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Period of Performance: January 1. 2022 through Decen rcr 3I.2022 <br />Exhibit A <br />Statement of Work <br />Contract Term: 2022-2024 <br />DOH Program Name or Title: DCHS - ELC COVID- 9 Response - <br />Effective January 1.20 2 <br />Local Health Jurisdiction Name: Kittitas Counfy Public Health Deparknent <br />Contract Number: CLH3l015 <br />SOW Type: Original Revision # (for this SOW)Type of Payment <br />X Reimbursement <br />f] Fixed Price <br />Federal Compliance <br />(check if appticable) <br />Xn FFATA (Transparency Act) <br />Research & Development <br />Funding Source <br />X Federal Subrecipient <br />I state <br />I othet <br />Statement of Work Purpose: The purpose of this staten :nt of work (SOW) is to provide supplemental funding for the LHJ to ensure adequate culturally and lingquistically <br />responsive testing, investigation and contract tracing resol rces to limit the spread of COWD-19. This fuqding is the actual carryforward amount. <br />Revision Purpose: N/A <br />DOFI Chart of Accounts Master Index Title <br />FFYI9 ELC COVID ED ALLOCATION <br />FFY2O ELC EDE LHJ ALLOCATION <br />TOTALS <br />Activity <br />mitigation, communications and or other preparedness ar l response activities for COVID-l9. <br />Examples of key activities include: <br />o Incident management for the response <br />r Testing <br />r Caselnvestigation/ContactTracing <br />o Sustainable isolation and quarantine <br />r Care coordination <br />. Surge management <br />r Data reporting <br />Total <br />Allocation <br />14,588 <br />754.494 <br />0 <br />0 <br />0 <br />0 <br />769.082 <br />Allocation <br />Change <br />Increase (+) <br />14,588 <br />754.494 <br />0 <br />0 <br />0 <br />0 <br />769.082 <br />0 <br />0 <br />0 <br />Current <br />Allocation <br />0 <br />0 <br />0 <br />0 <br />t0/r8122 <br />12/31122 <br />LHJ Funding Period <br />Start Date End Date <br />01/0t/22 <br />01/01/22 <br />BARS <br />Revenue <br />Code <br />333.93.32 <br />333.9332 <br />Assistance <br />Listing <br />Numtrer <br />93.323 <br />93.323 <br />Master <br />Index <br />Code <br />t897129G <br />I 897120E <br /># <br />Task Payment Information <br />and/or AmountDue Date/Time F'rameDeliverables/Outcomes <br />Exhibit A, Statement of Work Page 1 of7 Contract Number CLH31015