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AMENDMENT #23Submission of Invoice Vouchers: The LHJ shall submit correct monthly Al9-lA invoice vouchers for amounts billable under this statement of work to DOH by the 25s of thefollowing month or on a frequency no less often than quarterly.COVID-!9 Vaccine Services - Task 3 - allowable activities https://www.doh.wa.eov/Portals/l/Documents/9240lAllowableUseFedOpsFunds.pdfMass Vaccination - Task 4Program Manualo Handbook, Policy ReferencesEmergency Response Plan (or equivalent)Medical Couutermeasure/IVlass Vaccination PlanRestrictions on Funds (what funds can be used for which activities, not direct payments, etc.):Non-mass.vaccination efforts are not allowable through this funding stream.Duplication of billing (sending request for reimbursement) to entities outside of this agreement is prohibited.Indirect rates are not applicable to these funds.Special References (RCWs, WACs, etc.)County Health Emergency Documentation if applicableMonitoring Visits (frequency, type):Occasional visits from DOH or IMT/IMO personnel for the purpose of monitoring and surveillance of mass vaccination activities may be expected.DefinitionsSpecial Billing Requirements:Monthly invoices must be submitted timely to the regional lMT/Organization for reviedapproval prior to submission to DOH for reimbursement.Conhact (MI) Code: 934V0200 General Mass VaccinationBARS Revenue Code: 333.97.03 Mass Vaccination ReimbursementSpecial Instructions:The LHJ is considered a CONTRACTOR of DOH not a subrecipient for this portion of the statement of work. An allocation of funds is not provided as these FEMA funds are onlyavailable as reimbursement of costs associated with implementation of the mass vaccination plan.Detailed documentation must be maintained as directed by the regional IMT/Organizationand DOH to substantiate costs associated with these activities for submission to FEMAupon request by DOH.Eligible costs from the timeframe of January 21,2021through December 31,2021 include facility rentals, medical and support stafffor planning, management, support, andproject and must be billed as a direct charge; timesheets are required documentation and must be available upon request by DOH. Indirect rates are not applicable to these funds.portable vaccine units for transportation, supplies such as emergency medical supplies (for emergency medical care needs that may arise in the adminisfation of the vaccine),Equipment over $5,000 a piece must be preapproved by the IMT and should be leased rather than purchased. Any diversion from the list of pre-approved expenses will require adetailed/specific description is required for those not working at the vaccine site.Exhibit A, Statements of Work Page l7 of 39 Contract Number CLHlB24g-23Revised as of September 15,2021