BOARD OF SUPERVISORS
Hilda L. Solis
Holly J. Mitchell
Lindsey P. Horvath
Janice Hahn
Kathryn Barger
EXECUTIVE LEADERSHIP
Dr. Laura Trejo
Director
Lorenza C. Sánchez
Chief Deputy Director
Mia C. Atencio
Acting Administrative Deputy II
Anna Avdalyan
Assistant Director
Winna Crichlow
Assistant Director
Jerrell D. Griffin
Acting Assistant Director
Ivan Pacheco
Chief Information Officer
GET IN TOUCH
510 S. Vermont Avenue , Suite 1100
Los Angeles, CA 90020
ad.lacounty.gov
[email protected]
Aging & Adult Information & Assistance Line:
(800) 510- 2020
Report Elder Abuse:
(877) 477- 3646
Community & Senior Centers:
(800) 689- 8514
Disability Information &
Access Line:
(888) 677- 1199
December 11, 2023
City of Burbank
Attention: Mr. Justin Hess
1301 West Olive Avenue
Burbank, CA 91506
FISCAL YEAR 2023-24 BUDGET AND MANDATED
PROGRAM SERVICES MODIFICATION NUMBER ONE
FOR ELDERLY NUTRITION PROGRAM SERVICES
Dear Mr. Hess:
Pursuant to Subparagraph 9.9 (Modifications) of the Elderly Nutrition Program ( ENP) Subaward, City of Burbank
(Subrecipient) has submitted a request to modify Exhibit W1 (Budget) Amendment 14 {FY 2023-24 CDA ARPA Funding},
Exhibit W2 (Budget) Amendment 14 {FY 2023-24 FY 2023-24 CDA ARPA Funding }, Exhibit X1 (Mandated Program
Services) Amendment 14 {FY 2023- 24 FY 2023- 24 CDA
ARPA Funding} , Exhibit X2 (Mandated Program Services) , Amendment 14 {FY 2023-24 CDA ARPA Funding}. County of
Los Angeles Aging and Disabilities Department (County) has completed its review of the modification as outlined below:
• Purpose: County approves the modification of Exhibit W1 (Budget) Amendment 14 {FY 2023- 24 CDA ARPA
Funding}, Exhibit W2 (Budget) Amendment 14 {FY 2023-
24 FY 2023- 24 CDA ARPA Funding}, Exhibit X1
(Mandated Program Services) Amendment 14 {FY 2023-
24 FY 2023- 24 CDA ARPA Funding}, Exhibit X2
(Mandated Program Services), Amendment 14 {FY 2023-
24 CDA ARPA Funding}.
• Subaward Number: ENP202102
• Amendment Number: Fourteen
• Modification Number: One
ATTACHMENT 2
FY 2023-24 Modification Number One
Elderly Nutrition Program
City of Burbank
• Subaward Term: July 1, 2023 through June 30, 2024
• Supervisorial District: 5
The attached Budget and Mandated Program Services exhibits will supersede Subrecipient’s previously approved Exhibit W1 (Budget) Amendment 14 {FY 2023-24 CDA ARPA Funding}, Exhibit W2 (Budget) Amendment 14 {FY 2023-24 FY 2023-24 CDA ARPA Funding}, Exhibit X1 (Mandated Program Services) Amendment 14 {FY 2023-24 FY 2023- 24 CDA ARPA Funding}, Exhibit X2 (Mandated Program Services), Amendment 14 {FY 2023-24 CDA ARPA Funding}. Please retain a copy of these documents for your files.
If you have any questions, please contact Lynn Tran of my staff by phone or e-mail as follows:
(323) 513-4214 or [email protected].
Thank you.
Carol Domingo
Carol Domingo, Program Manager
Contracts Management Division
Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
11.44$ [Enter] 200,000$ [Enter] [Enter] [Enter] 8,000$ 544,204$ 7.07$ 4.37$ [Enter] -$
-$ -$
COUNTY USE ONLY
Assigned Program Analyst:
Assigned Contract Analyst:
Gacia Atachian Equipment Purchase(s) Approved by: N/A
Lynn Tran
[Enter]
NOTE:
(1) The SSY4 for each Service Category shall match the SSY4 Cash Other reflected in Exhibit X1 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. (2) The SF for each Service Category shall match the SF reflected in Exhibit X1 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. (4) Funding Amount for Equipment (Purchase(s)) reflected under SSY4 and SF shall match the Equipment (Purchase(s)) Funding Amount reflected in Exhibit X1 (Mandated Program Services), Section I (Units of Service Summary).
Angela O'Connor Principal Accontant (818) 238 54 90 [Enter] [email protected] Prefix Budget Analyst Job Title Phone Number Ext. E-Mail Address Ms.
-$
Grand Total (6)
[Enter]
8,127$ 356,000$ -$
Equipment (Purchases) (4)
Grab and Go C-1 Meals 336,204$
Job Title
(818) 238 5402
Phone Number
[Enter]
[Enter] [email protected]
Prefix
Erin Barrows
Authorized Representative
Recreation Service Manager
Job Title
Ms.
SUBRECIPIENT'S FUNDS (SF) (2)
(C)
MATCH (3)
(D)
NON-MATCH
(E)
PROGRAM
INCOME
Roxana Tabibi
Project Manager
Ms.
(1)
CASH
(3)
TOTAL
FUNDING
3.26$
(1)
SSY4
7.07$ 9,012$
(2)
IN-KIND
(1)
CASH
127$
Ext. E-Mail Address
Social Service Supervisor Proram - Nutrition
(2)
IN-KIND
Phone Number
28,935$
(F)
TOTAL
FUNDING
(B+C+D+E)
[email protected](818) 238 5358
PROGRAM FUNDING SUMMARY
[Enter] [Enter] 10.33$
(A)
SERVICE CATEGORY
(B)
SUBAWARD SUM
YEAR 4
(SSY4) (1)
(1)
CASH
OTHER
(2)
CASH
NSIP
19,796$
(1)
CASH
EXHIBIT W1 (BUDGET)
AMENDMENT 14 {FY 2023-24 CDA ARPA FUNDING}
CA 91506
Zip CodeState
State
CA 91506
CONGREGATE MEAL SERVICES
2023-2024
City of Burbank
ENP202102
Subrecipient's Legal Name:
1301 West Olive Avenue
Main Administrative Office Address
Burbank
Mailing Address (if different from above) City Zip Code Fourteen Modification Number: N/A
American Meals [Enter]
(G)
UNIT RATE
City
Same as above Burbank
(2)
SF
-$ 209,012$ 573,139$
[Enter]
E-Mail AddressExt.Prefix
[Enter]
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
(3) The minimum required total match is twelve percent (12%) of SSY4.
ALL COSTS REPORTED ON THIS BUDGET SHALL BE ALLOWABLE, NECESSARY, AND REASONABLE FOR THE PROGRAM SERVICES TO BE PROVIDED.
Aylin Karim Masihi Date: 11/27/2023
[Enter] [Enter]
Budget Reviewed and Approved by:
Equipment (Other) (5)
Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
Senior Food Services Aide 50% 4,774$ 6 14,322$ 8,000$ $06,322$ 14,322$ 14,322$ 8,000$ 6,322$
9,000$ 14,538$ 23,538$
6 14,322$
$0
Food Service manager /Supervisor/ 50% 5,160$ 6 15,480$ 8,000$ 7,480$ Site manager at Tuttle site/ Social
Services Coordinator 100% 5,739$ 6 34,434$ 9,000$ $0Senior Food Services Aide 50% 4,774$
Principal Clerk 50% 6,422$ 6 19,266$ 8,000$ $011,266$ 19,266$ 5,739$ 34,434$
$025,434$ 34,434$
6 34,434$ 9,000$ 25,434$
CONGREGATE MEAL SERVICES
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) (A)
POSITION TITLE (1)
(B)
% OF TIME
ON
PROGRAM
(2)
(C)
MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
AMOUNT
(K)
VARIANCE
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(B*C*D) (1)
CASH OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
I. BUDGET DETAIL - PERSONNEL
DIRECT
Project Manager/Social Service
Supervisor- Nutrition 50% 8,986$ 6 26,958$ 9,000$ $017,958$ 26,958$ 15,480$ $0
Site manager at Joslyn site/ Social
Services Coordinator 100%
3,734$ 6 22,404$
6,887$
Food Service Aid/ Tuttle 100% 3,923$ 6 23,538$
Recreation Leader 20% 4,701$ 6 5,641$
Site manager / Social Services
Coordinator McCambridge 20% 5,739$ 6 6,887$
19,254$
Food Service Aid / Joslyn
$0
Work trainee 100% 3,209$ 6
5,641$ $0
Facility Attendant 20% 2,768$ 6 3,322$ 3,322$ $0 1,000$
100%
Five (5)
ENP202102
Fourteen Modification Number: N/A
19,254$ $0
$0
22,404$
2,000$ 1,322$
$0
3,000$
City of Burbank
5,887$
8,000$
9,000$ 13,404$
11,254$
2,641$
Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 2 (A)
POSITION TITLE (1)
(B)
% OF TIME
ON
PROGRAM
(2)
(C)
MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
AMOUNT
(K)
VARIANCE
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(B*C*D) (1)
CASH OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
I. BUDGET DETAIL - PERSONNEL
(2): If an individual's time is allocated to multiple Program Services, that individual's time shall not exceed 100% when his/her time is totaled for Congregate Meal Services, Home-Delivered Meal Services, and Telephone Reassurance Services.
