Agenda packet, closed session — Glendale City Council, October 6, 2026 (part 3 of 4)

D. UNALLOWABLE COSTS
The allowability of a variety of different costs are addressed in the following:
 AAA Program: Title 2 Code of Federal Regulations Part 200.421 et seq. and Title 45 Code of Federal Regulations Part 75.421 et seq.  WIOA and all Other Programs: Title 2 Code of Federal Regulations Part 200.421 et seq.

For all costs, there are certain restrictions and limitations; however, the following costs are not allowable under any circumstances:
 Bad debts
 Contingency provisions (exceptions may include self-insurance, pension funds and reserves for normal severance pay)
 Contributions and donations rendered
 Fines and penalties (e.g., including but not limited to NSF Check Fees, Traffic Citation Fees)
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 Lobbying and fundraising activities
 Interest expense (unless expressly allowed by Federal guidelines)  Losses on other awards
 Capital expenditures
 Advertising and public relations
 Entertainment/alcoholic beverages
Additionally, Subrecipient shall not use Subaward Sums to repay disallowed costs.

E. REPORTING FRAUD, ABUSE, MISCONDUCT OR NON-COMPLIANCE

1.0 Subrecipient shall report suspected fraud (including welfare fraud), abuse, waste, or misuse of public monies, and misconduct of County personnel to the Los Angeles County Fraud Hotline. Subrecipient shall also report suspected fraud, abuse, waste, or misuse of public monies, and misconduct committed by its employees, volunteers, and any Lower Tier Subrecipients when that fraud affects its Subaward with County.

Reportable conditions of fraud include, but are not limited to:
 Requests for bribes/kickbacks/gratuities by County personnel  Favoritism/nepotism in the awarding of County contracts, selection of vendors or hiring of Subrecipient’s employees
 Theft or misuse of any funds, resources or equipment
 Falsification of records
 Violation of conflict of interest requirements; etc.

2.0 Failure to report the types of fraud/misconduct discussed above may be grounds for termination of this Subaward as solely determined by County.

3.0 Reports can be made anonymously to the Los Angeles County Department of Auditor-Controller, Office of County Investigations as follows:

Website: www.lacountyfraud.org
E-Mail Address: [email protected]
Fraud Hotline: (800) 544-6861
Fax: (213) 633-0991
Mail: Office of County Investigations
500 W. Temple St., Room 515
Los Angeles, CA 90012

4.0 User Complaint Report

4.1 County’s staff shall complete the User Complaint Report (UCR) to report Subrecipient’s non-compliance with the requirements of this Subaward.

Areas of Subrecipient’s non-compliance include, but are not limited to, the following:

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 Subrecipient’s Project Manager or other staff not responding to messages/requests from County staff.
 Subrecipient’s Project Manager or other staff does not attend trainings/meetings required by County.
 Subrecipient staff changes without prior notification to County.  Illegal or inappropriate behavior by Subrecipient’s staff.  Subrecipient not submitting reports/documents or maintaining records as required.
 Subrecipient not complying with the quality assurance requirements as specified in this Subaward.

4.2 County’s Compliance Manager shall maintain the UCR, and it will be used to evaluate Subrecipient’s performance of the requirements of this Subaward in addition to being used as the basis for placing Subrecipient on probation, suspending payment, suspending this Subaward, terminating this Subaward or any other remedies that are available in this Subaward. The UCR may also be used during County’s solicitation process to evaluate Subrecipient's past performance on this Subaward in addition to being used when Subrecipient requests a reference from County for purposes of applying for other grants.

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FY 2020-2021

EXHIBIT R
(JOINT FUNDING REVENUE DISCLOSURE)
List all revenue provided to Subrecipient on an annual basis (including the Subaward Sums, foundation grants, donations, etc.). Use additional pages as necessary.

Revenue Source (Agency or Organization
Name, Contact Name and Phone Number)
Funding Amount Funding Period
Start Date End Date
LA County WDACS Elderly Nutrition Program $291,000 7/1/2020 6/30/2021 City of Glendale General Fund $84,577 7/1/2020 6/30/2021 Congregate/Home Delivered Meals Donations $40,700 7/1/2020 6/30/2021 Meals on Wheel America COVID Response
Fund $90,000 4/24/2020 8/21/2021
LA County WDACS Supportive Services
Program $49,000 7/1/2020 6/30/2021
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PAGE TOTAL Click here to enter amount.

GRAND TOTAL OF ALL PAGES $555,277
City of Glendale ENP202106
Subrecipient’s Legal Name Subaward Number
Aylin Isayan 6/16/2020
Name of Preparer (Print) Date Prepared
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EXHIBIT S
(PURCHASE, INVENTORY AND DISPOSAL REQUIREMENTS

FOR FIXED ASSETS, NON-FIXED ASSETS AND SUPPLIES)
I. GOVERNING REGULATIONS AND POLICIES
A. If this Subaward indicates that Subrecipient may purchase Fixed Assets, Non-Fixed Assets and Supplies using Subaward Sums, pursuant to Subparagraph 9.5 (Fixed Assets, Non-Fixed Assets and Supplies) of the Subaward, Subrecipient shall adhere to all Federal, State and County purchasing and fiscal policies, procedures and requirements. Regardless of the source of the Subaward Sums (i.e., Federal, State or County/local monies), Subrecipient shall adhere to these purchasing, inventory and disposal requirements for all Fixed Assets, Non-Fixed Assets and Supplies which are defined in Section II (Fixed Asset, Non-Fixed Asset and Supplies), herein. Such requirements include, but are not limited to, the following:

1.0 Area Agency on Aging (AAA) Programs:

1.1 The requirements of this Exhibit S.

1.2 Administrative requirements, procurement standards
and cost principles (Administrative Requirements)
outlined in Title 2 Code of Federal Regulations Part
200 et seq. and Title 45 Code of Federal
Regulations Part 75 et seq.

1.3 Additional requirements which may be communicated
to Subrecipient through County memorandum,
directives, Change Notices, Subaward Amendments,
etc.

2.0 Workforce Innovation and Opportunity Act (WIOA) Programs:

2.1 The requirements of this Exhibit S.

2.2 Administrative requirements, procurement standards
and cost principles (Administrative Requirements)
outlined in Title 2 Code of Federal Regulations Part
200 et seq. and Title 2 Code of Federal Regulations
Part 2900 et seq.

2.3 Additional requirements which may be communicated
to Subrecipient through County memorandum,
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directives, Change Notices, Subaward Amendments,
etc.

3.0 All Other Programs:

3.1 The requirements of this Exhibit S.

3.2 Administrative requirements, procurement
standards and cost principles (Administrative
Requirements) outlined in Title 2 Code of Federal
Regulations Part 200 et seq.

3.3 Additional requirements which may be communicated to Subrecipient through County memorandum, directives,
Change Notices, Subaward Amendments, etc.

B. Throughout this Exhibit S, references will be made to the Administrative Requirements. These references shall mean that Subrecipient shall follow Administrative Requirements that apply to Subrecipient based on the type of Program being funded through this Subaward (e.g., Area Agency on Aging Programs, Workforce Innovation and Opportunity Act Programs, etc.) and the type of entity that best describes Subrecipient’s organization (e.g., non-profit, local government, educational institution, etc.).

C. The requirements outlined in this Section I, herein, are applicable to Fixed Assets and Non-Fixed Assets. When specific requirements related to Supplies are not addressed, Subrecipient shall exercise the same due diligence and care required for the purchase, inventory and disposal of Fixed Assets and Non-Fixed Assets when Subrecipient uses Subaward Sums to purchase Supplies.

D. In the event of any conflict or inconsistency between the requirements established in this Exhibit S and any of the governing Administrative Requirements, the conflict shall be resolved by giving precedence to the governing Administrative Requirements.

II. FIXED ASSET, NON-FIXED ASSET AND SUPPLIES
A. Fixed Asset

1.0 A Fixed Asset is an item which has all of the following attributes:

1.1 Includes, but is not limited to, property, plant,
equipment, land, buildings, additions, attachments,
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improvements, betterments, machinery, vehicles,
furniture, tools, intangibles, mineral resources, etc.
used to conduct business under this Subaward and are
not consumed/sold during the normal course of
Subrecipient’s business under this Subaward. Such
asset must provide a direct benefit to the Program and
Services.

1.2 Has a normal useful life of at least one (1) year and has a unit acquisition cost that is $5,000 or more.

1.2.1 For purposes of determining how to classify
items as either a Fixed Asset or a Non-Fixed
Asset, a unit is defined as either one (1) item or
a group of individual items which are purchased
together as a bundle in order to be used
together. As an example, a desktop computer
system which includes a tower along with other
peripheral items such as a monitor and/or
printer or a laptop system which also includes
additional peripherals are considered one (1)
unit when each of these systems are purchased
as a unit.

1.2.2 The unit acquisition cost is the net invoice price of a unit, which includes shipping costs and
sales taxes, any applicable credits and
discounts as well as the cost of any
modifications, attachments, accessories, or
auxiliary apparatus which are necessary to
make this unit usable for the purpose for which
it is acquired.

1.2.3 To determine the unit acquisition cost of an
asset, consider the following example: four (4)
identical pieces of equipment, which cost $3,000
each, totaling $12,000 would not meet the
$5,000 unit acquisition cost threshold.

1.3 Is either purchased with Subaward Sums and/or was
acquired by Subrecipient under a Predecessor
Agreement(s) for the same/similar purpose as this
Subaward. Such purchases must be allowable and
allocable under the requirements of this Subaward.

For purposes of this Subaward, a Predecessor
Agreement(s) shall mean a subaward between County
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and Subrecipient that was executed prior to this
Subaward for the same/similar Program Services as
this Subaward, and such subaward has expired or
terminated.

2.0 Must be ordered or purchased no later than May 31st of the Fiscal Year.

B. Non-Fixed Asset

1.0 A Non-Fixed Asset is an item which has all of the following attributes:

1.1 Does not meet all of the requirements for a Fixed
Asset, which are outlined above in Subsection II.A
(Fixed Asset), herein, and includes, but is not limited to, computers, laptops, copier machines, printers, etc.
used to conduct business under this Subaward. Such
asset must provide a direct benefit to the Program and
Services.

1.2 Has a normal useful life of over one (1) year and has a unit acquisition cost that is less than $5,000 but is at least $500.

1.2.1 For purposes of determining how to classify
items as either a Fixed Asset or a Non-Fixed
Asset, a unit is defined as either one (1) item or
a group of individual items which are purchased
together as a bundle in order to be used
together. As an example, a desktop computer
system which includes a tower along with other
peripheral items such as a monitor and/or printer
or a laptop system which also includes additional
peripherals are considered one (1) unit when
each of these systems are purchased as a unit.

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1.2.3 To determine the unit acquisition cost of an
asset, consider the following example: four (4)
identical pieces of equipment, which cost $3,000
each, totaling $12,000 would meet the
requirements for the unit acquisition cost
described herein.

1.3 All computing devices, regardless of cost (including but not limited to, workstations, servers, laptops, personal digital assistants, notebook computers, tablets,
smartphones and cellphones).

1.4 All Portable electronic storage media, regardless of cost (including but not limited to, thumb/flash drives and portable hard drives).

1.5 Is either purchased with Subaward Sums and/or was
acquired by Subrecipient under a Predecessor
Agreement(s). Such purchases must be allowable and
allocable under the requirements of this Subaward.

1.6 Must be ordered or purchased no later than May 31st of the Fiscal Year.

2.0 Whatever amount is approved for the equipment must be the same amount that’s reflected on the Budget.

3.0 You must submit a minimum of three (3) bids when
requesting approval for equipment.

C. Usage of the Term “Assets”

1.0 Throughout the entirety of this Exhibit S, references will be made to items that are classified as either Fixed Assets or Non-Fixed Assets. The use of these classifications is based on whether the item meets the requirements outlined in
Subsection II.A (Fixed Asset), herein, and Subsection II.B (Non-Fixed Asset), herein. In some instances where a specific type of asset is being discussed or addressed, the
appropriate term will be used to identify that asset as either a Fixed Asset or a Non-Fixed Asset. Otherwise, any usage of the specific term “Assets” shall mean that the requirements apply to both Fixed Assets and Non-Fixed Assets, collectively (hereafter “Assets”).

1.0 Additions and Attachments are products that typically involve physical extensions of existing units that are necessary to make these units usable for the purposes for which they are acquired, but do not involve renovations.

1.1 An Addition or an Attachment is considered a Fixed
Asset when its cost, combined with the cost of the unit it is attached to, along with its other characteristics, meet the definition of a Fixed Asset as set forth
herein.

1.2 Examples of Additions and Attachments include new
rooms, new roof, new heating, ventilation and air
conditioning (HVAC) system added to an existing
building, etc.

2.0 Improvements and Betterments are products that typically do not increase the physical size of the unit.

2.1 Requirements for AAA Programs, WIOA Programs and
all Other Programs

2.1.1 Improvements and Betterments enhance the
condition of a unit (e.g., extend life, increase
service capacity, lower operating costs, etc.).

2.1.2 An Improvement or a Betterment is considered
a Fixed Asset when the final cost of the unit
being improved or bettered along with its other
characteristics, meet the definition of a Fixed
Asset as set forth in Subsection II.A (Fixed
Asset), herein.

2.1.3 Examples of Fixed Assets that might be
improved or bettered include roads, bridges,
curbs and gutters, tunnels, parking lots, streets
and sidewalks, drainage and lighting systems,
etc.

3.0 Intangible Property is an item which lacks physical substance but gives valuable rights to the owner; and, such item can be either a Fixed Asset or a Non-Fixed Asset.

3.1 The acquisition cost of the Intangible Property
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includes all amounts incurred to acquire and to ready
the Asset for its intended use. Typical Intangible
Property costs include the purchase price, legal fees,
and other costs incurred to obtain title to the Asset.

3.2 Examples of Intangible Property include patents,
copyrights, leases, computer software, etc.

4.0 Hardware consists of tangible equipment including
computers, printers, terminals, etc.; and, such item can be either a Fixed Asset or a Non-Fixed Asset.

E. Supplies

1.0 Supplies are items which have all of the following attributes:

1.1 Are goods, materials or other items which are
consumed during the normal course of business and
may include, but are not limited to, paper, pencils,
printer cartridges, file folders, etc. (i.e., Supplies are items which are used in such a way that once used,
they cannot be re-used or recovered afterward).

1.2 Have a unit acquisition cost that is less than $500.

1.3 Are necessary for Subrecipient to effectively and
efficiently carry out the objectives, tasks and activities of the Program and provide Services hereunder.

1.4 Are either purchased with Subaward Sums and/or were acquired by Subrecipient under a Predecessor
Agreement(s).

III. GENERAL REQUIREMENTS FOR ASSETS AND SUPPLIES
A. The following requirements are applicable to both Assets and Supplies. In some areas, the requirements are only applicable to Assets; however, Subrecipient shall exercise due diligence in the use and maintenance of Supplies when specific requirements related to Supplies are not addressed.

B. Management of Assets and Supplies

1.0 To prevent misuse, destruction or theft, Subrecipient shall exercise due diligence in its care, use, maintenance,
protection and preservation of all Assets and Supplies.

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2.0 During the entire term of this Subaward, Subrecipient is responsible for the replacement or repair of Assets until Subrecipient has complied with all written instructions from County regarding the final disposition of the Assets as detailed in Section X (Disposal Requirements for Assets and Supplies) herein.

3.0 Subrecipient shall not use Assets or Supplies for personal gain or to usurp the competitive advantage of a privatelyowned business entity.

4.0 Subrecipient shall use Assets and Supplies for the purpose for which they are intended under this Subaward. When no longer needed for that purpose, Subrecipient shall treat them as prescribed in Section X (Disposal Requirements for Assets and Supplies), herein.

5.0 Subrecipient may share use of Assets or allow use by other programs upon prior written approval of County. As a
condition of approval, County may require payment under this Subaward for that use.

C. Loss, Destruction or Theft of Assets

1.0 Subrecipient shall promptly investigate, fully document and report the loss, destruction or theft of Assets. Subrecipient shall report such loss, destruction or theft as follows:

1.1 Subrecipient shall notify the local law enforcement agency with jurisdiction over the location where the
crime occurred by telephone (and confirmed in writing
by filing a police report) within twenty-four (24) hours of occurrence or discovery of such incident.

1.2 Subrecipient shall notify County’s Contract Manager by telephone (and confirmed in writing) or by e-mail within five (5) business days of occurrence or discovery of
such crime. Subrecipient shall prepare an Incident
Report, as described below, which shall be provided to
County’s Contract Manager.

1.3 Incident Report

1.3.1 At a minimum, Subrecipient’s Incident Report of
such loss shall contain the following elements:

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1.3.1.1 Identification of the Asset(s)

1.3.1.2 Recorded value(s) of each Asset

1.3.1.3 Facts relating to the crime

1.3.1.4 A copy of the police report, where
appropriate

1.3.2 Subrecipient shall retain the Incident Report
pursuant to the record retention requirements
outlined in Subparagraph 8.38 (Record
Retention, Inspection and Audit Settlement) of
the Subaward.

2.0 Subrecipient agrees to indemnify County for any loss resulting from the use of any Assets.

IV. DEPRECIATION, USE ALLOWANCE AND CAPITALIZATION POLICY

FOR ASSETS
A. Any Asset purchased with the Federal portion of Subaward Sums, if any, and/or with Subrecipient’s required matching contributions may not be depreciated or capitalized.

B. Any Asset purchased with the non-Federal portion of Subaward Sums, if any, may be capitalized and/or depreciated over the estimated useful lives of these Assets pursuant to Subrecipient’s acquisition policies.

C. Unless otherwise approved by County, compensation for the use of buildings and other capital improvements may be made through depreciation, or a use allowance:

1.0 The computation of depreciation/use allowance is based on the acquisition cost of the asset(s).

2.0 The computation should exclude the cost of land, buildings, and equipment donated by federal, State or County
governments and the cost of buildings and land contributed by Subrecipient to satisfy funding matching requirements.

3.0 For depreciation, an appropriate useful life must be established for the asset(s) which considers factors such as the nature of the asset used, susceptibility to technological obsolescence, etc.

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4.0 A use allowance is computed as an annual rate that may not exceed an annual rate of two-percent (2%) of the acquisition cost if the asset is a building or improvement. A use
allowance in excess of the ceiling percentage must be justified by Subrecipient.

V. TITLE TO ASSETS
A. Assets Purchased with Subaward Sums

1.0 Unless otherwise required by Federal or State laws or regulations, or as agreed upon in writing by the parties, Assets remain the property of County until such time as County approves the final disposition of the Assets (i.e., County retains title to all Assets used in the performance of this Subaward).

B. Assets Purchased Under a Predecessor Agreement(s)

1.0 Unless otherwise required by Federal or State laws or regulations or as agreed upon in writing by the parties, Assets purchased under a Predecessor Agreement(s) remain the property of County until such time as County approves the final disposition of these Assets (i.e., County retains title to all Assets purchased under a Predecessor Agreement(s)).

C. Title to Vehicles

1.0 County retains title to vehicles that are purchased with Subaward Sums. County also retains title to vehicles
purchased with funds from a Predecessor Agreement(s),
when such vehicles are currently in the possession of
Subrecipient.

2.0 Vehicles shall be registered only in the name of Subrecipient.

Such registration applies to all vehicles which are purchased with Subaward Sums as well as those purchased under a
Predecessor Agreement(s), when such vehicles are currently in the possession of Subrecipient.

3.0 For each vehicle(s) purchased with the Subaward Sum(s) under this Subaward and/or under a Predecessor Agreement that is used in the operation of the Program (i.e., Countyowned vehicle(s)), Subrecipient shall ensure that such vehicle(s) undergo a certified smog inspection as required under applicable State and Los Angeles County laws.

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Subrecipient must receive evidence of a passing inspection (i.e., smog certificate) for each vehicle and shall submit a copy of the smog certificate to County’s Compliance Manager on an annual basis in the manner and timeframe designated by
County. When the vehicle(s) is not required to undergo a smog inspection during any year, Subrecipient shall provide evidence (copy of vehicle registration, etc.) indicating that the inspection is not warranted for the specified year.

D. Throughout the entire term of this Subaward, Subrecipient shall adhere to the following:

1.0 Subrecipient shall provide current, ongoing and adequate insurance covering all vehicle drivers pursuant to
Subparagraph 8.24 (General Provisions for all Insurance Coverage) and Paragraph 8.25 (Insurance Coverage) of the Subaward.

2.0 Subrecipient shall ensure that each vehicle driver has a current, valid California driver's license.

VI. APPROVAL REQUIREMENTS FOR PURCHASING ASSETS
A. Necessary Prior Approval to Purchase Assets for Area Agency on Aging Programs

1.0 Prior to purchasing or acquiring any Assets, Subrecipient must receive written approval from County authorizing the purchase when Subrecipient will use any amount of Subaward Sums to purchase the Asset. Prior approval is also required for the following:

1.1 All computing devices, regardless of cost (including but not limited to, workstations, servers, laptops, personal digital assistants, notebook computers, tablets,
smartphones and cellphones).

1.2 All Portable electronic storage media, regardless of cost (including but not limited to, thumb/flash drives and portable hard drives).

2.0 Prior approval is not required for the purchase of Supplies.

However, Subrecipient shall adhere to all of the other
procurement policies governing the purchase of Supplies as outlined herein and in accordance with Administrative
Requirements.

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3.0 Subrecipient shall submit a written request to County’s Contract Manager to request authorization to purchase such Asset. Subrecipient shall submit this written request at least thirty (30) days in advance of the date/time that Subrecipient intends to purchase the Asset.

3.1 For WIOA Programs, Subrecipient shall submit a
written request to County’s Contract Manager following
the instructions provided in WIOA Directive number DDWA-04-024/D-YTH-04-08 (dated August 24, 2004).

Copies of this Directive are available on the Work
Source California website, which may be accessed
using the following address:
http://www.worksourcecalifornia.com/information/directi ves.htm

4.0 Upon receiving written approval from County, Subrecipient shall ensure that all Asset purchases are also approved in writing by Subrecipient’s Board of Directors or its Authorized Representative, before the Asset is purchased.

5.0 County’s approval of Subrecipient’s Budget does not constitute approval for Subrecipient to purchase the Asset.

Once all written approvals have been received, Subrecipient shall then include the Asset in its Budget and proceed with the purchase.

6.0 Examples

6.1 If Subrecipient intends to purchase an item which costs $475 and Subrecipient will use $475 of Subaward
Sums to purchase this item, prior approval is not
required.

6.2 If Subrecipient intends to purchase an item, which costs $550 and Subrecipient will use $500 of Subaward
Sums to purchase this item, prior written approval is
required.

VII. APPROVAL REQUIREMENTS FOR DISPOSING OF ASSETS
A. Necessary Prior Approval to Dispose of Assets for AAA Programs:

1.0 Subrecipient shall obtain prior written approval from County (and State) in order to sell, trade-in, discard, or transfer to another entity any Asset with a unit acquisition cost of at least DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE of
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$500 and/or any item which meets the standards outlined in the Subaward pertaining to Information Technology.

Subrecipient shall not dispose of any Asset or Information Technology product unless/until Subrecipient receives such written approval.

2.0 Subrecipient shall contact County’s Contract Manager to obtain specific instructions on how to request prior approval, and Subrecipient shall adhere to all County and State
requirements for the disposal of these Assets/Information Technology product.

3.0 Prior to the sale, trade-in, discard or transfer of any Asset consisting of electronic equipment with digital memory or storage capability, Subrecipient shall send a written
notification to County’s Contract Manager attesting that the device’s memory and/or any information stored in the memory is permanently removed, erased and cleared of all Subaward, Program and Client related records and information (or any information that would compromise Subrecipient’s ability to adhere to the confidentiality requirements of this Subaward, including Subparagraph 7.6 (Confidentiality) of the Subaward, Exhibit G1 (Subrecipient Acknowledgement and
Confidentiality Agreement), and Exhibit N (Business
Associate Agreement Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)) – if/when Exhibit N (Business Associate Agreement Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)) is included with this Subaward.

4.0 Upon receipt of written approval from County, Subrecipient shall follow all guidelines to dispose of Assets and Supplies pursuant to Section X (Disposal Requirements for Assets and Supplies), herein.

B. Necessary Prior Approval to Dispose of Assets for WIOA Programs

1.0 Subrecipient shall obtain prior written approval from County in order to sell, trade-in, discard or transfer to another entity any Asset with a unit acquisition cost of at least $500.

Subrecipient shall not dispose of any Asset unless/until Subrecipient receives such written approval.

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2.0 Subrecipient shall contact County’s Contract Manager to obtain specific instructions on how to request prior approval from County, and Subrecipient shall adhere to all County requirements for the disposal of these Assets.

