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Exhibit A <br />Statement of Work <br />Contract Term: 2022-2024 <br />DOH Program Name or Title: SupplementalNutrition Assistance Program -Education - <br />Effective January 1, 2022 <br />SOW Type: Ori�alal Revision # (for this SOW) <br />Period of Performance: January 1 202 through December 31, 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 0 FFATA (Transparency Act) ❑ Fixed Price <br />❑ Other ❑ Research & Development <br />Statement of Work Purpose: The purpose of this statement of work is to provide SupplementalNutrition Assistance Program -Education (SNAP -Ed) to improve the likelihood <br />that persons eligible for SNAP (Basic Food, Food Stamps)will make healthy food choices within a limited budget and choose active lifestyles consistent with the current USDA <br />dietary guidelines. <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 Funding Period <br />Current <br />Start Date End Date Allocation <br />Allocation <br />Chan e <br />g <br />Increase (+) <br />Total <br />Allocation <br />FFY22 IAR SNAP ED PROG MGNT-REGION 2 76701937 <br />10.561 <br />333.10.56 <br />01/01/22 09/30/22 0 <br />30,818 <br />30,818 <br />eligible sites and/orwith eligible audiences. <br />01/01/22 to 09/30/23 <br />on-time receipt and <br />0 <br />0 <br />0 <br />10/01/23 to 12/31/24 TBD <br />approvalof acceptable <br />0 <br />0 <br />0 <br />deliverables/out- <br />included in the Washington SNAP -Ed State Plan <br />0 <br />0 <br />0 <br />approved by Department of Social and Health <br />3. Project plan supports at least one State SNAP- <br />0 <br />0 <br />0 <br />Services (DSHS) and United States Department of <br />Ed goal as selected by Subrecipient. <br />dates during the federal fiscal <br />0 <br />0 <br />0 <br />TOTALS <br />year, and no later than <br />County Public <br />0 <br />30,818 <br />30,818 <br />Task <br /># <br />Activity <br />Deliverables/Outcomes <br />Due Date/Time Frame <br />Payment Information <br />and/or Amount <br />1.0 <br />Project Planning, Implementation, and <br />1. Project provides 100% of SNAP -Ed activities at <br />For the Period: <br />Reimbursement upon <br />Performance <br />eligible sites and/orwith eligible audiences. <br />01/01/22 to 09/30/23 <br />on-time receipt and <br />For SNAP -Ed, the Subrecipient will develop, <br />2. On-time delivery, implementation, and <br />10/01/23 to 12/31/24 TBD <br />approvalof acceptable <br />implement, and evaluate a SNAP -Ed project <br />evaluation of Project activities as scheduled in <br />deliverables/out- <br />included in the Washington SNAP -Ed State Plan <br />approved state plan and project work plan. <br />Due: per the approved work <br />comes for the funding <br />approved by Department of Social and Health <br />3. Project plan supports at least one State SNAP- <br />plan and per the required due <br />period will not exceed <br />Services (DSHS) and United States Department of <br />Ed goal as selected by Subrecipient. <br />dates during the federal fiscal <br />$30,818. Kittitas <br />Agriculture (USDA); and, as described in the <br />4. Demonstrates progress towards project <br />year, and no later than <br />County Public <br />Subrecipient's project work plan approved by <br />objective(s), and additionalprojectgoal(s) <br />09/30/23.10/01/23 to 12/31/24 <br />Health Department <br />Department of Health (DOH). <br />determined by Subrecipient are demonstrated <br />TBD. <br />will be paid the <br />and reported. <br />I <br />I allowable costs <br />Exhibit A, Statement of Work Page 1 of 12 Contract NumberCLH31015 <br />Template September2021 <br />