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FOCAL HEALTH DEPARTMENT <br />N.C. Department of Environment, A <br />Health, and Natural Resources A (f r <br />Division of General Services 1� ' 1 Revisio Number <br />1 y �f F. l <br />SP]' Division of Epidertuolo�` <br />3 a <br />07 / 91 05 / 92 H `i <br />P. O. Number <br />Effective Date (� 1 9 2 2 0 6 8 <br />Termination Date , l Contract Number <br />J 1 <br />Contractor: <br />Orange �tY�► Department I <br />Activity: CDC-Community Base In ur <br />Project Director: Daniel B. Reimer Total Budget: $ 3,861 <br />Hen l tb m ran t•nr <br />LOCAL FUNDS: <br />R Appropriation APPROP 101 <br />E Txlx /SSBG Fees Txix /SSBG 102 <br />C <br />Other Recei is OTHR RE C 103 <br />_ <br />E Subtotal Local Funds $ <br />I <br />STATE/FEDERAL /SPECIAL FUNDS: <br />p D» Funds <br />7.�- zo�loo- 528s -�3�1 <br />T I`'%Yv yy3j �i]rl <br />S $3,851 <br />Subtotal State/Federal /S al <br />$ $3,861 <br />TOTAL RECEIPTS —equal to Total Expenditures <br />$ 3,861 <br />Official S <br />Finance Officer Signature <br />DEI NR 2948 (Revised 2/90) <br />General Services Division (Review 2/93) <br />6 .9 6 4j <br />Fw <br />Date er.r+Ga Mda Division/ on Signature Date <br />I -- 26_ClI <br />L -`I/ <br />Date m, fiscal ement Signature Date <br />