3.0 Prior to the sale, transfer, donation or other disposal of any Asset consisting of electronic equipment with digital memory or storage capability, Subrecipient shall send a written notification to County’s Contract Manager attesting that the device’s memory and/or any information stored in the
memory is permanently removed, erased and cleared of all Subaward, Program and Client related records and
information (or any information that would compromise
Subrecipient’s ability to adhere to the confidentiality requirements of this Subaward, including Subparagraph 7.6 (Confidentiality) of the Subaward, Exhibit G1 (Subrecipient Acknowledgement and Confidentiality Agreement) and
Exhibit N (Business Associate Agreement Under the Health Insurance Portability and Accountability Act of 1996
(HIPAA)) – if/when Exhibit N (Business Associate
Agreement Under the Health Insurance Portability and
Accountability Act of 1996 (HIPAA)) is included with this Subaward.

C. Necessary Prior Approval to Dispose of Assets for all Other Programs:

1.0 Subrecipient shall obtain prior written approval from County in order to sell, trade-in, discard or transfer to another entity any Asset with a unit acquisition cost of at least $500, or $300 if purchased under a Predecessor Agreement(s) (regardless of the residual or current fair market value of the Asset).

Subrecipient shall not dispose of any Asset unless/until Subrecipient receives such written approval.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE of
Exhibit S (Purchase, Inventory and Disposal Requirements for Fixed Assets, Non-Fixed Assets and Supplies)
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3.0 Prior to the sale, transfer, donation or other disposal of any Asset consisting of electronic equipment with digital memory or storage capability, Subrecipient shall send a written notification to County’s Contract Manager attesting that the device’s memory and/or any information stored in the
memory is permanently removed, erased and cleared of all Subaward, Program and Client related records and
information (or any information that would compromise
Subrecipient’s ability to adhere to the confidentiality requirements of this Subaward, including Subparagraph 7.6 (Confidentiality), Exhibit G1 (Subrecipient
Acknowledgement and Confidentiality Agreement), and
Exhibit N (Business Associate Agreement Under the Health Insurance Portability and Accountability Act of 1996
(HIPAA)) – if/when Exhibit N (Business Associate
Agreement Under the Health Insurance Portability and
Accountability Act of 1996 (HIPAA)) is included with this Subaward.

D. Necessary Prior Approval to Use Program Income from Sales Revenue

1.0 Subrecipient shall obtain prior written approval from County in order to use Program Income derived from revenue earned after the sale of Assets pursuant to Exhibit Q (Accounting, Administration and Reporting Requirements).

4.0 Subrecipient shall contact County’s Program Manager to obtain specific instructions on how to request prior approval from County, and Subrecipient shall adhere to all County requirements for the use of such Program Income.

VIII. PURCHASE REQUIREMENTS FOR ASSETS
A. The following requirements are applicable only to Assets.

However, Subrecipient shall exercise due diligence in the purchase of Supplies when specific requirements related to Supplies are not addressed.

1.0 Subrecipient shall perform a cost or price analysis prior to the purchase of an Asset.

1.1 A cost analysis includes the review and evaluation of each element of cost to determine its reasonableness,
allocability and allowability. Subrecipient shall ensure that the cost of the Assets are allowable and allocable pursuant to the cost principles outlined in
Administrative Requirements.

1.2 A price analysis includes the comparison of price
quotations submitted, market prices, and similar
indicia, together with discounts.

2.0 Subrecipient shall conduct an analysis of lease and purchase alternatives to determine the most economical and practical procurement method.

3.0 Subrecipient shall avoid purchasing unnecessary or
duplicative items. Subrecipient shall ensure that the costs for Assets are reasonable and proper and that the Assets are necessary to carry out the purposes and activities of the Program (or are necessary and reasonable for the proper and efficient accomplishment of Program objectives).

4.0 Subrecipient shall ensure that all costs associated with the purchase of an Asset are included in the Asset’s true actual cost (i.e., the true actual cost of the Asset should include all amounts to be incurred to acquire and to ready the Asset for its intended use). The true actual cost shall also include any deductions for discounts, refunds, adjustments, rebates and allowances received by Subrecipient as well as any charges for taxes, delivery/shipping, etc.

5.0 Subrecipient shall only charge the true actual cost of the Asset to this Subaward. If the true actual cost of the Asset is allocable to multiple funding sources, the share of costs charged to this Subaward shall not be charged by
Subrecipient to another grant, program or contract.

C. Competitive Procurement

1.0 Subrecipient shall conduct all procurements for Assets in a manner that provides full, open and free competition
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE of
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consistent with the procurement standards outlined in
Administrative Requirements.

2.0 Subrecipient shall ensure that it obtains and thoroughly evaluates a minimum of three (3) written competitive bids from the best known sources prior to purchasing the Asset.

3.0 Subrecipient shall avoid organizational conflicts of interest and non-competitive practices among vendors that may
restrict or eliminate competition or otherwise restrain trade.

4.0 Subrecipient or Subrecipient’s agent who develops or drafts specifications, requirements, statements of work, invitation for bids and/or request for proposals for the procurement of Assets shall be excluded from competing for such
procurements.

5.0 Subrecipient shall select the most responsible vendor whose bid is most responsive to the requirements outlined in the solicitation.

6.0 Sole Source Procurement (Non-competitive Procurement)

6.1 Sole source procurement is the solicitation of a
proposal from only one (1) source or after solicitation from a number of sources, competition is determined
inadequate.

6.2 Sole source procurement may only be used when the
procurement is not feasible under the small purchase
procedures, sealed bids or competitive proposals (as
defined in Administrative Requirements and at least
one (1) of the following applies:

6.2.1 The Asset is available only from a single
source/vendor.

6.2.2 Public exigency or emergency for the Asset will
not permit a delay resulting from a competitive
solicitation.

6.2.3 County provides written authorization for noncompetitive procurement of the Asset.

6.2.4 After solicitation of a number of sources, and
with written approval from County, competition
is determined inadequate.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE of
Exhibit S (Purchase, Inventory and Disposal Requirements for Fixed Assets, Non-Fixed Assets and Supplies)
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6.3 The sole source procurement must be documented,
and such documentation shall include a full
justification providing an explanation as to why this
non-competitive procurement method was used.

7.0 Subrecipient shall ensure that solicitations for Assets provide:

7.1 Clear and accurate description of the technical
requirements for the Asset to be procured and such
description shall not contain features which unduly
restrict competition.

7.2 Requirements which the bidder must fulfill and all
other factors to be used in evaluating bids.

7.3 Description of the functions to be performed (i.e., performance required), including the minimum
acceptable standards.

7.4 Description of specific features of “brand name”
products or an equivalent that bidders are required to
meet when such items are included in the solicitation.

7.5 Acceptance, to the extent possible and as
economically feasible, of Assets dimensioned in the
metric system of measurement.

7.6 Preference, to the extent possible and as
economically feasible, for Assets that conserve
natural resources, protect the environment and are
energy efficient.

8.0 Subrecipient shall make an effort to utilize small businesses, minority-owned firms and women’s business enterprises
whenever possible, pursuant to the procurement procedures outlined in the applicable Administrative Requirements.

D. Procurement Instrument

1.0 Subrecipient shall determine the type of procuring or contracting instrument to be used for the purchase. Such instrument may include purchase orders, fixed price
subawards, cost reimbursable subawards, etc.

2.0 Subrecipient shall determine and use the most appropriate instrument for the particular procurement and such
instrument shall promote the best interests of the Program.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE of
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3.0 “Cost-plus-a-percentage-of-cost” or “percentage of
construction cost” methods of contracting shall not be used.

E. Documentation Requirements

1.0 Subrecipient shall maintain proper forms of documentation to demonstrate the significant history of the procurement for all Assets (e.g., requisitions, purchase orders, receipts, price quotes/vendor bids, etc.).

2.0 Subrecipient shall have written internal procurement procedures in place (including processes for vendor
selection, requisition approval, etc.).

3.0 Subrecipient shall maintain documentation of its cost/price analysis and any sole source procurement.

4.0 Subrecipient’s Budget

4.1 Subrecipient shall report Assets purchased with
Subaward Sums on the Budget. Prior to reporting
Assets on the Budget, Subrecipient shall receive
written approval from County in order to purchase
Assets as detailed in Section VI (Approval
Requirements for Purchasing Assets), herein.

4.2 Assets purchased by Subrecipient shall match the
Assets reported on the Budget.

4.3 The total cost of Assets purchased shall not exceed the amounts reported on the Budget. Subrecipient
shall be liable for the cost of any Asset when that cost exceeds the amount approved by County for the
purchase of the Asset.

4.4 In the event that the actual purchase price is less than the cost reported on the Budget, Subrecipient shall
submit a Budget Modification to County’s Contract
Manager before the end of the Fiscal Year pursuant to
Subparagraph 9.9 (Modifications) of the Subaward.

5.0 Additional Documentation Requirements for Area Agency on Aging Programs

5.1 In addition to the documentation requirements
outlined above, the following requirements shall also
apply to AAA Programs:

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE of
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5.1.1 Subrecipient shall submit supporting
documents including, but not limited to,
receipts, purchase orders, invoices, etc. for all
Assets.

5.1.2 The supporting documents shall be submitted
to County’s Contract Manager at the same time
that Subrecipient submits its invoice to County
for the Asset.

F. Assets must be physically received prior to the end of the Fiscal Year during which they are purchased.

G. Assets purchased either wholly with the Federal share of Subaward Sums and/or with any required Subrecipient matching contribution shall be charged directly to the Program.

IX. INVENTORY REQUIREMENTS FOR ASSETS
A. The following requirements are applicable only to Assets.

However, Subrecipient shall exercise reasonable care in the maintenance and tracking of Supplies.

B. Asset Bar Code Identification Tags

1.0 Subrecipient shall ensure that all Assets are properly identified with Asset Bar Code Identification tags. These tags include a unique identifier which is used to track the Asset until its final disposition.

2.0 Subrecipient shall notify County’s Contract Manager to obtain the Asset Bar Code Identification tags and County is
responsible for ensuring that all Assets are tagged. As such, Subrecipient shall provide County full access to these Assets so that County can affix the tags on each Asset.

C. Inventory Tracking

1.0 Every two (2) years, or more frequently as requested by County, Subrecipient shall conduct a physical inventory of all Assets and shall document its activities. Subrecipient shall reconcile the results with Subrecipient’s Asset accounting and inventory records.

2.0 Subrecipient shall investigate any difference(s) between quantities determined by the physical inspection and those DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE of
Exhibit S (Purchase, Inventory and Disposal Requirements for Fixed Assets, Non-Fixed Assets and Supplies)
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shown in the accounting and inventory records to determine the causes of the difference(s).

3.0 As part of its inventory tracking, Subrecipient shall verify the existence, current utilization and continued need for Assets.

4.0 Subrecipient shall inventory these Assets until the final disposition procedures have been completed for the Assets.

Upon final disposition of the Assets, Subrecipient shall remove these Assets from its accounting and inventory
records. Subrecipient shall continue to maintain the
disposition records in accordance with the record retention requirements outlined in Subparagraph 8.38 (Record
Retention, Inspection and Audit Settlement) of the Subaward.

D. Reporting Current Fiscal Year

1.0 As part of the annual Closeout process which is conducted at the end of each Fiscal Year, Subrecipient shall complete its report of all Assets purchased during that Fiscal Year.

2.0 Subrecipient shall maintain supporting records for all Assets.

3.0 County may require Subrecipient to submit such supporting records upon request.

4.0 Subrecipient shall ensure that the information on the supporting records match the information reflected on
County’s inventory records.

X. DISPOSAL REQUIREMENTS FOR ASSETS AND SUPPLIES
A. The following requirements are applicable to both Assets and Supplies. Additionally, Subrecipient shall exercise due diligence to dispose of Supplies when specific requirements related to Supplies are not addressed. Subrecipient shall ensure that it obtains prior written approval from County in order to dispose of Assets pursuant to Section VII (Approval Requirements for Disposing of Assets), herein.

B. Consistent with Federal and State regulations, Subrecipient may dispose of Assets and Supplies pursuant to the guidelines reflected in this Exhibit S as well as in the Administrative Requirements.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE
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C. For purposes of this Exhibit S, disposal shall include the sale, discard, transfer, donation, trade-in or other disposal of Assets.

D. Only Assets that are considered Salvage or Surplus may be sold, transferred, donated or otherwise disposed of.

1.0 Salvage items include Assets which are obsolete, broken or irreparable.

2.0 Surplus items are Assets which are no longer needed for the Program due to expiration or termination of this Subaward, termination of the Program, dissolution of Subrecipient’s operations, or other similar circumstances.

3.0 Subrecipient may sell, transfer, donate or otherwise dispose of Assets when these conditions are met:

3.1 Only after the Assets have first been offered to and declined in writing by County.

3.2 The sale, transfer, donation or other disposal does not create a conflict of interest for County or
Subrecipient. For purposes of this Exhibit S, a
conflict of interest may exist when the disposal of
Assets involves certain individuals or entities who
become the recipients of these Assets. These
individuals and entities may include the
following: Subrecipient employees; Subrecipient
employees' family members; entities that conduct
business or have a relationship with Subrecipient;
Clients; etc.

E. Disposition of Assets upon Dissolution of Subrecipient’s Operations, Expiration or Termination of Subaward or Termination of Program

1.0 County reserves the right to determine the final disposition of the Assets when any of the following occurs:

1.1 After dissolution of Subrecipient’s operations

1.2 Upon expiration or termination of this Subaward

1.3 When the Program, for which Assets were purchased,
has ended

2.0 Disposition may include, but is not limited to, County taking possession of and acquiring the Assets.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE of
Exhibit S (Purchase, Inventory and Disposal Requirements for Fixed Assets, Non-Fixed Assets and Supplies)
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3.0 Subrecipient shall prepare a final Inventory Control Form reflecting the Assets to be provided to County, and shall submit it to County’s Contract Manager within the timeframe designated by County.

4.0 County reserves the right to require Subrecipient to transfer such Assets to another entity, including, but not limited to, State, County or another subrecipient.

5.0 To exercise the right referenced in Subsection X.E.4.0, herein, County will issue specific written disposition
instructions to Subrecipient no later than ninety (90) days after expiration or termination of this Subaward, notification of Subrecipient's dissolution or termination of the Program.

F. Supplies

1.0 Subrecipient shall compensate County for its share of the residual inventory of unused Supplies if the residual or current fair market value of the inventory exceeds $500 or more in the aggregate when the items are no longer needed for either the Program or another Federally-funded program.

2.0 The aggregate value in this case is the total value of all remaining unused Supplies.

G. Current Fair Market Value

1.0 Subrecipient shall determine the current fair market value of all Assets being sold, transferred, disposed of or donated.

2.0 Subrecipient shall use one (1) or more of the following methods/resources to determine the current fair market value of an Asset:

2.1 Orion Computer Blue Book

2.2 Professional or expert appraisal

2.3 Public advertisement

2.4 Industry quotation

2.5 Other similar methods/resources
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE of
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H. Sale of Assets

1.0 After receiving written approval from County for this action, Subrecipient may sell Assets, which meet the requirements outlined in Subsections X.D.1.0 – X.D.3.0, herein, as a method of disposing those Assets.

2.0 Subrecipient shall have proper sales procedures in place in order to sell Assets. These procedures shall provide for competition to the extent practicable and shall result in the highest possible return.

3.0 Subrecipient shall record all sales revenue information relating to the sale or disposition of the Assets. Revenue from the sale of Assets becomes Program Income and
Subrecipient may be required to reimburse County for the revenue that is earned pursuant to Exhibit Q (Accounting, Administration and Reporting Requirements).

4.0 After the sale of an Asset, Subrecipient shall prepare an updated Inventory Control Form and submit it to County’s Contract Manager within the timeframe to be specified by County. The updated Inventory Control Form shall reflect information on the Assets sold.

5.0 Subrecipient shall obtain receipts from the recipient of the sale item(s) acknowledging receipt of the sale item(s) and shall forward copies of the receipts to County’s Contract Manager along with the completed Inventory Control Form.

I. Transfer of Assets

1.0 After receiving written approval from County to transfer Assets, which meet the requirements outlined in Subsections X.D.1.0 – X.D.3.0, herein, Subrecipient may proceed with this action as a method of disposing those Assets.

2.0 Subrecipient shall transfer Assets according to this order:

2.1 To another program providing the same or similar
service as that provided under this Subaward.

2.2 To a Federally or State-funded program.

3.0 After the transfer of an Asset, Subrecipient shall prepare an updated Inventory Control Form and shall submit it to County’s Contract Manager within the timeframe to be
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE of
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specified by County. The updated Inventory Control Form shall reflect information for the Assets transferred.

4.0 Subrecipient shall obtain receipts from the recipient of the transferred item(s) acknowledging receipt of the transferred item(s). Subrecipient shall forward copies of these receipts to County’s Contract Manager along with the completed
Inventory Control Form.

J. Donation of Assets

1.0 After receiving written approval from County to donate Assets, which meet the requirements outlined in
Subsections X.D.1.0 – X.D.3.0, herein, Subrecipient may proceed with this action as a method of disposing those Assets.

2.0 To donate Assets, Subrecipient shall:

2.1 Prepare an updated Inventory Control Form and
submit it to County’s Contract Manager within the
timeframe to be specified by County. The updated
Inventory Control Form shall reflect information for the Assets donated.

2.2 Obtain receipts from the recipient of the donated
item(s) acknowledging receipt of the donated item(s)
and shall forward copies of the receipts to County’s
Contract Manager along with the completed Inventory
Control Form.

2.3 Obtain liability waiver(s) for donated items.

Subrecipient shall be responsible for developing its
own liability waiver, which should provide the
following information, at a minimum:

2.3.1 Names and addresses of Subrecipient and
recipient organization.

2.3.2 Complete description of the Asset(s) being
donated including, but not limited to, Asset Bar
Code Identification tag number, Asset name
and make/model, serial number, quantity and
condition.

2.3.3 Date when donation was received by recipient
organization.

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2.3.4 Certification statement to be attested to by
recipient organization releasing Subrecipient
from all liability for the donated Asset(s).

2.3.5 Name, signature and title of the recipient
organization’s authorized representative.

XI. NON-COMPLIANCE WITH PURCHASE, INVENTORY AND DISPOSAL

REQUIREMENTS
A. Subrecipient shall be under a continuing obligation throughout the entire term of this Subaward to comply with the purchase, inventory and disposal requirements outlined in this Exhibit S and in Administrative Requirements.

B. Subrecipient’s non-compliance with these requirements shall subject Subrecipient to remedies which will be determined by County at County’s sole discretion. Such remedies may include, but are not limited to, those actions noted in Subparagraph 9.19 (Remedies for Non-Compliance) of the Subaward. County may also impose the following remedies as warranted by the noncompliance:

1.0 Disallow the cost for Assets purchased without prior written approval

2.0 Require Subrecipient to remit payment for Assets which are not properly disposed or inventoried

3.0 Remove those Assets from Subrecipient which are not properly maintained pursuant to the requirements outlined herein.

XII. RECORDKEEPING
A. Subrecipient shall retain all Inventory Control Forms and all supporting records (including but not limited to invoices, receipts, purchase orders, etc.) for Assets and Supplies pursuant to Subparagraph 8.38 (Record Retention, Inspection and Audit Settlement) of the Subaward.

B. Subrecipient shall make these documents available for collection and/or viewing by Federal, State and County authorities upon request.

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EXHIBIT T
(INTENTIONALLY OMITTED)
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EXHIBIT V
(CONTRACT MANAGEMENT SYSTEM –
CONTRACTOR’S GATEWAY TERMS AND CONDITIONS OF USE)

1.0 County has developed the Contract Management System – Contractor’s Gateway (hereafter “System”), an automated system designed to electronically manage this Subaward. County has implemented the System and Subrecipient shall use the System to perform its administrative contracting functions as directed by County.

2.0 County has established policies concerning the access, use and maintenance of the System. Subrecipient shall adhere to these policies, which include this Exhibit V (hereafter “Terms and Conditions of Use”), the Contract Management SystemContractor’s Gateway User Acknowledgement Agreement (“User Acknowledgement Agreement”), instruction guides/tutorials provided by County, training sessions conducted by County, etc. Subrecipient’s non-compliance with these policies may subject Subrecipient to denial of access to the System, suspension of payment(s), termination of this Subaward, and/or other actions which County may take at its sole discretion.

3.0 System Access and Control

3.1. Subrecipient shall access the System using the following Uniform Resource Locator (URL) link:
https://gateway.css.lacounty.gov:4443/OA HTML/AppsLogin (please note there is an underscore between “OA” and “HTML” in the URL).

3.2. Subrecipient shall ensure that data that is accessed using County information technology resources must be used for County authorized purposes and must not be disclosed to others without County’s prior written authorization or unless required by Federal, State or Program regulations.

3.3. Unauthorized access by Subrecipient to any County information technology resource, including the System, network, software application programs, data files, and restricted work areas is prohibited.

3.4. Accessing the System During Non-Business Hours

3.4.1. County recommends that Subrecipient does not access the System during non-business hours in order to allow County to provide technical assistance when requested from Users (who are defined in Section 5.0 (User Accounts), herein).

3.4.2. For purposes of this Terms and Conditions of Use, non-business hours are defined as the days and times that are outside of the traditional work week (where the traditional work week is DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 457 of 1182
Exhibit V (Contract Management System – Contractor’s Gateway Terms and Conditions of Use)
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recognized as Monday – Friday, 8:00 a.m. to 5:00 p.m.). The traditional work week does not include County-recognized holidays.

3.4.3. Generally, County-recognized holidays are the same as Federallyrecognized holidays such as January 1st, July 4th, December 25th ,
etc. of each year. Subrecipient may obtain a current list of Countyrecognized holidays from County’s Contract Manager or designee.

4.0 System Protocols and Security

4.1. Digital communications that occur between Subrecipient and County within the System are conducted over a secure network, which has been established by County using Secure Socket Layer technology, one of the most robust encryption platforms available.

4.2. The System’s URL provides an assurance to County and Subrecipient that accessing and using the System are done securely. A Web browser in secure mode will display a URL address beginning with “https://” rather than the standard “http://”, where the “s” in “https://” stands for “secure”.

4.3. County has established these secure, standard protocols which encrypt data across publicly used Internet connections.

4.4. County will make every effort to provide standard Internet-level performance while Users utilize the System. Subrecipient shall contact County when it experiences any disruptions in services by following the guidelines established in Sub-section 8.2, herein.

5.0 User Accounts

5.1. Designation of Users

5.1.1. Subrecipient shall designate Subrecipient Employees (Users) who shall be responsible for operating the System on Subrecipient’s behalf.

5.1.2. For purposes of this Terms and Conditions of Use, a Subrecipient Employee is defined as a staff member on Subrecipient’s payroll who works on this Subaward.

5.1.3. Subrecipient shall obtain prior approval from County to designate an account for each User who accesses the System. Subrecipient shall follow the instruction guides/tutorials provided by County and the general guidelines outlined in Sub-section 5.5 (Requesting User Accounts), herein, for requesting, creating and designating User accounts.

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5.2. User Account Classification

5.2.1. User accounts are classified as either View-Only or Administrative.

Subrecipient shall designate a classification for each User when requesting approval for a User account.

5.2.2. There are two (2) types of User account classifications:

5.2.2.1. View-Only User: A User who can access the System to view all Subaward documents and agency
information.

5.2.2.2. Administrative User: A User who can access the System to view all Subaward documents and agency
information, submit Subaward documents to County,
update Subrecipient’s administrative information,
receive automated System alerts/notices (when
designated as the contact person for this responsibility), and perform other functions as defined by County.

5.3. Active and Inactive User Accounts

5.3.1. An active User account is defined as a User who has an approved, current, valid account, which does not have an inactive or termination date in the System. This User can access the System and perform functions based on his/her account classification (as defined in Sub-section 5.2 (User Account Classification), herein).

5.3.2. An inactive User account is defined as a User whose account profile has been assigned an inactive or termination date and User can no longer access the System.

5.4. Subrecipient shall designate and maintain a minimum of two (2) active Users (up to a maximum of four (4) active Users) at all times as follows:

5.4.1. Subrecipient shall designate at least one (1) Administrative User at the level of Subrecipient’s Project Manager.

5.4.2. Subrecipient shall designate at least one (1) User who has delegated authority to execute this Subaward. This User shall be at the level of the Executive Director and may be classified as either a ViewOnly User or an Administrative User.

5.4.3. One of the two Users shall be designated as the responsible contact who shall receive and respond to System generated alerts/notices pertaining to Subaward Document Deliverables (e.g., insurance certificates, business licenses, permits, etc.).

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 459 of 1182
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5.5. Requesting User Accounts

5.5.1. Subrecipient shall obtain prior approval from County in order to establish User accounts in the System. Subrecipient shall follow these general guidelines to obtain County’s approval:

5.5.1.1. Subrecipient shall review its Employees, assess each of their responsibilities, and determine which
Employee(s) should have a User account in the System.

5.5.1.2. Subrecipient shall provide the Employee with the User Acknowledgement Agreement, and the Employee shall
read and complete the form. Subrecipient’s Authorized
Representative shall review and sign the form.

