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_ <br /> OMB APPROVAL NO. PAGE OF <br /> REQUEST FOR ADVANCE 0348-0004 ~ 2 PAGES <br /> a. ~C" one or 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 instructions on back) RECauESrEO QJ FINAL ? PARTIAL ®ACCRUAL <br /> <br /> II 3. FEDERAL SPONSORING AGENCY AND ORGANIZATIONAL ELEMENT TO 4. FEDERAL GRANTOR 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 HEF041M06 ~ <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 October 1, 2004 June 30, 2005 <br /> 9. RECIPIENT ORGANIZATION 10. PAYEE (lNhere check is to be sent ildifferent than item 9) <br /> Name: City of Eugene Name: <br /> Number Number <br /> and Street: 777 Pearl Street and Street: <br /> City, State City, State <br /> and ZIP Code: Eugene, OR 97401 and ZIP Code: <br /> 11. COMPUTATION OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED <br /> PROGRAMSlFUNCTIONS/ACTIVITIES ~ <br /> Botanical Assistance TOTAL <br /> a. Total program (As o(date) ~ 14 500.00 $ $ ~ 14,500.00 <br /> outla to date ~ <br /> b. Less: Cumulative rogram income 0.00 0.00 <br /> c. Net program outlays (Line a minus 14,500.00 0.00 .0.00 14,500.00 <br /> Gne b) <br /> d. Estimated net cash outlays for advance <br /> rind 0.00 <br /> e. Total (Sum oflines c & d) 14,500.00 0.00 0.00 14,500.00 <br /> f. Non-Federal share of amount on line a 0.00 0.00 <br /> . Federal share of amount on line a 14,500.00 14,500.00 <br /> h. Federal a ments reviously re nested 0.00 0,00 <br /> i. Federal share now requested (Line g 14, 500.00 0.00 0.00 14,500.00 <br /> minus line h) <br /> 1• Advances required by <br /> month, 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 <br /> 0.00 <br /> 12. ALTERNATE COMPUTATION FOR ADVANCES ONLY <br /> a. Estimated Federal cash outla s that will be made during 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 (Line a minus line b) $ 0.00 <br /> JTHORIZED FOR LOCAL REPRODUCTION (Continued on Reverse) STANDARD FORM 270 (Rev. 7-87) <br /> Prescribed by OMB. Circulars A-102 and A-110 <br /> <br />