[Complete
as needed]
[Complete
as needed]
[Complete
as needed] -$
Do indirect costs exceed the ten percent (10%) maximum? (5): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). 336,439$ -$1
NOTE:
(1): Enter the title of each position. List all mandatory staffing positions noted in Exhibit A (Statement of Work). If a mandatory position is performed by staff under a different position/payroll title then list both the position title noted in Exhibit A (Statement of Work) and the payroll title (e.g., Project Director/Recreation Director). (3): Enter the amount of funding that Subrecipient will use to fund any portion of the total cost for taxes. (4): Enter the amount of funding that Subrecipient will use to fund any portion of the total cost for benefits.
GRAND TOTAL
GRAND TOTAL PERSONNEL 336,438$ 127,427$ 209,012$ -$ -$ -$ -$ No
Indirect Costs (Personnel) (5)
[Complete as
needed] -$
[Complete
as needed]
[Complete as
needed]
240,262$ $0
-$ -$ -$ 336,439$ -$1
INDIRECT
(4) (4) (4) 96,105$ $0
TOTAL DIRECT PERSONNEL 336,438$ 127,427$ 209,012$ 96,105$ 36,400$ 59,705$ (4)
Taxes 0.03% 72$ 27$ 45$ SUBTOTAL DIRECT PERSONNEL 240,262$ 91,000$ 149,262$ -$ (3) (3) (3) (3) 72$ $0
-$ -$ -$
-$
Benefits 40.00%
Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 3 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:NOTE:
(2): When using volunteer services as an in-kind match to meet the minimum required match, this in-kind match shall not exceed more than fifty percent (50%) of the minimum required match. For example, if volunteer services total $2,000 and the minimum required match is $1,500 then a maximum of $750 of volunteer services will count toward meeting the minimum required match. Additionally, Subrecipient does not have to change the amount of volunteer services reflected as in-kind match since only a portion of it may be counted toward meeting the minimum required match. Using the previous example, Subrecipient may reflect $2,000 (as opposed to $750) as in-kind match for volunteer services but only $750 of this amount will be counted toward meeting the minimum required match.
GRAND TOTAL
GRAND TOTAL VOLUNTEERS -$ -$ -$ -$ $0 (1): If an individual's time is allocated to multiple Program Services, that individual's time shall not exceed 100% when his/her time is totaled for Congregate Meal Services, Home- Delivered Meal Services, and Telephone Reassurance Services.
INDIRECT
Indirect Costs (Volunteers)
[Complete
as needed]
[Complete as
needed]
[Complete as
needed]
TOTAL DIRECT VOLUNTEERS -$ -$ -$ -$ $0 [Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
(G)
MATCH (2)
(H)
NON-MATCH
DIRECT
City of Burbank
[Enter title]
[Enter title]
CONGREGATE MEAL SERVICES
Fourteen Modification Number:
2023-2024
(B*C*D*E) (1)
IN-KIND
(1)
IN-KIND
(G + H) (F - I)
II. BUDGET DETAIL - VOLUNTEERS
(A)
POSITION TITLE
(B)
NUMBER
OF
POSITIONS
(C)
% OF TIME
ON PROGRAM
(1)
(D)
MONTHLY
SALARY
EQUIVALENT
(E)
NO. OF
MONTHS
(F)
TOTAL
SALARY
EQUIVALENT
SF (I)
TOTAL
IN-KIND
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
N/A
(J)
VARIANCE
Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 4 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
(1) Effective January 1, 2023, County’s approved mileage rate is $0.615 per mile and State's mileage rate is available online at: http://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx. Reimbursement for mileage shall not exceed the lesser of County's rate and State's rate. (2): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). -$ -$ -$ -$ $0 NOTE:
Do indirect costs exceed the ten percent (10%) maximum? No
GRAND TOTAL
GRAND TOTAL VOLUNTEER
EXPENSES -$ -$ -$ -$
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed] Indirect Costs (Volunteer Expenses) (2) -$
-$ -$ -$ -$ $0
INDIRECT
TOTAL DIRECT VOLUNTEER
EXPENSES -$ -$ -$ -$
[Enter description of other expenses]
[Enter description of other expenses]
[Enter description of other expenses]
[Enter description of other expenses]
[Enter description of other expenses]
[Enter description of other expenses]
DIRECT
Training
Mileage (Cost/Mile) (1)
(A)
DESCRIPTION
(B)
UNIT COST
(C)
NUMBER OF
UNITS
(D)
NO. OF
MONTHS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
(K)
VARIANCE
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(B*C*D) (1)
CASH OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
ENP202102
Fourteen Modification Number: N/A
City of Burbank
III. BUDGET DETAIL - VOLUNTEER EXPENSES
CONGREGATE MEAL SERVICES
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 5 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
IV. BUDGET DETAIL - LOWER TIER SUBAWARDS/SUBCONTRACTS FOR CATERED FOOD (A)
LOWER TIER SUBRECIPIENT'S/
SUBCONTRACTOR'S NAME (1)
(C)
UNIT COST
(D)
NO. OF
UNITS
(E)
NO. OF
MONTHS
(C*D*E) (F - K)
American Meals 5.00$ 466 13,980$ 13,980$ $06 (J)
PROGRAM
INCOME
(1)
CASH
(B)
SERVICE CATEGORY
(G)
SSY4
SF(F)
TOTAL COSTS
(K)
TOTAL FUNDING
(L)
VARIANCE
-$ -$
[Complete as
needed] $ -
228,573$ -$ 228,573$ -$ -$ -$ -$ -$ -$ -$
No
-$ $0
INDIRECT
228,573$ 228,573$
(1): Use this Budget Detail to report lower tier subawards/subcontracts with caterers by entering the name of the caterer. The information provided herein shall be included in Exhibit Y (List of Lower Tier Subawards). Subrecipient shall obtain prior written approval from County before executing lower tier subaward(s). (2): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column G (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a
Do indirect costs exceed the ten percent (10%) maximum? Indirect Costs
(Lower Tier Subawards/Subcontracts for Catered Food) (2)
TOTAL DIRECT LOWER TIER SUBAWARDS/
SUBCONTRACTS FOR CATERED FOOD -$
GRAND TOTAL LOWER TIER SUBAWARDS/
SUBCONTRACTS FOR CATERED FOOD
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
GRAND TOTAL
- - -$
NOTE:
228,573$ $0-$
-
228,573$ $0
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(2)
CASH
NSIP
(G+H+I+J)
(I)
NON-MATCH
(1)
CASH
OTHER
(H)
MATCH
Grab & Go C-1 Meals 5.00$
Select Description
[Enter caterer's name] Select Description
[Enter caterer's name]
[Enter caterer's name]
Select Description
7,153 6 214,593$
CONGREGATE MEAL SERVICES
Tender Loving Care
214,593$ $0
[Enter caterer's name] Select Description
Tender Loving Care
[Enter caterer's name] Select Description
214,593$
13,980$
DIRECT
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
Fourteen Modification Number: N/A
City of Burbank
Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 6 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
NOTE:
(1): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval).