Subrecipient shall ensure that the User
Acknowledgement Agreement is completed for each
Employee that will receive a User account.

5.5.1.3. Subrecipient shall ensure that the completed User Acknowledgement Agreement is attached/saved in the
System as a Subaward Document Deliverable (on the
General Page of the Administration tab) prior to
requesting and being granted access to the System by
County.

5.5.1.4. Subrecipient shall create a profile for each User in the System.

5.5.1.5. Upon County’s receipt of the User profile submitted by Subrecipient, County will review User’s profile and
Employee’s completed User Acknowledgement
Agreement.

5.5.1.6. County will inform Subrecipient whether the User account has been approved or rejected.

5.5.2. Approved and Rejected User Accounts

5.5.2.1. Upon approval of Subrecipient’s request for a User account, County will provide User with a unique User
Name (logon/System identifier) and a default
password.

5.5.2.1.1. User shall be responsible for changing
his/her password when prompted by the
System.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 460 of 1182
Exhibit V (Contract Management System – Contractor’s Gateway Terms and Conditions of Use)
Rev. 10/2019 Page 5

5.5.2.1.2. User may begin accessing the System
immediately.

5.5.2.2. Upon rejection of Subrecipient’s request for a User account, County will follow-up with Subrecipient to
discuss the reason(s) for rejecting Subrecipient’s
request for a User account.

5.5.3. Subrecipient’s Assurances Upon Creating User Accounts

5.5.3.1. Subrecipient is responsible for the conduct of all Users who access and utilize the System. Subrecipient shall
ensure that Subrecipient and its Users adhere to this
Terms and Conditions of Use, the User
Acknowledgement Agreement, instruction
guides/tutorials provided by County, training sessions
conducted by County, etc. which establish the policies
under which the Users shall operate the System.

5.5.3.2. Subrecipient shall ensure that each User’s copy of the User Acknowledgement Agreement forms are saved in
the System as a Subaward Document Deliverable.

Subrecipient shall not delete any User
Acknowledgement Agreement forms from the System
without County’s written prior approval.

5.5.3.3. Subrecipient shall ensure that all Users receive and maintain current copies of all instruction guides/tutorials for using the System, which are developed by County
and provided to Subrecipient.

5.6. User Name and Password

5.6.1. Subrecipient shall ensure that its Users do not share their unique User Name and password with any other person.

5.6.2. County recommends that Users change their passwords every three (3) months to ensure additional password security.

5.6.3. Subrecipient shall ensure that all Users maintain valid, secure e-mail accounts, which shall be used for self-service maintenance of User Name and password information. In the event that Users forget their User Name or password, User shall adhere to the instruction guides/tutorials provided by County for resetting the User Name or password.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 461 of 1182
Exhibit V (Contract Management System – Contractor’s Gateway Terms and Conditions of Use)
Rev. 10/2019 Page 6

5.6.4. Repeated changes to a User’s password outside of the recommended three-month period, as noted in Sub-section 5.6.2, herein, shall be monitored and investigated by County and may result in County suspending User’s access.

5.7. Change in User’s Status

5.7.1. When a User’s status changes (e.g., he/she is no longer employed by Subrecipient or User’s responsibilities change), Subrecipient’s Authorized Representative shall take immediate action to update the User’s account profile. Updates to User account profiles shall be approved by County.

5.7.2. Subrecipient shall update User account profiles in the System by removing a User’s account once that User is no longer an Employee on this Subaward.

5.7.3. New Employees/Users

5.7.3.1. When Subrecipient determines that a new Employee shall receive a User account, Subrecipient shall adhere to the guidelines established in Sub-section 5.5
(Requesting User Accounts), herein, to create an
account in the System.

5.7.3.2. Prior to requesting a new User account, Subrecipient shall ensure that it continues to maintain at least two (2) active Users and does not exceed the maximum of
four (4) Users (pursuant to Sub-section 5.4, herein).

5.7.4. Subrecipient shall regularly review all User account information to ensure accuracy and completeness. Subrecipient shall ensure that updates are completed whenever administrative changes occur.

5.7.5. If County determines at its own discretion that Subrecipient is creating or removing User accounts too frequently then County shall take appropriate measures to investigate and remedy these occurrences. Upon County’s request, Subrecipient shall provide sufficient justification for these frequent User account updates.

6.0 General Policies for Use

6.1. County information technology resources are to be used solely for County business purposes.

6.2. County may periodically update this Terms and Conditions of Use and the User Acknowledgement Agreement policies. County may also implement future enhancements to the System. Subrecipient shall ensure that DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 462 of 1182
Exhibit V (Contract Management System – Contractor’s Gateway Terms and Conditions of Use)
Rev. 10/2019 Page 7
Subrecipient and Users adhere to all policy updates as well as any new procedures for using System enhancements.

6.3. Data Integrity

6.3.1. Subrecipient shall ensure that Users maintain the integrity of data they enter in the System, and do not save, store or attach electronic files in the System which do not meet the following requirements:

6.3.1.1. File types must be Word, Excel or Portable Data Format (PDF) documents. Files such as pictures, videos,
music, PowerPoint presentations, or other files as
determined by County are not acceptable types of
documents.

6.3.1.2. File types must be compatible with standard/common national brands, including Microsoft Office 2003
products or later version (Word, Excel, etc.), Adobe
Reader 9.0 (or later version) or their equivalent.

6.3.1.3. Files shall not be corrupted (i.e., documents shall be free of viruses).

6.3.1.4. The size limit of each file shall not exceed ten (10) megabytes (10 MB).

6.3.2. Subrecipient’s non-compliance with the data requirements outlined herein will be remedied at County’s sole discretion.

6.4. E-Mail Alerts and Notices

6.4.1. The System generates automatic e-mail alerts and notices based on the occurrence of certain events. These events may include, but are not limited to, confirmation of executed Subaward (or Amendments), request for Subaward Document Deliverables, notification of expired Subaward Compliance Document
Deliverables, etc.

6.4.2. Subrecipient shall ensure that its Users adhere to all alerts and notices generated by the System. These alerts and notices shall convey and have the same effect and importance as alerts and notices sent by County’s Administration (or their designees) as defined in Paragraph 6.0 (Administration of Subaward-County) in this Subaward and Exhibit E (County’s Administration). Subrecipient shall appropriately respond to all requests for documentation, promptly adhere to due dates/deadline requirements and diligently follow all instructions indicated in the alert/notice.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 463 of 1182
Exhibit V (Contract Management System – Contractor’s Gateway Terms and Conditions of Use)
Rev. 10/2019 Page 8

6.5. Administrative Changes

6.5.1. Pursuant to Paragraph 7.0 (Administration of SubawardSubrecipient) and Paragraph 8.34 (Notices) of this Subaward, Subrecipient shall designate its authorized staff by using Exhibit F (Subrecipient’s Administration). Further, Subrecipient shall initiate any changes in its staff, including those listed on Exhibit F (Subrecipient’s Administration), by giving written notice to County.

6.5.2. When changes to Subrecipient’s staff, address or other items requiring written notice are necessary, Subrecipient shall:

6.5.2.1. Adhere to the requirements outlined in Paragraph 8.34 (Notices) of this Subaward.

6.5.2.2. Upon providing the required written notice to County, update the administrative data in the System, including all User account profile information.

6.5.3. Implementation and use of the System shall not excuse Subrecipient from adhering to the requirements for providing proper written notice to County when changes occur in Subrecipient’s administration.

7.0 Monitoring

7.1. All County information technology resources are subject to audit and periodic, unannounced review by County.

7.2. County reserves the right to administer, monitor, audit and/or investigate Subrecipient’s access to and use of County’s information technology resources (i.e., System, e-mails, Subrecipient-generated data files, etc.). If evidence of abuse or negligence is identified, County will take the appropriate actions to remedy any areas of Subrecipient’s non-compliance.

7.3. During County’s monitoring of User activities, unusual practices will be investigated and reported to County’s Administration. County will take the necessary steps to remedy Subrecipient’s inappropriate use of the System.

Unusual practices may include, but are not limited to, the following:

7.3.1. Users frequently accessing the System during non-business hours (pursuant to Sub-section 3.4 (Accessing the System During NonBusiness Hours), herein).

7.3.2. Subrecipient not maintaining the minimum and/or exceeding the maximum number of Users at any point in time (pursuant to Subsection 5.4, herein).

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 464 of 1182
Exhibit V (Contract Management System – Contractor’s Gateway Terms and Conditions of Use)
Rev. 10/2019 Page 9

7.3.3. Users changing their passwords more than the recommended limit (pursuant to Sub-section 5.6.4, herein).

7.3.4. Subrecipient frequently changing its Users (pursuant to Subsection 5.7.5, herein).

8.0 System Maintenance and Technical Assistance

8.1. To ensure proper operation of the System, County will periodically perform routine System maintenance activities. Since these activities will impact the ability of Users to access the System, County will notify Users when they attempt to login that System maintenance is occurring and County will indicate the time when the System will become available. Generally, System maintenance activities will occur during non-business hours (e.g., weekends, late evenings, County-recognized holidays, etc.) to limit the impact to Users.

8.2. County will provide assistance to Users in the event of technical difficulties that may occur while utilizing the System. Technical assistance will be provided as follows:

8.2.1. Monday through Friday, 8:00 a.m. to 5:00 p.m. (excluding Countyrecognized holidays).

8.2.2. County’s Administrators

8.2.2.1. Ms. Tsotso Odamtten may be reached by phone or email, respectively, as follows: (213) 738-2663 or [email protected].

8.2.2.2. Ms. Lynn Tran may be reached by phone or e-mail, respectively, as follows: (323) 513-4214 or
[email protected].

8.2.3. County will follow-up on requests for assistance from Subrecipient within at least two (2) business days during the traditional work week (pursuant to Sub-sections 3.4.2 and 8.2.1, herein).

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 465 of 1182
466 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

N/A
Five (5)
ENP202106
N/A Modification Number: N/A
City of Glendale
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
I. BUDGET DETAIL - PERSONNEL
DIRECT
Project Manager ( CSP Supervisor) 25% $ 7,775 12 $ 23,324 $ 23,324 $ 23,324 $0 Older Americans Act (OAA) Title III C-1 Congregate Meal Services 2020-2021
Baseline Funding
(A)
POSITION TITLE (1)
(B)
% OF TIME
ON

PROGRAM
(2)
(C)

MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY1
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)
$ 42,204 $0
Meal Site Manager (Sparr Hourly City
Worker) 100% $ 1,560 $ 18,720
$ 10,401 $0
12 $ 18,720 $ 18,720
$ 7,956 $ 7,956 $ 7,956 $0
12 $ 9,360
$0
Food Service Manager( Community
Services Specialist) 100% $ 3,517 12 $ 42,204 $ 42,204
Meal Site Manager (ARC Hourly City
Worker) 25% $ 3,467 12 $ 10,401 $ 10,401
Driver ( Hourly City Worker) 50% $ 1,560 $0
Meal Site Manager( Pacific- Hourly City
Worker) 100% $ 663 12
$ 9,360 $ 9,360
[Enter title]
Exhibit W1 (Budget) Page 2
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 467 of 1182
468 of 1182
469 of 1182
470 of 1182
471 of 1182
472 of 1182
473 of 1182
474 of 1182
475 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

N/A
Five (5)
ENP202106
N/A Modification Number: N/A
City of Glendale
IX. BUDGET DETAIL - OTHER COSTS
Older Americans Act (OAA) Title III C-1 Congregate Meal Services 2020-2021
Baseline Funding
(A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY1
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)
$ 16,706 $0
DIRECT
Maintenance and Repairs (2 CFR 200.452 & 45 CFR

75.452) $ 1,392.17 1 12 $ 16,706 $ 16,706
6,059$ $ 6,059 $0
1 2 $ 3,293 3,293$ $ 3,293 $0
Select Description (2) (3) (4) (5)
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) $ 1,514.75 1 4 $ 6,059 Lease (Equipment) (2 CFR 200.465 & 45 CFR 75.465) (3) $ 1,646.50 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)
Exhibit W1 (Budget) Page 11
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 476 of 1182
477 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
$ 3.51 [Enter] [Enter] [Enter] [Enter] $ 5.50 [Enter] [Enter] [Enter] [Enter] $ 0.80 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ 0.71 [Enter] [Enter] [Enter] [Enter] 2 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] 1.80$ [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]

1.99$ [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]

0.71$ [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]

2.78$ [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] 1.51$ [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] 2020-2021
Baseline Funding
N/A
Five (5)
ENP202106
N/A Modification Number: N/A
City of Glendale
Older Americans Act (OAA) Title III C-1 Congregate Meal Services In-Kind (SF)
$ 57,970
$ -
$ -
$ -
$ -
Cash (SF)
3 Raw Food
Space In-Kind (SF)
Non-Match
-$
$ -
Cash Other
(SSY1)
$ -
5 Cash (SF)
$ -
In-Kind (SF)
7 $ -
3 Volunteer Expenses
Cash Other
(SSY1) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
$ 239,000
$ 107,101
$ 76,569
Cash NSIP
(SSY1) $ 27,325 In-Kind (SF)
Cash Other
(SSY1)
-$
Cash (SF)
$ -

6.21$ -$
SSY1
$ 69,291
1 (A)

COST CATEGORIES
4 (B)
COSTS (1)
$ -
2 Subtotal
Cash Other
(SSY1)
Cash NSIP
(SSY1)
$ 211,675
$ 27,325
DIRECT
$ 135,106
$ -
$ 30,602
Personnel
Lower Tier Subawards for Catered Food
In-Kind (SF)
Cash Other
(SSY1)
Cash (SF)
In-Kind (SF)
Volunteers
Lower Tier Subawards
In-Kind (SF)
-$
Cash Other
(SSY1)
In-Kind (SF)
$ -
Cash (SF)
$ -
Cash (SF)
$ -
Cash Other
(SSY1)
Cash NSIP
(SSY1)
X. BUDGET SUMMARY
1 6
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
$ -
(D)
FUNDING (1)
Match
Cash (SF)
Exhibit W1 (Budget) Page 13
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 478 of 1182
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
(A)

COST CATEGORIES
(B)
COSTS (1)
X. BUDGET SUMMARY
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
(D)
FUNDING (1)
[Enter] [Enter] [Enter] [Enter] [Enter] $ 0.95 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ 0.68 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ 5.50 $ - $ - $ - $ - $ 5.50 $ - $ - $ - $ -
$ 0.71 $ - $ - $ - $ - $ 0.71 $ - $ - $ - $ -
$ 4.26 $ - $ - $ - $ - $ 4.26 $ - $ - $ - $ -
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] 12 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ -
$ -
$ 211,675
$ 163,761
$ -
$ 27,325

INDIRECT
Cash (SF)
10 Cash (SF)
$ -
5 Subtotal Funding for
Direct Costs
Cash Other
(SSY1)
Cash (SF)
In-Kind (SF)
Cash NSIP
(SSY1)
$ -
8 9
$ 163,761
$ -
$ 211,675
$ -
Cash (SF)
Cash NSIP
(SSY1) $ 27,325
$ 26,058
Cash Other
(SSY1)
Cash Other
(SSY1)
In-Kind (SF)
Equipment
Other Costs
Subtotal Direct Costs
$ -
Cash Other
(SSY1)
In-Kind (SF)
Cash Other
(SSY1)
In-Kind (SF)
$ -
6 13 Volunteer Expenses
Cash Other
(SSY1) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
11 Personnel
Cash Other
(SSY1)
Volunteers In-Kind (SF)
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF)
$ -
Match
$ -
7 SSY1
$ -
In-Kind (SF)
4 Program Income Cash (SF) $ 36,500
Variance (Costs-Funding)
Cash Other
(SSY1) $ -
Cash
In-Kind
$ -
In-Kind (SF)
$ -
Cash (SF)
15 Lower Tier Subawards for Catered Food
Cash Other
(SSY1)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
14 Lower Tier Subawards
Exhibit W1 (Budget) Page 14
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 479 of 1182
480 of 1182
481 of 1182
Program Services: HOME-DELIVERED MEAL SERVICES
Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District
Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
I. BUDGET DETAIL - PERSONNEL
N/A Modification Number: N/A
City of Glendale
2020-2021
Baseline Funding
N/A
Five
ENP202106
(A)
POSITION TITLE (1)
(B)
% OF TIME
ON

PROGRAM
(2)
(C)

MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY1
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)
DIRECT
$ 22,775
HDM Case Worker (Community Services
Specialist) 50% $ 3,796 12 $ 22,775 $ 22,775 $ 22,775 $0 $ 22,775 $0
Project Manager ( CSP Supervisor) 25% $ 7,775 $ 23,324
$ 8,829 $0
12 $ 23,324 $ 775 $ 22,549 $0
HDM Meal Coordinator(Community
Services Specialist) 50% $ 3,796 12 $ 22,775
Driver (Hourly City Worker) 45% $ 1,635 12 $ 8,829 $ 8,829 [Enter title]
[Enter title]
[Enter title]
Exhibit W2 (Budget) Page 2
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 482 of 1182
483 of 1182
484 of 1182
485 of 1182
486 of 1182
487 of 1182
488 of 1182
489 of 1182
490 of 1182
Program Services: HOME-DELIVERED MEAL SERVICES
Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District
Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

IX. BUDGET DETAIL - OTHER COSTS
2020-2021
Baseline Funding
N/A
Five
ENP202106
N/A Modification Number: N/A
City of Glendale
(A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY1
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)
$ 4,502 $0
DIRECT
Materials and Supplies (2 CFR 200.453 & 45 CFR

75.453) 1,125.50$ 1 4 $ 4,502 4,502$
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)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Exhibit W2 (Budget) Page 11
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 491 of 1182
492 of 1182
Program Services: HOME-DELIVERED MEAL SERVICES
Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District
Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(2)
Hot
Meals
Unit Rate
(3)
Frozen Meals
Unit Rate
(4)
Emergency
Meals
Unit Rate
(2)
Hot
Meals
Unit Rate
(3)
Frozen Meals
Unit Rate
(4)
Emergency
Meals
Unit Rate
[Enter] $ 1.62 [Enter] [Enter] $ 5.50 $ 7.44
[Enter] $ 11.58 [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] $ 0.71 [Enter]
2 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter]
[Enter] [Enter] [Enter]
[Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] $ 0.67 $ 5.58
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] $ 3.88 [Enter] [Enter] [Enter] [Enter]
[Enter] $ 0.71 [Enter] [Enter] [Enter] [Enter]
[Enter] $ 0.88 [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] $ 7.44 [Enter] $ 11.83 [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] $ 5.58 [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
2020-2021
Baseline Funding
N/A
Five
ENP202106
N/A
City of Glendale
Modification Number: N/A
In-Kind (SF)
$ 93,326
$ -
$ -
Non-Match
Cash Other
(SSY1)
In-Kind (SF)
$ 2,000
Cash (SF)
$ 1,500
Cash (SF)
$ -
Cash Other
(SSY1)
Cash NSIP
(SSY1) $ -
$ -
Cash Other
(SSY1)
$ -
5 Cash (SF)
$ -
In-Kind (SF)
7 $ -
3 Volunteer Expenses
Cash Other
(SSY1) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
$ 51,000
$ 6,925
$ 30,652
Cash NSIP
(SSY1) $ 5,602 In-Kind (SF)
Cash Other
(SSY1)
$ 6.21
Cash (SF)
$ -
-$ $ 7.44
SSY1
$ 6,777
1 $ -
$ 91,376
Personnel
Lower Tier Subawards for
Catered Food
In-Kind (SF)
Cash Other
(SSY1)
Cash (SF)
In-Kind (SF)
Volunteers
Lower Tier Subawards
In-Kind (SF)
Raw Food
Space In-Kind (SF)
$ -
X. BUDGET SUMMARY
1 6
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
$ -
(D)
FUNDING (1)
Match
Cash (SF)
Cash (SF)
3 (A)

COST CATEGORIES
4 (B)
COSTS (1)
$ -
2 Subtotal
Cash Other
(SSY1)
Cash NSIP
(SSY1)
$ 45,398
$ 5,602
DIRECT
$ 12,746
Exhibit W2 (Budget) Page 13
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 493 of 1182
(2)
Hot
Meals
Unit Rate
(3)
Frozen Meals
Unit Rate
(4)
Emergency
Meals
Unit Rate
(2)
Hot
Meals
Unit Rate
(3)
Frozen Meals
Unit Rate
(4)
Emergency
Meals
Unit Rate
X. BUDGET SUMMARY
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
(D)
FUNDING (1)
(A)

COST CATEGORIES
(B)
COSTS (1)
[Enter] [Enter] [Enter] [Enter] $ 0.53 [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] $ 0.57 [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
$ - $ 5.50 $ 7.44 $ - $ 5.50 $ 7.44
$ - $ 0.71 $ - $ - $ 0.71 $ -
$ - $ 13.03 $ 5.58 $ - $ 13.03 $ 5.58
$ - $ - $ - $ - $ - $ -
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
12 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
$ -
$ -
$ 45,398
$ 104,303
$ -
$ 5,602

INDIRECT
8 9
$ 104,303
$ -
$ 45,398
$ -
$ -
Cash (SF)
Cash Other
(SSY1)
In-Kind (SF)
Cash NSIP
(SSY1)
Cash Other
(SSY1)
In-Kind (SF)
Equipment
Other Costs
Subtotal Direct Costs
In-Kind (SF)
$ 5,602
Cash (SF)
$ -
$ 4,502
Cash Other
(SSY1)
5 Subtotal Funding for
Direct Costs
Cash Other
(SSY1)
Cash (SF)
In-Kind (SF)
Cash NSIP
(SSY1)
11 Personnel
Cash Other
(SSY1)
Volunteers In-Kind (SF)
$ -
Cash (SF)
$ -
6 10
Cash Other
(SSY1)
13 Volunteer Expenses
Cash Other
(SSY1) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF) $ -
17 Space
Cash Other
(SSY1) $ -
In-Kind (SF) $ -
16 Raw Food
Cash Other
(SSY1) $ -
8 $ -
In-Kind (SF)
$ -
Cash (SF)
15 Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF)
$ -
Non-Match
Match
$ -
7 SSY1
$ -
In-Kind (SF)
4 Program Income Cash (SF) $ 4,200
Variance (Costs-Funding)
Cash Other
(SSY1) $ -
Cash
In-Kind
Lower Tier Subawards for
Catered Food
Cash Other
(SSY1)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
14 Lower Tier Subawards
Exhibit W2 (Budget) Page 14
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 494 of 1182
495 of 1182
496 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number: Modification Number:

Subrecipient's Legal Name:
[Enter title]
I. BUDGET DETAIL - PERSONNEL
N/A
2020-2021
Baseline Funding
[Enter title]
(A)
POSITION TITLE (1)
(B)
% OF TIME
ON

PROGRAM
(2)
(C)

MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY1
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)
DIRECT
Hourly City Worker 5% $ 1,635 12 $ 981 $ 981 $ 981 $0
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
N/A

TELEPHONE REASSURANCE SERVICES
Five
ENP202106
N/A
City of Glendale
Exhibit W3 (Budget) Page 2
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 497 of 1182
498 of 1182
499 of 1182
500 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
IV. BUDGET DETAIL - OTHER COSTS

TELEPHONE REASSURANCE SERVICES
2020-2021
Baseline Funding
N/A
Five
ENP202106
N/A Modification Number: N/A
City of Glendale
(A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY1
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
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)
Exhibit W3 (Budget) Page 6
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 501 of 1182
502 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 DIRECT
1 Personnel
Cash Other
(SSY1) $ 1,000 $ 0.68
1 SSY1 Cash Other (SSY1)
$ 1,000 $ 0.68
Cash (SF) $ 279 $ 0.19
In-Kind (SF) $ - [Enter]
V. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (2)
(1)
Total Budgeted
Costs
(2)
Telephone Calls
Unit Rate
(1)
Total Budgeted
Costs
(2)
Telephone
Calls Unit Rate
Cash (SF) $ - [Enter]
$ 0.19
[Enter]
Volunteers In-Kind (SF) $ - [Enter] 2 MatchCash (SF) $ 279 Program Income Cash (SF)
In-Kind (SF)
$ - [Enter]
Cash (SF) $ -
3 Volunteer Expenses
Cash Other
(SSY1) $ - [Enter] In-Kind (SF) $ -
$ - [Enter] In-Kind (SF) $ -
[Enter]
Cash (SF) $ - [Enter] 3 Non-Match
5 Subtotal Direct Costs
Cash Other
(SSY1) $ 1,000 $ 0.68
4 [Enter]
In-Kind (SF) $ - [Enter]
Cash Other
(SSY1) $ - [Enter]
4 Other Costs
$ 1,000 $ 0.68
Cash (SF) $ 279 $ 0.19Cash (SF) $ 279 $ 0.19
In-Kind (SF) $ - $ -In-Kind (SF) $ - $ -
5 Subtotal Funding for
Direct Costs
Cash Other
(SSY1)
Variance (Costs-Funding)
Cash Other
(SSY1)
Cash (SF)
In-Kind (SF)

TELEPHONE REASSURANCE SERVICES
2020-2021
Baseline Funding
N/A
Five
ENP202106
N/A Modification Number: N/A
City of Glendale
Exhibit W3 (Budget) Page 8
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 503 of 1182
504 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
[Enter]
Ext.
[Enter]
Phone Number Ext.
[Enter]
Phone Number Ext.

