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AMENDMENT #4 Task *May Support PHAB Due Date/Time Payment Task/ Activity /Description Deliverables/Outcomes Information and/or Number Standards/Measures Frame Amount 3 Conduct an evaluation of the interventions Final written report, including a June 15, 2019 Reimbursement for implemented. report showing ending actual costs incurred, immunization rates for the target not to exceed total population (template will be funding consideration provided) amount. See Restrictions on Funds below *F'or Information Onlv: 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 Standard/Measure. More detail on these and/or other Public Health Accreditation Board (PHAB) Standards/Measures that may apply can be found at: hrtp:l/www . phaboard .Org/WD;:COnten l/ up loads/PH AB -S tandards--and-Measures-Version-1. .0 .pdf Program Specific Requirements/Narrative Tasks in this statement of work may not be subcontracted without prior written approval from DOH OICP . Special Requirements Federal Funding Accountability and Transparency Act (FFATA) This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act (FF ATA or the Transparency Act). The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent. To comply with this act and be eligible to perform the activities in this statement of work, the LHJ must have a Data Universal Numbering System (DUNS®) number. Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282. Restrictions on Funds (what funds can be used for which activities, not direct payments, etc.) Allowable Uses of Federal Operations Funds document (dated 12/20/2017) is posted on the DOH Consolidated Contract website at this link. These federal funds may not be used for expenses related to travel or attendance at any non-DOH sponsored conference, training, or event without prior written approval from the DOH Office oflmmunization and Child Profile. Other Deliverables may be sent electronically via email to oicpcontracts@doh.wa.gov, by fax to 360-236-3590, or by mail to PO Box 47843, Olympia WA 98504-7843 DOH Program Contact Tawney Harper, MP A Budget and Operations Manager Office oflmmunization and Child Profile Department of Health PO Box 47843, Olympia WA 98504-7843 tawney.harper@doh.wa.gov / 360-236-3525 Exhibit A, Statements of Work Revised as ofJuly 16, 2018 DOH Fiscal Contact Vanessa Mojica Special Projects Coordinator Office of Immunization and Child Profile Department of Health PO Box 47843, Olympia WA 98504-7843 vanessa.mojica@doh.wa.gov /360-236-3 802 Page 17 of32 Contract Number CLH 18249-4