Attachment 2 — Burbank City Council, June 4, 2024

ELDERLY NUTRITION PROGRAM (ENP)
SUBAWARD NUMBER ENP202102
SUBAWARD PERIOD JULY 2020 – JUNE 2024

AMENDMENT FIFTEEN

This Amendment is made and entered into by and between

COUNTY OF LOS ANGELES THROUGH ITS

AGING AND DISABILITIES DEPARTMENT
(“County” or “AD”)
County’s Business Address
510 South Vermont Avenue, 11th Floor
Los Angeles, CA 90020
and

CITY OF BURBANK
(“Contractor” or “Subrecipient”)
Subrecipient’s Business Address
1301 West Olive Avenue
Burbank, CA 91506
WHEREAS, reference is made to that certain document originally entitled “Elderly Nutrition Program (ENP) Subaward Number ENP202102 Subaward Period July 2020 – June 2021” dated July 1, 2020, which is renamed as “Elderly Nutrition Program (ENP) Subaward Number ENP202102 Subaward Period July 2020 – June 2024”, and the Amendments thereto (hereafter collectively referred to as “Contract” or “Subaward”); and

WHEREAS, the parties hereto have previously entered into the above referenced Subaward for the purpose of providing Elderly Nutrition Program (ENP) Services, which include serving congregate meals and home-delivered meals as well as conducting telephone reassurance to the older adult population in Los Angeles County (excluding the City of Los Angeles); and

WHEREAS, County and Subrecipient recognize and agree that specific terms (including, but not limited to, Contract, Subaward, Contractor, Subrecipient, Subcontract, Lower Tier Subaward, Subcontractor and Lower Tier Subrecipient) are used interchangeably throughout this Amendment in order to comply with Federal, State, and County regulations; and

WHEREAS, it is the intent of the parties to amend this Subaward to allocate Older Americans Act (OAA) Title III C-1 (Nutrition Services) One-Time-Only (OTO) funding in the ATTACHMENT 2
Elderly Nutrition Program Subaward Number ENP202102Amendment Fifteen Page 2 amount of $60,000, which will be reimbursed to Subrecipient in exchange for additional defined and contracted ENP Congregate Meal Services as specified herein to be provided by Subrecipient during FY 2023-24; and WHEREAS, it is the intent of the parties to also amend this Subaward to allocate OAA TitleIII C-2 (Nutrition Services) OTO funding in the amount of $55,000, which will be reimbursed to Subrecipient in exchange for additional defined and contracted ENP Home-DeliveredMeal Services as specified herein to be provided by Subrecipient during FY 2023-24; and WHEREAS, it is the intent of the parties to also amend this Subaward to provide for the other changes set forth herein; and WHEREAS, the Subaward provides that changes to its terms may be made in the form of a written Amendment, which is formally approved and executed by the parties. NOW THEREFORE, THE PARTIES HERETO AGREE AS FOLLOWS: I. This Amendment will commence upon execution by all parties. II. Subparagraph 5.1.6 is deleted in its entirety and replaced as follows: 5.1.6 Subaward Sum Year 4 Funding Source(s) 5.1.6.1 The Subaward Sum Year 4 for this Subaward is comprised of monies which are identified by the funding source(s) or governing statute(s) listed below. The funding source(s) and governing statute(s) authorize County to use these monies to provide Program Services. 5.1.6.2 Older Americans Act (OAA) Title III B (Supportive Services and Senior Centers) baseline funds 5.1.6.2.1 Subaward Sum: $1,000 5.1.6.2.2 Service Area: Supervisorial District 5 5.1.6.2.3 Period of Performance: July 1, 2023 – June 30, 2024 (consistent with California Department of Aging contract number AP-2324-19) 5.1.6.2.4 Allocation Letter: Fiscal Year 2023-24 Baseline Funding Allocation for Elderly Nutrition Program Services Elderly Nutrition Program Subaward Number ENP202102Amendment Fifteen Page 3

5.1.6.3 OAA Title III C-1 (Nutrition Services) baseline funds5.1.6.3.1 Subaward Sum: $271,000 5.1.6.3.2 Service Area: Supervisorial District 5 5.1.6.3.3 Period of Performance: July 1, 2023 – June 30, 2024 (consistent with California Department of Aging contract number AP-2324-19) 5.1.6.3.4 Allocation Letter: Fiscal Year 2023-24 Baseline Funding Allocation for Elderly Nutrition Program Services 5.1.6.4 OAA Title III C-2 (Nutrition Services) baseline funds5.1.6.4.1 Subaward Sum: $312,000 5.1.6.4.2 Service Area: Supervisorial District 5 5.1.6.4.3 Period of Performance: July 1, 2023 – June 30, 2024 (consistent with California Department of Aging contract number AP-2324-19) 5.1.6.4.4 Allocation Letter: Fiscal Year 2023-24 Baseline Funding Allocation for Elderly Nutrition Program Services 5.1.6.5 California Department of Aging (CDA) American Rescue Plan Act (ARPA) funds for ENP Congregate Meal Services 5.1.6.5.1 Subaward Sum: $356,000 5.1.6.5.2 Service Area: Supervisorial District 55.1.6.5.3 Period of Performance: July 1, 2023 – June 30, 2024 (consistent with California Department of Aging contract number AP-2122-19, Amendment #3) 5.1.6.5.4 Allocation Letter: Fiscal Year 2023-24 California Department of Aging American Rescue Plan Act Funding Allocation for Elderly Nutrition Program Services Elderly Nutrition Program Subaward Number ENP202102Amendment Fifteen Page 4

