Loading...
HomeMy WebLinkAboutState of Washington Department of Health Consolidated Contracts Amend 21 - 090924 Page 1 of 55 JEFFERSON COUNTY PUBLIC HEALTH 2022-2024 CONSOLIDATED CONTRACT CONTRACT NUMBER: CLH31013 AMENDMENT NUMBER: 21 PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as"DOH", and JEFFERSON COUNTY PUBLIC HEALTH,a Local Health Jurisdiction,hereinafter referred to as"LHJ",pursuant to the Modifications/Waivers clause,and to make necessary changes within the scope of this contract and any subsequent amendments thereto. IT IS MUTUALLY AGREED: That the contract is hereby amended as follows: I. Exhibit A Statements of Work,includes the following statements of work,which are incorporated by this reference and located on the DOH Finance SharePoint site in the Upload Center at the following URL: t :flJrli Q:II: :yf,G�iC)'.�C'.i-11i;:uri�:a._..4Jl�U::C?JI:Ct lLC? ::'' ll .I'' L C uJd�lt!(:4��.t�IV I�'CW0'4. the`'Crt:7c ® Adds Statements of Work for the following programs: Office of Immunization COVID-19 Vaccine-Effective July 1,2024 Office of Immunization-Promotion of Immunizations to Improve Vaccination Rates-Effective July 1.2024 Office of Resiliency &Health Security-PHEP-Effective July 1,2024 ® Amends Statements of Work for the following programs: DCHS-ELC COVID-19 Response-Effective January I,2022 Foundational Public Health Services(FPHS)-Effective July 1,2024 Maternal &Child Health Block Grant-Effective January 1,2022 Sexual&Reproductive Health Program-Effective January I,2022 WIC Nutrition Program-Effective January 1,2022 ❑ Deletes Statements of Work for the following programs: 2. Exhibit B-21 Allocations,attached and incorporated by this reference,amends and replaces Exhibit B-20 Allocations as follows: • Increase of$1.258.189 for a revised maximum consideration of$10,6741468. ❑ Decrease of for a revised maximum consideration of ❑ No change in the maximum consideration of Exhibit B Allocations are attached only for informational purposes. Unless designated otherwise herein,the effective date of this amendment is the date of execution. ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect. IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof. JEFFERSON COUNTY WASHINGTON STATE OF WASHINGTON BOARD OF COUNTY COMMISSIONERS DEPARTMENT OF HEALTH Qk1- V'f elp tt f�.�A_. 09/11/2024 Kate Dean,Chair Date Date APPROVED AS TO.FORM ONLY APPROVED AS TO FORM ONLY Assistant Attorney General for 09/05/2024 Philip C. Hunsucker, Date Chief Civil Deputy Prosecuting Attorney Page 1 of 1 CC-22-002-A21 S to 1 33ed 86t'SEZS 8Z/I£/80 LI/10/L0 CLO£/ll ZZ/1WI0 ZI 99.EEC CZI'99 SI'S'Z PWV I0081f10 t tlss.I.SSO SINS Sd (P59'IS) 2Z/1E/80 LI/10/LO EZ/O£!ll ZZ110/10 Z1'99'flC £2199 CI'LPWV IOO8If10 1,1IST/.L SSO S-iISSSd tt8'£9ZS 448'E9ZS 000.013 8V11180 LI/10/LO CZ/O£ftI ZZ/10/10 ZI99frE £ZI99 41PWV IO031f10 I' SSO S.IISSSd IS9'S£S IS9'S£S I59'S£S £UOf190 £Z/10110 £Z/O£/90 £Z/10/10 ZO IZ"££E LZO IZ EI PWV Z00041:115 IBluawalddnsdu()61-QIAOD111l OtL'91'S 5Z/0£/90 CZ/IO/LO tZ/6Z/Z0 EZ/10/LO ZO I C£C LZO IZ 61'51 PWV Z000d21d1S Vd?IV 61-CIIAO3 fHl tZAd 10f'6S IOC'6S (6Ct'LCS'l SZ/0E/90 £U10/LO tZ16U10 EZ/IO.!LO ZO IZ•£££ LZO IZ 61 PWV Z000d2111S VdSV 61-111AO0 fHl tZAA 915S 9lSS ZZ/0Cf60 ILIO/01 ZZ/OE/60 ZZ110/50 LS'0I E££ ZLS'01 VPWV LVM0I8VML SAN&LddWNd VUS:IZZA44 96tS 96tS EZ/O£l60 ZZ/I0/01 CZ/OE/'60 EZIIO/90 L5.01 E££ ZL5'0I SI PWV LVM018VML Mu9W Sad&AYH VUSf EZA3:1 805'IS 96PS 9611 PZ/O£f60 CZ/l0/Ol 4ZfOE/60 1/Z/i0/80 LS•O1£EC ZLS•01 61 PWV LVMOI 8VML 1W2I41 sold dN141d VUSfl PZAd:1 008`ZS 008'ZS oolr S EZ/0£./60 ZUI0/01 EZ/OC/60 CZ/I0/10 SS 01 EEE L55.01 01 PWV LVMOOLVML SSD mow scud DIM VOSf£ZAdd OSO'PLS ZZ/0£/60 lZ/IWOI ZZ/0G'60 ZZ/10/10 SS 01£E£ LSS 01 1 PWV LVMOOLVML s1a111uoD s+S IuaIID DIM WW1 ZZAdd 9ZL'9S ZZ/0£l60 IZ/1W01 ZLOC/60 ZZ/IWIO S5'01 CEf LSS 01 S PWV LVMOOLVML 93e110O3 s+S luagJ DIM VUS(l ZZAd:I 9L£'98S 009'SS ZZJO£660 lZ/1W01 ZZ/0E160 ZZ/I0/10 SS•O1"tE£ LSS'01 L PuV LVMOOLVML slaellun;)s+s luau DIM VUSfl ZZAdd OSL'CZS CZ/OE/60 ZLI0/01 ELO£160 ZZ/1W01 S5'01.CCC LSS'0I I PTV LVMOOLVML sP iIUUD s+S IWagD JIM VUSf1£ZAdd CIL'SLS CZ/O£/60 ZZ/IWOI ELOC/60 ZZ/1W01 SS'Oi•£C£ LSS'01 01PuV LVMOOLVML slaellWOJ SAS IWN!IJ DIM VUSfCZAdd Mtn EVO£/60 ZZ/10/OI ELOC160 ZVI0/01 SS OPEC£ LSS•0I Zl PWV LVMOOLVML S1aenlwD s+S wa!1;1 JIM VUS11 CZAJd IIEVZ£IS LS9'IIS CZ/0£/60 ZZ/10/01 EL0C/60 ZZ110/01 55.01'£££ LSS'OI 51 PWV LVMOOLVML slaenuo3s.SWa!IDJIM VCISf1 CZ.Cid 8£Z.SZS tZ/OV60 £U10/01 PZ/OEf60 EZ/I0101 SS 01'££E LSS'OI SI'01 PWV LVMOOLVML slasnuO3 s4S lu !DD DIM VUSII tZA.4d 00S'ZS 1Z/0C/60 £Z/10/01 tZ/0Ef60 CZ/10/01 5S 0I•EEC LSS•OI SI PWV LVMOOLVML sIas11u0D s^S 1u4!I3 DIM VUSI1 PZAdd 060'6LS tZ/O£/60 £U10/01 tri0£160 EZ/IW01 SS 01'££E LSS'0l LI PWV LVMOOLVML slasnu0DsekS 19a!lD DIM VUS:I PZAdJ CS 1'84S tZ/OC/60 £Z/10f01 tZ/O£!60 £Z/Iarol Sc 0I.EEE LSS OI 81 PWV LVMOOLVML sPsIIUOD SAS Iua!IJ JIM VUS:1 tZAJJ ELLS tZ/OC/60 £Z/10/01 PL'0£/60 £Z./10/01 SS OI'££E LSS 01 EZ PWV LVMOOLVML sP.11uo)SAS 1ua!13 JIM VUSfl IZAJJ ZLP'091$ 8ICPS PVOf/60 £Z/10/01 PZ/Off60 £7/10/0I SST I'Cif LSS'01 IZ PWV LV.110OLVML sPslluO,)snS lUa!l.).)IA1 VOfSf1 PZA3d 89Z'9ZS SZ/0E/60 4Z/IO/01 PIA£KI tK/10/01 SS 01 TEE LSS 01 LI PWV pauaaa)3 loN VDN slaslluoDSAS 1u3!I0 DIM VUSfl SZA:1:1 tlt-LOPS St1'SZS 098'IS SVO(/60 tv10/0I PVIVZI 1Z/10/0I SS'01'ftf LSS'Ol IZ PWV Pa•N3)311*ON V9K slaralu0.1 sAt lua!C);)IM Vasa SZ.IJJ 68£'£tS 68C£PS PZ/OE/60 IZ/10/01 PL0£/60 ZZ/10,/10 SS OI•£CE LSS Ol L I 'I PW V I VM0OLVML WAIN 8o,d add8 VUSf1 ZZAdd £l4'6S SZ/Ofi60 ZZ./lo/Ol tr/t£/Z1 ZU10fol SS 01'£££ LSS 01 LI.0I 8 PWV 1VM0OLVML 1u18yy Scud;MAR VCISf EZAdd 8£Z'8ZS SZ/OE/60 ZZIIO/0I PZJIE/ZI ZZ/I0f01 SS 01'EEC LSS 01 LI'01 PWV 1VM00LVML IU18W scud Jddtf VUsn EZ>tdd 190'LPS fl4'6S SUOf/60 ZZ/I0/0l PZ/lf/ZI ZZ/IWOI Sti'01'fff LS5'01 IZ PWV IV.MOOLVML 3W R btu."JdAU VUSII 5ZA3d t•0148Z I S 159'Lf 5 159'LES tZ/OC160 CZ/10/01 tZ/OE160 CZ/10,/01 55 01•EEE LSS 01 SI PWV I VM0OLVML RuSP11 Bay Ddill VUSII PZAdd IIlo.L Inn II'" 'tummy ale(I Puy alii(I Innis aie(1 pu:1 a3e(I UP15 •.apsJ .#1,ri #MaWn• #N011ea1)lluaPI aIIII N1.19ad slummy Jo1V) swooaal P°ua,l pOuad s!Pun I INn1a,I:Yu!1 munA I'll I anoaw,all Is!ssV lus IV!wapad )o Iasg;) xu!pun,I slunO).V)o laeg7 Tao I°Iuama►ul5 SUV( SIN)a%1 11(1(1 91IsaH allgnd%P6'LZ:110Z'If•agW3»d g9na41 tZOZ'1.iasnu.r aloe Pa11IWI 41IsaH allgnd%8V'Sf=fZOZ'Is JagWaaad g9noagl(rot'I.Gsnusrais21 13JJ1Pnl 4Ns2H'Wind%fZ'6Z:ZZOZ'If aa9Waaa(1 991s0111 ZZOZ'I ALsnusr alsa I0a11P1I IZOZ'I lsnznS' :ale(l PZOZ-ZZOZ:awl,w U UO.) £I0ICII'IJ :aa4Wnn Ias'wq) SNOU.VJU'1'IV ea a n yano, nos/anal. g5)0 z a6ed 411 H !Ig d• 7 IZ-8.LIflIHa3 S3oZdled ZIL'Z8S ZZ/81/O1 OZ/61/S0 ZZ/81/01 ZZfI0110 Z£'£6.£EE EZE'E6 Z PI11V S15000)005 114 001Ie3011V(H1 PH CI1AOJ J13 6IA:Id (1,69`8LS) ZZ/81/01 OZ/6I/S0 ZZ/8I/0I Z 'IO/10 ZE'E6'EE£ £ZE'E6 ►PwV SISOOOXJOSf1N uugcxllIV fH1 PH CDAOO J13 61Add LEG IS Lie IS (IHZ'ZS) ZZ/81/01 OZ/61/SO ZZ/81/0I ZZ110/10 ZE E6£££ £Z(E6 L PWV S15000J[JOSf1N u011¢30I1V fH1 PH UTAOJ 31t16lAdd P99`4IS 6991,IS t99'tIS tZ/If/LO OZ/EZ1t0 ZZ/ZZ/t0 ZZ/10/10 ZE(6'EUE CU E6 Z PwV 51S000JIJ0STIN S311VJ CIIAOJ 6IAdd 009'SS 009'SS ZZIOC/90 IZ/IO'LO ZZIOE190 ZZ/10/10 9Z.£6EE£ 89Z E6 f PWV 619ZZ6dIEZIIN WO:MA ZZAdJ OOZ'IIS 009'SS 009'SS CZ/Of/90 ZZ/IO/L0 £Z.'O1/90 lliI0/L0 9Z't6EE£ B9Z E6 5 PwV 6I9ZZ6difZHN sdO)IA EZAdd 009'SS tZ/0£/90 CZ/10/L0 ►VOC/90 £ZIIWLO 9Z16£E£ 89Z'£6 4I PWV 619ZZ6d1EZHN SdO 31A DOD►ZAdd 091'9S 0954 tZ/0£/90 £Z/IO/LO EV/0E190 £ZIIWLO 9Z'£6£E£ 89Z'£6 S 1 Pn"V 619ZZ6dICZIIN SdO JdA J(1J tZA:id 09L'1IS 009'SS 009'SS SZ'0VV90 tZ/10/L0 11/11/ZI tZ/IWLO 9Z'f6'fff 89Z'f6 I Z PIUV Pae!»aa ION V9SI sd0:),.I' ..HI.)SZAdd EU8'45(S t"ci0Ei90 OZ/IWLO tZ/OE/90 ZZ/10/10 9Z'E61•££ S9Z't6 I PuV 619ZZ64.11£ZIIN 421 saula3VA 6IULLO:) 909'60LS CO/1'45ES tZ/OE/90 OZ/iWLO 1110E/90 ZZ/10110 9Z'E6'f£E S9Z'£6 6 play 619ZZ6dI£ZIIN to sa'!aaeA 6IC11AOJ ZLS'OZLS 996'01S 996'01S PUif/ZI OZ/10/L0 Pt/If/II 1VI0/L0 9Z'f6'ff£ 89Z16 IZ PWV 619ZZ6difZHK tN S U 33YA 610IAOJ tl I.SLZS ►I l'SLZS t1 I'8LZS PI/OE/90 Ot/IO/L0 11/0E/90 ZZ/IO/I0 9Z E6 EEE 891£6 4 PwV 619ZZ6difZHN, SautaaeA 6101A03 LEI'LZS LCI'LZS CZ/IF/CO ZZ/10/t0 EZ/IE/E0 ZZ/10/40 IZC6Ef£ LIZ to 5 P' V 095900VdI1d1 8uluueld M!wlld X aP!.L ZZAdd 656'LSS ZZ8'OES ZZ8 0(S tZ/1£/E0 EZ/I0/t0 4VIE/£0 £Z/10/1P0 IZ't6Et£ LIZ L6 4I Ix11V 09S900VdHdd 8uluueld MP1e:l X anti EZAdd £EL'LIS SZ/IfUEO motto tV1E,ZI tZI0/1,0 IZ'£6£££ LIZ'f6 61 PWV 093900VdIld.i ugh!(111uedX anti Vdlldd tZA.i l 08t'ICS Ott'IFS LOL'fIS SV1f/fO ►Z/10/t0 tZ/Ifat ttb0/1O IZ'£6'C££ LIZ'£6 tZ Plot/ 093900VdHd3 urld A PWed X 41/1L vdlld.i tZA1.1 990'tS 990'4S 990'1S ZZ/I£/£0 ZZ/tI/I0 ZVIE/E0 ZI.1tI/10 IZ'£6£EC LIZ.£6 Z ItV S61900Vdlldd sP334Ia110XDI1!1ZZA:H 000864 000)36S 000'86$ tVI£/80 £Z/10/60 ttIt180 tz110/10 EI E6£E£ 9£1£6 LI pwv 8IZ0103JLi(lN JCIJCEO VZCIO EZAdd rSCEIS ►SL'EIS ZZ/OE/90 IZ/I0/L0 ZZ/O£/90 ZZ/10/10 90 E6'£E£ 690'f6 Z.PWV £tOZZ6d.L0611N 8u!Pund fH'I£d11 d311d IZAdd HIV t£5 ►8t'4ES CZ/OE/90 ZZ/I0/L0 £Z/O£/90 ZZ/10/L0 90 E6 LEE 69016 L PwV £t0ZZ6d.I.O6f1N 8wpuni(Hi td8 dAl(d ZZA:1J ZZS'Z8S t8E'VCS t8£'t£S tVOE/90 £ZJIWLO ►Zi0£'90 £Z/10'LO 90 E6LE£ 690 E6 SI PWV EPOZZ6d106f1N BUIPund 1111 Sd8 diHd£ZAUJ Of9'OZS Of9'OZS Of9'0ZS SZ/O£/9O tZ/IO/LO tt/I£/ZI tZ/IWLO 90T6'fff 69016 IZ PWV S9000011.1A1611K S13UU6d rH'I-JUJ-Idll d3Hd VIM,' 000'SIS 000'SIS ZZ/0E/I1 ZZIIO/IO ZZ/I£/0I ZZ/I0/f0 LI,99'£££ ZLt99 Z PWV I0EtLf10 (A33)11V11ua013V4aeaHSn!w111!MSZZAi:I 000'SIS 000'SIS CZ/IC/01 £Z/I0/£0 CZ/I£/01 CZ/I0110 LP 99'E£E UV 99 I I PWV 10E$Lf10 (A73)HVI 111tiD UV LINDH eunuwlmS EZA 4 000'St5 000'SIS 000'SIS tZ/OE/l I tZ/I0/I0 tt10£/60 tZ/101£0 Lt 99'E£E ZLt 99 II I'uwv I00Lfto (A3l)NVi Iueu)IaV 43e3t18unuw!mS PZAAd Igs.L lonisloS IonowV also Poi alga Ian awn pu:S ma 11ety ..3P113 .q ls!'1 0 puxuV q w,!Ieag!loapl 411!.1.wluKoad SIun033V JO UVIL) slaeoaaV+ pad Puled u!PoNA Po!lad 811!Pood fil'I anoaaaH lslssV PitoktV 1IaaWd Jo situp Y1gp11113 gao033V Jo 14$q) 11l0,4A Jo Iaawale)S SHVA Ap70 311 HOQ gIP'a11 a!Ignd%.t6'LZ:CZOZ'ii uagwaaa0 gtno.lgl uuoz'I Ainnusralea pampa' 4111'all a!Ignd%.S8'Sf:fZOZ'lf uagula300 gKnoagl f=OZ'I kinnueralsl(laaaIP"i 'lllvall allgnd%fV6Z:ZZOZ'if aagmaaa0 q$nagl ZZOZ'I,lemur aInll 3334IPnl tZOZ'IMISIIV :NOG PZOZ-ZZOZ:aua.LIaoaloei noon) 'aagwnK law pun) SNOI.LV')O'11V gslsaii3!I9nd.(iogo.)uouaj(ar SS 10£a6ed IZ-11.1.181HX3 10 E'Vet' 0ZZ'S£S ZZ/0£190 I /iO/LO ZZ./O£190 ZZ 10/10 16 tO tEE V/N I PwV am4S MD 410-1 dal'V IenxaS ZZAJS OOI'PPS 088'ST ZZ/O£/90 1/J10/LO ZZ/0£f90 ZZ'I0/10 161.0 PEE YIN 5 PwV am4S 1so;)4111-I daa V IsnxaS ZZA3S ZS9 6ES £U0£/90 ZZ/10/L0 £Z/0£190 ZZIIO/L0 16t011E V/N 01'L NA, a1u45 MO 411H dam 72 IsnxaS£ZAdS 600'08$ LS£'OPT £Z/0£/90 ZZ/10/LO £Z/0£/90 ZZ/IoILO 163,0't£E V/N 01 PwV aJe4S 1so0 y11H dam 7g IsnxaS£ZA3S 9Z6`ZPS tZ/0£/90 £Z/10/L0 tZ/0£/90 £Zl10/L0 161,017££ V/N LI'SI PIIV 3m4S 1 O3 91111 daa It IenxaS tZAdS 9Z6'Zts tZ/0f190 £UIO/LO tZiO£/90 £Z1I0/L0 I6'tO'PCE V/N LI PwV antis 15O3 41111 daa Ip IB+IxaS tZAdS Z59`L8S 00S'IS tZ/0E/90 £Z/I0/LO tZ'0£/90 EZ'IO/L0 16 t0'11E V/N SI NW am4S 1SoJ 44H &El V IenxaS tZAdS t80'09ZS EZ£'StS £Z£`817S SZ'OE/90 ►Z/IO/LO tZi1£/ZI tZ/10/LO 16 t0't££ V/Y OZ PwV a1e4S 1so)411H loll 18 IenxaS SZAJS 000 OSIS 000'0SIS 000'05IS £Z/OE/90 ZZ/I0/L0 EZ/0£/90 ZZ/I0/LO 06'40'P£( VIM S PwV slatua)41Ie411 pasgl I0043S EZAJS 000'01IS P1/0£'90 CU10/L0 tUOE/90 £Z/IO/L0 06 tO PEE V/N t1 PwV Ostook!NIBS PZAiS 000'SES tZ/O£/90 £Z/10/L0 tZ/OE/90 EZ/'IO/LO 06 PO Kt V/N 91 PwV °S(+old 31113S►ZA3S 000`55IS 000401S tZ/0£/90 £Z/10/LO tZ/OI/90 £Z/10✓L0 061.0 III V/N 61 PwV OS(4ad 311EIS tZAJS 000'Z9S SUO£/90 4Z10/LO tZ/IE/ZI tZ/IWL0 06.40 PEE V/N tl PwV Os1Aad 3111S SZAJS 000'943 000'16T 000'6ZT SZ/0£/90 tZ110/LO 1Z/1£/ZI tZ/l0/L0 06't0 PE£ V/N 61 PwV osinoid JHUS SZAJS SZS'LZS SZS'LZS SZS'LZT ZUO£'60 IUIO/O1 ZZ/0£160 ZZ'I0/10 66£6£C£ 1'6616 I PwV ISi:001 1'011 si3e1Iu0:)nil OBHJW ZZA33 t£8'91S t£8'915 PC8`91S CZ/0E/60 ZZ/10/0I EZ/0£160 ZZ/I0/0I 66'£6'£E£ P66'£6 SI PwV ISZ5401PoH to Ie!aadS J£IIIJIN VSNH ZZAd3 00L`9ES £U0E/60 ZZ/10/0I EZ/0£160 ZZIIOl0I 66'£6'£E£ t66'£6 L PwV ESPLt7Wt0H slasiluO)f 11 DfiHJW VSHI1£ZA.l'l 998'615 (t£8`918) CZ/OE/60 ZZ/10/01 EZ/0£160 ZZ/l0/01 66'E6'£££ 466£6 S I PwV ESPLtD1/SP08 slx1111oD fill DBHJIN VS2111£ZA3:1 00L'9£$ OOL'9ES P110E/60 £Z/I0/01 ►Z/OE/60 £Z/10/01 66'£6.£££ 466£6 SI PwV 096Z531Nt08 siaeiw03 fill 9 IIiDW VS1111 tZAd3 IteS9S SL1'6S iL1'6S SZ10f/60 tZ/10J0I ► /1ERl PVIOIOl 66'£6'£ff t66'£6 I PwV pamaus IoK SCOW sueJluo.)fill 98HJ1 VSHH SZAd3 000'00Z5 000'00ZT 0o0.o0ZS 5UOE/90 ZZ/10/ZI tZ/I£/ZI tZ/10/10 96.E6'Et1 L96 E6 LI Pull! CS000030113N 1I1'!-1VdwoJanwlulseAJuIlidZZA:1:1 000'1 IS ZVI£/ZI ZZ/10/60 ZVI£/ZI ZZ/I1/40 Zt'E6E1E IZP E6 5 PwV 00E000.1.08£f1N 111e1()41InaH V a1H193 VI3HN ZZAd:1 000'ZZS 000'1:ZS 000.1 IT ZU1f1Z1 ZZ/iw/to ZZ/1£/Z1 ZZ/I I/t0 ZIP£6'£CE IZt E6 6 PwV 00E000108E11N 11e11.)411ea1I V a1O1114D VHHN ZZAdd OW'OOZT 000`00Z5 000'00ZS SZI0E/90 £Z/10/LO tZil£/ZI £Z/10/L0 S££6'£t£ PS££6 Or'91 PWV ISIZZ6d.L0611N f fl(]dM/id 61-U1AO3 DOD IZAdd 6E0'6£1S SZ11E/LO IZ/SI/10 PV1£/ZI ZZ/10/I0 ZE'E6'££E £Z£'£6 IZ'6`Z Ie11V 5I5000)I30Sf1N uO111»OIIV fH'1 HUH:Yu OZA3.d (ZtS'06$) SZ/I£/LO 1USI/10 11/I£1ZI ZZ/10/10 Z££ti££E EZE£6 IZ'6`P PwV Si S000)lJ0511N u0!IaaOIIV lli']HUH J'1H OZAdd (SL£'90 SVIE/LO IZKI/I0 ►Ulf/Z1 ZZ/IQ'I0 ZE£6-££E £ZE E6 It'6 PwV S I;000)1)0S11N UOI8:1011V flfl HUH J'13 OZAJJ ZO►'LS£S ZOP'LSIS oscSIS SZ/I£iL0 IZ/SI/I0 ►UIf/Z1 ZU10/16 Zf'E6fff IZf'f6 IZ PwV $IS000`1J0S:lA OOIIe>011V fin 3E13:YISI OZ.Lid 'roil 1nitygnS immure air('PU I alef INe1S a1e(I pail alvU 1f1t1S ssapOJ .p on ii PIIiwV ii IIP.lijiiu ip all!.1 WIu&>Jd slunoa3V Jo IJ1t43 slunw.)v pound pound Nu!pund pound 71u!pun3 nil annanaa )slsw I1 ' riapa.4 Jo ue4:) i!u!punA slafO3 VJO 3-Ic4.) 'Po%%10 luxaalgS save 4100 3s.1 11(XI 411cail a119nd•/.t6'LZ;PZOZ'if JagIUMa 43no.191 PZOi*I usnuu f ais l laanpq 411eal1 J!19nd•ASS'Sf:£Z0Z`1f aagwaaaq 4Snoa91 EZOi'1.uenuef ales palms! 411ei11 a!19nd•A£Z'6Z:ZZOZ`ICaagwaaaU 48noi41 ZZOZ'I,uenusf JINN 1•w!pu1 PZOZ'1lsn7f11V :am! hIOZ-ZZOZ:uua.I.las41103 Ciolci'IJ :Jaquln%.I.ilupw) SNOILV:30T1V gg Io t a6e� gowna!19nd 1eno3 uuslaJlaf It'8 118111X3 Si°h oiled 000'0SSS £UO£/90 1Z/10/L0 £Z/0£/90 ZU101L0 SZ'409£f ViN 1PWY (NA)OsLOid-fH-I-SHdd 181'S4►S OS (000'OSSS) £UO£/90 1Z/10/L0 £Z/0£/90 ZZIIO/LO SZ'40'9Ef V/N LPWV (Ell A)os!noad-flI'1-SHdd 000'ift'IS 4Z/O£/90 EUlO/LO PZ/0£.90 £Z/IWLO SZ't0 9f£ V/N 41 ptuv Sd -SPu"d-1H"I-SIIJJ►ZAAS 000'£££'ZS 000.006S 4U0£/90 £ilO/L0 4U0£r90 £Z/IO/LO SZ't0'9E£ YIN SI PtuV S49-SPu"d-fH1-SHdJ►ZA:1S O0S'991`1S SZ/0£/90 tZ/10/L0 4Z/I£/ZI 1U10/L0 SZ'40'9E£ V./N OZ PwV S.i9-Pund 1111-SHdd SZAdS 011049991S 000'fff ZS 00S'991'IS SZiOf/90 rZ%lllIL0 1VI£1ZI 4Z/10/L0 SZ.t0'9ff VIK I luuV Sl19-sPnn,i fH'1-S1144 SZAdS 000`E Et'IS 000`EEt'1$ 000'££4'IS £UOE/90 1Z/101L0 EUO£/90 ZZ/I0/L0 SZ.40.9£E V/N 6'9PwV Sd:)'fH'I-SHdi£ZA:1S 000'0ES 000'0ES £Z/O£190 1Z/10/L0 tZ/O£/90 ZU10/L0 4.6 40 t£E V/N 1 lxuY Sn-wowaSeuelm wientalsem 016.19S OL61(S 0L6'IES SZ/OV90 EVIO/L0 tZ/If,ZI 11/10/L0 f660.4£f VNI 91 PUIV SJ/J'luxuaSeueINI-01 Malse,MSZAAS 0L6'I£S 5U10/LO EZ/10/L0 4ZfItil 4Z/10/L0 E6'40Pff V/N tI PuIV (Sd0)IuatudruclSol!suO!IettlS OS OS (OL6'I£S) SU10/L0 EU10/LO 4Z/I£/Z1 t1/10/L0 £6'40'4Et V/N 91 PtuV (Sd0)IuaWaHeueN DIISu(11eWS O05'ZZS EUO£/90 1Z/10/L0 ZZ/O£.90 1Z110/10 E6't0 PEE V/N 11"V (1.1:110Iuawa8luuy4 0I!11O IIrwS SZI`£IS (SLE'6S) £UOE/90 1U10/L0 ZZIOV90 ZZ110J10 £6'V0►£t V/N I IruV (W1'M luatuaSuuttriausuoll¢0IS 000'51s tZ/O£/90 1Z/10/L0 EUO£/90 ZZ/I0/L0 £(i r0 PEE V/N I PtuV I VH'ly)►uatuaileuew ausu()HIe1Us SLE'PZS 5L£'6$ £Z/OE/90 IU10/L0 EUOE/90 ZZ/10/L0 £6'r0 PEE V/N ZI PtuV (VJ'IV)IuawaSeuelnl a1!su(news £E£'EES EE£'££S 5Z/O£/90 £UIO/LO 4UOE,90 £Z/10/L0 £61,0'PE£ V/N t1 PWV (V9'IV)ulawa8eunyi ausuQ news 991'40IS £E£`EES E££`£ES SZ/O£/90 £Z/10/LO PZ/I£./ZI 4UI0/L0 £6.t0'4E£ V/N 41 PWV (V9'Iv)Wawa8euey4allsuoluaus 00S'OIS £Z/OE/90 1Z/10/L0 t /Ot./90 ZZ/10/10 f640'4Ef V./N I MY u!x010!a'4SU1135IS aalI 005`LIS 000'LS EUO£/90 1Z/10/L0 £Z/OE/90 ZZ/10/10 t6 PO IEE V/N 6 PWV uptolo!fL'ysIllagS aaa OOI'II$ SZ/0£/90 £ZI10/L0 ►Z/l£/Zl fZ/I0/L0 £6.404E£ V/N 41 PWV Up1010t(L'ysllllaySaaa 009'I£S 001171$ 000'E$ 5Z/O£/90 £Z/IO/LO PZ/1£/ZI £Z/I0/L0 E6'40'4EE V./N OZ PWV u!xomotaltis nays 3as 6f4'LLS 6Er'L£S 6f4 LES tZ/OE/90 EZ/IOJLO 4U0£/90 EUI0/LO Z6'4O'4££ V/N 61 PIuV S.19 61-CHAO)fill o0S'LS OOS'LS £U0E/90 IZ/I0/L0 ZZ/0£/90 ZU10/10 16'1r0.11£ V/N I PIuV we,Ao,d 41I H iasf1 SnIQ MS 005'ZZS 000'SIS 000`S I$ £U0E/90 IUI0/L0 £Z/0£/90 ZZ/10/L0 I6'4O'PE£ V/N 5 PWV =Atom,'glleafl ias(I SW]ate1S OOS'LS OOS'LS 41/OE/90 EZ/10/L0 (UI£/ZI EL/10/L0 16'PO"4fE V/N 41 PWV WeJSOad Luca))Jain SIu(1 PZA:IS OSZ'OPS OSZ'04S PUOE/90 £UI04.0 ►UO£/90 ►U10/10 16.40"4£E V/N Li Pun' woad tOlcaH masfl S"K]PZA.S 000'B8S 05Z`045 05Z"04S 5Z10£/90 Pi/10/LO PZ/lf/ZI ►Z/10/L0 16 POitUE V/N LI PWV ulemSOad IpleaH 13511 S"K]SZAiS WW1 11401(10s tummy am Pua aiu11 situs moo Pu i al1U)ants **OPO.) .ii'sr' II!maul,' rr tnnlragpulpi ap!.I.turato J s)unoaav Jo ueq) s)unoaav POuad pupa,'51u!pund pound 8ulpund f117 anua.+an Is9ssV parttt !e.,ap.11 JO1angL Su1Pn41 VIunoaavJOt.Ieq,) IJO,%JOIuawal17s salve ilu0 3s.1 110U g11uaH a!Ignd%P6'LZ:slot'If Jagmuaaaf ga;nrugl rzo 'I Saunuui.amen Iaaa!pel tl1lt'JII JINNI VeSB'Sf:ftOZ'If JaywaaaU qSn"aqI IZOZ'l venue f 31111 l) 'lPaI 1111ea11 a!Igrt(1 7efr6Z:ZZOZ'I£J39W33311 44"0"11 ZZI)Z'l iaunuu f 31e11 laanpal 4Z0Z`1 Isnilnv :almU 110Z-ZZOZ:mJa.L)a1a1o0) f101£Ill) :JagtunN IauIluo.) SNOI.I.V:1O11V 5510 g 060d gllca11 agyn,'.IIunO,)unsmaJlaf IZ-8118111X3 rn s e IS w N G 0 0 C 00 00 O O_ O Z O 0 Cl y1 A r+ a q F. -r V N As M L ? c- cc <V N 4,N ! fr r.. .r.. .e — VI Ci I O h h ,n d in 0 m �b '� iat no� :e 8 �d o 25 "' 8 F z' is. 4 HNN n in IR CA a E 9 N p 0 E a Z i I/, N a 8 v $ ` 1 Si c 4 0 00 CIg g .1 90$ $ i E 8 8 N r+ C — Na- CI R ac . M h N N N N N N N an rA N r` f_ y z. O V9 z r,1CCr an Qeat V CVC n"�, QC ° _ — 0 0 0 0 0 0 O s U_ _ 1 Al r.' CC CCC CCC CV'' CC' A X L g2Q8 "i ." QQo goon v y C 0 0 OZO S S S S O O O 'e g t 0 I N N 4 M N r' A A I M N C .'�. r 0 0 C r N _ _ _ C C C c i 000 .-. t�.-�. . el f3 — — — .N. NI NI N A CA DA CO N g E A 1. 4.1 �r N N P.ea N r r N r CQ i i N _, , A O` e C C R e s2 R R Q e e ry z N "!, J• 0 O O 0040 0 0 0 0 .000 0p C N t .-I N N ,G t L •AO •AO A O `O .O kF O C N N N N N N CO N N N z a < v a T v— .. M M en in in en M 0y N iig e. C v = u < < < < << << < < < < �c Z x z z z z r z z z z z z x. a . _ aP N T YYA' 4ai •s ..., 77 e h ;Des i p c A+ b ?� p� N AI N ` 1yy51 .i t1 N N N V � O O O O r — N N N V C • G M M M Y t V V k 1 i^ t V 4 :n aaCD a y _ e C w L CA I' F F I; ' T. 7 w s in et. r,. t' < < < .. < < g al o. a a a5 4 .a .Qi rci, R Ti & �i ',a .. g p .37 u. v. ' y 0 • 2 aacz aaa rnr'na o"coez2 s F. o , 4[� o .a _1 cc 0. CO v. v, n , C c apt Y i i i b i 01 rn N N N ea N N N (.�n V Q top 9 e y o. c. p4 04 a x x x x o 3- x v 9 _ _ Li. ,. o rr v: v: v: rrrr F F -E - N e'4C. CO O O O e9 N CCj V a N. V;, r O = i� v_ T .Q M a C = E w 7 3 i4 4) p .G o. X, u N O C C `c '� u y oZi - E o E N. o f-� x 3 F Q C < •0 E C OOGfi Cr L ... Q, 0 U '9 C v in ^ a in IS C • M1 a V ? 'C a CO ed r a. m ..1 C. 40 .0 a C` LP L u a. � Q y Z` .8 u o o E R 2.a s a > y R el C,1 OON A M E Z • 5 o E a, F. �! •v C a � E e L td o `� •- F cu L e o j c U L L „. 4 v. ° U _ Z. fJ. .Vr ®❑ '� O A 12 AI N N 5 o L C oo C OR u Y .4) 7 o. 'O C N u rT. v -6 R C 64 C Ts ta. L • NCu O` R N u o y N t� � ;ao w c c d v = w ;e a. ,3 0 .a o 0 o u u :; 0 M e 9 V 1 .r g .= p C 4- V: O J 0 en en 0 m i e4 f2 ED E eV n in C d 0 v v E G N C O Q r o eel N1 y N y O E ci Ci U M eM�1 �.. O, 4. O .. OP A ° E V L o 41) rai a+ ,- e Cim, >CoO es c. .CO Ot 2 0 C y CS an .y C e"� e7 V 2 C.% = (6 oo < .] Z c c O .. O C „ u U U 1.. N �> .; III en 4.P O V E .i a 9 Z O, O,• •� hs� N 3 _ - X S. U x x h e M 4. 2 0 _ __ Cp +.. .. u �' C :IS v• .8 y 2 t! 4e Z EaE, gw- .a <rd'_ 3 5yVI 41 ticc N C y s C a�i oqILI Tr- oq0. C ud O Z aIt d m EwC o a9 < r= uF.�.. o u �,. C F ' o .C`1 " C. ° ` F v a u I. a v d . c l 8 ¢ `o� . . C a y U °' a o m :S .° a 2. - 0 vE C .E w U g CC °' E V o a .Q 'G Q .a . Cp «,,, E C �� C d 0 E c e a. to o -C > CC ..171 = a• A.0 V • •C H C Z v € o on !� Q C p a E u 0 au c K g E 0 E E oC ,� E o C? a: a E x u ao- } a� d Om o ? t U L c `°' o v 0 S 0 3 C A o. F o co ..y 0 U as o < a'� c 32 z � � F 4 ." � I la 0 (o) o a c d p � � OF F a E w x o. V1 L CL W Page 8 of 55 Task Activity Deliverables/Outcomes Due Date/Time Frame Payment Information and/or Amount NOTE:The purpose of this agreement is to supplement existing funds for local health jurisdictions to carry out surveillance,epidemiology,case investigations and contact tracing,laboratory capacity,infection control,mitigation,communications,community engagement,and other public health preparedness and response activities for COVID-19. DCHS COVID-19 Response 1 Establish a budget plan and narrative to be submitted to the Submit the budget plan and narrative using Within 30 days of Reimbursement of actual Department of l lealth(DOH)Contract Manager. DOH will the template provided. receiving any new award costs incurred,not to send the"Budget narrative Template","Budget Guidance"and for DCHS COVID-19 exceed: any other applicable documents that may be identified. Response tasks. $1,737 FFY19 ELC I) LHJ Active monitoring activities.In partnership with WA Data collected and reported into DOH Enter performance metrics COVID ED LHJ DO1-1 and neighboring Tribes,the LHJ must ensure systems daily. daily into DOH identified ALLOCATION Funding adequate culturally and linguistically responsive testing, systems (MI I897I29G) investigation and contact tracing resources to limit the Funding end date spread disease.LHJs must conduct the following activities I0/18/2022 in accordance with the guidance to be provided by DOH. Quarterly performance reporting updates S357.402 311.822 FFY20 a. Allocate enough funding to ensure the following ELC EDE LHJ Contact Tracing and Case Investigation Support:Hire a ALLOCATION Funding minimum of 1.0 data entry FTF,to assure system (MI 18971420E)Funding requirements for task 2.I.a. end date 12'31 2024 i. Contact tracing -31 2023 1. Strive to maintain the capacity to conduct Enter all contact tracing data in CREST targeted investigations as appropriate. following guidance from-DOH. 2. Have staff that reflect the demographic makeup of the jurisdiction and who can provide culturally and linguistically competent and responsive services. In addition,or alternatively,enter into an agreement(s)with Tribal,community-based and/or culturally-specific organizations to provide such services. DOH centralized investigations will count towards this minimum. 3. Ensure all contact tracing staff are trained in accordance with DOH investigative guidelines and data entry protocols. 4. Coordinate with Tribal partners in conducting contact tracing for Tribal members. 5. Ensure contact tracing and case investigations activities meet DOH case and Contact Tracing Metrics. (Metrics to be determined collaboratively by DOH,LHJs and Tribes.) Exhibit A, Statement of Work Page 2 of 7 Contract Number CLH3 1013-Amendment 21 C CV C C U 7 E 'e c E y ey M I T. 6 a E c o >. :'' rrl a C..) .. N d E E L 7 i U E E a z 0 d ez R 0 M en C V - a g p 3 0- = E C .e 0 0 a E v) > t v O 0 c 7 e G u ° Ts ? c— is :i > > a a°, 3 o n e.. 7. o u 3 o 0 GI on ea a's Q•— on = . c _ n. LL ee°,, Fi � Gt Cc N ea •"' VI Ii ii ..0TO .O "IC C C C C/ ern '7 E urt: V ._ u ,fib 7 V VI u H > co u V E C ku 7 ill E tsE -07 > E- en yo ' yv uy u . ea •7, 0� C G aaai 6 e0 C o0 — is '7 u eu u eo C = G.a� C a . a•o_ y es — N ° .7'r to oap g •> '+_ tv 6' o' a fn "'•1 0 40 as.. ee C - r e'•' •^ L U T., E r, •_ p ea ,, •E •� > ea v u E � •— •,,, � C = o o 8 y � 8 u o y •y •p " ; " > % .X > g .. 