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]0 <br />State of North Carolina <br />Division of Social Services <br />Contract Application <br />Page 2 of 7 <br />E. Contract Identification: <br />1. Provider <br />a, Name of Contract Administrator Don Wilson <br />Tel. # : (919) 644-1051 <br />b, Name of Program Contact Person: 7immy Modlin <br />Tel. #: <br />c, Program Name, Location and Mailing Address: Employment Security Commission <br />d. Additional Service Delivery Sites: Skills DevelopmenU.TobLink Center <br />e, Status : (X) Public ()Private, non-profit <br />( )Private, for Profit ( )Individual <br />f: Provider Contract ID #: <br />2, County Denaztment of Social Services <br />a, Name of Contract Administrator: Nancy Coston <br />Teh # : (919) 245-2800 <br />b, Name of Services Program Contact Person: Gwendolyn Price <br />Tel. #: (919) 245-2800 <br />c, Address of Count~partment of Social Services: <br />300 W. Tryon St. <br />Hillsborough, NC 27278 <br />