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Task <br /># <br />Activity <br />Deliverables/Outcomes <br />Due Date/Time Frame <br />Payment Information <br />and/or Amount <br />Vaccine Registration Systems— If a local jurisdiction or region <br />Jurisdiction/Regions will ensure a fair and <br />does not have a registration system(s) the include internet <br />equitable process forregistration of <br />based, phone option and other methods to ensure equitable <br />eligible Washingtonians across all <br />registration, the state PrepMod system and tools will be <br />available modalities. <br />available foruse. <br />1 D <br />Regularly report on vaccinations sites and operational activities <br />Provide monthly situation report to <br />Monthly <br />(number of vaccinations, personnel to operate the site, <br />IMT/IMO on status of implementation of <br />challenges, successes to share for learning across the public <br />ma ss vaccination plan, or more frequently <br />health system). <br />if that is the LHJ procedure. Sites <br />operating for the time period, vaccines <br />administered by site for the time period, <br />estimated costs for the time period, any <br />challenges/successes of note, including <br />assistance requested. <br />DOH Program and Fiscal Contact Information for all ConCon SOWS can be found on the DOH Finance SharePoint site. Questions related to this SOW, or any other <br />finance -related inquiry, may be sent to financendoh.wa.gov. <br />DOH General Mass Vaccination Program and Fiscal Contact <br />Patrick Plumb <br />COVID FEMA Project Management Analyst <br />Washington State Department of Health <br />Office of Financial Services <br />111 Israel Road SE, Tumwater, WA 98501 <br />patrick.plumb@doh.wa.gov / (360) 236-4291 <br />Federal Funding Accountability and Transparency Act (FFATA) (Applies to federal grant awards.) <br />This statement of work is supported by federalfunds that require compliance with the Federal Funding Accountability and Transparency Act (FFATA or the Transparency Act). <br />The purpose of the Transparency Act is to make information available online so the public can see how the federalfunds are spent. <br />To comply with this act and be eligible to perform the activities in this statement of work, the LHJ must have a Data Univers al Numbering System (DUNS(g) number. <br />Information about the LHJ and this statement of work will be made available onUSASpending_.gov by DOH as required by P.L. 109-282. <br />Program Specific Requirements <br />Program Manual, Handbook, Policy References <br />Emergency Response Plan (or equivalent) <br />Medical Countermeasure/Mass Vaccination Plan <br />Billing Requirements: <br />Monthly invoices must be submitted timely to the regional IMT/Organization for review/approvalprior to submission to DOH for reimbursement. <br />Contract Master Index (MI) Code: 934VO200 General Mass Vaccination <br />BARS Revenue Code: 333.97.03 Mass Vaccination Reimbursement <br />Exhibit A, Statement of Work Page 3 of 4 Contract NumberCLH31015 <br />