3 •E S u 3 u u c eo v QO 2 e0 D oo U u 10 O u E— LIifflhi ni 0 - C C p O v C _ aS X • ..• ° ,7 N i• 3 = ° N 0 ° 7 re? •,�_-j, O .X eat u e ... ` C ,_ y 'C y g _ ,'a+ .e = C u 'c V. u . e tC • Eeade-- .. 63 � v' 6v > > g :oLiQ = G0 .t th . -' � ? � _ = p y = E = _ c E °v v, E . a illliluljilfli 33 u b oO a v C o o u u . an 3 f. ov t , '- a o 0 rr� 3 = -e a U E U u E ' • .0 B .x C aum r E Q P. �u .. ° J . ri =3 ea E o3 0. :. 2. v v2U F. AI N • u — o ._ v W C N C [ V E ° •E in L. C. In 0 E y 15 C .t E O — .. Q a) C C M EE C O 1 Q ... R f^ a = C: 1 V E E 7 6 Z E a o to re C ev C a, 4,1 vl E A o •v 2 CO: H h L C`w 'n '"'' ar �' A .. •V c '= .O . O O .. a 00 . > c 2 N E t s = e0 . O C 130— U �•�O . C 7 .c 7 ••"= p c 42 M.Con c Mg0o �:a s. 0p4 • .- op•r = u n i C CIG - a-0 EO V a- 0 9 1- 'fl H C U > Vt .a+ C.CZ O G c i COV U L C >,>, ip ta oA 4. . Ecy r. o cg a G a' acte r p Y L 0' U i o. g. 20. O G `p 8 _. C U C 09 .0— O C� L C r_ 0 ^� A o y .Nv. s ' H .0 `0 5 C t oos c c 3 p GL .� ao :: 0 Z c p .o ,�. .` Z = G u w ° aU -� `-' v > o �: c F. y c ou I, amp 61s '� u i 'E E $ `o ca ca..c v c £ E �•5 �. aCU -0 C G ) y C V •ad C 0 .C •0 W 0 c U N O O 1.. y C CA es - .+ •� .^. . ^ N C > a. in E •r N — 1 c C C 3 V t •$ O ' .o O ` .'. C IVo •~ u o = C A rL„ •L y .7rs >, p m •v >. E o = c V) a.) C w. E 3 <n C.•v e E s s C ^ . L c E as 3 0 Pt 3 C E •? V E e •a w p c c.E >, oN4 c s u > c v a' - P s 0.) a u E a E •9. 'E S u >. V A u .0� '2 = 3 ^0 A 7 > G $ •3 � � 0 � o oG � y c '8 .. c o rco0 � = c °� LI132 ' •v E u 4,0 rpp rQ `'5. p N rii c E vim_, es `� - .c •J 3 to is w u •`v c e 0 4 Y A 0 0 c 4.3, u E E a. o C_ .C P o a H •� o E- C. 61 C H `� u }� j 40 0 .71 u o e " ee pp t; In 4' � 'p Z.' 3 •C V 'r �_ 41%V u� C to. C 4. A. VI 6.CI y V •C ag u > C U �n C C 71 = C ill O O E.' 3 M „4 V' '. r E 3 .` 0 c_ p 0...— 1° c -C E, V `—C° g .U. SU U 0 ••C . .:, C V u G7r y "' C .Q. 4. K E a M a. a0 0) .fl j L `O 2 Z 00 .3 n• c0 C C v' �L C y U C ej N V oq= V .= O c E c E L Q w C uE ., O `'•- . Y u C .. O co io y 3' 0 0 0 .v, p V O tel v C V ..' t.. g a.•C U O a. t' `.s ., y ro V 3 3 c s •= V U a 6. a6; o .o L' A �' ?? c ° 1° _, i `o 3 A c4, a $,m `-� o LI € v � D = u 13o psooaai oci1 u0i E.-§ `o E v, r` e v c .. •a. 7 0 a V C v> >o Q r •R R. a (a ."" lit CJ -.E .E 5 G.x O. A.r 5 axi o t70III � � oco1.- EV3 EEC ma' s aa _ O ... � FA Y _ E V a) oe cn •e GO i. X W C eV O ea e v 7 E C O IC o E c e Q E u 4 a.. o a Y -0 N1 a w o AL, 2 .a U L u u 0 3 1... Z i• v E g c O w U 4 C u 0 u 7 u 0 c 0 .O a •c co so O •v CO ..,, c E g 0 •O C O A i a. -0 u u a`= eq a c1. C -0 GAO •C n '� t o c C F N f• d inTiCIis. Y as `u 0 C C.u O. • en •' Es t3 7cO �. C O t colr N � 04 C I- L .— O N n••- uCA L 'c s is '� < v R -a eyyrd ° ° o4. «6 > our,� y >, 0 0 N C 04!E .. V .1 N O 0 ? N S. C y u• o. > .7 ICeki y� C O 4, o i0 o c0 u Y _ C to a �^ a y 'Tr4 t '0 Y C E 4p O C •'C C A �j C to; ►Y. 00 > N vi •O J u Q 7 N N >' C •o u e _ `� aY G o S coQ•-otJL w oCa V 'r w a c o u `c' 2 = '� c% a a •° '`- c N c.0 .i'_'` Vi u � � c � °� `` O.u o c u y s S c m g p; c = v) °g e: - c _ ^ a L to ,o c , u OD c o L L •7 0 'c 7 • o .E ' -0 N u O u C v N es u L >,•— cv er o c E .c • o .L a �;= 3v u s u+ � s c U u �-' yw .o E-- �' Ezr ,. L C =° To - n c u a a_ = C is �«= u - o fib ' - a o 4- �- '0 �v oo y • N - � c ac, 'E -` o bU o 0. C. u c 15 c - 4> � c0004,44)• 3 01- LS c os = N . c � N .� o a c � �s •-'• `` 0 2.9 o s° N g CQ o " c u • o o. es E v - a Y ono c 31 0 s y o _e y� .0 �, C ,� '^ •C J E N 3 u C tE E C ' C 'C O •• y"• C C 1. c a �• J N v N d •2''. C v.u. t' C C '� O N •'7: U V 'N U .� 3 7 .fl 173 CO Y ^ 7 cs O v '� ^ .'_I t fl. 7 ' v U �j' 5-;6 •c g- 1 c C _ L C = •.s V C C .0 :, 0. A .A ca p, •p ) O Y C C a._ c 7 C .� O ° �_ .'Jr •C Y w C a A J 'U y M .c C E C E Y t L. C V "� N C 'N 4 'C C O N O u S C = u •C oc co to u 67 O U C N C i,•C O C C U N N Y O C U co y O G.'O ,� �' 17 O 0. V '0 _0 3 CA C > .y •t0 @ A a. y '0 O C N co u N o H •�, t C H .� u ▪ o v u o P •i7 c b C u v u 'N N u o g •.'3 4 e u g A . o e A e o •a o b A '= b u ac •g. a g 8 g - c u `° '_ v ..c o t> c u � 'C 4. c L is •-, a y = C O O N S� •+, E V u .7 4 �o '- o ..0 O L o-'u a 4., L V 0 ,C VI 16 •r •� y E •,, v c• =� h o. 0 C t E U = L w v _? '.. •o y `-' E o E t '� u o A u �° `o _ °v .2 L "Z ° a• 0 .5 b gvu^ s e•y o o E o .o = 'o .., o Hs .? A i 3 0 a c c ae E cE = a o ._ c cis coy � �? J $ °, Ev c u E o.: ob s u v: d aI ..E F- x x 0 O eV O N O O L V N v 10 km 8 t, C `c o < y T _ V O E N "'' O O a O U E. ¢i OY C -. -o >, ^ CC to q W Ml ors 3 Sis u U 9 y V L d VI E�i ',0:E4 e, ea V, E 13 L Z C A V V L N -, L CJI �: t . C O y h o •v 3 c 0' U « a. •:_ u •C a; � � T U vo fi y W 0 ° a c s 8to eOa ►' £ 0 CUv. O 0 Ch - -p A td '"co CA = a owu 0 c es 44U .8 a c ^ « � 2 E° c _ � c o >' �' ou = L 0 mto Syr E x . •a o c to U • t�, y• C C C L eeto C - u se oCI °• ° � ° ... � a ' y ° U 0 — ea • - c . . t � tit 4. V 440 . M L = IS C L O A 0.1a co C '0 2 O C Z 1. ,O 0 73' U E cr Leo o ea o . too c_ eil C^ u w CL Ci u c Li,' O Q'OC O d t r � � y w L. � €vi LLy ° L t L H r Vi •� (�"• 0 4i 14Oi1 LIih! Iih L 0 et I •Cal. I. •y ` N .:' 1- ee C ?,Q, ° v g °4 w t eQ t ` •a 4 0 •3 0 5- .E •v .5 ° ,r $ oo � 2 .- � , u g ^ eca .o E a °Ci ,, A' O 0 �o „ C 6 C •U r Sr, (". 7 v ... ›' U °YCsO 'U . Ch° '3c r � oe �•� y o 3 : • a o .0 n � 6 a0 1— cC U) Q) 0 Cu • • yl A U co� _. Fr U � Vi a 7 ° >c • cC . •—. ODeqOe H ✓ im Z c hi 0e.. G °E -. E aE .5. wc 0 .Ea .n -1 III N •v d ti G. 8yC E ii Cu °Fb 'O 'RLO �, V , ce i= 4, 90 > G U � , `esU ._.. tT0. ]. co Ue0 •C n to2 'c , c > to � Li. t+ v A Oy ' E C p c. O co OI d '0 .. L iN • dC Eto to C U Q C e.. .c 7 to 4, e L C c c E C C w t O Cw o-, . O_ L z at et ., nOD . E c C v, m :et.' ag r U L G Q 'L .. C e ' V ( ' (� = cca 7 `� U VVV 0 i 3 eyii j� . O °, �• g+ i,4) t Page 13 of 55 Submission of Invoice Vouchers: The LHJ shall submit correct monthly A 19-1 A invoice vouchers for amounts billable under this statement of work to DOH by the 25th of the following month or on a frequency no less often than quarterly. Other: Required activities,deliverables,and funding is for the entire project period:January 2021 through specified date above. Unspent funds and tasks not completed by December 31,2021,were reauthorized for work in this new consolidated contract term beginning January 1,2022. It is the LHJ's responsibility to assure that the unspent funding amount carried forward to this statement of work does not exceed the remaining available balance from the 2018-2021 contract. Exhibit A,Statement of Work Page 7 of 7 Contract Number CLH31013-Amendment 21 .. r 1 Q O O O O O O V y 0 •� vi CIG O N X f..1 ^ v 2 O O '0M en NI w C J .+, j II 1+1 a ... w 74. U A ,'b„ y O N N Y O Q C a' is A, .o -0 E •c E: Q aaI o roE �+ o. 5 c > O. o 1 E G Y ,� w u .-. Oo 0 0 0 0 0 QO rO •", O �.-, O. a �a = a e �' 'I h w w o C Z PO El N ° Y u �$ N, trinb u ie v ty C es _ 1. a w C (] •• C G t = co tr.. y !r �.•. y tom. ill U Q 0 v 'O Q U E U Y N — Cv 'AZ' $ 0000c a ci � n � �' aEi zY v v U e „c �p a y w y ,- ,. ue a s c6 0 e = .•C c.. 0 00 0 E u E n. H = -" `o . a .5 .E C .E c .5 c U v � Q = = w UQ 35 3 £ y � 3 � L F LL " —_ p Y o v O v ` �i Q frC y 0 u .� V 6, u •� k. u 7 Y .n s Y aui W W c C p .. 2SNI • O YL at Z.;.. U L Y 0 0 ❑❑ E G M oc v) v cc x m YTs > � C LC ct Y U 7 O I jidijj U Q I. •o L y Q OOOe a Is V u l .L Y end . . G. ' ' o`. . N '� Gtc O E- E. i .5 c .5 .__ C .5 c 43N ❑®❑ a mCtC.i ^ •o' 0 u 0 0 o u O I w oG 3 to 5 T 'S g' o 0 " .. Y Y Y Y V Y K E - Vu c) s Yo d anc4 n `) Cn CAC « U `� Ui �' o f o Q � z z 12‘) `� o J ? 9 �n M a, U a. ... h O.�LL ° • I N0 00 CYO" Lei °: x 0 c n. y O " Y .p f. UU aa. " cn a o c� �«. ?r. U .>L. d'CSi C 0 2aU o. 8 CA as .N C e J cn '� `° `n .«� v Ts — M .9 .0 i -o .E 'O a 'C '> m ►. ,„ o = v 3 2o -0 pw owO ow 3 v V N Q R, C a e C Y `� .D (I) N'd '-' C ._ u C O E :0 e 7 �. .0 es " O d . N V y. .2 0> Q a) % U Y — it s a a _ c ea o ` `0 w I. s, U � •a- NoG •� N u 0 0 Cr J 10/ e 'Si 7'" p. a co 0. VI �ar v v .0 O '0 •U V. vj X ` ti O 3 y 0 , Q e Q Q - O �'B a U w 3 0 Y e 7 :, OC H v Z E = C 0. " .O .0 o " C r. L. O E. E- O LT. C a �i: :e .Y = N v "y C E v d E iu Y a G y E o u . Q 2 u E a; E u o .E 'Fa' a, 3 `0 3Z v, c -? 7n .E E • (0� 3 Y aE, R t p V) T. .. Y O w C 'fl OZ 1. L. Y O 7 . = d Y af, . y a, iC O =. = c a a G. VJ f+ OL Q -• Q Or .a w N a` F `o0 U E u e N Y Q fv/.' 0`. it: 0 O. CC to 0 F. ...r N L. _ O o N E c e E u n . C 7 u .n E O O Vi. C 1 sL E QF._ r c o c � c `cc c c t Q 0 0 , c c c c . c o y, y° N .O C .� - -�ri r. • p .'i•i ' ^.i r, : - C 0 . '0 N +� +. -- �C ? Co r., b 'n e0dA L9 <+9 ai9 a� 0 '.�". to; V900.3toe) tot V - to 0 •_ 3 3 u c) Vu v V u u v v u u u 1 .0 P. U 'o w ai a) v u v u ai u C) u = v == 9 u 9 s 0 ca e.do a� aJo a.0 a.0 a� a� g..0 K7E a� a� 25.^ &Z E - V: E co) E co: 0 v1 L V: E .•I) E col E h E V)ro 0 :A E V] i V1 "2 VI A r 0 co U 0 0 O � Q ❑ � 0 0 = Ola OA �A °qG7 O0 Om 337) to �� a e0 E i� fn a a M o. y } H N y fA to G •= O ea .E C .= C .0 C .E E .E C .E a .E a .E c .e C C .. .E C .E C C = ,), 7 U C u V V V V V u V u 4) u V '-L C , of. iv cE of � E of of cE cE cE of of of cE •o C .0 .= .0 3 - •= .0 •= .o •= - '= .0 '7 ._ '7 .o ? .0 •_ '= .0 •7 0 jic V u u V $ u a u v uu a y Q y c u us u o V u y u v 0, 04 :i) O4 v) W v: 04 v) 04 CA a LA a: an ce an a: v: 04 v) = oC v) oC ai y y es 0U o4 o U C) C) 0 4 U 0 u •- '0 4, v u V 'U V 'y4 L • .Y a) C) V V a_4 F. ) u V y d U v u 0 o c. V C O. am a G. &� Q3 a� Q� p,�y a� p,� 6.Op a o ►. an ►•, V: .. !A E V: E ✓) v) E an v) .10.. J1 $ v) V ✓) E N $ u V 1.) u V V V V u V V co u v: 3 d o $v co 00 oz oz o Ea c0 0 ,- c ppC o0 a ..1 i .= C .0 .= C .E C .E C E C .. C .= C •C C .= C •E C .0 E .E C = an C) co ai • V • V u • u V • u • u u V V u oE 0E oEE) o0E) Ow) oaf, of of of of of of of 3= - 0 .7 U . '7 V . Ti h L U . V U . ►' V V . S) .1 y v. :: 'i C ,0 •7 V .c . '7 .0 U . .0 7 .0 7 .0 '0 .0 0 .0 0 .0 'a .0 l0 .0 1 0 p' u Cr u 0 y Cr y Cr y V Q' y C 0 C• V a L. yy Q' u - N e) V u 6) V u 6) u aj 0 V 4 u V 0 V 0 u 0 V u N V u u C -d u v) 04 :A 04 v) 04 v) 04 v) v) 0G v) 04 vo 04 at) = v) 04 v) 04 an 04 IY o a- o c h 3 1/3 = $ y q u C - eo `p £ I 4.o. i0 C es V C i u `.. E �' �) u `'_ ot1 0 x 4 :2 A •� V) Ow - • 1 = ° = 04. c .y 0 = > <a Ilk 8 Lai. cd r 1 h , rn e = v .ca fl u l o u a, 'v • .n flhiii ! H p U ' y v av) y V 'c w 0 '2 4 C o V Uv' C a e E CC {1 d 3 2 c C ,° u e . C y •a C C) o o ,o' Q 0. � u o a E a� uJ ° . V .o `A o u c E w g e w 1 �; E a > � . y5 q � I � � a � a, = A � m A � Uo oa d $ at " = y V a tau 2 1 ° e E . 2 1 2 ea I 1 a � •- u $ Q e - V 04 0 w � A y $ e a,v c � 4, , io " 'y am a E ° I'• I 7 `A o u 04a c o 1 .E. 0 - Q `A 2.-c ' `° . o � 0 3 e .y 2 . 41 E •5 �•E '� E .. .� a_ U '>> 1Y . el TO are $•� e Q f 'a •a 3 aa)) .. U Z N i O _ 8'. -• A u eD = U c) p 'E ad u -' r J « E v 04 W C 4 y V c Z U CA �e in a=a�� Q e CA E v) V V y .A OS• ,, to U Q " H Z H IliUhi = hi1ill = > $ 3 U ._ r..•> I U EaEi aT Q Q I it Q `-, $1 .1 a` i l I .� .o E 1 a 1 h a N a•- :A e• n N 15 y y yI T0., y :: �. y, e -0 v) L v A Leal ° Liz u m = P. la' u a er a E $ E E .. ti E 'Ti" Eg. o a rs w. •5 Z ' Q LC .0 w 1 7 CA •E V u V C V a o d 3 y3rN - o v? 'a l h3 _ ''' u 3 V F ai F u F •= v a = e o 3 O W r = 3 v u c W u a) V OC W a: ✓) 04 04 $ 3 o i W 'o 'S C . e 42 Z .2 • w _C '`v L4 7 e Z • v E E u ;t o o O V ..Z. 8.8 C O . O V C Q L` `3 u Z �i . as .i Z V Z 1.i ° o ev . _ H� . t= U U a= U � U v = - t° .= O` u ' Z,' e = L u o 30 •o a". 7.'5 g 2 3 a+ U 'X- _ -- _ _ 'u = - _ _ 'u e - E 0. io Cv) � a Q ;r ;, cUo7- 4uaag. ;s a, 1L _ e. c au a aue a ': e � � .. n U I W I �. .0 w Gz. Cr. a' ` ra7 U 04 Q .to W v) w rt W J W W 0 .. W v) a ,� o. u VI a = e `A w F'• v'.. so n co Q, C _ `+; e• C a K Sw wH' L4 7 N y 9 7 C C > °' 0 c v E °' -5 E u E ,2 O 7 O V > • -to g0 C e, e CO4.1 3U° � •= °tee o = . v >, c � � y u o o p, OD •-�_. a .fin ... .c ea u 7 u y a. U a � •G9 . $ . K a o v d - a e-0a a oq o w V C C N .CI D u A X .a .La e V u c o ) ..a C.A. O A .. 9 c r e) ea u y u s C c . 3 u a ' N a; • .c C3 a e`3 E a V1 U O ' u w ►. ^I F" 4- e�a c c ea a u u 3 u ea = c f l L > V I•V 7 � V T t N �0 V 0 CO u w 7 e y A ' '� °•.b w e,in o eE ... a `° E A 03 U u - N %: c c u C V V O c h E _3 Q '_ 5 ca C 'rr c 0 w O C O x > O >+ e E v' � a) U U '0 U Y * V y •O C •.e a• oo •> v 4a. N Q '� e , c swp ''�3 o 'o •C = 'c G7 04 c Cd l6 7 Z C .4 N a' IC E caNY = g v 3e 2z 10 a °B pa _ 2 0 0D- w u ea 0. N 0 0 •-, v: u C � u =� i -' a eei u u .c A O 121,) E G t V RR ='F.. V .0 eea N e.... C eV' t w a s •...• O V O 'a > .9 C a � �i• N 'O a .0 H 'C r7f .� • N u c red '?1'J CP V- eG N E =celN �'• +J•• E R. ` G. .� O •••,jJj t 1:I to �i 0 0 U 61 i0 0 v -.. •uC a•ea .o 0 ° y is ,p >, t i VI 0 00 (-? ld ea 3.3 Q•= Q '> ... 40 L. 7 0 V N C V a L• o s o N �- o 0 �' p- a CQ -o M — "� O < � � Lc. a A -r C7 0 g e9 7• so c e. j x 0.0 O 7 -- V G S V v� , 0 L M• O. 7 • N N •v it 1::*- >,I:: (e : 0 U ;A; O,ow G 4)= rn ^ i ea ° ff. ut:" 57 c a ae' u > : a o a c L : .0 CI ass u03 2 E � � YU e • e Ges u ? y c otc w $>, - 8c >o , u,t e ° ` c.°. 3 �. Ori a � ' c a I I 0 CA .) O u 3 >•.p . e. ea d. 1, Nuv " E .-� C ,2 a v, e. e • t E o • • € L c $ 3 N rn •C N v• C V y 7 e7 C /1 N C. .� .V eJ N C N I\ Q �S N o 6. 'n �OA N C .c .E T Q 41) c ` N'a a v) ..— �• c ate, y fl as w ° 7 s. ``- E N .c Q w 0 Y Q Q Y c E c •.. o c•_ rQ o ++ — Yea c vw o ^ a 0 > r > c V 0 .e c 'a a d C 'a '- . E U >. >, C ea c n 4. . E ,_,i ,o ea e• t o r ea e, « a >1 ea ag 6 e Q ° a, pp 48 c ' , c0., cl t� 0 o E yG v a . v a C0 0 c�iT .Nn 43 3 C o G ?� v = c a 3 id 'E ea p ea i 3 y .32 7 y y T. v G, N « -' 2 ` } C •r =• 'C y y Z N .y E = [z. c J Qr 4-' ° G '` c y 7 �- 7 a y .r' N 0 ' . 0 IA a3 U 'C E V) •0 E 06 y .� 44 v G7 n... v C �" +•. ca y T '� 7 O i eui .... c,.= H .! 0 `O O n C. .r7 T O s C E N N mi ,bQ « ..N.. tu ire�a+ •N (i. H N •° N •� N e Ci y fl '� 0 C N C Ir G " e .' .y E N :r.... .. ^! 7 Yj - m c gyp. N .0 � a, f/) C .�•. M W y -. � .°i S • L d .T] u 6 F .= -c'er -L� t, = 2 E 4- w C ei o m •, e. — w , i e o0 I ii. C 0 Qa c .•. 0•u02 v) = a •� e=°a •u , •c = z _ o o c ea taac $ e>' � s T v Q Jt _aPro ° �+ a o d y 0 0 LpL O ~ a E s C a 7 C es y e" " ♦r e, 7 I C G V) V) 7es c u u e°'`a c e e�' ¢ u w v u ! o u aa.. CT. 0 cn c'• e O c F .> N Do y, to _. 0 L R �0 = u 5- u t oL Lc. v u c c C — Ea. 7 El ee Co �, `� �, C' • C '^ •O 'fl u E �' V u vi 7 N , end N ea 7 E E > •u — �•,j u°. ✓) c. ea -o W) 0 aooy o o`o Qa 1- w >. CU 4'n' a ci°i O u N e v E Lo a) E a e1 as a o —I en aa) E a Z U co C O U co g a od 0 G V a, V 4-• N 0 he ii id Si o I, C u s ii E kli IA c, _V O eO c a, y a a *4 co) u, ii G. I a H y F- x cn v) > c J ,M •v— a, ^ 1 1 1 1 1 1 1 �?..` a O ee V •c a 0 s < v '7 oa.2 e e e e e e e xi '— 3 Z 'g - Y > E o s n u C 7 V e e e % .O O O O o O O C ... a .. e0 to C ^ >�'g as a'�y� e . �e m is w m �v E °' O a' a� E = Eo c_ 3 e s _ .% p`, •� fs. E G. E .w •w .w .y 'v 'H A. 3 a) :: '- y ' C eCa 00 `J o; v-� C' •> . C C rn C ;a _S ta4 O4 Q. U 5 pp E > > V, ° ea o v as u u 4) H G e u o�j = v •� W 'o '� a t7 •� 04 « ° 3 D E �° E �' E ° r 0 E ev ev `� = $ �i'm x .. 5. a . _ E �; . o .. K G ° E o .o E la , 4 Cu' N u 0 ZA. o ? •= e o u u s E = a U E " 3 -0 • -r 3 -- E ... u_ c.: t) tz: Vas W F•. U � f� L1fsC] C1f� cc.1Ci. cL vnvnFF- en0Nd -1 U < P' -1 .I o..: E r. CV) v) V) v) rnrnVnV) V) 40V) v) v) v) cnv) enenanv) V) V) V) V) ) V) VncnencnC/) U) ) v4 _ _ _ _ _ = Z = _ _ _ E x E _ _ = Z Z = S x = = Z = _ = Z = X eu I f r 4. ,°, ''ao waaaaw � a � aaaaaaa. n. an. W. W. U. aaaaaaD. W. aac e ^ e o � W .. .. wwwce. cL czrs. a. wwwwwwwwcJ. cJ. cLrs. wwwwwwc�. ce cc. c,. ww •; cz p, O fJ tr1 V O n O — VI CV v1 VD r 00 C O N M er Q et Q ' V1 V`. V; in %C f� oe C C I. 'l. "I. V V: A C N N N N ri rl rJ N N -S et et et � ^ = i � 1 LaJ Page 18 of 55 Activity Special Instructions: Investments to Each LHJ: 1. FPHS Funds to Each LHJ These funds are allocated to be used to provide any programs and services within all of the FPHS Definitions.Each LHJ is empowered to prioritize where and how to use these funds to maximize equitable,effective and efficient delivery of FPHS to every community in Washington. Use BARS expenditure codes from the list above that most closely align with expenditure made. Targeted Investments to Each LHJ: 2. Assessment Reinforcing Capacity(FPHS definition G.2) Support LI IJ assessment capacity with flexible funds to meet locally identified needs.BARS expenditure codes: 562.10 or II 3. Assessment—CHA/CHIP(FPHS definitions G.3) Support any Cl-IA/CHIP activity or service(e.g.,data analysis,focus groups,report writing,process facilitation)and may be used to contract with other agencies for staff time or services. Use BARS expenditure codes: 562.11 4. Lifecourse-NEW SFY 24 Full Lifecourse Workforce Capacity(FPHS definitions D,E,F) Infrastructure and workforce investments to each LHJ to meet fundamental needs in three areas:Maternal/Child/Family Health; Access/Linkage with Medical,Oral and Behavioral Health Services; and Chronic Disease,Injury and Violence Prevention. Use BARS expenditure codes:562.60, 562.70,and/or 562.80 5. CD-NEW SFY 24 Immunization Outreach,Education& Response(FPHS definition C.3) Promote immunization education and use of the statewide immunization registry through evidence-based strategies. Funding can also be used to support vaccine- preventable disease response.BARS expenditure codes: 562.21 and/or 562.27 6. EPII-NEW SFY 24 Fully fund Environmental Public Health Policy&Leadership Capacity(FPHS definitions B.2,A.C,J.1-3,K.1-2,L.1) These funds are to be used for staffing costs for environmental health responsibilities and functions(that are not directly fee-based)within leadership,policy development, foundational public health services implementation,evaluation,or administration, including(but not limited to)Environmental Health Directors.Examples of funded roles include work relating to general policy,statewide and/or system-wide.and/or cross jurisdictional work,legislation,and rulemaking,SBOH engagement,leadership support and/or development,workforce development,leadership within health equity,climate,and environmental justice.Use BARS expenditure codes:562.14,562.40— 562.53 7. FC-NEW SFY 24 Strengthening Local Finance Capacity(FPHS definitions L.2-4,L.6,L.8) Capacity and infrastructure to assure fiscal management and contract and procurement policies and procedures are effectively implemented to support programs and services. Use BARS expenditure codes:562.16 8. FC-NEW SFY 24 Public Health Communications(FPHS definitions 1.1-2) Capacity to enhance the frequency,accuracy,and accessibility of public health communications to diverse populations via various media to support programs and services.Use BARS expenditure codes: 562.13 9. Lifecourse-NEW SFY 24 Illicit Substance Use and Overdose Response(FPHS definitions D.1-2,D.4,F.1-3,G.1-3,1.1-2,J.1-J.3,K.1-2) Capacity and infrastructure related to addressing overdose crisis. This includes but is not limited to:Overdose response trainings,convening stakeholders or coordination groups.data analysis,and community education. Use BARS expenditure codes:562.13,562.14.562.15,562.60, 562.70,562.80 Exhibit A,Statement of Work Page 5 of 7 Contract Number CLH31013-Amendment 21 co CO O C u 0 N a — e ti o y y J? C c v E C V a '0 C V le V ° cif) e ,A u v ^ . c y •v rn c� y y a= o y= ° y F a� v = '^ V 0 y E V e 1 V 8 .0 V 0 Q. "r. F.`° o 3 s G V '� s en O GE 0 3 •y U G aMi U v ICJ .� V a.m s us C s W 0 x H U 'S y �L V1 = ^ V to > L y F a o` .c 'E ▪ ea > E co 3 y = = v e' z ,' u c b u .a•g .e v 'c. CI a •U 'FA•CvC P y E C eaea C d .� y OYO td y .a E y • O� y jL b 3 ea a 'O E E 7 C H p m el o ui. c aet. 00 V G. V .`°J k u • Cl. `� o u 7.1 o � y6. oUy V ° � a V v En y O 0 Y u u Y O C w t U E. c e eLy. � � y n •o Cv Is.. 8 le ` ...1 e c L r , W -0 C § Y C 0. >, N y q O . O1:1. pup is c c.; O u r i. U V_ U O C ‘71 U C.) U LI._ u0. E u e V e r, a . ea V a t'>, a _ S Cain coo `o � 3 �' r' •cL c o Uv et Ev .. m " t, y V y p"p pp `� es 0. `u C E p �, t e G •u H ?- Ll 0 = o v 0 a � = C c = •0 � y 5 `u' d 5c so V Ea o pvvc c g, a 3 4 :on V O L y V 'C N as.* C � • L O `' r` s $ °' ea d' Y a a•° - E ° a " ate, a o y _ co w 0. .` b 'i Cf ug ,. y p e w = .'� `1 `y' e.E. , Ban, ^ oy -' o p u .� H y v _ �i� � o g�, C u y ••UG. , € 3 .E a, t .) `c n = c `c; u E E U u u a ..+ :, ouo 3 » U y U u -o a 'u �.- o c °u a id.ER C. c > E E n.RI 8. ee°i ▪ et e L C ayi w a �_ eo O = n a.. E— I 0 as d O c a. O Ic G O Li- y c • y v .p F' > y tr. « •� Y •. y u v a. r n.e0 c O e3. e U C c.ec u . V a d - 2 g .� eV '=An 2 u g O' I.T. a- - I O eC y u EA I > J1 C. -- y Q ,o 0. eta cea E .0 e e `ed — i w c s 0. o• `� ° es u q E c [z. 1•- w o r u '� E ..yam u = �. •e a �. t z d u N ` 2 rn E yo115 u M rb E.., E u R x o0 •v • c. ccd ,No ` I LIi p,b u `cr' - c v u = > s F ` `u e y 6. O g O �+ C! r .'� �' fA p .E tat 7 p w o .V to y s y ea L n. p C e.°r 0 � v • °, ° C y •— N Lj .No c . 2 Ea o en t- E U c o a „us h $ a E ° 0 .- . v — y v c � � ,a� a ea o e z = o 3 a S _ W E .�, E u 3 C. y = talc E u Y ` "� u = o yo Q e a >• = ^ c ° P r4 C=. 0 ,u„ E a is > ,c W e IX v v; yen 2 E _ u ;; *' u •o . vi c e '�, c e ° E y w >� u y y Ev y O a 2, H E ye O _ o E O N x S u el '° ma y •= = aEa 1 `" V V V 5 y ° aayaaaa E u� . E 6. y ;n a e I, e > eta ell y U _U y e 0 u T. C a� n y C a O CA y V: E _ .. o exi a e>4 F+ �" d V 'u en is OL ead y .d e G F �b �r on e a H N ..,...c a V Q ` O ` V Y G b X d ail V (i `Y >, v d 4. E w 3 -a z I •= � 9d �. o � ° i� wu ._ » E E y ' ors _o W 1° q e• c q a+ W e t u '8 u d V o c E y 3 'c y vei S E Z •v ai �`•a E E u E Z u a� c y 0° rti=. t e u alai ^ y �; >' '" Z c. ° E :] E Z. u u ao e`d en u �+ e 'v ai en w y ~ .E :? F W E ea £ F- 3 E ea e- u �S �+ F w E °' Cg a > a+ 0 = `r > 'E � .^ u -= V E Q •-'w i Le y E v u E L u y o o. as V y V - F. e 8 c E. ° c SZ V d > O O .c >,— u is ° es L Y O V1 wV ea .O < - W •y _ � u J W E -o as CC y .5 V 3 I- en (.) -.732en c V w E < u • o a, _ — e'i 3 8 ft w 1 1 z v en i. O. 0. X W "7 kJ :7 ec • i y Cl)c el N �. V yM y a ° ° s E c u V s y " L V • a m o pq S+ .o e A c c 1 Q = >p a c) a E �; c a•c 0 0 o c R o V V � 0 3 �.� V a � • _ > Lam, et? N to v O > > .3 r- v' 1.5 G. y u Z y E 0> ! a `� o 0 o =� ul ` f w o a O E c 5 u G _ U Q co C1. :se' c c V 0 v O C a) 0 to a°i C `r E .c '$ v c .. s v o .E o E u ._ e y o C. 0 E $ u c s S a =s u E c o Z pUO g'' C .= V ISO V C. •I)vit 3 v u et "0 a il "0 a V c.93 _ Q IS 'o $ u 3 a vs >, , E :: E c� a, c 'U y E a an a ° `� e c - E e U u N a C.I. O a '^ J w 'J C ` U u E- U. s•^+ ed v V .§ U o g U `�° IA y 0 U y o. e �' 3 V o y y >, d 0 0 V J v E U E O V _g =) s S V 4: Ll. U '*0�y. U .o II) = U U. F- A U a C C!em s' U E L 0 E •0 a •c •r. ... v OD a) 8 c n sill 2 v •v s Ts. A •v QoI. es y lV a. 0 31 V C- y V ; _e = L en in 0 C n. 0 '° E 2 c " a in o " ._ ki y > 3 a v 66 � � y ••U ) g V N C. 2 P.' =0 V 0.1L ea V t a ba V s co ° O V ti 'fl E so c. O to - y V ,, a = c es..5 w V a c 0 V inE 3 R a 0 L y E u E76_ es Con y v `Si X C Sr' V 4 W E 9 ..r �� = V U G Er �5 � � � � s3 a a � F" c tsE ° off = 3 - s .. _ u � e -�`- a o E o U. .r E o a oS 2 H Lv 3 "u 0 .