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OMB APPROVAL NO. PAGE OF <br /> 0348-0004 1 2 PAGES <br /> REQUEST FORADUANCE a. '2C"one or bothbozes 2. BASIS OF REQUEST <br /> OR REIMBURSEMENT ? ADVANCE 0 REIMBURSE- <br /> TYPEOF MENT ? CASH <br /> PAYMENT b. '7C"the applicable box <br /> (See instructions 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 /> BYFEDERAIAGENCY <br /> U.S. Bureau of Land Management HEF031M01 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 June 19, 2003 September 30, 2003 <br /> 9. RECIPIENT ORGANIZATION 10. PAYEE (Where check is to be sent if different than item 9) <br /> Name: City of Eugene Name: <br /> Number Number <br /> and Street: 777 Pearl Street and Street: <br /> <br /> ~,I City, State City, State <br /> and ZIP Code: Eugene, OR 97401 and ZIP Code: <br /> 11. COMPUTATION OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED <br /> (a) (b) (c) <br /> PROGRAMS/FUNCTIONS/ACTIVITIES ? TOTAL <br /> a. Total program (Aso date) ~ ~ Q Q O_o0 <br /> outla s to date W W <br /> b. Less: Cumulative pro ram income <br /> c. Net program outlays (Line a minus <br /> line b) 0.00 0.00 0.00 0.00 <br /> d. Estimated net cash outlays for advance 0,00 <br /> eriod <br /> e. Total (Sum oflines c & d) 0.00 <br /> f. Non-Federal share of amount on line a <br /> g. Federal share of amount on line a <br /> h. Federal pa ments previousl re uested <br /> i. Federal share now requested (Line g O.oo O.oo O.oo O.QQ <br /> minus line h) <br /> J• Advances required by <br /> month, when requested 1st month <br /> by Federal grantor <br /> agency for use in making 2nd month <br /> prescheduled advances ~.~Q <br /> 3rd month <br /> 12. ALTERNATE COMPUTATION FOR ADVANCES ONLY <br /> a. Estimated Federal cash outlays that will be made during ,eriod covered by the advance ~ 8, 938.00 <br /> b. Less: Estimated balance of Federal cash on hand as of beginning of advance period <br /> $ 8,938.00 <br /> c. Amount requested (Line a minus line b) <br /> AUTHORIZED FOR LOCAL REPRODUCTION (Continued on Reverse) STANDARD FORM 270 (Rev. 7-9~ <br /> Prescribed 6y OMB Circulars A-102 and A-110 <br /> <br />