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Task <br /># <br />Activity <br />Deliverables/Outcomes <br />Due Date/Time Frame <br />Payment Information <br />and/or Amount <br />Guidance on vaccination protocols must be followed as <br />provided by DOH and CDC. <br />1 A <br />Local health jurisdiction (LHJ) will coordinate planning and <br />Submit to DOH amass vaccination plan <br />Within 30 days of <br />implementation of mass vaccination clinics/sites provided <br />including: <br />contract amendment <br />within the county(s) with a regional incident management <br />, e of site <br />si'p <br />execution. <br />team/organization as approved by DOH. <br />• site locations, <br />Request for regional IMT should be submitted through the <br />• throughput, <br />normalprocess through WebEOC. <br />• considerations made to ensure <br />equity to historically <br />LHJ is the coordinating agency for the mass vaccination plan <br />marginalized populations, <br />within the county. <br />• and tothe extent possible a <br />regional map of sites/locations. <br />Regional IMT will be under the delegation authority of DOH <br />and they are to provide support and coordination forall efforts <br />around vaccine planning, resource support and general <br />guidance and information sharing in order to regionally <br />coordinate efforts. Local jurisdictions will maintain all <br />decisional authority around vaccination planningand execution <br />within their jurisdiction/district. <br />Provide any information as requested by the regional IMT. <br />1 B <br />Funding for eligible Mass Vaccination activities are reimbursed <br />Submit estimated budget for the mass <br />Within 30 days of contract <br />on actualcosts as outlined in the DOH guidance to provide the <br />vaccination plan. <br />amendment execution. <br />services and to carry out the mission. Funding will be <br />dependent on full participation in the LHJ and IMT processes <br />Monthly Cost Summary Spreadsheet to <br />Monthly <br />and all documentation will be required to be provided to fully <br />the IMT/IMOby the fifth of the following <br />close out funding requests by the end of the mission period of <br />month. <br />performance. <br />Allowable costs include expenses such as facility rentals, staff <br />to conduct planning, management, support and operation of the <br />site, medical personnel for vaccinations, site security personnel, <br />wrap around services for staff (meals, travel, lodging), <br />equipment (which must be pre -approved by IMT/DOH if it <br />exceeds $5,000 each), supplies for vaccinations and site <br />operation. LHJs should provide narratives to help assist IMT <br />and DOH finance know what expenditures were necessary to <br />cant' out the mission. <br />1C <br />Vaccination data—will be maintained according to current state <br />Submission of vaccine use into WA IIS <br />Daily <br />and federal requirements. <br />database within 24hrs of use. <br />Exhibit A, Statement of Work Page 2 of 4 Contract NumberCLH31015 <br />