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N.C. Department of Environment, <br />Health, and Natural Resources <br />Division of General Services <br />SxY <br />0 / <br />Effective Date <br />LOCAL HEALTH DEPARTMENT BUDGET <br />06 / 92 <br />Termination Date <br />Division of Adult Health <br />33 <br />Revision Number — <br />P. O. Number <br />9 2 5 5 0 5 0 6 8 <br />Contract Number <br />Contractor: Activity: Health Promotion <br />Project Director: Pei1jlPt_._.. Total Budget: $ — 52, 5 55 _ <br />ITEM DESCRIPTION CLASSIFICATION ITEM AMOUNT <br />R Subtotal State Expend. $17,869 <br />E LOCAL EXPENDITURES: FLOCAL EXP 9000 <br />$ I TOTAL EXPENDITURES — equal to Total Receipts $ 52,555 <br />LOCAL FUNDS: <br />R <br />Appropriation <br />E <br />STATE EXPENDITURES: <br />E <br />TXIX /SSBG Fees <br />OTHR REC 103 <br />Salaries & Fringe Benefits <br />C <br />SA/FR <br />1000 17,$99 <br />X <br />Operating Expenses <br />OP EXP <br />_ _ -__ <br />2000 _ _ 0 µ! <br />P <br />Purchase of Equipment <br />I <br />EQUIP <br />5000 _ _ 1 <br />E <br />General Contracted or <br />T <br />17,869 <br />Purchased Services <br />GENERAL <br />100 <br />N <br />School Health <br />' 'SCH HLTH <br />D <br />Clinician <br />� C�:N <br />Laboratory <br />>. >LAB':;.:::,.;,........ <br />.6862. <br />T <br />Pharmacy Services <br />>< >:.:SER <br />U <br />Transfer TXIXSC4`' <br />:' :. ;» ::::::::',;:;:::;::';:::': '::;:;.':::.':': <br />r. <br />R Subtotal State Expend. $17,869 <br />E LOCAL EXPENDITURES: FLOCAL EXP 9000 <br />$ I TOTAL EXPENDITURES — equal to Total Receipts $ 52,555 <br />Local Authorized Official Signature <br />Finance Officer Signature <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/93) <br />Date <br />Date <br />Beech Head <br />Wnel <br />Division /Section Signature <br />A«uetmt Fiscal Management Signature <br />bufw <br />Date <br />Date <br />LOCAL FUNDS: <br />R <br />Appropriation <br />APPROP 101 31,686_ <br />T XIX /SSBG 102 0 <br />E <br />TXIX /SSBG Fees <br />OTHR REC 103 <br />Other Receipts <br />C <br />Subtotal Local Funds $ 34,686 <br />E <br />STATE /FEDERAL /SPECIAL FUNDS: <br />I <br />P <br />T <br />17,869 <br />S <br />Subtotal State/Federal /S 'al $ <br />TOTAL RECEIPT'S — equal to Total Expenditures $ 52,555 <br />Local Authorized Official Signature <br />Finance Officer Signature <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/93) <br />Date <br />Date <br />Beech Head <br />Wnel <br />Division /Section Signature <br />A«uetmt Fiscal Management Signature <br />bufw <br />Date <br />Date <br />