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DocuSign Envelope lD: FF I 48287 -E90C-42B9-840F-A1 4FA00E82AFExhibit A-3Please complete and submit report electronically to:Janice Tadeo, ABCD Program Manager at ianice.tadeo@hca.wa.qovCc: Pixie Needham, Dental Program Administrator at pixie.needham@hca.wa.gov andHeather Gallag her, ABCD State Managi n g Director, hgallaq her@arcorafoundation. orqABCD Ouarterly Community and Provider Outreach and Gase Management ReportYear One July 1 ,2022 - June 30,2023 o 4th Ouarter ReportBrief description (for events, provide date held/attended/ forstaff assignments, provide name and title) - no more than100 words (complete Exhibit A-3 and attach supportingdocument if providinq additional detail)Complete Exhibit B-3Complete Exhibit B-3Complete Exhibit B-3Maximum$$ availablefor thisdeliverable$1,000.00$100.00$1.298.00$324.004th Quarter4t1t2023 -6t30t2023Yes/NoanizationABCD Contact Person:Phone and Email:Report Due: 07/09/2023 (report due on thisdate to allow HCA to close out fiscal year)Performance CateqorvAttend and participate in ABCDCoordinator/Proq ram MeetinqUpdate ABCD provider roster to DentistlinkCommunity and Provider OutreachCoordinate CareHCA Contract No.: K2747-04Page 11 of20