City
Congregate Meal Services
2020-2021
Baseline Funding
N/A
Five
ENP202106
City of Glendale
N/A Modification Number: N/A
Budget Analyst Job Title E-Mail Address
[Enter City] CA [Enter Zip]
Accountant I 818-550-3060 [email protected]
Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title
EXHIBIT X1 (MANDATED PROGRAM SERVICES)
Subrecipient's Legal Name:
[Enter Address]
Director, Community Services and Parks [email protected] State Zip Code
613 E. Broadway Street Room 120 Glendale CA 91206
Main Administrative Office Address
E-Mail Address
Mr. Onnig Bulanikian 818-548-2000
Phone Number
Senior Community Services Supervisor [email protected] Prefix Project Manager Job Title E-Mail Address
Mr. Maggie Kavarian 818-548-3715
Mr. Hanre Chang
Prefix
MPS Reviewed and Approved by: Sheri Stanton Date: 7/22/2020

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Irma Panosian
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 505 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

SSY1
(Cash NSIP)
[Enter Units]
[Enter Units]
I. UNITS OF SERVICE SUMMARY
500
American Meals
Subrecipient's Legal Name:

Congregate Meal Services
2020-2021
Baseline Funding
N/A
Five
ENP202106
City of Glendale
Ethnic Meals
Total (4)
SSY1 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
[Enter Total
Unduplicated
Units]
[Enter Units]
[Enter Unit Rate]
N/A Modification Number: N/A
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
SSY1 (6)
(Cash Other)
$ -
[Enter Unit Rate]
38,486
38,486
38,486
[Enter Unit Rate]
$ -
$ 211,675
$ 10.47 $ 402,761
$ 0.71 $ 27,325
[Enter Total
Unduplicated
Units]
$ 6.21 $ 239,000
$ 5.50
$ 4.26 $ 163,761
Subtotal SSY1
(Cash Other and Cash NSIP)
Total (4)
SSY1
(Cash NSIP)
Subtotal SSY1
(Cash Other and Cash NSIP)
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
[Select Ethnic
Meal Style]
SF (7)
(Cash and In-Kind)
Exhibit X1 (Mandated Program Services) Page 2
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 506 of 1182
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
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 the Budget (cover page) column (F) Total Funding.
(9) Enter the amount of equipment (other) that is reflected on the Budget. (6) SSY1: Subaward Sum Year 1
(7) SF: Subrecipient's Funds
(8) Enter the approved amount of equipment purchase(s) that is reflected on the Budget.

Equipment (Purchases) (8) [Enter Approved
Amount]
(2) Please Enter the Unit Rates: a) for SSY1 (Cash Other) and for SSY1 (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 SSY1 (Cash Other), SSY1 (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. [Enter Amount]
Total (4)
[Enter Total
Unduplicated
Units]
[Enter Unit Rate]
SSY1
(Cash NSIP) [Enter Unit Rate]
$ - $ -
GRAND TOTAL SERVICES/FUNDING 500
SSY1 (6)
(Cash Other)
Subtotal SSY1
(Cash Other and Cash NSIP)
-
SF (7)
(Cash and In-Kind)
$ 402,761
[Enter Unit Rate]
[Select Ethnic
Meal Style] Ethnic Meals
[Enter Units]
[Enter Units]
[Enter Units]
Exhibit X1 (Mandated Program Services) Page 3
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 507 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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)
1 300 3,000 3,000 3,000 2,700 2,700 2,700 2,520 2,500 2,500 2,500 2,500 2,541 32,161 2 175 400 400 400 400 400 400 400 400 400 400 400 441 4,841 3 25 0 0 0 0 0 0 243 240 240 240 240 281 1,484
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
500 3,400 3,400 3,400 3,100 3,100 3,100 3,163 3,140 3,140 3,140 3,140 3,263 38,486 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 Glendale
N/A Modification Number: N/A
ENP202106
Congregate Meal Services
2020-2021
Baseline Funding
N/A
Five
II. SERVICES BY MONTH - AMERICAN MEALS
(B)

SITE NAME
Adult Recreation Center
Sparr Heights Community Center
Pacific Community Center
Grand Total
Exhibit X1 (Mandated Program Services) Page 4
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 508 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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 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) 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 Glendale
[Select Ethnic Meal Style] III. SERVICES BY MONTH - ETHNIC MEALS (B)

SITE NAME
NOTE:

Grand Total
ENP202106
N/A Modification Number:

Congregate Meal Services
2020-2021
Baseline Funding
N/A
Five
N/A
Exhibit X1 (Mandated Program Services) Page 5
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 509 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

NOTE:
(B)

SITE NAME
Grand Total
Congregate Meal Services
2020-2021
Baseline Funding
N/A
Five
ENP202106
N/A Modification Number:

IV. SERVICES BY MONTH - ETHNIC MEALS [Select Ethnic Meal Style] N/A
Subrecipient's Legal Name: City of Glendale
Exhibit X1 (Mandated Program Services) Page 6
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 510 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
[Enter]
Ext.
[Enter]
Phone Number Ext.
[Enter]
Phone Number Ext.

N/A Modification Number:

ENP202106
N/A
City of Glendale
Five
N/A
Baseline Funding
2020-2021

HOME DELIVERED MEAL SERVICES
MPS Reviewed and Approved by: Sheri Stanton Date: 7/22/2020

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Irma Panosian
Senior Community Services Supervisor [email protected] Prefix Project Manager Job Title E-Mail Address
Ms. Maggie Kavarian 818-548-3715
Mr. Hanre Chang
[Enter Address]
Director, Community Services and Parks [email protected] Prefix Authorized Representative Job Title E-Mail Address Mr. Onnig Bulanikian 818-548-2000
Phone Number
State Zip Code
EXHIBIT X2 (MANDATED PROGRAM SERVICES)
Prefix Budget Analyst Job Title E-Mail Address
[Enter City] CA [Enter Zip]
Accountant I 818-548-3060 [email protected]
Mailing Address (if different from above) City
State Zip Code
613 E. Broadway Street Room 120 Glendale CA 91206
Main Administrative Office Address City
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 511 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Hot Meals
Subtotal SSY1
(Cash Other and Cash NSIP)
SSY1 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
SSY1 (6)
(Cash Other)
Frozen Meals
7,890
Total (4)
SF (7)
(Cash and In-Kind)
[Enter Total
Unduplicated
Units]
[Enter Unit Rate]
[Enter Total
Unduplicated
Units]
$ -

HOME DELIVERED MEAL SERVICES
2020-2021
Baseline Funding
N/A
Five
ENP202106
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

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

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
$ -
[Enter Unit Rate]
[Enter Unit Rate]
[Enter Units]
[Enter Units]
[Enter Units]
Total (4)
SSY1
(Cash NSIP)
Subtotal SSY1
(Cash Other and Cash NSIP)
$ 151,803
$ 102,803
$ 49,000
$ 5.50
$ 19.24
$ 5,602
$ 6.21
$ 43,398
$ 0.71 SSY1
(Cash NSIP)
7,890
7,890
I. UNITS OF SERVICE SUMMARY
52 $ 13.03
Exhibit X2 (Mandated Program Services) Page 2
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 512 of 1182
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
(B)

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
Equipment (Other) (9)
Emergency Meals
269
269 SF (7)
(Cash and In-Kind)
Total (4)
[Enter Total
Unduplicated
Units]
$ 13.02 $ 3,500
$ 7.44 $ 2,000
SSY1
(Cash NSIP) $ - $ -
$ 7.44 $ 2,000
GRAND TOTAL SERVICES/FUNDING 52
SSY1 (6)
(Cash Other)
Subtotal SSY1
(Cash Other and Cash NSIP)
- $ 155,303
[Enter Amount]
(5) Thet Total and Grand Total amounts under column (E) Funding Amount shall match the Total and Grand Total amounts reflected in the Budget (cover page) column (F) Total Funding.
(9) Enter the amount of equipment (other) that is reflected on the Budget. (6) SSY1: Subaward Sum Year 1
(7) SF: Subrecipient's Funds
(8) Enter the approved amount of equipment purchase(s) that is reflected on the Budget.

Fiscal Year:

Funding Type:

Los Angeles County Region:

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
2020-2021
Baseline Funding
City of Glendale
N/A Modification Number: N/A
N/A
Five
ENP202106
Exhibit X2 (Mandated Program Services) Page 4
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 514 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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 13 164 164 164 164 164 164 164 164 164 164 164 172 1976 2 13 164 164 164 164 164 164 164 164 164 164 164 172 1976 3 13 164 164 164 164 164 164 164 164 164 164 164 173 1977 4 13 164 164 164 164 164 164 164 160 160 160 160 173 1961 5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
52 656 656 656 656 656 656 656 652 652 652 652 690 7890 (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:

Route 2
Route 3
Route 4
Route 1
III. SERVICES BY MONTH - FROZEN MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2020-2021
Baseline Funding
City of Glendale
N/A
Five
ENP202106
N/A Modification Number: N/A
Exhibit X2 (Mandated Program Services) Page 5
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 515 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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 0 0
2 0 0
3 0 0
4 0 0
5 0 0
6 0 0
7 0 0
8 0 0
9 0 0
10 0 0
11 0 0
12 0 0
13 0 0
14 0 0
15 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 ENP202106
N/A Modification Number: N/A
City of Glendale
NOTE:

Grand Total
(K)
FEB
(L)
MAR
(I)
DEC
(J)
JAN
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
N/A
Five

HOME DELIVERED MEAL SERVICES
2020-2021
Baseline Funding
Exhibit X2 (Mandated Program Services) Page 6
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 516 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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 13 9 9 9 9 9 9 0 9 9 9 81
2 13 9 9 9 0 9 0 9 9 0 9 9 72
3 13 9 9 9 9 9 9 0 0 9 0 9 72
4 13 9 0 9 9 0 9 0 0 8 44
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
52 36 27 36 18 36 18 9 18 18 18 27 8 269
(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:

Route 2
Route 3
Route 4
Route 1
V. SERVICES BY MONTH - EMERGENCY MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2020-2021
Baseline Funding
City of Glendale
N/A
Five
ENP202106
N/A Modification Number: N/A
Exhibit X2 (Mandated Program Services) Page 7
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 517 of 1182

TELEPHONE REASSURANCE SERVICES
Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
[Enter]
Ext.
[Enter]
Phone Number Ext.
[Enter]
Phone Number Ext.

COUNTY USE ONLY
Assigned Program Analyst:

Assigned Contract Analyst:

MPS Reviewed and Approved by:

Sheri Stanton
Irma Panosian
Sheri Stanton Date: 7/22/2020
Prefix Project Manager Job Title E-Mail Address
Mr. Hanre Chang Accountant I 818-548-3060 [email protected] Prefix Budget Analyst Job Title E-Mail Address
Ms. Maggie Kavarian Senior Community Services and Parks 818-548-3715 [email protected] Mailing Address (if different from above) City State Zip Code Prefix
Mr. Onnig Bulanikian Director, Community Services and Parks 818-548-2000 [email protected] Authorized Representative Job Title Phone Number E-Mail Address EXHIBIT X3 (MANDATED PROGRAM SERVICES)
2020-2021
Baseline Funding
N/A
Subrecipient's Legal Name: City of Glendale
Five
Program Services:

ENP202106
N/A Modification Number: N/A
[Enter Address] [Enter City]
613 E. Broadway Street Room 120 Glendale CA 91206
CA
City State Zip Code
[Enter Zip]
Main Administrative Office Address
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 518 of 1182

TELEPHONE REASSURANCE SERVICES
Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name: City of Glendale
I. UNITS OF SERVICE SUMMARY
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
SSY1 (6)
(Cash Other) $ 1,000
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
(E)
FUNDING AMOUNT (5)
52 Total
SF (7)
(Cash and In-Kind)
1,471
Telephone Calls 1,471
$ 0.87 $ 1,279
Program Services:
2020-2021
Baseline Funding
Modification Number: N/A
N/A
Five
ENP202106
N/A
$ 0.68
$ 0.19 $ 279
NOTE:

GRAND TOTAL SERVICES/FUNDING (4) - $ 1,279 52
(6) SSY1: Subaward Sum Year 1
(7) SF: Subrecipient's Funds
(2) Please Enter the Unit Rate for both the SSY1 (i.e., approved rate to be reimbursed by County as reflected in the funding allocation letter) and SF (amount of Match, Non-Match, and Program Income - reflected as a rate - that will be funded by Subrecipient for the Services). (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), Subsection 1.4 (Client Eligibility Criteria). These individuals are counted only once within a FY for reporting purposes.
(3) Please enter the number of Units for each Service Category to be provided using SSY1, NSIP, and SF. If SSY1 and SF will both be used to provide the same Units then enter the number of Units for SSY1 only. If additional Units will be provided using SF then enter the number of SF Units. (4) The Total Units for each Service Category under column (C) Units of Service shall match the Total Units reflected in Section II (Services by Month) column (P) Total.
(5) The Grand Total Funding Amount under column (E) Total shall match the Grand Total Funding Amount reflected in the Budget (cover page) column (G) Total Funding.

Exhibit X3 (Mandated Program Services) Page 2
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 519 of 1182

TELEPHONE REASSURANCE SERVICES
Fiscal Year:

Funding Type:

Los Angeles County Region:

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 12 31 31 30 31 29 31 31 29 31 31 31 31 367
2 14 31 31 31 31 29 31 31 29 31 31 31 31 368
3 12 31 31 31 31 29 31 31 29 31 31 31 31 368
4 14 31 31 31 31 29 31 31 29 31 31 31 31 368
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
52 124 124 123 124 116 124 124 116 124 124 124 124 1471 NOTE:
(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 ENP202106
N/A
Subrecipient's Legal Name: City of Glendale
N/A Modification Number:

II. SERVICES BY MONTH - TELEPHONE CALLS
Thursday Route Calls
(B)

ROUTE NAME
Monday Route Calls
Tuesday Route Calls
Wednesday Route Calls
Grand Total
Program Services:
2020-2021
Baseline Funding
N/A
Five
Exhibit X3 (Mandated Program Services) Page 3
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 520 of 1182

EXHIBIT Y (LIST OF LOWER TIER SUBAWARDS)
Subrecipient’s Legal Name: City of Glendale
Select the certification below that is applicable to Subrecipient’s use of Lower Tier Subrecipient(s)/Lower Tier Subaward(s):
☒ Subrecipient intends to use Lower Tier Subrecipient(s)/Lower Tier Subaward(s) to provide Program Services (details are provided in the chart below).
☐ Subrecipient will not use Lower Tier Subrecipient(s)/Lower Tier Subaward(s) to provide Program Services.

Lower Tier Subrecipient Description of Services
to be Performed Legal Name Address Contact Person’s Name and Phone Number

BATEMAN

COMMUNITY
LIVING/LLC. Dba TRIO

COMMUNITY MEALS
101 Pine Park Drive
Lafayette, CA 70508
Magi Brettler
☒ Congregate Meal Services (American Meals)
☐ Congregate Meal Services (Ethnic Meals)
☐ Home-Delivered Meal Services (Hot Meals)
☒ Home-Delivered Meal Services (Frozen Meals)
☐ Home-Delivered Meal Services (Emergency
Meals)
☐ Other (if applicable): Click here to enter text.
337-593-0433 X3
If you need to report additional Lower Tier Subrecipients, use this Exhibit Y and include page numbers on each completed Exhibit Y as follows: Page 1 of X, Page 2 of X, Page 3 of X, etc. (where ‘X’ represents the total number of completed forms).

Page 1 of 1 ends

FY 2020-2021
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 521 of 1182

EXHIBIT Z
(INTENTIONALLY OMITTED)
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 522 of 1182
523 of 1182

EXHIBIT BB
(CRITERIA AND STANDARDS FOR LETTERS OF CREDIT

AND CERTIFICATES OF DEPOSIT)

1. The Letters of Credit (LOC) or Certificates of Deposit (CD) shall be drawn by or on a financial institution that meets at least one (1) of the ratings from the table below:

Deposits Rating Agency
Moody’s
(a) Standard
& Poor’s
Bauer
Financial
The
Street.
com(b)
If the term of the CD is
less than three (3) years,
the minimum ratings are:

A2 or
better
A or
better
4 stars or
better
B or better
If the term of the CD is
three (3) years or greater
and the total assets of
the financial institution
are less than $150
billion, the minimum
ratings are:

Aa1 or
better
AA+ or
better
4 stars or
better
B or better
If the term of the CD is
three (3) years or greater
and the total assets of
the institution are $150
billion or more, the
minimum ratings are:

Aa3 or
better
AA- or
better
4 stars or
better
B or better
a. Bank Financial Strength (only for Moody’s, a subcategory of the overall rating standard) should be B or better. Bank Financial Strength is a rating standard that must be met if the financial institution’s total assets are less than $1.5 billion and Moody’s rates that institution.
b. Formerly Weiss Ratings, Inc.

2. If the financial institution is rated by all four (4) of the rating agencies, the rating that is considered in the analysis will be the lower rating of Moody’s or Standard & Poor’s.

However, if the financial institution receives ratings from Bauer Financial and TheStreet.com, only the higher of the two (2) ratings will be considered.

3. All deposits shall be insured through either the Federal Deposit Insurance Corporation (“FDIC”) or National Credit Union Administration (“NCUA”) at their maximum standard rate.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 524 of 1182

4. The CD or LOC shall be irrevocable and in County’s name or pledged to County.

5. As directed by County, the CD or LOC shall be issued for an amount that is sufficient to support the terms of the performance agreement, unless otherwise stated in the Subaward.

6. The CD or LOC shall mature at a definite time, which, unless otherwise stated in the Subaward, may not be prior to direction by County, or the expiration of the performance agreement or other provisions thereof.

7. The CD shall meet the minimum criteria and standards at the time the funds are placed with the financial institution. However, a liquidation of the placement is not required should the financial institution’s ratings fall below the minimum criteria and standards during the term of the placement. At the placement’s expiration or maturity, the funds should be placed with a different financial institution that meets the minimum criteria and standards.

Exhibit BB (Criteria and Standards for Letters of Credit and Certificates of Deposit) Rev. 09/2019 Page 2
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 525 of 1182
Exhibit CC (FEMA Provisions) Page 1

EXHIBIT CC
(FEMA PROVISIONS)
A. CLEAN AIR AND WATER REQUIREMENTS. [Applicable to all subawards (that is “contracts”) and lower tier subawards (that is, “subcontracts”) in excess $150,000, including indefinite quantities where the amount is expected to exceed $150,000 in any year)

1. Subrecipient (that is, “Contractor”) agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act, as amended, 42 U.S.C. 7401 et seq., and the Federal Water Pollution Control Act, as amended, 33 U.S.C. 1251 et seq.

2. The Contractor agrees to report each violation to County and understand and agrees that the County will, in turn, report each violation as required to assure notification to the Federal Emergency Management Agency (FEMA), and the Regional Office of the Environmental Protection Agency (EPA).

3. Contractor agrees to include these requirements in each subcontract exceeding $150,000 financed in whole or in part with Federal assistance provided by FEMA.

B. DEBARMENT AND SUSPENSION CLAUSE.

1. This Agreement is a covered transaction for purposes of 2 C.F.R. pt. 180 and 2 C.F.R. pt. 3000. As such, the Contractor is required to verify that none of Contractor's principals (defined at 2 C.F.R. § 180.905), or its affiliates (defined at 2 C.F.R. § 180.905) are excluded (defined at 2 C.F.R. § 180.940) or disqualified (defined at 2 C.F.R. § 180.935).

2. Contractor must comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C and must include a requirement to comply with these regulations in any lower tier covered transaction it enters into.

3. This certification is a material representation of fact relied upon by the County. If it is later determined that the Contractor did not comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C, in addition to remedies available to the County, the Federal Government may pursue available remedies, including but not limited to suspension and/or debarment.

4. The bidder or proposer agrees to comply with the requirements of 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C while this offer is valid and throughout the period of any contract that may arise from this offer. The bidder or proposer further agrees to include a provision requiring such compliance in its lower tier covered transactions.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 526 of 1182
Exhibit CC (FEMA Provisions) Page 2
C. BYRD ANTI-LOBBYING AMENDMENT, 31 U.S.C. § 1352 (AS AMENDED).

1. Contractor shall not use or pay any funds received under this Agreement to influence or attempt to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with obtaining any Federal contract, grant, or any other award covered by 31 U.S.C. § 1352.

2. Contractor agrees to the provisions of Attachment 1, Certification Regarding Lobbying, attached hereto and incorporated herein.

3. Contractor agrees to include paragraphs 1 and 2 above in each third party subcontract financed in whole or in part with Federal assistance provided by FEMA. It is further agreed that the clause shall not be modified, except to identify the lower tier subrecipient (that is, “subcontractor”) who will be subject to its provisions.

D. PROCUREMENT OF RECOVERED MATERIALS (2 CFR 200.322).

1. In the performance of this Agreement, the Contractor shall make maximum use of products containing recovered materials that are EPA-designated items unless the product cannot be acquired—
• Competitively within a timeframe providing for compliance with the contract performance schedule;
• Meeting contract performance requirements; or
• At a reasonable price.

2. Information about this requirement, along with the list of EPA-designated items, is available at EPA’s Comprehensive Procurement Guidelines web site, https://www.epa.gov/smm/comprehensive- procurement-guideline-cpg-program.

3. Contractor also agrees to comply with all other applicable requirements of Section 6002 of the Solid Waste Disposal Act.

E. ACCESS TO RECORDS.

The following access to records requirements apply to this Agreement:

1. Contractor agrees to provide the County, the FEMA Administrator, the Comptroller General of the United States, or any of their authorized representatives access to any books, documents, papers, and records of the Vendor which are directly pertinent to this Agreement for the purposes of making audits, examinations, excerpts, and transcriptions.

2. Contractor agrees to permit any of the foregoing parties to reproduce by any means whatsoever or to copy excerpts and transcriptions as reasonably needed.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 527 of 1182
Exhibit CC (FEMA Provisions) Page 3

3. Contractor agrees to provide the FEMA Administrator or his or her authorized representatives access to construction or other work sites pertaining to the work being completed under the Agreement.

4. In compliance with the Disaster Recovery Act of 2018, the County and the Contractor acknowledge and agree that no language in this contract is intended to prohibit audits or internal reviews by the FEMA Administrator or the Comptroller General of the United States.

F. DEPARTMENT OF HOMELAND SECURITY SEAL, LOGO, AND FLAGS.

Contractor shall not use the Department of Homeland Security (DHS) seal(s), logos, crests, or reproductions of flags or likenesses of DHS agency officials without specific FEMA prior e-approval.

G. COMPLIANCE WITH FEDERAL LAW, REGULATIONS, AND EXECUTIVE ORDERS.

This is an acknowledgement that FEMA financial assistance will be used to fund all or a portion of the contract. The Vendor will comply with all applicable Federal law, regulations, executive orders, FEMA policies, procedures, and directives.

H. NO OBLIGATION BY FEDERAL GOVERNMENT.

The Federal Government is not a party to this Agreement and is not subject to any obligations or liabilities to the non-Federal entity, contractor, or any other party pertaining to any matter resulting from the Agreement.

I. PROGRAM FRAUD AND FALSE OR FRAUDULENT STATEMENTS OR RELATED ACTS.

Contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and Statements) applies to the Contractor’s actions pertaining to this Agreement.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 528 of 1182
529 of 1182
530 of 1182

ELDERLY NUTRITION PROGRAM (ENP)
SUBAWARD NUMBER ENP202106
SUBAWARD PERIOD JULY 2020 – JUNE 2021

AMENDMENT ONE
This Amendment is made and entered into by and between

COUNTY OF LOS ANGELES THROUGH ITS DEPARTMENT OF

WORKFORCE DEVELOPMENT, AGING AND COMMUNITY SERVICES
(“County” or “WDACS”)
County’s Business Address
3175 West Sixth Street
Los Angeles, CA 90020
and

CITY OF GLENDALE
(“Contractor” or “Subrecipient”)
Subrecipient’s Business Address
613 East Broadway Street, Room 120
Glendale, CA 91206
WHEREAS, reference is made to that certain document entitled “Elderly Nutrition Program (ENP) Subaward Number ENP202106 Subaward Period July 2020 – June 2021” dated July 1, 2020 (“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 Chief Executive Office (CEO) Coronavirus Aid, Relief, and Economic Security (CARES) Act funding in the cumulative amount of $406,000, which shall be reimbursed to Subrecipient in exchange for additional defined and contracted ENP Congregate Meal and HomeDocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 531 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment One Page 2
Delivered Meal Services as specified herein to be provided by Subrecipient during Fiscal Year 2020-21; and
WHEREAS, it is the intent of the parties to amend this Subaward to allocate California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act funding in the cumulative amount of $264,000, which shall be reimbursed to Subrecipient in exchange for additional defined and contracted ENP Congregate Meal and Home-Delivered Meal Services as specified herein to be provided by Subrecipient during Fiscal Year 2020-21; and
WHEREAS, it is the intent of the parties to amend this Subaward to allocate the 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 shall commence upon execution by all parties.

