New Search
I <br /> i <br /> - ~ -OMB APPROVAL NO. PAGE OF <br /> REQUEST FOR ADVANCE 0348-0004 1 2 PAGES <br /> 1. a. "X" one or both boxes 2. BASIS OF REQUEST <br /> OR REIMBURSEMENT ?ADVANCE ®REIMBURSEMENT ? CASH <br /> TYPE OF ' <br /> PAYMENT b. "X" the applicable box ®ACCRUAL <br /> REQUESTED <br /> (See Instructions on back) ®FINAL ? PARTIAL <br /> <br /> ~ 3. FEDERAL SPONSORING AGENCY AND ORGANIZATION ELEMENT TO WHICH THIS 4. FEDERAL GRANT OR OTHER IDENTIFYING 5. PARTIAL PAYMENT REQUEST <br /> REPORT IS SUBMITTED NUMBER ASSIGNED BY FEDERAL AGENCY NUMBERFOR THIS REQUEST <br /> <br /> I <br /> U.S. Bureau of Land Management HAF061M11 1 <br /> 6. EMPLOYER IDENTIFICATION NUMBER 7. RECIPIENT ACCOUNT NUMBER OR g, PERIOD COVERED BY THIS REQUEST <br /> INDENTIFYING NUMBER FROM (month, day, year) ~ TO (month, day, year) <br /> 93-6002160 1536-0031-8601 July 1,2007 December 15, 2008 <br /> 9. RECIPIENT ORGANIZATION ~ 10. PAYEE (Where check is to be sent'rf different than item 9) <br /> Name Name <br /> City of Eugene <br /> Number Number' <br /> and SVeet 777 Pearl Street and SVeet <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) (d) <br /> Hazardous Fuels <br /> PROGRAMS/FUNCTIONS/ACTIVITIES ~ TOTAL <br /> a. Total program outlays to date (As of date) $66,117.60 $66,117.60 <br /> b. Less: Cumulative program income 0.00 0.00 <br /> c. Net program outlays (Line a minus line b) $66,117.60 $66,117.60 <br /> d. Estimated net cash outlays for advance period 0.00 0.00 <br /> e. Total (Sum of lines c & d) $66,117.60 $66,117.60 <br /> f. Non-Federal share of amount on line a 0.00 0.00 <br /> g. Federal share of amount on line a $66,117.60 $66,117.60 <br /> h. Federal payments previously requested $54,236.27 $54,236.27 <br /> i. Federal share now requested (Line g minus line h) $11,881.33 $11,881.33 <br /> 1~` month 0.00 <br /> j. Advances required by month, <br /> when requested by Federal 2"d month 0.00 <br /> .grantor agency for use in making <br /> prescheduled advances <br /> 3rd month 0.00 <br /> 12. ALTERNATE COMPUTATION FOR ADVANCES ONLY <br /> -a. Estimated Federal cash outlays that will be made during period covered by the advance ~ 0.00 <br /> b. Less: Estimated balance of Federal cash on hand as of beginning of advance period <br /> c. Amount requested (Line a minus line b) 0.00 <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 /> a <br /> ~ t <br /> ~ ~ t~ <br /> <br />