°C, v o f •= N = 'O .) C.i •� A E U _ 4'•b .E eC O V c CO• V M , >.O co ° c� = y o • ff •U e c c v pC V y esta ,4 v et o v o a 'Yi. ,c) v: u su. rn 3 aCi n' �;cc a. puq;a eNi eJ p u - v G E 4, ce £ 3 ? 0. a o x _ v E u a _ .= 3 E .5 as a) y fi ;U 9 C � G bi) = 0 a E A "to 0. E •_ =o r C d y s -co, 'O C V C SS ii = co cLi i= a Q t c aZ. i6 ° _ G �! vo y E E E a u e � y a) u E i° V ° u 7 `—° W ca ') c. g- o a a+ a y o = E o > a, . ;, V E > y u `o .. a x a � cc uV os U v �v V F � v �v e .� �v E V 7 cce y A 0:1 u ti U OG Y� C Cl) > Q y c = U =_ _ e cr.. eei ^ = e Y a) er V u 0 V I,: ' to e=a E � sr. y I V c cc I O X I • % I s o , . V y = ti - L y u c e r E o a) `° u E 3 E V as E as E v 3 y �j - c :o x 3 V ° y �) 2 a E V .c .= t/) x E p a ._ V) a v; a E 1) c.. a e E T v� Y ar ea a co -, a) . a) V a 7 y e... y V k e u x to a) U U y O OC [.., d Q, F .< r, er F .0 oL o V . = y v y a W L "J t•" y to < V (- 4e t..., a d F a a V y _ F = V �i E •V+ E V e �. V C G1' v V V.1:3 s. ° m U V CO L V m N le E E a") > o o 0 t y N c < D - s , ys tO= LI sJ ysD 7) 0 x .5 U 3 r • • • • • • ' �; F a co a • :J F • r • F • W F • a 1 W 43 M ... O N N ems-•. O n p O .5 N O Y u t C 4'1 00 OO n — '7 ... N eV am = C n o . .O o O C ; = ' y u es .ea� 6.40 M pp7 u N M .� C Y O yC E G 7 C Vi p C C o e E d a c = o eo �a = " E L Y U x s `E E ` F' 4.. a N e Ydy',,�.�p��i.���7. .0 u .e pp� Ime C X 'fl E Ar c p e PILY❑ f Q ip. N + 0 0 0 Co F O N Y v 0 •C a .; — a V Z - ea v L a tit o e c.: a E a c o >. `yg' ..; U a E u � Vc «�atea to - _ es t < e 1 € a a aw ` a •E 'r� cu u O I.I. ai l- '- E E p � a J ° 0 u '7 C E N esh .0 �"er 0 0 0 a In Z ea a u eC c o f ... -0 = t-O�•D.. e t /. C u C C i. . N M O U w C E G ��' . 9, '= p. cop tu E Y = r 's E N G u J as < 2 a . U y p °° 1`. o :a '1- N Ci co ot 0 s. leA wa: so x u ; N '- v t� CF t. JD LL .V�®❑ 'fl 0' .� -5 O N N N N N N d � v' C � 0 G o000 > a <e E R r: r en r: N "- a=1 CI e4 O O r = GNI 0 0 4 ea t N a = 'u .- V o. ... C « C a N N N N N m ta V V e�0 ,a u ` O p 7 Q Q Q ti I 0 •rC O 01 ▪ 3 � y+ a --. 0000 2 O J) O E -p le ... �p O u ` Y WI) u u •E U e d v a _ A o N g3 a -c u •• `� = r E 0 b .$ o Cwen5 Z n L r " . d a"joo`. a. C. C' U • o u N (i®❑❑ _ = .> C u .3 22 V 'VO 0,. 0:T 0: 0,...C` OM• C ux 3 0 V ` �+ d, Q Cif 0 MMMMM O N ev V e N U Cl) e0 0. el 0 W V AM••. M e•: en een v 0 oUio c.. +- 0 'C R p . .C.16 •'p O p pp v I. G.-� d d v d '� N V1 M C V i x (-J y pp . _ RpCet {Q 4. 4. a M E * O M r1 M r1 M C U = CA e �' cU �C .� Z o• o o o' er M E ° C CO) „" Q v.. . 0.0 fb eO ` r « O C Ts. L. NN N N N C U U O C - 7 dy _ _ _ tin on Vu e . O C ` • * 00 — OOC N Y0 O p O 00 exi 00 0' i is L1. • 8. Jot 0 — 0 0 = .C —_ 0 e O V °'o 3 v u ° ``" = 0 a a . O U • ' � `n o • ✓� c N 3N 3 � � Ca ea U LCU t O = 0 ` ON 3N 40 P. O • y V i N V N ♦, to 00 to cv y �, N Sa = c E' �+ CFiU a U �� a o E �'- It N �_ •C h C as Q C Q 4 e- 'E m E '�• N C. .'J C •a- uL. .. g cc ad =n O. F. Fr U a q., °" V Y Y Ems- 0 - = 1. H .�°t. V 0400 < = `u' s V .0 CL O in aN Q C p� U V UU Oa 7 z 7 .. N C R E"' .Z Ct. '.T. rZ .:''. C E r: 6 f6.6. 0' 6 :E ? a 0 .] ...1 a No u o U = u 61 L. o eaQ 01 UC7Cp7qa00o =to yN No a E = C. 2 ` E O RZTT2 b Ts (NI NNE �, e• 'v> ea se, L IA V U O 4 Z •> E L E N N V .3 O D U U U N y v o g v eN Q Ci22 ;F2 y u � E E O fC t . 1-4 Q jj 'ti rY. p 3 C. Gs. . u a' F O Y = 4O''. F C 2 V N M N en E C O 0 O a �^ '7" O E y Y •y 17 t 'a.- N N N N N F a' 8 • u ° •�► u Ora' p wwck; kw. G}r. F Fes- " t k • C. cn a CC a Z re _ w $ IN Op .4%. e i. a+ .3. 0 ;j = 75 o p r "g E a7 _ O v v a.- e0 'p� O ^_ '? O :I C O .S. �' d U y O L E ea «. 4Y' G. C N i q etOlc CA tE E`j C X ^ 'O O = 1 a. E• E c $ 2 0 c e�` cd a. v v Z ea ea enE = � «a A. en � ' C E � ve6 11 � uu U a ..A. Q V: oG m ex u .G 2 a in S' 2 E 7 N >' Z N •O 0 .41 V N ad en Lea0 N g a s G 0 0 C 0 O 1 N O^1 a O C. eql O CI cm. N N N N N ^4 C. N N U 7 a NVI yyy( O+ N 00 N N h ^'n NON y u O O Q▪ .� N N L. N 04 cyi ^ N N D74 a N y 6. ct — s N 0. Ca v U v , ' y aaa v A \ c G. C _ (.4 >x x Ci =CI ti X co a co A ►►C OHO 0p =CO L Go x. ` O rpZ <v U `cc 0 Uc U o 0 U `o 2 V c '� z Q 0 0 a, E g � E E g � E z O o = o s "S. s Q o E 'C C C�'' C"per'-' 0 .0 C�'' G .~. t Cc ad, o d o '� ,g v O 7 8 c V O 7 cp, 4 J O i et t L 44 `' ..... ''al V N y — J • No 0 C3C . CS v L Lam,. p�p y •U Zi 1 5 • 01 al — Q• 3O o°'.og y0 on ' 0C ` ^ 3 O o = ▪ C to 6. ._ 0 0 W co 0 YE.Si '; N > •,' •x u X x g o o J ` d x >, `w 0 L.0 >. o°a es a. To 5 rz ° ppC� oo a, ,� a, �, o U o aco tio ` r cg on ,� � ° (..) E 2O E0 U@ .0 c• o � ,c C. � � E � E V ° E °cb'▪ •E o°'n •E c�O' E to o E •E to a • o°'o _ `' o b .E .E in .0 '0 .0 0 .0 'd .0 'O . c . "O .t; ..p '4 y C .7 0 .0 0 .7 0 V 77 = 0 > > 7 = 70 7 7 C .Z` 7 0 77 0 0 E v. Co v) v v) CO va M t/) o Cl) CO h 00 Co c, v .. Cl) U v) 0 Cl) v _ = EOA I E -c o O o ._ .9 O R .EI.. d '5 -X ' •C 0 '(n 'C h C v G. V I .-r $ 2 N 7 a K. M C C m �_ N YN O YN .G H 0 b _ ; x ~ V w 0 U 4.- ON 0M ON O . . o4'1 QN 2 50 2 C7 3o Eo 0 � N L E � ? c v Cl F. c M CO LM KN .o UM . N 'C N --1 Cl C • 0 X O e) !; y - S op y H O t., t oL. N .� O N .0+ i, 7 u M U 'O .0 :J M ;Al a v -C ` e►. u M e... 4.3 �r 7 7 "y - O a N O a s 0 co E $ _ Q� E 6. C) S C Q O ; I. c, ;, . L W � yE N yE �? C? d w '� CD a w m �° J C c E °3 0it r � h � � � y• = d Vt h O 'fl 2M O 'O 8° ob 3_ rob ?_ moo Li Leo s _▪ z_ 9s 4 0 > a 73 -0 • 7p p 7 O 7p is �3 O O y p E M N E C 2 z 7 Z Y ,0 Z n. M E o. p v el o = :3 v .5 a o c -o ai a= C o k-t a � .y.; 0 e o CL ° X N N N eC X N X N N 1n a X M y H y , e'.1 v C)` Q J x Cl C ivta FA NO s AC m0 NC aao z . 3C ^ O y s• 'r. 8 N � '.' O 0 N N M N E N ^�1 + H C > -1 0 W .> LQI . 7 O 7 O y -. O y 2 U O N ._ U — U N ._ , V y y --: e• --. Q j C C`1 p •,� = E O to e6 .a a r. 'fl CI a. 7 C. L. 'V (0 y Z `C v L. Z. L. 0 a0 a. I. M 00 . aE t E ° u .b a, r E ° u41 r a, _ t o � � ` c - X = ° � = X = u 0 0 070 7 O y � TD Q .D i ,.. 0 0 y .p « 6, N a A t v w e ti a, a, o a, v y 0 o, c, 0L. d V . a, E 0 - z a E oGv) Q0 aoG0 oGv: 00 a:C0 � v`) 0C 40 a.y E a+ o 0 N oG Ga :: d Q co «. a. a_ A v — on — _ £ E r .0 N O 0 a+ E in elJ Q� y NO o t° $ R M7 I' E N .C. L V: L _ M c O w C ? tEp y 7 a+ 7 11) i. eel I. 04 = o.° U cn CC m ` E 7 en er N N u N N rj d N M N 0• •p en(NI e.; NJ' N cNIsp N ee enb co N O M N N 0.. en N 0 0 N O N N N N N N N et N N C C W. ^NNONMMM O � yr E �j'N viviNNON � � � O ^ E '='; ^ viNNCN � et � 0 d d v'iNON NN N 7 L ,. ^N ONNNN 7 CO M wNON NNN 0 E , ^ NNNO � ti re E. wl ,_ H NOOC ^ woo..E. a. r' �• � NN 0G5 CI .0u h N 7 v .D u h N N N 7 ell N E ' �.e — = in N Ems, `;� E � E r s ='' � � '! ..., EQ � E E c � `°�t _= - H 7 a� C u to 7 y u V E G to C >' y R C y y p g� y A •G• s c . S e C °- o N y a..ci C E>' o ❑ -. u. QoC -7, .7, < cn ni. tnV ZC� ., u. .t ¢ .f -7. -, 000w4.. on ZCZ ., u. 2 < .t ., .,, 2 Sc u . r 3 _ 0 :esO N 3 . O v O c u L. u T ❑ U E ?' o .c = 7 "E -= I. 0 O .0 o c wc3 oE O a e o 12 V a ty� t C i v >, m u y 4 E ? to 9r O ° 'S— O t . O 2 w C. G c,s p U tv •v * E7 as —'' E E E ate. ' 00 E .a + i. E E E . m c 7 C n = C a 0 Al v 0 V) u V) E V) u VI, MI ❑ ❑ .E • a o., u O E os ❑t e) Ep > Co ° 0) x w. 0 M p ' �2; E u3 oC . o ,a O 2 eo 7 N > ....s CQ, 3 (42 O. C N $ C 0 A 0 U 0 oo 7 co X t 0 u e02 't. er w � a= > ` P ` — Q O yP. 72 V Y a o C� el a, 0 C? n t_, E - ,« tj F V. a O 4 - o F. co > a, v, C U v 7 = Us h °g .9. s CO MD � ' E<le -7 ❑ O o :° U •C Y M � • 3 �N, NaC. 3Q 3 o. C ; es' N a) cua s m 0 N 0 N C a ° ai a 3 ai.. � y C = E O to' b O o 'E € oa ea N IIOG a Pal a to ri) ❑ 0 a.+ .0 E" N eVN N N K W s N 9. iS T3 caa cc Ec S c u e = c = ea c o Ismw � E c. c E iV Nd.� aJr7 eoen y .7 E S pa .>_ � o �' R L O C S m a. I 4 E15 yco = c U u a 7 2 w3 aai E z a+ N NN ry ^� T 1• ^ ^� n ^. N FC a i N OO 4.4 CryCN � NOti• 1 OC OQONy NC N0 0 y a � .... w eM eINI (VN � G ^+ � � hN Q ^e ^Irrvee4 � NON ea y y � � � ` Uj^� N ^`_eNh y `� ? y � a ice ~ ri ^1NP. . L enN N t0 .0 F` E E � E E 'fi '' + � � h E Q1 EA E ? S _� � � � %i fi ^,yam >,^ c av o " c c Q, k ��, �cy1zH c ° y ta = .o a � �• fi ; ro r. eat+ -0 E CI) �950 .z4 '� � z T � ' QSiOCCP, C% 4 :z4U. � c{ » -`rc74 = Q = o °u 4o u 0 0 0 7.1 3 inN El V C �' i S. v v • O Z Q u ` ° fio 2 Q oo x �, U o scil U fi ° rn « "0 25 a i s c o 3 ai a o ° c = = . ay' Q. a ,. z :a - , 'C E d , v e°o u v v u w ea Cv m C a a•-, 3 ed C O. c is � � �‘ .Z G L. E .G O •it E i o. ° IS Le pp g 8 N y . 4 .p E .o _� C '_ « 1. L .t E 2y In E r J 4 O— CA P. t VI C r, .2 ` $ P. � oo Z � c c Co ti O fi C V eta v • , tk y ,o 3 u u U M p v fiN • � Z � " e ev ,, v471 +. ° -2 o g a U C v > u es. y CC M 0 L c� y0 2 c N L y0. F+ w F. a G H y y p 2. b y 1 as J a „ .5 ` . 4 fi C ° „O °p a k waiE 6 0 wO e Ei ot 4. z o � 3 = _ � >- E czF 3 c ; £ aa °z r di HNilI ON € O u -1:11 O � c c O a. zN` = SO F H ry r`, U el el W N _ C. £ •$ E RI S 'a wn. C y c o f -e0 co $ -o u E to 0 etN "' a. 3 a v) I O e . c c V a M cly ' a e'e o, © $ a u en es E '!El' s . ,e a 8 if oCm u E a a, a, 4.c z 3 end v ° .- E N N .0* �' "y' Q L N N N C co Nr N Hne Pc i O aCI s �° oN o 0o U :t. O N N Na M �, O N N N V' I. O Na N n1 "'1 i 0 p "• NN eau eJ '-'' HNN A N a, ~ ~ ' ~ 3 G a. len .9 a-' _ at o. 0 en O443.44 ; rn 3 v) O � ¢� rn 3 cn 0 •-:" M (0 A A IS Qof C C 0 fi 04 ta 4 0 aC tv EC $V OOee a G. ZOa O u Ci a a . t. =35 OGis C �: I 0 e x v 3� us 6 y u . u V 3• V� V y ,'i = ° 0 — t D i0 fl. r o a E e o _ a. pp ,r L E• ''' , •• eQ y ' = °a «� to to H T I '^ 'v p ,5 r 1 = e' y 3 VI .. O € ."3 0 Q a $ c, w 7 • ea ❑ e •E u L. ae ❑ o u >. eve 4 L ...5 .Cill 53 a A 3 •C o 2 CS e 3 y E c • $ E m 1° 3 - fi ` i .. o ° = , " U v .% aa Q a a a a v P. co a a Q a o a ... i- PM3. y � oo en ¢ e.L. aaa env) oo en ¢ 01 . 3 (: : -, 4. 4 as es w - ,.'ter. e; y Z b Z J � lb e r -o o t Cg U Z O HG C p t0 ts3`-0 0 'ZS U E °'o °-' Z y V 2 aDLiT n7i 0 � c� C i ! 1LI1LCi O te °, p s �" >co $ O v psi > v c a -t .z i >+ :i -t ° a y -0 a Co v-o E z a = eaap, a Et'° c z a• e Ra. °'' fi1Z5 z v % " ° t. y �' ,� .�°�. u cn v U cv 'C = v u U A v, c a v :� m y = L 3 i�, 7� ^ c C v] w = 7 .. g C V W c � �V Z`f i w � __ Q ru.. t 3 c e�.. U 8 `" u u 3LI3 c u 8 `E C ti i ` Z= 4 3 C . ea e! c - u L CO a ^ 4 c • `�u 8 $ = a) o O O o 0. a/ N b y O C u t0 '' ep C 0 -a - w aD u H y C i O y V `ti GL m C o p ` era u 3 ,J O a v t y S.o Y f. 4R 51 7TF� .sip o ,is zz •trI Zo ooi � E o 2 o av' :d a�c, G _ o g o a>-. 7 aei $ C4 � 'c o ay o ` o ° •3 cn 3 e U Hu a72 8 C 3 e u v° U e4.i a ❑ ce R C� h '� 4. `'g •t •Z 84 .r a * u no as OD .e ae x F.4 e n rei M e'7 e•.1 e'7 M '�I .on Gx _c N E_ �' 3 c • .�. O O p O 15 a as i E s0.. •p O 7 C s `� a0i !` c v N E `a o c .. v u fl � i 3a `n 'e o O a°u r%i h aA ca o a. d °i. c O U a. C 2 c d ce `c v < Z en E L c Lv u u c '3 ,c 3 . .� 15. y C C C a a _ o O •c s.. cC U 2 2 e y y tc OG Co' .c a 0 RI F' I. E a c 0 o w w 7. 41 V1 u a+ "6 E N N h �� N �� N Q = c Q vs ^+ 0NN,� N ery .�,4 'NI 'n � N C N , �' V 0. N 'n N h 40 a+ O� a � ti � y� NpeONN � O ^n O e . y y � a a + �riN ^+ NN "y L v L d Sn a • c y Cam+ a rr C �� 4 M. so C �; tel Co: 'J :t 64 '� � c C » 't c ri O 'w C `.r'. [Ct •o d �I •�'w a. >, 60 ; 4 4 eat= i o o y a C y a, �, r. IS a c ea Cu _ H 3 O Oil S ._. a C 0 O a >' J o eq a a:n _cE gg w a Zs Q _ E. •C o o c an y U rJ ..0 L. N 7 O C rT C O C L y "C tu no 1 $ e a a a O d " c 4.) y a o a � oq EA £ c d ..e i .; O 4.+ O �_ c = a �, - - . y 3 H aci ..c0 tit . J N O o _ .Q L C 0, C a N Ts •y \ en E ... �f C. o a h 'G C • Gi, a.. c -- en .1 to C y y E y v (j O 4.+ .�.. .O •C v t E c c 1... y z 3 € ev E E4i o H a G .� a °c ? w° a G c u o r, '' , E c0i °C of2. .� t e ? w '4 �' �*•• o fi 0 -i`C ? O fi 817s. C C N E E. • C c Q o '� o � �•� a ° co ya _o cu V h' W ?� O • C O C ,�� ^ O a C 0 o e, U 'v u '> 'a °~`v 4 .o — >, a 0 -O cn o c U 01 Q 0 Y " •s • y 5'z - C V g E C y A L v 'o y y 'n u $ O o o ' a w a. 3 Y c a 0 0 ._ y �. ` Y m o .' y O. 'n l0 W �' co C �.. y o o ..o c E y p 'u O ` E e c `" L E y z s Co t C H R O O o C •' E c a. vs a c �: -c a, b v a a 0 4. u IN. 'Z n. C E a CC L 0,,,r. y ' u .iI C 61 H C. O l' F v, M 2.la wFs- = 0 r U p al N I y — c al o m `o 0 3 -5 a euiu'? u a.s E N m •C yr 3 V •7 _y t 'b N 0 o '_ Ec° -5a v Uo C.a d s C. Q L U V E X .0 o t> y J d, 5 'c `� v t S � 'ju I. C V a tg, 17 C y L .b u > p 6U. �$ O • 1- co N w U Q -p 7 - a w p, p Z a $ 5 a m •o 8 u p _ Q c..' yC" u J d = co CJI N .� c 'n twi, 1 O E v 7 O lVP. > Nl V ° U •_ o p w X • L„ >o X. .a U p E u 1.. u •a IS E 8 a > � > e E ,� = E 04 p , a M y c o172 w = •a E OD 2 _ . �Q - a p �q u .0a 3 O . N V 1° 0. v u u 0 ct c «�ce) oo �e • u a c0 as) 7 .= w T '_' y L V c0 'fl S E .= p u y � U � a s � >, ► s p> vo Qo U V C. w p X Ry as Ac R � a>+ C o E O w u �C es . v V e• � e°C = ° c u = - v � v `o e •c °p o .0 0 3 U s u, v �', A •E 3; `� - au my ' co 7 o u v = 00 ,, ua + s - 00 Zcv .� > E 4 p y0 U to c, = u L — '� v c as `�°' s O u �� ai° 'v o C N on 3..- / .To as •V V / '9 O N 'O y , a u O ,� C O J I u L = u vAi w ` a c p a ,. c c• '0 u csa E. r r •fl `� c ee t E u a = 0 a c U u O c w u o.-§43 u U =0 a. c .0 ▪ > • o L 3 p p y 'o u▪ V 3 p -o v 0 'll L •c M vy y V y E R G y tC co p r c w }C ^ .•: C s tto u Q y c a L O E v tC� .. > 0 L ci/QJ] �°, o v fl .. on V V d � � = - oI 'r ,,0 ..�44uys Vkata s = ,n E Zero 0 `' y y 0` • Q 0. • to o s bau 3 V 1° V o �' a 0 � � 0 3 s u C, n . c ° CA e c p� o Q w s c u u a, �' _ w s �' to ^ c •0 UU = v '0fi E I. E E t. 'C E C C .EcTs 0 u pq V u V OC o = • y v c.4, •t1.4..p «. C U a.c t - •v - U ic e `E0 >,y - c�.. J CN •E13 '� E `o •Etn 4U $ 3 c- c = � 3 y N. >' c c i cQ c 7 •� 0 C u u 3..- N t 'yyt ce) „U, U E C Z ..E 4.1 V O U I1. -- V L a 'C u> •Q v N r. t� J, ,A U '•- w — Q o VV Oa C 2 ^..0 cn i/: H - p u y' y .o .c •a .. y V G s y U V L w y >+04 E y d a . e a 10 5 _ • u _U w U su 4.3 ,0 ac a 3 s o ow es u 0 o c v u � _ R uY F. o = w .o "' .E � .� o �fi � a R O o u y u Es -' o $ w w 0 .c = u E HI aQ3 a0 y fli II! i1IIIll al0 C }• ;�• V O >a � -0 •.E -a, 111 of !JE tii •. C .. ` a E ' t w a ' 1 a a�vo p u = eo�e p 7 s C Q y w ci d ai w ,� a i 3 ON LI :C Z I IX - ri r; et m F' o o vJ 14 ,C M « _ � 0 0 0 0 0 b e0 N y O aCi u ON CI. O > a C C ccO a, u ,.; y E el. _ �' O 3 C 'g .o U a .o v _ 'fl ar .N 1-• C C C X ° PE ,ov0000 ,c o ° m y ° " inNO 10 411 E va C z o c o `� CNc .. ., d a c 2 o u so to so o. �iOu• u` i Q 0 oJ cQuxL yv ri a � 0 y o Q U - � 0 L., vd O c, yh E ai V ;, � T., 0 0 0 0 0 0 0 - 0 v O c a H o ° y E ° N co G. `'�_ ►c, ft �,, y O Cal U (..II .tt O = y u C c+' a. U Y cs. cr C —c. N �" 0 .0 'fl V V .0 Ea. .Vr®❑ fa N - 7�) M y d C' 0. 'O M o cll.) VI r. v p e b 3 s a L c c -7 'C a+C in O td y y Y V a. O c 0 N 4. c01 •00 c . a. •. _ 7 � O n gi 0 0 O L" u 0 •C .fl O Z' .0, O C �, 9 U C C OD �. '1 O V as r '> >. a N N "' U ,D > > •C N k0 ON O y N c Li. f/J 0 g a N O y ° c y '. V 7J C N Lz.®❑❑ CNI _ N y V T 3 g .� V ., ° XiOL U M 'U O -� _ v a0 u c 0 E cc W d a im A o A 3 a s m a : a •" y Z B N -o a A C .d ,c op 1 O H s . C` 5.. > E 7 y 7 .�.. > + 0 c y .= Q ^lZ Os '7O 0 L O os c O a C y Gel -0O a. 3 a y O U 3 a - R U VI s 0 I. N •C C n v d CO 12 a en OL. C v Zip O. ' i ° J h a CZ yd A •2 a u. .E c0ac. 0 v 0 .c os o'o a com — wO .. E '> ° 40 W c) o F. u '_ am`' .0 v U > 3 •o0 3 � y � o 0 E :° red co a ° % >, Ov o 7U E > r C s c U ai 6 >, e e O I.E E 1 c � C a � c � �u v t a p. 4,i! x `" vs °J O O cui > chi 16 or. v es O. O a ecv r i. c Y c v o o 0 I.; p., _ E"' t', ° E > > aes .> o u •ti ° u sue) y d E., 'uw o .�e C �' o -. ` CO U e . � co U€ U Y � . c '� ya Ec 5 e VI s . a. C O O O s C a •`. u c as O Q VJ G. I. 0 y 0 {, ❑ 7 g 8 m > F �_ O C > 0 0 Z V O 0 * . sn ria oG o U E-, E. _ 0 M Page 29 of 55 Task Activity Deliverables/Outcomes Due Date[fime Frame Payment Information and/or.Amount Example 2:Engage in other vaccination planning activities such as partnership development,provider education, vaccination point of dispensing(POD)planning,tabletop exercises,engagement with communities, leaders,non- traditional provider,or vulnerable populations to develop strategies to ensure equitable access to vaccination services 3.B Implement the communication strategies or other activities, Written report describing November 1,2024 Reimbursement for actual working with health care providers and other partners to reach activity/activities and progress made to- costs incurred,not to the locally identified population,support providers in date and strategies used(template to be exceed total funding vaccination plans,and support equitable access to vaccination provided) consideration amount. services. Forecast of expected spend down of remaining funds through remainder of contract(if extended past December 31, 2024)in DOH template provided). 3.0 Catalog activities and conduct an evaluation of the strategies Written report,showing the strategies used December 31,2024 Reimbursement for actual used and the final progress of the reach costs incurred,not to (template to be provided) exceed total funding consideration amount. 3.D As needed to meet community needs,expand operations to Reports summarizing quantity,type,and December 31,2024 Reimbursement for actual increase vaccine throughput(i.e.,providing vaccinations during frequency of activities costs incurred,not to evenings,overnight,and on weekends)or adjust vaccine exceed total funding delivery approaches to optimize access. Activities may include consideration amount. vaccine strike teams,mobile vaccine clinics,satellite clinics, temporary,or off-site clinics to travel and provide vaccination services in non-traditional settings,or to supplement the work of local health departments in underserved communities,and may include administration costs for other vaccines co- administered at the events.These activities may be done by the local health department or in collaboration with community partners.(see Restrictions on Funds below) DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOH Finance SharePoint site.Questions related to this SOW,or any other finance-related inquiry,may be sent to finance'u`doh.wa.gov. Federal Funding Accountability and Transparency Act(FFATA) 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). The purpose of the Transparency Act is to make information available online so the public can sec how the federal funds are spent. To comply with this act and be eligible to perform the activities in this statement of work,the LI-1J must have a Unique Entity Identifier(UEI)generated by SAM.gov. Information about the LHJ and this statement of work will he made available on USASpcnding.gov by DOH as required by P.L. 109-282. Exhibit A,Statement of Work Page 2 of 3 Contract Number CLH31013-Amendment 21 2 k in § % 2 \ ea ea .ez I \ & / LI co ID c/ 2 0 aiE - \ > _ % » HI 0 Ts I -\e >,� 2 uE. �a.k / 0 = •e u 2 '2 0 u § � 4) � k B \ \ / 0 \ V .. § � = c ■ 2 _ ■ � q � � -• \ .- k �5 � � . § 2 § c _ E c § § � .? \ § •_ 8 2 -• k - � i § 2 k a. \ \ \ / \ �$ © / 22 •c> CO: § -4. S � I t •- \ § \ g k k u �o 12 k \ � � ( .k � 5 / ° . . 0 I- ; § F. ? - u § . o • •¢ 41 0 0 .c © u ¢ � � • k - a 'e % © ) 2 2 { \ 2 0\ ( 0 / 0 e , ■d c 5 . - E2 e om• k � � \ •q \ ° � o . c _ > £ § i u . E J c § - •2 _ } � « t\ .4 • in u \ « § ;Psi: Q o � g = ! m ■ / � �� � 6 J � _ �§ a \ � 'C § 1- J E : o / 2 § 2 \ 8 ƒ 2 %= f .§ _ 2 & t tu » . oo _ ue. 4 ; - c o ■ • _ - 2 .. - 2 ,� iso e a e ° 3 / � I 2kCC r4 .L f. Cr 0 0 0 Cr Co — L © �O O 7 M d E y p v1 Vi = U �.. C 'd Y1 C.l .� .O ya„ O p O c % u a' L. 'gtj'to X C L 'j 43 c Q M �+ 12SI� `o, • L. Eta .° Na O 7 H K + O O O O C O C1 'O V r1 .e E� ,o o E e a c D o O. Z :° o r v' a s _ H o c x R o t 0 e i CC u axi c°i U L V Q c O ^ i u U u E c Q CJ Itto Gi a► � � a > o o00000 0 es 2z' L. Z u § •CZ u u p eS c a F � ° e 67 N E •oa. " E 0° 1. u E o to ua < E F a w u o Ci Q - i. z7 ,c u Lt, OG E t Gz ®❑ 2'26 c C vs (4 pO. a A 4 .0 e1 au ao, - v .= - 0 G% — u a4 = Q 0 cd 0N v .0 a 0 as N Sj t o C = C d c 'V E -pa Op u = U z - H 'N . N • U «z O C ap 3 e~E ° b Oµ v) � w c ` oN O C E c .> Gz.®❑❑ u E 'N • .. 0 - R 0 0 7. 0 M t y y 0 R' r'' ea _ n O Ilam 7,1,mp c � aU en m `Q tome O p V a+ C 61 d G. ° G. .3 d V 'o tre L1. c = € e a C co :: °� ea CM tae ea 4 N N U E y E N E n o •0 _ y Q :» c 3 F v E — u e _ E g 3 v-. w O u CA0 '— — t " � u G k0 w 3 q ° o a O a Z .5U r ur 4.� -o G. y c > E . CV o w (Li� � `� ' I. 0 N p a y CO 0..E O 2 _ 0 N b ,= E 0. 61 ,c r�ii C L. c ee = o O y Vi = u1 M .g 0 E a 2 E = cs -F. a i" U coU w O .a u a2 a E j.E _ j N v E , x ° EC U .0 'E Cr .c E 4 E u ' ` 4 g N �.F., ; ' O 0 �+ 0. N _E aa.. vi .a. E H 0 u o u H �= el E .0 o u _ .u. tia E O O q N C C v j ` H y O = c u ... 0. c, = w .3 .° o v y ._ a 0 E c a a "� c v es O 'C 0 H vI O Y Q 3 a z .— E ` .0 ens u L c a .> y u E �0 3 y h o o f —6 .Ea c ° E . . . ■ u a L. E 0. > y — ca RS an • U u 0 x c c a. G ° a 0 Cues °u ° m v' G. - a v O Cad gin 4t or .l d. I 'O E GSi .2 = CV ("" et c s 2 N p g O ...4. '4 �j L E I Iii ! c`41 c Zas oR ro O Nl a, y y a, rs; o H. < c c aa)i c°i x u axi u 3 aui V 0 O 'O a. as 2 E- y cc E •E �O U. 4V0 c°i Z N V ,r. V 7 E _ N i1:Q = O -a O N N T i O v ` V vi v-i N C r T. c Z' o c " —O u ai C c CL 7 0 41 c p� ea N 0 F- V 03 2 N 2 .0 tgaa . Os g 3 = o v ea a, a 2 L. f ° '$ `° c ? u aw ate{ .�, Et $ c" > = a, o ,. Z V yy 0 = vi °D3 .. us O L. 7 - V ° to o f C O C •C 0 y :J 'fl ea) 3 N T c C c V a� C '2 E c7 c O = .o Ey cpas a = • 3 'ov a a ` mo . o _ 41, u o 12 kyto . ° �• °n =( eoa a • C. - ° In °off ' -.F. v Q i rao Cs OE ' .. V _' p N Cs 3 0 ;: •- _ Eo .° ` c u v •v -v o c .7 •E w c $ as a 3 , = n. jI : ur sa iEc 2 ` 2 = 3R V c' o a5 •C is 0 u C y 'S 'G O . cst., ,A <.°. ° z 0 Oh N Q Ep t u `.. E y a! c O 'v eo c e c F J c v w u -o = •� ao E c •� e > U ca. •` > c pn E Y •° 3 •C co •.• -• h •V Q j �' C c 0 y 'O G. w O O •c E .. s7 Q cd V . c n E g :° 5 .9 E u 3 s 2 I.. ti .... o =sts E •-• O .a E 0 �i i c c € 3 s y ea .c ^ V V '3 O V c �' .c ° ,t� •0' `yam, L E F '., .. ° a, y a O c• in c.. ° Np H ,ra•v v or >` C pVp s 3 . .c tti C h T V t O C O C 'C 'p G. � .O to " n. c O1 *" C V VE O Y ca �" > H ° .� > L C .41 C V u >' a O c`d Cj 'w O °!� y u O _ O O 4-. O V Ti A vl V vi •n �' °q c c ° aci `' °'° � u E p - y c _ 0 E o " ea y '0 ., c > O O o .•• 1. 'O a. u O a @ u •-1 cg '2 y .�, ee O O O _ V • V Lrr. t .ci °'lc a c E e= ;,; 5 000 .0 •a � o E- H � n, c ° 0 > o c '6w o••M7 v f au uv acr 'Z3a, 2 _ u y ° 000iSELEu u c _ !«. c_ cc o > E a. ae a `" 'c = o •«• u ,c l0 E E 3 w M .c .a 3 ca. 0 .c c cc 1 w is. E `u' >` c > - _ u Q as it .., R N , V 0 0 aQ N O • • ♦ • • L N M v cn _ Q L.L E- L F •E a a t ad W co CA k 2 15 S § § < Ti T C C 8en . = ) d E -c E 4 / 5 as .