Common use of Population(s Clause in Contracts

Population(s. served by this location (select all that apply) General pediatric population General adult population Adults 65 years of age and older Long-term care facility residents (nursing home, assisted living, or independent living facility) Health care workers Critical infrastructure/essential workers (e.g., education, law enforcement, food/agricultural workers, fire services) Military – active duty/reserves Military – veteran People experiencing homelessness Pregnant women Racial and ethnic minority groups Tribal communities People who are incarcerated/detained People living in rural communities People who are underinsured or uninsured People with disabilities People with underlying medical conditions* that are risk factors for severe COVID-19 illness Other people at higher risk for COVID-19 (Specify: ) [List IIS Identifier: ] If YES If NOT, please explain planned method for reporting vaccine administration data to the jurisdiction’s IIS or other designated system as required: If NOT APPLICABLE, please explain: Refrigerated (2°C to 8°C): No capacity OR Approximately additional 10-dose MDVs Frozen (-15°C to -25°C): No capacity OR Approximately additional 10-dose MDVs Ultra-frozen (-60°C to -80°C): No capacity OR Approximately additional 10-dose MDVs

Population(s. served by this location (select all that apply) General pediatric population General adult population Adults 65 years of age and older Long-term care facility residents (nursing home, assisted living, or independent living facility) Health care workers Critical infrastructure/essential workers (e.g., education, law enforcement, food/agricultural workers, fire services) Military – active duty/reserves Military – veteran People experiencing homelessness Pregnant women Racial and ethnic minority groups Tribal communities People who are incarcerated/detained People living in rural communities People who are underinsured or uninsured People with disabilities People with underlying medical conditions* that are risk factors for severe COVID-19 illness Other people at higher risk for COVID-19 (Specify: ) [List IIS Identifier: ] If YES If NOT, please explain planned method for reporting vaccine administration data to the jurisdiction’s IIS or other designated system as required: If NOT APPLICABLE, please explain: Estimated number of 10-dose multidose vials (MDVs) your location is able to store during peak vaccination periods (e.g., during back-to-school, influenza season) at the following temperatures: Refrigerated (2°C to 8°C): No capacity OR Approximately additional 10-dose MDVs Frozen (-15°C to -25°C): No capacity OR Approximately additional 10-dose MDVs Ultra-frozen (-60°C to -80°C): No capacity OR Approximately additional 10-dose MDVs

Population(s. served by this location (select all that apply) General pediatric population General adult population Adults 65 years of age and older Long-term care facility residents (nursing home, assisted living, or independent living facility) Health care workers Critical infrastructure/essential workers (e.g., education, law enforcement, food/agricultural workers, fire services) Military – active duty/reserves Military – veteran People experiencing homelessness Pregnant women Racial and ethnic minority groups Tribal communities People who are incarcerated/detained People living in rural communities People who are underinsured or uninsured People with disabilities People with underlying medical conditions* that are risk factors for severe COVID-19 illness Other people at higher risk for COVID-19 (Specify: ) [List IIS Identifier: ] If YES If NOT, please explain planned method for reporting vaccine administration data to the jurisdiction’s IIS or other designated system as required: Data will be entered in the NHIIS after required training and creation of clinic location. If NOT APPLICABLE, please explain: Refrigerated (2°C to 8°C): No capacity OR Approximately additional 10-dose MDVs Frozen (-15°C to -25°C): No capacity OR Approximately additional 10-dose MDVs Ultra-frozen (-60°C to -80°C): No capacity OR Approximately additional 10-dose MDVs

Population(s. served by this location (select all that apply) General pediatric population General adult population Adults 65 years of age and older Long-term care facility residents (nursing home, assisted living, or independent living facility) Health care workers Critical infrastructure/essential workers (e.g., education, law enforcement, food/agricultural workers, fire services) Military – active duty/reserves Military – veteran People experiencing homelessness Pregnant women Racial and ethnic minority groups Tribal communities People who are incarcerated/detained People living in rural communities People who are underinsured or uninsured People with disabilities People with underlying medical conditions* that are risk factors for severe COVID-19 illness Other people at higher risk for COVID-19 (Specify: ) [List IIS Identifier: ] If YES If NOT, please explain planned method for reporting vaccine administration data to the jurisdiction’s IIS or other designated system as required: If NOT APPLICABLE, please explain: NA - NH Does not currently have an IIS Refrigerated (2°C to 8°C): No capacity OR Approximately additional 10-dose MDVs Frozen (-15°C to -25°C): No capacity OR Approximately additional 10-dose MDVs Ultra-frozen (-60°C to -80°C): No capacity OR Approximately additional 10-dose MDVs