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J: n C[ 87 CA <br /> 069 LOCAL HEALTH DEPARTMENT BUDGET <br /> N.C.Department of Human Resources <br /> Division of Health Services Maternal and Child Care Revision Number <br /> SFY Office,Section or Branch <br /> 07 / 01/ 87 06 / 30 / 88 P. O. Number <br /> Effective Date —�- 3 <br /> Termination Date Contract Number <br /> • <br /> Contractor: Orange County Health Department Activity: r.SHS–nrthopedj <br /> Project Director: Jerry Robinson Total Budget: $ 556 <br /> ITEM DESCRIPTION CLASSIFICATION ITEM <br /> AMOUNT <br /> E STATE EXPENDITURES: <br /> X Salaries E Fringe Benefits SA/FR 1000 56 <br /> Operating Expenses OP EXP 2000 - <br /> P Purchase of Equipment EQUIP 5000 <br /> E General Contracted or <br /> Purchased Services GENERAL 6100 <br /> School <br /> Health <br /> - - 0 <br /> Clinician CLN 6863 <br /> I Delivery Services :;; 300 <br /> Laboratory LAB 6862 ..... <br /> T Pharmacy Services RX SERV 6865 <br /> U Transfer TXIX/SSBG 6864 <br /> R Subtotal State Expend. $556 <br /> LOCAL EXPENDITURES: <br /> LOCAL EXP 9000 <br /> S <br /> TOTAL EXPENDITURES —equal to Total Receipts $556 <br /> — <br /> R LOCAL FUNDS: <br /> • Appropriation APPROP 101 <br /> TXIX/SSBG Fees ---- <br /> C Other Receipts 102 <br /> OTHR REC 103 - <br /> E Subtotal Local Funds <br /> I STATE/FEDERAL/SPECIAL FUNDS: $ _ <br /> P DHS <br /> T 556 <br /> S <br /> Subtotal State/Federal/Special $556 <br /> TOTAL RECEIPTS—equal to Total Expenditures <br /> $556 <br /> Local Authorized Official Signature - e) '�cch-- y/ ) _ a(6-7 Hea Date �lmwd DHS Section Chief Signature Date <br /> Finance Officer Signature - <br /> Date Ac oun n DHS Budget Officer Signature Date <br /> DHS 2948(Revised 2/87) <br /> Contracts Administration(Review 2/88) <br />