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LOCAL HEALTH DEPARTMENT BUDGET <br />29 <br />N.C. Department of Environment, <br />Health, and Natural Resources Revision Number — _.., <br />Division of General Services <br />SFY Division of Maternal and Child Health — — — — P. O. Number <br />/ 91 06 / 99 2 _Q_. -6- 4— <br />Effective Date Termination Date Contract Number <br />Contractor:._, CBANZ 03U1J1Y Ht''AT Tj =02= _ Activity,: Maternal Health <br />Project Director: --Daniel B. Rgitr Total Budget: $ 35,5.,w <br />Local Authorized Official Signature <br />Date <br />Finance Officer Signature Date <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/93) <br />a* HOW Division /Section Signature <br />Inind <br />Fiscal Management Signature <br />Date <br />Date <br />ITEM DESCRIPTION <br />CLASSIFICATION <br />ITEM <br />AMOUNT <br />E <br />X <br />P <br />E <br />N <br />D <br />1 <br />Z, <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 />Laboratory <br />Pharmacy <br />y <br />Transfer TXIX <br />SA/FR <br />1000 <br />54,653 <br />OP EXP 2000 <br />1(,.= <br />EQUIP 5000 <br />_ <br />0 — .. <br />GENERAL 6.10.0 -- - - <br />- 52388 <br />::$CH 1,00 .. <br />.. .... .' 777777 <br />CLN 6863 <br />0 <br />P <br />77777777. <br />- -. - <br />LAB 6862 <br />0 <br />RX SERV 686 5 <br />76,976 <br />S <br />R <br />Subtotal State E nd. <br />TOTAL RECEIPTS -- equal to Total Expenditures $ <br />$ 76,976 <br />E <br />LOCAL EXPENDITURES: <br />LOCAL EXP <br />9000 <br />278,584 <br />S <br />TOTAL EXPENDITURES — equal to Total Receipts <br />$355,560 <br />Local Authorized Official Signature <br />Date <br />Finance Officer Signature Date <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/93) <br />a* HOW Division /Section Signature <br />Inind <br />Fiscal Management Signature <br />Date <br />Date <br />LOCAL FUNDS: <br />R <br />Appropriation <br />APPROP 101 224,7Q2 <br />TXIX /SSBG 102 53,875 <br />E <br />TXIX /SSBG Fees <br />Other Receipts <br />OTHR REC 103 0 <br />C <br />Subtotal Local Funds $ 2 <br />E <br />STATE /FEDERAL /SPECIAL FUNDS: <br />i <br />P <br />T <br />76,976 <br />S <br />Subtotal State/Federal /5 $ <br />TOTAL RECEIPTS -- equal to Total Expenditures $ <br />Local Authorized Official Signature <br />Date <br />Finance Officer Signature Date <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/93) <br />a* HOW Division /Section Signature <br />Inind <br />Fiscal Management Signature <br />Date <br />Date <br />