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AMENDMENT #13 <br />Exhibit A <br />Statement of Work <br />Contract Term: 2015-2017 <br />DOH Program Name or Title: FPHS Communicable Disease & Support Capabilities- <br />Effective July 1, 2017 <br />Local Health Jurisdiction Name: Kittitas County Public Health Department <br />Contract Number: C17114 <br />SOW Type: Original Revision # (for this SOW) Funding Source Federal Compliance Type of Payment <br />D Federal <Select One> (check if applicable) [gI Reimbursement <br />[gI State D FF AT A (Transparency Act) D Fixed Price <br />D Other D Research & Development <br />Period of Performance: July 1, 2017 through December 31, 2017 <br />Statement of Work Purpose: The purpose of this statement of work is to specify how Foundational Public Health Services (FPHS) state funds will be used during this interim <br />period of July 1,2017 -June 30, 2018 . <br />Note: The total funding consideration is for the period of July 1, 2017 through June 30, 2018. Deliverable due dates after December 31, 2017 are included in this <br />statement of work for informational purposes only. Unspent funds, tasks and deliverables with due dates after December 31, 2017 will be included in a new statement of <br />work under the new 2018-2020 consolidated contract term beginning January 1, 2018. <br />Revision Purpose: N/ A <br />Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change rrotal <br />Revenue Index (LHJ Use Only) Consideration Increase (+) Consideration <br />Code Code Start Date End Date <br />FPHS FUNDING FOR LHJS DIR N/A 336 .04.25 91106102 07/01/17 I 12/31j17 0 42,000 42,000 <br />TOTALS 0 42 ,000 42 ,000 <br />Note: New BARS Revenue Code listed above. See Special Instructions below for mo re information. <br />Task *May Support PHAB Payment <br />Task! Activityillescription Deliverables/Outcomes Due Date/Time Frame Information and/or Number StandardslMeasures Amount <br />These funds are for delivering ANY or all of the FPHS communicable disease service (listed below) and can also be used for the FPHS capabilities that support FPHS <br />communicable disease services as defined in the most current version of FPHS Defmitions -Version 1.2 (March 20J6) <br />G. Control of Communicable Disease and Other Notifiable Condit ions <br />1. Provide timely, statewide, locally relevant and Brief report on how funding will October 1,2017 Reimbursement for <br />accurate information statewide and to be used to support the FPHS actual expenditures. <br />communities on communicable disease and communicable disease services <br />other notifiable conditions and their control. listed in tasks 1-6 or FPHS <br />capabilities in support of <br />communicable di sease services <br />2 . Promote immunization through evidence based Report on metrics (TBD) <br />strategies and collaboration with schools , health <br />I <br />I <br />I <br />Exhibit A, Statements of Work <br />Revised as ofJuly 17 , 2017 <br />Page 8 of17 Contract Number CI7114-13