{ U k V 2 o 00 2 U ■ \ / 0 o en C ¥ 9 § - oo \js % 2 % ,£$ o 2 '6 ( _ 5E. ti 5 } N. IA-0 C $- V E / OD c 4$ E $ I - 4. .OA 4. • 0 :E § § k S 00 / 71�� { f 0. \ � a_ 8 _ $ .0 % / ; I I. a % :$ .0 k § $a / ° V22 ° � \ \ J w EMI « j '5 > coc0p / ¥ § - 2C3o5 a © k 2 § / • § § § \ k § E G § ■ 2 a e = 5 2 Q -E. a. m = > .E \ Page 34 of 55 Exhihit A Statement of Work Contract Term: 2022-2024 D011 Program Name or Title: Office of Resiliency&Health Security-PREP- Local Health Jurisdiction Name: Jefferson County Public Health Effective July I.2024 Contract Number: CLH31013 SOW Type: Original Revision #(for this SOW) Funding Source Federal Compliance T pe of Payment ®Federal Subrecipient (check if applicable) Reimbursement Period of Performance: [ltly I,2024 through December 31,2024 ❑ State ®FFATA(Transparency Act) ❑Fixed Price ❑Other ❑Research&Development Statement of Work Purpose: The purpose of this statement of work is to establish funding and tasks for LHJs to strengthen their capacity and capability around the Public Health Response Readiness Framework(CDC)to prepare for,respond to,and recover from public health threats and emergencies through a continuous cycle of planning, organizing,training,equipping,exercising,evaluating,and implementing corrective actions as described in the Public Health Emergency Preparedness(PHEP)Cooperative Agreement.Many L11Js support a position responsible for public health emergency preparedness and response. LHJs use different titles for these positions.DOH wants to be respectful of this diversity and refers to the people who fill these important roles as Public Health Emergency Response Coordinators(PHERCs). Note:The current Consolidated Contract ends December 31,2024.Once a new contract is in place,the program plans to submit a new statement of work for January 1 - June 30, 2025.Deliverable due dates after December 31,2024 are referenced in this statement of work for informational purposes only and will be updated in the January-June 2025 statement of work. This statement of work(ending 12/31/24)includes 60%of the total allocation of these funds.The January-June 2025 statement of work will reflect the remaining 40%.Once all invoices have been submitted and balances are reconciled for this statement of work(ending 12/31/24),any remaining funds will be added to a revised January-June 2025 statement of work. Guidance Documents-LHJs are strongly encouraged to use the Guidance Documents listed in the Program Specific Requirements in the bottom section of this Statement of Work. Revision Purpose: NA Master Assistance BARS Allocation LHJ Funding Period Change Index Listing Revenue Current g Total DO11 Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation FFY24 PHEP BPI -CDC-LHJ PARTNERS 31602241 93.069 333.93.06 07/01/24 12/31/24 0 20,630 20,630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTALS 0 20,630 20,630 Exhibit A,Statement of Work Page I of 8 Contract Number CLH31013-Amendment 21 C N O C CO C lain @o ws � to a.0.. E 0 0 = as V o C < u cc- c E .. a en a. 'y V C •_• 0. (Y N 00 ..1 V L a) a) O E E IS 7 LL R N Q z U E N H N T eC t el eV N 'b as fun N N C 0 w v O c m y N CV v, N vn N :J C EE c ai .0 o o Cr en c e N Wi t„ C V N a) e u C0 C N s a) = '^ 0 c � a N H o o �i:" �' C ._ a co .b y 2 S C4 ,, T .a cc ah. .) O a 0aQ ay h 0 04 Y .O C en M 4: 0 C V > U 76. - .0 O N c Q C O Cr C c o d c C .+.� C. C 40 C 3 a . . '- m V J c.. ea = E a) co 15, E u ODoo -c-4 .s a ` �_ ' o n v, c 0 CI' C V V w CJ — 0 ... C.. < L C. a) ea Cio Vet � y C _., .v! u 7 1.50. Ji 0.0 2 T 'O NC 1.4 V- C e v -0 V d 9 0 C C C V V gg ra ; 4, � N �� b c, • t Lg c ;? � a�i c 03 � = Ca' � o v w .�, ? � y �aa � s °J aEi y 3 ••o 6. QQ> 5 o .� > a, i au s1a e 5 2 co E Q co c • EU C is � � a oo a) �.Ft C. R o •� 4 alb A E ` y u = = t � v C ._ � V .0 yp �.. 3 c w E > a)•; c • - E. d 3 a c o G. 0 �.. C 3 80 4) C >, r >, C ca� 3v 3 .oe.. �= c L VI £ C c = N C .C ? 'O "g C %) U aJ y y C 7) y 'emu O. J ar .E. - v o Q' = Qo 00 0- 45 0 `� c O u o '° c'c en a... W4 cAe CnCu :� CEa, :J4 . C8 Uc3 ma co 0 2 - a 6. eloGe h cE a _1 C. $`� > . c to 0 .c X / y R E q> a Y0ae V .w CLI. EV O •st ,nr� v E U = c on O a GE; a ; c .x E I 2,3 a 1 00 in O l a �' = I °a I I C. I r E 0 O N H E '4" c C J an a LV-. M tr CC T K i cc c � a I.c 6v d i a ,cm . a 6e 1Y � ode C w0 d .1. aai u w .c C y c 1... < •- E ° .� E E E — c E d E E - c E c. n 0 et a ZOS so. r i P: 46 ra. L se Y. e : C i 1p 6 .0 Co) Ls. G. N ..1 fa. 'O en a CC r..., 0 a .t CC la, Iv Y. w s r, a cr., el a W Page 36 of 55 Task# Activity Deliverables/Outcomes Due Dater lime Frame Payment Information and/or Amount Framework 8—Incorporate Including(but not limited to): health equity practices • Administrative preparedness plans. • Recovery operations. • Incident response improvement plan data elements. 6 Review LHJ public health preparedness and Mid-and end-of-year reports on December 31, 2024 Planning- IPPW response capabilities and identify gaps,priorities, template provided by DOH. June 30,2025 and training needs. Framework 2—Enhance IPPW Workbook provided by Partnerships Complete the Integrated Preparedness Planning DOH. Workshop(IPPW)Workbook provided by DOH. Framework 5—Build Participation in IPPW. workforce capacity Participate in the DOH Integrated Preparedness Planning Workshop(IPPW).The Workshop is Framework 10—Prioritize planned for early 2025. mufti u nity recovery efforts 7 Develop or update crisis and emergency risk Mid-and end-of-year reports on I)ecember 31,2024 Communication& Planning communication and information dissemination template provided by DOH. lune 30,2025 plans. Framework 7—Strengthen risk communication activities S Complete training to ensure baseline competency Mid-and end-of-year reports on December 31,2024 Training and integration with preparedness requirements. templates provided by DOH, June 30,2025 including title,date(s),sponsor of Framework 5—Build Participate in at least one public health emergency the training or conference,and workforce capacity preparedness.response,or recovery training. summary of what you learned. Participation in a conference related to public health emergency preparedness,response,or recovery may be used to meet this requirement. Work with Public Health Emergency Response Coordinators(PHERCS)to review public health preparedness and response plans and identify gaps, priorities,and training needs. Exhibit A,Statement of Work Page 3 of 8 Contract Number CLH31013-Amendment 2 I N O [ v `o e E N. a. < el 4E. 0 d y M a > a o ' M a. N C E c Li.. z d U I I H v 3 7 C v w t R L a. ., O co !a. 0 d' 0) CO to O OD O e a _ u e I a O y td o .0 ✓J i •h N to gn G I t�d� 04 es h C 'a N 2 c caz o H ¢'•. C t. a E C > a. _ aft y to 7. X 9 G .21 4. W v G w -0 a > U `mow W 3 > -. L o E `0 4` e V U `-� Q y N o r, .� v e 'iQn l3 CO ;; „ 2 V CO en w, •O °�' y e '� aG G . N u o to N C •0 a d C >. 0 0 l0 N 2 ... N V V 'D • 09 L B in ° V3 G. ••�. y > C> �' i. y y f� E v (/5 F A U tI! 1I1HJllI to cn = .c v oonit iii m v II i �< fi ? flul ! I ! O ! iiti o = E I r a r )4 c� Ca' a tij u E1Iil ea o �,u] u u C a 4:. • P. a .= Z cn 0 � co T_ a o I- a. 0 3 0 It 5-- a E InlaF Tai 0n II 1 W N 0 • o ce e u e o E it) •.Lc c E e o n < E co C) .+r Q y O & d M 0- >. 0 o m M 0. S U 6. E E to r. N I I .) fy N ." N N C L el1- N " N U O r E en Cn E M u on ^ _ 41 c U c u o c d i 0 � T t E E0 > $^ P_ L g .�i v v, 0 .0 4, Z.y ?,.'C C >.•O ?�'O ,.., u . 073 0. 4 � 0 L. ,33 O L Ic ., C p 0 u u Q. •o u .o u a is > E a is A is 00 vE a 2 •pE � E o G V. = 7 .r N u L 00 . C v O `>.,e0 .0; a. E. INI1c 73 c 5 I P.. E 0 I1it N 'C u d xsi O uu y c M NO C y �+ o0y .a . •E .0 'o CO 0 731.X 7 L C 0 E. ly E s . O . ►•uCV0 = = I g, c4 v ,u, •Eo = 0. -oEA >. C % 4.4 co t u ' s O>' w ev . w O E u OOC 0 U > u_ c E c3 ' o 0 �' o ° E u o . •«- Eo c0 Ey , � E . v> _ u 6. OE4 ,'• (4c •u 'u vi an'• uu '^ N 0. O00 u c u n uE E IC; •= a C u V> e O 9 " E I. -oa col -0a y,dw .Eta ,� u0o > cuE ; EL.0 M „ •"�0 °' •E ia v u „- ,o E CEa y e ' v ' :.@ A °E i° ' = °' u uL u er' 3 o o ` ..-•5 .0 ua• . I. a N 0. E xu -ooA : a c . 0 o .0 -5 R. ,5 wee EE � n E = a w o • Qr ' 0 L C CJ,1 4/40 l0 ve c 'i. I. O e. >+ N •� _ '.r. G . a u u a r--. 0. W a 0. Ur O N C - = s w u .0 � � V .� v E ' u .3 E ou � o F -aE H tS C v '• = 4. e ''fw3 , N • r • • • 0 — — EE ca .0 a. ry ZPuio 3 $ 0gE . Z M =o 4.4 C euf 41 C O C in 2 ri ^1 0 Cr •` t a C.,C C. 6=J = > Q 0 Y 0 i C > C £l f� ei OG E 4+ 0. 0, a '' 0 0 u J « • 0 CL y A p ` p 0 c I U v i U o 0 E 00 N y N'1 �. Et W 0 V Z I •E C — L y .Y O -a ' .4 .E 0cm 6 5 Oa � E oc oEin z oa `C `n ; I. f o r d 0 TA S E 0 I 3 y 3 0 t E 0 E - "0 *— = E '` E u E a E E .. a •� . N i = 6. o y p 0 it I. 0 0 U 10 .4 V 0 :� O% 1.4 6a. M. 4. •. 0 .^ c W fI '►. 0 2 V. .. fii v w C N 4- in 2a C 0 E in w 8 U 3 ` E 0 C a. etce a -� V g E E I. a 'i N . N Z t E N co N CO - r1 N '" N N C .. V fV I. N 6� N L./^ O =, O C f•^. E v.., 7 v ? 3 C O C yO Y v y E � = oZ oZ o �0 ug v0 O ..gt" � d -0 ffi u Dui w u In alC O` C 00. C D cC " 41)3 s i o00 e 'a . 0. . 0. 0 5 2 IIV ea co o a 0 co O 0 s. obi I ° 42 1. 0 v S iv 2 s ti y :J .e . cc 'P. �' c i to 0 o X MZ ° U V) - 'n > u a , ,... - � •! • W ..1 y C C w C „ v 0s • .01 .- O - E ce '=t p V 0d .9 O u p , = =r ^ sU 3 U en c O - .0 O pp O L C C. •� .y •E C ea 7 0 o co p y L 0 > o I- .e „ W aw 3 u o2. .6' = 5 d o a E a r. = C t.:, 00et = � � avi .5 ^ O E `� � d a 0 '_ � � «: ,t °' 2S o aci a y b `� °� `� u a is w 8_ '> 3 H _° o a _ m > c a 0 c u 7 °�, c 'V `� u U 3 0 a 3 at n.c 8 v 'C u E o y •E u Cr ova � � 'Ea > � ' c c4Vw 8 c uQ = 7u c c0 .ns ?' N O r E m o y -0 C •W Q •= ;+ y V .,, r^.' E •v .Q 'C c L" o 1.�.. � '�Q •c "' n• >, c . >. = 3 .2 3 o d o " •a-a p � 2 � 0 � 0 ° •ma c —1 'c � �° E u E � v uc4oa > � Te o . • • • � C E � n Bc $ oLEo gbl ' ;,o o o va' � EdU U a r� Oa° a v v .E, .� Ucn c aU a 7 sv 0M •v C d .0 r g w 3 L d yC y C tC C . t.. L C d C N L O L. .+ O y 0 Li. O. P C V V' i .R C %I. I o L N C r Cre an L t E on G d e II W d o I. E E d 0 = 6 . a U) E '•' 'a EE EE O q �. Q ' . oo � 6 - IL 'c a - cz. 'Yea - V U s0 0 W C, N I73 C u Q = y u• c `o c At y E Oel alY :a-. `G OD e"1 d .. R A, 1 C iiI as N Z -an �O V Q j tel p •: Z C M Ncoas N vJ . N V U EM oA .' E. 3 4.) �' ,), .= .)I A , & a e v �'i 4 C el ,-• a' C v1 g ,..6 Li.: L 4. k` :4 •i O - v v C v •C ti E oZ i = ` '� v 0 C .`i. L p - J ` J -• O C R Ol 0 fi O d -6 s 3 .co .cc E Q 'R p u pU C °' ad € o — u co�Cc y y, p r •= 4.Cb " et y U5 C • boi o .G u C .v J O :, o n p V u LC vii = z ` S u 4. V N fi c C Cl., O C r O •C v' •y t6 ~ 3 w = q 3 H v C v O f 'o `' „ •n O u •eo 0 L c v o ,*-. Q G C eta C h °� fi R /� ,y,. cc O o eC s E c - .5 cs m r Q•a d y • > o ` C r Ti `O n Q = �• ` 0 F C .a o y v O •� y oEiv Ey U o � Y o — c a, 1.�� es c 3 ram, ` C g ->o. 3 -G N 2:1 `o a s .. a s - • a .. S - •v � E m y yP 4. v, C w c16i c8 - " v' �o t Y L r awe t Qcr -g -6 - o v a c co Lei °�' = 8 3 .� L C ° 3 y.• 72, = s 'u Z E c E aE .; y es es ° 0 y i = a y v ti •e v y V Eo `o `o. x C c = ' E a aci v z —_ J 3 'c5 .� y w - p S U c% F- W FL- .- o v eo G ^% $ O y y .,' IC" „s V C, ►pal « w' L" �' y Z. 0 ''' -0 :: ?J 0 fJ rf l0 WVr V G -0 < eo N_ 'n Z' h 7 . Z `. C tyil ^ CO >, N C � L4 41 n C y Q .. 'C a C v� ^ S .a C 4' c C CU L yO v C ce E o .= vl g `Z .7 . y H C O Y v� w v h _'K o Fvc o o .'_'.It e ,E, E y y E as Cs; o M r E -c c - — S - o Q x i � .] o -� °' F e � i Li = C L 4,, 3 `� c p s r = � V G E A o ,. ab 7 H G J: fi 3 '^ 3 cs gal 4 eo 40 C. V E i. u a 4 O ,.. Y „.4. Co 1 T.. O -, ti 4 E q G. u ` .E 3 E e• eci E - = - u ^' .•. .T.44 a. ra e c) C 4 ° 4° ►c. C6 o = o o Lal caw wi-• f- - S 0. un V3 0. = aa. 0N0e1 Page 41 of 55 Follow all Federal requirements for use of Federal funds: Code of Federal Regulations(CFR),Title 2,Subtitle A,Chapter II,Part 200 Uniform Administrative Requirements,Cost Principle,and Audit Requirements for Federal Awards CFR:: 2 CFR Part 200—Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards The following expenses are not allowable with these funds: • Clothing(except for vests to be worn during exercises or responses). • Incentives. • Items to be given to community members(members of the public). • Salaries at a rate more than Executive Level 11(Federal Pay Scale). • Vehicles(with preapproval,funds may be used to lease vehicles). Preapproval from DOH is required to use these funds for: • Contracting. • Purchasing food or beverages(unless employees arc in travel status,then reimbursement of food and beverages is allowable). • Purchasing equipment(see definition of equipment in 2 CFR 200,link above). • Disposition of equipment with a current value of(see 2 CFR 200,link above). • Leasing vehicles. • Out of state travel. Note:Preapproval is no longer required for paying overtime. See also DOH A 19 Documentation,bfutrix for additional expenses that may require preapproval. Billing: All expenses on invoices must be related to statement of work tasks. Submit invoices monthly on a signed A 19 with backup documentation appropriate for risk level.DOl 1 will provide A 19 and risk level. • If your invoice includes indirect costs,you must have an indirect rate cost agreement approved by DOH. • If you have no expenses related to this contract for a month, let your DOH Fiscal Contact know via email. • Submit final billing within 60 days of the end of the contract period. Exhibit A,Statement of Work Page g of 8 Contract Number CLH3 1013-Amendment 21 •.0 M ++ CD VO r 0 N N O M 0 0 0 ON .--� C CD �O .M- 0 N 00 N 00 ... O O 00 'O R M 41. M d R C � � NOON eo u Cc X r.l ar a -= O a N 00 M 00 en E M tt u� F O co O 00. U p E le .'�• u N .. C E o o — v O.OG i C N N F <. ¢ o c C -eV O O O O O O r 0 0 0 0 r- at S E � 70 x _I 4 4 u c O al N a.O a 4 U ,a 0 V E ° • u , N t (i .C. V O 0. u M J II O4Or01NNM000 NV � rnZ 0 O O00 .0l wM 0 Ca 3 .�+ ea o ,� a �e:oo�_ oo oC v . �• p a u C N ar « N 00 M 00 of M ` o E E. a� E c - o 0 0 c to U ��, („ v° 3 -ri 6. 0 0 c is = � = a. oC $ v Co s •j E O 0 w N N M M d ... H �i p= •� .Y im 0r .., p .•. p .-. ea t o el 8 u 0. .0 MMMMMMMM 0 A O 0 .0 L c kJ OOOOO en O - a t� u v; u -- C O •y 41 E .� 'O e.0. 2 a N N N N N N N N 7 au. u H ms 7 1' 0Z00000 o p Q 3 C w = on 0 0 0 0 0 0 0 0 Co N Q E-02 � .c 2 0 c 4- i -- --- O pLLOnO CIt •- N v -- as G� NNCNCN C .' N 2 ONO a G CD N V L C v M M V M V M '1 ON '4 .-; C w E Q ir y OO'. C% OCN000O INN X ~ M IS (r < L70 MMMMMMM ei M N v u '_04 — m C U M M M M M M M M 4- ►e F y ° R F, n L ea u u 0.— N F y Q y ° r r N. C.- C a C N E -, 0. w, ¢ NNQNQNQ un `' T c .= 5 , — gt < . Z Zo, o. ZGNZa. Z -a C N O N N O — Q Q CD° N N N M et er tg, 4 CO et N ° w a"i w o0000000 O N Y 1- co -, 00 a 'O et et vt . of et L C C O '. ^ 00 00 00 00 00 ea 00 e0 c N 3 > 9 E a r U r r r r r r r b .c ttit - 4„, c L °O. I- e. I. 0 5 u I. °L M Jo 0 0 4. I o E E 3 to 72 .o t 7 in to n V) u ^ !�I N m 's aO O .0 _ ua C .s4- •0 J On° � JM y o v .h - i All u F N= o h � el CS u N O • = . Or a.0 C C.> Q C ta N W V on W — 8,4 L L N N C/7 747 !/) F fi 0 — a tgd I_ t t .c b. o l0 — a I o u C .Z V `.t x :L ✓ ;E; O • 'fl 7 ' Z i� >. CL x CL O 04 •= a A �'C 3 ae a 8 a,e is ia" .= a `c Z o E— c ob e x . 6 1.... w. m ,- m E R °c t 3 ° _ S. o ; xx ax -, la u I.00 a d W V v 'p 7 L t+ 7 C1 e) ° e) ° .1.a.• E a, O. G '$ ea 7v' ev A. etv".0 F= i= a f= 0 U.. v .. Q 4 E. 0 0 H N «� •V C0 v N N N M• M. d• Nit Vl Z O 0 Ew .0 C. v L L4. '> v tL LL LL LL LL LL 4L fs. Q S_.r I V1 a 0. s O O u - u. U. V7 U. con U. t/: F k !A ai as I- u. U. MCW tab e WI + c uVI 3 8 _ `� ' a v = �' eta c'o 'J 6 O c > , u o a, c >, 3 o c. >+? > > E " a c 3 > c = •E u `a " ° " y c° ° -a 1 0 -0 cxi c E E w C.y c E 0 o E v � '' 0 = an' a � � a U ; � a 0.�? � � E � ja? � = 3w � � evv, •� .'= • E 'c Q 0 w a eEnE .y p es E > u 0Z v , — 8 E•� ? -5 tt > c xx 3 u $ 'o a %, Cr .c E M n E, a S � >.Z 'E .. UO •E � aUHc5v4Q °v °w' sc`s0 �^ ES =° s) = Qu >, ea0 Cd ("3 - u M a - R u 3 *a >, a, ea 3 p A. CO 0 to 0L 1 3 = • • • • 0. 5 e>a S o • C • .=.1 U w pp _ 2 E o .0 p n E „ E S E cc ar a 'ti `. .a .a V¢ a = y V V r+ C d lg. I. >. 'r. C E V i 0 0 o g ; � � .= • a. U C E .ti a W $C4. Z s c Q 04 0L - • Q u >' o` 0 u0 .0 :: `' nu =a az ccm > b, >. 0 L 10 o cab .� N 'ea E> _ � C w ° u d °' to '� >+spa °�' C ° 4.)i n. O 0 ` 4. n E vO � � aQ o .0. 0. w A v E a .§ -0 a 0 — I -= t F, cc • OD o •o Vc 0 c E LI , 0 .,0va c eaa ea oeZ �e � ovm 0 a ° ' >' � 2 aw 3 12 � N a d a C•_ _ O ° 12 16 �? ,� Z. O 3 c :a a = a+ e0 n T. h o as p «' v 0u -0 •C c -g C. es 0. c Cs C A C _ :•d O «O�. J V C O > A v.) -a 0e .asu °. rCi -00 c'— o s .a _c6. '" u `" -a •` _eaL. d c.p Ef eA . Q rJ - 0 0 •° 7 t—° e0 -0 (n > r,4 eta ¢3 • • • • • • • • O o in 'a 0 r w w —e e,.., L. v Ct C = R h s O E ea 'r. > a! C OL 44+ ea A •� J V V — N . — 0 ;'. ; U L C C s •.a C > r L j B A .E H 4.. N t -0 o V E C t !d C y a 3 v, y 3 04 ° G— 3 _ 0 u E 3 3 L = 3 3 ,c '« a, a — g I t1V E C O E L N C E 'O ^ c .— 0 O e0 ron G� � L - s. 'gL. vae V �+ -- V off! p' u .ea � co °� $ d 3 e0 E ti► O Z V = > 4) c 6 5 _ en r c e s L - 0 0 .5 E 0 C vC y . •o e.- >, E F'• e a vq� a, 2 E Q 0 U G La �i ty V .� O d ` c 4. ea •3 A E 7 •� G.` 6! L •p 3 V. "} �' v 04 °qu c' `� c a�i yt" ° uco) o` =' o `� a+ a°i Z' h t 0 .C='n < d v "CM e3yot -0c = ... c .5s E1..... cc3 •c � Q n ° ° o v 3 3 0 � k d � X a C� :e ° .. > e' E E u E T." 3 c = e>a ♦v'. 3 0 a >.9 = c = c a) e 0 a_ o w_ •' y E= v c'ci L .= o E ° a C 3 o _ € u y E oo° E L 'o ., '_ 3 u �% E a 3 .°U 3 6 E . a) P. `O .� E" C >, ` d c_ c0 I" v 12 y X >> a' a) ' H p a 3 dd E V ca > C c .0+ y 7 c y E is et a o,e- 1 CC .E cs.'a 0 v "a o e s :.. 2 ate' C� .0 E — E s E °: 5 >,.= �i •o o ;?. e0 .5 ° Or .O • 0 •a 'a A u O V e 3 ,0., nC is . E 3 'y' f.+ �+ C.1wc� X U .E z c 0. e0 .n — (Ni cr; d' Tay Vl41 �eC 4! m U w -V L _. x u: e c`, .1 fV C Vi L O d4 4. N la R C .0 4.,•, .0 C ) ." jj2 .0 7•. fit.. .e E • Ii flfl — g �'a > _ 4 E `O i e — 'n '- .N.• c :Q E D. a .o .y. C N E 0. O . 'S r.. v▪ 0 � y vs 3 .at•i a, syye'r' •3M E.LtLEQ.e re = xE34.N L a, a, Vcc =Q �sy, 5C •o E Cr .=.1 U IAI. .0 d ,p o O = 1.: E cL c a.E .th 0 c x U u M 4. u c �. O 0 O 0 .47 0 es It' tl tr.. E t- CO•.0�.. V= - co • w0 c y C_ 'w 3 ^ •$ ,E .� ea O V E U C .0 - o X 2 y L. LP. o aa) ocnacv ¢ .E a) 3 t u < I v•L O 06 „ a Cd g E O C - -• iiei e ed 0 r = c 0 $ - `� t u _>, c is O fl E$ U 0 n;i L es til -0 aN 16 O ._ ,A CA U • u d a Cam.;' « • • ri u _ N ..co4 S s ., _ X = 8 y _ hn O ` O 0 7CT.) 4. u t.-.G o . .E v 0 O a0 2R0e,0 E u C .0 -p .... u € = a L 0 3 7 . u M cL1 ea 0.. .o h u 0 '> 3 w ' v v -0 E ° >, o R co" 0 ivy o'. as ft •> �C C •C , C N 4 •^ L 7 .. E a.7 0 = a(�J •C F C •�`" v 0 n' aUi uu ..... � .0 :3E _ '� Zgs •0 V (=. a« ._ ^C � 0. 0 to—. 4) a c` p61 yaN y ,� 0 Du a e >,'G c E u 0 41 •v c . _ c •c = 0 c E vs o .,u �. � = y 5 I1j !I1I11I y •cE . o a' 'o c ° •- .5Zoc,N •� a .yi1. • V• uuC T.. yC 'b 2 uo E cd a4-' € Eu - OD0. E .yceo-ca . a> 'cw �° NC > .DN 8b. O � - x. mccr";a00I ?'U2ySW8 = A 'v .ts zoxmEaQi 3 • • • • • 0, P„' • •- • • • U to - ri ci CA 7 • • • • aw' w 0 ul z .w 5 a a. ci u•i Qr 1 ea4 .0 F- x w C fV O_ C y E E '7 inL t 4J O C I E 0 — , a nE a o R R a .1 U u c '+- u ao cy o e E zob a v G _ 7 ��.. Y = C 'a R8L Z a 8 E Q > u Ei tiE -° ^ oo4. e pea g o o Q O 0 a °z = u Cr o < >, < a 2 m .E u) .8 . 90 au >. N ` j in 0.0 al •�+ N u 24, 'b .a E e uJ vi c 71 Cp ?2 N .. C7 >. 7 y L « N u > p V •� O U Y R L Z. O N L C p c`+0 O4.1 R C .u. -G = C al R C 3a. -Ctw V 7 NL D wQ eti660 t ev = C .Ci 7 Y "0 •R 'U •� U it V 'C ▪ E Q 'Vr O ^ 'C lV a+ C • Q O F C N C c € -p • .Y+ •.r'.., y �' N C OS E U8. C 7 > L ea)L. Tr .L _ = to, .0 ' is = c .••. 7• ea a 4-8 '£ U Y b e` L. X2 C . 'fl = o a n y S u es ,, S H .E yp u u • u .� 7 11 in - Oq V. 0 L Y 01 C O a'J. A 0 U LL7 L Q ' •� V Y O C r. C = 7 v� •fl Nii, W Y E -7 .0 7 TC 'c =' • = " U e = c `Q O. - v _ � < °L' = •oo= '" = V3E- u u -D a ° 71- 4, S. as CLI - e = iJ oho L0 o - c .N ` d a c eu>a E it' �, .__ t•y c =. .0N Oc% O 3 .= ca°Sg . u4 5% to3 u 0 = uu = cc c. E « = c o oTa £ •Z c E ^ C o o i° u �' = � o p -.ca. eher: . `` •- `o • y o .E c o E �= V U C1 0 U V •c iJ > y x N ti E Esu- _ CA 4.. 6� C EO w u ru, y u L e0 N p u O Y 41 'C ° cd •° E � E E -`- ... S .z '/_, 1- E cd .o ci •d 6e..: € v U c.4E e40 -°vZ � cn .5 M w " u g o ✓ y ° F- o E .; o ZacicU4w - Q xi E u S 2 p ^ 3 u u 888 H 6 V Q cv v = QE . o ~ RI O• u-7 I°n x „, ,_ • - 35 v ` 2' rs44) id -I= c 2 Z o N V u0 1, Q ' n.Cy- ;� E-= -p E 7 z t e y• oCJ ° �3 � ,o � 7 o L � 4. y Win, N c3 S Y R 7 O 7 Y O ie Y 0 e °u ` • n= I a. 12 u a . > ° � Og31 Eo ` 'rxaz u 0) y o `° YaO Y A E Y « o •c x i . V .3Y = E 7 •E 1 d = :J• E �• E Q o N .c o .E E o n a o Co �! Y .0 E" CL LxL' C ' N o C a C u b N €' 0 8 4) ° C Q6. E C en ad - a E G 4,1 CI = .a U .. u >' y $ St) - z"C CO 5. au t c >c Use 7 uu C i � OTr Uos C V U• _, r Q C •= u3 co U 7 ° N 7 t a. � C 'C Cr s c ca U o d S .- . x 'o o Z W. 4 C _ C v v G. .V a' u C . C > G E C . 1 E t" 'vi ° J > asta. u = p 'as t. o $ •d 'o • '" 8 Lw yCO v s OD V eCtw �' 7 , ,� Ct.. y L •ea .C .e u •— h o C .— y 3 'r e Vfi 'U v .CV N t'D la 1 � ' o � > vs �O ° �� ° � � ,03 � wsob� X A O .. T ao uE 2 Zta.Le y ° c o p g u CO 0 C u o : q ° c 'a s :? x o v �Ea s DOu 0 c 2 a•s •• a6. e c cl � E1.- v ==p o g.o CO °6. o .R u U a - a 0 © � E c •° n t. u u � •o •� v o aC] � o o d � � u > _ � H L 44 a- a u � " y c = " 6. u uC 0 a To CI m a Q = tr a = u `- u u usel0 >o5 o o � ;: n = �' . a ° � ; _ ii � a o ^ o yus = -00 D u v > u o . ea `u i u c E 8 as '" v ea w . y c> o v �, A c E ^ c a. E• . •_ ' u E u $ o > o C E I ~ 3 3 ..>-, aJr. '� • - y - E "' r. co `+a. G c.c. 3 t E c . •`� It i V c (A .0 e R .'A+ H ° o u •y •7—i tc. en ea *aa n aui ece E = rE c a E `� '° ` ' ` H F a :� •� _ a"i ^�� a Q y s>' •a°qi °e m v ri o > uu '9 u „ wo E > t� CC ° aa» F9 "re aauoG3 � si -6 co u .. D :fl 0 5 o e E u ° u a ' U CO u a I. = 3 U earn C_ 33. a = = Ia. s • • • o • - 00 V • • F C V) Q M I. Z < C• CUGu. MI u _ g e`a . r .— ai c ° >' c 0 3 4.• L.r O O u = u u u ad c r ` >, - o ^ u 1-, •o z 0Q c." = ECI ° E. E aCV .- r `C .F. • gVo 5 Vi ; = °iL = a o .•= a Oc c o °N' � U 3 v o 2 o. ° - � � ri eav C t. E� € s IV ue Kt --. io e 42 o E +� c Q 8 e8 :4 cea t 6)i ai E a V) V) . 3 c4. 5. 'v ^ V. ee ,n N M Q R It F Page 47 of 55 _ __ Task Activity Deliverables/Outcomes Due Dateffime Payment Information Frame and/or Amount Financial data emailed to DOH Contract Manager R&E showing Other Revenue through the end of the grant as described below. Subsequent agreements will request that data be collected and reported on during the appropriate contract period of performance.(FPAR due 01-31 annually through 2027) 4. Clinic Visit Reports(CVRs) Clinic visit records must include all elements specified The 15th of the in the Clinic Visit Record(CVR)Manual available at: following month. https://www.doh.wa.gov/Portals/I/Documents/Pubs/930- Within thirty(30)days 139-CVRManual.udf. of receiving error or rejection report or CVR data must be submitted to DOH data contractor request from DOH (Ahlers&Associates)electronically in a format compatible SRH data manager. with Ahlers software. - Each month's CVR data - Corrected CVR data Data elements will be changed in 2024. CVRs submitted start 01-01-24 must be done so based on the new reporting requirements. 5. Revenue and Expense Reports(R&E) Completed R&E for time period that shows all revenue Submitted with each I (including program income)that support Task 1 SRH invoice(A 19).No Services and all expenses related to providing those more than monthly services. R&E workbook will be provided by DOH. and no less than A. Expenses must match General Ledger. quarterly. B. Other revenue/program income must reflect revenue R&E showing all actually received in the reporting month. All entries on"Other"rows must be accompanied by a sources of revenue that description of the revenue source or expense, including any support services must calculations uses. be billed within 45 days of the budget period.December billings must be submitted by February 10's. DOH Program and Fiscal Contact Information for all ConCon SOWs can be found on the DOFI Finance SharePoint site.Questions related to this SOW,or any other finance-related inquiry,may be sent to t uiance.a doh.wa.gov. Federal Funding Accountability and Transparency Act(FFATA) 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). The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent. Exhibit A,Statement of Work Page 6 of 7 Contract Number CLI131013-Amendment 21 . 