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X Budget <br />A Expenditures (Please detail major arpenditures, by line item). <br />Line Item motion <br />I. Injury Control Devices: <br />2 Supplies and Materials: <br />3. Other Operating Expenses: <br />4. Equipment: <br />5. Contractual Services: consultant hours <br />(Inc u es s a , <br />— <br />admin, <br />materials) <br />B. Revenues <br />1. Funds re4uestcWfr6nf tCS: <br />2. Total other applicable funds: <br />Funding organization: Amount. <br />Funding organization: Amount: <br />TOTAL INJURY CONTROL PROJECT FUNDS <br />(must equal total expenditures) = (1 + 2) = <br />X. Signatures <br />z zf._ <br />DATE <br />L 9 I-- <br />DATE <br />t <br />18 <br />Amount <br />6720.00 <br />6720.00 <br />0 <br />0 <br />6720.00 <br />z .Z. t/� <br />PROJECT DIRECTOR <br />Eileen C. Kugler <br />NAME TYPED OR PRINTED <br />HEALTH DIRECTOR <br />Daniel B. Reimer <br />NAME TYPED OR PRINTED <br />(Disposition: Retain FY 1993 Proposal for New Mini- Grants until notification of award. Then Destroy.) <br />DEHNR T723 (17.)91) <br />Injury Control Section <br />12 <br />