II. Subparagraph 5.1.3 is deleted in its entirety and replaced as follows:

5.1.3 Subaward Sum Year 1 Funding Source(s)

5.1.3.1 The Subaward Sum Year 1 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.

5.1.3.2 Older Americans Act (OAA) Title III B (Supportive Services and Senior Centers) Original Baseline Funds

5.1.3.2.1 Subaward Sum: $1,000

5.1.3.2.2 Service Area: Supervisorial District 5

5.1.3.2.3 Period of Performance: July 1, 2020 – June
30, 2021

5.1.3.2.4 Allocation Letter: Fiscal Year 2020-21
Original Baseline Funding Allocation for
Elderly Nutrition Program Services

5.1.3.3 OAA Title III C-1 (Nutrition Services) Original Baseline Funds
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Elderly Nutrition Program
Subaward Number ENP202106
Amendment One Page 3

5.1.3.3.1 Subaward Sum: $239,000

5.1.3.3.2 Service Area: Supervisorial District 5

5.1.3.3.3 Period of Performance: July 1, 2020 – June
30, 2021

5.1.3.3.4 Allocation Letter: Fiscal Year 2020-21
Original Baseline Funding Allocation for
Elderly Nutrition Program Services

5.1.3.4 OAA Title III C-2 (Nutrition Services) Original Baseline Funds

5.1.3.4.1 Subaward Sum: $51,000

5.1.3.4.2 Service Area: Supervisorial District 5

5.1.3.4.3 Period of Performance: July 1, 2020 – June
30, 2021

5.1.3.4.4 Allocation Letter: Fiscal Year 2020-21
Original Baseline Funding Allocation for
Elderly Nutrition Program Services

5.1.3.5 CEO CARES Act Funds for ENP Congregate Meal
Services

5.1.3.5.1 Subaward Sum: $390,000

5.1.3.5.1.1 Subrecipient shall expend
these funds before OAA Title
III C-1 (Nutrition Services) and
FFCRA (if applicable) for ENP
Congregate Meal Services
funding

5.1.3.5.1.2 Subrecipient shall ensure that
these funds are also used to
serve waitlist Clients which are
assigned to Subrecipient by
County.

5.1.3.5.2 Service Area: Supervisorial District 5
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Elderly Nutrition Program
Subaward Number ENP202106
Amendment One Page 4

5.1.3.5.3 Period of Performance: July 1, 2020 –
December 30, 2020 (pursuant to CEO Board
Motion)

5.1.3.5.4 Allocation Letter: Fiscal Year 2020-21
CARES Act Funding Allocation for Elderly
Nutrition Program Services

5.1.3.6 CEO CARES Act Funds for ENP Home-Delivered Meal Services

5.1.3.6.1 Subaward Sum: $16,000

5.1.3.6.1.1 Subrecipient shall expend
these funds before OAA Title
III C-2 (Nutrition Services) and
FFCRA (if applicable) for ENP
Home-Delivered Meal
Services funding

5.1.3.6.1.2 Subrecipient shall ensure that
these funds are also used to
serve waitlist Clients which are
assigned to Subrecipient by
County.

5.1.3.6.2 Service Area: Supervisorial District 5

5.1.3.6.3 Period of Performance: July 1, 2020 –
December 30, 2020 (pursuant to CEO Board
Motion)

5.1.3.6.4 Allocation Letter: Fiscal Year 2020-21
CARES Act Funding Allocation for Elderly
Nutrition Program Services

5.1.3.7 CDA CARES Act Funds for ENP Congregate Meal
Services

5.1.3.7.1 Subaward Sum: $248,000 (available for use
only after exhausting all CEO CARES Act for
ENP Congregate Meal Services, OAA Title
III C-1 (Nutrition Services), and FFCRA (if
applicable) for ENP Congregate Meal
Services funding)
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 534 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment One Page 5

5.1.3.7.2 Service Area: Supervisorial District 5

5.1.3.7.3 Period of Performance: July 1, 2020 – June
30, 2021 (consistent with CDA Program
Memo No. 20-13 (Corrected) issued on July
16, 2020)

5.1.3.7.4 Allocation Letter: Fiscal Year 2020-21
CARES Act Funding Allocation for Elderly
Nutrition Program Services

5.1.3.8 CDA CARES Act Funds for ENP Home-Delivered Meal Services

5.1.3.8.1 Subaward Sum: $16,000 (available for use
only after exhausting all CEO CARES Act for
ENP Home-Delivered Meal Services, OAA
Title III C-2 (Nutrition Services), and FFCRA
(if applicable) for ENP Home-Delivered Meal
Services funding)

5.1.3.8.2 Service Area: Supervisorial District 5

5.1.3.8.3 Period of Performance: July 1, 2020 – June
30, 2021 (consistent with CDA Program
Memo No. 20-13 (Corrected) issued on July
16, 2020)

5.1.3.8.4 Allocation Letter: Fiscal Year 2020-21
CARES Act Funding Allocation for Elderly
Nutrition Program Services
III. Subparagraph 5.10.4 is deleted in its entirety and replaced as follows:

5.10.4 Federal Award Identification Number (FAIN)

5.10.4.1 July 1, 2020 - June 30, 2021: 2001CAOASS-00;
2001CAOACM-00; 2001CAOAHD-00; 2001CAOANS-00;
2001CACMC2-00; 2001CAHDC2-00; and, 2001CAHDC3-00
IV. Subparagraph 5.10.7 is deleted in its entirety and replaced as follows:

5.10.7 Amount of Federal Funds Obligated by this Action:

5.10.7.1 Original Subaward: $291,000
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 535 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment One Page 6

5.10.7.2 Amendment One: $670,000

5.10.7.2.1 CEO CARES Act Funds: $406,000

5.10.7.2.2 CDA CARES Act Funds: $264,000
V. 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: $961,000
VI. Subparagraph 5.10.9 is deleted in its entirety and replaced as follows:

5.10.9 Total Amount of Federal Award (Maximum Subaward Sum): $961,000 VII. Subparagraph 5.10.10 is deleted in its entirety and replaced as follows:

5.10.10 Federal Award Project Description

5.10.10.1 July 1, 2020 - June 30, 2021: Federal Title IIIB 3BSL; Federal Title IIIC1 3C1L and NSIP C1 NC1L; Federal
Title IIIC2 3C2L and NSIP C2 NC2L; Federal Title IIIC1
CRCM and Federal Title IIIC2 CRHD; and, CARES Title
IIIC2 - HDM
VIII. Exhibit W1 (Budget) Amendment 1 {FY 2020-21 CEO CARES Act Funding}” is added, is an addendum to "Exhibit W1 (Budget)", and is incorporated herein by reference.

IX. “Exhibit W1 (Budget) Amendment 1 {FY 2020-21 CDA CARES Act Funding}” is added, is an addendum to "Exhibit W1 (Budget)", and is incorporated herein by reference.

X. Exhibit W2 (Budget) Amendment 1 {FY 2020-21 CEO CARES Act Funding}” is added, is an addendum to "Exhibit W2 (Budget)", and is incorporated herein by reference.

XI. “Exhibit W2 (Budget) Amendment 1 {FY 2020-21 CDA CARES Act Funding}” is added, is an addendum to "Exhibit W2 (Budget)", and is incorporated herein by reference.

XII. “Exhibit X1 (Mandated Program Services) Amendment 1 {FY 2020-21 CEO CARES Act Funding}” is added, is an addendum to "Exhibit X1 (Mandated Program Service)”, and is incorporated herein by reference.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 536 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment One Page 7
XIII. “Exhibit X1 (Mandated Program Services) Amendment 1 {FY 2020-21 CDA CARES Act Funding}” is added, is an addendum to "Exhibit X1 (Mandated Program Service)”, and is incorporated herein by reference.

XIV. “Exhibit X2 (Mandated Program Services) Amendment 1 {FY 2020-21 CEO CARES Act Funding}” is added, is an addendum to "Exhibit X2 (Mandated Program Services for Title III C-2 Program)”, and is incorporated herein by reference.

XV. “Exhibit X2 (Mandated Program Services) Amendment 1 {FY 2020-21 CDA CARES Act Funding}” is added, is an addendum to "Exhibit X2 (Mandated Program Services for Title III C-2 Program)”, and is incorporated herein by reference.

XVI. The "Fiscal Year 2020-21 CARES Act Funding Allocation for Elderly Nutrition Program Services" funding allocation letter is incorporated herein by reference.

All other terms and conditions of the Subaward shall remain in full force and effect.
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DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 537 of 1182
IN WITNESS WHEREOF, the Board of Supervisors of the County of Los Angeles has caused this Amendment One to be subscribed on its behalf by the Acting Director of Workforce Development, Aging and Community Services, 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
By
Otto Solórzano, Acting Director Date
County of Los Angeles
Workforce Development, Aging
and Community Services

SUBRECIPIENT
City of Glendale
Subrecipient’s Legal Name
ENP202106
Subaward Number
By
Name of Authorized Date
Representative

Title
Approved as to Form:

Signature

OFFICE OF COUNTY COUNSEL
Mary C. Wickham, County Counsel
By
Name of Authorized Date
By Representative
Lawrence M. Green
Senior Deputy County Counsel
Title

Signature
Yasmin K. Beers (Sep 30, 2020 09:39 PDT)
Yasmin K. Beers
City Manager Yasmin K. Beers
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ELDERLY NUTRITION PROGRAM (ENP)
SUBAWARD NUMBER ENP202106
SUBAWARD PERIOD JULY 2020 – JUNE 2021

AMENDMENT THREE
This Amendment is made and entered into by and between

COUNTY OF LOS ANGELES THROUGH ITS DEPARTMENT OF

WORKFORCE DEVELOPMENT, AGING AND COMMUNITY SERVICES
(“County” or “WDACS”)
County’s Business Address
3175 West Sixth Street
Los Angeles, CA 90020
and

CITY OF GLENDALE
(“Contractor” or “Subrecipient”)
Subrecipient’s Business Address
613 East Broadway Street, Room 120
Glendale, CA 91206
WHEREAS, reference is made to that certain document entitled “Elderly Nutrition Program (ENP) Subaward Number ENP202106 Subaward Period July 2020 – June 2021” dated July 1, 2020 (“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 Additional California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act funds in the amount of $143,000, which shall be reimbursed to Subrecipient in exchange for additional defined and contracted ENP Congregate Meal DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 547 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Three Page 2
Services as specified herein to be provided by Subrecipient during Fiscal Year 2020-21; and
WHEREAS, it is the intent of the parties to amend this Subaward to allocate Fiscal Year 2019-20 Families First Coronavirus Response Act (FFCRA) Carryover funds in the amount of $850, which shall be reimbursed to Subrecipient in exchange for additional defined and contracted ENP Home-Delivered Meal Services as specified herein to be provided by Subrecipient during Fiscal Year 2020-21; and WHEREAS, it is the intent of the parties to amend this Subaward to provide for 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 shall commence upon execution by all parties.

II. Subparagraph 5.1.3 is deleted in its entirety and replaced as follows:

5.1.3 Subaward Sum Year 1 Funding Source(s)

5.1.3.2 Older Americans Act (OAA) Title III B (Supportive Services and Senior Centers) Original Baseline Funds

5.1.3.2.1 Subaward Sum: $1,000

5.1.3.2.2 Service Area: Supervisorial District 5

5.1.3.2.3 Period of Performance: July 1, 2020 – June
30, 2021

5.1.3.2.4 Allocation Letter: Fiscal Year 2020-21
Original Baseline Funding Allocation for
Elderly Nutrition Program Services

5.1.3.3 OAA Title III C-1 (Nutrition Services) Original Baseline Funds

5.1.3.3.1 Subaward Sum: $239,000
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 548 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Three Page 3

5.1.3.3.2 Service Area: Supervisorial District 5

5.1.3.3.3 Period of Performance: July 1, 2020 – June
30, 2021

5.1.3.3.4 Allocation Letter: Fiscal Year 2020-21
Original Baseline Funding Allocation for
Elderly Nutrition Program Services

5.1.3.4 OAA Title III C-2 (Nutrition Services) Original Baseline Funds

5.1.3.4.1 Subaward Sum: $51,000

5.1.3.4.2 Service Area: Supervisorial District 5

5.1.3.4.3 Period of Performance: July 1, 2020 – June
30, 2021

5.1.3.4.4 Allocation Letter: Fiscal Year 2020-21
Original Baseline Funding Allocation for
Elderly Nutrition Program Services

5.1.3.5 CEO CARES Act Funds for ENP Congregate Meal
Services

5.1.3.5.1 Subaward Sum: $390,000

5.1.3.5.1.1 Subrecipient shall expend
these funds before OAA Title
III C-1 (Nutrition Services) and
FFCRA (if applicable) for ENP
Congregate Meal Services
funding

5.1.3.5.1.2 Subrecipient shall ensure that
these funds are also used to
serve waitlist Clients which are
assigned to Subrecipient by
County.

5.1.3.5.2 Service Area: Supervisorial District 5

5.1.3.5.3 Period of Performance: July 1, 2020 –
December 30, 2020 (pursuant to CEO Board
Motion)
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 549 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Three Page 4

5.1.3.5.4 Allocation Letter: Fiscal Year 2020-21
CARES Act Funding Allocation for Elderly
Nutrition Program Services

5.1.3.6 CEO CARES Act Funds for ENP Home-Delivered Meal Services

5.1.3.6.1 Subaward Sum: $16,000

5.1.3.6.1.1 Subrecipient shall expend
these funds before OAA Title
III C-2 (Nutrition Services) and
FFCRA (if applicable) for ENP
Home-Delivered Meal
Services funding

5.1.3.6.1.2 Subrecipient shall ensure that
these funds are also used to
serve waitlist Clients which are
assigned to Subrecipient by
County.

5.1.3.6.2 Service Area: Supervisorial District 5

5.1.3.6.3 Period of Performance: July 1, 2020 –
December 30, 2020 (pursuant to CEO Board
Motion)

5.1.3.6.4 Allocation Letter: Fiscal Year 2020-21
CARES Act Funding Allocation for Elderly
Nutrition Program Services

5.1.3.7 CDA CARES Act Funds for ENP Congregate Meal
Services

5.1.3.7.2 Service Area: Supervisorial District 5

5.1.3.7.3 Period of Performance: July 1, 2020 – June
30, 2021 (consistent with CDA Program
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 550 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Three Page 5
Memo No. 20-13 (Corrected) issued on July
16, 2020)

5.1.3.7.4 Allocation Letter: Fiscal Year 2020-21
CARES Act Funding Allocation for Elderly
Nutrition Program Services

5.1.3.8 CDA CARES Act Funds for ENP Home-Delivered Meal Services

5.1.3.8.2 Service Area: Supervisorial District 5

5.1.3.8.3 Period of Performance: July 1, 2020 – June
30, 2021 (consistent with CDA Program
Memo No. 20-13 (Corrected) issued on July
16, 2020)

5.1.3.8.4 Allocation Letter: Fiscal Year 2020-21
CARES Act Funding Allocation for Elderly
Nutrition Program Services

5.1.3.9 Additional CDA CARES Act Funds for ENP Congregate Meal Services

5.1.3.9.1 Subaward Sum: $143,000 (available for use
only after exhausting all OAA Title III C-1
(Nutrition Services) and FFCRA (if
applicable) for ENP Congregate Meal
Services funding)

5.1.3.9.2 Service Area: Supervisorial District 5

5.1.3.9.3 Period of Performance: July 1, 2020 – June
31, 2021 (consistent with CDA Program
Memo No. 20-13 (Corrected) issued on July
16, 2020)

5.1.3.9.4 Allocation Letter: Fiscal Year (FY) 2020-21
Additional CDA CARES Act and FY 2019-20
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 551 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Three Page 6
FFCRA Carryover Funding Allocation for
Elderly Nutrition Program Services

5.1.3.10 FY 2019-20 FFCRA Carryover Funds for ENP HomeDelivered Meal Services

5.1.3.10.1 Subaward Sum: $850 (available for use only
after exhausting all OAA Title III C-2
(Nutrition Services) for ENP Home-Delivered
Meal Services funding)

5.1.3.10.2 Service Area: Supervisorial District 5

5.1.3.10.3 Period of Performance: July 1, 2020 – June
31, 2021 (consistent with California
Department of Aging Notice on California
Major Disaster Declaration Approved – Area
Plan (AP-1920) Contract Program Spending
Flexibility)

5.1.3.10.4 Allocation Letter: Fiscal Year (FY) 2020-21
Additional CDA CARES Act and FY 2019-20
FFCRA Carryover Funding Allocation for
Elderly Nutrition Program Services
III. Subparagraph 5.10.1 is deleted in its entirety and replaced as follows:

5.10.1 Subaward Sums, either in whole or in part, are identified as Federal monies. The Federal portion(s) of the Subaward Sums is (are) identified by several key pieces of information including, but no limited to, the following: Federal Award Identification Number (FAIN), Assistance Listings Number(s) (which identifies and describes the Federal assistance that is available to various entities) and a Federal Grantor office (which provides oversight and administration for these Federal monies). When Subrecipient and its Lower Tier
Subrecipient(s), if any, are being audited by an independent auditor, Subrecipient shall provide the information identified in this Subparagraph 5.10 to the independent auditor. The information outlined herein is only provided for the Federal portion(s) of the Subaward Sums. In the event that the information is not listed herein for all of the monies included in the Subaward Sums then the excluded amounts are not Federal monies and therefore the information is not applicable to them.

IV. Subparagraph 5.10.7 is deleted in its entirety and replaced as follows:

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 552 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Three Page 7

5.10.7 Amount of Federal Funds Obligated by this Action:

5.10.7.1 Original Subaward: $291,000

5.10.7.2 Amendment One: $670,000

5.10.7.2.1 Federal CARES Act Funds: $406,000

5.10.7.2.2 CDA CARES Act Funds: $264,000

5.10.7.3 Amendment Two: $0

5.10.7.4 Amendment Three: $143,850

5.10.7.4.1 Additional CDA CARES Act Funds: $143,000

5.10.7.4.2 FY 2019-20 FFCRA Carryover Funds: $850
V. 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: $1,104,850
VI. Subparagraph 5.10.9 is deleted in its entirety and replaced as follows:

5.10.9 Total Amount of Federal Award (Maximum Subaward Sum):
$1,104,850
VII. Subparagraph 5.10.12 is deleted in its entirety and replaced as follows:

5.10.12 Assistance Listings Numbers and Titles: 93.044 - Special Programs for the Aging, Title III, Part B (Grants for Supportive Services and Senior Centers); 93.045 - Special Programs for the Aging, Title III, Part C (Nutrition Services); 93.053 - Nutrition Services Incentive Program; and, 21.019 – Coronavirus Relief Fund
VIII. Subparagraph 8.25.8 is deleted in its entirety and replaced as follows:

8.25.8 Cyber Liability Insurance

8.25.8.1 Subrecipient shall secure and maintain cyber liability insurance coverage with limits of one point five million dollars ($1,500,000) per occurrence and in the aggregate during the term of Subaward, including coverage for:
network security liability; privacy liability; privacy
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Elderly Nutrition Program
Subaward Number ENP202106
Amendment Three Page 8
regulatory proceeding, defense, response, expenses and
fines; technology professional liability (errors and
omissions); privacy breach expense reimbursement
(liability arising from the loss or disclosure of County Information no matter how it occurs); system breach;
denial or loss of Service; introduction, implantation, or spread of malicious software code; unauthorized access
to or use of computer systems; and Data/Information loss and business interruption; any other liability or risk that arises out of Subaward. Subrecipient shall add County as an additional insured to its cyber liability insurance policy and provide to County certificates of insurance evidencing the foregoing upon County's request. The procuring of the insurance described herein, or delivery of the certificates of insurance described herein, shall not be construed as a limitation upon Subrecipient's liability or as full
performance of its indemnification obligations hereunder.

No exclusion/restriction for unencrypted portable
devices/media may be on the policy.

IX. Exhibit W1 (Budget) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding}” is added as an addendum to "Exhibit W1 (Budget)", and is incorporated herein by reference.

X. “Exhibit W2 (Budget) Amendment 3 {FY 2019-20 FFCRA Carryover Funding for FY 2020-21} is added as an addendum to "Exhibit W1 (Budget)”, and is incorporated herein by reference.

XI. “Exhibit X1 (Mandated Program Services) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding}” is added as an addendum to "Exhibit X1 (Mandated Program Service)”, and is incorporated herein by reference.

XII. “Exhibit X2 (Mandated Program Services) Amendment 3 {FY 2019-20 FFCRA Carryover Funding for FY 2020-21} is added as an addendum to “Exhibit X2 (Mandated Program Services)”, and is incorporated herein by reference.

XIII. The " Fiscal Year 2020-21 (FY) Additional CDA CARES Act and FY 2019-20 FFCRA Carryover Funding Allocation for Elderly Nutrition Program Services " funding allocation letter is incorporated herein by reference.

