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V v N.C. Department of Environment, o -V l�J <br /> Health,and Natural Resources Revision Number 19 <br /> Division of General Services <br /> SFy 93 Division of Adult Health <br /> P. O.Number <br /> 12/1/ 92 12/30/93 9 3 5 4 5 2 0 6 8 <br /> Effective Date Termination Date Contract Number <br /> Contractor: Orange County Health Department Activity: COMP. Breast & Cervical Cancer Control <br /> Project Director: Daniel B. Reimer, Health Director Total Budget: $ 22,040 <br /> ITEM DESCRIPTION CLASSIFICATION ITEM AMOUNT <br /> E STATE EXPENDITURES: <br /> - Salaries & Fringe Benefits SA/FR 1000 9,510 <br /> Operating Expenses OP EXP 2000 4,465 <br /> p Purchase of Equipment EQUIP 5000 <br /> E General Contracted or <br /> N . Purchased Services GENERAL 6100 2,5 5 5w::xw <br /> School Health .�>.�.:., S�: �" <br /> D Clinician CLN 6863 <br /> ;.:off:::„. .;: ::>�".: ;, ....�<:z.�i.':�' :•..: •..':. <br /> tea...::::»> ...,...:.:�..;:.t,..:.:::.,.::;::>.::::.;..:::;::.:.::.> >::;::>::�<:::;.::,;�:��:: <br /> Laboratory LAB 6862 <br /> Pharmacy Services tningiii :.:: ......... . <br /> :.fir<:<�.,�<.>;:><>: ;<.., <br /> U Transfer IX ..... ::: .::>;. E.:��.: .: ;. v <br /> TX <br /> IX <br /> Subtotal State Expend. $ 16,530 <br /> E LOCAL EXPENDITURES: _ LOCAL EXP 9000 : 5;510 <br /> S <br /> TOTAL EXPENDITURES—equal to Total Receipts $ 22,040 <br /> LOCAL FUNDS: <br /> R Appropriation APPROP 101 1•,885.. <br /> E TXIX/SSBG Fees TXIX/SSBG 102 --0= <br /> Other Receipts OTHR REC 103 3,625 <br /> C <br /> Subtotal Local Funds $ 5,510 <br /> E STATE/FEDERAL/SPECIAL FUNDS: <br /> I <br /> P $16,530 <br /> T <br /> S <br /> . Subtotal State/Federal/Special $ 16,530 <br /> TOTAL RECEIPTS—equal to Total Expenditures $ 22,040 <br /> Ault i l % / / //r-& <br /> Local Authorized Official Sign. r,r Date - Branch Head Division/Section Signature Date <br /> Initial <br /> Finance Officer Signature Date Accountant Fiscal Management Signature Date <br /> Initial <br /> DEHNR 2948(Revised 2/92) <br /> General Services Division(Review 2/94) . <br />