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EXHIBIT A, DOH CONTRACT GVL26649-0 <br />Sub-recipient Statement of Work <br />KITTITAS COUNTY HEALTH DEPARTMENT <br />Period of Performance: March 15, 2021 through May 31, 2023 <br /> <br />DOH Contract GVL26649-0 Page 10 of 27 <br />Revision October 2021 <br />4 Progress and Performance Reporting: <br />Subrecipient will submit a quarterly progress <br />report using a template provided by DOH <br />manager. <br />Progress and Performance <br />reports are submitted in <br />accordance with CDC grant <br />requirements <br />Quarterly <br />5 Develop a plan for sustainability. <br />Sustainability plan includes but is not <br />limited to: <br /> Covid-19 community recovery <br />strategies <br /> Emergency preparedness planning <br /> <br />Sustainability Plan in place <br />and shared DOH program <br />manager <br />5/31/2023 <br /> <br />Special Requirements: <br />This is a federally funded contract. All expenditures incurred and reimbursements made for performance <br />under this contract shall be based on actual, allowable and allocable costs. See Exhibit C for further detail. <br /> <br />For activities that require the purchase of equipment: For purchases of pieces of equipment in which the <br />aggregate unit price of the equipment (including shipping, handling and associated costs) is $5,000 or more, <br />the contractor shall obtain written prior approval from the Washington State Department of Health, and <br />adhere to all federal requirements as referenced in; <br />2 CFR 200.313, Equipment at: https://www.gpo.gov/fdsys/granule/CFR-2014-title2-vol1/CFR- <br />2014-title2-vol1-sec200-313 , and <br />2 CFR 200.439, Equipment and other Capital Expenditures at: <br />https://www.gpo.gov/fdsys/granule/CFR-2014-title2-vol1/CFR-2014-title2-vol1-sec200-439 <br /> <br />Invoicing must include backup documentation as described in the statement of work deliverables: <br />Billings/invoices shall include copies of backup documentation for all expenses. Backup documentation can <br />include, but is not limited to; receipts, invoices, billing records, work orders, positive time and attendance <br />records (timesheets), travel vouchers and accounting expense reports. <br /> Additional backup documentation may be requested if needed. <br /> <br />Signed A-19 invoices must be received prior to approval and payment. A scanned copy of your A-19 with <br />signature is acceptable. <br /> <br />Please email the signed A-19s and backup documentation to: <br /> <br />Washington State Department of Health <br />ATTN: Eileen Kazura <br />Community Health Systems <br />PO Box 47850 <br />Olympia, WA 98504-7850 <br />Eileen.kazura@doh.wa.gov