 0.00 232 303.14 " <br /> e. Total Sum of6nes c & + ~ <br /> f. Nan-Federal share of amount on line a 207,803.14 207,803.14 <br /> . Federal share of amount on line a 24,500.00 24,500.00 <br /> h. Federal a ments reviousi re nested 0.00 0.00 <br /> i. Federal share now requested (Line g 24 500.00 0.00 0,00 24 500.00 <br /> minus line h ~ s <br /> Advances required by <br /> month, when ,requested l st 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 during rind covered by the advance $ f <br /> b. Less: Estimated balance of Federal cash on hand as of be innin of advance eriod <br /> f. <br /> c, Amount r nested Une a minus line b $ 0.00 <br /> AUTHORIZED FOR LOCAL REPRODUCTION (Continued on Reverse) srANDARO FORM 2~0 (Rev. ~-e~ <br /> <br /> ' Prescribed by OMB Circulars A-102 and A-110 <br /> y. <br /> r; <br /> <br />