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CZ <br /> Ai <br /> LOCAL HEALTH DEPARTMENT BUDGET <br /> N.C.Department of Human Resources Revision Number—— <br /> Division of Health Services Epidemiology <br /> SF? Office,Section or Branch <br /> P. O.Number <br /> 07/ 01 / 87 06 / 30 / 88 2 4 0 <br /> Effective Date Termination Date Contract Number <br /> Contractor: . Orange County Health Department Activity: Tuberculosis <br /> Project Director: Jerry Robinson _ Total Budget$ 11,338 <br /> ITEM DESCRIPTION CLASSIFICATION ITEM AMOUNT <br /> E STATE EXPENDITURES: <br /> X Salaries & Fringe Benefits SA/FR 1000 11,338 <br /> Operating Expenses OP EXP 2000 <br /> P Purchase of Equipment EQUIP 5000 <br /> E General Contracted or <br /> N Purchased Services GENERAL 6100 <br /> • <br /> School Health ::.. <br /> D <br /> Clinician <br /> I <br /> Delivery <br /> Services <br /> Laborato <br /> T ry <br /> : •, 5:::::o-i::::1::..::. ::.. . :::•: <br /> Pharmacy Services ":.. .:;: :..a.'�^ ... .. .. <br /> U Transfer TXIX/SSBG <br /> 6864 <br /> R Subtotal State Expend. $11,338 <br /> E LOCAL EXPENDITURES: LOCAL EXP 9000 <br /> S <br /> TOTAL EXPENDITURES—equal to Total Receipts $111338 <br /> R LOCAL FUNDS: <br /> Appropriation APPROP 101 <br /> E. TXIX/SSBG Fees <br /> 102 <br /> C Other Receipts OTHR RECD — 103 <br /> E Subtotal Local Funds 2�2VZc Ju"j`7 r Y <br /> I STATE/FEDERAL/SPECIAL FUNDS: .. - sy- <br /> P ,�: X50 �, <br /> 0 is <br /> T • DHS `� os0" - 11,338 <br /> S Pa'cs' L16\.} n' <br /> Subtotal State/Federal/Special �`t�. ` �� <br /> �9/5L171E $11,338 <br /> TOTAL RECEIPTS—equal to Total Expenditures $11,338 <br /> I ' 11. ./. I/ <br /> _ ' / / / 5/19/ -1 <br /> Local Authorized Official Signature Dater ' DHS Section Chief ignature�gnarure /Z Date <br /> init.: <br /> Z:w 7. ; G/,7/P7 <br /> Finance Officer Signature Date M DHS Budget Officer Signature Date <br /> hada <br /> DHS 2948(Revised 2/87) <br /> Contracts Administration(Review 2/88) - <br />