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'JUN 0 1 1F7 CA <br /> • LOCAL HEALTH DEPARTMENT BUDGET Jury ' 'e7 CA N.C. Department of Human Resources Revis'�v Dumber <br /> Division of Health Services Adult Health Services <br /> SF? Office, Section or Branch <br /> P. O. Number <br /> 07 / 01 / 87. 06 / 30 / 88 5 1 0 <br /> Effective Date Termination Date Contract Number <br /> Contractor: Orange County Health department <br /> Activity: Adult Health <br /> Project Director: _ Jerry Robinson Total Budget: $ 65,901 <br /> • ITEM DESCRIPTION CLASSIFICATION ITEM AMOUNT <br /> E STATE EXPENDITURES: <br /> X Salaries & Fringe Benefits SA/FR 1000 3,017 <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 /> School Health !:> <br /> D Clinician CLN ... 6863 <br /> • I Delivery Services <br /> : ::>:=ss:::::::::< .: M:: :: . ::i0 -; ; ;.>.; : <br /> Laboratory LAB 6862 <br /> Pharmacy Services RX SERV 6865 <br /> U _ Transfer TXIX/SSBG 6864 <br /> R _ •Subtotal State Expend. $ 3,017 <br /> E LOCAL EXPENDITURES: LOCAL EXP 9000 62,884 <br /> S <br /> TOTAL EXPENDITURES—equal to Total Receipts $ 65,901 <br /> R LOCAL FUNDS: <br /> E Appropriation APPROP 101 62,884 <br /> TXIX/SSBG Fees 102 <br /> C Other Receipts OTHR REC 103 <br /> E Subtotal Local Funds $ 62,884 <br /> I STATE/FEDERAL/SPECIAL FUNDS: <br /> P 3,017 <br /> T . <br /> S <br /> Subtotal State/Federal/Special $ 3,017 <br /> TOTAL RECEIPTS—equal to Total Expenditures $ 65,901 <br /> ' i ------ � – -- Ii .-�- cA <br /> 7 Authorized Official Signature Date a w t'°� Section Chief Signature Date <br /> `� <br /> VeVri <br /> Finance Officer Signature Date nccam DHS Budget Officer Signature Date <br /> OHS 2948(Revised 2/87) <br /> Contracts Administration(Review 2/88) <br />