3 4 el 0 Y in 0 0 N c e E as Vi It CI a Q ti E a c �° a `Lp z 00 >. :is• E. C 'n v g yVy • ri Q a- s o as 00 a, • a. X a e 00 ,^ v u • E c w as soi VI 12 •...• Cr ... ›.:i .".0 .... :� u L R. L 0 u Cr v S ti y E as m _ 5 . _ u E a 3 C IA — Q V CO C cii O =n. _ v v Y Q 40 C • OD - _ Y y OC ie 7 a+ 1� efi V w A = E it° 4.. 7 C _ Y , ti -2 0. u G 'a «• � o V y a) 4. cn .5 T. oho V1 Li Li aLc. d L' Q A •C O C N V G. •O C Q .E o •i d 0 .4. tC " N E, 04 R as—0 E O 0 vui Q..2 o.7 v .c y,'d o y Ln •> ...'•s D` h •5 Q 2, E s M, .t. o u y2y as � t 0 0 Z U _ y L T U OS V G a) .. G y • L id 4 V ▪ A X A a. .�., 4.. y0 0 .0 > < 0Ei '' > 3CO > •p t2 V r. u a U •u„ _ E LA m 3 o. gi w cis3L. V ui. ar O p -a y •L 7 oO J t� t� ^ 0 ctv � �, � � � 3Q ; aEo y � o C � h o s 3 p� v '- a. = ii a .a m of a `� c'e � g y 3 O .6 Q 6s u .s . - v � • Eo IX • € • E aoH3 cev• u n gd eE r 2.2 tiCS v aa `� u o 0Eo `—'•�, vH a vZ e 2 u, y '.3 e ,2 Cho E ' >, - teau •v A �p E E E• Q T H C `m ate' i7 d .tF.. C s0i Y s ; G U , 000 a > 33 U L. as E o 14 •v 4r m �' E E •5 u ,2 y a ,,, o y v .1 o •v ...NC u E. aZ = u o c ti V H O Q cd .a H H u t E L Qa ...a a> O rn o V "'1 a0Cs •0 n O aui 4.-. as C Y Y .s c •� - s s r w •..... V 0 O ra .r Ce t a , ° a 0 ._ a E U .° 11 v nw <CUwV E E ° EIL) V u Tv ar s O • C n. = o eyi y Q R v,.23 E E E000 •• 0 VI u •• n. • g E E h Q CS s U a OC E .- � U .a «1 Ci n a _ 0 `0 = E C2 OC ca a y u '� OG 8 et Wa n oE— 4. o. = CO c Vi Q Q ( col S 1.1 ' 00 C' NDp N ' — 00 VD O '.D L. "'• .+ C U H h en 00 � CD r c .n N C's N 0 N O C C C M M e vfOooehet 'o 7 N u = � L^ c°�i g ,se vN � MN a .. :v a o G'. U • E v �7 p ° O C a=i y U a s E a v 04 iz 3 2 F a A. E Q El 2 3 ft 0000 _ 00000e� oo d o• o r+ _ " — A " Ilea .Z g aa < to I.L. o OS L v 00N u U = T. 6. m t u Ce `7 �, — °' O cn Q QU - E eN> o 2 U O �. ❑ LL C `'L d �' N V) '.D oo Q+ V0 — O et '0 — 00 4tOp C 1n C u C u d a. > N M 00 — v) O O+ �n VD CM M w C C Z E a V5l a> w MM [•' 4) c0001, .400NTr N 8 t ° 'Z p,O. F °� 3 C a~°+ 00 M Nvn M N h pa �� E C ,_ '.7r N a C 6.• v Q C ° a E en - L u I' „ .a 7 V I—. y '0C 5 Q ° OL r. A L D L ... Q y or iv v ZEI 7'+C U a N N_ N N CA N CA N N .0 u q �" C CDO O O — O O O O — O m y a on en M en en en rn M M M M . ' C `pT O O O O O O ONO 0 y 10 A E • O Cv a � y U C N N N N N e+i P•1 M M Tr 0. 00 Q . 2 E = h O Q N N N /V N N el N N N N y 'U C ..1 v c7 > > �� ' o0000000cov E m £ ° h O C .. a N o — VI o o 4D o o rn 0 °••v L. 0 o 00 0 0 0 =W O•p •= ', 41 vl In N in cn cn r. cn vs N 4 O m C c. cn O y U d vi vn v, 41 4n 'n .n vl 'n WI .n a pN w®❑❑ z U d D 66666 � CCOGC W CU N E > •g M M M M M M Pi Pi Ni M M 0 •00y Q w N V •^ Q �. V M M M. M M M M M M M M y .•�. r :E E ' o = . � r L v d O OL 0 E E GA F4+ LQ `I aDa La u ey . 4; N N N N N N NNN O tr C. rr 0 ci >. ia v'. an ten N .n .n .n an .n N a o i0, Yl Y1 V1 n n cn ILA cn .n ny N Ly Le. C A 0- CA _ U � wJZ o000000000o 42 p •o 2. U cCd . — h — N al 00 d• O vi b M d• M M •. V- d• eh vi It o Nam_. E'•'• v, —u 'O O O N .� N O O � N O h C .... N ,T'7 z �+ p ° VD �D VD VD VD MD ND VD VD VD VD G G .. U N N N e, N V+ N r- n F- C ta U — a=i C UU z w in c "' .0to 0 � y 0 . 0 E E v I- o o � 6. 3 b h a,od Wry a ❑ 0 e r Lon O. a. ` on E`er 1--• h o ° 3 3 .. H 0 � a .- E- :- • z 4t N ° O Q it .�w zz 5 � A V p¢. v ❑ O 9 v •e JO CCuc aN a UUF F U FU c.•- Et :4 > i :nv) 5 FCP) M � E 17 OC o hVi 2 2 2 vcn � .. . O.•a ao F f- 2 E- E= � - w X zz8 c7 z . c.D 2 N ar o �' a3 'Cv h W W p40 � WC70WC7 a N v > y = ii vi m a .� .� Qa, aaoG -a � a -� � °o o 0 0 w u ° ° UU a 0Ua Ua > - ° E h w C. E F- II UUa aUU A ce u C o i+. co 33 co 3 IL: = T �w EE e z 4) Ts v 0Q4QQQ000QQQ el a .Q r ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 un C . _ c aa 0. a VI 410VVI u.t, 01 a: cE y ° C; N en N NM M d• en Tr vn er Q Z" 3 1E d r.., N Cl N N N N N N N N N E„� 0 00 s a CI La. c. : ca. c:. wwwwww ClF ti Page 50 of 55 Task Payment Activity Deliverables/Outcomes Due Date/Time Frame Information and/or Amount The Department of Health(Department)State WIC Nutrition Revised authorized Program has the option of reducing authorized participating participating caseload for caseload and corresponding funding when: January 2023 through I. Unanticipated funding situations occur. December 2024=265 2. Reallocations are necessary to redistribute caseload statewide. Revised authorized 3. Caseload declines. caseload for January 2024 through December 2024= 270 1.2 Submit the annual Nutrition Services Plan for each year of the Nutrition Services Plan First year due 9/30/22 Payment withheld if contract. Second year due 9/30123 not received by due Third year due 9/30/24 date. 1.3 Submit the annual Nutrition Services Expenditure Report for each Nutrition Services Expenditure Report 11/30/22 Payment withheld if year of the contract. 11/30/23 not received by due 11/30/24 date. Tell participants about other health services in the agency. If Documentation must be available for review 1.4 needed,develop written agreements with other health care agencies by WIC monitor staff. Biennial WIC Monitor and refer participants to these services. Provide nutrition education services to participants and caregivers Documentation must he available for review 1.5 in accordance with federal and state requirements. by WIC momtor staff. Biennial WIC Monitor Issue WIC benefits while assuring adequate WIC card security and Documentation must be available for review 1.6 reconciliation. by WIC monitor staff Biennial WIC Monitor Collect data,maintain records,and submit reports to effectively Documentation must be available for review 1.7 enforce the non-discrimination laws(Refer to Civil Rights by WIC monitor staff. Biennial WIC Monitor Assurances below). Submit entire WIC and Breastfeeding Peer Counseling Budget Budget Workbook First year due 9/30/22 1.8a Workbook for each year of the contract Second year due 9/30/23 Third year due 9/30/24 Submit Rev-Exp Report spreadsheet from the WIC Budget Revenue and Expense Report and A-19 First year due monthly Workbook monthly with A-19 through December 31,2022 18b Second year due monthly through December 31,2023 Third year due monthly through December 31,2024 See`Billing 2 Breastfeeding Promotion Requirements" below. Provide breastfeeding promotion activities in accordance with Status report of chosen activities in First year due 11/30/22 federal and state requirements. Nutrition Services Plan. Second year due 11/30/23 2.1 Third year due 11/30/24 Documentation must be available for review by WIC monitor staff. Exhibit A,Statement of Work Page 2 of 7 Contract Number CLH31013-Amendment 21 L 0 N TS a ¢ E SO C in a r, 0 C as C L u y Vtt ^ EHi u 6) E m .' c a h , e. as M g 3 U E N � N � N r;= O o Im `L 0 N0C • L. N .r.' - .°9. y C NC _ 0 y Q E a Iti M 'c .... c C N el, 'c .'T. Q' 7 E ° � � _ s N a ° ° a0 Z oo u y C • L. O Z 7 u /! N u ed -0 CJ Uit) ° a U u 'c 0 U C_ y O O U u v E Li 3 � 3 L. 3 3 L . yN a E 0 >` L >+ y —, G L N _ E y. ° uu "0 T 03 u .O y, ea A >,to C C U c •_ y' e � c _>( c .0 E c -IL v v .0 O_ 0 `~ ` c u t •v 44)) u e N C.". co I.:, v: m wv� - oo m 3 � ¢ � N ca a c :° a u u u 3 a. 0 T u 1 m ` u N c '9 I. C °l' `0 0 a o v L. •c ',.- e t..„ o a e.., Cr _ u o a '� V Q t u u O •V a u n ea E o as• le e at R a0O. m 7 — v • OO 77 e- 7 « > u Q to C� U C > u u c 5 2 7 v u on �, U v *C A °C. = r. s▪ c e▪s A. O vrOi 1. le = E 7 i° g v) / 7 v. 3 L e.. .0 C `O 4 u y c 0 E r. ` ° E o - r. 'n O 9. o .. aea x >, c O c 1 E .2 c o - c c u C C u • c '• C u _ ° c �� a. ea u ° G O V) u 0 03 o ca. H ' _ 0 t et u u u u en C. g uU 'c° �' uC•E. uV c ys u J = 3. u .o auto .n '... E C — E E v = E •v v - ea a 'c 73 LI a ' 3 ° 3 u p • ws 03 a c+. c Z '� -0 C1a . .0 CA 3 S c' '° et y. 0 _ a c ,C u L u u °. E eu c 13 yy c • u el Q eu co; ea , O.y u G c v u y O ° u .� "ei ° C O E .o c = u C vU 1 •s o `i'� •-, Ee u toH e40 at u' E s u ° r s ° o• > �- e 4.1 A C E C E 1 5 0 a. g 6 a u a � � 2 R � a E 0 0 > E er - e 04) , E v', ea toZ on 2 Ts '� = > eu ay ° � o E E E .; '° c`D °u. E ems - vw Q o.. E o u ed E. a et._ E c a ., se'. E 0 ,uv re, •o .a R ; C C zr ea O c C Q.. ,s; is u ° ° Q 'a u ° o crt E °tI o O = E u c Qy+ Ea o fonv0, a E oi° on � c !. L za e.. '.= F- u �• u e t C u ea •� U '.X a °- G to CL y 7 — O ^ ;•. in r Q ° 3 ` a = H .o {.• U ° R a t c o .as 0Du c 'c a c L. .: O u uQ . ' 0Mg '° 0 ?: cugd C, eo � o , a• s ° � 3 ev Wig. " u — r ae E U .. .0 ese $ sou ay C � "u ^ w by o f " a U y, ea = c o loeuiuozi s E -E w vwu o ea .. . � 3v0c0c.) ovo ° mga' 3 m a L � � a .c oo � E u '' a 'S3 33 aa`. d a S o tcis -hhe as v. 8 '0 0. 8 � ▪ eo01 2 • . 8 m ad a. a To M3 $° E L. ,�' o0 pi — �, = u evHa eR yr elelO e 'a co E Page 52 of 55 To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Unique Entity Identifier(UEI)generated by SAM.gov. Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.I.. 109-282. Program Specific Requirements Program Manual,Handbook,Policy References: The LHJ shall be responsible for providing services according to rules,regulations and other information contained in the following: • WIC Federal Regulations,USDA,and FNS 7CFR Part 246. • Washington State WIC Nutrition Program Policy and Procedure Manual • Office of Management and Budget,Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards,2 CFR 200 • Farmers Market Nutrition Program Federal Regulations,USDA,FNS 7CFR Part 248 • Other directives issued during the term of the contract Staffing Requirements: The LHJ shall: • Use Competent Professional Authority staff,as defined by WIC policy,to determine participant eligibility,prescribe an appropriate food package and offer nutrition education based on the participants'needs. • Use a Registered Dietitian(RD)or other qualified nutritionist to provide nutrition services to high risk participants,to include development of a high-risk care plan. The RD is also responsible for quality assurance of WIC nutrition services. See WIC Policy for qualifications for a Registered Dietitian and other qualified nutritionist. • Assign a qualified person to be the Breastfeeding Coordinator to organize and direct local agency efforts to meet federal and state policies regarding breastfeeding promotion and support. The Breastfeeding Coordinator must be an International Board-Certified Lactation Consultant or attend an intensive lactation management course,or other state approved training. Restrictions on Funds: The LHJ shall follow the instructions found in the Policy and Procedure Manual under WIC Allowable Costs and 2 CFR Part 200 Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards. Special References: What is the WIC program? 1. The WIC program in the state of Washington is administered by the Department of Health. 2. The WIC program is a federally funded program established in 1972 by an amendment to the Child Nutrition Act of 1966.The purpose of the program is to provide nutrition and health assessment;nutrition education;nutritious food; breastfeeding counseling;and referral services to pregnant,breastfeeding,and postpartum women, infants,and young children in specific risk categories. 3. Federal regulations governing the WIC program(7 CFR Part 246)require implementation of standards and procedures to guide the state's administration of the WIC program. These regulations define the rights,responsibilities,and legal procedures of WIC employees,participants,persons acting on behalf of a participant,and retailers.They arc designed to promote: a. High quality nutrition services; b. Consistent application of policies and procedures for eligibility determination; c. Consistent application of policies and procedures for food benefit issuance and delivery;and d. WIC program compliance. 4. The WIC program implements policies and procedures stated in program manuals,handbooks,contracts,forms,and other program documents approved by the USDA Food and Nutrition Service. 5. The WIC program may impose sanctions against WIC participants for not following WIC program rules stated on the WIC rights and responsibilities. 6. The WIC program may impose monetary penalties against persons who misuse WIC benefits or WIC food but who are not WIC participants. Exhibit A,Statement of Work Page 4 of 7 Contract Number CLH31013-Amendment 21 O ^ O 117 eV C e C �CCw. t 5 r u c .0 O v •C _ u 7' «'^ > u _ ` 'fl > > C4 u U n O 'Ea u, eS C '0 L O u >' t U h CZ u v o � .�. `m •E .0 E aE � 0 L. > a LJ $ CA in C € . t E c but uu - E „) '._1,1 M a) LL c r O r, ti •p el3 U) L. d A • eS . . Cg E e`a y 4 c9 O a yea � ,. im u La � ° d 'C 3 A i' 0"' _ 61 0 c u .0 ats c Vi .E .a u U. . o4. c vr � �. -0 02 ` co a c u $ uv e O Li `" u e `° N0 o 5. v y v (4 rat . r3 ' �a Z ZT OO C C N V —o a . ..... c. � F'�U R c `U° "CI o c N e c ?� r y (NI V 0 •A � � 3 n � aZo )34g �� � tr � o E C 'b Ti A ;�iC u � 9 `• • 0. 0 '44 ' � u b a' Na a� u p y •a c 0ceal� 3CU Ts' a�i y o • �; C. g, w = o vl C .= C s U C en •C C G H C 0. ta 1 v N o H17 C p w c ►. `E O u N u d 'a •y r 7 O u e 17 c is N u T u C O N V v T. .U„ L• u N o C u = �y' 3 = m `• aro p E w C w !,c° E E 3 u a •N ii, ° c a 0 0 _ a u c � .� I. = u ca„ 0. H VV'• y a ►. u U 'S ^ OD LL O egd c > „, 9 •a E •- ai ,Cpo O Li VI . « � ue...• Q u 0u op 0 H E 17 a.ss „ • e=6 NZ 15 U 0 U O vOi a) £ u 7 K A y ►y. u C C C E ►. Q f. `' y •� O n m s E L .= v •a E. 0 w et E ., o s a 9 ouo >, n c 4. u O. E ° d a u 4U o e ' Os O ... .e -ov .D y .Q.3 u c 'el 6 r T 7 V] C 'ap ao..: 2 to u g o. o O E N E o u m a u • o C C C .. CO u • E � W ,o g " T.c E u °GCE $ a` u c E too H v o QhQ= tea, c•s `c° E d tea, n csu, 4g, c 3 ✓"� y o id E s>, `'- .0. C 2 '3 7 rL r0 E e,OF., E .ue s U C.1 U O •_ E u G. L 0 54 a eT -o .o Z .. .a U C 'Q A �cc€o v a E O C .. ...2 _ m O c• O c v b u c s = S L = u •� cs eo a c 0 E y w o. C u E E •a v •tea- > u °u `"° = = 0 .E ac, v4- c ai Z c., •'CI- dE o era .� •� >,°; a ]i 1c�s+2 _ u E b R y E n ``' qQ u 0 U o y a u - u U u W u �. E F .c w ` c. V CCi v •� •. a Is e N C C u 3 •= V' 'E eo 3 _ •p c �_ O a g c u u $ O A •_ g'F N W O emu+ Q C U 3 C 'L7 O 's vi QQ =' C E N C T0 •:fl 0 I. a r-. O T0 -5 y r 0 y tC «� _T O u 7 A u y u 00 .. u •fl ea 0 INN e ,v_ s a) ` `° � Eo `� u Ea e2ou1O E �� 'E 3 E w E .Sy h $ ti Q. 0 00 � � s a u ° rCC0 .= Q Nay a u O L V C O. = 7 00 0 tu r O. C co Y .. Li 2 w eai u u au F`- u W a w e c o u e >, V .u p u G 4�. A ELI ►- = E u 0 N • I. •n et O = G 0 ai = .ram O iC O £ p O u y U. O •fl ani _ G `"" —' y �a p '^ C =N a 4 u' `'" t E u w d u >. ` E 0 en o Te -o u •c 3 ee en = c c p v g o .v .c m o u as u a 3 ea •- u o, C] � u c w co U v w E o 0 3 u uD 1 c v `� a w `° �ap� C _ �t T C as i� C O 5 0 `� U >..7 O `� =� 0 `3 `o. �_ is m = al O C + V y Q _u O Cr tn g u0 t0 0 ^ bf, O 'C u c �. c O`O p.=• I. a) g u Te at^ "E s c Laz goo = E ;� a.'.. 0 0 0 • v 0 n -c u_ 'o A C E C 8 c u e .A E oU N v S eia u v u � y E y � �_ ''^ u �' e c e b d S A.c a•2 io s -J• v t "0 E c = E H 5. 'E a 'y e4 y y �4 �• '/> CT > p ^• {� .+ r e C 00 E V } O a) O w L en e9 •o = `0" E ,o � ° er' u u �' � g .o 'y w `;: i E = u rsV E •u - 3 m c � a . . >.b7a>i' a u •E c 0 " E. E 3 E E Q v u c ` O a n '� a s vi u = u coE u a r �.. 0 .- 'g00 ` as € v .a ►.7 o °r' c, ccouu .- ° AEj •E0 `" i = e3 .5L. 0 0aci `° 0 E e a'_ •ia u o V 9 4.. '7 o en •r. •C • p CI e I s Lo o > .2 u 0 0 UEC c y ^« ea E Q O o. E n E 'o '- C a> u u 4t v. oDlV �' u.0 C u u o u E .` E .0 5 iW v p " A= E 8i v at >, eZyh •c .' u u y rs c " = 7 u in u pp'S 4, V y .4 Lg.' . 5j' ,' y = ,= 4 Q �.. :z E. pp u O- •7 .0 E § >•1IH C.• 44� c ... ea cc .a ° Q 1 • • • • c c.) - °� E- < ea .a 6 •v E— (.) ee .6 u ev E^ e i h .0 00 0 U on to: X �,.... `'= G. c — u 3 u E al 'E - — h C to c `0 mow_- v < c E c �.. w .c 'ea N 7 ��,,, .. `n w > w u p V w C 1 c $ e% c -o ce = cd :: o u J •E c n C E In H p to 3 b an •.+ ON 0 x — < O O U k Q •C J 7 - 'fl -.1 = -0 O J N u .w• V Q 0 w C 0 O ` T. ;/1 `„ �j �c0• u a co = C, T .0 O a i 44 •cJ a u o u — :' "0 a� -c o c a . E 0 .7 £ g, -a u r''' > _a c Z L a •0 t w a ° c �, = H � < . c . E $' g � U .c <5 0L c J ea E y w N 3 >0 ' X o E o a° � € a •= � E o u O eC 3 ., = y O U 0 c 'O 2 w ea ` ` C O u a, y 0 V O u a. Q O u `t 0 u _12 C U U 0 0 0 O OC •O. '7 '> 0. y u O y V b u `' 4 3 $ u C O as y .. N uro u a) O. Y 7 0 y G ea O .d,., w o -C V .p a t0 'c oq .E = V c vim' u .� c > �•O. y ... u ._ a. e 1- y 3 w to O .- pc �" u 'O t u s °� o "' o' o'3 aru -v No. E W a c a4 Ty LA o .o �+ ;; cn 'u E .= a .° (� W �° op � ;c e.o w o `u c ri, v Lisc, . o 0 o v0. co Li - `o C p0. 4"" •0 = p y OL N C y v v' V a g •C G' > u v a, m u � - m h L; 6. a R u .o W u ou •v c oo �� oa a v .0 s pC •• 3 as c as «u NNNN 'o := 7 � c csi aci � 4 � _. °Q c o .� y Q ,O a .4 a N N NN .� ' C � � i° E w0 � y a E J ` L' O? ...4 aY aw t Q V � s C'fl . . ,, Ou U u W a .'A wu� M Qc h'oOp �MM , O. S y avim . E c ° ` c o a. Er w 0OA CA e•E. EEEE �+ As ac •`y6 � u � � o .ac' � � -o _ -II a E m e � a ��., a. r O u w O0iO'0 a.. 'fl V • r, v' v' •a0 �C,, •> Q a 7j ✓' ,'O.' 1 o u• a aai 0 o a o u Q .0 u •>- `�° iv v >, u g. -a U .1 c s 713 0 ass a � _o � o. a * o = ; 7 o `c.� � o o Q rV 00040A00 a. u � .r -0 •p ._ ch. _ u c c `" o N U a 0000 v w L "Cl •� A Q,= O A '0 �0. C O .to., C C. O N -E •v s s '$ -5 Fes- u c.. � .. m u ax -co o c criy `' °� b o 00 •o �" �.. N N N N •Y y .0 V im' y '�. .0 � a C 0 ay.. N 7 �C E t% t^. 4� O 0 O O O 0 u _ .'C.. W C! n' > C C •.: .wj 0 CA V cC I L. C - - - •• C 5 a ► a •p c C a,C p .. ` esa ,� NNNO C UE a a•- _ 0. O ", u7a. u .E ti..C . ` — � o y _ O aio o` a w O u J... ° .0 u'a — cUwu Ec ° v u $ i cu na � = Euu oc ° '5 ec � aos, ru„ a a)) oN u _ c CO a v a2 = s cu„ 3 > y VI _ ai a be. p0 - uti 1.0 s> CA W >, `° o E t' we a yo I . • g 0, a: C c ell; C 0 0 .3 E CO L- t w - a Ci ^ = N.. O G' N N O O >.,-0 p 0 e4 w N U III c. 00 7 3 E CC -, E aJ N N C �; "i' u •" e C E ea y ` u °� u c N en o � a � ,, E .E w � � � g' E,� ra t. = E 0 > 5o a0 e 0 •c E E g = — * y c u" ea E.. �a yy, F= V 0 .-. N ►-. N C. in «. O O ,C w p • ., H — e4— O OY O 'YOB io 2 .. vim. A N d = •N 4) C 0. U -0 E •p` u •C I u y 7 y u y a`6 C y .C C E E _ 6 0 awi O. .c p 4 M E v. G. m w du y rn y u co w A = �ppi v y 3 .� o, w O N a N •�'� Ill 14 V �'� T C O O ' _ O V.. N s :� •0 _ a N O O N 73 � �c a e cQO .0Q Ewrsa. CO .- aQ — e ; C . o CO o � a .0 Q O O = 00 0 7 c° ,a„ eO p ��-' E C .— co p] ee c� 'C aiw oq s a — � G� :, °` :, E V O C a a 4i u O p u u s m ^ N ul (- r; N M Cu) Gi -� V) •-. V) L.L7 I Z luawpuawy-£10I£H13 JagwnN pealuoD L Jo L a5R(1 )IaoM]o WawalelS't+1!q!yxi •spun]Jo luauuCsdaL JO soul.;iCaelauow u!imam,CEw puE uonaR 3n!1331100 01 laafgns aq i(e<u paMollo3 iou are Imp sluawaa!nbaa wea&ud Auy :aagI •sasuadxa 2wweal DIM panoadde aaglo pue'(saolaealuoa ao aw!1-ued aoI slgauaq!.isles) 1 Su!u!sal u!aled!a!ued o1 aw!1Den'sasuadxa lance`suopeals!Saa 8u!u!ea1 aanoa 01,CaoSalea SpsaluoD iZOZ VZOZ lagwaldaS saa!naas wagD DIM HQSII all u!poppy •Su!u!Ea1 palelaa-DIM u!aledmued o1•Ijes DIM Ile ao3 s!8u!punl s!q,I, 00S`ZS aagwaldaS-£ZOZ aag0130 -£ZOZ aagoloO 99 10 99 abed 615 Sheridan Street �✓//�� Port Townsend, WA 98368 ITn www.JeffersonCountyPublicHealth.org Consent Agenda Public Healt ti JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners Mark McCauley, County Administrator FROM: Apple Martine, JCPH Director Veronica Shaw, JCPH Deputy Director DATE: �e 1s'( a m kLer SUBJECT: Agenda Item — Consolidated Contracts Amendment #21 with the Department of Health; January 1, 2022 — December 31, 2024; additional $1,258,189 for a total of $10,674,468 STATEMENT OF ISSUE: Jefferson County Public Health (JCPH) requests Board approval of Consolidated Contract Amendment #21 between JCPH and State of Washington Department of Health (DOH); January 1, 2022 — December 31, 2024; additional $1,258,189 for a total of $10,674,468. ANALYSIS/STRATEGIC GOALS/PROS and CONS: The purpose of this agreement is to provide public health services to the people of Washington State. This Amendment adds and/or amends statements of work (SOW) and funding for the following programs: • Office of Immunization COVID-19 Vaccine — provides funding to conduct COVID-19 vaccine activities (funding of $10,966). • Office of Immunization-Promotion of Immunizations to Improve Vaccination Rates — contracts with local health to conduct activities to improve immunization coverage rates (funding of $5,600). • Office of Resiliency & Health Security-PHEP — establishes funding and tasks for local health to strengthen preparedness for public health threats and emergencies (funding of $20,630). • DCHS - ELC COVID-19 Response — extends period of performance (additional $15,580) • Foundational Public Health Services (FPHS) — adds entire SFY25 allocation (additional $1,166,500) • Maternal & Child Health Block Grant— provides additional funding, adds activities and deliverable due dates, and extends period of performance and funding (additional $9,175) • Sexual & Reproductive Health Program — adds funding for period of 4/1/24 — 12/31/24 (additional $13,747) • WIC Nutrition Program — additional funding provided (additional $15,991) Community Health Developmental Disabilities Environmental Public Health 360-385-9400 360-385-9444 360-385-9401 (f) (f) 360-3/9-448/ Always working for a safer and healthier community CC-22-002-A21 FISCAL IMPACT/COST BENEFIT ANALYSIS : Total consideration for this Contract Amendment is an increase of $1,258,189 for a total of $10,674,468. The Consolidated Contract is funded by DOH, and comprises both Federal and State funds. RECOMMENDATION: JCPH Management recommends BoCC approval of Consolidated Contract Amendment #21; January 1 2022 — December 31, 2024; additional $1,258,189 for a total of $10,674,468. REVIEWED BY: Mark McCauley, C anty Administrator Date Community Health Environmental Public Health Developmental Disabilities 360-385 9444 360-385-9400 Always working for a safer and healthier community (f) 360-379-4487 360-385-9401 (I) CONTRACT REVIEW FORM Clear Form (INSTRUCTIONS ARE ON THE NEXT PAGE) CONTRACT WITH: State of WA Dept of Health Contract No: CC-22-002-A21 Contract For: Consolidated Contracts, Amendment 21 Term: 1/1/2022 - 12/31/2024 COUNTY DEPARTMENT: Public Health Contact Person: Veronica Shaw Contact Phone: x 409 Contact email: veronica@cojefferson.wa.us AMOUNT: Additional$1,258,189 for a total of S10,674,468 PROCESS: Exempt from Bid Process Revenue: $1,258,189 Cooperative Purchase Expenditure: Competitive Sealed Bid Matching Funds Required: ^ Small Works Roster Sources(s) of Matching Funds Vendor List Bid Fund # 127 ._ RFP or RFQ Munis Org/Obj 12756220 Other: APPROVAL STEPS: STEP 1: DEPARTMENT CERTIFIES COMP.LIA'atCE WI H Jt -. so AND CHAPTER 42.23 RCW. CERTIFIED: ❑ N/A:I I � �... _ Aug. 28, 2024 Signature Date STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE COUNTY (CONTRACTOR) HAS NOT BEEN DEBARR D BY ANY FEDERAL, STATE, OR LOCAL AGENCY. ‘("// /CERTIFIED: N/A: / � (9 ' r n l Aug. 28,2024 Signature Date STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche): Electronically approved by Risk Management on 9/4/2024. Contract amendment - state contract. STEP 4: PROSECUTING ATTORNEY REVIEW (will he added electronically through Laserfiche): Electronically approved as to form by PAO on 9/5/2024. State contract - cannot change. Amendment#21 with all prior amendments and original contract attached per PAO request. STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND PROSECUTING ATTORNEY(IF REQUIRED). STEP 6: CONTRACTOR SIGNS STEP 7: SUBMIT TO BOCC FOR APPROVAL Page 1 cf 33 JEFFERSON COUNTY PUBLIC HEALTH 2022-2024 CONSOLIDATED CONTRACT CONTRACT NUMBER: CLII31013 AMENDMENT NUMBER: 20 PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as "DOH". and JEFFERSON COUNTY PUBLIC HEALTH,a Local Health Jurisdiction, hereinafter referred to as "LHJ", pursuant to the Modifications/Waivers clause,and to make necessary changes within the scope of this contract and any subsequent amendments thereto. IT IS MUTUALLY AGREED: That the contract is hereby amended as follows: 1. Exhibit A Statements of Work, includes the following statements of work,which are incorporated by this reference and located on the DOH Finance SharePoint site in the Upload Center at the following URL: htl�s:!'statcof}vasharencieutsom/sitec!doh.ofsfundiw*cso_ki sitcy1a o,llonw.Aspx'' r,1:9ah4( tI 'd94d3catQac7;1}c s).c4d lc ® Adds Statements of Work for the following programs: Foundational Public Health Services (FPHS)- Effective July 1, 2024 ® Amends Statements of Work for the following programs: Executive Office of Resiliency& Health Security-WFD LHJ-Effective July 1,2023 Recreational Shellfish Activities -Effective July 1, 2023 Sexual & Reproductive Health Program - Effective January I, 2022 WIC Nutrition Program - Effective January 1, 2022 • Deletes Statements of Work for the following programs: 2. Exhibit B-20 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B-19 Allocations as follows: ® Increase of$1,218,566 fora revised maximum consideration of$9,416,279. Decrease of for a revised maximum consideration of • No change in the maximum consideration of . Exhibit B Allocations are attached only for informational purposes. Unless designated otherwise herein, the effective date of this amendment is the date of execution. ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect. IN WITNESS WHEREOF,the undersigned has affixed his/her signature in execution thereof. JEFFERSON COUNTY WASHINGTON STATE OF WASHINGTON BOARD OF COUNTY COMMISSIONERS DEPARTMENT OF HEALTH 07/17/2024 Kate Dean,Chair Date Date APPROVED AS TO FORM ONLY APPROVED AS TO FORM ONLY Assistant Attorney General July 4. 2024 Philip C. Hunsucker, Date Chief Civil Deputy Prosecuting Attorney page l of 1 C C-22-002-.1120 S.lo I ales 000'SIS 000'SIS ZUOE/11 ZZ/l0/10 ZZ/IEi01 ZU10/EO L4'99'£CC Z44'99 ZP'-OV 10f4Lf10 (A03)1IVI11,1c1 »Vgaaig9unu'.uiMSZZ/.3d 000'SIS 000'SIS £U1E/01 EZ/10/£0 EUlv01 £U10/E0 L4'99'£E£ LL4'99 11PWV 10E4Lf10 (A33)JIVIwe1O)3V43e3g2wwwIMS£ZAd3 000'SPS 000'51 S 000'51S 4Z/OE/11 14/1O/10 4Z./OEI60 4Z110/£0 L4'99'££E ZL4'99 Si PWV P3^13332110K VON (A03)ZIVI Iuei913V gaeag 3u!unu!MS vZA33 8617'SEZS 8Z/IE/80 LI/10/L0 EZ/Ot/I I ZZ/10/TO Zl'99'EEE EZ1'99 SI'S t PuIV 10081/10 trXsul SSO S-I ISS Sd (4591S) BZ/IS/SO LI/10/L0 £Z/OE/ll ZU10/10 Zl'99'ECE £ZI'99 SI'L?IuV 10081110 4:IsulSSOS-11SSSd 448'ECZS VWE9ZS 000.0ES 8Z/I£/80 LI/10/L0 EZ/O£/11 ZZ/10/10 ZI 99'E££ £Z1'99 SI Pu'V 1008If10 V I SSU s-1 ISS Sd IS9'SES IS9'SLS 1S9'SfS SZ/O£/90 £Z/I0/10 £U0C/90 EZiIO/10 ZO'IZ'E£t LZO'lZ El PwV ZOOOd1l31S leluawalddnSdc061-QIAOJQCI 04L'94S SZIOE/90 EUIO/LD 4U6Z/t0 £Z/IO/LO ZO'1Z'f£E LZO'IZ 61'51 PWV ZOOOd1131S Vd11V 61-01A03(1114ZAd IOt`65 10£'6S (6C4'LES) SUOE/90 EZ/IO/L0 4Z/6Z/ZO EU(0/L0 ZO'IZ'fE£ LZ0'1Z 61 PWV Z000d1Id1S VOW 61-a1AOJ(Hi PZAd 9155 91SS ZZ/0E160 1Z/10/01 ZZ/OE/60 ZZ/10/SO LS101'EC£ ZLS'0I 4 PWV LVMOILVML mat%Soia dNWJ VUS11 ZZA33 96^S 964S EZ/0f/60 ZU10/01 1Z/0E/60 £Z/10/90 LS OI10E ZLS'01 SI PWV LVMOOLVML nual42O1adNlti3 VCS11 EZAd3 SOS'IS 9611 964S 4Z/0£/60 £U10/01 4Z/0E/60 41/10/S0 LS"OI'£LE ZLS"01 61 Pwv LVMOO8VML P1443oi1d'IKJ VUS'l4ZAd3 OCR'ZS 008'ZS 008'ZS EZ/O£/60 ZU1O/0I CZ/0£/60 EUI0/10 SS'Ol'E£E LSS'01 0l PwV LVMOOLVML SSJ V l 9o1d JIM VUSf1£ZA:I:1 OSO'4LS ZUOE/60 (Z/10/01 ZUO£/60 ZUI0/10 SS'OI TEE LSS'01 I PWV LVMOOLVML slailo°J s"S Iu343 JL1M VUSI1 ZZAd3 9ZL'9S ZZ/0E/60 1Z/10101 ZUOEI60 ZU10/10 SS'OI'EEC LSS'01 S MN LVMOOLVML sPenao)°nS 1=11)JIM VCISf ZZA33 9L£'98S 009'SS ZZ/OE/60 IZ/10/01 ZZ/0E/60 ZZ/10/10 SS'OI'f£t LSS'01 L Puv LVMOOLVML sp iluoD sAS 1u93:)L'IA VaSfl ZZA33 OSCEZS EZ/0E/60 ZZ/10/01 £Z/OC160 ZZ/10/01 SS'01'ICE LSS'01 1 PWV LVMOOLVML *nGIIWJ SAS iU !IJ JL11 VCS11£ZA+1 EICSLS £L/DE/60 ZZ/10/01 EVOE/60 ZZ1I0/01 5S'01'£CE L5S'01 01 PtuV LVMOOLVML SlaraluOJ sn51u31I3 JIM VCSfl(ZAd:1 BIZ'lZS EUO5160 ZZ/I0/01 £Z10E/60 ZZ/10/01 55'01 EEC L5S'01 ZI PWV LVMOOLVML slacnuo3SnS1uay)DIM VQSf fZAdi 8EE'Zt15 LS9'lIS EUOE/60 ZZ/10/01 £Z/OE/60 ZZ/10/01 SS'Ol'EEE LSS'01 SI PWV LVMOOLVM4 slac,luo3SASlu3!IDJIMVCSl EZA33 8fZ'SZS 4ZI0E/60 EZ/10/O1 4UOE/60 £U10J01 SS'OI'EEC LS5'01 SI'01 PwV LVMOOLVML slaeunoj s''S luali)JIM VQSf1 tZA3d 005'ZS 4U0f160 EZ/10/01 4Z/0£160 £U10/01 SS'Ol'tft LS5.01 S I InuV LVMOOLVML slaenuOJ S"S I11311J JIM VOSEI PZA33 060'6LS 4U0560 CZ/10/01 PZ/0£/60 EZ/10/01 S5'01'EC£ LSS'01 L I PIV LVMOOLVML S13e1 UOJ sts 1u3!la JIM vase 7ZAdd CSI'84S 41/0E/60 EU10/01 P110E/60 £Z/10/01 SS'0l'E5C LSS'OI SIPuV LVMOOLVML slaenuo3snsiu311JJIMVUSIIPZA33 a>.:'5513 itg..S tZillf 60 £UIOAH tZ'I)£/64 lI Ill.HI S>111YCi Li>'III Ii rusk L�'.1t110LV the :pv_iluo;1<.,S Iua!IJ:11.1t V(1S,1 ti.13 9fL`OOPS 89Z'9ZS 89Z'9ZS SZ/Ot/60 4Z/10/01 WI ER I 4Z/10101 55 01'£EE LSS'01 LI PWV paniaws ION VON sinaluOJ snS 1u3113 JIM VUSII SZAdd 680.41 6RE'E4S 11/0£/60 1Z/10/01 PZ/0C/60 ZZ/10/1D SS'DI'££E LSS'01 L I'I Pun/ I VM0OLVML IwSw Scud Jd38 VOSI1 ZZA33 E14'65 SZ/0£160 ZZ/10/01 PZ/IERI ZU10/01 SS OI CEE LSS 01 LI'01'R WIN, IVMOOLV/11L 1uSt Stud 3d39 VUSJ CZA:1:1 IS9'LCS 8EZ'8ZS SZ/0560 ZZ/10/01 4Z/IC/Zl UUI0/01 SS'01'fEE LSS'01 LI '01 P"V 1VMOOLVML 1u12112uld 3d38 VUS11 EZA33 169`81IS IS9'L£S TS9'LCS PZ/OE/60 EZ/10/01 PI/Of/60 £Z/10/01 SC'01'E£E LSS'01 S l pUV IVMOOLVML 1ut91418431d 3413H VUS/I trZA33 IYj°.I. IelolgnS loamy aIeU Pu3 311011e1S 41ra Pu3 31'U uCIS ..JP0J .q 1s17 S Puawv At uolleaw!uapl ova wa18o1d slunoaaV;o map sluno3aV POlaad p0uad 8u!pun3 PONad SalPund fll'1 anuana„ IslsgV pae W Ie.Iapa3 Jo IJe4J SuIPung s7un033V Jo PJe4J IIaOMJO IUaw33a1S SNVEI ,f1u0 asfl HOU 411eall allgnd%46'LZ:4Z0Z`IE JagwaaaU 42n0J916Z0Z`1 L1enue f 31811 Iaanpul 41Is3H allgnd%S8'SE:EZOZ`IC Jagwaaa0 48no.t41£ZOZ'I moue f alell laa.Ilpul glRaH allgnd%£Z'6L:ZZOZ'IC ragwaaaa g5noig1 ziOZ'I Siemer mu laaJ!pul 4ZOZ`i aunf :alma 4Z0Z-ZZOZ:Waal WBJluo;) £lO1CH'lD :.IagwnN lasaluoD SNO11VJ0'1'1V 411oaH allgnd.S1anoJ uosaa,0af £E 10 Z 06ed 0Z181181HX8 Si"Z u8ed 000'113 ZZ/l£Rl ZZ/10/t0 ZZ/I£!Zl ZZ/I I/40 ZVE6 ftE IZP'£6 S P"V 001000.I.ORff1N IUJD g)IeOH'9 31u' ID VII4N ZZA.33 000'ZZS 000'ZZS 000'11' ZZ/I£/Zl ZZ/10/t0 ZZ/1Cal ZZ/I Il40 ZVE6'11E IZ416 6 PIuV 00E000108E11N 1ue1D 4)Ie01-1'9IIIew1'J III!3N ZZAHH 000'00Z3 000'00ZS 000`00Z5 SZ/OE/90 CZ/101L0 VZ,Iz'Z1 CZ/10/LO St'161tt 4Sf'16 0I'91PIUV ISIZZ6d106f1N fH1•U3AV1d61-QIAOJJ1131ZAHH 6t0'6£4S 4Z/1£lL0 1Z/S1/10 £U1£/L0 ZZ110/10 Z££6 Ef£ ELL 16 6'Z.Put' SIS0001D05.1N uo!teaoily fill 3Q3 Dia OZAa:3 (Z48'065) PZ/I£/L0 1Z/S1/10 EL/I£ILO ZZ/10/10 ZC£6££f £Zt'16 6'4PIUV 515000)130511N uo11eOIIV fill 7Q37130ZAHd ZZ8'1KS ZZ8'14ES (SL£'93) 4Z/IE/L0 1Z/SI/10 EIJIEJLO ZZ/10/10 ZL'£6'£ff fl1't6 6PUN SIS000ND0Sf1M uuneaOIIVf111 101 313 0ZA31 ZIL'Z8S ZZ/S1/0I 0Z/61/SO ZZ/81101 ZZ110/10 Z£'£6£££ £ZE'E6 Z PII'V SISOOOiiJOSf1N UoptxIIIV(H1 P3 CIIAOJ 313 61A:14 (069'8LS) ZZ/81/01 0Z/61/SO ZZ/81I01 Z1/10/10 Z£'E6'£IE EZE'£6 4 Put' S ISOOONDO5f1N u04E)0:]V 1H11'3 UTAOD:713 61AAA LEL`IS LEL'IS (ISZ'ZS) ZZ1Sl/OI 0Z/61/SO ZZ/81/01 ZZ/10'10 ZE'E6'f1E EZE'E6 L p:uy SIS000N170S11N UOf1e501IV 1E11,3 U1AOJ 313 61Add '99'41S 499'bIS 49013 tZ/I£/L0 OZ/CZ/40 ZUZZ/b0 ZZ/10'IO ZE 16 tt. EZ££6 Z PIIIV SIS000)IDO5f1N S311VJ GL\OJ 6iA:IH 009'SS 009'SS ZZ/0E190 1Z/l0/L0 ZZ/0£/90 ZL10/10 9Z£6'Et1 89Z t6 E Putt/ 619ZZ6dl£ZHN Sd03i'L ZZAdd 1.)0Z':IS 009'SS 009'SS £Z/Of/90 ZZ/IWLO fZ/0t/90 ZZ/10/1.0 9Z t6[tt 89Z'f6 S PUIV 619ZZ6d1£ZHN Sd0 3.A£ZAfl 009'5S PZ/OE/90 £Z!IO/L0 4Z101/90 fltO,L0 91.£6'tC£ 89Z'f6 41 P'uV 619ZZ6df£ZH. sdO7HA DID 4ZA33 091'93 091'93 095$ 4Z/Ot/90 42/10/LO 4Z/0E/90 £Z/10iL0 9Z't6£C£ 99Z'£6 SfPa'V 619ZZ6d1EZHN sdO73ADUD4ZA3H f0R'45fS PZ/0C/90 OZ/IOlLO 4Z/OE/90 ZVI0/10 9Z.£6£E£ 89Z'£6 i PIUV 619ZZ6dICZHN PX S2U' ''A 6101A0D 909'60LS 909.60LS EOR'4S(S IZ/OC/90 0Z/10ILO PZ/0L'90 ZZ/1W10 9Z'£6'£££ 89Z'C6 4 P ud 619ZZ6d1EZIIN 41i s=u!ooeA 61U11103 P11'8LZ$ 41 l'BLZS VI1'8LZS 4Z/OE/90 OZ/10/L0 PZ/0L190 ZZ10/10 9Z'E6'f£E 89Z16 V PUIV 6I9ZZ6d1£ZHN sau133eA 61Q1AOJ LEI'LZS Lf l'LZS EZ/1E/EO ZZ/10/40 £Z/1£.10 ZU10/40 ll't6'£(( L1Z'£6 S P"V 095900Vd1-1dg &1luueld.(Itms;X 313!I ZZAdd 6S6`LS3 ZZ8'OfS ZZ8'0fS PZ/IE/E0 EZ/10/40 4Ul£l£0 EZ/103,0 1Z'E6'CfC LIZ.£6 41PIUV 09S900VdHdI Bu!uueld AlUued X 3 iit LEZAHH ££L`LIS ttL`LIS £EL'LIS SZ/It/CO PZ110/P0 41/1£/Z1 PZ/10/170 1Z'E6£££ LIZ E6 61 NW P7/`!33a111°V VON Ueld X1!we3 X 31ILL V&1d3 4LAHH 990'11 9901S 990'4S ZZ/I£/£0 ZZ1P1/10 ZZ/l1£0 ZZ/01/10 IZ t6££( LIZ£6 Z PUN 564900VdHd3 sPaaN aa'C1 X 0P11 ZZA33 000'86S 000.86S 000'863 vZ/IC/80 £Z/10/60 PZ/1t/80 PZ/10/10 £I'£6'El( 9E1 E6 LI PIUV 81Z010:IJLif1K JUJQIO VZOO£ZA3d PSL'EIS 4SL'£lS ZZ/0E/90 IUIO/LO ZZ/0£/90 lli10/10 90'£6'Ef£ 690.16 Z PUN £40ZZ6d.L06f N 8U!PUuZ(H1 fd8 alai Id 1ZAdd 18E'4fS 48£'4£3 1Z/0£/90 ZU10/LO EZ/Of/90 ZZ/10/LO 90'£6'E£t 690'£6 L PIUV E40ZZ6d1.0611+I au!Pund all 4dfl d3Hd ZZA33 ZZS'ZBS 7SE'44:S 4Rf'bfS 4Z/0£/90 tZ/10/LO PZ/0£/90 W IO/LO 90•£6'EE£ 690'f6 S1 Pu'V tPUZZ6d1.0611N Su!PUn3(H1 Sd8 d3Hd(ZA1:I lalul lslojgnS lunowV also Pu3 also I,IgS a)'Q PU3 alSU UsIS '.. P'D .H I511 9 Pu3WV q uollannivapl 'II!J.W PASoad s)uno33V Jo ua43 Sluno3)V P0110d pupa,'3u!pond polaad swum fll'l anuanaa 19%V pigmy Isaapa3 Jo I1843 Sulpund qunoo3V Jo Ps4J *toms Iualua)SIS SNUB ,flu0 off'lioa '1I11'all aU4nd%f6LZ:4ZOZ'IC aagwa3aaglinoagl4ZOZ'l.(arounpa)sH laaa!Pul 411e1H 31i4'Id%58'SE:Eton'lc aagw430a g8noagl EZOZ'l Saenuef 3lel)lampui 41Ieal(j119n<1%EZ'6Z IZZOZ`T£aagwaaaa 45no.Igl ZZOL'1.(aanuef air);l3aa!pul 1102`I aunt :aleu 4ZOZ-Z1OZ auaa,l,i)ealuq) £10T£H1D .Iagwn6133ealuOJ SNOLLVi('l1V g1183H align,]d)unoD uosaaJJaf cc10£a6rd 02-f1 3.Ia111X:1 Si°£a8cd 0011IS SZ/OC/90 £VI0/LO PZ,IC/ZI 1Z/10'LO £6'40'PE£ V/N 41 PI"V• uponoluigsgpa4SOa21 Hiq 1,s +wit i`• 000`fS SZ10E/90 CZ:101LO PZIIE41 EZ+IU/LU tb P0'Ptt s, \ or.I.).s ulsolo1EJ141I111a4S J'H 6EP'LES 6E4'LfS 6£P'LES 4l/OE/90 £ZII0/L0 1110E/90 £Z/IO!L0 Z6'P0'6E£ V/N 61 PtuV SAD 61'NAO3 fill 00S'LS 00S'LS £UO£/90 1Z/10IL0 ZZ/0£/90 ZZ/10?10 16170 PE£ VN 1 Pu►V wriIwd 4tieaH 13S7 BtuU JPLS OOS'ZZS 000`SIS 000'SIS EZIOCI90 1Z/10/LO EZOE/90 ZV10/LO 16'PO'PC£ V/K S Pun/ u+uJtlold 4:IraH Jasn91UQ awls 005'LS 00S'LS 0JOC/90 EZ/I0/LO £Z/1E1Z! fUI0/L0 16-40'4£E VIN PI NW wriVowd 41leaH(PM 8nJU;ZA.AS OSZ'04S OSZ'OPS 0UOC/90 EVIO!LO PZ.'OE/90 4Z/101I0 1600 P£E V'i\ LI Pu1VN weaald 41leollJasn 9n1G 0ZA3S U01►'8R4 OScZ'Ot'S Ocl'OPS SZfO£/90 PZ/I0/LO PZ/ICIZI 4Z/10;10 :6'PO't'££ Vest LI PuIV tucl8OJd 411ea1lJasf:2nlc cis OZZ`11£S ZZJOC/90 IZ/I0/L0 ZZ(OC/90 ZZ/10i10 l6'00'4fE V/N. 1 pwy antis►co:)411H day v IenxaS LZA:IS 001'P05 088'SS ZZ10£190 IZlIO/L0 ZZ/O£/9D ZZ/10J10 161.01,E£ ViN S PwV 01egS ISo;)gt1H dall►g IenxaS lZAJS 159'6ts EZ/0f/90 ZZ/10/L0 EUOC/90 ZZ/10/L0 16'001,E£ ViN 01'L Pu%V anvils Imo(NH daj;q IenxaS EZA:is 600'08S LS£'UPS EZ/0E/90 ZZ/10/L0 £ZU0f/90 ZZ/IOIL0 l6'P0'P££ V/N (11 PwV aicgs I$OJ gm 3 loll JA iun*as£.ZAIS 9Z6'Zt'S PZ/0f/90 EZIt0/L0 PZ10£/90 EZ/I0'LO 16P0'0££ V/N L l'SI Pu►V 5Je4S lso.,111111 da2I V lraxaS PZA:IS 9Z6'ZVS PZ/0£/90 £ZI10/L0 PZ10E/90 £Z/101LO I640'0E£ V/N LI PwV aJc4S ISOJ 41Iri OM V le11xaS VZAIS ZS9'L8$ 008'IS PU0E/90 EZ/10/LO PUO£/90 E1/10/L0 16 V0'PEE Sins: 8l PtuV a.ie4S ISO;)4gfl d321 7s)IenxaS 4ZAdS i:(').h` £Z(V% Sz(AE/90 PZil0;L0 14I£f!Z1 PZII11!LO 16 1,0'Pi£ I+i 1'II 'J`It`:v.)+I+tlt d'?t `'"ro"v; `''t, 000.0cIS 000'OSIS 000'oStS £UO£/90 ZZ/10/L0 £ZiOE/90 ZU10/LO 06'P0'PEt V.Ti S IN1IV s:atua:)48eaH Panfl 1°°4oS LZAJS 000'011S PUOC/90 £Z/(0/L0 PVOC/90 £Z/101L0 06170 PC£ V/N Pt PwV os!AOJd JHflS PZAdS 000'SiS PU01/90 £ZJI01L0 PUO£/90 £Z/101LO 06'40'PCC V!N 91 PUN OSIAnJd:MSS 4ZA.IS 0D0'SSIs 000'OIS PU0E/90 EVIO/LO 0110E/90 CZ/10/LO 0640 PEE VIN 6I PwV os!AUJd:DHSS 1),ZA3S 00D'Z9$ SUOE/90 4Z/10/L0 PZ/1£/ZI PU10/LO 06'00'4EE V.IN Vl PwV os!Aad JHUS SZAiS 000'9PZS 000`16$ 000'6Z$ SUOE/9O 4Z/10/LO PUIE/ZI PUIO/LO 06.170411 V!N 61 Piny os!AOJd JJlfls SZAJS SZS'LZS SZS'LZS SZS'LZS ZUOE/60 IZ/I0/01 ZUOE/60 Z /I0/10 66'E6'EEE 06616 I PInV ISZS03010011 swrnuoD fill DIIIIJlti ZZA3J Pf8'91$ VE8`9t$ 0£8'9IS £UOEi60 ZZ/10/01 £ZIOE/60 ZU'10i01 66'£6'£££ 1:66'E6 SI Pull ISZS4JW40H 10J1 le!aadS JHHJIN VS)IH ZZA33 00L'9£S (ZJOE/60 ZU10/0I (Z/0Ei60 2UI0101 66'£61£E P66'f6 L PuIV £S,L031N40E1 sPcimon fH'I°WOK VSHH£ZA3:1 998'6i5 (P£8'91S) EL/OE/60 ZZ/1001 £U0E/60 ZZ/10/0I 66'£6'£££ 466'E6 SI PuiV ES'L03IN40H SIOcnUO;)flfJ IJHHJIN VS2JH£ZA33 99S'9is 00L'9£S OOL'9ES PZ/OE/60 EV10/0I PUOE/60 EU1010I 66'£6'EEE P6616 SI PwV 096ZSJI4117o13 mem:0D(Hi 9Ellf..NAI VS2iH'ZAi 1 000'00ZS 000'ODZS 000'00ZS SL'0E/90 ZZ/10/Z1 tut Ern 4U10/10 96.E6 tI£ L96'£6 LI PwV £S0oD030113N f11'1-lV dw0J aJnons►SeiJuI lId ZZA_MJ !elo]. IelU.L4ns IUtI U1V a)'G Pu3 ai (J 11 )S a)ap 0u3 Dira)JeIS ..al/o.) ,11 Isl1 Il puawV p u011e3ppuapl ail!1 wr.JBo.1d slunuaaV Jo pay) Slummy pu!J3J PoNad Sulpang po!JM Su!p(1n,J fill anuaAaH IsissV p.Ix.NV IcJapa3 Jo yttg7 8u!pund shmoaat+JO)-Ia4J )1"MJo luawaleIS SHVH JIuO asn HOG 4l1aaH J!Igud%P6'LL:PZOZ'I£Jagwaaau 48nw41 4ZOZ•1•(Januc f ale);IaaJ!pui 41110H J!Ignd%S8'S£:fun'I(Jagwaaan 48n°J41 EZOZ'I.(Jenuaf a)et1 uaIIPUI turn]a!lgnd%t16Z:ZZOZ'iE Jagwaaap 48n0441 ZZOZ'I.(Januaf alell)aaalpul PZOZ`I aunt :amp 4ZOZ-ZZOZ:w.Ia1 IaeJIUUJ £101EH'l'J :JagwnN Ianiluo;) SNOLLVDO11V 4►irat/ IIgnJ iluno;1 uosJaJla f g£io0a6ed 01-fl1181HX3 S:o g a3ed 000'IS £Z/WC/Z1 CZ/10/10 EZ/IC/ZI CZ/I0/10 99'9Z'91•E V/K 11 PWV V1(%SI)1ssV te)0'1-311S SZ NA OS (000'IS) £Z/I£Rl CZ/10/10 £Z/IUZI EZ/10i10 99'9Z'9VC V/N 61 PWV V.1.(%SI)tssVle?01-411SSZNA 00o'3 000'IS 000'IS SZ/OU90 £Z/10/L0 4Z/IEfz1 4Z110110 99'92'90£ V/N 61 PWV V1MS1)1sgV leaol- t is9Z NA 004'IS PZ/!UZI 1Z/10/LO Pt/1E2l ZV10/10 S9'9Z'9PE V/N 91'11'I PWV atelS-SSsaadAanln5 Anil ues 00Z'ZS PZ/IERI 11110/LO PZ/IC/LI ZZ/10/10 S9'9Z 94E YIN 91'(I P10V alelS-SS saa3 fawns AionuoS 004'SS 004`SS 008'1S VZ/AE/ZI 1Z/IO/L0 4Z/IUZI ZZ/10/10 S9'9Z'94£ V/N 91 PWV aWIS-SS sand AmungAlcl!ucS OOP'IS OOP'IS £Z10C/90 1Z/10/LO ZZ/IUZI ZZ/IO/10 49.9Z'9P£ V/N I PWV SS(MS-03)(%S1)tssV lexr{-OS 4Z SA 00Z'ZS 00Z'ZS £UIUZI EZ/10/I0 EZ/IElnI EZ/TO/TO 49'9Z•9VE V/N. 11 PWV SS(%SI)tssV luou l-3IfS SZ MA 004'SS 008'IS 009'IS SZ/OU90 EZ/10/LO PZ/1£/Z1 4Z/10/I0 49'9Z'9OE V/K 91 PWV SS(%SI)1ssV le501-3tlS 9Z IIA 000'OSSS £VO£/90 11'lll0/L0 ZZ/0£/90 ZZ/10/t0 SZ'40'9C£ V/NI I PulV (111A)0s!noid-fHl-SHdd (U OS'L£I$) EZ►0£/90 I ZIT 0/L0 ZZ/0£/90 ZZ/10110 SZ'00'9CE V/N 4PtuV (119A)Os!Aoid-f111-Slldd 1111'S44S I89'ZES CZ/OE/90 I110/LO ZZ/OU90 ZZ/10110 SZ'40.9££ V/N 01 PWV (I/1A)asutogd-flll-Sl!dd 000'05SS CZ/OE/90 1Z/10/LO CZ/OE/90 ZZ/I0/L0 SZ VO'9E£ V/N 1 PWV (Z )0s!notd-flil-SHdd 191'5414 OS (000'05SS) CZ/OE/90 1Z/10/LO CU0U90 ZZ/l0/LO SZ'VO'9£E V/N L PWV (z)os!eoid-1Hl-SHd3 000'£es'1S PZ/OE/90 £Z/10/LO P1/0E/90 £Z/101L0 SZ'419££ WIN PI PWV Sap-spun3-f)I1-SHd3 VZAds 000'E(its 000`006$ *110f190 CZ/I0/LO 4Z/0E/90 EU[O/LO SZ170'9EE V/N SI PWV SaD-sPWt31111-SHdd PZAJS O,aSont'i% wNi`991'IS 4tos'4911S SZIO£190 PZiIO/LO YZ.'l\:Z1 rZ;1JL11 STrU',ft \ Is 4Z pwt SAD-%Pun3!'ITl-VIM-bi 1.1s OD0'££4'IS 000'££V'IS 000'£C4'IS £Z/0£/90 IZ/10/L0 £Z/0£190 ZU10/L0 SZ170'9C£ V/N 6`9 PWV SID-fill-SIIdi£ZMS 000'0£S 000'0£S EZ/0£/90 1Z110/LO CZ/Of/90 ZU1011.0 E6'40'VCE V/N( 1 PWV s40-luawa8eusyl(latranalsrM OL6'19S 0L6'ICS 0L6'IES SZ/OE/90 £Z/10/LO PZ/IC/ZI P1/IC/L0 £6'PO'4£E V/N 91 PWV S3J-10atuaSeueyy!IalentaISrM SZAAS OL6'1£S SZ/10/LO £Z/10/LO PZ/IE/ZT PZ/10/LO £6'1,01r£C V/N PI PwV (SdD)luawa9surWausuOIIeU1S OS OS (0L6'1ES) SU10/LO CZ/I0/L0 nil E/2T PZ/IO/LO £6'401/EC V/N 91 PUUV (Ego)tuawa8nuel1lalltW01(eus 00S'ZZS CZ/OE/90 IZ/10/LO ZZ/0U90 ZZ/I0/10 £6'40'4££ V/N 1 PWV (VI1V)laauta8eueysi 0ttsu0llowS SZI'CIS (SLE'6S) CZ/0£/90 IZIIO/L0 ZZ/0E/90 Zr/10/10 £6'P0'PE£ V/N Zl PWV 1V31V)tuatuaaeurya al!su0IluwS 000'SIS CZ/OE/90 (UtO/LO EUOE/90 ZUI0/L0 £6'40'4££ V/N 1 PWV (V31V)lUS SItel^at!suO 1l WS SL£'4ZS SL£'6S EZ/0U90 1Z/10/LO £Z/0£/90 ZZ/10/40 E61,01,££ V/N ZI PWV (V31V)Iuatua nueV alISUO IIaWS E£C'C£S CE£'EES SZ10U90 £Z/10/L0 4UOU90 EZ/10/L0 £6'40.0EE V/N 4I PWV (V31V)luaW Srue!M1 ausuO tiswS 99!'PUI3 ECCLES EEE'£ES SZi0E/90 £Z/I0/LO PZ/IUZ1 PZ/10/LO E6'40'PE£ V/N P1PwV (V'31V)luawoSgttewattsuOHaws 0o5'01S £Z/0U90 IUIO/LO £10U90 ZU10/10 £6'40'PEE V/N 1 PwV u!xow!a/t!sg!)a4S a,g 005'L1S 000'c-S CZ/OE/90 1Z/10/L0 £Z/O£190 ZZ/10/10 £6'40 VE£ V/N 6 PWV uuoto!gn(sgINq$aag Pawl Iaplgns ianowV aq'a pug a11101gSIS aqua P03 alto Uoig 1,0POD .a on #puawV a uolle)y(uapl aj1!y touaoid siunoaay Ia l-trg) Slunoi)V P01aaJ Poliad atl(pua3 pol.ad Su!pun3 nil anuaaaH ls!SSV pAriA1'In/allaA{ JO IM1 3 9a!puog tiano»V 10 usg0 IIAa.1S Jo luawaulS SIIVB AI00 asa HOU aural!alignd%46'LZ:puOZ'1E Aagwaaaa yanoiy1 pug AArnucfawf laat!Pu1 411eil1 alignd y,S8'Sf:ROI'IC Aagwaaaa ganoJgq£Z02'1 AAgnus f alga laaAlpttl viva)/alignd%ft'62:ZZOZ'If Aagtuaaaa ganoiyi cm`l AAenur f ate8 pam!pal 4ZOZ'I aunp :aisa ►ZOZ-ZZOZ away l)S41103 E10I£HDJ :Aagw,N i3SAluoa SNOl.LV0011V gilrail a!Ignd.yunu3 uosaauaf ££/9 068d 0Z-8 J.IHIHX3 jk ! ) k § � \ ° � / el } R % <0 ■72 a a2 ■ $ �( / • 0 © a 3k / $ 2J a 3 o k \ « IA } 04, V0 o S22 \ § G. ■a § § ) 32 o uz t e a E _v 2 : g 3 § 3f■ - _ 'a 2 ® ge § / c' £ § § a3 ! 202 Sr - - ° 2 k _ ° � ■ � Q � < ¥ VI $ u at ea ii e § .t2 .2 r: - 33 222 - et2 \ � � � k■ ■ j \ \ -- \ a e▪ol col el k I� / k \ s @ ■ 0 g = � 22 / � .Z t ea ec ■ ( cC O 111 ii 1I1 ® a cd 1 } k o k ) e / k k ) I a § \ < ?I • - - - Q ¥ A I . w co 0 0 0 0 0 0 �A, O i7 r. U C R. — C a G ,•n, a U •V .�.. C. d O 00 v ar J O U a 6J O 6 C A O E e Z000 E Or. 8 y •O Jo 'fl ea 0 v cV N E p p •$ q 4 .c a. C a L. _ C' p a p gy O a. O .E_ U y ..r ° a O C C X A 4:2 Q g �. �' O $ M rn go . O ca o (�{�❑ w a O y u _ : a A o d p0 .. V • O pZ tr ,Val � i O q p + _ J _ C � a 00 y Z ei "E L Q a 3 C.) 3 h a _° >' 0 ea 0 o4 C) w V W a A U .fir V L A V a c 0 .0 O N col o 6 u a .. N QU Z U r o ^ : O v S — 0 8 ;; V a, = � a ` 3 O 3 0000000 0 0 0 E a y. a ,> a E. L c Y 0 i C 0 0 _ M v C O O. v� ^+ V i p A p a N N - tV 4 O ,0 w PL a o a o o n a V V ti V u ®� •� O. S. C °sn C •C O p NIIIII O O. fir .. e • inpnzi ,! v C. 01 Ti a en •x 4) E , R .x o = w: M '- ad L N • ro w a. cV a fa " o v a c1 a M ar A t {•j.��' a O C p i••i - E Jo N 1 L. o 0 C.L. rn Q = o .a O m = I 0 y • ° ° N ,,, Ko Vi C ` c Oa o a a ' 0 L o 3 0 � o0 e0 in any c � � CQ Et O = '; •m O - a C ya, w Q . ,Z O% .000 A O M 0. V 7 0Q ►. I .0 vi A V -0 o c O F y 0 a N w (7 cn v ts .ti N 0 L N x C.) V U O 0 LE N d M o O 0 ,. N C w •Opp .0 V d ter. w .0 0.1 - F°+ V �'�1 O O ✓ N .. C 4. .0 J v .n .b 53 M y •C u O v C g id CI 0 x $ U 0. 05 La . X u a N a .� O S a YS v o L C� a « o ns 0 .0 v V. - . C C V Q 4r C i c y i 0 u O `? L v y .. 0 L 7 ..' Fr 1 • is C v O m A ,C O .+ O i U O +� �^. O •p +r C R 'b '; �. Y! 1 Tr 0. .� A o en3 G Q u ^ V p^ O 0 a Q 0 L i 4 0.R p .+ 0 to . Vu7O �� I ci � a ' vw 0 0w aw : N iN t 7 VY O O C p" Qw O Lea �•• 0 Q CO A O O70 _o 0S .W .•. aOVG. a V > R a U Z uE s. > 0 ^ on p ooO � .0 ccaa0 y u s E wa • V � ^ o 1 O a ' .c E A " a3 U ua° L c a t• p 7C P. aoC L . 7 in Ed O. (~ 0 a 3 a. u e • I. Z C O N Q Y 'o E A c # ea a Z y F ^, az Papa 8 of 33 Task Activity Deliverables/Outcomes Due Date/Time Frame Payment Information # and/or Amount work, including management,program staff,and accounting Within 30 days of the and/or financial staff. change. 2 Develop a plan to use these funds for one or more of the Implementation Plan December 31,2023,or allowable costs listed below. sooner ' • Submit plan to the DOH Program Contact for review and 'i,u' prior approval as soon as possible. We want to be sure your planned activities are allowable,and we will be able to reimburse you for the expenses. 3 Funding is intended to establish,expand,train,and sustain Implementation Plan December 31,2023,or public health staff to support LHJ COV1D-19 prevention, sooner or when LIUJ preparedness,response,and recovery initiatives. r.•quests.funds or another ;.hange to the Plan. Funding can be used for permanent full-time and part-time staff,temporary or term-limited staff,fellows,interns, Data on form provided by DOH. January 10,2024 contractors,and contracted employees. July 10,2024 Allowable costs include: • Costs including,wages and benefits,related to recruiting,hiring,and training of new or existing public health staff. • Purchase of supplies and equipment to support the expanded and/or current workforce and any training related to the use of supplies and equipment. • Training and education(and related travel)for new and existing staff on topics such as incident management training,health equity issues,working with underserved populations,cultural competency, disease investigations,informatics or data management,or other needs identified by the LHJ. • Costs of contractors and contracted staff. Notes: • Prcapproval from DOH is required to contract with i these funds. • Preapproval is required for the purchase of equipment.(Equipment is a tangible item with an original per-unit cost of S5,000 or more.) f— I Exhibit A, Statement of Work Page 2 of 4 Contract Number CLH31013-Amendment 20 0 N C M O r Y V I O�! C Q Y O O U „" L O H11,1 O ar O T a u 'fl m ,�, O e° I. F" vQ. Y A. 1 3 I. .0 u °CO) O 6 r ai Q C z 03 L v _ ::. ti W .4t F O - `o L n",i C 0 0.) ell CC t 04 r O C C 7 E y >. L, .7a � h r v W d_ Cd Y O. ix C Q• w O ad i I. t, lE l0. a ? N f/11111, .7 Cam] Y Y 0 V > 0. & x �Q s A CS N 1 S. 3 b 5 1 = ..c al a u U co CI —' 0 0 owe .2a :0 3 -1 w u c Q o eo is M1 O ▪ 0' . Ts .� �� t 00 0 a a sA a!aa0 Q,d Y C C .o y 3 CA .44i o y O E 0 y '' C .a . £ .0 .o 08 y a3 = N y � ,.. v = m is --- C 0 t • cd � � — `CCs. .L i7 a —• C � o . 00 vz _ =� > M , � =. - .03L s ea, < � - H 6J 'C C Y Y ' CC ° 0 s.. LaV U j Y x Z N C Z Z = J , _a e as � C no . Oc o i tZ 8 c7O •. p .a C • ...G • ^ U - 5t' E .% . W 1 N 0 O •� a .ZN � ? � � 0 �• N ��. Y C r ` �E 0E a 6 0c`io ; � o O U R .3'. n L '♦.4.0 SC C OIa..d54) .5 g C O.• Y ` O N .. TO V �Q L .00 oU60 O ^ d1Ca • p. i t O + a13 C) M • CaVIv 1111 •'C .t i� p = QpG -0 Y L S . oOA ' W . l � 0 a+ea G 7 � 0 >C. C h • cn u 5C. C "' L•ct F •C c7 G 'U '� y .5 C u o ° •. O .4 ' .s = S t0o n°o2 ycz esXAQc AaW < cf = n" b01. ` 44 • • • • • • • v.. np ` o @ O 0 G iki O U Y 3 G W '0 ' V) h A. u o f a. o L O Y 2 Y ..o ..�. 0 = = U i 0 0 Cr K Ato t� f-- E- F= C O. czU � ?: to C N to C `? F_ 0 c) < M c — os_ cn L L .0 E a z U a 0 O C.)as ° Y v: 'C 'O ce O• V < e) > :2 'e z ° 47.43 C.0 ° = O 8 as j a 4 ° X ei J C. p > o. C. C] ° ° • a en Tu. A..l o o is/ 0 d 0 63 O. v i Eto 2 i a a CV °" 7. d 8 _ . 0 E ` a0 o O a02 A c 1 O p 0 ,d? .O O c.. E I a § ^ G 0. G. •V G •E ° •¢ 'fl u 0 t0 d p v) .: g •0 0 �o .1) i. C d 0) a 0 v H C r° > C° °' E C � c Eua w ces c •« E � a c ° _ 'd es >13 E y R a o 0 3 v 5. ea o 'o a a 'a L.> .. Cr' C 4 00 C 1-Cj tom. t.' �. a.. es .0 'a G ,• SE s. ea . u O Q, ,r 0. S vi ; ° E Fr >, C v �.. g '°' E = E s O C o .� u b c o u -0 0 0 x y m " p Oki C ,r V = p 0 o '0 0 u d a `''o w 3 E o.� > r • a o E s er E aa c 0 — S .. 0 " � 'ti c. cw o � o V � ' 4 ao .o c v, E w B E 0 .. m ° Cl) o ce!' v w 'a 0 ` 3 a.p ao > 0 �oUw .