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OMB APPROVAL NO. PAGE OF <br /> REQUEST FOR ADVANCE o34s-0004 1 2 PAGES <br /> a. 7C"one or both boxes 2. BASIS OF REQUEST <br /> OR REIMBURSEMENT ? ADVANCE is REIMBURSE- <br /> TYPE of MENT ? CASH <br /> PAYMENT b. 'x" the applicable box <br /> (See instructions on back) REQUESTED is FINAL ? PARTIAL ®ACCRUAL <br /> 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 HEF051 M08 2 <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 January 1, 2007 October 1, 2007 <br /> 9. RECIPIENT ORGANIZATION 10. PAYEE (Where Check IS t0 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 /> 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 ? <br /> Engineering Construction TOTAL <br /> a. Total program (As of date) ~ 13,124.00 $ 6 876.00 $ ~ 20,000.00 <br /> outla s to date <br /> b. Less: Cumulative ro ram income 0.00 0.00 0.00 0.00 <br /> c. Net program outlays (Line a minus 13,124.00 6,876.00 0.00 20,000.00 <br /> line b) <br /> d. Estimated net cash outlays for advance <br /> period 0.00 <br /> e. Total (Sum oflines c & d) 13,124.00 6,876.00 0.00 20,000.00 <br /> f. Non-Federal share of amount on line a 0.00 0.00 0.00 0.00 <br /> . Federal share of amount on line a 13,124.00 6,876.00 20,000.00 <br /> h. Federal ayments reviouslyrequested 12,237.50 3,876.00 16,113.50 <br /> i. Federal share now requested (Line g 886.50 3,000.00 0.00 3,886.50 <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 0.00 <br /> 12. ALTERNATE COMPUTATION FOR ADVANCES ONLY <br /> a. Estimated Federal cash outlays that will be made during eriod covered by the advance $ 0.00 <br /> b. Less: Estimated balance of Federal cash on hand as of be inning of advance eriod <br /> c. Amount requested (Line a minus Line b) $ 0.00 <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 />