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1D <br />! <br />Task <br />ccme <br />Activity <br />- If a loca or reglon <br />does not have a registration system(s) the inch ,le intemet <br />based, phone option and other methods to enst re equitable <br />registralion, the state hepMod system and toc s will be <br />available foruse. <br />Regularly report on vaccinations sites and ope <br />(number of vaccinations,personnel to operate <br />challenges, successes to share for leaming acr <br />ational activities <br />he site, <br />ss the public <br />health system). <br />DOII program and Fiscal Contact Information for al ConCon SOWs can be found on the DOH Finance SharePoint site. Questions related to this SOW' or any other <br />finance-related inquiry, maybe sent to finance@.doh.wa ,9914. <br />DOIf General Mass Vaccination Program and Fiscal lSontact <br />Patrick Plumb <br />COVID FEMA Proj ect Management Analyst <br />Washington State Department of Health <br />Office of Financial Services <br />I I I IsraelRoad SE, Tumwater, WA 98501 <br />patrick.plumb@doh.wa.gov I (3 60) 23 6 429 1 <br />Program Manual, Handbook' Policy References <br />Emergency Response Plan (or equivalent) <br />Medical Countermeasure/Mass Vaccination Plan <br />Billing Requirements: <br />uontn"ly invoices must be submitted timely to the regior ll IMT/organization for reviedapprovalprior to submission to DoH for reimbursement' <br />Contrait Ma ster Index (MI) Code : 93 4V02 0 0 General Il a ss Vaccination <br />BARS Revenue Code: 333 .97 .03 Mass Vaccination Rei nbursement <br />Exhibit A, Statement of Work Page 3 of 4 <br />f,'ederal Fundine Accountabilitv and Transoarency I ,ct (FFATA) (Applies to federal grant awards.) <br />Thisstatementofworki'@I'"q"i''*-pliancewiththeFederalFundingAccountabi1ityandTransparencyAct(FFATAortheTransparencyAct). <br />The purpose ofthe TransparencyActL to makeinform tionavailableonline so the public cansee howthe federalfundsarespent. <br />Tocomplywiththisactandbeeligible toperformthea tivitiesinthisstatementofwork,theLHJmusthaveaDataUniversalNumberingsystem(DtlNs@) number' <br />Information about the LHJ and this statement of work u rLl be made available on USASpendins.gov by DOH asrequired by P'L' 109-282' <br />Pro gram Specific Requirements <br />Payment Information <br />and/or Amount <br />Ivlonthly <br />Due Date/Time Frame <br />furisaictioVnegions will ensure a fairand <br />equitable process for registration ol <br />eligible Washingtonians across all <br />available modalities. <br />Provide monthly situation report to <br />IMT/IMO on status of implementation of <br />mass vaccination plan, or more frequently <br />if thatis 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 recuested. <br />Deliverables/Outcomes <br />ContractNumberCLH3 I 0 I 5