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JUh 02 87 CA <br /> LOCAL HEALTH DEPARTMENT BUDGET <br /> N.C. Department of Human Resources Revision Number — <br /> Division of Health Services Maternal and Child Care <br /> SFY Office,Section or Branch <br /> P. O. Number <br /> 07 / 01/ 87 _ 06 / 30 / 88 �� 3 <br /> Effective Date Termination Date Contract Number <br /> Contractor: Orange County Health Department Activity: ('cI-S—nrrhopedi c <br /> Project Director: Jerry Robinson Total Budget: $ 556 <br /> ITEM DESCRIPTION CLASSIFICATION ITEM AMOUNT <br /> E STATE EXPENDITURES: <br /> Salaries & Fringe Benefits SA/FR 1000 56 <br /> X Operating Expenses OP EXP 2000 <br /> p Purchase of Equipment EQUIP 5000 <br /> E General Contracted or <br /> N Purchased Services GENERAL 6100 200 _ <br /> School Health <br /> D Clinician CLN 6863 300 <br /> I Delivery Services . ............ -- ... ................ <br /> Laboratory LAB 6862 <br /> Pharmacy Services RX SERV 6865 <br /> U Transfer TXIX/SSBG 6864 <br /> R Subtotal State Expend. $556 <br /> E LOCAL EXPENDITURES: LOCAL EXP 9000 <br /> S • <br /> TOTAL EXPENDITURES—equal to Total Receipts $556 <br /> R LOCAL FUNDS: <br /> . Appropriation APPROP 101 <br /> TXIX/SSBG Fees 102 <br /> C Other Receipts OTHR REC 103 <br /> E Subtotal Local Funds $ <br /> I STATE/FEDERAL/SPECIAL FUNDS: <br /> P DHS 556 <br /> T <br /> S <br /> Subtotal State/Federal/Special $556 <br /> TOTAL RECEIPTS—equal to Total Expenditures $556 <br /> ' ' / r) a(g-7 <br /> Local A v.-- Officia Signature Date <br /> DHS Section Chief Signature Date <br /> gr.ee-- 7 Ve7 <br /> Finance Officer Signature Date Accaun ne DHS Budget Officer Signature Date <br /> DHS 2948(Revised 2/87) <br /> Contracts Administration(Review 2/88) <br />