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State of North Carolina <br />Division of Social Services <br />Contract Application <br />Page 2 of 7 <br />E. Contract Identification: <br />1. Provider <br />a. Name of Contract Administrator Dorothy Pennell <br />Tel. # : (919) 644-1051 <br />b. Name of Pro„.g~am Contact Person: <br />Tel, #: <br />Jimmy Modlin <br />c. Program Name, Location and Mailing Address: Employment Security Commission <br />d. Additional Service Delivery Sites: Skills Development/JobLink Center <br />e. Status : (~ Public ()Private, non-profit <br />( )Private, for Profit ( )Individual <br />f. Provider Contract ID #: f RF.~ 1 <br />2. County Department of Social Services <br />a. Name of Contract Administrator: Nancy Coston <br />Tel. # : (919) 245-2800 <br />b. Name of Services Program Contact Person: Gwendolyn Price <br />Tel. #: (919) 245-2800 <br />c. Address of CountyDepartment of Social Services: <br />300 W Trvon St <br />Hillsborough, NC 27278 <br />