5.1.6.6 CDA ARPA funds for ENP Home-Delivered Meal Services5.1.6.6.1 Subaward Sum: $38,0005.1.6.6.2 Service Area: Supervisorial District 55.1.6.6.3 Period of Performance: July 1, 2023 – June 30, 2024 (consistent with California Department of Aging contract number AP-2122-19, Amendment #3) 5.1.6.6.4 Allocation Letter: Fiscal Year 2023-24 California Department of Aging American Rescue Plan Act Funding Allocation for Elderly Nutrition Program Services 5.1.6.7 OAA Title III C-1 (Nutrition Services) One-Time-Only funds 5.1.6.7.1Subaward Sum: $60,000 5.1.6.7.2 Service Area: Supervisorial District 5 5.1.6.7.3 Period of Performance: July 1, 2023 – June 30, 2024 (consistent with California Department of Aging contract number AP-2324-19, Amendment #1)5.1.6.7.4 Allocation Letter: Fiscal Year 2023-24 One-Time-Only Funding Allocation for Elderly Nutrition Program Services 5.1.6.8 OAA Title III C-2 (Nutrition Services) One-Time-Only funds5.1.6.8.1 Subaward Sum: $55,000 5.1.6.8.2 Service Area: Supervisorial District 5 5.1.6.8.3 Period of Performance: July 1, 2023 – June 30, 2024 (consistent with California Department of Aging contract number AP-2324-19, Amendment #1) 5.1.6.8.4 Allocation Letter: Fiscal Year 2023-24 One-Time-Only Funding Allocation for Elderly Nutrition Program Services Elderly Nutrition Program Subaward Number ENP202102Amendment Fifteen Page 5 III. Subparagraph 5.10.7 is deleted in its entirety and replaced as follows:5.10.7Amount of Federal Funds Obligated by this Action: 5.10.7.1 Original Subaward: $395,000 5.10.7.2 Amendment One: $172,000 5.10.7.2.1 Federal CARES Act Funds: $106,0005.10.7.2.2 CDA CARES Act Funds: $66,0005.10.7.3 Amendment Two: $74,000 5.10.7.4 Amendment Three: $11,000 5.10.7.5 Amendment Four: $190,000 5.10.7.5.1 Additional CDA CARES Act Funds: $136,000 5.10.7.5.2 FY 2019-20 FFCRA Carryover Funds: $54,0005.10.7.6 Amendment Five: $408,000 5.10.7.7 Amendment Six: $188,3815.10.7.7.1 FY 2020-21 FFCRA Reallocation Funds: $10,1905.10.7.7.2 FY 2020-21 CDA CARES Act Reallocation Funds: $178,191 5.10.7.8 Amendment Seven: $0 5.10.7.9 Amendment Eight: $33,000 5.10.7.10 Amendment Nine: $160,0005.10.7.11 Amendment Ten: $584,000 5.10.7.12 Amendment Eleven: $275,000 5.10.7.13 Amendment Twelve: $27,500 5.10.7.14 Amendment Thirteen: $584,000 5.10.7.15 Amendment Fourteen: 394,000 Elderly Nutrition Program Subaward Number ENP202102Amendment Fifteen Page 6

5.10.7.16 Amendment Fifteen: $115,000IV. Subparagraph 5.10.8 is deleted in its entirety and replaced as follows: 5.10.8 Total Amount of Federal Funds Obligated to Subrecipient (Subaward Sum): 5.10.8.1 Subaward Sum Year 1: $842,000 5.10.8.2 Subaward Sum Year 2: $789,3815.10.8.3 Subaward Sum Year 3: $886,500 5.10.8.4 Subaward Sum Year 4: $1,093,000 V. Subparagraph 5.10.9 is deleted in its entirety and replaced as follows: 5.10.9 Total Amount of Federal Award (Maximum Subaward Sum): $3,422,500 (FY 2020-21 Reallocation funds in the amount of $188,381 excluded) VI. “Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO Funding}” is added, is an addendum to "Exhibit W1 (Budget)” and is incorporated herein by reference. VII. “Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO Funding}” is added, isan addendum to "Exhibit W2 (Budget)” and is incorporated herein by reference. VIII. “Exhibit X1 (Mandated Program Services) Amendment 15 {FY 2023-24 OTO Funding}” is added, is an addendum to "Exhibit X1 (Mandated Program Service)” and is incorporated herein by reference. IX. “Exhibit X2 (Mandated Program Services) Amendment 15 {FY 2023-24 OTO Funding}” is added, is an addendum to "Exhibit X2 (Mandated Program Services)” and is incorporated herein by reference. X. The "Fiscal Year 2023-24 One-Time-Only Funding Allocation for Elderly Nutrition Program Services" funding allocation letter is incorporated herein by reference. All other terms and conditions of the Subaward will remain in full force and effect.////////////////// IN WITNESS WHEREOF, the Board of Supervisors of the County of Los Angeles has caused this Amendment Fifteento be subscribed on its behalf by the Director of Aging and Disabilities Department, and the Subrecipient has subscribed the same through its Authorized Representative. The Authorized Representative(s) signing on behalf of Subrecipient warrants under penalty of perjury that he or she is authorized to bind Subrecipient.COUNTY OF LOS ANGELES ByDr. Laura Trejo, Director Date County of Los AngelesAging & Disabilities DepartmentSUBRECIPIENTCity of Burbank Subrecipient’s Legal NameENP202102 Subaward NumberByName of Authorized Date Representative TitleApproved as to Form: Signature OFFICE OF COUNTY COUNSEL Dawyn R. Harrison, County CounselBy Name of Authorized Representative Date By Lawrence M. Green Senior Deputy County Counsel Title Signature Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Older Americans Act Title III C-1
Five (5)
(3) The minimum required total mach 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: 5/7/2024
[Enter] [Enter]
Budget Reviewed and Approved by:

Equipment (Other) (5)
(G)

UNIT RATE
City
Same as above Burbank
(2)
SF
-$ 612,776$ 992,905$
[Enter]
E-Mail AddressExt.Prefix
[Enter]
American Meals 12,661$
EXHIBIT W1 (BUDGET)
AMENDMENT 15 {FY 2023-24 OTO 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 Fifteen Modification Number: N/A
Ext. E-Mail Address
Social Service Supervisor Proram - Nutrition
(2)

IN-KIND
Phone Number
243,857$
(F)
TOTAL

FUNDING
(B+C+D+E)
[email protected](818) 238 5358

PROGRAM FUNDING SUMMARY
[Enter] [Enter] 13.67$
(A)

SERVICE CATEGORY
(B)

SUBAWARD SUM
YEAR 4
(SSY4) (1)
(1)
CASH
OTHER
(2)
CASH
NSIP
113,420$
(1)
CASH
(1)
CASH
(3)
TOTAL

FUNDING

6.60$
(1)
SSY4

7.07$ 112,776$
(2)

IN-KIND
(1)
CASH
5,000$
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.
-$
Grand Total (6)
[Enter]
49,129$ 297,760$ 33,240$
Equipment (Purchases) (4)
Grab and Go C-1 Meals 184,340$
Angela O'Connor Principal Accontant (818) 238 54 90 [Enter] [email protected] Prefix Budget Analyst Job Title Phone Number Ext. E-Mail Address Ms.
(5) Funding Amount for Equipment (Other) reflected as SF shall match the Equipment (Other) Funding Amount reflected in Exhibit X1 (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 X1 (Mandated Program Services), Section I (Units of Service Summary), Column (E) Funding Amount. [Enter] -$
-$ -$

COUNTY USE ONLY
Assigned Program Analyst:

Assigned Contract Analyst:

Sheri Stanton 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).

