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Task <br />Activity <br />Deliverables/Outcomes <br />Due Dite/Time Frame <br />Payment Information <br />and/or Amount <br />2 <br />Upon approval of proposal, implement the plan to increase <br />Written report describing the progress <br />Novemb--r 30, 2023 <br />Reimbursement for actual <br />immunization coverage rates with the target population <br />made on reaching milestones for activities <br />costs incurred, not to <br />identified. <br />identified in the plan (template will be <br />March 3 _, 2024 <br />exceed total funding <br />provided) <br />consideration amount <br />3 <br />Develop final report to include comparison of change or <br />Final written report including measured <br />June 15, 2024 <br />Reimbursement for actual <br />improvement of targeted outcome from start of the <br />and/or observed outcomes [what was <br />costs incurred, not to <br />project/intervention [This can be short-term or intermediate <br />achieved as a result of the <br />exceed total funding <br />outcomes with overall goal to increase immunization rates] <br />activity/intervention?]. <br />consideration amount. <br />Examples: <br />• Increased partner knowledge on immunization <br />(Template will be provided) <br />guidelines <br />• Change in attitudes about childhood vaccines <br />• Increase in school district immunization coverage <br />rates <br />DOH Program and Fiscal Contact Information for all ConCon SOWS can be found on the DOH.Finanee Shae&Qi.ht site. Questions related to this SOW, or any other <br />finance -related inquiry, may be sent to. fihancQ)dnh.wa.eo2. <br />Federal Fundinc Accountability and Transparency Act IFFA'l'A1(Applies to federal grant awards.) <br />This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act (FFATA or the Transparency Act). <br />The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent. <br />To comply with this act and be eligible to perform the activities in this statement of work, the LHJ must have a Unique Entity Ident fier (UEI) generated by SAMgov. <br />Information about the LHJ and this statement of work will be made available on I)SASpendinggov by DOH as required by P.L. 10)-282. <br />Fruirunr suceire Rrrlulrenrenls <br />flnallowable Costs: <br />There are limitations./i•om the funding source on allowable costs for this contract. /f the contractor is unsure if'cr cost is allowable, they should coniact the contract manager.for <br />approval of the cost prior to making the purchase or charge, <br />• Advertising costs (e.g., conventions, displays, exhibits, meetings, nemorahilio, gifis, souvenirs) <br />• Alcoholic beverages <br />• Building, purchases, constriction, capital improvements <br />• Clinical care (non -immunisation services) <br />• Entertainment costs <br />• Fundraising Cost <br />• Goods and services.forpersonal use <br />• Honoraria <br />• Independent Research <br />• Land acquisition <br />Exhibit A, Statement of Work Page 2 of 3 Contract Number CLH31015-Amendment 17 <br />