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N.C. Department of Environment. <br />Health, and Natural Resources Revision Number <br />Division of General Services V/h�viaioti of Environmental Health <br />SFY P. O. Number <br />07 90 Q6 9 1 c; n 1 8 <br />Effective Date Termination Date Contract Number <br />Contractor: —93ANZ 0M HE6= LEB== Activity: Environmental Health <br />Project Director: DRM.B- -ROM Total Budget: $ <br />'n <br />—ci-730-21 —1)64,1 <br />ITEM DESCRIPTION <br />CLASSIFICATION <br />ITEM AMOUNT <br />APPROP 101 <br />STATE EXPENDITURES: <br />T=/SSBG Fees <br />Other Receipts <br />TXLX/SSBG 102 <br />OTHR REC 103 <br />C <br />Salaries & Fringe Benefits <br />SA./FR <br />1000 6,000.QQ m <br />X <br />Operating Expenses <br />OP EXP <br />2000 <br />P <br />Purchase of Equipment <br />EQUiP <br />5000 6,000.00 <br />General Contracted or <br />hased Services <br />Subtotal State/Federal/Special <br />GENERAL <br />6100 <br />School Hea lth <br />.......... <br />Clinician <br />Delivery Services <br />--- MEL: SEKV-':::::::: <br />Laboratory <br />LAB <br />6862 <br />T <br />Pharmacy Services <br />'RX SEFLV <br />6865:.,. <br />U <br />Transfer T)CIX <br />W; <br />R <br />Subtotal State Expend. <br />E- <br />LOCAL EXPENDITURES: <br />LOCAL E(P <br />9000 <br />S- <br />f TOTAL EXPENDITURES — equal to Total Receipts <br />—ci-730-21 —1)64,1 <br />WAAIWIII;-��111-162 <br />J�20 a nuEno %. rnc2w abgnarure/ <br />Finance Officer Signature <br />bERM 290 (RA--.d 2J90) <br />Gcnc l &Tvkm Division (Review 2/91) <br />Date bwah Had Division/Section Sign " Date <br />Date Isa Management - Signature Date <br />LOCAL FUNDS: <br />R <br />Appropriation <br />APPROP 101 <br />E <br />T=/SSBG Fees <br />Other Receipts <br />TXLX/SSBG 102 <br />OTHR REC 103 <br />C <br />Subtotal Local Funds <br />STATE./IFEDERAL/SPECLA,L FUNDS: <br />Subtotal State/Federal/Special <br />TOT RECEIPTS — equal to Total Expenditures <br />WAAIWIII;-��111-162 <br />J�20 a nuEno %. rnc2w abgnarure/ <br />Finance Officer Signature <br />bERM 290 (RA--.d 2J90) <br />Gcnc l &Tvkm Division (Review 2/91) <br />Date bwah Had Division/Section Sign " Date <br />Date Isa Management - Signature Date <br />