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Exhibit A <br />Statement of Work <br />Contract T erml. 2022_2024 <br />DOHProgramNameorTitIe:LocalHealthJurisdictionName: <br />Effective January I . 2022 <br />SOW Type: Original Revision # (for this SOW) <br />Period of Performance: January 1.2022through December 31. 2024 <br />Type of Payment <br />El Reimbursement <br />I Fixed Price <br />Federal Compliance <br />(check if applicable) <br />El rFera (Iransparency Act) <br />LJ Research & Development <br />f,'undins Source <br />El E.OJrat Subrecioient <br />U State <br />E otttet <br />SupplementalNutrition Assistance Program -Education (SNAP-Ed) to improve the likelihoodchoices within a limited budget and choose ac tive lifestyies consistent witt the current USDA <br />Kittitas Countv Public Health Deoartment <br />Contract Number: CLH3 l0l 5 <br />statement of work Purpose: The purpose of this statement of work is to providethat persons eligible for SNAp (Basic Food, Food stamps; win make heattny rooadietary guidelines. <br />RevisionPurpose: N/A <br />Exhibit A, Statement of Work <br />Template Sep temb er 2021 <br />Total <br />Allocation <br />l830 <br />0 <br />0 <br />0 <br />0 <br />0 <br />3 <br />Change <br />Increase (+) <br />18J <br />0 <br />0 <br />0 <br />0 <br />0 <br />Current <br />Allocation <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />09130t22 <br />LHJ Funding Period <br />Start Date End Date <br />0l/01t22 <br />BARS <br />Revenue <br />Code <br />333.10.56 <br />Assistance <br />Listing <br />Number <br />10.561 <br />Master <br />Index <br />Code <br />76701937 <br />DOH Chart of Accounts Master Index Title <br />MGNT-R-EGION 2PROGEDSNAPIARFFT22 <br />Payment Information <br />and/or Amount <br />Reimbursementupon <br />on-time receipt and <br />approval ofacceptable <br />deliverables/out- <br />comes forthe funding <br />period will not exceed <br />$30,818. Kittitas <br />County Public <br />Health Department <br />will be paid the <br />allowable costs <br />Due Date/Time Frame <br />For the Period: <br />0l/01/22to 09/30/23 <br />| 0 / 0 1 / 23 to 12 / 3 1 / 24 TBD <br />Due: per the approved work <br />plan andperthe required due <br />dates during the federalfiscal <br />year, and no later than <br />09 /30 /23. r0 I 0 | /23 to lzl 3 I I 24 <br />TBD. <br />Activify Delivera bles/Outcomes <br />Project Planning,Implementation, and ProJ ectprovides 100% of SNAp-Ed activities atPerformance <br />For SNAP-Ed, the Subrecipient will develop, <br />implement, and evaluate a SNAp-Ed project <br />included in the Washington SNAp-Ed Stlte plan <br />approved by Department of Social and Health <br />Services (DSHS) and United States Department of <br />Agriculture (USDA); and,asdescribed in the <br />Subrecipient's project work plan approved by <br />Department of Health @OH). <br />I <br />2. <br />eligible sites and/orwith eligible audiences. <br />On-time delivery, implementation, and <br />evaluation of Project activities as scheduled in <br />approved state plan and proj ect work plan. <br />Project plan supports at least one State SNAP- <br />Ed goal as selected by Subrecipient. <br />Demonstrates progress towards prdect <br />objective(s), and additionalproject goa(s) <br />deterrnined by Subrecipient are demonstrated <br />J. <br />4. <br />and <br /># <br />Task <br />1.0 <br />Page 1 of12 Contract Number CLH3 I 0 1 5