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Exhibit A <br />Statement of Work <br />Contract Term: 2018-2020 <br />AMENDMENT #4 <br />DOH Program Name or Title: Office ofEmergencv Preparedness & Response- <br />Effective July 1, 2018 <br />Local Health Jurisdiction Name: Kittitas County Public Health Department <br />Contract Number: CLH18249 <br />SOW Type: Original Revision # (for this SOW) Funding Source Federal Compliance Type of Payment <br />~ Federal Subrecipient (check if applicable) ~ Reimbursement <br />Period of Performance: July 1, 2018 through June 30, 2019 D State ~ FFATA (Transparency Act) D Fixed Price <br />D Other D Research & Development <br />Statement of Work Purpose: The purpose of this statement of work is to establish the funding and tasks for the Public Health Emergency Preparedness and Response program <br />for the 2018 grant period. <br />Revision Purpose: N/ A <br />Chart of Accounts Program Name or Title <br />FFY18 EPR PHEP BPI SUPP LHJ FUNDING <br />TOTALS <br />Task <br />Number Task/ Activity/Description <br />FFY18 EPR PHEP BPl SUPP LBJ FUNDING <br />1 Attend emergency preparedness events , ( e.g. <br />trainings , meetings , conference calls , and <br />conferences) as necessary to advance LHJ <br />preparedness or complete the deliverables in this <br />statement of work. <br />2 Complete reporting templates as requested by <br />DOH to comply with program and federal grant <br />requirements ( e.g. performance measures , gap <br />analysis, mid-year and end-of-year reporting <br />templates , etc.) <br />3 Training & Evaluation: <br />3.1) Provide training for appropriate staff who <br />Exhibit A, Statements of Work <br />Revised as of July 16, 2018 <br />CFDA# BARS Master Funding Period <br />Revenue Index (LBJ Use Only) <br />Code Code Start Date End Date <br />93 .069 333 .93.06 18101580 01101118 I 06130119 <br />*May Support PHAB <br />Standards/Measures Deliverables/Outcomes <br />Submit summary on the mid-year <br />and end of year progres s report . <br />Submit completed templates to <br />DOH <br />Submit mid-year and end-of-year <br />progress reports <br />Page 12 of32 <br />Current Change Total <br />Consideration Increase(+) Consideration <br />0 48~249 48 ,249 <br />0 48,249 48,249 <br />Due Date/Time Payment <br />Frame Information and/or <br />Amount <br />Reimbursement for <br />actual costs not to <br />December 31 , 2018 exceed total funding <br />and June 28 , 2019 consideration amount. <br />I <br />Upon request by DOH <br />December 31 , 2018 <br />and June 28 , 2019 <br />Contract Number CLH18249-4