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I r <br />N.C. Department of Environment, <br />Health, and Natural Resources <br />Division of General Services <br />SFY <br />LOCAL HEALTH DEPARTMENT BUDGET <br />Division of Maternal and Child Health <br />Effective Date Termination Date <br />Revision Number SL -L- <br />P. O. Number <br />g 1 5 4 2 1 0 6 8 <br />Contract Number <br />Contractor: Orange County Health Department Activity: Child Health <br />Project Director: Tlan i pl 'R- _R i Mer Total Budget: $ 2Z., 02? <br />ITEM DESCRIPTION <br />CLASSIFICATION ITEM AMOUNT <br />E <br />X <br />P <br />E <br />N. <br />D <br />j <br />T <br />U <br />STATE EXPENDITURES: <br />Salaries & Fringe Benefits <br />Operating Expenses <br />Purchase of Equipment <br />General Contracted or <br />Purchased Services <br />School Health <br />Clinician <br />Delivery Services <br />Laboratory <br />Pharmacy Services <br />Transfer TX1X <br />SA/FR 1000 14,427 <br />OP EXP 2000 <br />E UIP 5000 <br />GENERAL 6100 <br />SCH HLTH 6200 <br />CLN 6863 <br />- DEL:SERV 6869 <br />LAB 6862 <br />RX SERV 6865 <br />6864 <br />R <br />Subtotal State Expend. $ <br />E <br />LOCAL EXPENDITURES: <br />LOCAL EXP 9000 <br />S <br />TOTAL EXPENDITURES --- equal to Total Receipts 27,027 <br />Local Authorized Official Signature <br />Finance Officer Signature <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/91) <br />Date arm He d Division /Setrion Signature Date <br />wtai <br />Date <br />^«mmnt Fiscal Management Signature Date <br />Waal <br />LOCAL FUNDS: <br />R <br />Appropriation <br />APPROP 101 <br />TXIX /SSBG 102 12,600 <br />E <br />TXIX /SSBG Fees <br />Other Receipts <br />.. _ <br />OTHR REC 103 <br />C <br />Subtotal Loral Funds S <br />E <br />STATE/FEDERAL /SPECIAL FUNDS: <br />I <br />P <br />Child Care Coordination <br />14,427 <br />T <br />S <br />Subtotal State/Federal/S22cial S 14 427 <br />TOTAL RECEIPTS -- equal to Total Expenditures $ <br />Local Authorized Official Signature <br />Finance Officer Signature <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/91) <br />Date arm He d Division /Setrion Signature Date <br />wtai <br />Date <br />^«mmnt Fiscal Management Signature Date <br />Waal <br />