All other terms and conditions of the Subaward shall remain in full force and effect.
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DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 554 of 1182
IN WITNESS WHEREOF, the Board of Supervisors of the County of Los Angeles has caused this Amendment Three to be subscribed on its behalf by the Acting Director of Workforce Development, Aging and Community Services, 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
By
Otto Solórzano, Acting Director Date
County of Los Angeles
Workforce Development, Aging
and Community Services

SUBRECIPIENT
City of Glendale
Subrecipient’s Legal Name
ENP202106
Subaward Number
By
Name of Authorized Date
Representative

Title
Approved as to Form:

Signature

OFFICE OF COUNTY COUNSEL
Rodrigo A. Castro-Silva, County Counsel
By
Name of Authorized Date
By Representative
Lawrence M. Green
Senior Deputy County Counsel
Title

Signature
Roubik Golanian (May 7, 2021 09:52 PDT)
Roubik Golanian
City Manager Roubik Golanian May 7, 2021
Otto Solorzano (May 7, 2021 14:38 PDT)
Otto Solorzano
May 7, 2021
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 555 of 1182
556 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

N/A
Five (5)
ENP202106
Three Modification Number: N/A
$0
City of Glendale
[Enter title]
[Enter title]
Custodial Worker
(Kitchen/Sanitization/COVID) 100% $ 3,863 3 $ 11,589
[Enter title]
[Enter title]
[Enter title]
I. BUDGET DETAIL - PERSONNEL
DIRECT
Driver (Hourly City Worker) 100% $ 2,000 4 $ 8,000 $ 8,000 $ 8,000 $0 Older Americans Act (OAA) Title III C-1 Congregate Meal Services 2020-2021
Additional CDA CARES Act Funding
(A)
POSITION TITLE (1)
(B)
% OF TIME
ON

PROGRAM
(2)
(C)

MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY1
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)
$ 8,000 $0
Driver (Hourly City Worker) 100% $ 2,000 $ 8,000
$ 8,000 $0
4 $ 8,000 $ 8,000
$ 16,902 $ 16,902 $ 16,902 $0
3 $ 7,800
$0
Driver (Hourly City Worker) 100% $ 2,000 4 $ 8,000 $ 8,000 Driver (Hourly City Worker) 100% $ 2,000 4 $ 8,000 $ 8,000 Hourly City Worker 100% $ 2,600 $0
Community Services Specialist 100% $ 4,226 4
$ 7,800 $ 7,800
$ 11,589 $ 11,589
Custodial Worker
(Kitchen/Sanitization/COVID) 100% $ 3,863 3 $ 11,589 $ 11,589 $ 11,589 $0 Exhibit W1 (Budget) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 557 of 1182
558 of 1182
559 of 1182
560 of 1182
561 of 1182
562 of 1182
563 of 1182
564 of 1182
565 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

N/A
Five (5)
ENP202106
Three Modification Number: N/A
City of Glendale
IX. BUDGET DETAIL - OTHER COSTS
Older Americans Act (OAA) Title III C-1 Congregate Meal Services 2020-2021
Additional CDA CARES Act Funding
(A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY1
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)
$ 2,379 $0
DIRECT
Maintenance and Repairs (2 CFR 200.452 & 45 CFR

75.452) $ 2,379.00 1 1 $ 2,379 $ 2,379
$ 15,000 $0
3 1 $ 21,000 $ 21,000 $ 21,000 $0
Advertising/Public Relations (2 CFR 200.421 & 45 CFR

75.421) $ 2,730.00 1 1 $ 2,730 $ 2,730
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) $ 5,000.00 1 3 $ 15,000 $ 15,000 Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) $ 7,000.00 $ 2,730 $0
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) $ 2,000.00 1 4 $ 8,000 $ 8,000 $ 8,000 $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)
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)
Exhibit W1 (Budget) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding} Page 11 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 566 of 1182
567 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
$ 2.02 [Enter] [Enter] [Enter] [Enter] $ 6.21 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] 2 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]

3.58$ [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] 2020-2021
Additional CDA CARES Act Funding
N/A
Five (5)
ENP202106
Three Modification Number: N/A
City of Glendale
Older Americans Act (OAA) Title III C-1 Congregate Meal Services In-Kind (SF)
$ -
$ -
$ -
$ -
$ -
Cash (SF)
3 Raw Food
Space In-Kind (SF)
Non-Match
$ -
$ -
Cash Other
(SSY1)
$ -
5 Cash (SF)
$ -
In-Kind (SF)
7 $ -
3 Volunteer Expenses
Cash Other
(SSY1) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
$ 391,000
$ -
$ 221,274
Cash NSIP
(SSY1) $ -
In-Kind (SF)
Cash Other
(SSY1)
$ -
Cash (SF)
$ -

6.21$ $ -
SSY1
$ -
1 (A)

COST CATEGORIES
4 (B)
COSTS (1)
$ -
2 Subtotal
Cash Other
(SSY1)
Cash NSIP
(SSY1)
$ 391,000
$ -
DIRECT
$ 120,617
$ -
$ -
Personnel
Lower Tier Subawards for Catered Food
In-Kind (SF)
Cash Other
(SSY1)
Cash (SF)
In-Kind (SF)
Volunteers
Lower Tier Subawards
In-Kind (SF)
$ -
Cash Other
(SSY1)
In-Kind (SF)
$ -
Cash (SF)
$ -
Cash (SF)
$ -
Cash Other
(SSY1)
Cash NSIP
(SSY1)
X. BUDGET SUMMARY
1 6
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
$ -
(D)
FUNDING (1)
Match
Cash (SF)
Exhibit W1 (Budget) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding} Page 13 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 568 of 1182
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
(A)

COST CATEGORIES
(B)
COSTS (1)
X. BUDGET SUMMARY
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
(D)
FUNDING (1)
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ 0.60 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ 6.21 $ - $ - $ - $ - $ 6.21 $ - $ - $ - $ -
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] 12 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ -
$ -
$ 391,000
$ -
$ -
$ -

INDIRECT
Cash (SF)
10 Cash (SF)
$ -
5 Subtotal Funding for
Direct Costs
Cash Other
(SSY1)
Cash (SF)
In-Kind (SF)
Cash NSIP
(SSY1)
$ -
8 9
$ -
$ -
$ 391,000
$ -
Cash (SF)
Cash NSIP
(SSY1) $ -
$ -
Cash Other
(SSY1)
Cash Other
(SSY1)
In-Kind (SF)
Equipment
Other Costs
Subtotal Direct Costs
$ 49,109
Cash Other
(SSY1)
In-Kind (SF)
Cash Other
(SSY1)
In-Kind (SF)
$ -
6 13 Volunteer Expenses
Cash Other
(SSY1) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
11 Personnel
Cash Other
(SSY1)
Volunteers In-Kind (SF)
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF)
$ -
Match
$ -
7 SSY1
$ -
In-Kind (SF)
4 Program Income Cash (SF) $ -
Variance (Costs-Funding)
Cash Other
(SSY1) $ -
Cash
In-Kind
$ -
In-Kind (SF)
$ -
Cash (SF)
15 Lower Tier Subawards for Catered Food
Cash Other
(SSY1)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
14 Lower Tier Subawards
Exhibit W1 (Budget) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding} Page 14 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 569 of 1182
570 of 1182
571 of 1182
Program Services: HOME-DELIVERED MEAL SERVICES
Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District
Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
DIRECT
[Enter title]
(A)
POSITION TITLE (1)
(B)
% OF TIME
ON

PROGRAM
(2)
(C)

MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY1
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
Three Modification Number: N/A
City of Glendale
2020-2021
Families First Coronavirus Response Act Funding
N/A
Five
ENP202106
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
Exhibit W2 (Budget) Amendment 3 {FY 2019-20 FFCRA Carryover Funding FY 2020-21} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 572 of 1182
573 of 1182
574 of 1182
575 of 1182
576 of 1182
577 of 1182
578 of 1182
579 of 1182
580 of 1182
Program Services: HOME-DELIVERED MEAL SERVICES
Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District
Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

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)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
DIRECT
Select Description (2) (3) (4) (5)
(A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY1
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)
IX. BUDGET DETAIL - OTHER COSTS
2020-2021
Families First Coronavirus Response Act Funding
N/A
Five
ENP202106
Three Modification Number: N/A
City of Glendale
Exhibit W2 (Budget) Amendment 3 {FY 2019-20 FFCRA Carryover Funding FY 2020-21} Page 11 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 581 of 1182
582 of 1182
Program Services: HOME-DELIVERED MEAL SERVICES
Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District
Subaward Number:

Amendment Number:

FUNDING CATEGORIES
$ -
(D)
FUNDING (1)
Match
Cash (SF)
Cash (SF)
3 (A)

COST CATEGORIES
4 (B)
COSTS (1)
$ -
2 Subtotal
Cash Other
(SSY1)
Cash NSIP
(SSY1)
$ 850
$ -
DIRECT
$ -
Raw Food
Space In-Kind (SF)
$ -
Personnel
Lower Tier Subawards for
Catered Food
In-Kind (SF)
Cash Other
(SSY1)
Cash (SF)
In-Kind (SF)
Volunteers
Lower Tier Subawards
In-Kind (SF)
Cash Other
(SSY1)
$ 6.21
Cash (SF)
$ -
-$ -$
SSY1
$ 122
1 $ -
$ -
$ -
Cash Other
(SSY1)
$ -
5 Cash (SF)
$ -
In-Kind (SF)
7 $ -
3 Volunteer Expenses
Cash Other
(SSY1) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
$ 850
$ 122
$ 850
Cash NSIP
(SSY1) $ -
In-Kind (SF)
Non-Match
Cash Other
(SSY1)
In-Kind (SF)
$ -
Cash (SF)
$ -
Cash (SF)
$ -
Cash Other
(SSY1)
Cash NSIP
(SSY1) $ -
$ -
$ -
$ -
In-Kind (SF)
2020-2021
Families First Coronavirus Response Act Funding
N/A
Five
ENP202106
Three
City of Glendale
Modification Number: N/A
Exhibit W2 (Budget) Amendment 3 {FY 2019-20 FFCRA Carryover Funding FY 2020-21} Page 13 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 583 of 1182
(2)
Hot
Meals
Unit Rate
(3)
Frozen Meals
Unit Rate
(4)
Emergency
Meals
Unit Rate
(2)
Hot
Meals
Unit Rate
(3)
Frozen Meals
Unit Rate
(4)
Emergency
Meals
Unit Rate
X. BUDGET SUMMARY
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
(D)
FUNDING (1)
(A)

COST CATEGORIES
(B)
COSTS (1)
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
$ - $ 6.21 $ - $ - $ 6.21 $ -
$ - $ - $ - $ - $ - $ -
$ - $ - $ 8.15 $ - $ - $ 8.15
$ - $ - $ - $ - $ - $ -
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
12 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
Lower Tier Subawards for
Catered Food
Cash Other
(SSY1)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
14 Lower Tier Subawards
4 Program Income Cash (SF) $ -
Variance (Costs-Funding)
Cash Other
(SSY1) $ -
Cash
In-Kind
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF)
$ -
Match
$ -
7 SSY1
$ -
In-Kind (SF)
Cash Other
(SSY1) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
$ -
In-Kind (SF)
$ -
Cash (SF)
15 11 Personnel
Cash Other
(SSY1)
Volunteers In-Kind (SF)
$ -
Cash (SF)
$ -
6 10
Cash Other
(SSY1)
13 Volunteer Expenses
Equipment
Other Costs
Subtotal Direct Costs
In-Kind (SF)
$ -
Cash (SF)
$ -
$ -
Cash Other
(SSY1)
5 Subtotal Funding for
Direct Costs
Cash Other
(SSY1)
Cash (SF)
In-Kind (SF)
Cash NSIP
(SSY1)
8 9
$ 122
$ -
$ 850
$ -
$ -
Cash (SF)
Cash Other
(SSY1)
In-Kind (SF)
Cash NSIP
(SSY1)
Cash Other
(SSY1)
In-Kind (SF)
$ -
$ -
$ 850
$ 122
$ -
$ -

INDIRECT
Exhibit W2 (Budget) Amendment 3 {FY 2019-20 FFCRA Carryover Funding FY 2020-21} Page 14 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 584 of 1182
585 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
[Enter]
Ext.
[Enter]
Phone Number Ext.
[Enter]
Phone Number Ext.

MPS Reviewed and Approved by: Sheri Stanton Date: 5/24/2021

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Irma Panosian
Senior Community Service Supervisor [email protected] Prefix Project Manager Job Title E-Mail Address
Mr. Maggie Kavarian (818)548-3715
[Select] [Enter Name]
Prefix
E-Mail Address
Ms. Onnig Bulanikian (818)548-2000
Phone Number
EXHIBIT X1 (MANDATED PROGRAM SERVICES)
AMENDMENT 3 {FY 2020-21 ADDITIONAL CDA CARES ACT FUNDING} Subrecipient's Legal Name:
[Enter Address]
Director, Community Services and
Parks [email protected]
State Zip Code
613 E. Broadway Street Room 120 Glendale CA 91206
Main Administrative Office Address
Budget Analyst Job Title E-Mail Address
[Enter City] CA [Enter Zip]
[Enter Title] [Enter #'s Only] [E-Mail Address]
Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title
City
Congregate Meal Services
2020-2021
Additional CDA CARES Act Funding
N/A
Five
ENP202106
City of Glendale
Three Modification Number: N/A
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 586 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subtotal SSY1
(Cash Other and Cash NSIP)
Total (4)
SSY1
(Cash NSIP)
Subtotal SSY1
(Cash Other and Cash NSIP)
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
[Select Ethnic
Meal Style]
SF (7)
(Cash and In-Kind)
$ -
[Enter Unit Rate]
62,963
[Enter Units]
[Enter Units]
[Enter Unit Rate]
$ 391,000
$ 6.21
[Enter Unit Rate]
[Enter Total
Unduplicated
Units]
$ 6.21 $ 391,000
$ 6.21
[Enter Unit Rate]
Subrecipient's Legal Name:

Congregate Meal Services
2020-2021
Additional CDA CARES Act Funding
N/A
Five
ENP202106
City of Glendale
Ethnic Meals
Total (4)
SSY1 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
[Enter Total
Unduplicated
Units]
$ -
[Enter Units]
Three Modification Number: N/A
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
SSY1 (6)
(Cash Other)
SSY1
(Cash NSIP) [Enter Units]
I. UNITS OF SERVICE SUMMARY
805
American Meals
Exhibit X1 (Mandated Program Services) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 587 of 1182
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
Equipment (Other) (9)
[Enter Units]
[Enter Units]
[Enter Units]
[Enter Amount]
Total (4)
[Enter Total
Unduplicated
Units]
[Enter Unit Rate]
SSY1
(Cash NSIP) [Enter Unit Rate]
$ - $ -
GRAND TOTAL SERVICES/FUNDING 805
SSY1 (6)
(Cash Other)
Subtotal SSY1
(Cash Other and Cash NSIP)
-
SF (7)
(Cash and In-Kind)
$ 391,000
[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.
(9) Enter the amount of equipment (other) that is reflected in Exhibit W1 (Budget). (6) SSY1: Subaward Sum Year 1
(7) SF: Subrecipient's Funds
(8) Enter the approved amount of equipment purchase(s) that is reflected in Exhibit W1 (Budget).

Equipment (Purchases) (8) $ -
(2) Please Enter the Unit Rates: a) for SSY1 (Cash Other) and for SSY1 (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 SSY1 (Cash Other), SSY1 (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.

Exhibit X1 (Mandated Program Services) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding} Page 3 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 588 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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)
1 775 15,439 15,439 15,439 15,439 61,756
2 30 302 302 302 301 1,207
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
805 0 0 0 0 0 0 0 0 15,741 15,741 15,741 15,740 62,963
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
Adult Recreation Center
Sparr Height Community Center
ENP202106
Congregate Meal Services
2020-2021
Additional CDA CARES Act Funding
N/A
Five
Subrecipient's Legal Name: City of Glendale
Three Modification Number: N/A
Exhibit X1 (Mandated Program Services) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding} Page 4 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 589 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

ENP202106
Three Modification Number:

Congregate Meal Services
2020-2021
Additional CDA CARES Act Funding
N/A
Five
N/A
NOTE:

Grand Total
Subrecipient's Legal Name: City of Glendale
[Select Ethnic Meal Style] III. SERVICES BY MONTH - ETHNIC MEALS (B)

SITE NAME
Exhibit X1 (Mandated Program Services) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 590 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

ENP202106
Three Modification Number:

IV. SERVICES BY MONTH - ETHNIC MEALS [Select Ethnic Meal Style] N/A
Subrecipient's Legal Name: City of Glendale
Congregate Meal Services
2020-2021
Additional CDA CARES Act Funding
N/A
Five
NOTE:
(B)

SITE NAME
Grand Total
Exhibit X1 (Mandated Program Services) Amendment 3 {FY 2020-21 Additional CDA CARES Act Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 591 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
[Enter]
Ext.
[Enter]
Phone Number Ext.
[Enter]
Phone Number Ext.

State Zip Code
613 East Broadway Room 120 Glendale CA 91206
Main Administrative Office Address City
EXHIBIT X2 (MANDATED PROGRAM SERVICES)
AMENDMENT 3 {FY 2019-20 FFCRA CARRYOVER FUNDING FY 2020-21} Prefix Budget Analyst Job Title E-Mail Address
[Enter City] CA [Enter Zip]
Accountant (818) 551-3060 [email protected]
Mailing Address (if different from above) City
[Enter Address]
Director [email protected]
Prefix Authorized Representative Job Title E-Mail Address Mr. Onnig Bulanikian (818) 548-2000
Phone Number
State Zip Code
Senior Community Services Supervisor [email protected] Prefix Project Manager Job Title E-Mail Address
Ms. Maggie Kavarian (818) 548-3715
Mr. Hanre Chang
MPS Reviewed and Approved by: Sheri Stanton Date: 5/6/2021

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Irma Panosian
Five
N/A
Families First Coronavirus Response Act Funding
2020-2021

HOME DELIVERED MEAL SERVICES
Three Modification Number:

ENP202106
N/A
City of Glendale
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 592 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

SSY1
(Cash NSIP)
137
[Enter Units]
I. UNITS OF SERVICE SUMMARY
10 [Enter Unit Rate]
$ 850
$ 6.21
$ 6.21
$ 6.21
$ 850
[Enter Unit Rate]
$ -
[Enter Unit Rate]
[Enter Unit Rate]
[Enter Units]
[Enter Units]
[Enter Units]
Total (4)
SSY1
(Cash NSIP)
Subtotal SSY1
(Cash Other and Cash NSIP)

HOME DELIVERED MEAL SERVICES
2020-2021
Families First Coronavirus Response Act Funding
N/A
Five
ENP202106
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

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

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
Hot Meals
Subtotal SSY1
(Cash Other and Cash NSIP)
SSY1 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
SSY1 (6)
(Cash Other)
Frozen Meals
[Enter Units]
Total (4)
SF (7)
(Cash and In-Kind)
[Enter Total
Unduplicated
Units]
[Enter Unit Rate]
[Enter Total
Unduplicated
Units]
$ -
Exhibit X2 (Mandated Program Services) Amendment 3 {FY 2019-20 FFCRA Carryover Funding for FY 2020-21} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 593 of 1182
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
(B)

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
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 W2 (Budget) (cover page) column (F) Total Funding.
(9) Enter the amount of equipment (other) that is reflected in Exhibit W2 (Budget). (6) SSY1: Subaward Sum Year 1
(7) SF: Subrecipient's Funds
(8) Enter the approved amount of equipment purchase(s) that is reflected in Exhibit W2 (Budget).

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. $ 8.15 $ 122
$ 972
[Enter Amount]
Total (4)
[Enter Total
Unduplicated
Units]
$ 8.15 $ 122
$ - $ -
SSY1
(Cash NSIP) [Enter Unit Rate]
$ - $ -
GRAND TOTAL SERVICES/FUNDING 10
SSY1 (6)
(Cash Other)
Subtotal SSY1
(Cash Other and Cash NSIP)
-
Emergency Meals
15 [Enter Units]
15 SF (7)
(Cash and In-Kind)
Exhibit X2 (Mandated Program Services) Amendment 3 {FY 2019-20 FFCRA Carryover Funding for FY 2020-21} Page 3 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 594 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

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

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2020-2021
Families First Coronavirus Response Act Funding
City of Glendale
Three Modification Number: N/A
N/A
Five
ENP202106
Grand Total
NOTE:

Exhibit X2 (Mandated Program Services) Amendment 3 {FY 2019-20 FFCRA Carryover Funding for FY 2020-21} Page 4 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 595 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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 2 11 14 49 74
2 1 7 7 7 21
3 1 7 7 7 21
4 1 7 7 7 21
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
5 0 0 0 0 0 0 0 0 0 32 35 70 137
(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 Route 1
III. SERVICES BY MONTH - FROZEN MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2020-2021
Families First Coronavirus Response Act Funding
City of Glendale
N/A
Five
ENP202106
Three Modification Number: N/A
Route 2
Route 3
Route 4
Grand Total
NOTE:

Exhibit X2 (Mandated Program Services) Amendment 3 {FY 2019-20 FFCRA Carryover Funding for FY 2020-21} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 596 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

HOME DELIVERED MEAL SERVICES
2020-2021
Families First Coronavirus Response Act Funding
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
(K)
FEB
(L)
MAR
(I)
DEC
(J)
JAN
Grand Total
NOTE:

ENP202106
Three Modification Number: N/A
City of Glendale
Exhibit X2 (Mandated Program Services) Amendment 3 {FY 2019-20 FFCRA Carryover Funding for FY 2020-21} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 597 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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 2 6 6
2 1 3 3
3 1 3 3
4 1 3 3
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
5 0 0 0 0 0 0 0 0 0 0 0 15 15
(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 Route 1
V. SERVICES BY MONTH - EMERGENCY MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2020-2021
Families First Coronavirus Response Act Funding
City of Glendale
N/A
Five
ENP202106
Three Modification Number: N/A
Route 2
Route 3
Route 4
Grand Total
NOTE:

Exhibit X2 (Mandated Program Services) Amendment 3 {FY 2019-20 FFCRA Carryover Funding for FY 2020-21} Page 7 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 598 of 1182
599 of 1182
600 of 1182
City of Glendale
FY 2020-21 Additional CDA CARES and FY 2019-20 FFCRA Carryover Funding Allocation Elderly Nutrition Program

Page 3 ends

If you have any questions, please contact Irma Panosian of my staff by phone or e-mail as follows: (323) 336-5426 or [email protected].

Thank you.

Carol Domingo
Carol Domingo, Program Manager
Contracts Management Division
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 601 of 1182
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ELDERLY NUTRITION PROGRAM (ENP)
SUBAWARD NUMBER ENP202106
SUBAWARD PERIOD JULY 2020 – JUNE 2022

AMENDMENT FIVE
This Amendment is made and entered into by and between

COUNTY OF LOS ANGELES THROUGH ITS DEPARTMENT OF

WORKFORCE DEVELOPMENT, AGING AND COMMUNITY SERVICES
(“County” or “WDACS”)
County’s Business Address
510 South Vermont Avenue, 11th Floor
Los Angeles, CA 90020
and

CITY OF GLENDALE
(“Contractor” or “Subrecipient”)
Subrecipient’s Business Address
613 East Broadway Street, Room 120
Glendale, CA 91206
WHEREAS, reference is made to that certain document entitled “Elderly Nutrition Program (ENP) Subaward Number ENP202106 Subaward Period July 2020 – June 2021” dated July 1, 2020, which is renamed as “Elderly Nutrition Program (ENP) Subaward Number ENP202106 Subaward Period July 2020 – June 2022”, 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
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 633 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Five Page 2
WHEREAS, it is the intent of the parties to amend this Subaward to reallocate Fiscal Year (FY) 2020-21 California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act funds in the amount of $124,578, which shall 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 2021-22; 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 shall commence upon execution by all parties.

II. Subparagraph 2.2 is deleted in its entirety and replaced as follows:

2.2 Federal and County Terms

2.2.1 In compliance with the requirements of Title 45 Code of Federal Regulations Part 75 et seq. and Title 2 Code of Federal Regulations Part 200 et seq., the following terms shall be used to refer to this Agreement:

2.2.1.1 Subaward: Subaward By and Between
County of Los Angeles Workforce
Development, Aging and Community Services
and City of Glendale for Elderly Nutrition
Program (ENP) Services Subaward Number
ENP202106 Subaward Period July 1, 2020 –
June 30, 2021;

2.2.1.2 Subrecipient: The party to this Agreement
who is identified as City of Glendale

2.2.1.3 Lower Tier Subaward: A third-party
agreement; and

2.2.1.4 Lower Tier Subrecipient: A third-party

2.2.2 In compliance with County of Los Angeles statutes and Board mandates, the following terms also may be used to refer to this Agreement in certain instances:

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 634 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Five Page 3

2.2.2.1 Contract: Subaward By and Between County
of Los Angeles Workforce Development,
Aging and Community Services and City of
Glendale for Elderly Nutrition Program (ENP)
Services Subaward Number ENP202106
Subaward Period July 1, 2020 – June 30, 2021;

2.2.2.2 Contractor: The party to this Agreement who
is identified as City of Glendale;

2.2.2.3 Subcontract: A third-party agreement

2.2.2.4 Subcontractor: A third-party

2.2.3 In all cases, when the terms Subaward, Subrecipient, Lower Tier Subaward, and Lower Tier Subrecipient are used, then these shall have the meaning provided herein and as noted in Exhibit P (Definitions).

III. Subparagraph 5.1.4 is deleted in its entirety and replaced as follows:

5.1.4 Subaward Sum Year 2 Funding Source(s)

5.1.4.1 The Subaward Sum Year 2 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.

5.1.4.2 Older Americans Act (OAA) Title III B (Supportive Services and Senior Centers) original baseline funds

5.1.4.2.1 Subaward Sum: $1,000

5.1.4.2.2 Service Area: Supervisorial District 5

5.1.4.2.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with California Department of
Aging contract number AP-2122-19)

5.1.4.2.4 Allocation Letter: Fiscal Year 2021-22
Baseline Funding Allocation for Elderly
Nutrition Program Services

5.1.4.3 OAA Title III C-1 (Nutrition Services) original baseline funds

5.1.4.3.1 Subaward Sum: $247,000
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 635 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Five Page 4

5.1.4.3.2 Service Area: Supervisorial District 1

5.1.4.3.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with California Department of
Aging contract number AP-2122-19)

5.1.4.3.4 Allocation Letter: Fiscal Year 2021-22
Baseline Funding Allocation for Elderly
Nutrition Program Services

5.1.4.4 OAA Title III C-2 (Nutrition Services) original baseline funds

5.1.4.4.1 Subaward Sum: $53,000

5.1.4.4.2 Service Area: Supervisorial District 5

5.1.4.4.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with California Department of
Aging contract number AP-2122-19)

5.1.4.4.4 Allocation Letter: Fiscal Year 2021-22
Baseline Funding Allocation for Elderly
Nutrition Program Services

5.1.4.5 CDA CARES Act Funds for ENP Congregate Meal Services

5.1.4.5.1 Subaward Sum: $124,578

5.1.4.5.1.1 Subrecipient shall expend these
funds before utilizing OAA Title
III C-1 (Nutrition Services) funds
for ENP Congregate Meal
Services

5.1.4.5.2 Service Area: Supervisorial District 5

5.1.4.5.3 Period of Performance: July 1, 2021 –
September 30, 2021 (consistent with CDA
Program memo No. 20-13 (Corrected) issued
on July 16, 2020)

5.1.4.5.4 Allocation Letter: Fiscal Year 2020-21 Funding Reallocation for Elderly Nutrition Program
Services
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 636 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Five Page 5
IV. Subparagraph 5.10.4 is deleted in its entirety and replaced as follows:

5.10.4 Federal Award Identification Number (FAIN)

5.10.4.1 July 1, 2020 - June 30, 2021: 2001CAOASS-00;
2001CAOACM-00; 2001CAOAHD-00; 2001CAOANS-00;
2001CACMC2-00; 2001CAHDC2-00; 2001CAHDC3-00;
and, SLT0198

5.10.4.2 July 1, 2021- June 30, 2022: 2101CAOASS-01;
2101CAOACM-0; 2101CAOAHD-01; and, 2101CAOANS01
V. Subparagraph 5.10.7 is deleted in its entirety and replaced as follows:

5.10.7 Amount of Federal Funds Obligated by this Action:

5.10.7.1 Original Subaward: $291,000

5.10.7.2 Amendment One: $670,000

5.10.7.2.1 Federal CARES Act Funds: $406,000

5.10.7.2.2 CDA CARES Act Funds: $264,000

5.10.7.3 Amendment Two: $0

5.10.7.4 Amendment Three: $143,850

5.10.7.4.1 Additional CDA CARES Act Funds: $143,000

5.10.7.4.2 FY 2019-20 FFCRA Carryover Funds: $850

5.10.7.5 Amendment Four: $301,000

5.10.7.6 Amendment Five: $124,578
VI. 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: $1,104,850

5.10.8.2 Subaward Sum Year 2: $425,578
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 637 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Five Page 6
VII. Subparagraph 5.10.9 is deleted in its entirety and replaced as follows:

5.10.9 Total Amount of Federal Award (Maximum Subaward Sum):
$1,405,850 (FY 2020-21 Reallocation funds excluded)
VIII. “Exhibit W1 (Budget) Amendment 5 {FY 2021-22 CDA CARES Act Funding}” is added, is an addendum to "Exhibit W1 (Budget)", and is incorporated herein by reference.

