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Exhibit A <br />Statement of Work <br />Contract Term: 2022-2024 <br />DOH Program Name or Title: Office of ImmunizationCOVID-19 Vaccine - <br />Effective January 1, 2022 <br />SOW Type: Orip-ina Revision # (for this SOW) <br />Period of Performance: January 1,2022 through June 30, 2024 <br />Local Health Jurisdiction Name: Kittitas County Public Health Department <br />Contract Number: CLH31015 <br />Funding Source Federal Compliance Type of Payment <br />® Federal Subrecipient (check if applicable) ® Reimbursement <br />❑ State ® FFATA (Transparency Act) ❑ Fixed Price <br />❑ Other ❑ Research & Develo ment <br />Statement of Work Purpose: The purpose of this statement of work (SOW) is to provide funding to conduct COVID-19 vaccine activities. <br />Revision Purpose: N/A <br />Master <br />Index <br />DOH Chart of Accounts Master Index Title Code <br />Assistance <br />Listing <br />Number <br />BARS <br />Revenue <br />Code <br />LHJ Fund ing Period Current <br />Start Date End Date Allocation <br />Allocation <br />Change <br />g <br />Increase (+) <br />Total <br />Allocation <br />COVID19 Vaccines R4 74310230 <br />93.268 <br />333.93.26 <br />01/01/22 06/30/24 0 <br />359,803 <br />359,803 <br />be used with health care providers and <br />costs incurred, not to <br />0 <br />0 <br />0 <br />exceed total funding <br />0 <br />0 <br />0 <br />consideration amount. <br />with health care providers, community, and/orotherpartners to <br />0 <br />0 <br />0 <br />help build vaccine confidence broadly and amonggroups <br />0 <br />0 <br />0 <br />anticipated to receive early vaccination, as well as dispel <br />0 <br />0 <br />0 <br />TOTALS <br />1 0 <br />359,803 <br />359,803 <br />Task <br /># <br />Activity <br />Deliverables/Outcomes <br />Due Date/Time Frame <br />Payment Information <br />and/or Amount <br />3.A <br />Identify activity/activities to support COVID vaccine response <br />Summary of the engagement strategies to <br />January 31, Annually <br />Reimbursement for actual <br />in your community, using the examples below as a guideline. <br />be used with health care providers and <br />costs incurred, not to <br />other partners, and the locally identified <br />exceed total funding <br />Example 1: Develop and implement communication strategies <br />population to be reached. <br />consideration amount. <br />with health care providers, community, and/orotherpartners to <br />help build vaccine confidence broadly and amonggroups <br />anticipated to receive early vaccination, as well as dispel <br />vaccine misinformation. Document and provide a plan that <br />shows the communication strategies used with health care <br />providers and otherpartners and the locally identified <br />population anticipated to reach. <br />Example 2: Engage in other vaccination planning activities <br />such as partnership development, provider education, <br />vaccination point of dispensing OD planning, tabletop <br />Exhibit A, Statement of Work Page 1 of 3 Contract NumberCLH31015 <br />