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10 <br />State of North Carolina <br />Division of Social Services <br />Contract Application <br />E. Contract Identification: <br />1. Provider <br />Page 2 of 7 <br />a. Name of Contract Administrator Doroth Pennell <br />Tel. # ~ (919) 644-1051 <br />b. Name of Program Contact Person: Jimmy Modlin. <br />Tel. #: <br />c. Program Name, Location and Mailing Address: Employment Security Commission <br />d. Additional Service Delivery Sites: Skills Development/JobLink Center_ <br />e. Status : (X) Public ()Private, non-profit <br />( )Private, for Profit ( )Individual <br />£ Provider Contract ID #: ERFO1 <br />2. County Department of Social Services <br />a. Name of Contract Administrator: Nanc Coston <br />Tel. # : (919) 245-2800 <br />b. Name of Services Program Contact Person: Gwendolyn Price <br />Tel. #: (919) 245-2800 <br />c. Address of County Department of Social Services: <br />300 W. T on St. <br />Hillsborou h, NC 27278 <br />