IX. “Exhibit X1 (Mandated Program Services) Amendment 5 {FY 2021-22 CDA CARES Act Funding}” is added, is an addendum to "Exhibit X1 (Mandated Program Service)”, and is incorporated herein by reference.

X. The "Fiscal Year 2020-21 Funding Reallocation for Elderly Nutrition Program Services" funding allocation letter is incorporated herein by reference.

All other terms and conditions of the Subaward shall remain in full force and effect. //
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DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 638 of 1182
IN WITNESS WHEREOF, the Board of Supervisors of the County of Los Angeles has caused this Amendment Five to be subscribed on its behalf by the Acting Director of Workforce Development, Aging and Community Services, 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
By
Otto Solórzano, Acting Director Date
County of Los Angeles
Workforce Development, Aging
and Community Services

SUBRECIPIENT
City of Glendale
Subrecipient’s Legal Name
ENP202106
Subaward Number
By
Name of Authorized Date
Representative

Title
Approved as to Form:

Signature

OFFICE OF COUNTY COUNSEL
Rodrigo A. Castro Silva, County Counsel
By
Name of Authorized Date
By Representative
Lawrence M. Green
Senior Deputy County Counsel
Title

Signature
Roubik Golanian (Aug 25, 2021 17:51 PDT)
City Manager Roubik Golanian Aug 25, 2021
8/26/2021
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 639 of 1182
640 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
[Enter title]
$0
Meal Site Coordinator (Hourly City
Worker) 14% $ 3,640 2 $ 1,019 $ 1,019
Meal Site Coordinator (Hourly City
Worker) 100% $ 2,779 2 $ 5,558 $ 5,558
[Enter title]
Meal Driver (Hourly City Worker) 100% $ 3,120 2 $ 6,240 $ 6,240 $ 6,240 $0 $ 1,019 $0
Meal Driver (Hourly City Worker) 100% $ 3,120 $ 6,240
$ 5,558 $0
2 $ 6,240 $ 6,240
Older Americans Act (OAA) Title III C-1 Congregate Meal Services 2021-2022
California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act (A)
POSITION TITLE (1)
(B)
% OF TIME
ON

PROGRAM
(2)
(C)

MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY2
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
Food Services Manager (Comm. Serv
Specialist) 100% $ 4,226 2 $ 8,452 $ 8,452 $ 8,452 $0
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
N/A
Five (5)
ENP202106
Five Modification Number: N/A
City of Glendale
Exhibit W1 (Budget) Amendment 5 {FY 2021-22 CDA CARES Act Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 641 of 1182
642 of 1182
643 of 1182
644 of 1182
645 of 1182
646 of 1182
647 of 1182
648 of 1182
649 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

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)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
1 2 $ 416 $ 416
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 208.00$ $ 416 $0 $ 2,418 $0
DIRECT
Maintenance and Repairs (2 CFR 200.452 & 45 CFR 75.452) 1,209.00$ 1 2 $ 2,418 $ 2,418 (A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY2
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)
N/A
Five (5)
ENP202106
Five Modification Number: N/A
City of Glendale
IX. BUDGET DETAIL - OTHER COSTS
Older Americans Act (OAA) Title III C-1 Congregate Meal Services 2021-2022
California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act Exhibit W1 (Budget) Amendment 5 {FY 2021-22 CDA CARES Act Funding} Page 11 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 650 of 1182
651 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
$ 1.71 [Enter] [Enter] [Enter] [Enter] $ 6.21 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] 2 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]

4.35$ [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] X. BUDGET SUMMARY
1 6
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
$ -
(D)
FUNDING (1)
Match
Cash (SF)
Cash Other
(SSY2)
In-Kind (SF)
$ -
Cash (SF)
$ -
Cash (SF)
$ -
Cash Other
(SSY2)
Cash NSIP
(SSY2)
(A)

COST CATEGORIES
4 (B)
COSTS (1)
$ -
2 Subtotal
Cash Other
(SSY2)
Cash NSIP
(SSY2)
$ 124,578
$ -
DIRECT
$ 34,386
$ -
$ -
Personnel
Lower Tier Subawards for Catered Food
In-Kind (SF)
Cash Other
(SSY2)
Cash (SF)
In-Kind (SF)
Volunteers
Lower Tier Subawards
In-Kind (SF)
-$
Cash Other
(SSY2)
-$
Cash (SF)
$ -

6.21$ -$
SSY2
$ -
1 -$
$ -
Cash Other
(SSY2)
$ -
5 Cash (SF)
$ -
In-Kind (SF)
7 $ -
3 Volunteer Expenses
Cash Other
(SSY2) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
$ 124,578
$ -
$ 87,358
Cash NSIP
(SSY2) $ -
In-Kind (SF)
$ -
$ -
Cash (SF)
3 Raw Food
Space In-Kind (SF)
Non-Match
$ -
$ -
$ -
Older Americans Act (OAA) Title III C-1 Congregate Meal Services In-Kind (SF)
2021-2022
California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act N/A
Five (5)
ENP202106
Five Modification Number: N/A
City of Glendale
Exhibit W1 (Budget) Amendment 5 {FY 2021-22 CDA CARES Act Funding} Page 13 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 652 of 1182
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos) Unit
Rate
X. BUDGET SUMMARY
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
(D)
FUNDING (1)
(A)

COST CATEGORIES
(B)
COSTS (1)
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ 0.14 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ 6.21 $ - $ - $ - $ - $ 6.21 $ - $ - $ - $ -
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] 12 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ -
In-Kind (SF)
$ -
Cash (SF)
15 Lower Tier Subawards for Catered Food
Cash Other
(SSY2)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
14 Lower Tier Subawards
4 Program Income Cash (SF) $ -
Variance (Costs-Funding)
Cash Other
(SSY2) $ -
Cash
In-Kind
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF)
$ -
Match
$ -
7 SSY2
$ -
In-Kind (SF)
Cash Other
(SSY2)
In-Kind (SF)
$ -
6 13 Volunteer Expenses
Cash Other
(SSY2) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
11 Personnel
Cash Other
(SSY2)
Volunteers In-Kind (SF)
$ 2,834
Cash Other
(SSY2)
In-Kind (SF)
8 9
$ -
$ -
$ 124,578
$ -
Cash (SF)
Cash NSIP
(SSY2) $ -
$ -
Cash Other
(SSY2)
Cash Other
(SSY2)
In-Kind (SF)
Equipment
Other Costs
Subtotal Direct Costs
Cash (SF)
$ -
5 Subtotal Funding for
Direct Costs
Cash Other
(SSY2)
Cash (SF)
In-Kind (SF)
Cash NSIP
(SSY2)
$ -
$ -
$ -
$ 124,578
$ -
$ -
$ -

INDIRECT
Cash (SF)
10 Exhibit W1 (Budget) Amendment 5 {FY 2021-22 CDA CARES Act Funding} Page 14 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 653 of 1182
654 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
[Enter]
Ext.
[Enter]
Phone Number Ext.
[Enter]
Phone Number Ext.

City
Congregate Meal Services
2021-2022
California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act N/A
Five
ENP202106
City of Glendale
Five Modification Number: N/A
Budget Analyst Job Title E-Mail Address
[Enter City] CA [Enter Zip]
Accountant I (818) 551-3060 [email protected]
Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title
EXHIBIT X1 (MANDATED PROGRAM SERVICES)
AMENDMENT 5 {FY 2021-22 CDA CARES ACT FUNDING}
Subrecipient's Legal Name:
[Enter Address]
Director Community Services & Parks [email protected] State Zip Code
613 East Broadway Room 120 Glendale CA 91206
Main Administrative Office Address
E-Mail Address
Mr. Onnig Bulanikian (818) 548-2000
Phone Number
Senior Community Services Supervisor [email protected] Prefix Project Manager Job Title E-Mail Address
Ms. Maggie Kavarian (818) 548-3715
Mr. Hanre Chang
Prefix
MPS Reviewed and Approved by: Sheri Stanton Date: 8/16/2021

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Irma Panosian
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 655 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

SSY2
(Cash NSIP)
[Enter Units]
[Enter Units]
I. UNITS OF SERVICE SUMMARY
600
American Meals
Subrecipient's Legal Name:

Congregate Meal Services
2021-2022
California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act N/A
Five
ENP202106
City of Glendale
Ethnic Meals
Total (4)
SSY2 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
[Enter Total
Unduplicated
Units]
[Enter Units]
[Enter Unit Rate]
Five Modification Number: N/A
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
SSY2 (6)
(Cash Other)
$ -
[Enter Unit Rate]
20,061
[Enter Units]
[Enter Units]
[Enter Unit Rate]
$ -
$ 124,578
$ 6.21 $ 124,578
[Enter Unit Rate]
20,061
$ 6.21 $ 124,578
$ 6.21
$ - $ -
Subtotal SSY2
(Cash Other and Cash NSIP)
Total (4)
SSY2
(Cash NSIP)
Subtotal SSY2
(Cash Other and Cash NSIP)
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
[Select Ethnic
Meal Style]
SF (7)
(Cash and In-Kind)
Exhibit X1 (Mandated Program Services) Amendment 5 {FY 2021-22 CDA CARES Act Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 656 of 1182
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
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). (6) SSY2: Subaward Sum Year 2
(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 SSY2 (Cash Other) and for SSY2 (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 SSY2 (Cash Other), SSY2 (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. [Enter Amount]
Total (4)
[Enter Total
Unduplicated
Units]
[Enter Unit Rate]
SSY2
(Cash NSIP) [Enter Unit Rate]
$ - $ -
GRAND TOTAL SERVICES/FUNDING 600
SSY2 (6)
(Cash Other)
Subtotal SSY2
(Cash Other and Cash NSIP)
20,061
SF (7)
(Cash and In-Kind)
$ 124,578
[Enter Unit Rate]
[Select Ethnic
Meal Style] Ethnic Meals
[Enter Units]
[Enter Units]
[Enter Units]
Exhibit X1 (Mandated Program Services) Amendment 5 {FY 2021-22 CDA CARES Act Funding} Page 3 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 657 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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)
1 500 9,900 9,861 19,761
2 100 150 150 300
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
600 10,050 10,011 0 0 0 0 0 0 0 0 0 0 20,061
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 Glendale
Five Modification Number: N/A
ENP202106
Congregate Meal Services
2021-2022
California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act N/A
Five
II. SERVICES BY MONTH - AMERICAN MEALS
(B)

SITE NAME
Adult Recreation Center
Sparr Heights Community Center
Grand Total
Exhibit X1 (Mandated Program Services) Amendment 5 {FY 2021-22 CDA CARES Act Funding} Page 4 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 658 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

Subrecipient's Legal Name: City of Glendale
[Select Ethnic Meal Style] III. SERVICES BY MONTH - ETHNIC MEALS (B)

SITE NAME
NOTE:

Grand Total
ENP202106
Five Modification Number:

Congregate Meal Services
2021-2022
California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act N/A
Five
N/A
Exhibit X1 (Mandated Program Services) Amendment 5 {FY 2021-22 CDA CARES Act Funding} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 659 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

NOTE:
(B)

SITE NAME
Grand Total
Congregate Meal Services
2021-2022
California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act N/A
Five
ENP202106
Five Modification Number:

IV. SERVICES BY MONTH - ETHNIC MEALS [Select Ethnic Meal Style] N/A
Subrecipient's Legal Name: City of Glendale
Exhibit X1 (Mandated Program Services) Amendment 5 {FY 2021-22 CDA CARES Act Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 660 of 1182
661 of 1182
662 of 1182

ELDERLY NUTRITION PROGRAM (ENP)
SUBAWARD NUMBER ENP202106
SUBAWARD PERIOD JULY 2020 – JUNE 2022

AMENDMENT SIX
This Amendment is made and entered into by and between

COUNTY OF LOS ANGELES THROUGH ITS DEPARTMENT OF

WORKFORCE DEVELOPMENT, AGING AND COMMUNITY SERVICES
(“County” or “WDACS”)
County’s Business Address
510 South Vermont Avenue, 11th Floor
Los Angeles, CA 90020
and

CITY OF GLENDALE
(“Contractor” or “Subrecipient”)
Subrecipient’s Business Address
613 East Broadway Street, Room 120
Glendale, CA 91206
WHEREAS, reference is made to that certain document entitled “Elderly Nutrition Program (ENP) Subaward Number ENP202106 Subaward Period July 2020 – June 2022” dated July 1, 2020, 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 extend the use of Families First Coronavirus Response Act (FFCRA) funds to December 31, 2021; and DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 663 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Six Page 2
WHEREAS, it is the intent of the parties to also amend this Subaward to extend the use of California Department of Aging (CDA) Coronavirus Aid, Relief, and Economic Security (CARES) Act funds to June 30, 2022; and
WHEREAS, it is the intent of the parties to 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 shall commence upon execution by all parties.

II. Subparagraph 5.1.4 is deleted in its entirety and replaced as follows:

5.1.4 Subaward Sum Year 2 Funding Source(s)

5.1.4.2 Older Americans Act (OAA) Title III B (Supportive Services and Senior Centers) original baseline funds

5.1.4.2.1 Subaward Sum: $1,000

5.1.4.2.2 Service Area: Supervisorial District 5

5.1.4.2.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with California Department of
Aging contract number AP-2122-19)

5.1.4.2.4 Allocation Letter: Fiscal Year 2021-22
Baseline Funding Allocation for Elderly
Nutrition Program Services

5.1.4.3 OAA Title III C-1 (Nutrition Services) original baseline funds

5.1.4.3.1 Subaward Sum: $247,000

5.1.4.3.2 Service Area: Supervisorial District 5
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 664 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Six Page 3

5.1.4.3.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with California Department of
Aging contract number AP-2122-19)

5.1.4.3.4 Allocation Letter: Fiscal Year 2021-22
Baseline Funding Allocation for Elderly
Nutrition Program Services

5.1.4.4 OAA Title III C-2 (Nutrition Services) original baseline funds

5.1.4.4.1 Subaward Sum: $53,000

5.1.4.4.2 Service Area: Supervisorial District 5

5.1.4.4.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with California Department of
Aging contract number AP-2122-19)

5.1.4.4.4 Allocation Letter: Fiscal Year 2021-22
Baseline Funding Allocation for Elderly
Nutrition Program Services

5.1.4.5 CDA CARES Act Funds for ENP Congregate Meal Services

5.1.4.5.1 Subaward Sum: $124,578

5.1.4.5.1.1 Subrecipient shall expend these
funds before utilizing OAA Title
III C-1 (Nutrition Services) funds
for ENP Congregate Meal
Services

5.1.4.5.2 Service Area: Supervisorial District 5

5.1.4.5.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with CDA Program memo No.
20-13 (Corrected) issued on July 16, 2020)

5.1.4.5.4 Allocation Letter: Fiscal Year 2020-21 Funding Reallocation for Elderly Nutrition Program
Services
III. Subparagraph 5.10.4 is deleted in its entirety and replaced as follows:

5.10.4 Federal Award Identification Number (FAIN)
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 665 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Six Page 4

5.10.4.1 July 1, 2020 – June 30, 2021: 2001CAOASS-00;
2001CAOACM-00; 2001CAOAHD-00; 2001CAOANS-00;
2001CACMC2-00; 2001CAHDC2-00; 2001CAHDC3-00;
SLT0198; 2001CASSC3-00; and, 2001CAFCC3-00

5.10.4.2 July 1, 2021 – June 30, 2022: 2101CAOASS-01;
2101CAOACM-01; 2101CAOAHD-01; 2101CAOANS-01;
2001CAHDC3-00; 2001CASSC3-00; and, 2001CAFCC3-00
IV. Subparagraph 5.10.7 is deleted in its entirety and replaced as follows:

5.10.7 Amount of Federal Funds Obligated by this Action:

5.10.7.1 Original Subaward: $291,000

5.10.7.2 Amendment One: $670,000

5.10.7.2.1 Federal CARES Act Funds: $406,000

5.10.7.2.2 CDA CARES Act Funds: $264,000

5.10.7.3 Amendment Two: $0

5.10.7.4 Amendment Three: $143,850

5.10.7.4.1 Additional CDA CARES Act Funds: $143,000

5.10.7.4.2 FY 2019-20 FFCRA Carryover Funds: $850

5.10.7.5 Amendment Four: $301,000

5.10.7.6 Amendment Five: $124,578

5.10.7.7 Amendment Six: $0
V. Subparagraph 5.10.10 is deleted in its entirety and replaced as follows:

5.10.10 Federal Award Project Description

5.10.10.1 July 1, 2020 - June 30, 2021: Federal Title IIIB 3BSL; Federal Title IIIC1 3C1L and NSIP C1 NC1L; Federal Title IIIC2 3C2L and NSIP C2 NC2L; Federal Title IIIC1 CRCM
and Federal Title IIIC2 CRHD; CARES Title IIIC2 HDC3;
and, Federal Title IIIE 3EFL
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 666 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Six Page 5

5.10.10.2 July 1, 2021 – June 30, 2022: Federal Title IIIB 3BSL; Federal Title IIIC1 3C1L and NSIP C1 NC1L; Federal Title IIIC2 3C2L and NSIP C2 NC2L; CARES Title IIIC2 HDC3;
and, Federal Title IIIE 3EFL
VI. Subparagraph 5.10.12 is deleted in its entirety and replaced as follows:

21.019 – Coronavirus Relief Fund; and, 93.052 – National Family Caregiver Support, Title III Part E.

All other terms and conditions of the Subaward shall remain in full force and effect. //
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DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 667 of 1182
IN WITNESS WHEREOF, the Board of Supervisors of the County of Los Angeles has caused this Amendment Six to be subscribed on its behalf by the Acting Director of Workforce Development, Aging and Community Services, 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
By
Otto Solórzano, Acting Director Date
County of Los Angeles
Workforce Development, Aging
and Community Services

SUBRECIPIENT
City of Glendale
Subrecipient’s Legal Name
ENP202106
Subaward Number
By
Name of Authorized Date
Representative

Title
Approved as to Form:

Signature

OFFICE OF COUNTY COUNSEL
Rodrigo A. Castro-Silva, County Counsel
By
Name of Authorized Date
By Representative
Lawrence M. Green
Senior Deputy County Counsel
Title
Signature
Roubik Golanian (Oct 18, 2021 17:42 PDT)
City Manager Roubik Golanian Oct 18, 2021
Otto Solorzano (Oct 19, 2021 10:12 PDT)
Otto Solorzano
Oct 19, 2021
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 668 of 1182

ELDERLY NUTRITION PROGRAM (ENP)
SUBAWARD NUMBER ENP202106
SUBAWARD PERIOD JULY 2020 – JUNE 2022

AMENDMENT SEVEN
This Amendment is made and entered into by and between

COUNTY OF LOS ANGELES THROUGH ITS DEPARTMENT OF

WORKFORCE DEVELOPMENT, AGING AND COMMUNITY SERVICES
(“County” or “WDACS”)
County’s Business Address
510 South Vermont Avenue, 11th Floor
Los Angeles, CA 90020
and

CITY OF GLENDALE
(“Contractor” or “Subrecipient”)
Subrecipient’s Business Address
613 East Broadway Street, Room 120
Glendale, CA 91206
WHEREAS, reference is made to that certain document entitled “Elderly Nutrition Program (ENP) Subaward Number ENP202106 Subaward Period July 2020 – June 2022” dated July 1, 2020, 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 California Department of Aging (CDA) American Rescue Plan (ARP) Act funds in the cumulative amount of $254,000, which shall be reimbursed to Subrecipient in exchange for additional DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 669 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Seven Page 2
defined and contracted ENP Congregate Meal and Home-Delivered Meal Services as specified herein to be provided by Subrecipient during Fiscal Year 2021-22; 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 shall commence upon execution by all parties.

II. Subparagraph 1.1 of Paragraph 1.0 (Applicable Documents) is deleted in its entirety and replaced as follows:

1.1 Exhibits A, D, E, F, G1, H, I, N, O, P, Q, R, S, V, W1, W2, X1, X2, Y, AA, BB, CC, DD, EE, and FF are attached to and form a part of this Subaward.

This Subaward constitutes the complete and exclusive statement of understanding between the parties, which supersedes all previous agreements, written or oral, and all other communications between the parties relating to the subject matter of this Subaward. No change to this Subaward shall be valid unless prepared pursuant to Subparagraph 8.1 (Amendments) and signed by both parties.

III. Subparagraph 1.6.27 is added as follows:

1.6.27 Exhibit EE (Information Security and Privacy Requirements) IV. Subparagraph 1.6.28 is added as follows:

1.6.28 Exhibit FF (COVID-19 Vaccination Certification of Compliance) V. Subparagraph 5.1.4 is deleted in its entirety and replaced as follows:

5.1.4 Subaward Sum Year 2 Funding Source(s)

5.1.4.2 Older Americans Act (OAA) Title III B (Supportive Services and Senior Centers) original baseline funds

5.1.4.2.1 Subaward Sum: $1,000
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 670 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Seven Page 3

5.1.4.2.2 Service Area: Supervisorial District 5

5.1.4.2.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with California Department of
Aging contract number AP-2122-19)

5.1.4.2.4 Allocation Letter: Fiscal Year 2021-22 Baseline Funding Allocation for Elderly Nutrition
Program Services

5.1.4.3 OAA Title III C-1 (Nutrition Services) original baseline funds

5.1.4.3.1 Subaward Sum: $247,000

5.1.4.3.2 Service Area: Supervisorial District 5

5.1.4.3.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with California Department of
Aging contract number AP-2122-19)

5.1.4.3.4 Allocation Letter: Fiscal Year 2021-22 Baseline Funding Allocation for Elderly Nutrition
Program Services

5.1.4.4 OAA Title III C-2 (Nutrition Services) original baseline funds

5.1.4.4.1 Subaward Sum: $53,000

5.1.4.4.2 Service Area: Supervisorial District 5

5.1.4.4.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with California Department of
Aging contract number AP-2122-19)

5.1.4.4.4 Allocation Letter: Fiscal Year 2021-22 Baseline Funding Allocation for Elderly Nutrition
Program Services

5.1.4.5 CDA CARES Act Funds for ENP Congregate Meal Services

5.1.4.5.1 Subaward Sum: $124,578

5.1.4.5.1.1 Subrecipient shall expend these
funds before utilizing OAA Title III
C-1 (Nutrition Services) funds for
ENP Congregate Meal Services
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 671 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Seven Page 4

5.1.4.5.2 Service Area: Supervisorial District 5

5.1.4.5.3 Period of Performance: July 1, 2021 – June 30, 2022 (consistent with CDA Program memo No.
20-13 (Corrected) issued on July 16, 2020)

5.1.4.5.4 Allocation Letter: Fiscal Year 2020-21 Funding Reallocation for Elderly Nutrition Program
Services

5.1.4.6 CDA ARP Funds for ENP Congregate Meal Services

5.1.4.6.1 Subaward Sum: $232,000

5.1.4.6.1.1 Subrecipient shall expend these
funds only after exhausting all
CDA CARES Act and OAA Title
III C-1 (Nutrition Services) funds
for ENP Congregate Meal
Services

5.1.4.6.2 Service Area: Supervisorial District 5

5.1.4.6.3 Period of Performance: December 1, 2021 –
June 30, 2022 (consistent with CDA Revised
Contract Information Summary of December
15, 2021)

5.1.4.6.4 Allocation Letter: Fiscal Year 2021-22
California Department of Aging American
Rescue Plan Act Funding Allocation for Elderly
Nutrition Program Services

5.1.4.7 CDA ARP Funds for ENP Home-Delivered Meal Services

5.1.4.7.1 Subaward Sum: $22,000

5.1.4.7.1.1 Subrecipient shall expend these
funds only after exhausting all
OAA Title III C-2 (Nutrition
Services) funds for ENP HomeDelivered Meal Services

5.1.4.7.2 Service Area: Supervisorial District 5
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 672 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Seven Page 5

5.1.4.7.3 Period of Performance: December 1, 2021 –
June 30, 2022 (consistent with CDA Revised
Contract Information Summary of December
15, 2021)

5.1.4.7.4 Allocation Letter: Fiscal Year 2021-22
California Department of Aging American
Rescue Plan Act Funding Allocation for Elderly
Nutrition Program Services
VI. Subparagraph 5.5.7 (Subaward-Related Documents) is deleted in its entirety and replaced as follows:

5.5.7 Subaward Related Documents

5.5.7.1 Subrecipient shall complete all Subaward-related documents in accordance with the requirements noted on each such
document, as directed by County, and pursuant to Program guidelines. Subrecipient's failure to timely submit Subawardrelated documents that are accurate and complete, as requested or required by County, may result in suspension of payments to Subrecipient or other remedies provided by law or under this Subaward. Such documents shall include, but are not limited to, the documents outlined in Subparagraph

9.20 (Subaward Document Deliverables), Subparagraph 9.21 (Fiscal Reporting Requirements) and the following: Exhibit A (Statement of Work), Attachment 8 (Site Summary); Exhibit A (Statement of Work), Attachment 10 (Route Summary);
Exhibit D (Subrecipient's Equal Employment Opportunity
Certification); Exhibit F (Subrecipient's Administration); Exhibit G1 (Subrecipient Acknowledgement and Confidentiality
Agreement); Exhibit O (Charitable Contributions Certification); Exhibit R (Joint Funding Revenue Disclosure); Exhibit U (Certification of Compliance with County's Defaulted Property Tax Reduction Program); Budget exhibit(s); Mandated
Program Services exhibit(s); Exhibit Y (List of Lower Tier Subawards); Exhibit AA (Subrecipient's Compliance with
Encryption Requirements); Exhibit CC (FEMA Provisions)
(applicable only when Subaward Sums include FEMA Funds); Exhibit DD (California Civil Rights Laws Certification); and, Exhibit FF (COVID-19 Vaccination Certification of
Compliance).

