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...Sheet instructions ahca form july section a florida administrative code page of available at httpahcamyfloridacom licensee info providerfacility type license for change ownership applications provider name telephone number street address fax city county state zip email mailing certified public accountant company if applicable signature accountantand date sch schedule estimated costs and source funds preopening total needed advertising equipment purchases legal costsconsulting beginning inventory insurance fee accreditation survey andor medicare amp medicaid certification deposits building utility other staffing recruitment training sum lines purchase price only working capital includes cost see checklist below contingency funding please attach documentation supporting the listed required cash on hand nonrelated financing ownersinvestors parent or affiliated entities describe applicant is amount to pay operating until positive flow reached should equal largest cumulative need from line ...