2015-2017 Activity Tracking Log Kitsap

2015-2017 CONSOLIDATED CONTRACT ACTIVITY TRACKING LOG

LOCAL HEALTH JURISDICTION: Kitsap Public Health District Contract # C17113

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Contract Amendment Date Sent Exhibit A Statement of Work Program Name or Title Date Activity/Descriptio Number to LHJ Fully n Executed Amendment 15 06/30/17 HIV Client Services-Clinic Space & Staff – Effective July 1, 2015 (Rev.2) 07/20/17 Office of Immunization & Child Profile – Effective January 1, 2017 (Rev.2) OSS LMP Implementation – Effective July 1, 2017 (New) Recreational Shellfish Activities – Effective July 1, 2017 (New) Tobacco and Vapor Product Prevention & Control Program – Effective July 1, 2017 (New) Youth Marijuana Prevention & Education Program – Effective July 1, 2017 (New) Amendment 14 05/03/17 Emergency Preparedness & Response – Effective July 1, 2016 (Rev.4) 06/19/17 Food Insecurity Nutrition Incentive Program – Effective April 1, 2017 (New) Infectious Disease Prevention Section (IDPS) – Effective January 1, 2017 (Rev.1) NEP-PIC NTA 0237 – Effective April 1, 2017 (New) Office of Drinking Water Group A Program – Effective January 1, 2015 (Rev.4) Office of Immunization & Child Profile – Effective January 1, 2017 (Rev.1) Amendment 13 03/01/17 BEACH Program – Effective February 28, 2017 (New) 03/13/17 Emergency Preparedness & Response – Effective July 1, 2016 (Rev.3) NEP BEACH Program – Effective February 28, 2017 (New) NEP Pollution ID & Correction Round 5 (Competitive Award) – Effective January 1, 2015 (Rev.3) Amendment 12 01/09/17 Emergency Preparedness & Response – Effective July 1, 2015 (Rev.6) 02/13/17 Emergency Preparedness & Response – Effective July 1, 2016 (Rev.2) Family Planning – Effective January 1, 2016 (Rev.1) HIV Client Services – Effective January 1, 2017 New) Infectious Disease Prevention Section (IDPS) – Effective January 1, 2017 (New) Maternal & Child Health Block Grant – Effective January 1, 2015 (Rev.3) Office of Drinking Water Group A Program – Effective January 1, 2015 (Rev.3) Office of Drinking Water Group B Program – Effective January 1, 2017 (New) Office of Immunization & Child Profile – Effective January 1, 2017 (New) Amendment 11 10/13/16 Emergency Preparedness & Response – Effective July 1, 2015 (Rev.5) 11/07/16 Emergency Preparedness & Response – Effective July 1, 2016 (Rev.1) HIV Client Services – Effective July 1, 2015 (Rev.3) NEP Onsite Sewage Management Round 6 – Effective November 1, 2015 (Rev.2) Amendment 10 08/30/16 Emergency Preparedness & Response – Effective July 1, 2015 (New) 09/09/16 Maternal & Child Health Block Grant – Effective January 1, 2015 (Rev.2) Supplemental Nutrition Assistance Program-Education – Effective October 1, 2016 (New) Amendment 9 06/16/16 Emergency Preparedness & Response – Effective July 1, 2015 (Rev.4) 07/12/16 HIV Client Services – Effective July 1, 2015 (Rev.2) HIV Client Services-Clinic Space & Staff – Effective July 1, 2015 (Rev.1) Infectious Disease Prevention Section (IDPS) – Effective July 1, 2015 (Rev.3) NEP Onsite Sewage Management Round 6 – Effective November 1, 2015 (Rev.1) Page 2 of 4 Note: (New) = Original SOW (Rev.x) = SOW Revision # 2015-2017 CONSOLIDATED CONTRACT ACTIVITY TRACKING LOG

Contract Amendment Date Sent Exhibit A Statement of Work Program Name or Title Date Activity/Descriptio Number to LHJ Fully n Executed Office of Drinking Water Group A Program – Effective January 1, 2015 (Rev.2) Recreational Shellfish Activities – Effective July 1, 2016 (New)

Amendment 8 04/22/16 Emergency Preparedness & Response – Effective July 1, 2015 (Rev.3) 05/05/16