25.84$ 20,579$ 500,000$ [Enter] [Enter] [Enter] 44,129$ 749,048$ 7.07$ 18.77$ Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Five (5)
ENP202102
Fifteen Modification Number: N/A
38,508.00$ $0
$0
44,808.20$ $0
3,000.00$
City of Burbank
[Enter title]
[Enter title]
6,643.00$ $0
[Enter title]
2,000.00$ 4,643.00$
[Enter title]
999.60$ 12,774.00$
8,000.00$ 30,508.00$
8,282.00$
$0
Work trainee 100% 3,209$ 12
11,282.00$ $0
[Enter title]
Facility Attendant 20% 2,768$ 12 6,643.20$
9,000.00$ 35,808.20$
[Enter title]
[Enter title]
[Enter title]
13,773.60$
Food Service Aid/ Tuttle 100% 3,923$ 12 47,076.00$ Recreation Leader 20% 4,701$ 12 11,282.40$
Site manager / Social Services
Coordinator McCambridge 20% 5,739$ 12 13,773.60$ 38,508.00$
Food Service Aid / Joslyn 100% 3,734$ 12 44,808.00$ I. BUDGET DETAIL - PERSONNEL
DIRECT
Project Manager/Social Service
Supervisor- Nutrition 50% 8,986$ 12 53,916.00$ 9,000.00$ $044,916.00$ 53,916.00$

CONGREGATE MEAL SERVICES
2023-2024
Older Americans Act Title III C-1
(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)
30,960.00$ $0
Site manager at Joslyn site/ Social
Services Coordinator 100% 5,739$ 68,868.00$
$059,868.00$ 68,868.00$
12 68,868.00$ 9,000.00$ 59,868.00$
38,532.00$ 8,000.00$ $030,532.00$ 38,532.00$ 12 28,644.00$
$0
Food Service manager /Supervisor/ 50% 5,160$ 12 30,960.00$ 8,000.00$ 22,960.00$ Site manager at Tuttle site/ Social
Services Coordinator 100% 5,739$ 12 68,868.00$ 9,000.00$ $0Senior Food Services Aide 50% 4,774$
Principal Clerk 50% 6,422$ 12
28,644.00$ 8,000.00$ 20,644.00$
9,000.00$ 38,076.00$ 47,076.00$
Senior Food Services Aide 50% 4,774$ 12 28,644.00$ 8,000.00$ $020,644.00$ 28,644.00$ SUBTOTAL DIRECT PERSONNEL 480,523$ 91,000$ 389,523$ -$ (3) (3) (3) (3) 144$ $0
-$ -$ -$
[Enter title]
-$
Benefits 40.00% 192,209$ 36,400$ 155,809$ (4) Taxes 0.03% 144$ 27$ 117$ Indirect Costs (Personnel)
[Complete as
needed] (5)
[Complete
as needed]
[Complete
as needed]
480,523$ $0
-$ -$ -$ 672,876$ $0

INDIRECT
(4) (4) (4) 192,209$ $0
TOTAL DIRECT PERSONNEL 672,876$ 127,427$ 545,449$ (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). 672,876$ $0
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 672,876$ 127,427$ 545,449$ -$ -$ -$ -$ Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 2 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

CONGREGATE MEAL SERVICES
Fifteen 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
Older Americans Act Title III C-1
Five (5)
ENP202102
N/A
(J)

VARIANCE
(G)
MATCH (2)
(H)

NON-MATCH
DIRECT
City of Burbank
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]

INDIRECT
Indirect Costs (Volunteers)
[Complete
as needed]
[Complete as
needed]
[Complete as
needed]
TOTAL DIRECT VOLUNTEERS -$ -$ -$ -$ $0 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.

Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 3 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

ENP202102
Fifteen Modification Number: N/A
City of Burbank
III. BUDGET DETAIL - VOLUNTEER EXPENSES

CONGREGATE MEAL SERVICES
2023-2024
Older Americans Act Title III C-1
Five (5)
(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)
DIRECT
Training
Mileage (Cost/Mile) (1)
[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]
-$ $0

INDIRECT

TOTAL DIRECT VOLUNTEER
EXPENSES -$ -$ -$ -$
[Enter description of other expenses]
Indirect Costs (Volunteer Expenses) (2)
-$ -$ -$
(1) From January 1, 2023 through December 31, 2023, County’s approved mileage rate is $0.615 per mile. Effective January 1, 2024, County's approved mileage rate is $0.63 per mile and State's mileage rate is available online at: http://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx. Reimbursement for mileage shall not exceed the lesser of County's rate and State's rate. (2): The maximum reimbursable amount allowable for indirect costs is ten percent (10%) of Subrecipient's modified total direct cost reflected under Column F (SSY4 Cash Other). Indirect costs in excess of the ten percent (10%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). -$ -$ -$ -$ $0
NOTE:

Do indirect costs exceed the ten percent (10%) maximum?

GRAND TOTAL

GRAND TOTAL VOLUNTEER
EXPENSES -$ -$ -$ -$
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 4 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2023-2024
Older Americans Act Title III C-1
Five (5)
ENP202102
Fifteen Modification Number: N/A
City of Burbank

CONGREGATE MEAL SERVICES
Tender Loving Care
28,000$ 255,453$ $0
[Enter caterer's name] Select Description
Tender Loving Care
[Enter caterer's name] Select Description
2,466$
132,807$ 29,785$
15,527$ 1,455$
DIRECT
5,677 9 255,453$ 64,861$
[Enter caterer's name] Select Description
[Enter caterer's name]
[Enter caterer's name]
Select Description
Grab & Go C-1 Meals 5.00$
Select Description
(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
(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 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)

TOTAL DIRECT LOWER TIER SUBAWARDS/
SUBCONTRACTS FOR CATERED FOOD 33,000$

GRAND TOTAL LOWER TIER SUBAWARDS/

SUBCONTRACTS FOR CATERED FOOD
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]

GRAND TOTAL
(2)
NOTE:
279,901$ $033,000$
279,901$ $031,240$ 67,327$
[Complete as
needed]
279,901$ -$ 148,334$ 67,327$ -$ -$ 31,240$ -$ -$ -$

INDIRECT
279,901$ 148,334$
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$ 543 24,448$ 5,000$ 24,448$ $09 (J)

PROGRAM
INCOME
(1)
CASH
(B)

SERVICE CATEGORY
(G)
SSY4
SF(F)

TOTAL COSTS
(K)

TOTAL FUNDING
(L)

VARIANCE
Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 5 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

NOTE:
2023-2024
Older Americans Act Title III C-1
Five (5)
ENP202102
Fifteen Modification Number: N/A
City of Burbank

TOTAL DIRECT RAW FOOD
Grab and Go C-1 Meals 8.00$ 1,000 2
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
SF(F)
SSY4
(J)

TOTAL FUNDING
(K)

VARIANCE
(B*C*D) (1)
CASH
OTHER
(2)
CASH
NSIP
(1)
CASH

CONGREGATE MEAL SERVICES
8,000$ $01,000$ 7,000$
(2)

