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4 <br /> LOCAL HEALTH DEPARTMENT BUDGET <br /> N.C.Department of Human Resources <br /> Revision Number_Si 2_ <br /> Division of Health Services Epidemiology <br /> SFY Office,Section or Branch ———_ <br /> P.O.Number <br /> 01 / 90 6 / 90 9 1 0 6 8 <br /> Effective Date Termination Date Contract Number <br /> contractor: ORANGE COUNTY HEALTH DEPARTMENT Activity: • ATf5 Control (IFf) TESTING <br /> Project Director: DANIEL B. REIMER Total Budget:$ 4,095.00 <br /> ITEM DESCRIPTION CLASSIFICATION ITEM AMOUNT <br /> E STATE EXPENDITURES: <br /> X Salaries & Fringe Benefits SA/FR 1000 $4,095 <br /> operating Expenses OP EXP 2les <br /> p Purchase of Equipment <br /> E General Contracted or <br /> Purchased Services <br /> `az:. S�E:w,.f ..rrs•, a n`�•2 :�%f> :.r ..,»rc` !'�. s,..>.,:.�f:�?Y <br /> N <br /> School Health <br /> D Clinician �^�`",,� � 'f?,:..4,�yJ ,b • c..s$. . � <br /> x Delivery Services, <br /> "�'�w``�"x";��1�°�w�:.i,i-0.�4.,�,� •z`�;z i{^e:�?>�:s:,m=�sfsr a"'f,,.tf fi.�rr�'f....`',..b���.>..z.c..'xi u'2 f ,wa;'G"`aw.",•v�,•F+sgi'�3�ro;�F::,:.s.f::.a•«�sxc:.,,;a'•`?^'rt,:��';.a c?"„y.z <br /> rr r. <br /> iiafiFsC.>i�d�'� 5 <br /> pharmacy Services <br /> �,viiiea.z:YF.�...c.,a:..:.�::..:.sw�ua. Ya�.wF�'m •�`'`,wiw`"33�.':..:�•a��xivxez?''"> <br /> Transfer <br /> U TXIX/SSBG F � <br /> PJus%f�'ti;ii..........,•... vv�� �.• .�v. .v�k.ypr,�,� .. <br /> R Subtotal State •- •. $ 4,095 <br /> E LOCAL EXPENDITURES: LOCAL EXP 9000 –O- <br /> S TOTAL EXPENDITURES—equal to Total Receipts $ 4,095 <br /> R LOCAL FUNDS: <br /> Appropriation APPROP 101 0 <br /> E TXDC/SSBG Fees 102 0 <br /> C Other Receipts OTHR REC 103 0 <br /> E Subtotal Local Funds $ 0 <br /> I sTATE/FEDERAL/SPECIAL FUNDS: <br /> P <br /> T <br /> 4,095 <br /> S <br /> Subtotal State/Federal/Special $ 4.099 <br /> TOTAL RECEIPTS—equal to Total Expenditures $ 4,095 <br /> Local <br /> Authorized Official Signature . Date Branch DHS Section Chief Signature Date <br /> hada Finance Officer Signature Date Aemount DHS Budget Officer Signature Date <br /> DHS 2948(Revised 2/87) <br /> Contract Administration(Review 2/90) <br />