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. - OMB APPROVAL NO. PAGE OF <br /> - REQUEST FO'R ADVANCE o34s-ooo4 1 2 PAGES <br /> a. '~C• one cr both boxes 2: BASIS OF REQUEST <br /> OR REIMBURSEMENT ? ADVANCE 0 REIMBURSE- <br /> TYPEOF MENT ? CASH <br /> PAYMENT b. the applicable boz <br /> (See instructions on back) REQUESTED is ACCRUAL <br /> ? FINAL 0 PARTIAL <br /> 3. FEDERAL SPONSORING AGENCY AND ORGANIZATIONAL ELEMENT TO 4. FEDERAL GRANTOR OTHER 5. PARTIAL PAYMENT REQUEST <br /> WHICH THIS REPORT ISSUBMITTED - ~ IDENTIFYING NUMBER ASSIGNED NUMBER FOR THIS REQUEST <br /> BY FEDERAL AGENCY <br /> U.S. Bureau of Land. Management 2 <br /> H EF051 M 08 <br /> 6. EMPLOYERiDENTIFICATION Z RECIPIENTS ACCOUNT NUMBER 8. PERIOD COVERED'BY THIS REQUEST <br /> NUMBER - OR IDENTIFYING NUMBER FROM (march, day, year) ~ TO (month, day, <br /> 93-6002160 1536-0031-8601 .September 1, 2005 December 31, 2006 <br /> 9. RECIPIENT (3F2GAN¢AiION 10. PAYEE (Whale checklS t0 t>e senti/dlirelent than item 9) <br /> Name: City of Eugene Name: <br /> Number Number. <br /> and street. 777 'Pearl Street and Street: <br /> 4 <br /> City, State ~ City, State <br /> and ZIP code: Eugene, OR 97401 <br /> and ZIP Code: <br /> 11. COMPl1TAT10N OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED <br /> (a) (67 (c) <br /> PROGRAMS/FUNCTIONS/ACTIVITIES <br /> TOTAL <br /> Engineering Construction . <br /> a. Total program (asordare~ <br /> outla to date $ 12,237.50 $ 3,876.00 $ $ 16,113.50 <br /> b. Less: Cumulative ram income 0.00 0.00 0.00 0.00 <br /> c. Net.program outlays (Line a minus <br /> 6ne b) z 12,237.50 3,876.00 0.00 16,113.50 <br /> d: Esti ~ted net cash outlays for advance.,, 0.00 <br /> e. Total (sum otCrnes c ~ 12,237.50 3,876.00- 0.00 16,113.50 <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 12,237.50 3,876.00 16,113..50 <br /> h: Federal nts revio nested 0.00 0.00 0.00 <br /> i. Federal share now requested (line g <br /> menus sne n) 12,237.50. 3,876.00 0.00 16,113.50 <br /> 1• Advances required by <br /> 1st month 0.00 <br /> month, when requested <br /> by Federal grantor _ <br /> agency for use in making 2nd nronth O.OO <br /> prescheduled advances 3rd month 0.00 <br /> 12. ALTERNATE COMPUTATION FOR ADVANCES ONLY <br /> „a. Estimated Federal cash outla that will be made Burin rind covered b the advance ~ 0.00 <br /> b. Less: Estimated balance of Federal cash on hand as of beginnin of advance rind <br /> c. Amount r nested (Line a minus one b) $ O.OO <br /> AUTHORIZED FOR LOCAL REPRODUC ION (ConSnued b ' e STANDARD FORM 270 (Rev. 7.97y <br /> Prescri by OMB Circulars A-102 and A-110 <br /> _ - - - - - <br /> _ _ - ~ <br /> L <br /> - <br /> <br /> _ = ~ <br /> ~ ~ F <br /> <br />