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Exhibit A <br />Statement of Work <br />Contract Term: 2022-2024 <br />DOH Program Name or Title: OfYise of PLople Service ( Public Iieahh Local Health Jurisdiction ]lame: Kittitas County Public Hea11h QepgrtmenI <br />Infrastrucl r t - Cffective Jan nary 12024 <br />Contract Number: CLH31015 <br />SOW Type: Oritdnal Revision tt (for this SOW) Funding Source Federal Compliance Type of Payment <br />® Federal Subrecipient (check if applicable) ® Reimbursement <br />Period of Performance: fanuary 1, 2024. through Ducember 31. 21�LrF. ❑ State E F -ATA (Transparency Act) ElFixed Price <br />[] Other ElR search & Development <br />Statement of Work Purpose: The purpose of this statement of work is to provide funding to establish, expand, train, and sustain the LHJ public health workforce in accordance <br />with the CDC Public Health Infrastructure Grant (PHIG). <br />NOTE: The funding allocation in this SOW is for the period of January 1, 2024 through June 30, 2025. Deliverables with due dates after December 31, 2024 are shown <br />for informational purposes only. DOH intends to include any unspent funding in a new SOW in the next consolidated contaact term beginning January 1, 2025 for <br />continuation of this project through June 30, 2025. <br />Revision Purpose: N/A <br />DOH Chart of Accounts Master Index Title <br />Master <br />Index <br />Code <br />Assistance <br />Listing <br />Number <br />BARS <br />Revenue <br />Code <br />LHJ Funding Period <br />Start Date End Date <br />Current <br />Allocation <br />Allocation <br />Change <br />Increase (+) <br />Total <br />Allocation <br />FFY22 PH Infrastructure Comp Al-LHJ <br />92321223 <br />93-967 <br />333,93-96 <br />01/01/24 <br />12/31/24 <br />0 <br />200,000 <br />200,000 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />1 0 <br />1 0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />TOTALS <br />0 <br />200,000 <br />200,000 <br />Task <br /># <br />Activity <br />Deliverables/Outcomes <br />Due Date/Time Frame <br />Payment Information <br />and/or Amount <br />1 <br />Submit names, position titles, email addresses and phone numbers <br />Submit information by March 15, <br />March 15, 2024 <br />Reimbursement for actual <br />of key LHJ staff responsible for this statement of work, including <br />2024, and any changes within 30 days <br />costs not to exceed total <br />management, program staff, and accounting and/or financial staff. <br />of the change. <br />Within 30 -lays of the <br />funding allocation amount <br />change. <br />2 <br />Develop a plan to use these funds for one or more of the <br />Implementation Plan <br />June 30, 2C24, or sooner. <br />allowable costs listed below. <br />Exhibit A, Statement of Work Page 1 of4 Contract Number CLH31015-Amendment 17 <br />