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DOH Program Name or Title: Supplemental Nutrition Assistance program-Education - Effective October l. 2020Period ofPerformance: October l. 2020 through September 30.2021AMENDMENT #I7Exhibit AStatement of WorkContract T erm: 2018-2021Local Health Jurisdiction Name: Kittitas coun8 public Health DepartmentContract Number: CLHI8249SOW Type: Orisinal Revision # (for this SOW)Type of PaymentX Reimbursement! Fixed PriceFederal Compliance(check if applicable)[l ffefa (Transparency Act)n Research & DevelopmentFunding SourceI Federal Subrecipientn stateI ottrerStatement of Work Purpose: The purpose of this statement of work is to provide Supplemental Nutrition Assistance Program-Education (SNAp-Ed) to improve the likelihoodthat persons eligible for SNAP (Basic Food, Food Stamps) will make healthy food choices within a limited budget and choose active lifestyies consistent with the current USDAdietary guidelines.Revision Purpose: N/AExhibit A, Statements of WorkRevised as ofSeptember 15,2020TotalConsideration26,04626,046ChangeIncrease (+)26,04626,046CurrentConsideration00Funding Period(LIIJ Use Only)Start Date End Date09130t21TOTALS10101/20MasterIndexCode76701912BARSRevenueCode330.10.56CFDA #10.561Chart of Accounts Program Name or TitleFFY21 IAR SNAP ED PROG MGNT-REGION 2Payment Informationand/or AmountReimbursement uponon-time receipt andapproval ofacceptabledeliverables/ outcomesfor the funding periodwill not exceed$26,046. KittitasCounty Public HealthDepartment will bepaid the allowable costsincurred based on theirapproved budget andprogram allowability.See special billingrequirements section.FFY2IDue Date/Time FrameFor the Period:10101120 to 09130121Due: per the approved workplan and per the requireddue dates during the federalfiscal year, and no later than09130/21.Measure (whereapplicable)Sites and audiencesincluded in Project bySubrecipient documentedas approved eligible sitesor audiences.Documented completereporting by Subrecipientof the delivery,implementation, andevaluation ofapprovedProject activities in therequired PEARS onlinereporting modules, whererelevant to Project(Program Activities, PSEDeliverables/OutcomesProject provides 100% ofSNAP-Ed activities at eligiblesites and/or with eligibleaudiences.On-time delivery,implementation, andevaluation of Proj ect activitiesas scheduled in approved stateplan and project work plan.Satisfactory progress towardsState SNAP-Ed project goal(s)selected by Subrecipient isdemonstrated and reported.Satisfactory progress towardsproject objective(s) andadditional proiect eoal(s)aaaaTask/Activity/DescriptionProject Planning, Implementation,and PerformanceFor SNAP-Ed, the Subrecipient willdevelop, implement, and evaluate aSNAP-Ed project included in theWashington SNAP-Ed State Planapproved by Department of Social andHealth Services (DSHS) and UnitedStates Department of Agriculture(USDA); and, as described in theSubrecipient's project work planapproved by Department of Health(DOH).TaskNumber1.0Page 29 of 42Contract Number CLHI 8249 - 1 7