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DoH Program Name or Title: Division of Emergency preparedness & ResponsePHEP - Effective Julv l. 2020SOW Type: Revision Revision # (for this SOW) IPeriod of Performance: July 1. 2020 throughJune 30. 2021AMENDMENT #I7Local Health Jurisdiction Name: Kittitas countv public Health DepartmentContract Number: CLHI8249Exhibit AStatement of WorkContract T erm: 2018-2021Type of PaymentX Reimbursementn Fixed PriceFederal Compliance(check if applicable)X ffefa (Transparency Act)I Research & DevelopmentFunding SourceI Federal Subrecipient! stateE otherStatement of Work Purpose: The purpose of this statement of work is to establish funding and tasks to support and sustain LHJ public health emergency preparedness as part ofstatewide public health emergency preparedness and response.Revision Purpose: The purpose ofthis revision is to extend the period ofperformance, add the remainder ofthe annual allocation, add an end-of-year report, revise the budgetdue date, add a training and exercise task, and remove activities no longer required.Exhibit A, Statements of WorkRevised as ofSeptember 15,2020TotalConsideration49,13349,133ChangeIncrease (+)19.65319.653CurrentConsideration29.48029,480Funding Period(LHJ Use Only)Start Date End Date06130/21TOTALS0710U20MasterIndexCode31102280BARSRevenueCode333.93.06CFDA #93.069Chart of Accounts Program Name or TitleFFY2O PHEP BP2 LHJPaymentInformation and/orAmountReimbursement foractual costs not toexceed total fundingconsideration amount.Due Date/TimeFrameDecember 31,2020June 30,2021Upon request.Deliverables/OutcomesMid-year report on templateprovided by DOH.End-of-year report on templateprovided by DOH.Additional reporting may berequired if federal requirementschange.DOH will maintain documentationof evaluation participation.*May Support PHABStandards/lVleasuresTask/Activity/DescriptionAcross Domains and CapabilitiesComplete reporting templates as requested byDOH to comply with program and federal grantrequirements, including mid-year and end-of-yearreports.Across Domains and CapabilitiesParticipate in an evaluation of LHJ responsecapabilities, upon request from DOH.TaskNumberI)Page 2 of 42Contract Number CLHI 8249 -1 7