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EXHIBTT D, DOH CONTRACT GVL26649-0 <br />DEPARTMENT OF HEALTH <br />Contra ctor/Vendor Certifi cation <br />Proclamatio n 2l-14 - COVID-l9 Vaccination Certification <br />KITTITAS COT]NTY HEALTH DEPARTMENT <br />OR <br />CDNTRACTOR/VENDOR DOES NOT HAVE A COWD-lg CONTRACTOR/VENDOR <br />VACCINATION VnrunCnnOr,l PLAN. Contractor/Vendor does not have a current <br />COVID-l9 Contractor/Vendor Vaccination Verification Plan and, is not able to <br />develop and provide a COVID-I9 ContractorA/endor Vaccination Verification Plan <br />to ensure thai personnel meet the COVID-l9 vaccination requirements as set forth in <br />the above-referenced Proclamation, and provide the same to Department of Health <br />within twenty-four (24) hours of such request. fNote: Compliance with the <br />Proclamation is mandatory and failure to comply could result in termination of <br />contract/purchase order.] <br />I hereby certiff, under penalty of perjury under the laws of the State of Washington, that the certifications <br />herein are true and correct unA tnut I arnauthorized to make these certifications on behalf of the firm listed <br />herein. <br />DoH Contract GVL26649-0 <br />Revision October 2021 <br />Page27 of27