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Task Task! Activity /Description Number <br />5 Provide communication, technical assistance, <br />consultation, and education to providers about <br />vaccine quality assurance, accountability, <br />program participation and vaccine management. <br />6 Conduct a total of two (2) VFC compliance site <br />visits at enrolled provider site(s) within your <br />jurisdiction per the following schedule: <br />January 1,2017 -September 30 , 2017: two (2) <br />Site visits should address all requirements <br />outlined in the Provider Agreement, the CDC <br />Vaccines for Children (VFC) Operations Guide, <br />and as directed by the state administrators of the <br />Exhibit A, Statements of Work <br />Revised as of May 15, 2017 <br />*May Support PHAB <br />StandardslMeasures Deliverables/Outcomes <br />d) Report all cases (or <br />suspected cases) of <br />.1 vaccine fraud or abuse . <br />Summary of LHJ Technical <br />Assistance Form <br />(DOH 348-257) <br />a) VFC Site Visit Selection <br />Planning tool (will be <br />supplied by DOH) <br />b) Enter responses from the <br />VFC Provider <br />Compliance Site Visit <br />questionnaire into the <br />VFC Provider Education, <br />Assessment, and <br />Page 6 of 10 <br />AMENDMENT #12 <br />Payment Information Due Date/Time Frame and/or Amount <br />d) Within seven (7) days April 2017 - <br />of the incident December 2017 <br />FFY17 AFIX- <br />74110275 <br />*See Restrictions on <br />Funds below <br />December 31 st Reimbursement for <br />actual costs incurred, <br />not to exceed total <br />funding consideration <br />amount. <br />Funds available for this <br />task*: <br />January 2017- <br />March 2017 <br />FFY16 PPHF 317 Ops- <br />74110267 <br />April 2017 - <br />December 2017 <br />FFY17 VFC Ops- <br />74110273 <br />FFY17 317 Ops- <br />74110271 <br />*See Restrictions on <br />Funds below <br />a) January 15th Reimbursement for <br />actual costs incurred, <br />not to exceed total <br />funding consideration <br />b) At the time oftbe VFC amount. <br />Compliance Site Visit <br />or within five (5) Funds available for this <br />business days of the task·: <br />site visit. <br />Contract Number C17114-12