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BXHIBTT A-2, DOFI CONTRACT GVL26649_2 <br />Sub-recipient Statement of Work <br />KITTITAS COUNTY PUBLIC HBALTH DEPARTMENT <br />Period of Performance for this Amendment: <br />Dale of Execution through May 3 I , 2024 <br />Certi Assurances - all requirements tnposed on the subrecipient by awarding agency: <br />The contract boilerplate covers all standard certifi catrons and assurances. <br />DOI{ Arnendrnent GV L26649 -2 <br />Revision 04/2020 <br />Are there any additional requiretnents irnposed by the pass-through entity (DOH) to meet its own responsibilities to the awarding agency yes n No E:If.applicable, this ls identified by the DOH program staffwriting the contract, This can also be found rn the "staternent of worki section ofthe contract.All subreclpients are required to make their accounting records available and accessrble to the awarding agency. <br />You can find this requirelnent in the "Records Maintenance" section ofthe contract. <br />Closeout Requiretnents: <br />( I ) Submit all final billings within 60 days of the end of the contract (This is required per standard contract language) <br />(2) Submit all required program repofts and deliverables within 60 days (This isrequiied per standard contractianluage) <br />(3) Dispose ofproperty purchased with subaward funds and dispose ofor return governrnent-furnished property nJtoi'ger used for subaward related activities(lfapplicable DOH rnust be contacted for disposal requirernents) <br />(4) Additional DOH prograrn specific contract closeout requirements: (lfapplicable, see SOW for additional closeout requirernents) <br />Page 4 of 4 <br />This table includes only active funding sources, <br />Federal Grant Information Sheet <br />Subrecipient/Contractor: <br />Contract No. <br />UEI No. <br />Period of Performance: <br />Project Description: <br />WQ23XPBSAU44 Contact Information: Limiting Indirect Cost Rate? yes tr No trStartDate: EndDate: dohcon.mqmt@doh.rva.gov ResearchandDevelopment? yesn NoE3/ts12021 5/31/2024 <br />National Initiative to Address COVID-19 Health Disparities Arnong Populations at High-Risk and Underserved, Includtng Racial and EthnicMinority Populations and Rural Cornrnunities. <br />Health Dept DOH Contract Managcr:Approved IndirectRate: yes E No tr <br />Bileen KazuraGVL26649-2 <br />Kittitas <br />F€dcral Award Identificttion <br />Number <br />Federal <br />Award Date <br />Federnl Agcncy <br />Name offlhc Federal <br />Amount <br />CFDA No.CFDA Program <br />Title <br />Name ofPass- <br />Through Agcncy Funds Obligated by <br />Amount <br />This <br />Total Amount of <br />Frnds Obligated for This <br />Source <br />l NH750T000042-0t CDC 5,581 93.39t l9 Health <br />Disparities <br />Washington <br />State DepanNent <br />$-0-