Laserfiche WebLink
AMENDMENT #9 <br />Task Task! Activity/Description *May Support PHAB Deliverables/Outcomes Due DatelTime Frame Payment Information <br />Number StandardslMeasures and/or Amount <br />3 Trained LHJ staff will provide direct Provide completed TA Report and Completed TA Report Upon acceptance of the <br />technical assistance (TA) to small any supporting documents and must be received by the completed TA Report, <br />community and non-community Group A photos to ODW Regional Office. ODW Regional Office the LHJ shall be paid for <br />water systems identified by the ODW within 30 calendar days of each technical assistance <br />Regional Office. providing technical activity as follows: <br />assistance . • Up to 3 hours of work: <br />See Specia l Instructions for task activity . $250 <br />• 3-6 hours of work: <br />$500 <br />• More than 6 hours of <br />work: $750 <br />Payment is inclusive of <br />all associated costs such <br />as consulting fee, travel, <br />lodging, per diem. <br />Payment is authorized <br />upon receipt and <br />acceptance of completed <br />TA Report within the 30- <br />day deadline. <br />Late or incomplete <br />reports may not be <br />accepted for payment. <br />4 LHJ staff performing the activities under Prior to attending the training, submit Annually LHJ shall be paid <br />tasks I, 2 and 3 must have completed the an "Authorization for Travel (Non-mileage, per diem, and <br />mandatory Sanitary Survey Training. Employee)" DOH Form 710-013 to lodging eosIS, and other <br />the ODW Program Contact below for miscellaneous travel <br />See Special Instructions for task activity. approval (to ensure that enough expenses as approved on <br />funds are available). the pre-authorization <br />form in accordance with <br />the current rates listed on <br />the OFM Web site <br />httQ://www .ofm.wa.gov/r <br />esouIcesltrave!.aso <br />- <br />*For Information Only: <br />Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a <br />Standard/Measure. More detail on these and/or other Public Health Accreditation Board (PHAB) Standards/Measures that may apply can be found at: <br />tlp:ll w,,","\v .phaboaJ'd.oralwQ-conlen tJ uploads /PHAB-Sland ard s-and -Measures -Version-I ;O.gdf <br />Exhibit A, Statements of Work <br />Revised as of September 15,2016 <br />Page 5 of7 Contract Number C17114-9