INDIRECT
GRAND TOTAL
Indirect Costs (Raw Food) (1)
$0GRAND TOTAL RAW FOOD -$ -$ -$ -$ -$ -$ -$ -$ -$ [Complete as
needed] -$
Do indirect costs exceed the ten percent (10%) maximum? No - - -$
[Complete as
needed]
[Complete as
needed]
-$ -$ -$ -$
- $0-$
-$
DIRECT
American Meals
Grab and Go C-1 Meals
-$ -$ -$
[Complete
as needed]
-$ $0
[Complete
as needed]
CONGREGATE MEAL SERVICES
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
V. BUDGET DETAIL - RAW FOOD
(A)
SERVICE CATEGORY
(B)
UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(2)
IN-KIND
(1)
CASH
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(E)
TOTAL COSTS
(K)
VARIANCE
(B*C*D) (1)
CASH
OTHER
(2)
CASH
NSIP
(1)
CASH
TOTAL DIRECT RAW FOOD
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
Fourteen Modification Number: N/A
City of Burbank
SF(F)
SSY4
(J)
TOTAL FUNDING
Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 7 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
[Enter name and description]
[Enter name and description]
(1): Please submit supporting documentation with this Budget for any unit cost, which exceeds $2.00 per square foot, that will be supported by the SSY4. (2): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). -$ -$ -$ -$ $0
NOTE:
Do indirect costs exceed the ten percent (10%) maximum? No
GRAND TOTAL
GRAND TOTAL SPACE -$ -$ -$ -$ [Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete
as needed] Indirect Costs (Space) (2) -$
-$ -$ -$ -$ $0
INDIRECT
TOTAL DIRECT SPACE -$ -$ -$ -$ [Enter name and description]
[Enter name and description]
[Enter name and description]
[Enter name and description]
[Enter name and description]
[Enter name and description]
DIRECT
(A)
NAME OF LOCATION AND DESCRIPTION
(B)
UNIT COST
(1)
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)
TOTAL
COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
(K)
VARIANCE
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(B*C*D) (1)
CASH
OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
Fourteen Modification Number: N/A
City of Burbank
VI. BUDGET DETAIL - SPACE
CONGREGATE MEAL SERVICES
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 8 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
NOTE:
-$ $0
GRAND TOTAL
TOTAL DIRECT EQUIPMENT -$ -$ -$ -$ -$ -$ -$ [Enter description] Select
[Enter description] Select
[Enter description] Select
[Enter description] Select
[Enter description] Select
Select
CONGREGATE MEAL SERVICES
(A)
DESCRIPTION (1)
(B)
EQUIPMENT
TYPE
(2) or (3)
(C)
UNIT COST
(D)
NO. OF
UNITS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(C*D) (1)
CASH
OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I)
(1) County's approval of Subrecipient's Budget does not constitute approval for Subrecipient to purchase the Equipment/Asset. Prior approval is needed for all computing devices, regardless of cost (including but not limited to, workstations, servers, laptops, personal digital assistants, notebook computers, tablets, smartphones and cellphones) as well as all portable electronic storage media, regardless of cost (including but not limited to, thumb/flash dri and portable hard drives), and/or when Subrecipient will use $500 or more of the SSY4 to purchase the Equipment/Asset.
Subrecipient shall obtain prior written approval from County at least thirty (30) days in advance of the date/time that Subrecipient intends to purchase the Equipment using SSY4 and no later than March 31st of the Fiscal Year.
Equipment must be ordered or purchased no later than May 31st of the Fiscal Year.
Subrecipient must submit a minimum of three (3) bids when requesting approval for Equipment that is $500 or more.
Subrecipient must ensure that the description and amount of the Equipment purchase(s) on the Budget are the same as the actual item(s) purchased.
The Grand Total Equipment purchase amount reflected under column (F) SSY4 shall match the total equipment amount reflected in the Mandated Program Services, Section I (Service Unit Summary). (2) Purchase includes any equipment that Subrecipient intends to purchase. Subreciept shall report this using any combination of SSY4, Match Cash, and Non-match Cash. (3) Other includes any equipment (except for leased equipment) which is not purchased by Subrecipient (e.g. donated items). Subrecipient shall report this using any combination of Match In-kind and/or Non-match In-kind. 2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
Fourteen Modification Number: N/A
City of Burbank
VII. BUDGET DETAIL - EQUIPMENT
(K)
VARIANCE
(E - J)
DIRECT
[Enter description] Select
[Enter description]
Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 9 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
(6)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Maintenance and Repairs (2 CFR 200.452 & 45 CFR
75.452) 625.00$ 1 2 1,250$ $01,250$ 1,250$ 1,752$ 1,752$ $0
Maintenance and Repairs (2 CFR 200.452 & 45 CFR
75.452) 292.00$ 1 6 1,752$
1 1 125$ Training and Education (2 CFR 200.472 & 45 CFR 75.472) 125.00$ 125$ 125$ $0 5,000$ 5,000$ $0
DIRECT
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 833.30$ 1 6 5,000$ (A)
DESCRIPTION (1)
(B)
UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
(K)
VARIANCE
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(B*C*D) (1)
CASH
OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
Five (5)
ENP202102
Fourteen Modification Number: N/A
City of Burbank
VIII. BUDGET DETAIL - OTHER COSTS
CONGREGATE MEAL SERVICES
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 10 (A)
DESCRIPTION (1)
(B)
UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
(K)
VARIANCE
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(B*C*D) (1)
CASH
OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
(4): Effective January 1, 2023, County’s approved mileage rate is $0.615 per mile and State's mileage rate is available online at: http://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx. Reimbursement for mileage shall not exceed the lesser of County's rate and State's rate. (5): Subrecipient shall obtain prior written approval from County if utilizing SSY4 for Travel (Other).( ) p g y ( ) p p p p p County review.
(7): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). (6)
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete as
needed] Indirect Costs (Other Costs) (7)
NOTE:
(6)
(6)
(1): Allowable costs are identified in accordance with Title 2 Code of Federal Regulations (CFR) Part 200 and Title 45 Code of Federal Regulations (CFR) Part 75. (2): Subrecipient shall obtain prior written approval from County if utilizing SSY4 for Conferences. (3): Subrecipient shall provide the following information to your assigned Contract Analyst: (a) Kind of equipment, (b) Indicate whether the equipment lease is program specific or a shared cost, (c) If a shared cost, provide the cost distribution methodology for County review and (d) Length of the lease. -$ -$ 8,127$ 8,127$ $0
Do indirect costs exceed the ten percent (10%) maximum? No
GRAND TOTAL
GRAND TOTAL OTHER COSTS 8,127$ -$ -$ -$ [Complete
as needed] -$
-$ -$ 8,127$ 8,127$ $0
INDIRECT
TOTAL DIRECT OTHER COSTS 8,127$ -$ -$ -$ Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 11 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
2 CONGREGATE MEAL SERVICES
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
Fourteen Modification Number: N/A
City of Burbank
IX. BUDGET SUMMARY
(A)
COST CATEGORIES
(B)
COSTS (1)
(C)
FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
Cash NSIP
(SSY4) -$
(1)
Total Budgeted
Costs
DIRECT
1 Personnel
Cash Other
(SSY4) 127,427$
1 SSY4
Cash Other
(SSY4) 356,000$
Volunteers In-Kind (SF)
-$
3 Volunteer Expenses
Cash (SF)
209,012$
In-Kind (SF)
-$
Cash (SF)
-$
In-Kind (SF)
-$
2 Subtotal 356,000$
4 Lower Tier Subawards/Subcontracts for
Catered Food
Cash Other
(SSY4) 228,573$
Cash NSIP
(SSY4) -$
Cash (SF)
-$
Match
In-Kind (SF)
-$
Cash (SF) 209,012$
-$ In-Kind (SF)
Cash Other
(SSY4) -$
5 Raw Food
Cash Other
(SSY4) -$
3 Non-Match
6 Space
Cash Other
(SSY4) -$
In-Kind (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
Cash (SF) -$
Cash NSIP
(SSY4) -$
Cash (SF)
-$
In-Kind (SF)
-$
7 Equipment
Cash Other
(SSY4) -$
4 Program Income
8 Other Costs
In-Kind (SF)
-$
Cash (SF) 8,127$
Cash (SF)
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
Cash (SF)
8,127$
Cash Other
(SSY4) 356,000$
Cash NSIP
(SSY4) -$
Cash NSIP
(SSY4) -$ 9 Subtotal Direct Costs
Cash Other
(SSY4) 356,000$
5 Subtotal Funding for
Direct Costs
Cash (SF)
217,139$
Cash
Cash (SF)
217,139$
In-Kind (SF)
-$
In-Kind (SF)
-$
Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 12 IX. BUDGET SUMMARY
(A)
COST CATEGORIES
(B)
COSTS (1)
(C)
FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
11 21 12
Variance (Costs-Funding) In-Kind
INDIRECT
10 Personnel
Cash Other
(SSY4) -$
6 SSY4Volunteers
12 Volunteer Expenses Cash (SF)
Match
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
Cash (SF)
-$
In-Kind (SF)
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
In-Kind (SF) -$
Cash (SF) -$
13 Lower Tier Subawards/Subcontracts for
Catered Food
Cash Other
(SSY4) -$
Cash (SF)
-$
In-Kind (SF)
-$
7 14 Raw Food
Cash Other
(SSY4) -$
8 Non-Match
15 Space
Cash Other
(SSY4) -$
In-Kind (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
Cash (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
Cash (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
16 Other Costs
Cash Other
(SSY4) -$
9 Program Income
Cash Other
(SSY4) -$
Cash (SF)
-$
Cash (SF)
-$
17 Subtotal Indirect Costs
Cash Other
(SSY4) -$
10 Subtotal Funding for
Indirect Costs
In-Kind (SF)
-$
Subrecipient meets minimum match requirement. Match Met NOTE:
(1): Costs and Funding shall match.
