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Task Task/Activity/Description Number <br />DOH will provide a tablet and GPS <br />unit for the LHJ to gather source data <br />during a routine sanitary survey. DOH <br />expects the LHJ to commit to using <br />the tablet and GPS for a five-year <br />period. <br />2 Trained LHJ staff will conduct <br />Special Purpose Investigations (SPI) <br />of small community and non- <br />community Group A water systems <br />identified by the ODW Regional <br />Office. <br />See Special Instructions for task <br />activity. <br />3 Trained LHJ staff will provide direct <br />technical assistance (TA) to small <br />community and non-community <br />Group A water systems identified by <br />the ODW Regional Office. <br />See Special Instructions for task <br />activity. <br />Exhibit A, Statements of Work <br />Revised as of May 15, 2019 <br />*May Support PHAB <br />Standards/Measures <br />: <br />Deliverables/Outcomes <br />2. Completed Small Water <br />System checklist. <br />3. Updated Water Facilities <br />Inventory (WFI). <br />4. Photos of water system <br />with text identifying <br />features <br />5. Any other supporting <br />documents. <br />* Final Reports reviewed and <br />accepted by the ODW <br />Regional Office. <br />The LHJ surveyor will record <br />at least two (2) GPS data <br />points, for each source, into <br />the preloaded Excel template <br />on the tablet and submit that <br />data file with the associated <br />sanitary survey. <br />Provide completed SP! <br />Report and any supporting <br />documents and photos to <br />ODW Regional Office. <br />Provide completed TA <br />Report and any supporting <br />documents and photos to <br />ODW Regional Office. <br />Page 4 of20 <br />AMENDMENT #9 <br />Due Date/Time <br />Frame Payment Information and/or Amount <br />Payment is inclusive of all associated <br />costs such as travel, lodging, per diem . <br />Payment is authorized upon receipt and <br />acceptance of the Final Sanitary Survey <br />Report within the 30-day deadline. <br />Late or incomplete reports may not be <br />accepted for payment. <br />Completed SP! Upon acceptance of the completed SP! <br />Reports must be Report, the LHJ shall be paid $800 for <br />received by the ODW each SP!. <br />Regional Office <br />within 2 working Payment is inclusive of all associated <br />days of the service costs such as travel, lodging, per diem. <br />request. <br />Payment is authorized upon receipt and <br />acceptance of completed SPI Report <br />within the 2 working day deadline. <br />Late or incomplete reports may not be <br />accepted for payment. <br />Completed TA Upon acceptance of the completed TA <br />Report must be Report, the LHJ shall be paid for each <br />received by the ODW technical assistance activity as follows : <br />Regional Office • Up to 3 hours of work: $250 <br />within 30 calendar • 3-6 hours of work: $500 <br />days of providing • More than 6 hours of work: $750 <br />technical assistance. <br />Contract Number CLH\8249-9