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MAY 1 8 'a9 WO. <br /> LOCAL HEALTH DEPARTMENT BUDGET JUN 'as C <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/ 89 06/90 ..._-5..1..i.._._ <br /> Effective Date Termination Date Contract Number <br /> Contractor: . Gram County Heal th Departtgent Activity: Chi 1d }1Pa1tb <br /> Project Director: 1)ani. l R. Rchi mar Total Budget:$ 351,306 <br /> ITEM DESCRIPTION CLASSIFICATION . ITEM <br /> . AMOUNT <br /> E STATE EXPENDITURES: <br /> Salaries & Fringe Benefits SA/FR 1000 28,194 <br /> Operating Expenses . OP EXP 2000 , <br /> E Purchase of Equipment EQUIP 5000 $,2S0 <br /> E General Contracted or <br /> N Purchased Services GENERAL 6100 10,000 <br /> School Health SCH HLTH 6200 8,750 <br /> D Clinician CLN 6863 <br /> I Delivery Services 0 <br /> Laboratory i t Gkl r . : `:�>zis ry i .s._.:E. s�'"a <br /> LAB �� T 2.. <br /> T Pharmacy Services 0 <br /> _ <br /> RX SERV <br /> U Transfer TX1X/SSBG 6865 0 <br /> R Subtotal State Expend. $ 55,194 <br /> � <br /> E LOCAL EXPENDITURES: i� <br /> LOCAL EXP 9000 296,112 <br /> S TOTAL EXPENDITURES--equal to Total Receipts $ 351,306 <br /> a LOCAL FUNDS: <br /> Appropriation APPROP 101 2942112 <br /> E TXIX/SSBG Fees 102 <br /> C Other Receipts _ OTHR REC 103 9.000 <br /> Q <br /> E Subtotal Local Funds $ 296,112 <br /> I STATE/FEDERAL/SPECIAL FUNDS: <br /> P <br /> T <br /> S 2: 1+5 P{lib 55,194 <br /> Subtotal State/Federal/Special $ 55,194 <br /> TOTAL RECEIPTS--equal to Total Expenditures $ 351,306 <br /> Vt (2 2) ;770 d10�19 <br /> Local Authorized Official Signature Date + DHS Secti,-,Grief Spare Date <br /> Finance Officer Signature Date 4'aMilaat <br /> DHS Budget Officer Signature Date <br /> DHS 2948(Revised 2/87) <br /> Cantrect,Administration(Review 2/90) <br />