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N.C. Department of Environment, <br />Health, and Natural Resources <br />Division of General Service <br />SFY <br />07 / 91 <br />Effective Date <br />Q <br />LOCAL HEALTH DEPARTMENT BUDGET <br />Division of Epidetnio, lc �! <br />/ 92 <br />Termination Date <br />Contractor: Orange Cotmty Health Depar uaent <br />Project Director: Daniel B. Reimer, _ <br />Health Director <br />VA <br />Revision Number , <br />P. O. Number <br />9 2 5 2 0 2 0 6 8 <br />Y `Contract Number <br />Activity: CDC- Community , Base Injury__ <br />Total Budget: $ 31861 <br />Local Authorized Official Signature Date a. rya <br />hkiw <br />Finance "Officer Signature <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/93) <br />Division /Section Signature Date <br />Date A=mwmm Fiscal Management Signature Date <br />ITEM DESCRIP'T'ION <br />CLASSIFICATION <br />ITEM <br />AMOUNT <br />E <br />X <br />P <br />E <br />N <br />D <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 <br />Clinician <br />Laboratory <br />Pharmacy Services <br />Transfer TXIX <br />SA/FR <br />1000 <br />OP EXP _- _ 2000 <br />OTHR REC 103 <br />EQUIP 5000 <br />_x$3,386 <br />.. 4 <br />GENERAL 6100 <br />-0- <br />5CH .'iII,TH 6200 <br />STATE/FEDERAL /SPECIAL FUNDS: <br />..:. <br />6963 <br />I. <br />P <br />DEEM Fwids <br />RX SERV <br />1520-6100 -5208 -3191 <br />R <br />Subtotal State EM2Md. <br />$3,861 <br />$ $3,861 <br />E <br />LOCAL EXPENDITURES: <br />LOCAL EXP <br />9000 <br />Subtotal State/Federal/Special $ $3,861 <br />S <br />TOTAL EXPENDITURES -- equal to Total Receipts <br />$ <br />Local Authorized Official Signature Date a. rya <br />hkiw <br />Finance "Officer Signature <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/93) <br />Division /Section Signature Date <br />Date A=mwmm Fiscal Management Signature Date <br />LOCAL FUNDS: <br />R <br />Appropriation <br />APPROP 101 <br />E <br />TXIX /SSBG Fees <br />TXIX /SSBG 102 <br />Other Receipts <br />OTHR REC 103 <br />C <br />E <br />Subtotal Loral Funds $ <br />STATE/FEDERAL /SPECIAL FUNDS: <br />I. <br />P <br />DEEM Fwids <br />. <br />1520-6100 -5208 -3191 <br />T <br />$3,861 <br />S <br />Subtotal State/Federal/Special $ $3,861 <br />TOTAL RECEIPTS — equal to Total Expenditures $ 3,861 <br />Local Authorized Official Signature Date a. rya <br />hkiw <br />Finance "Officer Signature <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/93) <br />Division /Section Signature Date <br />Date A=mwmm Fiscal Management Signature Date <br />