IN-KIND
(1)
CASH
(F+G+H+I) (E - J)
(1)
-$ 24,000$ $591,801
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
615,801$ 22,000$ 2,000$ -$ -$ -$ -$ [Complete as
needed]
DIRECT
American Meals 8.00$ 500 2 8,000$
(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)
$591,801GRAND TOTAL RAW FOOD 615,801$ 22,000$ 2,000$ -$ -$ -$ -$ -$ 24,000$ [Complete as
needed]
Do indirect costs exceed the ten percent (10%) maximum? $016,000$ 15,000$ 1,000$ 16,000$ Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 6 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Fifteen Modification Number: N/A
City of Burbank
VI. BUDGET DETAIL - SPACE

CONGREGATE MEAL SERVICES
2023-2024
Older Americans Act Title III C-1
Five (5)
ENP202102
(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)
[Enter name and description]
[Enter name and description]
DIRECT
[Enter name and description]
[Enter name and description]
[Enter name and description]
$0

INDIRECT
TOTAL DIRECT SPACE -$ -$ -$ -$ [Enter name and description]
[Complete
as needed] Indirect Costs (Space) (2)
-$ -$ -$ -$
[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?

GRAND TOTAL
GRAND TOTAL SPACE -$ -$ -$ -$ [Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 7 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(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
Older Americans Act Title III C-1
Five (5)
ENP202102
Fifteen Modification Number: N/A
City of Burbank
VII. BUDGET DETAIL - EQUIPMENT
(K)

VARIANCE
(E - J)
DIRECT
[Enter description] Select
[Enter description]
(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)

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
[Enter description] Select
Select
[Enter description] Select
[Enter description] Select
[Enter description] Select
NOTE:
-$ $0

GRAND TOTAL
TOTAL DIRECT EQUIPMENT -$ -$ -$ -$ -$ -$ -$ [Enter description] Select
Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 8 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Five (5)
ENP202102
Fifteen Modification Number: N/A
City of Burbank
VIII. BUDGET DETAIL - OTHER COSTS

CONGREGATE MEAL SERVICES
2023-2024
Older Americans Act Title III C-1
(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)
10,000$ 10,000$ $0
DIRECT
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 833.30$ 1 12 10,000$ $03,504$ 3,504$
125$ 125$ $01 1 125$
Maintenance and Repairs (2 CFR 200.452 & 45 CFR

75.452) 625.00$ 1 4 2,500$
Maintenance and Repairs (2 CFR 200.452 & 45 CFR

75.452) 292.00$ 1 12 3,504$
Training and Education (2 CFR 200.472 & 45 CFR 75.472) 125.00$ 2,500$ 2,500$ $0
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
-$ -$ 16,129$ 16,129$ $0

INDIRECT
TOTAL DIRECT OTHER COSTS 16,129$ -$ -$ -$ 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. -$ -$ 16,129$ 16,129$ $0 Do indirect costs exceed the ten percent (10%) maximum?

GRAND TOTAL
GRAND TOTAL OTHER COSTS 16,129$ -$ -$ -$ [Complete
as needed] (7)
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)
(6)
Select Description (2) (3) (4) (5)
(6)
(6)
(4): From January 1, 2023 through December 31, 2023, County’s approved mileage rate is $0.615 per mile. Effective January 1, 2024, County's approved mileage rate is $0.63 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). (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 (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)
NOTE:

Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 9 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 Variance (Costs-Funding)
Cash
In-Kind
Cash (SF)
661,905$
In-Kind (SF)
-$
In-Kind (SF)
-$
Cash Other
(SSY4) 297,761$
Cash NSIP
(SSY4) 33,240$
Cash NSIP
(SSY4) 33,240$ 9 Subtotal Direct Costs
Cash Other
(SSY4) 297,761$
5 Subtotal Funding
for Direct Costs
Cash (SF)
661,905$
Cash (SF) 49,129$
Cash (SF)
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
Cash (SF)
16,129$
7 Equipment
Cash Other
(SSY4) -$
4 Program Income
8 Other Costs
In-Kind (SF)
-$
In-Kind (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
Cash (SF) -$
Cash NSIP
(SSY4) 2,000$
Cash (SF)
-$
In-Kind (SF)
-$
5 Raw Food
Cash Other
(SSY4) 22,000$
3 Non-Match
6 Space
Cash Other
(SSY4) -$
2 Subtotal 331,001$
4 Lower Tier Subawards/Subcontracts for
Catered Food
Cash Other
(SSY4) 148,334$
Cash NSIP
(SSY4) 31,240$
Cash (SF)
100,327$
Match
In-Kind (SF)
-$
Cash (SF) 612,776$
-$ In-Kind (SF)
Cash Other
(SSY4) -$
Cash (SF)
545,449$
In-Kind (SF)
-$
Cash (SF)
-$
In-Kind (SF)
-$
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) 33,240$
(1)
Total Budgeted
Costs
DIRECT
1 Personnel
Cash Other
(SSY4) 127,427$
1 SSY4
Cash Other
(SSY4) 297,761$
Volunteers In-Kind (SF)
-$
3 Volunteer Expenses

CONGREGATE MEAL SERVICES
2023-2024
Older Americans Act Title III C-1
Five (5)
ENP202102
Fifteen Modification Number: N/A
Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO 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
Cash NSIP
(SSY4) 33,240$
Cash (SF)
661,905$
Cash (SF)
661,905$

GRAND TOTAL
In-Kind (SF)
-$
Variance (Costs-Funding)
Cash
In-Kind
Subrecipient meets minimum match requirement. Match Met NOTE:
(1): Costs and Funding shall match.

In-Kind (SF)
-$
In-Kind (SF)
-$

GRAND TOTAL COSTS
992,905$

GRAND TOTAL FUNDING
992,905$
20 Total Costs
Cash Other
(SSY4) 297,761$
11 Total Funding
Cash Other
(SSY4) 297,761$
Cash NSIP
(SSY4)
Variance (Costs-Funding) $0
33,240$
Cash Other
(SSY4) -$
Cash (SF)
-$
Cash (SF)
-$
17 Subtotal Indirect Costs
Cash Other
(SSY4) -$
10 Subtotal Funding
for Indirect Costs
In-Kind (SF)
-$
Cash (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
16 Other Costs
Cash Other
(SSY4) -$
9 Program Income
In-Kind (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
Cash (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
14 Raw Food
Cash Other
(SSY4) -$
8 Non-Match
15 Space
Cash Other
(SSY4) -$
13 Lower Tier Subawards/Subcontracts for
Catered Food
Cash Other
(SSY4) -$
Cash (SF)
-$
In-Kind (SF)
-$
7 Match
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
Cash (SF)
-$
In-Kind (SF)
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
In-Kind (SF) -$
Cash (SF) -$
10 Personnel
Cash Other
(SSY4) -$
6 SSY4Volunteers
12 Volunteer Expenses Cash (SF)

INDIRECT
Exhibit W1 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 11 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

18.99$ Grab and Go C-2 Meals 5,206$ 581$ 9,757$ 5$ 15,549$ (2)
SF

9.70$ 11.38$ 9,674$

7.72$
455$
(D)

NON-MATCH
(E)

PROGRAM
INCOME

10.25$
8,506$ 187,962$
31,302$

7.07$ 11.92$
-$
(818) 238 5402
Phone Number
(G)

UNIT RATE

15.10$
(3)
TOTAL

FUNDING

21.08$ 326$ 4,766$
(B)

SUBAWARD SUM
YEAR 4
(SSY4) (1)
(1)
CASH
OTHER
(2)
CASH
NSIP
241,781$
(1)
CASH
83,008$
(818) 238 5490 [Enter] [email protected]
Phone Number Ext. E-Mail Address
[Enter] [Enter]
(2)

IN-KIND
Job Title
23,135$
Prefix Budget Analyst Job Title
Ms.