In-Kind (SF)
-$
In-Kind (SF)
-$
GRAND TOTAL COSTS
573,139$
GRAND TOTAL FUNDING
573,139$
20 Total Costs
Cash Other
(SSY4) 356,000$
11 Total Funding
Cash Other
(SSY4) 356,000$
Cash NSIP
(SSY4)
Variance (Costs-Funding) $0
-$
Cash NSIP
(SSY4) -$
Cash (SF)
217,139$
Cash (SF)
217,139$
GRAND TOTAL
In-Kind (SF)
-$
Variance (Costs-Funding)
Cash
In-Kind
Exhibit W1 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 13 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
(4) Funding Amount for Equipment (Purchase(s)) reflected under SSY4 and SF shall match the Equipment (Purchase(s)) Funding Amount reflected in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary). (1)
SSY4
8.13$ 217,000$
(2)
IN-KIND
(1)
CASH
(5) Funding Amount for Equipment (Other) reflected as SF shall match the Equipment (Other) Funding Amount reflected in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary). (6) Grand Total Funding Amount under Column (F) Total Funding Amount shall match Grand Total Funding Amount reflected in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary), Column (E) Funding Amount.
[Enter] -$
-$ -$
COUNTY USE ONLY
Assigned Program Analyst:
Assigned Contract Analyst:
Gacia Atachian Equipment Purchase(s) Approved by: N/A
Lynn Tran
[Enter]
NOTE:
-$
Grand Total (6)
[Enter]
16,515$ 38,000$ -$
Equipment (Purchases) (4)
(2) The SF for each Service Category shall match the SF reflected in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category.
Date: 12/7/2023Aylin karim Masihi Budget Reviewed and Approved by:
Equipment (Other) (5)
311,465$
(3) The minimum required total mach is twelve percent (12%) of SSY4. 365,980$
[Enter]
(1) The SSY4 for each Service Category shall match the SSY4 Cash Other reflected in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category.
Emergency Meals 194$
Phone Number
244,091$
(F)
TOTAL
FUNDING
(B+C+D+E)
7.38$
E-Mail AddressExt.Prefix
[Enter]
SUBRECIPIENT'S FUNDS (SF) (2)
(C)
MATCH (3)
Hot Meals
PROGRAM FUNDING SUMMARY
[Enter] [Enter]
[Enter] [Enter] 116.12$
(A)
SERVICE CATEGORY
[Enter]
Project Manager
Main Administrative Office Address
Burbank
ALL COSTS REPORTED ON THIS BUDGET SHALL BE ALLOWABLE, NECESSARY, AND REASONABLE FOR THE PROGRAM SERVICES TO BE PROVIDED.
City
Same as above Burbank
[Enter]
[Enter]
Ext. E-Mail Address
Social Service Supervisor Program- Nutrition
[email protected]
Prefix
Erin Barrows
Authorized Representative
Recreation Service Manager
Job Title
Ms.
[email protected](818) 238 5358Roxana TabibiMs.
EXHIBIT W2 (BUDGET)
AMENDMENT 14 {FY 2023-24 CDA ARPA FUNDING}
CA 91605
Zip CodeState
State
CA 91605
HOME DELIVERED MEAL SERVICES
2023-2024
City of Burbank
ENP202102
Subrecipient's Legal Name:
1301 West Olive Avenue
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
Mailing Address (if different from above) City Zip Code Fourteen Modification Number: One
Prefix Budget Analyst Job Title
Ms.
Frozen Meals
[Enter] [Enter]
(B)
SUBAWARD SUM
YEAR 4
(SSY4) (1)
(1)
CASH
OTHER
(2)
CASH
NSIP
17,091$
(1)
CASH
19,926$
[Enter]
[Enter]
Angela O'Connor Principal Accountant
(1)
CASH
94,465$
10,000$
[Enter]
(2)
IN-KIND
[Enter]
-$
(818) 238 5402
Phone Number
(G)
UNIT RATE
44.59$
(3)
TOTAL
FUNDING
34.70$
(818) 238 5490 [Enter] [email protected]
Phone Number Ext. E-Mail Address
7.20$
[Enter]
(2)
SF
7.07$ 0.13$
Job Title
9.70$ 25.00$ 694$
37.21$
[Enter] 500$
(D)
NON-MATCH
(E)
PROGRAM
INCOME
Grab and Go C-2 Meals 789$ [Enter] [Enter] [Enter] [Enter] [Enter] 15$ 804$ 107.99$
[Enter] 6,000$ 120,391$
Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
6 5,641$ 200$ 5,441$
6 19,254$ 205$ 19,049$
19,266$ $0
6 3,322$ 199$ 3,123$ 3,322$ $0 6 19,266$ 205$ 19,061$
23,538$ 205$ 23,333$
6 23,538$ 205$ 23,333$
(2): If an individual's time is allocated to multiple Program Services, that individual's time shall not exceed 100% when his/her time is totaled for Congregate Meal Services, Home-Delivered Meal Services, and Telephone Reassurance Services.
[Complete
as needed]
[Complete
as needed]
[Complete
as needed] -$
Do indirect costs exceed the ten percent (10%) maximum? (5): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). 303,482$ -$1
NOTE:
(1): Enter the title of each position. List all mandatory staffing positions noted in Exhibit A (Statement of Work). If a mandatory position is performed by staff under a different position/payroll title then list both the position title noted in Exhibit A (Statement of Work) and the payroll title (e.g., Project Director/Recreation Director). (3): Enter the amount of funding that Subrecipient will use to fund any portion of the total cost for taxes. (4): Enter the amount of funding that Subrecipient will use to fund any portion of the total cost for benefits.
GRAND TOTAL
GRAND TOTAL PERSONNEL 303,481$ 30,000$ 273,482$ -$ -$ -$ -$ No
Indirect Costs (Personnel) (5)
[Complete as
needed]
[Complete
as needed]
[Complete as
needed]
216,726$ $0
-$ -$ -$ 303,482$ -$1
INDIRECT
(4) (4) (4) 86,691$ $0
TOTAL DIRECT PERSONNEL 303,481$ 30,000$ 273,482$ 86,690$ 8,570$ 78,121$ (4) Taxes 0.03% 65$ 6$ 59$ SUBTOTAL DIRECT PERSONNEL 216,726$ 21,424$ 195,302$ -$ (3) (3) (3) (3) 65$ $0
-$ -$ -$
[Enter title]
-$
Benefits 40.00%
Home Delivered Meal Services
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) (A)
POSITION TITLE (1)
(B)
% OF TIME
ON
PROGRAM
(2)
(C)
MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
AMOUNT
(K)
VARIANCE
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(B*C*D) (1)
CASH OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
I. BUDGET DETAIL - PERSONNEL
DIRECT
4,000$ 22,958$ $026,958$ 26,958$ 6 14,322$ $06
4,000$ 23,547$ 27,547$
14,322$ 4,000$ 10,322$
6 [Enter title]
[Enter title]
6 23,538$ $0205$ 23,333$
$0
6 Program Manager/ Social Service
Supervisor- Nutrtion
Food Service Supervisor/ site manager
Social Service Coordinator/ Case Worker
Senior Food Service Aide
23,538$
14,322$ $0
23,538$ $0
23,538$ $0
19,254$ $0
5,641$ $0
6 14,322$ 4,000$ 10,322$
6 15,480$ 4,000$ 11,480$ 15,480$ Five (5)
ENP202102
Fourteen Modification Number: One
27,547$ $0
City of Burbank
Senior Food Service Aide
Food Service Aide- Driver
Food Service Aide- Driver
Food Service Aide- Driver
Work Trainee
Principal Clerk
Facility Attendant
Recreation Leader
50%
50%
80%
50%
50%
100%
100%
100%
100%
50%
20%
20%
$6,422
$2,768
$4,701
$8,986
$5,160
$5,739
$4,774
$4,774
$3,923
$3,923
$3,923
$3,209
Exhibit W2 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 2 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:NOTE:
(2): When using volunteer services as an in-kind match to meet the minimum required match, this in-kind match shall not exceed more than fifty percent (50%) of the minimum required match. For example, if volunteer services total $2,000 and the minimum required match is $1,500 then a maximum of $750 of volunteer services will count toward meeting the minimum required match. Additionally, Subrecipient does not have to change the amount of volunteer services reflected as in-kind match since only a portion of it may be counted toward meeting the minimum required match. Using the previous example, Subrecipient may reflect $2,000 (as opposed to $750) as in-kind match for volunteer services but only $750 of this amount will be counted toward meeting the minimum required match.
