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LOCAL HEALTH DEPARTMENT BUDGET <br />N.C. Department of Environment, <br />Health, and Natural Resources <br />Division of General Services <br />SFY Division of Environmental Health <br />/ <br />07 06 / 92 <br />Effective Date - Termination Date <br />R <br />Revision Number <br />P. O. Number <br />9 2 4 8 5 2 0 -L 8 <br />Contract Number <br />Contractor: - O—rarge-Gotaity Health 292Mt=t Activity,: Food and Lodging ✓ <br />Projea Director: Daniel B. Reimer Tool Budget: $ 3,385.87 �.` <br />LOCAL Appropriation <br />E TXIX /SSBO Fees <br />C Other Receipts <br />E Subtotal Local Funds <br />I STATE /FEDERAL. /SPECIAL FUNDS: <br />P <br />T <br />S <br />Subtod State/Fedei <br />TOTAL RECPM <br />Local Authorised Official Signature <br />.. �� <br />Finance Officer Signature <br />DEI NR 2948 (Revised 2/90) <br />General Services Division (Review V93) <br />APPROP 101 <br />TXIX/SSBG 102 <br />OTHR REC 103 <br />— equal to Total Expenditures <br />- -R ? -9Z <br />Date a%o& M.d <br />m.w <br />3,385.87 <br />$ 3,385.87 <br />Division/Section Signature <br />-3d -9v <br />Date Fiscal Management Signature <br />Date <br />Date <br />