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Payment Information <br />and./or AmountDue Date/Time F'rame <br />contract amendment <br />execution. <br />30 ofcontract <br />amendment execution. <br />Monthly <br />Daily <br />Deliverables/Outco mes <br />to DOH a mass p lan <br />including: <br />' tYPe of site, <br />. site locations, <br />r throughput, <br />e considerationsmadetoensure <br />equity to historically <br />marginalized populations, <br />r and to the extent possible a <br />regional map of sites/locations. <br />Submit estimated budget for the mass <br />vaccination plan. <br />Monthly Cost Summary Spreadsheet to <br />the IMT/IMOby the fifth ofthe following <br />month. <br />Submission of vaccine use into WA IIS <br />database within 24hrs of use. <br />Activity <br />Guidance on vaccination protocols must be followed as <br />provided byDOH andCDC. <br />J urisdiction coordina te p and <br />implementation of mass vaccination clinics/sites provided <br />within the county(s) with a regional incident management <br />team/organnation as approved by DOH. <br />Request for regional IMT should be submitted through the <br />norrnalprocess through WebEOC. <br />LHJ is the coordinating agency for the mass vaccination plan <br />within the county. <br />Regional IMT will be under the delegation authority of DOH <br />and they are to provide support and coordination forall efforts <br />a round vaccine p la nning re source supp ort and genera I <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 j urisdiction/district. <br />Provide any information as requested by the regional IMT. <br />for ss Vaccination a are relm <br />on actualcosts as outlined in the DOH guidance to provide the <br />services and to carry out the mission. Funding will be <br />dependent on full participation in the LHJ and IMTprocesses <br />and all documentation will be required to be provided to fully <br />close out funding requests by the end of the mission period of <br />performance. <br />Allowable costs include expenses such as facility rentals, staff <br />to conductplanning 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 b e 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 a ssist IMT <br />and DOH finance know what exp enditures were necessa ry to <br />carryr outthe mission. <br />Vaccination data -will be <br />and federalrequirements. <br />maintained accordingto current staie <br />Task <br /># <br />1A <br />IB <br />1C <br />Exhibit A, Statement of Work Page 2 of 4 Contract NumberCLH3 I 0 I 5