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Task Task/Activity/Description *May Support PHAB Due Dateffime Number Standards/Measures Deliverables/Outcomes Frame Payment Information and/or Amount Inventory (WFI). Payment is authorized upon receipt and 4. Photos of water system acceptance of the Final Sanitary Survey with text identifying Report within the 30-day deadline. features 5. Any other supporting Late or incomplete reports may not be documents. accepted for paymenL *Final Reports reviewed and accepted by the ODW Regional Office. The LHJ surveyor will record DOH will provide a tablet and GPS at least two (2) GPS data unit for the LHJ to gather source data points, for each source, into during a routine sanitary survey. DOH the preloaded Excel template expects the LHJ to commit to using on the tablet and submit that the tablet and GPS for a five-year data file with the associated period. sanitary survey. 2 Trained LHJ staff will conduct Provide completed SPI Completed SPI Upon acceptance of the completed SPI Special Purpose Investigations (SPI) Report and any supporting Reports must be Report, the LHJ shall be paid $800 for of small community and non-documents and photos to received by the ODW each SP!. community Group A water systems ODW Regional Office. Regional Office identified by the ODW Regional within 2 working Payment is inclusive of all associated Office. days of the service costs such as travel, lodging, per diem. request. See Special Instructions for task Payment is authorized upon receipt and activity. acceptance of completed SPI Report within the 2 working day deadline. I Late or incomplete reports may not be accepted for _payment. 3 Trained LHJ staff will provide direct Provide completed TA Completed TA Upon acceptance of the completed TA technical assistance (TA) to small Report and any supporting Report must be Report, the LHJ shall be paid for each community and non-community documents and photos to received by the ODW technical assistance activity as follows: Group A water systems identified by ODW Regional Office. Regional Office • Up to 3 hours of work: $250 the ODW Regional Office. within 30 calendar • 3-6 hours of work: $500 days of providing • More than 6 hours of work: $750 See Special Instructions for task technical assistance. activity. Payment is inclusive of all associated costs such as consulting fee, travel, lodging, per diem. Exhibit A, Statements ofWork Page 7 of28 Contract Number CLH18249