2015-2017 Concon Activity Tracking Log Island

2015-2017 CONSOLIDATED CONTRACT ACTIVITY TRACKING LOG

LOCAL HEALTH JURISDICTION: Island County Health Department Contract # C17111

Contract Activity/ Amendment Date Sent Exhibit A Statement of Work Program Name or Title Date Description Number to LHJ Fully Executed Amendment 15 10/31/17 FPHS Communicable Disease & Support Capabilities – Effective July 1, 2017 (Rev.1) 12/22/17 Final Maternal & Child Health Block Grant– Effective January 1, 2015 (Rev.4) Recreational Shellfish Activities – Effective July 1, 2017 (Rev.1) Amendment 14 09/12/17 Emergency Preparedness & Response – Effective July 1, 2017 (New) 11/30/17 FPHS Communicable Disease & Support Capabilities – Effective July 1, 2017 (New) WIC Nutrition Program – Effective January 1, 2015 (Rev.11) Amendment 13 07/07/17 Office of Immunization & Child Profile – Effective January 1, 2017 (Rev.2) 11/30/17 OSS LMP Implementation – Effective July 1, 2017 (New) Recreational Shellfish Activities – Effective July 1, 2017 (New) Amendment 12 05/05/17 Office of Drinking Water Group A Program – Effective January 1, 2015 (Rev.4) 07/20/17 Office of Immunization & Child Profile – Effective January 1, 2017 (Rev.1) WIC Nutrition Program – Effective January 1, 2015 (Rev.10) Amendment 11 03/01/17 BEACH Program – Effective February 28, 2017 (New) 03/30/17 Emergency Preparedness & Response – Effective July 1, 2016 (Rev.1) WIC Nutrition Program – Effective January 1, 2015 (Rev.9) Amendment 10 01/17/17 Maternal & Child Health Block Grant– Effective January 1, 2015 (Rev.3) 02/27/17 NEP Onsite Sewage Management Round 6 – Effective January 1, 2016 (Rev.1) 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) WIC Nutrition Program – Effective January 1, 2015 (Rev.8) Amendment 9 08/30/16 Emergency Preparedness & Response – Effective July 1, 2016 (New) 10/04/16 Maternal & Child Health Block Grant– Effective January 1, 2015 (Rev.2) WIC Nutrition Program – Effective January 1, 2015 (Rev.7) Amendment 8 06/16/16 Office of Drinking Water Group A Program – Effective January 1, 2015 (Rev.2) 07/26/16 Recreational Shellfish Activities – Effective July 1, 2016 (New) WIC Nutrition Program – Effective January 1, 2015 (Rev.6) Amendment 7 04/22/16 NEP BEACH Program – Effective February 29, 2016 (Rev.1) 05/24/16

Amendment 6 02/26/16 NEP BEACH Program – Effective February 29, 2016 (New) 04/26/16 Office of Drinking Water Group A Program – Effective January 1, 2015 (Rev.1) Supplemental Nutrition Assistance Program-Education – Effective October 1, 2015 (Rev.1) WIC Nutrition Program – Effective January 1, 2015 (Rev.5)

of 2 Note: (New) = Original SOW (Rev.x) = SOW Revision # 2015-2017 CONSOLIDATED CONTRACT ACTIVITY TRACKING LOG

LOCAL HEALTH JURISDICTION: Island County Health Department Contract # C17111

Contract Activity/ Amendment Date Sent Exhibit A Statement of Work Program Name or Title Date Description Number to LHJ Fully Executed Amendment 5 01/07/16 NEP Onsite Sewage Management Round 6 – Effective January 1, 2016 (New) 02/23/16 Office of Immunization & Child Profile – Effective January 1, 2016 (New) OICP-Prevention & Public Health Funds (PPHF) VTrckS-IIS – Effective December 1, 2015 (New) WIC Nutrition Program – Effective January 1, 2015 (Rev.4) Amendment 4 08/27/15 Emergency Preparedness & Response – Effective July 1, 2015 (New) 09/22/15 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) WIC Nutrition Program – Effective January 1, 2015 (Rev.3) Amendment 3 06/22/15 NEP Onsite Sewage Management Rounds 1-4 – Effective January 1, 2015 (Rev.1) 07/24/15 Recreational Shellfish Activities – Effective January 1, 2015 (Rev.1) Supplemental Nutrition Assistance Program-Education – Effective January 1, 2015 (Rev.2) WIC Nutrition Program – Effective January 1, 2015 (Rev.2) Amendment 2 04/16/15 NEP Pollution ID & Correction Round 3 – Effective January 1, 2015 (Rev.1) 05/27/15 Supplemental Nutrition Assistance Program-Education – Effective January 1, 2015 (Rev.1)

Amendment 1 02/27/15 NEP BEACH Program – Effective March 1, 2015 (New) 04/28/15 NEP Onsite Sewage Management Rounds 1-4 – Effective January 1, 2015 (New) NEP Pollution ID & Correction Round 3 – Effective January 1, 2015 (New) Supplemental Nutrition Assistance Program-Education – Effective January 1, 2015 (New) WIC Nutrition Program – Effective January 1, 2015 (Rev.1) 2015-2017 Contract N/A 11/28/14 Emergency Preparedness & Response – Effective January 1, 2015 02/09/15 Initial SOW’s revised/resent Maternal & Child Health Block Grant– Effective January 1, 2015 12/04/14 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 WIC Nutrition Program – Effective January 1, 2015

of 2 Note: (New) = Original SOW (Rev.x) = SOW Revision #