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Exhibit A <br />Statement of Work <br />Contract Term: 2018-2021 <br />AMENI ]NT #19 <br />Local Health Jurisdiction Name: Kittitas countv public Health Department <br />Contract Number: CLHL8249 <br />DOH Program Name or Title: COVID-19 Coordinated Response - <br />Effective July 1^ 2020 <br />SOW Type: Revision Revision # (for this SOW) 2 <br />Period of Performance: July 1.2020 through December 31.2021 <br />Type ofPayment <br />[lReimbursement <br />I Fixed Price <br />Federal Compliance <br />(check if applicable) <br />X FP'are (Transparency Act) <br />! Research & Development <br />Funding Source <br />X Federal Subrecipient <br />Ll State Ll Other <br />I Federal *Conffactor <br />Statement of Work Purpose: The purpose of this statement of work is to provide supplemental funding for the LHJ to ensure adequate culturally and linguistically responsivetesting, investigation and contact tracing resources to limit the'spread of covlD-19 <br />NOTE: Pending execution of a new consolidated contract term or an extension to the 201 8 -202 I consolidated conkacts which currentiy end December 3l , 2021 ,DOH plans tocontinue the task activities and funding as noted in the task(s) below in a new or revised statement of work effective January 1,2022. <br />Revision Purpose: The purpose of this revision is to extend the period of performance from June 30, 2021 toDecember 31,2021;add funding and extend end date for Task 3FFY2i COVID19 VACCINE SERVICES-CARES thTOUgh DecembeT 37,2021; add FFY2O ELC EDE LHJ ALLOCATIoN and FFY19 ELC CoVID ED LHJ ALLoCATIoNfunding and revise language for Tasks 1 and2; add Task 4 and funding information for MASS VACCINATION FEMA l00yo andadd program Specific Requirements and DOHprogram and fiscal contact information. <br />036 <br />0 <br />385369 <br />161s3 <br />237 <br />0 <br />I <br />Change <br />Increase (+) <br />0 <br />., <br />0 <br />r61530 <br />237 <br />0 <br />I <br />Current <br />Consideration <br />0 <br />1 <br />0 <br />0 <br />0 <br />8 <br />12t30/21 <br />12t30t20 <br />r2/31/21 <br />l2/3lt2t <br />12/31/21 <br />04120t21 <br />Funding Period <br />Only)Use(LHJ <br />0710t/20 <br />01t01/20 <br />07/01/20 <br />01/t5/21 <br />01101t2t <br />0112U21 <br />Master <br />Index <br />Code <br />1897129V <br />1897129W <br />743t0209 <br />1897120D <br />1891129G <br />934V0200 <br />BARS <br />Revenue <br />Code <br />333.21.01 <br />333.91.03 <br />333.96.26 <br />333.93.32 <br />333.93.32 <br />33.91.03 <br />CFDA # <br />21.019 <br />97.036 <br />93.268 <br />93.323 <br />93.323 <br />91.036 <br />of Accounts Program Name or Title <br />BITV-COVID ED LHJ ALLOCATION-CARES <br />FEMA-75 COVID LHJ ALLOCATION <br />FFY2I COVID19 VACCINE SERVICES-CARES <br />FFY2O ELC EDE LHJ ALLOCATION <br />FFYIg ELC COVID ED LHJ ALLOCATION <br />*MASS VACCINATION FEMA IOO% <br />TOTALS <br />Payment <br />Information and/or <br />Amount <br />Due Date/Time FrameDeliverables/OutcomesTas k/Activity/D escriptionTask <br />Number <br />Examples of key activities include: <br />. Incident management for the response <br />r Testing <br />controlinfectioncapacfiyIaboratoryepidemiologysurveillanceincludemayThis <br />9ID-COV <br />COVID <br />for <br />for <br />vrtlesactl <br />activities <br />response <br />response <br />and <br />and <br />preparedness <br />preparedness <br />otherorand <br />emergencyhealthpublictn <br />communicationstrgatron, <br />Participate <br />m1 <br />r Case <br />Exhibit A, Statements of Work <br />Revised as ofJanuary 15,202L <br />Page 3 of30 Contract Number CLHI 8249 - 19