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DocuSign Envelope lD: FF'l 48287 -E90C-4289-8A0F-A1 4FA00E82AFExhibit A-3Please complete and submit report electronically to:Janice Tadeo, ABCD Program Manager at ianice.tadeo@hca.wa.govCc: Pixie Needham, Dental Program Administrator at pixie.needham@hca.wa.qov andHeath er Gallagher, ABCD State Managi n g Di rector, hgallaq her@arcorafoundation.orqABCD Quarterly Gommunity and Provider Outreach and Case Management ReportYear Two July 1, 2023 - June 30,2024 o 2nd Ouarter ReportBrief description (for events, provide date held/attended/ forstaff assignments, provide name and title) - no more than 100words (complete Exhibit A-3 and attach supporting document ifdiadditional detailComplete Exhibit B-3Exhibit B-3Exhibit B-3Submit invoice showing expenses for dental champion to attenddevelopment dav.Maximum$$ availablefor thisdeliverable$1,298.00$324.00$100.00$2,000.002nd Quarter10t1t2023 -12131t2023Yes/Nonization:ABCD Contact PersonPhone and EmailReport Due:.0113112024Performance GateqorvCommunity and Provider OutreachCoordinate CareUpdate Dentistlink rosterAttend and participate in development davHCA Contract No.: K2747-04Page 13 of 20