� (1) > LUa. 0 O ` A 0 4 c ... v, a a y Z a = " • • y � a ; E • as u 0 �.l C A .0 a Z ci) AO < v, cc1 Page 11 of 33 Exhibit A Statement of Work Contract Term: 2022-2024 DOH Program Name or Title: Foundational bablic Health Services(FPHS1- Local Health Jurisdiction Name: Jefferson County Public Health Effective July L 2024 Contract Number: CLH31013 SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment ❑Federal<Select One> (check if applicable) 0 Reimbursement Period of Performance: July 1.2024 through December 31.2024 El State 0 FFATA(Transparency Act) ®Periodic Distribution ❑Other 0 Research&Development Statement of Work Purpose: Per RCW 43.70.512,Foundational Public Health Services(FPHS)funds are for the governmental public health system:local health jurisdictions, Department of Health,state Board of Health,sovereign tribal nations and Indian health programs. These funds arc to build the system's capacity and increase the availability of FPHS services statewide. Revision Purpose: N/A Master Assistance BARS Allocation index Listing Revenue LHJ Funding Period Current Change Total DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation ; increase(+) Allocation SFY25 FPHS-LHJ FIJNDS-GFS 99210850 NiA 336.04.25 07/01/24 12/31/24 0 1,166,500 1,166,500 wy- 0 0 0 0 0 0 0 0 0 -I 0 0 0 1 I 0 0 0 TOTALS 0 1,166,500 1,166L500 Payment Task Activity Deliverables/Outcomes Due Date/Time Frame Information and/or # Amount 1 FPHS funds to each LHJ See below in Program Specific See below in Program Specific See below in Program Specific $260,000 Requirements-Activity Special Instructions for details Requirements-Deliverables ( Requirements deliverables 2 Assessment Reinforcing Capacity-See below in Program Specific See below in Program Specific See below in Program Specific $30,000 Requirements--Activity Special Instructions for details Reouirements-Deliverables Requirements-Deliverables 3 Assessment-CHA/CHiP-Sec below in Program Specific See below in Program Specific See below in Program Specific some itequiremcnts-Activity Special instructions for details Requirements-Deliverables Requirements-Deliverables Lifecourse-NEW SFY 24 Full Lifecourse Workforce Capacity-See See below in Program Specific See below in Program Specific 4 below in Program Specific Requirements-Activity Special Instructions Requirements-Deliverables RequirementsDeliverables $176,500 for details Exhibit A,Statement of Work Page 1 of 7 Contract Number CL1131013Amendment 20 O C I 0 N a W a 3 E d a , N a. a p O a pp a O a C O O O a ,.- �" lit L V1 O O 0 C S O v-, ,/1 O i v1 V9 0 'C M O ri O n n >' 0 ^' L. M n M n ado h 'Cr N V. M M N C CO O d lo 44 0 69 69 69 iN 0 69 49 69 to 44 69 CO •d el U u U U U U U U u U u v U 3 0 0 4.) y r//�� n y y y y y n y y y Vf y 0 XX U u u U N 5 U L u N g ^7 0 U u u y U N ?r y I .Cg E 3� a � a ch� `� � .c � a,.0 p acn a� a � a-o a s :a 9 es ti y y L� U �. u �� .....° y y u a �7v auv :: ea A O0a 623 00 oQ 0n o0 fl0 �0 00 oR o0 oon on �, o 0 .g C C C s. E. E I/1 GO a .0 C .5 C •E C .5 C .5 t •F a •E c v. J Q a u v u u v :7 a a a a U C w 3 E 3 E 35 3 g 35 3 E 3 E 35 3 35 35 3 a 3 E c E ,J, O u O 61 _o a o _o u O u _o a o a o u O u _o U O O uVI O A U . 1-• u U . u ..L.. u .'-' 43 .� U U . v ..L+ u .L. U .t a -- U ._ U U . •0 CI .d ' 1111111111 ilbilU ' .0 = il �0 '�U Y V v ' v e7in c4 v, a f 45 u U v u u u v U U U U u � b ,,, 4: y 4: s~ t.: 4; y F." , 4= y k: y t; y t„ y W "'t 8 a U • 4 'c7 a ci u u U S v w 5 a U70 — v = ci U p Cl) E v, E uz E rn E cn '0 rn 5 an C v: „ vi V v) E N 16 v] �° u7 3 S. § .� E > E 'e a > > E > Ea E �$? > � .� O © Q to 04 Ev IA o0 oL) F-6 Ira 0 o0 0 o 5 � o ]C h 0 o C] 0 0 Ca ? c, rQ py. p) a" CO) V, r�. i�. y W y I et ,h w �Vl.. w .mot/, `� V, "= r. 4 a CI 5v cu c � e e .5u .cam 5c 'Eaci .5w .Ee .E3 .c . _ rn 3 3 3 3 3 3 3 3 3 3 E n o o � c os o66 o , oh. o ,- O �. oh cu cr. ID. a) r H � o U V CI .0 •L /+ C.7 a .L a L a.0 I. O5 .0 O . O.0 •O . a L U .h e .0V . .� Q . t A ..•. v Q' 0 Cr' u O' 0 $' u S a c' 0 a. u Cr u u cr D a- u a- u 6. u x a n4 Gua tl rn a v) a rn c4rn c4 n a a n c cn aG cn IX n g rn aG ri u rn a °o O w 3 c 0 a y E 1 �0 0 li Z. = V •c0 E .2. .t E RS a CU . Zv C es 43i . rn O •oTu• q as 1 = 040 : m I !; cul! y 0 O = u aa. W o xv r. CI ay cu .o •MI Z E "0 u ^ O 'u v) Qs.._ L 3 a,v 4. C L. C a a J u a a7 n v O a V C Fr C �' a p l a CI d G v 0 as .9 .O O u O O Gn v O C .- mi � Q. � o _ its — o u o z � °� E _ o 0 v W ;� E e .a al a .v °� 7 r, L I '" ci !..? 7 .^7 u 0D d 7 U ;I co u -] .. 0 4.1 , v) O w ...1 CO) C 67 cu -' E '. h u ca..- v E eV', a. U c.. a a. c < 'E > '> id. ,5 ' O •' .2 C. faI. 3 b = v v0 - .... .1 a U a ' IY v o �} °= $ ov°' be = . rnv' a. jqq� a:Jv: ae .. a E G 64 v v:'4.6 ' „ 0 eg • a K d • 00� a12 Ci •v 'aI C >' 3 '"!' V +� a... CO) •> e� y) , a �+ 67 a s ,,{ S ^� E • U is a :: va a7 is.et ,1 a aa. A. ti u m a , .__ � E a o I o 1 ,� . E as y E i v es .. a .= v ai V a. 4 o a v " > la = a u - 3 c R = e• c a0 ‘A a a. N ;9 a,� v] _. " p c N eaa�Q E ?� I I u I 1 I u (} JD T. u' ta, 'nwV •`° › E 7. ., H u ° u 1 rcn a - G�. E . e.7., N . E b £ c� E a G. 3 k. CG o O. u Ls. k. • 4 fn v rn 'b v. 1 4 .3 - a7 u v • a E as �o va 3 vi A v w �.� _ , E a ,, 3 F g. F F F c y F 0. al G's. w Is 0 3 O a.w = c.i y U I c w a w a' W J t. VI L. W % a4 t $ 0CI W C '5 O �u 0 I41a7 ° % .ap Wa 54 _ ae _pZ �„ EEuZ of ov au 00 .. e1 m Oa C) Z u , ca .› Z • •4 Z o e ,., ' v �.'• b y U U L•:. V U u 'Pt V e= E 2 E ' E g T, ,, 1 ' o 'p ' y E. r cG IZ v H h j! = •v = - Z `"L' .= u 9 '= G7 a ne `O.. I Q .n .o n ac cs C ` is 14 O 'C N N u 57 p0 I; V -to P. uc u . C F c E y 0 u h `z v «. C) > Uc) c i C•9 E � U S G y U O .t 'a U 't ky p F , _ , p es a .-. V .V Ee0 C •oi fj a 2 to a 43 C OO N: > Nrt cR. L MC J J U u C C Z= u VQ. n E ' � ms S . r e. Vs O t a. 0 _fit• o .. g i st C e0 u a s a0 u •0 = •o cif > u ` 0 • ` 0 3 T. CC.° o 0 0 =. Z f� a. , u al g g 0 V ▪ >' ,-, -0 o 0 „ z V ..! e- s; 2 O.c • en O . t.. Ey E • > V. Vx. -E ` UE t Y U V. O E � — E. ..� e Y O2 .c C .—- 7 V: U «, es • 'a es U 4g 00 U .0 t•E U m P. L. a ° '. s C ' U CI v .Q E C el o o. •fr. 8, 8 a -7 •c a V G. en es3E o a t c. H U) o � .e� U. .. U s �v 'Yo &. I.. x ay E ° �+ a 0.()0 c O o c IR = O a �. n �.= � ° A C To ='i ... 0 'd . _ 'C as ". O yy oo mi . v O Cs0 . fa UH vJ 0' O> J a i O. o • = a • ai N x '40P. y C Li C... fl mr 'o . .0 A o CQ 'C . m O Li. -9 N E 0u Lim "O ' •U C = a w • c0 O DU 48 ? O7 A E c ... Q.O N r C g - ` u � 0. Cl. o u, o 2 .Jy o u. �U � O � '" � TOa .7 C tE ..e ki 0)t, O9 00 >, aVV1 « 'O � .. .. p ranC aCaaRCC a i 44 '.0 Ca) ti C6) ... -0 o , a I . y- = = n vR � o Q le; .0 pyst4 CI N• Ou rr L .0 rn et '0 >. . O Or " V w 00 E o a U c s '..0R 'o en eo . O 4 p,b C eC • c p � 0-7C0 —VU r CO .. I y 8 • �C u E o o � /3 W O 0Nu :fl N) UA0. � L:. 7 Zy d A d OLc) c I i COT oU d 0 A s E a ``�a. 'Z"' € V LL to O O = V .c0 00 c..) O t-0 u V H i� u o .c v GO tig as'_ loaE o. e cv2 0p .. ti, c :p ` C 7 G. ti Q to •0 .0 > e 'O 0-Se- 'C •O C T Y G' L CO b .i .. CO � O 2 E 7O 'C 7 « 'O Q C u e 7 N n O � et, Q ! C . C•3T H CR. .G A1 C C dCt • i O C.)3 j >, � O ? O C � U Oq cpe.. ' VO t .gse U B0. T h u •—, O ER vw E u O t) . a' en .no O e... U] `01 O 4C E y a ` O `2 C Ct, O a) Q v A u a —o wao 'J e0 i e on C yei a ` to 7 a) Lt.. 7 2 G.A W w = U .c ...I a to 'b E ea f. C« 'C a. �= -"' u O p e... O 73 c C) >, N'n to 7 a L m o . u .. 00 to E N hC n .0 - C• / y OaCbtFCO = a o) 5 > aC• '� E . Cuaca Hi i OOy,.s. le. .. u •p 't0 O�O ...14 3 � . w .F.,',.. • - 04 • 5.64 Ov a ° N p � p o• G ' o a C Cami a V C CCO ' y c C0 •' ooe w . y 6. C to •E CC U UVJ 'E ' .0 ou Cg "C O a• .c C w 'C nF 7 U E G :: :. t C O O e C ° ° E. •� Q ) O a) x 0. 00 U O. E a d a C in U 4) �' ' U N 7 I Ol) Cn V) O ;d L ... a .+ . 0 " O 0 .. • a Ru c uae,. i c. 0., .. u .. C o - o u . 0. a w ° s ao ° xv a °' ` v u $ ; Lt. CG a.7 y ¢ U <o > e = ,V _ s 0 ' a ' F " 'H0L . U gs" a V . ci • • U t .0 y , U . o .. — a 0 ¢ C o u tO < 3. - . 7 pUN Cu E... 1.6 J) .. 0 'C V 0ceIO (—' us 1 O N C v E .b n c � a) O E C . M a: a O ca d M U 9 7. U co 0 • U 0 E ro 7,1 olf a) V) o C y d cU ca a xi O.. c«s cv x Ao o > es a`? u a) m _ CO t) b > �.' G a u = :4 C �' G JEg ji Iv v .- •= c U 4 O - '�I C. .,2 'e 'a, u a' o c i f i I t I t .E Is a, : 1 c N yrC Occacc ccc 'h ,�i Sa ^y -1c > I -s. ._„s� •r ^HHijIL q GOOOp OOG y vi6V :+! 4 ... 7�o c ; " co CZ - — l00a ea `u 3 'c6aE `^ °' 0 I 1°" = c. 8 �', ', r, i, v v a. 3 m .. ` V n. O .E `' 03 `l e 0 t () c� ^ y ci v a �' , c�i 3: U o� c c ' c c c °a c 3 `° 'Q ' a u H � � J ° o o Q ;I y :� _ E • _ a "� a ce, d 30 > '0 a cc, a Q �3 8 .6 a, e, u u ,, e, e, a '� c » aci C W •«. .`? A .= i ie ti ( -7 Q E �q t� e0 p v, � v� :n w � O v, �L .. O m F v, .. .. ni(� D ta. d u E 5 E >+ E c ra ei W a u x • "pp c Iv X p e, o oo ? ), G'70 E J E w - O .y .9 .0 .0 .y = O V .g C '^ .pG' g O .^. p0 '0 u t, L V t .O A T r .+� ^ .,i ao c, a o p o a 8 A L a ov p u ., E 0 .. ,� a Gc1U43UwUOZFUaAAAAAQAwwWC50vnvnHHcnONax ..1 Ud > � ..� .-• , 3 a rn Cl) cn i/) �q Cl) Cl) Cl) Cl) Cl) Cl) Cn Cl) Cl) Cl) V1 Cn Cl) V) VJ V) Cl) Cl) Cl) Cl) 0 V) Cr) VJ Cl) Cl) V1 Sn Cl) V] Cl) Cl) a C� a x .'cw = = Z . = = = =' .=' SCZX = .. xx �Cx .=' T� �C �T, x 'JCxx .I .... wxxxx w a, waawaaa. a °. c�. aw °. aaa, aaait a. a °, aa. wwaaa a7 ° -� '° o � Qar.�. �; wwwwwwwwt1. wwwwwwwwwwww � �. �- www � � � wwwww :. •^ � �_� -i . . c c) N env1 VO C� 0 VI 'Cl- In C� 00 as O .-. N r-1 ct tel %c C-- 00 ON O — N C'� O CD CDO N a, �, !; , N mft N N N N N N N N N C d• et et et •4' d• of st d• In v) to t i •O t'- cc 0 0. 0,113 ` x a x w a 0., -_ m U u 0 I N 7 at .O iv C O .a.h C e s .0 4) O M .g u C u u U H RS r. O w O '6 U 'a 'O 4. - CO) 0 O U O N a C e Kt 0) al O 'd G p" v 4 O u C d 3 U ° C U'0 .0 fl. b cn O. Q" :-t' 0 x '3 a ..s LT.) u a o 0 ,.a a) 0NI 0 i„i u 0X = r a w C ..... en oc -v a 0 .: 0 NV 1 OS S O Q O t'10 Z p 0 O M ' -4Cl) eu U • Y U H7:1 . ^ � a "' v co ¢ - a 'E fV U U � ?. era •.� •r U ha C) .moo u S a cr. > � c VO h D-. 0CA ti >>,X le g PO •>- 0 • J - iv. a 4O vt =Q A ai O ti- C � U i M uti U is -, V -- `. v- viv0 • c o J C • bG : O � u (s. !O 0. •pt4 it, L. C .b U N 'p v vim.^ s V 0.I. �p ,..1.1 i ri Ca v ate') 2 P. ° C c -6 � a $ Ca o � V) . a. ^ ^ q •.�' O u C a0 vi oo y U + o w .a a p U V 4. C•Ei .O E r� U C)0 C • ° � 5 O C O y • V1 .0 in 1. y U V CA •I- f 0 L -C C 'C L 2 • Cw 0 a) o h0 oer - iO 'O .0 a) C a• p, y C pC NG lN • . i/ � C N J W 5O y et � 0U ..abGg MI en "4a ._ .0 G. 4) 74 •pq N bai C G. ..4 v o 0 ` �! pen .0 C dux a y ,-. C O 0 U w ti - en 03 G C oho 0 pC 4 4 0 � ca C a .d -6 ;„ b O = rr VA �. >, u E g C •� ;D x °) s � .b u o p, :fl > 0Qr. cs O Y 8 •0 03 COCti �+ o boa ° C7o g .... L. � 3v a0 > 0 ": .eaa y i '01EXi a •U u C u C a v 3a, z r� �o Ai . � C u c u aa= .r' i isUi CU m a Q. a v .0 C f 42 G 0, 0 C °ti c +o cam o trill U r + d W C � Od a+ . 6 4 ' ° v.v. A 00J V 0a.• CI) UN 3n i, UU 0 'fl Ca u VI I. -4 ° �� : y o Ob c a � -d °uv . o� i w ° .0 ; v C a00> . OW i T. ctirp r � T i3. •v o p C " = m L O20 U . ) • vi y a+ tl) ` ° a 4 '4 = Z cu = = 4 UU '"' ° cr ' •ei V P am a "0 5 . .1) i CN r, .v b " . co r, z 2 yk a >' u 1-1 o -- ° a A co >` EE = a `A5i = x r,tX C of O :s. C U V 3 b N A R ). �O .v •w j N a' N R ¢ T "d ..0 N �'+ �. 13 u ►''C'i o 0 e G 'd `2 U v W v >„ ._ .or. V) 0 A 3 W -5 G4 .0 pq Z .Gol c c °S. r1 » 4.K GG 1O I U u z U °) V] O ol O v1 .0 C) V) ') a) .0 .. .0 .0 C 4. ... i. A... U OS 'O v 1 _ , C C C b v) v v 0C=) C �' is 3 .0 W o a s 3 0 3 ` a °) '., LT3 ;Li LE a d £ E C 8 t a 2 .? Z m 7 0 - Z ' 0 Z ••-• ai ap ' uS a{ O DI U C� H O vi O C a0)or, a O b .y Out i os i �a o. :P li r. P'� .- N VJ a V al a Q � � � a5x ua, c wF �° ° r=. 0 wu ►ate o a 2 gp: ri �U.3 N M ' vi n ao 0 K co C a 11d Q 4 0Z ivawpuaury-£101£HD mgtunN loenuoD L Jo 9 aSed vOM Jo luatuale)s`NT t!gttlx3 o)asuas sa>lew!!a1agM•(s)eale a!do)-qns agtaads nags of 3upelaa sasuods a gtleaq atlgnd ptuawuonnua algeleas JoJ aoueptn3 J3JJo o)papualut`(s)weaoid lapow wow Jo auo Rutdolanap!pm pals%pea ale stueal NOD 3141'weal aioD otpoods-oldot leuo!1a!ps!lnf-ssoia a ut aled!a!ited o1 JJels fun ioJ Si luawlsanu!weal amp Hd3 pea (L-i'S uomullap SH L )(nuaugsanul SHdd may oiOD Hd3 HE o)sa!gddy)sweat 3ao3--Hd3 :sweat'a toD Hd3 asagl u!a)sd!al)lsd o)spunj 3u!nlaaai s!unslajjar sagttmwwoD 1C4lleaH 78 oyes • asuodsa)l ssaussalawoH • d1!aede)tuals1ts aa1eM • ainsodxg peal • asuodsag aZtuegp-aleunip • luawano.tdwl luawa3euey%l sled ap!/A-wals/(S • •algeagdde se`(s)eaie otdol-qns J!atll gpta`Moloy psi ale 4ogl sweat aJo)Hd3 xts Xpuallna att amgi .satauaSe gtleaq atlgnd uolllu!gseM Ile of algel!ene spew aq ll!M Ilion% =al atop 42nolq)padolanap stueiSoid lapolnl vim woJJ peal-oo auo glum`I-lpa VM pug sfHl uaa.)aq d!gs1auued ul`alttlorills SHdd ag1 ap!s)no ls!xa swear atop •stuawlsanu!SHdd U1001,3'o3 laglo 11e w01J an!laups!p s!luawlsanut SHdd weal 0l03 goe3 'luaunsanut paletaosse s)t of pagoe)te(s)eale a!dol-qns owaads a4t JoJ sa!ltnl)ae Ruj/J11enb-SHdd uo pun aledtatued of Anssaaau awn 2utme3s splemol spun;asagl puads r(etu slua!d!aaw luatwsanut gaea JoJ weal alto patetoosse ag1 u!aludtat3Jed o1 pannbat ale spun}SHdd weal atop asagl Jo sluatdtaa21 'salt:atdol-qns 4aea of ogtaads sotpeoidde pun spaau 34)uo 3ulpuadap Ann'pm stnefiloid lapow asag)Jo lndano pun lua)uoa atll•swe.aold lapow asatp jo uoneluawaldw!uo ltoM osle Xetu sweat glop alp`os op of asuas sMlgw)t ata4M•(s)cam atdo)-qns o!jlaads.t!agl o1 Su!)elaJ sasuodsa.t 411eaq a!lgnd ln)uawuoi!nua algeleas Jo.aoueptn2 JaJJo o)papualut 1s)wel3old ppow aloes 10 auo Sutdolanap tp!M pals!!!4oea alg sweat otoD aql•unral mop atj!aads-atdot leuo!1'!ps!in f ss0J3 a u!aledtatugd 0)3Jg)s(H'I 1oJ st lua(ulsanu!WWI,3100 Hd3 gae3 (L-l'fl uol)!u!jaP SHdd)(s)uaw)sanul SHdd weal a4o)Hd31le 0)sa!lddV)unsay aIoD—Hd3 817"Z95`Lb"Z9S'Ob"Z9S`SI79S 171795 :sapoaalnupuadxa SINE as fl •sasuadxa 3utweA)pue Su!;Jess pomp.'se!pm se`sat)tnpae asagl uoddns o1 pasn aq Ames spunj -sJaptnold a3Was!epos twit luatuAdua pug'uotleutpiooa a.in ptn uoddns vox.!epos ut 3u!SeSua JoJ saauelxtuf3na pue saseo dui tj))00pt's31ualle4a pue stu!g!dwoa Jo tuattts&Isce:apnlaut sautntl3V•siap!Aold aa!tuas!mos gums uotleutprooa anh pun uoddns tpont le!aos Jo txatuoa agt u!sa3uallega pun s)uugdwoa gtleaq leluatuuonnua of sasundsal!t•uontpen-uou uoddns o)papualw s!luaunsanut snLL, (S*1`£•'I`Z-i'�l`Z-I'r`£-Z'd`V3'Z'a va`Z'Q'i'H`L-9'S`£-i'fl suo!1!uiaP SHdd)).toddns 4aoM ItspoS PZ Ads M3h1-1143 'Z l uoga!ps!inr uemo u!alge!lKnV SHdd ao!inssy—srm)aalaS 0)sluaw)sanul pa)a3Jey 11 10 01"Z9S :sapoa a1n)!puadxa slydg as fl •spaau pomp!Allem!loam o)ppow)st8olo!wap!da palet{siluuo!3a1 gtn Mtaedea aolotwaptda pun luawssasse asealaul (Z`I'D suon!uiaP SHdd)(dHHJ/VHD`aaut;llla ungpuawssassy)leaaua9—4(8ololwap!d3 jeuo!SaH paaegs—)aatussassV .I! :suoliolps!ints a1a111n1% u!/i0J algel!e4V SHdd aupnsly— sfH'I)aalag o)s)uaut)sanul ZVZ9S :sapoo anutpuadxa save as fl'seam Jamul laafgns leatl!la ssOJae satltnnoe pun saapuos asuodsa)l pue ssaupaleda id Aanottautg SHdd Jo tian!Iap teat!041 aouegna pue uoddns o)alnlatulseiJut PUP Attaede3 (t-1 'li suol)lul3aP SHdd)k)!I!geda)pun,ylaedeo—asuodsag ag ssaupaiedaad A3uaSaatu3 CZ AdS M3N-Ud3 '0l to 10 9l°Bed C. '0 C: C tt I a b0 a a •;) G leo.se 'CI `e ..5 U U fl t R. eD Ca j •° c a t a ..c en 9 _ O o O —1 v w (.% .d O .p to 6. N_ ... C • �� A (+ U II > a Vl c 9 o ri z T O V O. u V 3 0 u o, U a V E. a. u o an 1 On e o 0t.1 V E o. •6 S O cO .. F d w ^E0v 5 .V- O g O w • O C 4 .G c V C ¢. ta O to a p .- u I •p > Q. .fy L C V et V u C ei Cu la G es _0 C d �J N q N _ q te V y CO O t V =� G •C �, L tv Oq cn CA CM a .r t Q CO e6 fi G Qa t U j L C� "0q g F fc C o '0. col o o cC A N 3 3 x CO u .b >, o Ce o V v O a eCo - U an C y w Et GiL. Q .._ e_ _m es S O 0WI 0 Cs. C "' C C -0 O u cl se O J •- CO ° 0 0 , v: R w E ono 0 CL °' u er 0 co co w a q E o L. 0 u .E N i N u O j «." , 7 v. m C J ate+ G Wit. b . a �4 C y CZ w . =.= v u '� 3 F ea 0 90 C) ee .. = to . ) N 3 u e, e. ' u a u ,r. c env to n 0 0 0 -0 E w 0 CO ,°, x v ue ' W o o c �« 0 .2 �b id _ '. A.' 2 a+ se :l CL C t07 '� •.A v O q F. 0 �C 5p y C V t�.�. � q.12 .5 0. F.V. ta. W E- G G'' ,Es G 'g C w ,C N ki „7 0 p ti '^ O e0 «G 'O '_ . , v;ta . co 0 ta 0 . � 40 . % ,_,I. .• V V .0 .3 V v r. ✓. G let 3 a 0 a ` O a " Tr occOy0 Etr• a. 7V > • VTw c so _ 4 _ 0ea0 4 u.EV •E � x oxJU ge oa :v ° uVo ' F lt CU chi tie 'vi GOA U = C C '� MVCA o u C o .>. 00 = En - > i oaa) v, % •o0 0, gu ie ... .. EV ''9 EW a. o?j r oQCa eS U ..- 3x cn Lc. GOu`705 a. Nlrto-0 es C4 h ... U 3 E— , • • s. E— • t- • a .0 X W c.., I OO OOO O N O NC "CV C _,'' ri ;2 ►3 " .� Q E . I el U0.. .0 O o la co co L N v K Er ---_� rw I. -.1 Q d Q~ c.c. .. ai 7 �� ^ QO0o 0o O 40 0 O to j C v S. G d Z 0 u e e 01) xma do 0. 1u i o0 U C u_ to o Co o ti 2U � _ d o00000 g Z m 0 AC,� II O Q C ...1 kr O a� � Q � CC L � Oa R Gn N O Co � _ O Uu = 0 u VI 71 � . < C)i) L U Q - 4 It4 L. P. Oy ' N �^ Q p N .0 ,emu.❑❑ 0 h. A ..... ' W w �.o 7 A g c. to C' co 0 8J' ° ° w 5 a u V C , r, 0 u v Z Ca N 0 .-. ,d„ %no aa ` v ea .. 0 I... C �p ° O V .0 C n d m c u w WINI 4. o o w 5 C si N � = s M ^_ Q 0 $ •ti y o � wv� C w o, O cam ' . NI3Ceati Q a V M Rvi r. . Cj" t. JoLC' V •Y C ce 1- C� O "..is ( .^ 0 *t a Z Z 0 o .c 0 o E w .. u 2 d h N .6 W 0 Ca b17 �T .y 1 cc' d' O .a w V N 0 O V '- O' v N 3 w _., O. C '0 ` 0 y N 0 -o CC ao"`�- .b O A C N n ram' I V .1 0 0 F 7.5 O C .X .O = V O L el 9 U • co ° .� ° ° V .fly., . c. C y L y V o .. C o0 i C C CO 0 = .. ? � w~ C41 .` > er, GA f� Ufj 'r C � 'd Q CO v O O as 'u0 a. 2 U .� C C. t._. ,.�.� G - a' o 0 ,D V O 'c fL� La ` N .0 0 A y m .� O ` C a '" 'o a X c u 9 i C u2 3 0 ° c �e i= m E a. o ikD -!.UHI a. VS 7� E ooGv . o . o OC Mr E / A u Ch 0 E 0 o 3 q Qfl1ilii ` 'd V v) OA 3 F .73 oG a o a -iH wI _- -- o V es « § G $ v % l4 B / f B 0 § VI 43& E0 I q / O o o k § 2 S & / a 0 _ / _ ii§ = k f \ \ R 2 k k � � 2 / \ k k- k Q � � K� . \ . _ % m - t 2 - 0 / 2 0 = § IN a R § 0 , . § a \ 7 �� _ I § g \ v f % § _ _ a , U , 2mR k .0 v C • - / © _ _ _ C ƒj � \ \ 2Tu 7 ,, 0 . a) § \ C 0 - a \ \ o < / 3 § 2 2 6k �� | . ,0%. 0 No 2 Q .'a.¢ S_ a o z _ 2 e / •o / \ \ 0 k § / • -1 it « f & no f .0 . . ii- _, • '0 § § - E 0 � � � � % k § a, / § � � m ce .9 k \ / \% / O « f � o \ \ ƒ Ea \ \ CS � � & 2 2 2 0 © / a$ R \ > a _U / ; 2 U .Ee S o % ' 2 - $m / ) . ( - - § __ 0Z \ •\ / � 2 in kf 2 0 ¥ # § in-; ; k \ § \ a) i k o . . -5 cn * - =: f1 ■ _ � . � _ 2 { E E § k � , - dk q 2 / »J \ 0 - + ¥ ! . § \ / E � � c.2 \ / ? � o 3-�7 / q � a. � n � U73 = 0 � w O .O r' O. N•C+I . .. N N -07i. cn a0 0 - 0 .. Op 0N0�'O vn n M 0000 0 <+ 0 O o d C a� O y G �t d r= 00 O 00 oo en C �. T >-• 00. • O4 R N 00 M 00 V M .0 C In — C .ur G al en C W 'U w 'O N % �"" p v.`". N o G i0 .: ° •ai X C y • N d E"i a ° -. :n C.P4 C en ®❑ 'b N .-• OOOCOOOM en C -2 E _ B y ,_., a.as O 7 Imo. N r. C1 + en eCA N G 0 C u •T.",. O o o en (3v0.D aob ea n v b o A4 O o Q o4 .a ° 44- o C ' U N u o o cC. r« 0 - N ac3S JD U V o a.) .. —Cp- C ei u w A v m 3 A O co VD on O' N rA VV) e�.1 0 ,�•I 6 O Z 0 ea El,E d 0 a�i .0 u C o — o OPooVor; In E u E a as c q r� .� o a.. ° �'d' r= o o 00 - .•. as $ C r. 3I p. o a. api b o .. r Cr Nooenoo — N C F .0 57 3. co a. .. 5 c ','. o d a C w v 0 a. o r pe°' d2 � o b o FL. o as oov U 6L. a �' u v O 4.. ( U C z 0 0 O .o w a' 0 0 w �, = W .V..® t- _ ..... C .r N N N N a., r� U p `� .0 A O O O L. V WI 37 �' C A. 'O —,-, -, .- - . ,, � V 0 v� ' .0 M en ti0 en V0 N N C N • I G � 0 L1. 0 W 000000 N u u 10 as �'Y O u - v C C~I 04 0 N N N N o M V' ct E O J .c 'b < 0 N C.-4 N N N N N ›., G p" c ° u aLan �' O -- OoO000 0 0 oO a. _ C OCOoo00o 04 � � � q U a o er u• U U o u a? NO 0wV] Q _ •a N a 0 x 0 0, NNOhNTNO: = X a elL N W®�❑ A C. N et ." '"a mo y G O O 0s O en b CN 0 0 3 A C O N > 10 d M M Ti P1 Ti Ni d r3 O C rn en 0 O M en M en en en M to ,aa ea 0 w o 0 r^ Q N % y. �_ W COxU eel Merl en M1MMM 0 y .m 8 C • O •• H . U O R v a V U ... E u .e A .' e p d .4 o .0 .$ u to 'V = ' s. 0 W E - o � 1 › E Q a�a e� ti � `- Q > � N � OW ui CD G 00 N aC on 11 W 4 3Z Z O. °. Z c. Zc'. Zs`r c oc x a . v 0 ' mAN N vul � o NNMaa u - 6 NN aMMMMMCD O CD 77 O ,.. sO rn Q C3 C3 I. G _ m �! � dd � 4Haell g O - G u O of o0 oo Oo 00 00 OO 00 00 CNI 0 7.3 cH . g .G U N t` ry r1C- r- r- r • t0. M _t"1 ° C N o . I. u O s. 0 U 000 peQ O X .-. . C S. c 69ID F i ,,V . V •}CZ C qi O : c :E; . n CA O 4 O _ NN •� L d • L' ea ` q 8- p _ onC O i a) C 4- .0 0 -. O V 1 as D� K .--, /. O = . 1 en yt0 a" I. p •1. X C. O • i V > N34 . ° o A o � u I 03 F. = • u cm 1 '0 V a 0) s i w O N '0 .-. vuz0. A 0O x rf ci)• W .-. � C s � '0ala , 44 cW 0 O I. Cl) V) bA yy C y � 3 c o `�EL U oU oc„� _ .1 qz -- ,. C *0, O it =3 o J � � rs O ..o L d +�. O o. o h E ns • O Cb V x ~ r3 E" °� C C > Fs) Q o3 ;z a� L:. o� �. O e0s 4. 3 0 ° ° a IL ° aXX 1X CFO ea G 1-3 0L G. M as 0. O C W 3 40 V " .. cxi v 0. G:] rn as 00 .0 Ai �, W 0 '3 i° y 71 p' rnE= E•^ vnErinu, vn Vl ..� 0con 0. F ° aJ m w Cy .U.. 0 C U N N N en en Tt a v1 Cl) v a + L. CGw p v3 . wvwO � rnrl" E■ E■ MI va CI W u. — _____ i Page 21 of 33 Task Activity Deliverables/Outcomes Due Date/Time Payment Information # Frame and/or Amount A. Comply with Washington State SRHP Manual, • All reports described in Reporting Requirements table As described in federal Title X requirements and all state and below. Reporting DOH reserves the right federal laws.Also see Program Manual, Requirements table to withhold payment Handbook,Policy References under Reporting • Other data and documentation in format requested by below. until: Requirements below. DOH. (Includes copies of program and financial • Compliance issues audits and reviews including summaries conducted by As requested by DOH or a previous B. Complete required Agency Information Request other entities.) invoice arc including Title X Assurance of Compliance and resolved in a way National Provider Identifier(NPI)billing • To facilitate DOH/TX desk reviews—requested accepted by DOH numbers. documentation available to DOH in requested format. • Current data is submitted to,and C. Provide medical services,community education • To facilitate DOHITX site-visits—appropriate staff accepted by, and outreach,and staff training,consistent with and documentation readily available prior to and Ahlers. state requirements: during review. • Al9 back up 1. LHJ is responsible for making sure all staff documentation have the knowledge to carry out the • Site review directed by DOH SRIIP. Follow-up site required by DOH requirements of the SOW. visits as needed until identified issues are resolved. has been submitted 2. Medical,laboratory,and other services As requested by DOII and approved. related to abortion are not covered by this • Submit documentation to DOH SRHP as requested for • Other deliverables task. a desk review prior to site visit. have been met. 3. Community education services must be based on the needs of the community.LHJ • Appropriate staff and documentation readily available Payment is limited to must have an information&Education the maximum funds 1&F committee with five(5)or more to DOH SRHP prior to and during site visit ( ) available for funding members that is broadly representative of source. the population or community for which materials are intended.The committee must DOH will reimburse review a batch of patient-facing materials for: annually(at least 15 products or 15%of • Actual allowable your total number of materials,whichever costs according to is smaller);meet at least annually and your approved cost establish a written record of its analysis(see ? determination.