Frozen Meals
EXHIBIT W2 (BUDGET)
AMENDMENT 15 {FY 2023-24 OTO FUNDING}
CA 91605
Zip CodeState
State
CA 91605

HOME DELIVERED MEAL SERVICES
2023-2024
City fo Burbank
ENP 202102
Subrecipient's Legal Name:
1301 West Olive Avenue
Older Americans Act Title III C-2
Five (5)
Mailing Address (if different from above) City Zip Code Fifteen Modification Number: N/A
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 Prgram- Nutrition
[email protected]
Prefix
Erin Barrows
Authorized Representative
Recreation Service Manager
Job Title
Ms.
[email protected](818) 238 5358Roxana TabibiMs.
(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 4,126$
Phone Number
598,780$
(F)
TOTAL

FUNDING
(B+C+D+E)

7.38$
E-Mail AddressExt.Prefix
8,836$
SUBRECIPIENT'S FUNDS (SF) (2)
(C)
MATCH (3)
Hot Meals

PROGRAM FUNDING SUMMARY

18.38$
(A)

SERVICE CATEGORY
Project Manager
Angela O'Connor Principal Accountant
(1)
CASH
87,612$
-$
Grand Total (6)
[Enter]
40,268$ 334,122$ 32,878$
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: 5/6/2024Aylin karim Masihi Budget Reviewed and Approved by:

Equipment (Other) (5)
404,697$
(3) The minimum required total mach is twelve percent (12%) of SSY4. 811,965$
[Enter]
(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$ 302,562$
(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:

Sheri Stanton Equipment Purchase(s) Approved by: N/A
Lynn Tran
[Enter]
NOTE:

Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Five (5)
ENP 202102
Fifteen Modification Number: N/A
500$ 6,643$ $0
$0
1,000$ 38,508$ $0
City fo Burbank
[Enter title]
[Enter title]
500$ 11,282$ $0
[Enter title]
3,000$ 7,782$
[Enter title]
12,000$ 26,032$
2,000$ 4,143$
$0
Facility Attendant 20% 2,768$ 12
[Enter title]
Recreation Leader 20% 4,701$ 12 11,282$
12,000$ 25,508$
[Enter title]
[Enter title]
[Enter title]
500$ 38,532$
Food Service Aide- Driver 100% 3,923$ 12 47,076$ [Enter title]
Principal Clerk 50% 6,422$ 12 38,532$
6,643$
Work Trainee 100% 3,209$ 12 38,508$
I. BUDGET DETAIL - PERSONNEL
DIRECT
Program Manager/ Social Service
Supervisor- Nutrtion 50% 8,986$ 12 53,916$ 18,000$ $034,916$ 1,000$ 53,916$ Home Delivered Meal Services
2023-2024
Older Americans Act Title III C-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)
1,000$ 30,960$ $0
Senior Food Service Aide 50% 4,774$ 1,000$ 28,644$ $042,795$ 500$ 66,802$
12 28,644$ 10,000$ 17,644$
28,644$ 10,000$ $017,644$ 1,000$ 28,644$ 12 47,076$
$0
Food Service Supervisor/ site manager 50% 5,160$ 12 30,960$ 10,512$ 19,448$ Social Service Coordinator/ Case
Worker 97% 5,739$ 12 66,802$ 23,507$
$0Food Service Aide- Driver 100% 3,923$
Senior Food Service Aide 50% 4,774$ 12
1,000$ 47,076$ 16,000$ 30,076$ 16,000$ 30,076$ 1,000$ 47,076$ Food Service Aide- Driver 100% 3,923$ 12 47,076$ 16,000$ $030,076$ 1,000$ 47,076$ SUBTOTAL DIRECT PERSONNEL 445,160$ 149,019$ 286,140$ -$ (3) (3) (3) (3) 134$ $0
-$ -$ 10,001$
[Enter title]
-$
Benefits 40.00% 178,064$ 59,608$ 118,456$ (4) Taxes 0.03% 134$ 45$ 89$ Indirect Costs (Personnel)
[Complete as
needed] (5)
[Complete as
needed]
[Complete as
needed]
445,160$ $0
-$ -$ 10,001$ 623,357$ $0

INDIRECT
(4) (4) (4) 178,064$ $0
TOTAL DIRECT PERSONNEL 623,357$ 208,672$ 404,685$ (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). 623,357$ $0
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 623,357$ 208,672$ 404,685$ -$ -$ -$ 10,001$ Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 2 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Home Delivered Meal Services
Fifteen 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
Older Americans Act Title III C-2
Five (5)
ENP 202102
N/A
(J)

VARIANCE
(G)
MATCH (2)
(H)

NON-MATCH
DIRECT
City fo Burbank
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]

Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 3 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

ENP 202102
Fifteen Modification Number: N/A
City fo Burbank
III. BUDGET DETAIL - VOLUNTEER EXPENSES
Home Delivered Meal Services
2023-2024
Older Americans Act Title III C-2
Five (5)
(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)

INDIRECT

Do indirect costs exceed the ten percent (10%) maximum?