GRAND TOTAL
GRAND TOTAL VOLUNTEERS -$ -$ -$ -$ $0 (1): If an individual's time is allocated to multiple Program Services, that individual's time shall not exceed 100% when his/her time is totaled for Congregate Meal Services, Home- Delivered Meal Services, and Telephone Reassurance Services.
INDIRECT
Indirect Costs (Volunteers)
[Complete
as needed]
[Complete as
needed]
[Complete as
needed]
TOTAL DIRECT VOLUNTEERS -$ -$ -$ -$ $0 [Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
(G)
MATCH (2)
(H)
NON-MATCH
DIRECT
City of Burbank
[Enter title]
[Enter title]
Home Delivered Meal Services
Fourteen Modification Number:
2023-2024
(B*C*D*E) (1)
IN-KIND
(1)
IN-KIND
(G + H) (F - I)
II. BUDGET DETAIL - VOLUNTEERS
(A)
POSITION TITLE
(B)
NUMBER
OF
POSITIONS
(C)
% OF TIME
ON PROGRAM
(1)
(D)
MONTHLY
SALARY
EQUIVALENT
(E)
NO. OF
MONTHS
(F)
TOTAL
SALARY
EQUIVALENT
SF (I)
TOTAL
IN-KIND
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
One
(J)
VARIANCE
Exhibit W2 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 3 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
(1) Effective January 1, 2023, County’s approved mileage rate is $0.615 per mile and State's mileage rate is available online at: http://www.calhr.ca.gov/employees/Pages/travel-personal-vehicle.aspx. Reimbursement for mileage shall not exceed the lesser of County's rate and State's rate. (2): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). -$ -$ -$ -$ $0 NOTE:
Do indirect costs exceed the ten percent (10%) maximum? No
GRAND TOTAL
GRAND TOTAL VOLUNTEER
EXPENSES -$ -$ -$ -$
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed] Indirect Costs (Volunteer Expenses) (2) -$
-$ -$ -$ -$ $0
INDIRECT
TOTAL DIRECT VOLUNTEER
EXPENSES -$ -$ -$ -$
[Enter description of other expenses]
[Enter description of other expenses]
[Enter description of other expenses]
[Enter description of other expenses]
[Enter description of other expenses]
[Enter description of other expenses]
DIRECT
Training
Mileage (Cost/Mile) (1)
(A)
DESCRIPTION
(B)
UNIT COST
(C)
NUMBER OF
UNITS
(D)
NO. OF
MONTHS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
(K)
VARIANCE
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(B*C*D) (1)
CASH OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
ENP202102
Fourteen Modification Number: One
City of Burbank
III. BUDGET DETAIL - VOLUNTEER EXPENSES
Home Delivered Meal Services
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
Exhibit W2 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 4 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
IV. BUDGET DETAIL - LOWER TIER SUBAWARDS/SUBCONTRACTS FOR CATERED FOOD (A)
LOWER TIER SUBRECIPIENT'S/
SUBCONTRACTOR'S NAME (1)
(C)
UNIT COST
(D)
NO. OF
UNITS
(E)
NO. OF
MONTHS
(C*D*E) (F - K)
Hot Meals 5.00$ 700 21,000$ 21,000$ $06 (J)
PROGRAM
INCOME
(1)
CASH
(B)
SERVICE CATEGORY
(G)
SSY4
SF(F)
TOTAL COSTS
(K)
TOTAL FUNDING
(L)
VARIANCE
45,983$ $0-$ 37,983$
[Complete as
needed] $ -
45,983$ -$ 8,000$ 37,983$ -$ -$ -$ -$ -$ -$
No
-$ $0
INDIRECT
45,983$ 8,000$
(1)
CASH
OTHER
(H)
MATCH
(1): Use this Budget Detail to report lower tier subawards with caterers by entering the name of the caterer. The information provided herein shall be included in Exhibit Y (List of Lower Tier Subawards). Subrecipient shall obtain prior written approval from County before executing lower tier subaward(s).
(2): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column G (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval).
Do indirect costs exceed the ten percent (10%) maximum? Indirect Costs
(Lower Tier Subawards/Subcontracts for Catered Food) (2)
TOTAL DIRECT LOWER TIER SUBAWARDS/
SUBCONTRACTS FOR CATERED FOOD -$
GRAND TOTAL LOWER TIER SUBAWARDS/
SUBCONTRACTS FOR CATERED FOOD
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
GRAND TOTAL
-$ - -$
NOTE:
45,983$ $0-$
-
Frozen Meals 5.00$
6 Select Description
789$ 789$
Select Description
[Enter caterer's name]
[Enter caterer's name]
Select Description
[Enter caterer's name]
194$ 5.00$ 6 $0
20,983$
6 194
24,000$ $0
789$ $0Tender Loving Care
Grab and Go C-2
Meals 5.00$
Tender Loving Care
Tender Loving Care Emergency Meals
800 6 24,000$
26 194$
3,017$
Five (5)
ENP202102
Fourteen Modification Number: One
City of Burbank
Home Delivered Meal Services
Tender Loving Care 17,000$ 4,000$
DIRECT
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) (1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(2)
CASH
NSIP
(G+H+I+J)
(I)
NON-MATCH
Exhibit W2 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 5 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
NOTE:
(1): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval).
INDIRECT
GRAND TOTAL
Indirect Costs (Raw Food) (1)
$0GRAND TOTAL RAW FOOD -$ -$ -$ -$ -$ -$ -$ -$ -$ [Complete as
needed] -$ $0-$
[Complete
as needed]
Do indirect costs exceed the ten percent (10%) maximum? No -
DIRECT
Hot Meals
- -$
[Complete as
needed]
[Complete as
needed]
-$ -$ -$ -$ -$ -$ -$ [Complete
as needed] -
-$ -$ $0
Home Delivered Meal Services
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
V. BUDGET DETAIL - RAW FOOD
(A)
SERVICE CATEGORY
(B)
UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(2)
IN-KIND
(1)
CASH
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(E)
TOTAL COSTS
(2)
CASH
NSIP
(1)
CASH
TOTAL DIRECT RAW FOOD
Grab and Go C-2 Meals
Frozen Meals
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
Fourteen Modification Number: One
City of Burbank
SF(F)
SSY4
(J)
TOTAL FUNDING
(K)
VARIANCE
(B*C*D) (1)
CASH
OTHER
Emergency Meals
Exhibit W2 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 6 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
[Enter name and description]
[Enter name and description]
(1): Please submit supporting documentation with this Budget for any unit cost, which exceeds $2.00 per square foot, that will be supported by the SSY4. (2): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). -$ -$ -$ -$ $0
NOTE:
Do indirect costs exceed the ten percent (10%) maximum? No
GRAND TOTAL
GRAND TOTAL SPACE -$ -$ -$ -$ [Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete
as needed] Indirect Costs (Space) (2) -$
-$ -$ -$ -$ $0
INDIRECT
TOTAL DIRECT SPACE -$ -$ -$ -$ [Enter name and description]
[Enter name and description]
[Enter name and description]
[Enter name and description]
[Enter name and description]
[Enter name and description]
DIRECT
(A)
NAME OF LOCATION AND DESCRIPTION
(B)
UNIT COST
(1)
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
(K)
VARIANCE
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(B*C*D) (1)
CASH
OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
Fourteen Modification Number: One
City of Burbank
VI. BUDGET DETAIL - SPACE
Home Delivered Meal Services
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
Exhibit W2 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 7 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
NOTE:
-$ $0
GRAND TOTAL
TOTAL DIRECT EQUIPMENT -$ -$ -$ -$ -$ -$ -$ [Enter description] Select
[Enter description] Select
[Enter description] Select
[Enter description] Select
[Enter description] Select
Select
Home Delivered Meal Services
(A)
DESCRIPTION (1)
(B)
EQUIPMENT
TYPE
(2) or (3)
(C)
UNIT COST
(D)
NO. OF
UNITS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(C*D) (1)
CASH
OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I)
(1) County's approval of Subrecipient's Budget does not constitute approval for Subrecipient to purchase the Equipment/Asset. Prior approval is needed for all computing devices, regardless of cost (including but not limited to workstations, servers, laptops, personal digital assistants, notebook computers, tablets, smartphones and cellphones) as well as all portable electronic storage media, regardless of cost (including but not limited to, thumb/flas drives and portable hard drives), and/or when Subrecipient will use $500 or more of the SSY4 to purchase the Equipment/Asset.
