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N.C. Department of Environment, <br />Idealth, and Natural Resources <br />Division of General Services <br />SFY <br />07 / 91 <br />Effective Date <br />LOCAL HEALTH. DEPARTMENT BUDGET <br />Division of General Services <br />06 / 92 <br />Termination Date <br />Contractor: Activity: <br />Revision Number <br />/c° � . Numb- <br />.0 er <br />9 2 0 6 8 <br />Contract Number <br />Transfer of Escrow <br />Project Director: ipI R. RP ;"'°r <br />Total Budget. S 121,070 <br />LOCAL FUNDS: <br />R Appropriation <br />E TXIX /SSBG Fees <br />Other Receipts <br />C <br />E Subtotal La .rat Funds <br />STATE/FEDERAL/SPECIAL FUNDS: <br />I <br />P TWS1! ER xrx <br />T <br />S <br />Subtotal State/Federal /Specia <br />APPROP 101 <br />TXIX /SSBG 102 <br />OTHR REC 103 <br />121,070 <br />$ 121 <br />TOTAL RECEIPTS --- equal to Total Expenditures $ 121,070 <br />4A) D-W / Loca Authorized Official 5ignarure at Divis' /Section Sign re Date. <br />k_ r7 -7► <br />� <br />/- <br />Finance Officer Signature Date n � � Fiscal Management Signature Date <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/91) <br />