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LOCAL HEALTH DEPARTMENT 3UDGET ��f q <br /> N.C.Department of Environment, <br /> Health,and Natural Resources Revision Number_— <br /> Division of General Services <br /> o . Division of Maternal and Child Hea lth —i.---— <br /> O.Number <br /> 7 / 94 6 './ 95 9 5 5 3 5 1 0 0 6 8 <br /> Effective Date Termination Date Contract Number <br /> Contractor: grange County Health Department Activity. Child Health <br /> ti <br /> Project Director: Daniel B. Reimer Total Budget•. $ 52,610.22 <br /> ITEM DESCRIPTION CLASSIFICATION 7EM AMOUNT <br /> E STATE EXPENDITURES: <br /> X Salaries & Fringe Benefits SA/FR ..000 <br /> Operating Expenses OP EXP _2000 <br /> P Purchase of Equipment EQUIP 5000 <br /> 'E'- ' - -General Contracted or y'__ <br /> N Purchased Services GENERAL 5100 <br /> School Health SCH HLTH 4.5200 <br /> D Clinician CLN 6863 <br /> T Laboratory LAB', 5862 <br /> Pharmacy Services RX SERV 6865 <br /> U Transfer TXIX <br /> Subtotal State Expend. $ <br /> LOCAL EXPENDITURES: LOCAL EXP 9000 52,610.22 <br /> S TOTAL EXPENDITURES—equal to Total Receipts $ 52,610.22 <br /> 4i <br /> LOCAL FUNDS: <br /> R Appropriation APPROP 101 <br /> E TXIX TXIX .102 52,610.22 <br /> Other Receipts OTHR REC 103 <br /> C <br /> E Subtotal Local Funds $ 52,610.22 <br /> STATE/FEDERAL/SPECIAL FUNDS: <br /> P <br /> T <br /> S <br /> Subtotal State/Federal/Special ^i $ <br /> TOTAL RECEIPTS—equal to Total Expenditures' $ 52,610.22 <br /> L1---1Y1wt4 <br /> Local Authorized Official Signature Date a w,Had Di vision/Section S ature D e <br /> CMS) <br /> inance Officer Signature Date +—, Fis:al Management SfgnAre Date <br /> DEHNR 2948(Revised 2/93) <br /> General Services Division(Review 2/94) <br />