Subrecipient shall obtain prior written approval from County at least thirty (30) days in advance of the date/time that Subrecipient intends to purchase the Equipment using SSY4 and no later than March 31st of the Fiscal Year.
Equipment must be ordered or purchased no later than May 31st of the Fiscal Year.
Subrecipient must submit a minimum of three (3) bids when requesting approval for Equipment that is $500 or more.
Subrecipient must ensure that the description and amount of the Equipment purchase(s) on the Budget are the same as the actual item(s) purchased.
The Grand Total Equipment purchase amount reflected under column (F) SSY4 shall match the total equipment amount reflected in the Mandated Program Services, Section I (Service Unit Summary). (2) Purchase includes any equipment that Subrecipient intends to purchase. Subreciept shall report this using any combination of SSY4, Match Cash, and Non-match Cash. (3) Other includes any equipment (except for leased equipment) which is not purchased by Subrecipient (e.g. donated items). Subrecipient shall report this using any combination of Match In-kind and/or Non-match In-kind. 2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
Fourteen Modification Number: One
City of Burbank
VII. BUDGET DETAIL - EQUIPMENT
(K)
VARIANCE
(E - J)
DIRECT
[Enter description] Select
[Enter description]
Exhibit W2 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 8 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
(4): Effective January 1, 2023, County’s approved mileage rate is $0.615 per mile and State's mileage rate is available online at: http://www.calhr.ca.gov/employees/Pages/travel-personal-vehicle.aspx. Reimbursement for mileage shall not exceed the lesser of County's rate and State's rate. (5): Subrecipient shall obtain prior written approval from County if utilizing SSY4 for Travel (Other). (6): Subrecipient shall contact their assigned Contract Analyst if there is a cost(s) that Subrecipient would like to add that is not included in the drop down list. Subrecipient shall provide detailed explanation of the cost to County review.
(7): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). (6)
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete as
needed] Indirect Costs (Other Costs) (7)
NOTE:
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
(1): Allowable costs are identified in accordance with Title 2 Code of Federal Regulations (CFR) Part 200 and Title 45 Code of Federal Regulations (CFR) Part 75. (2): Subrecipient shall obtain prior written approval from County if utilizing SSY4 for Conferences. (3): Subrecipient shall provide the following information to your assigned Contract Analyst: (a) Kind of equipment, (b) Indicate whether the equipment lease is program specific or a shared cost, (c) If a shared cost, provide the cost distribution methodology for County review and (d) Length of the lease. -$ -$ 16,515$ 16,515$ $0
Do indirect costs exceed the ten percent (10%) maximum? No
GRAND TOTAL
GRAND TOTAL OTHER COSTS 16,515$ -$ -$ -$ [Complete
as needed] -$
-$ -$ 16,515$ 16,515$ $0
INDIRECT
TOTAL DIRECT OTHER COSTS 16,515$ -$ -$ -$ 1 1 124$
Maintenance and Repairs (2 CFR 200.452 & 45 CFR
75.452) 292.00$ 1 6 1,752$
Training and Education (2 CFR 200.472 & 45 CFR 75.472) 124.00$ $01,752$ 1,752$
124$ 124$ $0
12,000$ 12,000$ $0
DIRECT
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 2,000.00 $ 1 6 12,000$ (A)
DESCRIPTION (1)
(B)
UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)
TOTAL COSTS
(F)
SSY4
SF (J)
TOTAL
FUNDING
(K)
VARIANCE
(G)
MATCH
(H)
NON-MATCH
(I)
PROGRAM
INCOME
(B*C*D) (1)
CASH
OTHER
(1)
CASH
(2)
IN-KIND
(1)
CASH
(2)
IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
Five (5)
ENP202102
Fourteen Modification Number: One
City of Burbank
VIII. BUDGET DETAIL - OTHER COSTS
Home Delivered Meal Services
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Exhibit W2 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 9 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
2 Home Delivered Meal Services
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five (5)
ENP202102
Fourteen Modification Number: One
City of Burbank
IX. BUDGET SUMMARY
(A)
COST CATEGORIES
(B)
COSTS (1)
(C)
FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
Cash NSIP
(SSY4) -$
(1)
Total Budgeted
Costs
DIRECT
1 Personnel
Cash Other
(SSY4) 30,000$
1 SSY4
Cash Other
(SSY4) 38,000$
Volunteers In-Kind (SF)
-$
3 Volunteer Expenses
Cash (SF)
273,482$
In-Kind (SF)
-$
Cash (SF)
-$
In-Kind (SF)
-$
2 Subtotal 38,000$
4 Lower Tier Subawards/Subcontracts for
Catered Food
Cash Other
(SSY4) 8,000$
Cash NSIP
(SSY4) -$
Cash (SF)
37,983$
Match
In-Kind (SF)
-$
Cash (SF) 311,465$
-$ In-Kind (SF)
Cash Other
(SSY4) -$
5 Raw Food
Cash Other
(SSY4) -$
3 Non-Match
6 Space
Cash Other
(SSY4) -$
In-Kind (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
Cash (SF) -$
Cash NSIP
(SSY4) -$
Cash (SF)
-$
In-Kind (SF)
-$
7 Equipment
Cash Other
(SSY4) -$
4 Program Income
8 Other Costs
In-Kind (SF)
-$
Cash (SF) 16,515$
Cash (SF)
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
Cash (SF)
16,515$
Cash Other
(SSY4) 38,000$
Cash NSIP
(SSY4) -$
Cash NSIP
(SSY4) -$ 9 Subtotal Direct Costs
Cash Other
(SSY4) 38,000$
5 Subtotal Funding for
Direct Costs
Cash (SF)
327,980$
Cash
Cash (SF)
327,980$
In-Kind (SF)
-$
In-Kind (SF)
-$
Exhibit W2 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 10 IX. BUDGET SUMMARY
(A)
COST CATEGORIES
(B)
COSTS (1)
(C)
FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
11 21 12
Variance (Costs-Funding) In-Kind
INDIRECT
10 Personnel
Cash Other
(SSY4) -$
6 SSY4Volunteers
12 Volunteer Expenses Cash (SF)
Match
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
Cash (SF)
-$
In-Kind (SF)
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
In-Kind (SF) -$
Cash (SF) -$
13 Lower Tier Subawards/Subcontracts for
Catered Food
Cash Other
(SSY4) -$
Cash (SF)
-$
In-Kind (SF)
-$
7 14 Raw Food
Cash Other
(SSY4) -$
8 Non-Match
15 Space
Cash Other
(SSY4) -$
In-Kind (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
Cash (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
Cash (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
16 Other Costs
Cash Other
(SSY4) -$
9 Program Income
Cash Other
(SSY4) -$
Cash (SF)
-$
Cash (SF)
-$
17 Subtotal Indirect Costs
Cash Other
(SSY4) -$
10 Subtotal Funding for
Indirect Costs
In-Kind (SF)
-$
Subrecipient meets minimum match requirement. Match Met NOTE:
(1): Costs and Funding shall match.