GRAND TOTAL

GRAND TOTAL VOLUNTEER
EXPENSES -$ -$ -$ -$
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 4 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2023-2024
Older Americans Act Title III C-2
Five (5)
ENP 202102
Fifteen Modification Number: N/A
City fo Burbank
Home Delivered Meal Services
TLC
[Enter caterer's name] Select Description
[Enter caterer's name]
[Enter caterer's name] Select Description
12$ 88,822$ 23,135$
DIRECT
[Enter caterer's name] Select Description
[Enter caterer's name]
[Enter caterer's name]
Select Description
Select Description
Select Description
(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
(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)

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
(2)
NOTE:
111,969$ $0-$
111,969$ $023,135$ 12$
[Complete as
needed]
111,969$ -$ 88,822$ 12$ -$ -$ 23,135$ -$ -$ -$

INDIRECT
111,969$ 88,822$
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$ 2,488 111,969$ 111,969$ $09 (J)

PROGRAM
INCOME
(1)
CASH
(B)

SERVICE CATEGORY
(G)
SSY4
SF(F)

TOTAL COSTS
(K)

TOTAL FUNDING
(L)

VARIANCE
Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 5 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

NOTE:
5,787$ $0
Frozen Meals 8.00$ 385 36,984$ $0
2023-2024
Older Americans Act Title III C-2
Five (5)
ENP 202102
Fifteen Modification Number: N/A
City fo Burbank
SF(F)
SSY4
(J)

TOTAL FUNDING
(K)

VARIANCE
(B*C*D) (1)
CASH
OTHER

TOTAL DIRECT RAW FOOD
Emergency Meals 8.00$ 450 1 3,600$ 3,280$ 320$ Grab and Go C-2 Meals 8.00$ 60 12 5,787$ 5,202$ 585$ (2)
CASH
NSIP
(1)
CASH
3,600$ $0
46,371$ $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
12 36,984$ 28,146$ 8,838$
DIRECT
Hot Meals
[Complete as
needed]
[Complete as
needed]
46,371$ 36,628$ 9,743$ -$ -$ -$ -$ [Complete as
needed]
-$
(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)
$0GRAND TOTAL RAW FOOD 46,371$ 36,628$ 9,743$ -$ -$ -$ -$ -$ 46,371$ [Complete as
needed] (1)
[Complete as
needed]
Do indirect costs exceed the ten percent (10%) maximum? Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 6 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Fifteen Modification Number: N/A
City fo Burbank
VI. BUDGET DETAIL - SPACE
Home Delivered Meal Services
2023-2024
Older Americans Act Title III C-2
Five (5)
ENP 202102
(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)
[Enter name and description]
[Enter name and description]
DIRECT
[Enter name and description]
[Enter name and description]
[Enter name and description]
$0

Do indirect costs exceed the ten percent (10%) maximum?

GRAND TOTAL
GRAND TOTAL SPACE -$ -$ -$ -$ [Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 7 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

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
Older Americans Act Title III C-2
Five (5)
ENP 202102
Fifteen Modification Number: N/A
City fo Burbank
VII. BUDGET DETAIL - EQUIPMENT
(K)

VARIANCE
(E - J)
DIRECT
[Enter description] Select
[Enter description]
(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)
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
[Enter description] Select
Select
[Enter description] Select
[Enter description] Select
[Enter description] Select
NOTE:
-$ $0

GRAND TOTAL
TOTAL DIRECT EQUIPMENT -$ -$ -$ -$ -$ -$ -$ [Enter description] Select
Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 8 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Five (5)
ENP 202102
Fifteen Modification Number: N/A
City fo Burbank
VIII. BUDGET DETAIL - OTHER COSTS
Home Delivered Meal Services
2023-2024
Older Americans Act Title III C-2
(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)
24,000$ 24,000$ $0
DIRECT
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 2,000.00$ 1 12 24,000$ $03,504$ 3,504$
125$ 125$ $01 1 125$
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 659.70$ 1 4 2,639$ Maintenance and Repairs (2 CFR 200.452 & 45 CFR

75.452) 292.00$ 1 12 3,504$
Training and Education (2 CFR 200.472 & 45 CFR 75.472) 125.00$ 2,639$ 2,639$ $0
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
-$ -$ 30,268$ 30,268$ $0

INDIRECT
TOTAL DIRECT OTHER COSTS 30,268$ -$ -$ -$ 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. -$ -$ 30,268$ 30,268$ $0
Do indirect costs exceed the ten percent (10%) maximum?

GRAND TOTAL
GRAND TOTAL OTHER COSTS 30,268$ -$ -$ -$ [Complete
as needed] (7)
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)
(6)
Select Description (2) (3) (4) (5)
(6)
(6)
(4): From January 1, 2023 through December 31, 2023, County’s approved mileage rate is $0.615 per mile. Effective January 1, 2024, County's approved mileage rate is $0.63 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). (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 (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)
NOTE:

Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 9 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 Variance (Costs-Funding)
Cash
In-Kind
Cash (SF)
444,965$
In-Kind (SF)
-$
In-Kind (SF)
-$
Cash Other
(SSY4) 334,122$
Cash NSIP
(SSY4) 32,878$
Cash NSIP
(SSY4) 32,878$ 9 Subtotal Direct Costs
Cash Other
(SSY4) 334,122$
5 Subtotal Funding for
Direct Costs
Cash (SF)
444,965$
Cash (SF) 40,269$
Cash (SF)
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
Cash (SF)
30,268$
7 Equipment
Cash Other
(SSY4) -$
4 Program Income
8 Other Costs
In-Kind (SF)
-$
In-Kind (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
Cash (SF) -$
Cash NSIP
(SSY4) 9,743$
Cash (SF)
-$
In-Kind (SF)
-$
5 Raw Food
Cash Other
(SSY4) 36,628$
3 Non-Match
6 Space
Cash Other
(SSY4) -$
2 Subtotal 367,000$
4 Lower Tier Subawards/Subcontracts for
Catered Food
Cash Other
(SSY4) 88,822$
Cash NSIP
(SSY4) 23,135$
Cash (SF)
12$
Match
In-Kind (SF)
-$
Cash (SF) 404,697$
-$ In-Kind (SF)
Cash Other
(SSY4) -$
Cash (SF)
414,685$
In-Kind (SF)
-$
Cash (SF)
-$
In-Kind (SF)
-$
City fo Burbank
IX. BUDGET SUMMARY
(A)

COST CATEGORIES
(B)
COSTS (1)
(C)

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
Cash NSIP
(SSY4) 32,878$
(1)
Total Budgeted
Costs
DIRECT
1 Personnel
Cash Other
(SSY4) 208,672$
1 SSY4
Cash Other
(SSY4) 334,122$
Volunteers In-Kind (SF)
-$
3 Volunteer Expenses
Home Delivered Meal Services
2023-2024
Older Americans Act Title III C-2
Five (5)
ENP 202102
Fifteen Modification Number: N/A
Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO 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
Cash NSIP
(SSY4) 32,878$
Cash (SF)
444,965$
Cash (SF)
444,965$

GRAND TOTAL
In-Kind (SF)
-$
Variance (Costs-Funding)
Cash
In-Kind
Subrecipient meets minimum match requirement. Match Met NOTE:
(1): Costs and Funding shall match.

