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HomeMy WebLinkAboutILA - Washington State Department of Health - COVID-19 Vaccination Site Reimbursements Amendment No. 1 DOH Amendment GVL26310-1 Page 1 of 2 Revision 04/2020 CONTRACT AMENDMENT 1. NAME OF CONTRACTOR City of Pasco 2. CONTRACT NUMBER GVL26310 ADDRESS OF CONTRACTOR (STREET) P.O. Box 293 2a. AMENDMENT NUMBER 1 CITY, STATE, ZIP CODE Pasco, WA 99301 SWV: 0007164 06 3. THIS ITEM APPLIES ONLY TO BILATERAL AMENDMENTS. The Contract identified herein, including any previous amendments thereto, is hereby amended as set forth in Item 5 below by mutual consent of all parties hereto. 4. THIS ITEM APPLIES ONLY TO UNILATERAL AMENDMENTS. The Contract identified herein, including any previous amendments thereto, is hereby unilaterally amended as set forth in Item 5 below pursuant to that changes and modifications clause as contained therein. 5. DESCRIPTION OF AMENDMENT: The purpose of this amendment is to revise the Statement of Work, and extend the Period of Performance, to continue the work laid out in the original contract. - 5.a Statement of Work: Exhibit A is revised in accordance with Exhibit A-1, attached hereto and incorporated herein. 5.b Payment: Compensation for the work provided in accordance with this Agreement has been established under the terms of RCW 39.34.130. 5.c Period of Performance: is extended through October 31, 2021. 5.d The Effective Date of this Amendment: is January 15, 2021. 6. All other terms and conditions of the original contract and any subsequent amendments thereto remain in full force and effect. 7. This is a unilateral amendment. Signature of contractor is not required below. Contractor hereby acknowledges and accepts the terms and conditions of this amendment. Signature is required below. 8. CONTRACTOR SIGNATURE (also, please print/type your name) {{Sig_es_:signer1:signature}} DATE {{Dte_es_:signer1:date}} 9. DOH CONTRACTING OFFICER SIGNATURE {{Sig_es_:signer2:signature}}_ }} DATE {{Dte_es_:signer2:date}} This document has been approved as to form only by the Assistant Attorney G eneral. David Zabell (Jun 28, 2021 18:32 PDT) David Zabell Jun 28, 2021 City ManagerDavid Zabell Jun 28, 2021 Frank L Webley, Contract Specialist IIIWA Department of Health Contracts Office EXHIBIT A-1 DOH CONTRACT STATEMENT OF WORK CITY OF PASCO Period of Performance for this Amendment: January 01, 2021 through October 31, 2021 DOH Amendment GVL26310-1 Page 2 of 2 Revision 04/2020 PURPOSE/OBJECTIVE: The purpose of this agreement is to have the Washington State Department of Health delegate to the Southeast Washington All Hazard Type 3 Incident Management Team, and the associated agencies within this agreement the authority to provide Incident Command for the 2019 Novel Coronavirus Benton County public health mass vaccination site for DOH and for other mass vaccination sites as assigned thru an addendum to the SEWA Delegation of Authority. • Provide for the safety of persons in Benton and Franklin counties assigned to the SEWAIMT3 and all responders assigned to the incident. • Develop and maintain communication with internal and external stakeholders as it relates to the mass vaccination point of distribution operations. • Provide an environment where all response agencies are respected and valued for their unique and important contributions to the mission. • Manage the site operations in the most efficient and cost-effective manner commensurate with established standards and guidelines. • Coordinate with the Washington State Department of Health, Benton-Franklin Health District, Benton and Franklin County Emergency Operations/Coordination Centers, Walla Walla County Health department and Walla Walla County Emergency Management and other partners as may be assigned in a addendum to the Delegation of Authority. • Manage the operations of the mass vaccination site within the framework of law (Federal, State, and local); city and agency policies of the responding resources, and the response plans of Benton Franklin Health District County Health District/Departments assigned within the current Delegation of Authority and the Washington State Department of Health. • Command Staff will include the Local Health Officer or their designee as a Medical/Technical Advisor • Expenditures shall be run through the WA State Department of Health Finance Section Chief • (doh-fsc.imt@doh.wa.gov). Reimbursement of indirect cost rates are not applicable to these funds. Administrative costs can be billed as a direct cost. • Immediately notify the BFHD representative, or BFHD Safety Officer of any response worker's possible exposure, illness, injury, death, hospitalization, or sever disability. • Complete Incident Action Plans and an ICS 209 form for each operational period as defined by the local Mass Vaccination site representative. Period of Performance: The operational period of performance will be from January 21, 2021 to June 5, 2021 as agreed by both parties. The financial reporting and documentation gathering activities will be from January 21, 2021 to October 31, 2021 as amended. Deliverables: • Submit at least monthly an invoice for a request for reimbursement of costs to provide the services outlined in this contract to the WA State Department of Health Finance Section Chief (doh- fsc.imt@doh.wa.gov). Include the Monthly Cost Summary Spreadsheet along with the invoice to DOH. Additional documentation (i.e., timesheets, reports, purchased materials, etc.) must be maintained and provided to DOH upon request to substantiate costs invoiced to DOH for this contract. • Submit Incident Action Plans to the Washington State DOH Incident Management Team Planning Section Chief (doh-psc@doh.wa.gov), Benton-Franklin Health District Planning Section Chief, and collaborating agencies until end of operations period. Special Requirements: Additional guidance may be provided by DOH for this contract.