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Exhibit A <br />Statement of Work <br />Contract Term: 2018-2020 <br />AMENDMENT #5 <br />DOH Program Name or Title: Office of E m er eencv Pr e paredness & Resoonse - <br />Effective July 1, 2018 <br />Local Health Jurisdiction Name: Kittitas County Public .Health Department <br />Contract Number: CLH18249 <br />SOW Type: Revision Revision # (for this SOW) 1 <br />Period of Performance: July 1, 2018 through June 30, 2019 <br />Funding Source Federal Compliance Type of P ayment <br />£2] Federal Subrecipient (check if applicable) f2l Reimburse men t <br />D State f2l FFAT A (Transparency A ct) 0 Fixed Price <br />D Other D Res¢arch & D ev elopment <br />Statement of Work Purpose: The pmpose 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: The pmpose of this revision is to increase PHEP funds and make changes to task activities . <br />Chart of Accounts Program Name or Title <br />FFY18 EPR PHEP BPl SUPP LHJ FUNDING <br />TOTALS <br />Task <br />Number Task/ Activityffiescription <br />FFY18 EPR PREP BPl SUPP LHJ 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 September 1 7, 2018 <br />CFDA# BARS Master Funding Period <br />Revenue Index (LHJ Use Only) <br />Code Code Start Date End Date <br />93.069 333.93.06 18101580 07/01 /18 I 06/30/19 <br />*May Support PHAB <br />Standards/Measures Deliverables/Outcomes <br />. -~ <br />Submit summary on the mid-y ear <br />and end of year progress report. <br />- <br />Submit completed templates to <br />DOH <br />' <br />Submit mid-year and end-of-year <br />I progress reports <br />Page 3 of6 <br />Current Change rrotal <br />Consideration Increase(+) Consideration <br />48 ,249 885 49,1 34 <br />48_.249 885 49,134 <br />Due Date/Time Payment <br />Frame Information and/or <br />Amount <br />Reimbursement for <br />actual costs not to <br />exceed total funding December 31 , 2018 consideration amount. and June 28, 2019 <br />Upon request by DOH <br />December 31 , 2018 <br />and June 28 , 2019 <br />Contract Number CLH18249-5