(42 CFR 59(59.6J) Reporting 4. Outreach is to ensure all populations in Requirements your community understands the services table). available.Focus your outreach efforts on or increasing equity. • The amount remaining in the Washington State Sexual and Reproductive Health ? R&E divided by Network priority populations are: the number of months remaining in the funding Exhibit A,Statement of Work Page 2 of 7 Contract Number CLI131013-Amendment 20 U 0 .5 I C • 0 en V :a m y eg y ty0 G ' V V A T 3 U i .-. ••- 7 O ^ W ... "a40 >. `�' o 0 c C. u .. ap V. ° o ,o o0—c a E O � � . 0 — .n >, c E C aoZ � ae a. Q ., a 4,.n 3 .b � 00v s cu c y v U � :c .3 a eqa 3 8 '3 > o ' $ � a d u , m = o � � v v u a a x A. a. LI aaa Q � 'S � A1v E I- U > .0 A x .5 E �,, � o �jA v cpi Z o �. 3 • U --- $, SEE v ° 1wo ►. x0, . = ,o w - 0 C 6- � � 4 d ,E 3 Z 0 Q � ..•a a H U C O U O O c0 . U E O J C N V O 040 N1 > O ° d c0i E ad a A ;, 13 U o. ca C U d h E U 26 0 -0 Z. M 4 .5. y O U .0 H Ce U 6 ea 1 b Vj • • E u iY N y• ° •• M r .7 •E O •N C $ E '� eA o 0 I. t .3aa. 0 m •2 .6 bN ° $ v o -0 -a — ti. ^ Z m0 L � le C E -- 15 c C U u ▪ , U .0 9 c au 0 E o8 - Zp ,>, Z m H `° n o > • tr, vv E ° Ica ^ T om0 - -0 O v 0 %, y. E 0 a0.At 2 ca 0 w v� -o eu Y H e ?g ao ao --0 �'' c E a"ib L_ Vl• 03 .. �' e4 X O 'vi -a-,..- 00 :1 .07: 0 ,00 53 .g >0 o e:t 0. 03 0 p� U •41 4^r « d 0 o O O E � o u � w •a 0 .0 a0 �' O 1... O a av C d u .f ° v ° 0 3 °' ° $ `° is C '= aCi A ro ... " ?= ..0 `° O O C > 7 OD ¢ E C. 0�. •0 , C 0 ea C c •ed �'C o m i. p 7 %> V? O LI *a > Y .e 6. 0 U 7 u a v , " 0 .� e7 c v ° a E e, o .O h H c -p .`a. io o P.v u0 > i : p , $20000. " o0 _ 0a 0 0 ° > = •o° , $. y � a0. >,b >, ° ' ` ° � c •..- -. V U � w o eO = w kacpip t« awwe = to0ua � a0a o ' rt.uc = o -o e''xa 'voXeLtEaae c6 o e oE t) • • • • • • ed 0 ' ••-• • • • U W en — [V e+i z • • • • K .b o O to w 0 0. c� G w Q .c .0 I 1 — — — 0 N o C 0.3 o 7 a M e V �c Q d el N ...4a N1 O: aCu '� O G. ' N en os r U a) W E �co q e =, o ^ Z co dtP a) L i i> 3. 4~ 0 a L .. -ej O 0 n co) 0 Q �, • G w -a •0 u N � >. A U A •C R F a U w°. 5 V 0 C < >. - Q 2 C GI ._ -. CA COi p y y .s* .0 1 0 0. V .... 00Ut OS C > V � d V � ,L y E 7 = •i 0 at 0 O el e0 ., C ►��., y C 0 3 ^ 4A g y a ai u .0 p 'e E. 34 a. v _S. _ b 6 U v 10 ►. 'C E ? >. 0 two ? c 0 CA > N '7O o o� •QM ° ° s u �.� .qa � u .C :o a. 0 G.^ — .► v o c o 04 Cy �- u v� .a a... '" o u v .e u .o aa L .Ti • T. C_ C .G r ea A V 'D .= ca ►�+ 7 C a O aw 3 E a d I* = W aL° aC �•o ° c o a • a � aP4 -� = v � .ogC � p u •< — a; E 0 u v a, ..• a u L > x y .0 3 ,_l o To .5 00 ax 7 u v s. 0 v d, a• a,h oo w ° o o v U W cm u a 0 u «� C = .a 3 o y .6 u u .0 DO .0 � p o C •a V c 0 ° c �5 0 ►. = yy u 0 to— .° 0 0 d -* ' = Q d y a >' •� VC 0 v 00 U t_. 0 .0 49 4. V a •-• .8 N ���•• V 0 c U W y V 6) 4-3 a tE V V. A > F O y • y 'y • aOw C s u .� y a E .. co 4. E a c- U d O o an C wA E . o ° � c ° • Uo � v 3 E C = ni v c ht .. .° 4 „ � oo 3 � q Aq O 8 r. O V C •C 4 '� 2 "- O6 cc' 4 :i 'O 6 a: d U 0..« V) L7 '°O 6-1 � 73 .9. q 74. ao IA aW F o E 'y ° o Q o1 V G W ,c Q ai $ 0 Z Z 0 0 .6 C y E O c h g N Q c o E o •9 is •8 v m - 3 Y -00 u� wy N co co 1� +y+ C W a. ~ G fC u to ar •O u o0 4. x '3 a `n = 2Z O 4 :. �•2, .n O •� 0. ti W 'aC 0 O O 'er O A O O Z u = u 0 ..] .y. G. y a... ,yv s 73 E b y 'a z4- b u x u W 'L7 > N C A y 0 i 4 L .. O t E u 0 .a y el . L y OD� 00 a a. 0 . -5 in ICC. to ` C)i i � 4) 01 a Q C 'a� cy .4SS. E30e 0 Oa rk - a w _ o N e. N e e E E 'c en e g E o c "' a CD 01 N b r0 7.1 __.. 1.. V N � g Z t 1. y� . _ r� TO 03 t p2� $ . ce G �1. 0. � d a' > ,0 U g'.�, v 7O A v A N tg a c y • C `g j 2s O .. is c 0 43. eu ° c a .: •o 'p u w .y V .0�ips V y V L G. 'C « c a 'eV'.'o �' O " d a�'ea,o O ',_. c - 2 ?+ u O O y u 4 7 a iy u 4 .. C coi N w a '"v • vs 6'-= �,.. 0 v: to c a b u '- ^ u �, cn O n % ►• -8 _ 4, a v, = >1 S 'it'd > c v = h b a h `.. 1 -0 >,a ou > 3 y0 h sae a au .F on e a v w L. P. L. �a " �' o 3 p C ,F u E ' ai u = L 5 •;, - L L. a F ' moo E >, 8 3 '' 0?o° E .; X � `- 'u 0 .6 '0 � .uc o' h a0 'A o 0 O u u '0 e w 0 s•t7 u u ZsO 3w a � 0�4rn 7 +- h X r, G > a t �. Do O X O u J 0 V e 55 N V c W o `"� . 'O .Q. c ,4 pp ~ C •p O . JCi .�. N C ; j 7 .a 0 s 7 a c a E a •c 5 1 r a o P a a 8 _ ,. s -v o 'voa .e � ° yak ° pro a " oa. U � eo o � c �. p � o i •in > > ° L� iC O z a V 0 0 .c .. > tL ca u O > N i u` v 8 = ° L v '.. ,, o '. >. o is ta a 0 4 = t.. H `I. 8 w v a b0 017 c y a 0 � v ;) 1,C 8 > s soJ2 3 a '� 'o w A R o = O .' � a .- °; a A w v � O •� a ►,. u .—'v c E � � " o a a, c t v o `dS C c e c 3 u m 00E ° o ' 0 '0 -7 P.. > 'S u V a c C v E O u ,' o o c 0Ts Leo o it C •E ^ a y . •- w _wb u .- . upz E — g = v = E = O el 2 u 4 0 V C . •G C R 3 •- 0 O V .2 y-y� t0 :A A 11 0 to.o •e V e E a u -o �•C u t E 13.CS 6 ,i a '� O O H N O ��' `� >. >+ OV01: 00 •E 'ty 0 .e a vi .:. 33ii . zn b = 'r�" 4- 0. I- .0 'e u u v, '° 3 u 1 s° $ > aCi v ,r u �° ° o .a � °� R ° a a > W , a a v tx 3 ., a s ci o g . ate = baao .= 1. « F:, U CAw = .0 . E. . . • • YW y v, oa3 es 8 a b r W < ai -g o � 6 4 m0C Z < LC •UCtri V; a E • o4.) 0 4 ° ►. . g3 € v u A. y E, aai C o as L. ° ad o ". () s 3 - h W ...Is V .� •0 QZ a owl oDg � 7 v' y 6 a C. C E ' u u •0 e .gVI 4 •.' •° �jt o 00 a0° �` a � = � sc ao ac � . 0u, O L. ° - ` - A ° O . c p Og Q' C . 0 � en .0 „ p . 0 C . e«. au 11:1" eo 01 ct = .4 a s N ,O 3 U 00 ++ E o E E w _, A V u V a. V) V1 i LT. ram. 'C v W '� 0 V) Y .o a4tI ILI Cl Iin N a. tA O r: U1 r 01 v b A M l O a CN LO F. M OS 'LI o. .0 v -— 0 c H ee to) Q 2 r. ►� x tLi a O �' 7 u r. .5 Q [ 7 E .ro o p ' Z Ja •� oou o Z � � wE � uEE 3 � E E � � � ) 0 . 60 o " IL) b L C .. O .b y .3 �•+ y 3 u v a a c � � - C� .0. 0w pa d � 0 - � g o y � � CI w U O C lc O .,� �' u G O . JSQ w 2 N .- u ec E 0 c V C u e«. uc `F' wa � O ►. � "� as >,'.: .- ems o XI -, a- > o •C as E-� W 3 O ►u. 1�.. 0 c ._ E C' aG vv) H .a 'C ca a H C N d b is w 'O .. ", A G 'rL" V g 'O d -C N N H it 0 > Vj v v 111 LL O y .r s O V II a. Orco F 9 v 3 M > co eisv. i C E e ^ C u O LiO O t i d•oecno a: - c O u C ^ •7 v E 'r .0 o .c E 0 0 o ed •up pG� = ^ e«e o « A p 4 �, u T u t V. a' t� U L GO 10 y -E,D 0 .y• y —y = ej .."' V E O Vr. ,� h ___ ' c v 0. v .s. r.4 is C e C d. 61 1. 'j E d N N v h' to v O ea u o .0 — 7 u > •a es 4 w O+ eo w a .Jq ea .Y 3 u u u ,o 0 3 � a = o : E ) CjE4 ie' 8 E u 0 o nS hoc o C a u •`= u a � ao 11 E CO e .«; .0 ,.. "' � °e Z".• ` Sip E ° 0) p i � o A A EH 'oa °' r� U �? E L : t ie p •A 3 cO awl 3 .. Oat (a� LW. 6i C O t1 !2 v u e C 4+ ESt V pi v SO T... `�' a+ BOO w > �7 .. m m gp+ as L W > w, d O C o L v = 7 v. �, C C C GK C.V �+ °w' >, Cp o ff 3 v, °' i Iii S 4 E � WiH w � c' `° 4+ U a C ._. Q V. m • u ee ya -c v] ca G U ... . — U ,.. 3 O J4 C U 'v VJ w Q L7 u C E u 'ii E G • Li. = `a O 7 U a . _ -> m `a 0i r W I. I. .5 ' c4 *6 ce ° . OC s � . � at Jo3a v e I c ac 15 E a. 1.0 • V ."' O 'O� co) UQq TA Q L M O u C. C a) a. W U .O .0 a. a) 2 H 4a >, ea ,- -0 C ai 'D 'a A '7 C 10 7 OF fn C O d OS G .. O — u ac 5 o U L Y c u . 3 4 1A OL as La. u 0 E .__ Q ,f. R ... E. E " r5 L Tel .O A l 0 - u u E- QV LLi- I.---• F W 0> W N 3 ° c N Cr. V N O C E �_ H Q G H 0 m CUV. 14.4 a 11 u41) 6 b y C 4.7 cd 0 C Z U A Ou0 -� .CO 0 0 U 00 .ti O o C a o L L m t0 of C4 G as 0 N 'd U S u ufa E-0 q eq` es y rt y E e C b o . w CI uO : a C❑ •n 4: Xi a• Imo .0 .3 � v; ' I o F 80 o ..." 0 "fit = w d `3 °�0 v o C V1 N C. a.a yi �. '� E .t 0 Gn .7.� h Or 2 'ci s zni ° C �iI 1 -a L' . .. .0 G `� 0 •` o m i-r-I _ .d g C 0 C o > n t O w U 0.-= m y as d c.1 O. C h N 0.4 y U Q 0. ues >Icy H ce .b r o p 'ie m .g 5 C > �v 0 N.CU r 'd 'b O •v a7 C = 3 as a. h m U c u .o '►u. -aw > o x o; o o ^ U u uV u ,c .1 co a . esv 0 ` x ,b Jo 3 C, a) O co ;� 4 al H of 0 O .0 N u C 9 v O - E g E° u a a' 'a g>. a u E Q u E u a. u o I. E �uC v Z. Z d is G a U p. C d 0 U G . 0 crA d .cw•u coE E u CP u Es C . d � " a v oaCyoc � 0 *; CS e 0 Z. H A .uo y y .0 F L d Q °.."T'.� �' y y 4. ° "Lijfl d c .e �e " yo " = U y a e su- a 30 0 V!.� iifl = u GI Ec ; Eau �' u 7 O E EO O O .>w .� .G ^'' O C .^..• .E 1. p 7 I . w U U U v� o. _ ' x .. d E E ,. • • • k d • • • • • ►Z IN ..F. a. aax m ;n v) dlt- ... cn Page 27 of 33 Exhibit A Statement of Work Contract Term: 2022-2024 DOH Program Name or Title: WIC Nutrition Program-EjTective January 1,2022 Local Health Jurisdiction Name: Jefferson County Public Health Contract Number: CLH31013 ` SOW Type: Revision Revision#(far this SOW) 11 Funding Source Federal Compliance Type�3, of Payment El Federal Subrecipient (check if applicable) I�Reimbursement Period of Performance: January I.2022 through December 31,2024 El state ®FFATA(Transparency Act) 0 Fixed Price ❑ Other l] Research&Development Statement of Work Purpose: The purpose is to provide Women,Infants,and Children(WIC)Nutrition Program services by following WIC federal regulations, WIC state office policies and procedures,WIC directives,and other rules. Refer to the Program Specific Requirements section of this document. Revision Purpose: To add FFY24 USDA WIC CLIENT SVS CONTRACTS funds. Master Assistance BARS Allocation LHJ Funding Index Listing Revenue Current Period Current Change Total DOH Chart of Accounts Master Index Title Code Number Code Start Date End Date Allocation Increase(+) Allocation FFY22 USDA WIC CLIENT SVS CONTRACTS 76101234 10.557 333.10.55 07/01/22 09/30/22 86,376 0 86,376 FFY23 USDA WIC CLIENT SVS CONTRACTS 76101244 10.557 333.10.55 10/01/22 09/30/23 132,338 _ 0 132,338 FFY22 USDA BFPC PROG MGMT 76214231 10.557 333.10.55 01/01/22 09/30/24 43,389 0 43,389 FFY22 USDA FMNP PROG MGMT 76540237 1 10.572 333.10.57 05/01/22 09/30/22 516 0 ( 516 FFY23 USDA BFPC PROG MGMT 76214241 ! 10.557 333.10.55 10/01/22 12/31/24 37,651 0 37,651 FFY23 USDA WIC PROG MGMT CSS 76101242 10.557 333.10.55 01/01/23 09/30/23 2,800 0 2,800 FFY24 USDA WIC CLIENT SVS CONTRACTS 76101248 ( 10.557 333.10.55 10/01/23 ! 09/30/24 I 155,011 743 155,754 FFY23 USDA FMNP MGMT 76540248 10.572 333.10.57 06/01/23 09/30/23 ! 4% 0 496 FFY24 USDA BFPC PROG MGMT 7621424A 10.557 333.10.55 10/01/23 09/30/24 37,651 0 37,651 FFY25 USDA WIC CLIENT SVS CONTRACTS 76101251 10.557 333.10.55 ; 10/01/24 12/31/24 26,268 0 26,268 FFY24 USDA FMNP MGMT 76540241 10.572 333.10.57 05/01/24 09/30/24 496 0 496 0 0 0 TOTALS _ 522,992 743 . 523 735 Payment Task Activity Deliverables/Outcomes Due Date/Time Frame Information and/or # Amount See"Billing I WIC Nutrition Program Requirements" below. 1.1 Maintain authorized participating caseload at 100%based on ' Outcomes based on monthly participation Authorized participating quarterly average as determined from monthly caseload data from state WIC caseload management caseload for January 2022 reports management reports generated at state WIC office. . through December 2024= 250 Exhibit A,Statement of Work Page 1 of 7 Contract Number CLH31013-Amendment 20 - O N o ^ m 5) y e O .Q • .O al) C C O �« 0 3 : E E 0boa. 8Q aciu VU SC .� 3 N a.0 2 6 ai d �• O en w 5, o > u O a A N O iQ l0 0 a0 Cl) .0 r... 0 •S a, G1 •O en L. N II NNV N N en 0 E ..` NN fir; M NN Y.N N pN ca. •p �O o 01 NI 'O N N M ` 2O .0.. 0 N rOI1 0 rrl 0 r'1 t r+•1 C • C a _ O •rn C •- •� •C OTr�5 C a. E U - l C II N = � r+1 � O C O O rJO� O � N � E q.1 •-• � " N acE o+ a °` a o+ � EE sdE ._, = u G.z .° OC el o s `' et a) •:s 0 U U U U u 'a o u 'flu 0 u a iy y p ~ N L y �, .0 ..i nr .•-. 3 'O R CVl •d t "." 0 os aN d R � � Nr�1d W_ 3 3 3 ;, 0 � A ;,c I) s •. 41 0 A °' ° a pp V •p �,N N 1° E 2 `� >,�° '` �, moo b eeo p''eL %17 >, P .: a v _ ._ a >'' 0v000 E o ° o ° o ° � ,CG ea Q Per u .. el L. to H •-• 0�1 GO Gi w V) H 6. rn ... F LL o o y Obi a) O J C co 0 V .fl E u a; •C CC 0 ea VS 0 rx C • K y c .o w P. tL. y S q co y .'3 y x a) "co ch. E ' O O O C O T ? .Y C O Fj F'j c`y O is O •O O coo p G O i) " O Ny a v) v, E eE cE cE 3ea uc u5 u 1 c .e0. EU d u O ►. O E 0 3 rE', 3 ' 33 8 a 7 Z A = A .a 0 .O A .a m im cnZ A .0 1 y co0 es .. >' v ra c C 8 w ,° `° w c c y o 3 0 b o O V U •p M w co 7 C Z '¢ u > eon •x ca s• w u Y �i " , �_ H C.) O Cl. i .0 d a 'J C V OU3:1 A c o `° c •0 •a u 3 u U u c u o G. o C. ° s o O E ; u E Go a O CL W w C 5 � O .+ r. , rJ i A � CDC 1 — �' u A 3 ' n yr h 3 NLA " u• y v, G ,� eog �' = `�~'� "5 c E 0 sq A to es 0 c C u !3 'V 'O H m E 4. s' , al To' C as w U •0 d ''3 C C V Gn V2 •C v H L.v 'C •C » C y V • '' «. A ,, pp o c C a V = VSc a a w �. �,¢ = E u C tl H C -C ad .r3 .� ��^ avi C O 03 U 'C7 o ._ O •C O of d s. is t " G G E °'03 cove 5fl U E •E T n. 3 � � se • O U ri 4. C C C 0 .� o G .. C • E' O 0 I. f.L1 O Q h O E et = c � y 03 2 ea o a y CZ v .b' O - mo w T. ,4 > E .o � •os e t si :� CG ,n U ,� M •.s •- .d C U c. cs w 8 c x a o m v C 'o E v a A " V �w •5 ,d V 'C L. R •v U U § 5Y .5x > . 0 `0 O rV e�i p C w v b O 0 N 0 O FOn .D .0 O E O` c O 0 4- �, ° ° = L 3 v) c; u C#) CC.3 to >>. •t•O� C CCO n .E 1. U v Q CA 3 v) C1 0.. 4... 44 ry yr. ''0. C.: 1 lc 0 L N a .0 Is C Is d r IA H Q a el d 0 a our tio^ � c el 8a ea) cu U6. s: R. en C91 ea � Cr C a Oda COC) n h w � en _ O 0 en I +s 3 u r0 M ... O O o V 0 N L 7 W -C M •E G '� lV N Q •a •r Q y O M O a c3 O O G .� O„ O 4 z OC = V 7 0 N U 0 •4 b p V . b O Q 1 O � 0 C� U G-G d � Q U °2 V �oo C ` d A �' s. �' fs .0N V0 • A U 5 t� .y.. 0 •- a) •0 u F -- tj N •0 v�i yr' f11 W V� (" C1 k. to CO CC �=-. Q ON 0 2 . • 0 V N 9 Go0 o GOo .0 0c y > a a 0 ;w q Tou ... a.. O WI- G U 4r a a> u u Cw. 00 o w Oa .0 O. 0 0.o 0 . r Y. r c.. C s 3 or+ QO w te °a at • l ,c E a+ 4- , ac o 73 L v � EN 2Ea 5u. E +., � o ? E4. C. ., 08 > G. .V C 0 0. 65. L O C O 0 ;; 4. 0 2 a k c +�.. 0 � L' "� O C •10 j _ea O y 0 p,. H Y g pp v V c, C Q S 0 ed 4%. y E EO E ,. 0 0 1. .0 W 6V r EV EJ 0 E >. E V .b a1t'" O M a • ayy3 v $. 0 03 � 3 0 8 L 83 0 l -a A a O b. N •0 ° ° N v ° r1 C -a v Z AA mCYi41! Q o t_ o rn c i A � o .a. O t .0 r 3 v) o 44 a, Y 5 0. • Ui t b a �' C.•.. c N to a � c -u T 3 .�� ,°° O E ett V L1 V 0 '� U .y ` ° u Vl ° 2 2 0. iy > L y U U •as >_ .y t� 0 •• 0 0 _. 0 0 •... E -a :d V. v u O C a V 0 O > 0. c . 3 u ° :° m 0 x o Uc' Ec .15 3taW vicn a H a 0. 0 .. Ec^ "' i eo 03 ° 0 $ E o 0 I+. i vA v a. a C. 0 v ee : s a,p V � LLV V � C y CS Z to� +. v � 4.., .0 L G. 0 C � a 0 E � 'O X 2° 2 ' C •0 t° ►. ullD • oo•- E a • g 3 * u ao c c Q m o 00 £ acn' •a , R 01 O E O bO t ei -u, -g 2 ° CD a 0 OWI y t. o O % O •i o Q �' i .E ° C :s 0. ca O :° to to 0.. z c G ". >,.0 0 c al •E O a U 0 n a, 0 v. C 0. ° U C 0 a .- 3 c s $ L. V) .t 'G ' OD r X r , u 0.€ c 5 .> � 3 c c a eu a y ` 3 v es v « bQ ao � � y. --,o o a ea a v c u C � u ! c H � s >, 4` 2i •0 d E cc0 U Q n N V 0. Y C n.. G a .° = a., v g 14 a s L p eD Q) u E o r v a, 4- �' o -. 2 - " a �', E 3 .a d A+ w c_ a pq 4„ w U. . a E o = p ,.,.., rn w. +.+ p, Cat . A aL Cv O ,� :dam . b3 0,) I* . U 11.1 PO L qa. > 3 83 ark w > o a �' 5 �.0 es � a so o ° a) E. C C) m = Li A d' L Ot +y `.• h Cn o ac a � oa .. F. 2 :s. a c a 2 E _. _ x � I". ya. p I r� 0 4 y CO ti U a rw. ° eai A a E 0 . 3 G l_ - E— v3 E o > C u :o 0,— > Q c'� O 2 0 M 4.. R 7, �00 4" t ° ^ 3 rn Oro b y . • .1 T N .0 A a) Cm an Q p 0. co4• . 'N %GO y • p VL 0 U Y " a. C p u v y es 1- F ,. co a; + ,C I. � Bq G a '_ 'u V O V A f u EEti .. C NZ0 90 O V 22 2 WQ• t0 w G. a 6.0 6�� a ca V a> d S� c o .=m e to 40 tsi .0 w u C3@ . ° °• A d N . 0. ' c o � 4-4 IV a to 1y • u G - 4., g C a' C o 3 .� •� G Uj. - E U b V V y v;.,,r 4 a es Q 'Cs 'n .0 Y •W p a •� `0, G 4.. 'AO u c a ED C V R at 0 .o r2 E chi u JD es CJ 4, U �.. ,C C V V p aJ 4r y ..• 9 0 O O Q O F •C o '7 'd -8 Tr ' ^ oDUo c c .3 u .n o 03) f IM •a 0.1 0 u N ' -v ^ u' ' u ° • g i••• Tl.; y Is. p C u C C a' ci F C :-7 a 51 U V •.� 0 c�� = a o E 3 F = 0 • - — coE V ea K ‘.. Z .,, 04 F 0 D. 'K C C L aV-. -y.. E�a F o 2 go X '5Q• Lt. °n, 0. t ca Q 'v yr "o ,i: 60 i... ..0 S 0 u u $ V E V , N L O u O /l a^i en 'a 7 c4 O V en .o ,C a 4. .•. CL ul > y o 3 � a o a H goo c $ ▪ "� u �o tub `� o o e_i ' o v N a• •o •E a. y, v, E ta a �, c a a a? L <. H A pp o e: y Z ZE C .c 01 "— `.^• d 0 u �. a0 Coy. j � J E o u o e o iflLr0. � eeVI EbF " iZfl asu •— C E34 • r • y c `" • a' u E u o r y if. V V •U U C R'� C C QO a i-•. . ` 7 1.L q 115 . `" ` � � s ... ;; Q0> OELa .S ac ..o ,,„ C . � u v 00 O n F 9. O s •c x ,, ^ rioc • -oO a. 0 C = w vi O C p h Z a o o V '$ o u • a u E • ° uE ° EEg ri • ,,ad p a+ 4. •� a • y .� ea G O . E �^ pU E 7 • C4 J . ! o • .= GC _p r _ C. A A y V Z p y C o •_ r O V co▪ ti L. . V E .C5 � 0 V �. . U E_ y 0 4. .., 0 ea F c`a ^ m u s .7) 'u'• 6 q o C 3 ;� 7 & R `4 . o E >' °' ^ �O ffi tb ar C '..E u a " .d w 5 sa E E E °u°'" 0,o a 4�. ° a o c 6- 3 a a - F v o o .0 o o 0 .n ° V e LI 'a w of u � :: U `• tea - �00 o - ro v � UvsS E a •a '.' {AUU EUU Ili 3 t3 r. V E g s a us u y o o H - w =• v u ;' u - 0 o C .— cn S.• 0 3 3 O ci 0 a Hn u D 0. ac°) o m y a, Y35 ,= = �xUv33z33 44 11111 e= 0Z a.• • • E .-1 • • • .C+ .1 •�i ..= IF 0.v) E- v vi �c w V _ c fY ' o p. 4i N 0, 'O ° .� R C C 4. VI ° U O R C J ea C v S. t.) V c N N _N > •�•' RCS •- C 'G . A G. .D ^ E a E L u o C U y -5 'v C C T T ,- c 'd _ = u S 0 rJ �' m CO 0 0 c • v) ` L v .~. E. `0 •0 �� T� o d -0�y 0 u A E 0 G, en n .0 • c ,rC", us '0 �p N y O pu0 g u C C � t— vC � a — ..a� } • � 0_ uE 0•uULa >, y cv.E u U ° p4 o 'u E '° 0 No ' RE14,1 a) m pVe ° e A a. § NZ zEp >, 0 °,al Z0: W t Y ro v o a EE= �� o. m is b U O Y — O ,UE00. D 0 a OQ i5 A 0,-, u }' R. ' ' 0 4 O R co 0 c b ,4 0 e "t U c= e.. "00 u 3 p, u . v r v 0 u 0 o Ca G ,J� c Rc.. b0 V • O .M ..c...' ^ UOQ G A 0 a' a G ►, .L aS 01) hu0•n. C_ N 0 O e) b v .. 3 _ G. 'JG .g Q p N .v 0 Q. 0 O_ 3 Q• vs O .� u v v '� vi A u � as " u 0 0 N G %7 O .0 C O.{v t 8 y N �•,^ O E des u O N ° a y., C. C 0 A .0 .3 0 CI 4 V c 0 F. N O ? c U .. .,'. Nl a) >• u 0 O N L: Ir A 3 o 0 4.4 0 • V R — 3 ee v. a .c c E 4 u U . y Ca u'a. ., V ',� oh m w R � �"W G yv '•b 0 y E U b0 ° y w �`•. 0.1 4. ¢ 0 buq 'd 6• LS O ..c V V le .. U • 'c U • u O ❑ 0 O •y R {y o 0, 0 +0•, N A 3 w. A s not p u o C E "It: 44 t •0, d iO v s a o '° a o �' t"oi EaU _ G c.i0 O� % U C " Aa Oh c y �3 aoi a cl 0. ek`�•• c 'ao 0 e 0 C 0 L 4 o e' /a a S aW ,o o. 8 a,.c0+ u Eat E orb y • X- E oo ° Ns y o a ti .0 •- •'.• , .b .7 .s 5 e c » V •� > �.% R .c 6� L N (� Y a� n� • y R R 00 u a • ,; � u •o ,� .. . . o u o` c s N • E o 0 9 1 a u C o F v c .to o E•�''v q N u a. 3 `" F. b1Oo G . .o - C ae pQ . truS a� W C Q u o v_ C 0 C ^ v '° C •- CS .u. 0 P. }, 0 0 ,0 . 7 O >, 0 U U •� V 7 O •S1 5 0 Et° c — C — 0. a u � E .' � 3 uQ v u y � .a.0 o U Ui dV III �.7 7. HIHIHIII r. N• E U •i . 0 I 4r " 8 ' C O .... v. p ? a • N .ice 'b b N .a u Lt. g C 7 5 .5 >. A °. 0 O 0 H bfi .a v HI • li rJej c2 o a ,^ >, N ..U.. u o = ufa.— pH c .� ,.... cip, m ea us c 3 0 a o u n'=� = c = _ o � ` �C. G p v u a ou9 TT. u O 0 0 •E u = 4.., : `v e0a W `I• ma c .• a C. C 0 6 X 0 ° .n`o vE .5 , g5t � •soc cERcaZ0 'a -oEg •fl Q .v ; :S Q '� .. 0 0 O = w c u 0 ea 0 0 C .. O -G R r m R — A C. .> .C3 es � t •40 � L1,� N 0 p N el N O ° U U 00 A t� '7p C .� N •C O R N .v. v p A G j N -0 _ Q O :J is E y.R U ^ V O .= E :r .0 I. 0 u O I. r+ }�'• U G y, • @p, N •� C. .y • U 94 c 07 UL. •G O Q V C 0 . 's7 W b O g C 2 5 E ° 0 0' in C J •'. u yr C •� G, '� .+ u •0 ova 9. .tic - as•E 'a•.o �. u 0 E �' n � a • c• a .. 5C p O p 3 S 0 4. ^ ^ .... o q co�p C O,0 j .� , a G • 7 ... tS _" a.0 C . .9 u 1. .E J1• .0 V C E .C ayJ Q b0 b0 �0» /y�� /0� � .4 O '�• A �1▪ _ � i.' s. .fl E ,U R •5 0• 2 m c L. Vc. ..) A G1• �" fn V 2 _I og K• CJ C V 0- g '. t+ :° 7 •c 70 v ,0 4.. ••co O 'C • " ems: O " c � '�¢' o C O C a C e w is A '0 03 S C co F •C_ y �jU' W O 0 V a •0 6' .. .'c�+ 0 —' O N .0 a _ u u 'C h ••- , F ^ ,p -8 g •-- U E 2 i •O A L. e1? -0 �..' — .. . u +' — = e� i 3 A `J ��'• Y 0 R p as .. w • u �p ,T• C. V ° c C cCi ^ 4. ? aG c1G U u o. .0 '0 `� 0..c c 'v -. N `' u ° voi Eiit ` za IVU ,ra~, c v 0 u o is .. .x� •• •• •• •• = U _o. � E« EC] Fria o -tiF•+ U usi ci eV,e (�rNrv7 o Y o 2 0 . W 'AC. E- -' ...• N M 0 u„ .`.. N N d3 r, ,� 0 b71 �o �; a °0 b0 3 Z E �' :� " 0 l6 ^ o O 0 b w E 0 U g '$ 47R' o N 40. v0i .6 •a. ( `'' H I o • co Q `ej' > 0 v 0 .. U .O en 0 o > o b E (24 0 0 a) U •E o ed .-. a bn > Z � -0 a c x a y < 4.0 o U v ¢ .o = -, 'O ..1 ❑ 72 p V N A 01 2 U o Q o u al 0 a ' o > •a 0 0 U .0 .U.. •`p. G.r -0 O >~ '0 E -0 O � •del o > p. 0 00. Z '-' 4) o ' c ate) c n on o ° Q " 0 4 a. .0 ''J'' 'o n a' b O s I... 4)b o E o f ri cn0 > O 4. >> r a .. v cc, v •0 K -0 0yO U�i.. 0 q 0 O 0 .0 a7 O v. CO) E 'O _O a. •0 G >_ au E C o ua � ° �ca x a 00 aioc.0 O F CO C 'O N COOO r C ' ar 0.„r v) 1?. W � b0 Ncd v0 U J CQ 4. 4"0 O y.0 O° a''G . i- 0 . 0 .. ..1,Y � .. U O o 0 0 a i .> W .0 ad o aFa o H b .00 'b . Vyy y illb d a G O 4 G Y ,O O 0 0 O O. ,v i ? 0 ,0 0 O • v' v 0 •_ o z < E > E - = got U - a}y a c 0 u c co• U ° d) 0 d •- cd C:v E" v O v, H v � ZZ a '' d •> aoo o :° c +E > •d ao a.0 4 w 0 0'0 0. o ea 0 v; _o � .E w W .S a • 0 >,.5 .n E ° o 0 p` a5i c •y c 8', °" 'V U > O N 72 0 O C 00,... E ca% '0 0 G 0 o "0 0 U U V ¢,'«r7 a) >~ w u o 0 v4 v v: 0' �i V > 0 so U N N N N 'b .0 c w ♦n U 0 > 1 00 Q �" ci 74 � t]. y 0 r V d •U L �. C.7 C4 0 p 0 0 p 'b .v. O al 0 a0j ai 'O LT•i 'L� w X ° /2' . E t� c0 �' O es N (..� v4, E ,� C O 0 0 y O r. d to O 'C >i 0 y 1. in>, G U 44 4. O 0 �} .� C3 70�' .0 y M M+ MM o� •5 p ' 4. R. 0 U �04+ Oar O •L 44 7 0 C. CCDA ta" Cli 'C I.., w•' aaj. L., fl U 0 r.. v 8 �v u = s.) d O rn C per' 0 40 C U G .OD'0 .a .00 y .00 'U� t 0 0. O •*' cd v v u c u .0 v5i b C �" .E CO Y C14, re hi "C 0 y 0 0 y 1 0 ,� 0.,b N v *" h •.= .R.O $ O C n v y •b 12 En . CO. .0 414 > o o 0 b a 1 0 o 0..c r4 0 .. 0 CC Q P E- U :v _ O � .� .0 •E a'7 O IZ.0 . O ;� as v - 0 4 ti a) 0.. .0 ) 4) 4) 0 U >, v v av6 V y O N •5 � � '!7 s C _O .E 0 O 0000 w '0 • 0.. E 4-. N' b N 3 N N N N • 'a) 4 .0 V a) C 6� p 0. F 4 ~ @ O 5 1 6A (A el 04 ppOp U U A'b O > R 1= m U '� C tbrv. v d v G N N N N •O 4, .0 0 0 0 0. 0, O 40 ,O 0 co .n :E .0.. v .fl .� 0 ":4. 4.. .-. �. ,E v •� O cv 0 U O a0i .� a' I ai 0 ra. v A.0 .0 . Q 0 0 0 -0 y ►., N U O O .�, U - y V '" { 0 E E 0 a) O r0 Y $ r4�' .... O .L - p d C. to 41 r.L. 'd 1 `�., N :: .,� o $ = g o 0 o Q, E . u o S "- o > N Q ,E v o x ai O.u' ! et . Ca N F� =, 000 r a 3 C o c Y. ., 0 U P. v tt no 0 0 e rl �' cA N F" • `� as C�" h c4Cd as ~ o - y a 90 aD.te+ N en 00 00 0 .0 O 0 0 O U y ti CD 0 E pq . Oi 0 N .0 E >00 '-• 0 ad 'd N 0 O V vi O v a.. 6) 0 - y 2 U 10 0 0 y 'a ,0 u w O 00 E c Q 0 as i) .v. +J. 0 0 a+ •� A N 'M 0 C 'C ail u) ; E E 0 O a) y '- � OO aV) a ) Q' a O N O N o `' P+ ci Pi '3 E E o g ea 'E, .o 'F = a 04, A , F i cs N �° N o ,hr ? O h boa 5 •-•-. v a) .O >,'"' O '}, y h cd 0 w •F. C 000 � L�' � y ,a �+ '� � � 3 � ao >r a. t°') 'VE :dc.> •C w y, •b p t ad 0 U .0. 0 .v'. cd ) 70 O E FU+' � O N '� p. �° 0 �Y r1 �' E d C V O ad A -0 0. .. O N • N U a) v. G. M MO. 4.a) v1 . va a2 On v C 7 ,_ O) tad 3 ran ... O .0 'i N p c+l 0 �0 00 '"' -o rn >,40 c ?,•E y a, G -c L x 0 Q b 0 ., a 0 U N d 0 al On•- 0 0 0 co 0 4, 'd A cJ 0 cd C7 1 �'04.1. y 0Pa .0Q COwwam .Ea ¢ 1-.. � � .C '> i 3 °2 o y co o �,0 0 •, aW 0 W. O O .' N O va cd O y .fl td 0 a3 ) ar EAUU Go Cd p c� 'c aiw Ci) .e •� i .4aw oq E c e I e �, _ 0, U U . ^ c `, CO W .0 �i E. e.i r; Page 33 of 33 October 2023- October 2023-September $2,500 This funding is for all WIC staff to participate in WIC-related training. Added in the USDA WIC Client Services September 2024 2024 Contracts category to cover training registrations,travel expenses,staff time to participate in training (salary/benefits for part-time or contractors),and other approved WIC training expenses. Other: Any program requirements that are not followed may be subject to corrective action and may result in monetary fines or repayment of funds. Exhibit A,Statement of Work Page 7 of 7 Contract Number CLH31013-Amendment 20