In-Kind (SF)
-$
In-Kind (SF)
-$

GRAND TOTAL COSTS
811,965$

GRAND TOTAL FUNDING
811,965$
20 Total Costs
Cash Other
(SSY4) 334,122$
11 Total Funding
Cash Other
(SSY4) 334,122$
Cash NSIP
(SSY4)
Variance (Costs-Funding) $0
32,878$
Cash Other
(SSY4) -$
Cash (SF)
-$
Cash (SF)
-$
17 Subtotal Indirect Costs
Cash Other
(SSY4) -$
10 Subtotal Funding for
Indirect Costs
In-Kind (SF)
-$
Cash (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
16 Other Costs
Cash Other
(SSY4) -$
9 Program Income
In-Kind (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
Cash (SF) -$ Cash (SF)
-$
In-Kind (SF)
-$
14 Raw Food
Cash Other
(SSY4) -$
8 Non-Match
15 Space
Cash Other
(SSY4) -$
13 Lower Tier Subawards/Subcontracts for
Catered Food
Cash Other
(SSY4) -$
Cash (SF)
-$
In-Kind (SF)
-$
7 Match
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
Cash (SF)
-$
In-Kind (SF)
-$
In-Kind (SF)
-$
Cash Other
(SSY4) -$
In-Kind (SF) -$
Cash (SF) -$
10 Personnel
Cash Other
(SSY4) -$
6 SSY4Volunteers
12 Volunteer Expenses Cash (SF)

INDIRECT
Exhibit W2 (Budget) Amendment 15 {FY 2023-24 OTO Funding} 11 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
[Enter]
Ext.
[Enter]
Ext.
[Enter]
Ext. E-Mail Address
5/7/2024

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Lynn Tran
MPS Reviewed and Approved by: Sheri Stanton Date:

Prefix Phone NumberBudget Analyst Job Title
(818) 238 5402
Phone Number
Ms. Angela O'Connor
Phone Number
Social Service Supervisor- Nutrition [email protected] Prefix Project Manager Job Title E-Mail Address
Ms. Roxana Tabibi (818) 238 5358
EXHIBIT X1 (MANDATED PROGRAM SERVICES)
AMENDMENT 15 {FY 2023-24 OTO 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
Burbank CA 91506
Principal Accountant (8181) 2385490 [email protected] Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title E-Mail Address Ms. Erin Barrows
City
Congregate Meal Services
2023-2024
Older Americans Act Title III C-1
Select District
ENP202102
Ciy of Burbank
Fifteen N/AModification Number:

Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Equipment (Other) (9)
1200
Grab and Go C-1 Meals
SSY4 (6)
(Cash Other) 28,984 6.36$ 184,340$ SSY4
(Cash NSIP) 28,984 0.71$ 20,579$ Subtotal SSY4
(Cash Other and Cash NSIP) 7.07$ 204,919$ SF (7)
(Cash and In-Kind) 28,984 18.77$ 544,129$ Total (4) 1,200 25.84$ 749,048$ Subtotal SSY4
(Cash Other and Cash NSIP)
Total (4)
SSY4
(Cash NSIP)
Subtotal SSY4
(Cash Other and Cash NSIP)
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
[Enter Units]
[Enter Units]
[Select Ethnic
Meal Style]
SF (7)
(Cash and In-Kind)
[Enter Units]
-$
[Enter Unit Rate]
17,833
17,833
17,833
[Enter Unit Rate]
-$
113,420$
243,857$ 13.67$

0.71$ 12,661$
1,200

7.07$ 126,081$

6.36$

6.60$ 117,776$
Subrecipient's Legal Name:

Congregate Meal Services
2023-2024
Older Americans Act Title III C-1
Select District
ENP202102
Ciy of Burbank
Ethnic Meals
Total (4)
SSY4 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
[Enter Total
Unduplicated
Units]
[Enter Units]
[Enter Unit Rate]
Modification Number: N/AFifteen
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
SSY4 (6)
(Cash Other)
Total (4)
[Enter Total
Unduplicated
Units]
[Enter Unit Rate]
SSY4
(Cash NSIP) [Enter Unit Rate]
-$ -$

GRAND TOTAL SERVICES/FUNDING -
SSY4 (6)
(Cash Other)
Subtotal SSY4
(Cash Other and Cash NSIP)
2,400
SF (7)
(Cash and In-Kind)
992,905$
[Enter Unit Rate]
[Select Ethnic
Meal Style]Ethnic Meals
(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.

SSY4
(Cash NSIP)
[Enter Units]
[Enter Units]
(9) Enter the amount of equipment (other) that is reflected in Exhibit W1 (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 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]
Exhibit X1 (Mandated Program Services) Amendment 15 {FY 2023-24 OTO Funding} Page 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 6,903 8,001 96 350 267 509 509 16,635
2 200 391 807 1,198
3 300 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
1,200 6,903 8,001 487 350 1,074 0 0 0 0 0 509 509 17,833 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.

Grand Total
II. SERVICES BY MONTH - AMERICAN MEALS
(B)

SITE NAME
Joslyn Adult Center
McCambrideg
Tuttle Senior Center
ENP202102
Congregate Meal Services
2023-2024
Older Americans Act Title III C-1
Select District
Subrecipient's Legal Name: Ciy of Burbank
Modification Number:Fifteen N/A
Exhibit X1 (Mandated Program Services) Amendment 15 {FY 2023-24 OTO Funding} Page 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 3,016 3,247 6,993 3,000 3,000 19,256
2 200 1,487 1,733 754 700 700 5,374
3 300 1,982 2,304 34 34 4,354
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 6,485 7,284 7,747 0 0 0 0 0 3,734 3,734 28,984 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.

Grand Total
Fifteen Modification Number: N/A
Subrecipient's Legal Name: Ciy of Burbank
III. SERVICES BY MONTH - GRAB AND GO MEALS
(B)

SITE NAME
Joslyn Adult Center
McCambrideg
Tuttle Senior Center
ENP202102
Congregate Meal Services
2023-2024
Older Americans Act Title III C-1
Select District
Exhibit X1 (Mandated Program Services) Amendment 15 {FY 2023-24 OTO Funding} 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.

Modification Number:Fifteen
ENP202102
N/A
City of Burbank
Five
Older Americans Act Title III C-2
2023-24

HOME DELIVERED MEAL SERVICES
MPS Reviewed and Approved by: Sheri Stanton Date: 5/7/2024

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Lynn Tran
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
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
EXHIBIT X2 (MANDATED PROGRAM SERVICES)
AMENDMENT 15 {FY 2023-24 OTO 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
State Zip Code
1301 West Olive Avenue Burbank CA 91506
Main Administrative Office Address City
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Equipment (Other) (9)
Hot Meals
Subtotal SSY4
(Cash Other and Cash NSIP)
SSY4 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
241,781$
SSY4
(Cash Other)
Emergency Meals
Frozen Meals
12,445
459
459
459
Total (4)
SF
(Cash and In-Kind)
150
SF
(Cash and In-Kind)
598,780$ 18.38$

0.71$ 23,135$
150

8.13$

HOME DELIVERED MEAL SERVICES
2023-24
Older Americans Act Title III C-2
Five
ENP202102
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
Fifteen
City of Burbank
Modification Number: N/A
(B)

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
Total (4) 150 21.08$ 9,673$

8.99$ 4,126$
SSY4
(Cash NSIP) 0.71$ 326$

9.70$ 4,452$

GRAND TOTAL SERVICES/FUNDING -
SSY4
(Cash Other)
Subtotal SSY4
(Cash Other and Cash NSIP)
1,269
Grab and Go C-2 Meals
SSY4
(Cash Other) 819
SSY4
(Cash NSIP) 819
Subtotal SSY4
(Cash Other and Cash NSIP)
811,965$
96,118$
91,844$

6.67$
[Enter Amount]

15.10$
8,836$

7.38$
83,008$

0.71$

6.36$ 5,206$

0.71$ 581$

7.07$ 5,788$
(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)
12,445
12,445
(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).