In-Kind (SF)
-$
In-Kind (SF)
-$
GRAND TOTAL COSTS
365,980$
GRAND TOTAL FUNDING
365,980$
20 Total Costs
Cash Other
(SSY4) 38,000$
11 Total Funding
Cash Other
(SSY4) 38,000$
Cash NSIP
(SSY4)
Variance (Costs-Funding) $0
-$
Cash NSIP
(SSY4) -$
Cash (SF)
327,980$
Cash (SF)
327,980$
GRAND TOTAL
In-Kind (SF)
-$
Variance (Costs-Funding)
Cash
In-Kind
Exhibit W2 (Budget) Amendment 14 (FY 2023-24 CDA ARPA Funding) 11 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
[Enter]
Ext.
[Enter]
Phone Number Ext.
Phone Number Ext.
City
Congregate Meal Services
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five
ENP
City of Burbank
Fourteen N/AModification Number:
Budget Analyst Job Title E-Mail Address
Burbank CA 91506
Principal Accountant (818) 238 5490 [email protected] Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title
EXHIBIT X1 (MANDATED PROGRAM SERVICES)
AMENDMENT 14 {FY 2023-24 CDA ARPA FUNDING}
Subrecipient's Legal Name:
Same as above
Recreation Service Manager [email protected]
State Zip Code
1301 West Olive Avenue Burbank CA 91506
Main Administrative Office Address
E-Mail Address
Ms. Erin Barrows (818) 238 5402
Phone Number
ocial Service Program Supervisor- Nutritio [email protected] Prefix Project Manager Job Title E-Mail Address
Ms. Roxana Tabibi (818) 238 5358
Ms. Angela O'Connor
Prefix
MPS Reviewed and Approved by: Gacia Atachian Date: 11/27/2023
COUNTY USE ONLY
Assigned Program Analyst: Gacia Atachian
Assigned Contract Analyst: Lynn Tran
Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Equipment (Other) (9)
(5) Thet Total and Grand Total amounts under column (E) Funding Amount shall match the Total and Grand Total amounts reflected in Exhibit W1 (Budget) (cover page) column (F) Total Funding.
(9) Enter the amount of equipment (other) that is reflected in Exhibit W1 (Budget).
I. UNITS OF SERVICE SUMMARY
(6) SSY4: Subaward Sum Year 3
(7) SF: Subrecipient's Funds
(8) Enter the approved amount of equipment purchase(s) that is reflected in Exhibit W1 (Budget).
Equipment (Purchases) (8) [Enter Approved
Amount]
(2) Please Enter the Unit Rates: a) for SSY4 (Cash Other) and for SSY4 (Cash NSIP) (i.e., approved rate to be reimbursed by County as reflected in the funding allocation letter) and b) for SF (amount of Match, Non-Match, and Program Income - reflected as a rate - that will be funded by Subrecipient for the Services). (3) Please enter the number of Units for each Service Category to be provided using SSY4 (Cash Other), SSY4 (Cash NSIP), and SF. (4) The Total Unduplicated Units for each Service Category under column (C) Units of Service shall match the corresponding Total Units reflected in Sections II, III, and IV (Services by Month) column (P) Total.
NOTE:
(1) Please Enter the total number of unduplicated clients that will be served by your agency. Unduplicated clients are individuals who meet the eligibility requirements outlined in Exhibit A (Statement of Work). These individuals are counted only once within a FY for reporting purposes.
American Meals
[Enter Amount]
GRAND TOTAL SERVICES/FUNDING - 2,800 573,139$ Grab And Go C-1 Meals
2,800
10.33$
-$
2,800
7.07$
Congregate Meal Services
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five
ENP
City of Burbank
Modification Number: N/AFourteen
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)
UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
SSY4 (6)
(Cash Other)
SF (7)
(Cash and In-Kind) 47,554 4.37$ 208,000$ Subrecipient's Legal Name:
SSY4 (6)
(Cash Other) 47,554
Total (4)
SSY4
(Cash NSIP)
Subtotal SSY4
(Cash Other and Cash NSIP)
(E)
FUNDING AMOUNT (5)
(A)
SERVICE CATEGORY
(B)
FUNDING SOURCE
SF (7)
(Cash and In-Kind)
19,796$
Total (4) 47,554 11.44$ 544,204$
7.07$
3.26$ 9,139$
1200
7.07$ 336,204$
SSY4
(Cash NSIP) -$
Subtotal SSY4
(Cash Other and Cash NSIP) 7.07$ 336,204$ 19,796$
28,935$
2,800
Exhibit X1 (Mandated Program Services) Amendment 14 (FY 2023-24 CDA ARPA Funding) 2 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.
CLIENTS
(D)
JUL
(E)
AUG
(F)
SEP
(G)
OCT
(H)
NOV
(I)
DEC
(J)
JAN
(K)
FEB
(L)
MAR
(M)
APR
(N)
MAY
(O)
JUN
(P)
TOTAL (1)
1 700 210 210 210 210 210 210 1,260
2 200 120 120 120 120 120 120 720
3 300 150 150 150 130 120 120 820
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
1,200 0 0 0 0 0 0 480 480 480 460 450 450 2,800
NOTE:
(1) The Grand Total Units under column (P) Total shall match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total.
Subrecipient's Legal Name: City of Burbank
Modification Number:Fourteen N/A
ENP
Congregate Meal Services
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five
II. SERVICES BY MONTH - AMERICAN MEALS
(B)
SITE NAME
Joslyn Adult Center
McCambridge Center
TuttleSenior Center
Grand Total
Exhibit X1 (Mandated Program Services) Amendment 14 (FY 2023-24 CDA ARPA Funding) 3 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.
CLIENTS
(D)
JUL
(E)
AUG
(F)
SEP
(G)
OCT
(H)
NOV
(I)
DEC
(J)
JAN
(K)
FEB
(L)
MAR
(M)
APR
(N)
MAY
(O)
JUN
(P)
TOTAL (1)
1 700 3,200 3,200 3,200 3,200 3,200 3,200 3,200 22,400
2 200 1,600 1,554 1,600 1,600 1,600 1,600 1,600 11,154
3 300 2,000 2,000 2,000 2,000 2,000 2,000 2,000 14,000
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
1,200 0 0 0 0 0 6,800 6,754 6,800 6,800 6,800 6,800 6,800 47,554 NOTE:
(1) The Grand Total Units under column (P) Total shall match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total.
ENP
Congregate Meal Services
2023-2024
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five
Fourteen Modification Number: N/A
Subrecipient's Legal Name: City of Burbank
II. SERVICES BY MONTH - GRAB AND GO MEALS
(B)
SITE NAME
Joslyn Adult Center
McCambridge Center
TuttleSenior Center
Grand Total
Exhibit X1 (Mandated Program Services) Amendment 14 (FY 2023-24 CDA ARPA Funding) 4 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
[Enter]
Ext.
[Enter]
Phone Number Ext.
[Enter]
Phone Number Ext.
State Zip Code
1301 West Olive Avenue Burbank CA 91506
Main Administrative Office Address City
EXHIBIT X2 (MANDATED PROGRAM SERVICES)
AMENDMENT 14 {FY 2023-24 CDA ARPA FUNDING}
Prefix Budget Analyst Job Title E-Mail Address
Burbank CA 91506
Principal Accountant (818) 238 5490 [email protected] Mailing Address (if different from above) City
Same as above
Recreation Service Manager [email protected]
Prefix Authorized Representative Job Title E-Mail Address Ms. Erin Barrows (818) 238 5402
Phone Number
State Zip Code
Social Service Supervisor Program- Nutritio [email protected] Prefix Project Manager Job Title E-Mail Address
Ms. Roxana Tabibi (818) 238 5358
Ms. Angela O'Connor
MPS Reviewed and Approved by: Gacia Atachian Date: 12/7/2023
COUNTY USE ONLY
Assigned Program Analyst: Gacia Atachian
Assigned Contract Analyst: Lynn Tran
Five
California Department of Aging (CDA) American Rescue Plan Act (ARPA) 2023-24
HOME DELIVERED MEAL SERVICES
Modification Number:Fourteen
ENP202102
One
City of Burbank
Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
Equipment (Other) (9)
(5) The Total and Grand Total amounts under column (E) Funding Amount shall match the Total and Grand Total amounts reflected in Exhibit W2 (Budget) (cover page) column (F) Total Funding.
SSY4
(Cash NSIP)
2,700
(9) Enter the amount of equipment (other) that is reflected in Exhibit W2 (Budget).
I. UNITS OF SERVICE SUMMARY
(6) SSY4: Subaward Sum Year 4
(7) SF: Subrecipient's Funds
(8) Enter the approved amount of equipment purchase(s) that is reflected in Exhibit W2 (Budget).
