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Exhibit A <br />Statement of Work <br />Contract Term:2022-2024 <br />DOH Program Name or Title: Of is oClipmtttliaStion COV [D-19 Vaccine - Local Health Jurisdiction Name: KittiLas ggunty Public Health Dea=nent <br />Effective January 1. 20?2 <br />Contract Number: CLH31015 <br />SOW Type: Re�ision Revision # (for this SOW) 5 Funding Source Federal Compliance Type of Payment <br />Federal Subrecipient (check if applicable) ® Reimbursement <br />Period of Performance: j1,uttuaty 1. 2t132 through June 30 26242624 ❑ State ® FFATA (Transparency Act) ❑ Fixed Price <br />❑ Other D Research & Development <br />Statement of Work Purpose: The purpose of this statement of work (SOW) is to provide funding to conduct COVID-19 vaccine activities. <br />Revision Purpose: The purpose of this revision is to add Program Specific Requirements in reference to unallowable costs and update Master Index Codes <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 Current <br />Start Date End Date Allocation <br />Allocation <br />Change <br />None <br />0 <br />Total <br />Allocation <br />359,803 <br />COVID19 Vaccines R4 <br />74310259 <br />93,268 <br />333.93,26 <br />01/01/22 <br />01/01/22 <br />06/30/24 359.803 <br />06/30/24 225A25 <br />COVID 19 CDC Vaccines <br />74310236 <br />93.268 <br />333.93,26 <br />0 <br />0 <br />0 <br />225,125 <br />0 <br />0 <br />0 <br />0 <br />_ <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />TOTALS 584,928 <br />0 <br />584,928 <br />Task # <br />Activity <br />Deliverables/Outcomes Due Date/Time Frame <br />Payment Information <br />and/or Amount <br />The purpose of this statement of work is to identify activities and provide funding to support COVID vaccine response outreach,-ducation, and operations. The activities may <br />include other vaccines recommended for the audience population, as long as COVID vaccine is the primary focus and references =o other vaccines are secondary. <br />3,A <br />Identify activity/activities to support COVID vaccine response <br />Summary of the engagement strategies to <br />Januay 31, Annually <br />Reimbursement for actual <br />in your community, using the examples below as a guideline. <br />be used with health care providers and <br />costs incurred, not to <br />other partners, and the locally identified <br />exceed total funding <br />Example 1: Develop and implement communication strategies <br />population to be reached. <br />consideration amount. <br />with health care providers, community, and/or other partners to <br />help build vaccine confidence broadly and among groups <br />anticipated to receive early vaccination, as well as dispel <br />vaccine misinformation, Document and provide a plan that <br />shows the communication strategies used with health care <br />providers and other partners and the locally identified <br />population anticipated to reach. <br />Exhibit A, Statement of Work Page i of 3 Contract Number CLH31015-Amendment 17 <br />