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Exhibit A <br />Statement of Work <br />Contract Term: 2018-2020 <br />DOH Program Name or Title: :Supplemental Nutrition Assistanci Program-Eau.cation <br />Effective Januarv I, 1018 <br />Local Health Jurisdiction Name: KittitaS Countv Public Health Department <br />Contract Number: CLH18249 <br />SOW Type: Original Revision # (for this SOW) <br />Period of Performance : January 1, 2018 through September 30, 2020 <br />Funding Source Federal Compliance Type o f Payment <br />~ Federal Subrecipient (check if applicable) ~ Reimbursement <br />0 State 18] FFATA (Transparency Act) D fixed Price D Other 0 Research & Develo ent <br />State men t of W ork Parpose: The purpose of this siatemenc of work is to p rovide Supplemental Nutrition Assistance Program-Education (SNAP-Ed) 10 improve lhe likelihoo d <br />tha t persons eligib le fo r SNAP (Food Swnps) will make heallhy food croices within a limited budget and choose ac tive lifestyles consi stent with the current 'CSDA dietary <br />guidance system. <br />Revision Purpose: N/ A <br />Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change ~otal <br />Revenue Index (LBJ Use Only) Consideration Increase(+)f onsideratiou <br />Code Code Start Date End Date <br />FFY18 CSS lAR SNAP ED.&OG MGNT 10.561 333.10.56 76211981 01101118 r 09130118 0 8,830 I 8,830 <br />FFY17 CSS IAR SNAP ED PROG MGNT CF I 10.s61 t 333.10.56 76211971 01101118 I 09130/18 0 1.472 j 1,472 <br />TOTALS o l 10.,302 I 10,302 <br />Task *May Support PHAB I Payment <br />Number Task/ Activity/Description Standards/Measures Deliverables/Outcomes Due Date/Time Frame Information and/or <br />Amount <br />1.0 For SNAP-Ed, the LHJ will perform work as • Project qualified target for the Period: Reimbursement upon <br />descnbed in LlU' s approved FFYl 8 SNAP-Ed audiences reached. 0l/01/18-09/30/20 receipt and approval <br />project description and work plans approved • Project activities completed Due: per the approved work of deliverables for the <br />by Department of Health (DOH), Department (# direct education, PSE, plan and no later than funding period will <br />of Social and Health Services (DSHS), and etc.) noted in project plans 09/30/20. not exceed SI0,302. <br />United States Department of Agriculture and workbook. <br />(USDA) that was submitted to them via DOH • Required demographic data Kittitas County <br />email. collected Public Health <br />• Evaluation activities Department will be <br />completed per the state paid the allowable <br />cva1uation team (pre and costs incurred based <br />post surveys, PSE tracking, on their approved <br />success stories etc.). budget and program <br />allowability. See <br />special billing <br />reQuirements section. <br />Exhibit A, Statements of Work Page 22 of28 Contract Number CUI 18249