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031 Division of Public Health Agreement Addendum FY 1647 Page 1 of 1 Lee County Health Department Epidemiology/PH Preparedness & Response Local Health Department Legal Name DPH Section/Branch Name Amanda Fuller Moore, (919)546-1822, 613 Ebola Preparedness and Response Amanda.fullermoore@dhhs.nc.gov Activity Number and Description DPH Program Contact (name, telephone number with area code, and email) 07/01/2016 — 05/31/2017 Service Period 08/01/2016 — 06/30/2017 DPH Program Signature Date (only required for a negotiable agreement addendum) Payment Period ❑ Original Agreement Addendum ® Agreement Addendum Revision # 1 (Please do not put the Budgetary Estimate revision # here.) I. Backaround• No change. II. Purpose: This Agreement Addendum Revision #I provides additional funding enabling the Local Health Department to designate a Zika Planning Coordinator to carry out the tasks as described below. III. Scope of Work and Deliverables: As of December 1, 2016, this Agreement Addendum Revision #1 adds Paragraph 4 as follows: 4. Designate one staff member as Zika Planning Coordinator. The Zika Planning Coordinator will serve as the point of contact for Zika-related inquiries and maintain plans related to Zika. IV. Performance Measures/Reportina Requirements: As of December 1, 2016, this Agreement Addendum Revision #1 adds Paragraph 5 as follows: 5. Provide the name and contact information for the Zika Planning Coordinator to the Sub -Recipient Grants Monitor at PHPR by December 31, 2016. V. Performance Monitoring and Ouality Assurance: No change. VI. Funding Guidelines or Restrictions: No change. Health Director Signature (use blue ink) Date Local Health Department to complete: LHD program contact name: (If follow up information is needed by DPH) Phone number with area code: Email address: Sip -nature on this pap -e signifies you have read and accepted all paces of this document. Revised November 2016