Attachment

$2,454,590.49 Provide a general explanation of the Overhead Fees and Charges Overhead Fees & Charges Total Estimated Amount $2.454,590 49 10. STATUTORY AUTHORITY a. Requesting Agency's Authority (Check One) Franchise Fund Revolving Fund Working Capital Fund Economy Act (31 Other Authority □ U.S.C. 1535 / FAR 17.5) □ □ □ Fill in Statutory Authority Title and Citation for Franchise Fund, Revolving Fund, Working Capital Fund, or Other Authority b. Servicing Agency's Authority (Check One) Franchise Fund Revolving Fund Working Capital Fund Economy Act (31 Other Authority □ U.S.C. 1535 / FAR 17.5) □ □ □ Fill in Statutory Authority Title and Citation for Franchise Fund, Revolving Fund, Working Capijal Fund, or Other Authority 11. Requesting Agency's Scope (State and/or List Attachments that support Requesting Agency's Scope.) 12. Roles and Responsibilities for the Requesting Agency and the Servicing Agency (State and/or list attachments for the roles and responsibilities for the Requesting Agency and the Servicing Agency) FS Form 7600A (06-10) Department of the Treasury I Bureau of the Fiscal Service September 2016 - page 2 of 4