Amendment 7 02/26/16 Emergency Preparedness & Response – Effective July 1, 2015 (Rev.2) 04/07/16 NEP BEACH Program – Effective February 29, 2016 (New) NEP Pollution ID & Correction Round 5 (Competitive Award) – Effective January 1, 2015 (Rev.2) Office of Drinking Water Group A Program – Effective January 1, 2015 (Rev.1) Amendment 6 01/08/16 Family Planning – Effective January 1, 2016 (New) 02/04/16 HIV Client Services – Effective July 1, 2015 (Rev.1) Infectious Disease Prevention Section (IDPS) – Effective July 1, 2015 (Rev.2) NEP Onsite Sewage Management Round 6 – Effective November 1, 2015 (New) Office of Immunization & Child Profile – Effective January 1, 2016 (New) OICP-Prevention & Public Health Funds (PPHF) VTrckS-IIS – Effective December 1, 2015 (New) Amendment 5 10/23/15 Emergency Preparedness & Response – Effective July 1, 2015 (Rev.1) 12/04/15 Infectious Disease Prevention Section (IDPS) – Effective July 1, 2015 (Rev.1) NEP Pollution ID & Correction Round 3 (Competitive Award) – Effective January 1, 2015 (Rev.3) NEP Pollution ID & Correction Round 5 (Competitive Award) – Effective January 1, 2015 (Rev.1) Amendment 4 08/31/15 Emergency Preparedness & Response – Effective July 1, 2015 (New) 10/23/15 Maternal & Child Health Block Grant – Effective January 1, 2015 (Rev.1) OSS LMP Implementation – Effective July 1, 2015 (New) Recreational Shellfish Activities – Effective July 1, 2015 (New) Supplemental Nutrition Assistance Program-Education – Effective October 1, 2015 (New) Amendment 3 06/22/15 Emergency Preparedness & Response – Effective January 1, 2015 (Rev.2) 07/16/15 HIV Client Services – Effective July 1, 2015 (New) HIV Client Services-Clinic Space & Staff – Effective July 1, 2015 (New) Infectious Disease Prevention Section (IDPS) – Effective July 1, 2015 (New) NEP Pollution ID & Correction Round 3 (Competitive Award) – Effective January 1, 2015 (Rev.2) Amendment 2 04/16/15 Emergency Preparedness & Response – Effective January 1, 2015 (Rev.2) 05/08/15 HIV Client Services – Effective January 1, 2015 (Rev.1) HIV Client Services – Effective April 1, 2015 (New) NEP Pollution ID & Correction Round 3 (Competitive Award) – Effective January 1, 2015 (Rev.1) Amendment 1 02/27/15 Emergency Preparedness & Response – Effective January 1, 2015 (Rev.1) 04/13/15 revised/resent Family Planning – Effective January 1, 2015 (Rev.1) 03/09/15 Healthy Communities-Healthy Eating Active Living – Effective January 1, 2015 (New) Page 3 of 4 Note: (New) = Original SOW (Rev.x) = SOW Revision # 2015-2017 CONSOLIDATED CONTRACT ACTIVITY TRACKING LOG

Contract Amendment Date Sent Exhibit A Statement of Work Program Name or Title Date Activity/Descriptio Number to LHJ Fully n Executed HIV Client Services (Staff & Clinic Space) – Effective January 1, 2015 (New) Infectious Disease Prevention Section (IDPS) – Effective January 1, 2015 (New) NEP BEACH Program – Effective March 1, 2015 (New) NEP Onsite Sewage Management Round 4 – Effective January 1, 2015 (New) NEP Onsite Sewage Management Round 5 – Effective January 1, 2015 (New) NEP Pollution ID & Correction Round 3 (Competitive Award) – Effective January 1, 2015 (New) NEP Pollution ID & Correction Round 5 (Competitive Award) – Effective January 1, 2015 (New) 2015-2017 Contract N/A 11/28/14 Emergency Preparedness & Response – Effective January 1, 2015 01/15/15 Initial SOW’s Family Planning – Effective January 1, 2015 HIV Client Services – Effective January 1, 2015 Maternal & Child Health Block Grant – Effective January 1, 2015 Office of Drinking Water Group A Program – Effective January 1, 2015 Office of Immunization & Child Profile – Effective January 1, 2015 OSS LMP Implementation – Effective January 1, 2015 Recreational Shellfish Activities – Effective January 1, 2015

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