11.38$ 5,221$

7.72$
187,962$
SF
(Cash and In-Kind) 819 11.92$ 9,762$ Total (4) 819 18.99$ 15,549$ 150
264,916$

7.42$

10.25$ 333,864$
32,585
32,585
32,585
Total (4)
SSY4
(Cash NSIP)
Subtotal SSY4
(Cash Other and Cash NSIP)
Exhibit X2 (MPS) Amendment 15 {FY 2023-24 OTO Funding} Page 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 Grand Total
NOTE:

II. SERVICES BY MONTH - HOT MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2023-24
Older Americans Act Title III C-2
City of Burbank
Fifteen Modification Number: N/A
Five
ENP202102
Exhibit X2 (MPS) Amendment 15 {FY 2023-24 OTO Funding} Page 3 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

III. SERVICES BY MONTH - FROZEN MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2023-24
Older Americans Act Title III C-2
City of Burbank
Five
ENP202102
Fifteen Modification Number: N/A
Exhibit X2 (MPS) Amendment 15 {FY 2023-24 OTO Funding} Page 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 Frozen Hot Frozen Hot Frozen Hot Frozen Hot Frozen 1 30 1911 1246 2399 980 2107 1044 2076 1149 2299 983 2285 437 2311 1137 2367 1500 7415 1200 7415 1200 32585 10876 2 13 523 523 523 0 1569
3 20 0 0
4 20 0 0
5 20 0 0
6 20 0 0
7 17 0 0
8 10 0 0
9 0 0
10 0 0
11 0 0
12 0 0
13 0 0
14 0 0
15 0 0
150 1911 1246 2399 980 2107 1044 2076 1149 2299 983 0 0 0 0 2285 437 2311 1137 2367 2023 7415 1723 7415 1723 32585 12445 (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 ENP202102
Fifteen Modification Number: N/A
City of Burbank
NOTE:
7 Grand Total
8 (2A)
1 (K)
FEB
(L)
MAR
6 (I)
DEC
(J)
JAN
3 4
5 2 (2B)
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
Five

HOME DELIVERED MEAL SERVICES
2023-24
Older Americans Act Title III C-2
Exhibit X2 (MPS) Amendment 15 {FY 2023-24 OTO Funding} Page 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 30 459 459
2 13 0
3 20 0
4 20 0
5 20 0
6 20 0
7 17 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 0 459 0 459
(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 Grand Total
NOTE:
2 (2B)
3 4
5 6
7 8 (2A)
1 V. SERVICES BY MONTH - EMERGENCY MEALS
(B)

ROUTE NAME

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 50 141 22 325 331 819
2 50 0
3 50 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
150 0 0 0 141 22 0 0 0 0 0 325 331 819
(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 VI. SERVICES BY MONTH - GRAB AND GO MEALS

HOME DELIVERED MEAL SERVICES
2023-24
Older Americans Act Title III C-2
Five
ENP202102
Fifteen Modification Number: N/A
City of Burbank
(B)

ROUTE NAME
Joslyn Adult Center
McCambridge Center
Tuttle Senior Center
NOTE:

Grand Total
Exhibit X2 (MPS) Amendment 15 {FY 2023-24 OTO Funding}

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

Mike Tsao
Administrative Deputy II

Anna Avdalyan
Assistant Director

Winna S. Crichlow
Assistant Director

Mariella Freire -Reyes
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

April 25, 2024

City of Burbank
Attention: Mr. Justin Hess
1301 West Olive Avenue
Burbank, CA 91506

FISCAL YEAR 2023-24 ONE-TIME-ONLY FUNDING

ALLOCATION FOR ELDERLY NUTRITION

PROGRAM SERVICES

Dear Mr. Hess:

County of Los Angeles Aging and Disabilities Department (County) intends to amend City of Burbank ’s (Subrecipient’s) Elderly Nutrition Program (ENP) Subaward. The Subaward
Amendment information is outlined below:

• Purpose: Subrecipient shall utilize One-Time-Only (OTO) funding to provide additional defined and contracted ENP Older Americans Act (OAA) Title III C -1 and Title III C -2 during Fiscal Year (FY) 2023-24.

• Subaward Number: ENP202102

• Amendment Number: Fifteen

• Subaward Term: July 1, 2023 through June 30, 2024

• Total Funding Allocation: $115,000

• Period Funds are available for use (Subject to execution of Amendment): July 1, 2023 through June 30, 2024

• Service Area: Supervisorial District 5

• Funding Source(s) and Service Category(ies) are as follows:

FY 2023-24 One-Time-Only Funding Allocation
Elderly Nutrition Program
City of Burbank

Page 2 ends

Funding
Source
Service
Category
Unit
Rate
NSIP
Rate
Total
Unit
Rate
Baseline
Allocation
OTO
Allocation
Total
Allocation
Amount
OAA Title
III C-1
American
Meals $6.36 $0.71 $7.07
$271,000 $60,000 $331,000 1
Ethnic Meals
Grab & Go C-1 $6.36 $0.71 $7.07
OAA Title
III C-2
Hot Meals $7.42 $0.71 $8.13
$312,000 $55,000 $367,000 2
Frozen Meals $6.67 $0.71 $7.38
Emergency
Meals $8.99 $0.71 $9.70
Grab & Go C-2 $6.36 $0.71 $7.07

OTO Funding $115,000
CDA ARPA Funding
(Refer to FY 2023-24 CDA ARPA Funding Allocation Letter) $394,000 Baseline Funding
(Refer to FY 2023-24 Baseline Funding Allocation Letter) $584,000 Subaward Sum Year 4 (SSY4)
(OTO, CDA ARPA, and Baseline Funding) $1,093,000

1- 2 Complete one (1) budget and one (1) MPS for each Total Allocation Amount.

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.

Mike Tsao
Mike Tsao, Administrative Deputy II
Administrative Services Branch

Burbank City CouncilJune 4, 2024

Burbank City Council
June 4, 2024