Equipment (Purchases) (8) [Enter Approved
Amount]
(2) Please Enter the Unit Rates: a) for SSY4 (Cash Other) and for SSY4 (Cash NSIP) (i.e., approved rate to be reimbursed by County as reflected in the funding allocation letter) and b) for SF (amount of Match, Non-Match, and Program Income - reflected as a rate - that will be funded by Subrecipient for the Services). (3) Please enter the number of Units for each Service Category to be provided using SSY4 (Cash Other), SSY4 (Cash NSIP), and SF. (4) The Total Unduplicated Units for each Service Category under column (C) Units of Service shall match the corresponding Total Units reflected in Sections II, III, and IV (Services by Month) column (P) Total.
NOTE:
(1) Please Enter the total number of unduplicated clients that will be served by your agency. Unduplicated clients are individuals who meet the eligibility requirements outlined in Exhibit A (Statement of Work). These individuals are counted only once within a FY for reporting purposes.
25.00$ 500$
37.21$
120,391$
365,980$
100,465$
19,926$
7.38$
[Enter Amount]
44.59$
-$
7.38$
19,926$
[Enter Unit Rate]
Total (4) 20 34.70$ 694$
9.70$ 194$
SSY4
(Cash NSIP) [Enter Unit Rate]
9.70$ 194$
GRAND TOTAL SERVICES/FUNDING -
SSY4 (6)
(Cash Other)
Subtotal SSY4
(Cash Other and Cash NSIP)
4,822
Grab And Go C-2 Meals
SSY4 (6)
(Cash Other) 112 7.07$ 789$ SSY4
(Cash NSIP) [Enter Units]
HOME DELIVERED MEAL SERVICES
2023-24
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five
ENP202102
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)
UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
Fourteen
City of Burbank
Modification Number: One
(B)
FUNDING SOURCE
(A)
SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
Hot Meals
Subtotal SSY4
(Cash Other and Cash NSIP)
SSY4 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
17,091$
SSY4 (6)
(Cash Other)
Emergency Meals
Frozen Meals
2,700
20 [Enter Units]
20 Total (4)
SF (7)
(Cash and In-Kind)
2,700
SF (7)
(Cash and In-Kind)
244,091$ 116.12$
[Enter Unit Rate]
2,102
8.13$
150
Subtotal SSY4
(Cash Other and Cash NSIP) 7.07$ 789$ SF (7)
(Cash and In-Kind) 112 0.13$ 15$ Total (4) 112 7.20$ 804$ 17,091$
8.13$
107.99$ 227,000$
2,102
[Enter Units]
2,102
Total (4)
SSY4
(Cash NSIP)
Subtotal SSY4
(Cash Other and Cash NSIP)
Exhibit X2 (Mandated Program Services) Amendment 14 (FY 2023-24 CDA ARPA Funding) 2 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.
CLIENTS
(D)
JUL
(E)
AUG
(F)
SEP
(G)
OCT
(H)
NOV
(I)
DEC
(J)
JAN
(K)
FEB
(L)
MAR
(M)
APR
(N)
MAY
(O)
JUN
(P)
TOTAL
(1)
1 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
(1) Grand Total Units under column (P) Total shall match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total II. SERVICES BY MONTH - HOT MEALS
(B)
ROUTE NAME
HOME DELIVERED MEAL SERVICES
2023-24
California Department of Aging (CDA) American Rescue Plan Act (ARPA) City of Burbank
Fourteen Modification Number: One
Five
ENP202102
Grand Total
NOTE:
Exhibit X2 (Mandated Program Services) Amendment 14 (FY 2023-24 CDA ARPA Funding) 3 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.
CLIENTS
(D)
JUL
(E)
AUG
(F)
SEP
(G)
OCT
(H)
NOV
(I)
DEC
(J)
JAN
(K)
FEB
(L)
MAR
(M)
APR
(N)
MAY
(O)
JUN
(P)
TOTAL
(1)
1 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
(1) Grand Total Units under column (P) Total shall match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total III. SERVICES BY MONTH - FROZEN MEALS
(B)
ROUTE NAME
HOME DELIVERED MEAL SERVICES
2023-24
California Department of Aging (CDA) American Rescue Plan Act (ARPA) City of Burbank
Five
ENP202102
Fourteen Modification Number: One
Grand Total
NOTE:
Exhibit X2 (Mandated Program Services) Amendment 14 (FY 2023-24 CDA ARPA Funding) 4 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
Hot Frozen Hot Frozen Hot Frozen Hot Frozen Hot Frozen Hot Frozen Hot Frozen Hot Frozen Hot Hot Frozen Hot Frozen Hot Frozen Hot Frozen 1 30 200 100 102 100 100 302 300
2 13 200 100 100 100 200 300
3 20 200 100 100 100 200 300
4 20 200 100 100 100 200 300
5 20 200 150 150 150 200 450
6 20 200 150 150 150 200 450
7 17 400 150 150 400 300
8 10 400 150 150 400 300
9 0 0
10 0 0
11 0 0
12 0 0
13 0 0
14 0 0
15 0 0
150 0 0 0 0 0 0 0 0 0 0 2000 1000 102 1000 0 700 0 0 0 0 0 0 0 0 2102 2700 (1) Grand Total Units under column (P) Total shall match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total Five
HOME DELIVERED MEAL SERVICES
2023-24
California Department of Aging (CDA) American Rescue Plan Act (ARPA) IV. SERVICES BY MONTH - HOT & FROZEN MEALS ROUTES
(A)
LINE
NO.
(B)
ROUTE NAME
(C)
NO. OF
UNDUP.
CLIENTS
(D)
JUL
(E)
AUG
(F)
SEP
(G)
OCT
(H)
NOV
(P)
TOTAL (1)
(M)
APR
(N)
MAY
(O)
JUN
1 (K)
FEB
(L)
MAR
6 (I)
DEC
(J)
JAN
3 4
5 2 (2B)
7 Grand Total
8 (2A)
NOTE:
ENP202102
Fourteen Modification Number: One
City of Burbank
Exhibit X2 (Mandated Program Services) Amendment 14 (FY 2023-24 CDA ARPA Funding) 5 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.
CLIENTS
(D)
JUL
(E)
AUG
(F)
SEP
(G)
OCT
(H)
NOV
(I)
DEC
(J)
JAN
(K)
FEB
(L)
MAR
(M)
APR
(N)
MAY
(O)
JUN
(P)
TOTAL
(1)
1 30 20 20
2 13 0 0
3 20 0 0
4 20 0 0
5 20 0 0
6 20 0 0
7 17 0 0
8 10 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
150 0 0 0 0 0 0 0 0 0 0 20 0 20
(1) Grand Total Units under column (P) Total shall match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total 1 V. SERVICES BY MONTH - EMERGENCY MEALS
(B)
ROUTE NAME
HOME DELIVERED MEAL SERVICES
2023-24
California Department of Aging (CDA) American Rescue Plan Act (ARPA) City of Burbank
Five
ENP202102
Fourteen Modification Number: One
2 (2B)
3 4
5 6
7 8 (2A)
Grand Total
NOTE:
Exhibit X2 (Mandated Program Services) Amendment 14 (FY 2023-24 CDA ARPA Funding) 6 Program Services:
Fiscal Year:
Funding Type:
Supervisorial District:
Subaward Number:
Amendment Number:
Subrecipient's Legal Name:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.
CLIENTS
(D)
JUL
(E)
AUG
(F)
SEP
(G)
OCT
(H)
NOV
(I)
DEC
(J)
JAN
(K)
FEB
(L)
MAR
(M)
APR
(N)
MAY
(O)
JUN
(P)
TOTAL
(1)
1 30 20 20
2 13 20 20
3 20 20 20
4 20 10 10
5 20 10 10
6 20 10 10
7 17 12 12
8 10 10 10
9 0
10 0
11 0
12 0
13 0
14 0
15 0
150 0 0 0 0 0 112 0 0 0 0 0 0 112
(1) Grand Total Units under column (P) Total shall match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total V. SERVICES BY MONTH - GRAB AND GO MEALS
HOME DELIVERED MEAL SERVICES
2023-24
California Department of Aging (CDA) American Rescue Plan Act (ARPA) Five
ENP202102
Fourteen Modification Number: One
City of Burbank
(B)
ROUTE NAME
1 2 (2B)
3 4
5 6
7 8 (2A)
NOTE:
Grand Total
Exhibit X2 (Mandated Program Services) Amendment 14 (FY 2023-24 CDA ARPA Funding) 7