VII. Subparagraph 5.10.4 is deleted in its entirety and replaced as follows:

5.10.4 Federal Award Identification Number (FAIN)
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 673 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Seven Page 6

5.10.4.1 July 1, 2020 – June 30, 2021: 2001CAOASS-00;
2001CAOACM-00; 2001CAOAHD-00; 2001CAOANS-00;
2001CACMC2-00; 2001CAHDC2-00; 2001CAHDC3-00;
SLT0198; 2001CASSC3-00; and, 2001CAFCC3-00

5.10.4.2 July 1, 2021 – June 30, 2022: 2101CAOASS-01;
2101CAOACM-01; 2101CAOAHD-01; 2101CAOANS-01;
2001CAHDC3-00; 2001CASSC3-00; and 2001CAFCC3-00
VIII. Subparagraph 5.10.7 is deleted in its entirety and replaced as follows:

5.10.7 Amount of Federal Funds Obligated by this Action:

5.10.7.1 Original Subaward: $291,000

5.10.7.2 Amendment One: $670,000

5.10.7.2.1 Federal CARES Act Funds: $406,000

5.10.7.2.2 CDA CARES Act Funds: $264,000

5.10.7.3 Amendment Two: $0

5.10.7.4 Amendment Three: $143,850

5.10.7.4.1 Additional CDA CARES Act Funds: $143,000

5.10.7.4.2 FY 2019-20 FFCRA Carryover Funds: $850

5.10.7.5 Amendment Four: $301,000

5.10.7.6 Amendment Five: $124,578

5.10.7.7 Amendment Six: $0

5.10.7.8 Amendment Seven: $254,000
IX. 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):

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 674 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Seven Page 7

5.10.8.1 Subaward Sum Year 1: $1,104,850

5.10.8.2 Subaward Sum Year 2: $679,578
X. Subparagraph 5.10.9 is deleted in its entirety and replaced as follows:

5.10.9 Total Amount of Federal Award (Maximum Subaward Sum):
$1,659,850 (FY 2020-21 Reallocation funds excluded)
XI. Subparagraph 5.10.10 is deleted in its entirety and replaced as follows:

5.10.10 Federal Award Project Description

5.10.10.2 July 1, 2021 – June 30, 2022: Federal Title IIIB 3BSL; Federal Title IIIC1 3C1L and NSIP C1 NC1L; Federal Title IIIC2 3C2L and NSIP C2 NC2L; CARES Title IIIC2 HDC3;
CARES Title IIIB SSC3; and, CARES Title IIIE FCC3
XII. Subparagraph 5.10.12 is deleted in its entirety and replaced as follows:

21.019 – Coronavirus Relief Fund; 93.052 – National Family Caregiver Support, Title III Part E; 21.027 – Coronavirus State and Local Fiscal Recovery Funds
XIII. Subparagraph 8.2.2 is deleted in its entirety and replaced as follows:

8.2.2 Contractor shall not assign, exchange, transfer, or delegate its rights or duties under this Subaward (that is, "Contract"), whether in whole or in part, without the prior written consent of County, in its sole discretion, and any attempted assignment, delegation, or otherwise transfer of its rights or duties, without such consent shall be null and void. For purposes of this Subparagraph 8.2, County consent shall require a written Amendment to this Contract, which is formally approved and executed by the parties. Any payments by County to any approved delegatee or assignee on any claim under this Contract shall be deductible, at County's sole discretion, against the claims, which Contractor may have against County.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 675 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Seven Page 8
XIV. Subparagraph 8.2.3 is deleted in its entirety.

XV. Subparagraph 8.2.4 is deleted in its entirety, replaced, and renumbered as follows:

8.2.3 Any assumption, assignment, delegation, or takeover of any of Contractor's duties, responsibilities, obligations, or performance of same by any person or entity other than Contractor, whether through assignment, Lower Tier Subaward (that is, "Subcontract"), delegation, merger, buyout, or any other mechanism, with or without consideration for any reason whatsoever without County's express prior written approval, shall be a material breach of this Contract which may result in the termination of this Contract. In the event of such termination, County shall be entitled to pursue the same remedies against Contractor as it could pursue in the event of default by Contractor.

XVI. Subparagraph 8.59 (COVID-19 Vaccinations of Subrecipient Personnel) is added as follows:

8.59 COVID-19 Vaccinations of Subrecipient Personnel

8.59.1 At Subrecipient’s (that is, “Contractor's”) sole cost, Contractor shall comply with Chapter 2.212 (COVID-19
Vaccinations of County Contractor Personnel) of County
Code Title 2 - Administration, Division 4. All employees of Contractor and persons working on its behalf, including but not limited to, Lower Tier Subrecipients (that is,
“Subcontractors”) of any tier (collectively, “Contractor Personnel”), must be fully vaccinated against the novel coronavirus 2019 (“COVID-19”) prior to (1) interacting in person with County employees, interns, volunteers, and
commissioners ("County workforce members"), (2) working on County owned or controlled property while performing Services under this Subaward (that is, “Contract”), and/or (3) coming into contact with the public while performing Services under this Contract (collectively, “In-Person Services”).

8.59.2 Contractor Personnel are considered “fully vaccinated” against COVID-19 two (2) weeks or more after they have
received (1) the second dose in a 2-dose COVID-19
vaccine series (e.g. Pfizer-BioNTech or Moderna), (2) a single-dose COVID-19 vaccine (e.g. Johnson and
Johnson [J&J]/Janssen), or (3) the final dose of any
COVID-19 vaccine authorized by the World Health
Organization ("WHO").

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 676 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Seven Page 9

8.59.3 Prior to assigning Contractor Personnel to perform InPerson Services, Contractor shall obtain proof that such Contractor Personnel have been fully vaccinated by
confirming Contractor Personnel is vaccinated through any of the following documentation:

8.59.3.1 Official COVID-19 Vaccination Record Card
(issued by the Department of Health and
Human Services, CDC or WHO Yellow Card),
which includes the name of the person
vaccinated, type of vaccine provided, and date
of the last dose administered ("Vaccination
Record Card");

8.59.3.2 Copy (including a photographic copy) of a
Vaccination Record Card;

8.59.3.3 Documentation of vaccination from a licensed
medical provider;

8.59.3.4 A digital record that includes a quick response ("QR") code that when scanned by a SMART
HealthCard reader displays to the reader client
name, date of birth, vaccine dates, and
vaccine type, and the QR code confirms the
vaccine record as an official record of the State
of California; or

8.59.3.5 Documentation of vaccination from
Contractors who follow the CDPH vaccination
records guidelines and standards.

8.59.3.6 Contractor shall also provide written notice to County before the start of Work under this
Contract that its Contractor Personnel are in
compliance with the requirements of this
Subparagraph 8.59.3. Contractor shall retain
such proof of vaccination for the document
retention period set forth in this Contract, and
must provide such records to County for audit
purposes, when required by County.

8.59.4 Contractor shall evaluate any medical or sincerely held religious exemption request of its Contractor Personnel, as required by law. If Contractor has determined that
Contractor Personnel is exempt pursuant to a medical or sincerely held religious reason, Contractor must also
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 677 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Seven Page 10
maintain records of Contractor Personnel’s testing results.

Contractor must provide such records to County for audit purposes, when required by County. The unvaccinated
exempt Contractor Personnel must meet the following
requirements prior to (1) interacting in person with County workforce members, (2) working on County owned or
controlled property while performing Services under this Contract, and/or (3) coming into contact with the public while performing Services under this Contract:

8.59.4.1 Test for COVID-19 with either a polymerase
chain reaction (PCR) or antigen test has an
Emergency Use Authorization (EUA) by the
FDA or is operating per the Laboratory
Developed Test requirements by the U.S.

Centers for Medicare and Medicaid Services.

Testing must occur at least weekly, or more
frequently as required by County or other
applicable law, regulation or order.

8.59.4.2 Wear a mask that is consistent with CDC
recommendations at all times while on County
controlled or owned property, and while
engaging with members of the public and
County workforce members.

8.59.4.3 Engage in proper physical distancing, as
determined by the applicable County
department that the Contract is with.

8.59.5 In addition to complying with the requirements of this Subparagraph 8.59, Contractor shall also comply with all other applicable local, departmental, State, and federal laws, regulations and requirements for COVID-19. A completed
Exhibit FF (COVID-19 Vaccination Certification of Compliance) is a required part of any agreement with County.

XVII. “Exhibit W1 (Budget) Amendment7 {FY 2021-22 CDA ARP Funding}” is added, is an addendum to "Exhibit W1 (Budget)", and is incorporated herein by reference.

XVIII. “Exhibit W2 (Budget) Amendment 7 {FY 2021-22 CDA ARP Funding}” is added, is an addendum to "Exhibit W2 (Budget)", and is incorporated herein by reference.

XIX. “Exhibit X1 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding}” is added, is an addendum to "Exhibit X1 (Mandated Program Service)”, and is incorporated herein by reference.

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 678 of 1182
Elderly Nutrition Program
Subaward Number ENP202106
Amendment Seven Page 11
XX. “Exhibit X2 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding}” is added, is an addendum to "Exhibit X2 (Mandated Program Services)”, and is incorporated herein by reference.

XXI. “Exhibit FF (COVID-19 Vaccination Certification of Compliance)” is added as an Attachment to this Subaward and is incorporated herein by reference.

XXII. The "Fiscal Year 2021-22 California Department of Aging American Rescue Plan Act Funding Allocation for Elderly Nutrition Program Services" funding allocation letter is incorporated herein by reference.

All other terms and conditions of the Subaward shall remain in full force and effect. //
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DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 679 of 1182
IN WITNESS WHEREOF, the Board of Supervisors of the County of Los Angeles has caused this Amendment Seven to be subscribed on its behalf by the Acting Director of Workforce Development, Aging and Community Services, 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
By
Otto Solórzano, Acting Director Date
County of Los Angeles
Workforce Development, Aging
and Community Services

SUBRECIPIENT
City of Glendale
Subrecipient’s Legal Name
ENP202106
Subaward Number
By
Name of Authorized Date
Representative

Title
Approved as to Form:

Signature

OFFICE OF COUNTY COUNSEL
Rodrigo A. Castro-Silva, County Counsel
By
Name of Authorized Date
Representative
Lawrence M. Green
Senior Deputy County Counsel
Title

Signature
RGolanian (Feb 17, 2022 13:59 PST)
RGolanian
City Manager RGolanian Feb 17, 2022
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 680 of 1182
681 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
Older Americans Act (OAA) Title III C-1 Congregate Meal Services 2021-2022
California Department of Aging (CDA) American Rescue Plan (ARP) (A)
POSITION TITLE (1)
(B)
% OF TIME
ON

PROGRAM
(2)
(C)

MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY2
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 Director (Sr. Comm. Services
Supervisor) 50% $ 9,067 5 $ 22,668 $ 22,668 $ 22,668 $0 [Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
N/A
Five (5)
ENP202106
Seven Modification Number: N/A
City of Glendale
Exhibit W1 (Budget) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 682 of 1182
683 of 1182
684 of 1182
685 of 1182
686 of 1182
687 of 1182
688 of 1182
689 of 1182
690 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

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)
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)
$ 10,000 $0
DIRECT
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 400.00$ 5 5 $ 10,000 $ 10,000 (A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY2
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)
N/A
Five (5)
ENP202106
Seven Modification Number: N/A
City of Glendale
IX. BUDGET DETAIL - OTHER COSTS
Older Americans Act (OAA) Title III C-1 Congregate Meal Services 2021-2022
California Department of Aging (CDA) American Rescue Plan (ARP) Exhibit W1 (Budget) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 11 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 691 of 1182
692 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos)
Unit Rate
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos)
Unit Rate
[Enter] [Enter] [Enter] [Enter] [Enter] $ 6.21 [Enter] [Enter] [Enter] [Enter] $ 0.82 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] 2 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] 0.82$ [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]

5.94$ [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] X. BUDGET SUMMARY
1 6
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
$ -
(D)
FUNDING (1)
Match
Cash (SF)
Cash Other
(SSY2)
In-Kind (SF)
$ -
Cash (SF)
$ -
Cash (SF)
$ -
Cash Other
(SSY2)
Cash NSIP
(SSY2)
(A)

COST CATEGORIES
4 (B)
COSTS (1)
$ -
2 Subtotal
Cash Other
(SSY2)
Cash NSIP
(SSY2)
$ 232,000
$ -
DIRECT
$ -
$ -
$ 30,601
Personnel
Lower Tier Subawards for Catered Food
In-Kind (SF)
Cash Other
(SSY2)
Cash (SF)
In-Kind (SF)
Volunteers
Lower Tier Subawards
In-Kind (SF)
-$
Cash Other
(SSY2)
-$
Cash (SF)
$ -

6.21$ -$
SSY2
$ 30,601
1 -$
$ -
Cash Other
(SSY2)
$ -
5 Cash (SF)
$ -
In-Kind (SF)
7 $ -
3 Volunteer Expenses
Cash Other
(SSY2) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
$ 232,000
$ -
$ 222,000
Cash NSIP
(SSY2) $ -
In-Kind (SF)
$ -
$ -
Cash (SF)
3 Raw Food
Space In-Kind (SF)
Non-Match
$ -
$ -
$ -
Older Americans Act (OAA) Title III C-1 Congregate Meal Services In-Kind (SF)
2021-2022
California Department of Aging (CDA) American Rescue Plan (ARP) N/A
Five (5)
ENP202106
Seven Modification Number: N/A
City of Glendale
Exhibit W1 (Budget) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 13 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 693 of 1182
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos)
Unit Rate
(2)
Amer.

Meals
Unit Rate
(3)
Ethnic
Meals
(Cam)
Unit Rate
(4)
Ethnic
Meals
(Chi) Unit
Rate
(5)
Ethnic
Meals
(Ind)
Unit Rate
(6)
Ethnic
Meals
(Kos)
Unit Rate
X. BUDGET SUMMARY
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
(D)
FUNDING (1)
(A)

COST CATEGORIES
(B)
COSTS (1)
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ 0.27 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ 6.21 $ - $ - $ - $ - $ 6.21 $ - $ - $ - $ -
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
$ 0.82 $ - $ - $ - $ - $ 0.82 $ - $ - $ - $ -
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] 12 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ -
In-Kind (SF)
$ -
Cash (SF)
15 Lower Tier Subawards for Catered Food
Cash Other
(SSY2)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
14 Lower Tier Subawards
4 Program Income Cash (SF) $ -
Variance (Costs-Funding)
Cash Other
(SSY2) $ -
Cash
In-Kind
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF)
$ -
Match
$ -
7 SSY2
$ -
In-Kind (SF)
Cash Other
(SSY2)
In-Kind (SF)
$ -
6 13 Volunteer Expenses
Cash Other
(SSY2) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
11 Personnel
Cash Other
(SSY2)
Volunteers In-Kind (SF)
$ 10,000
Cash Other
(SSY2)
In-Kind (SF)
8 9
$ 30,601
$ -
$ 232,000
$ -
Cash (SF)
Cash NSIP
(SSY2) $ -
$ -
Cash Other
(SSY2)
Cash Other
(SSY2)
In-Kind (SF)
Equipment
Other Costs
Subtotal Direct Costs
Cash (SF)
$ -
5 Subtotal Funding for
Direct Costs
Cash Other
(SSY2)
Cash (SF)
In-Kind (SF)
Cash NSIP
(SSY2)
$ -
$ -
$ -
$ 232,000
$ 30,601
$ -
$ -

INDIRECT
Cash (SF)
10 Exhibit W1 (Budget) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 14 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 694 of 1182
695 of 1182
696 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District
Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
I. BUDGET DETAIL - PERSONNEL
Seven Modification Number: N/A
City of Glendale
2021-2022
California Department of Aging (CDA) American Rescue Plan (ARP) N/A
Five
ENP202106
(A)
POSITION TITLE (1)
(B)
% OF TIME
ON

PROGRAM
(2)
(C)

MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY2
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)
DIRECT
Project Director (Sr. Comm Services Sup 5% $ 9,067 5 $ 2,267 $ 2,267 $ 2,267 $0 [Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]

HOME-DELIVERED MEAL SERVICES
Exhibit W2 (Budget) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 697 of 1182
698 of 1182
699 of 1182
700 of 1182
701 of 1182
702 of 1182
703 of 1182
704 of 1182
705 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District
Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

IX. BUDGET DETAIL - OTHER COSTS
California Department of Aging (CDA) American Rescue Plan (ARP) Seven Modification Number:
(A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY2
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
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)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)

HOME-DELIVERED MEAL SERVICES
2021-2022
N/A
Five
ENP202106
N/A
City of Glendale
Exhibit W2 (Budget) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 11 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 706 of 1182
707 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District
Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(2)
Hot
Meals
Unit Rate
(3)
Frozen Meals
Unit Rate
(4)
Emergency
Meals
Unit Rate
(2)
Hot
Meals
Unit Rate
(3)
Frozen Meals
Unit Rate
(4)
Emergency
Meals
Unit Rate
[Enter] [Enter] [Enter] $ 6.21 [Enter] [Enter]
$ 0.86 [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
2 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter]
[Enter] [Enter] [Enter]
[Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] $ 0.86 [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
$ 6.21 [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] -$ [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
2021-2022
California Department of Aging (CDA) American Rescue Plan (ARP) N/A
Five
ENP202106
Seven
City of Glendale
Modification Number: N/A
In-Kind (SF)
$ -
$ -
$ -
Non-Match
Cash Other
(SSY2)
In-Kind (SF)
$ -
Cash (SF)
$ -
Cash (SF)
$ -
Cash Other
(SSY2)
Cash NSIP
(SSY2) $ -
Cash Other
(SSY2)
$ -
5 Cash (SF)
$ -
In-Kind (SF)
7 $ -
3 Volunteer Expenses
Cash Other
(SSY2) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
$ 22,000
$ -
$ 22,000
Cash NSIP
(SSY2) $ -
In-Kind (SF)
Raw Food
Space
$ 6.21 -$
SSY2
$ 3,060
1 $ -
$ 3,060
$ -
In-Kind (SF)
$ -
(B)
COSTS (1)
$ -
2 Subtotal
Cash Other
(SSY2)
Cash NSIP
(SSY2)
$ 22,000
$ -
DIRECT
$ -
Personnel
Lower Tier Subawards for
Catered Food
In-Kind (SF)
Cash Other
(SSY2)
Cash (SF)
In-Kind (SF)
Volunteers
Lower Tier Subawards
In-Kind (SF)
Cash Other
(SSY2)
-$
Cash (SF)
$ -

HOME-DELIVERED MEAL SERVICES
X. BUDGET SUMMARY
1 6
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
$ -
(D)
FUNDING (1)
Match
Cash (SF)
Cash (SF)
3 (A)

COST CATEGORIES
4 Exhibit W2 (Budget) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 13 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 708 of 1182
(2)
Hot
Meals
Unit Rate
(3)
Frozen Meals
Unit Rate
(4)
Emergency
Meals
Unit Rate
(2)
Hot
Meals
Unit Rate
(3)
Frozen Meals
Unit Rate
(4)
Emergency
Meals
Unit Rate
(B)
COSTS (1)
X. BUDGET SUMMARY
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
(C)

FUNDING CATEGORIES
(D)
FUNDING (1)
(A)

COST CATEGORIES
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
$ 6.21 $ - $ - $ 6.21 $ - $ -
$ - $ - $ - $ - $ - $ -
$ 0.86 $ - $ - $ 0.86 $ - $ -
$ - $ - $ - $ - $ - $ -
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
12 [Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter] [Enter] [Enter]
$ -
$ -
$ 22,000
$ 3,060
$ -
$ -

INDIRECT
8 9
$ 3,060
$ -
$ 22,000
$ -
$ -
Cash (SF)
Cash Other
(SSY2)
In-Kind (SF)
Cash NSIP
(SSY2)
Cash Other
(SSY2)
In-Kind (SF)
Equipment
Other Costs
Subtotal Direct Costs
In-Kind (SF)
$ -
Cash (SF)
$ -
$ -
Cash Other
(SSY2)
5 Subtotal Funding for
Direct Costs
Cash Other
(SSY2)
Cash (SF)
In-Kind (SF)
Cash NSIP
(SSY2)
11 Personnel
Cash Other
(SSY2)
Volunteers In-Kind (SF)
$ -
Cash (SF)
$ -
6 10
Cash Other
(SSY2)
13 Volunteer Expenses
Cash Other
(SSY2) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
$ -
In-Kind (SF)
$ -
Cash (SF)
15 Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF)
$ -
Match
$ -
7 SSY2
$ -
In-Kind (SF)
4 Program Income Cash (SF) $ -
Variance (Costs-Funding)
Cash Other
(SSY2) $ -
Cash
In-Kind
Lower Tier Subawards for
Catered Food
Cash Other
(SSY2)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
14 Lower Tier Subawards
Exhibit W2 (Budget) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 14 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 709 of 1182
710 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
[Enter]
Ext.
[Enter]
Phone Number Ext.
[Enter]
Phone Number Ext.

MPS Reviewed and Approved by: Sheri Stanton Date: 2/28/2022

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Irma Panosian
Senior Community Services Supervisor [email protected] Prefix Project Manager Job Title E-Mail Address
Ms. Maggie Kavarian 818-548-3715
Mr. Hanre Chang
Prefix
E-Mail Address
Mr. Onnig Bulanikian 818-548-2000
Phone Number
EXHIBIT X1 (MANDATED PROGRAM SERVICES)
AMENDMENT 7 {FY 2021-22 CDA ARP FUNDING}
Subrecipient's Legal Name:
[Enter Address]
Director Community Services & Parks [email protected] State Zip Code
613 E. Broadway Room 120 Glendale CA 91206
Main Administrative Office Address
Budget Analyst Job Title E-Mail Address
[Enter City] CA [Enter Zip]
Accountant I 818-551-3060 [email protected]
Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title
City
Congregate Meal Services
2021-2022
California Department of Aging (CDA) American Rescue Plan (ARP) N/A
Five
ENP202106
ENP202106
Seven Modification Number: N/A
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 711 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subtotal SSY2
(Cash Other and Cash NSIP)
Total (4)
SSY2
(Cash NSIP)
Subtotal SSY2
(Cash Other and Cash NSIP)
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
[Select Ethnic
Meal Style]
SF (7)
(Cash and In-Kind)
$ -
[Enter Unit Rate]
37,359
[Enter Units]
37,359
[Enter Unit Rate]
$ -
$ 232,000
$ 7.03 $ 262,601
[Enter Unit Rate]
120
$ 6.21 $ 232,000
$ 6.21
$ 0.82 $ 30,601
Subrecipient's Legal Name:

Congregate Meal Services
2021-2022
California Department of Aging (CDA) American Rescue Plan (ARP) N/A
Five
ENP202106
ENP202106
Ethnic Meals
Total (4)
SSY2 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
[Enter Total
Unduplicated
Units]
[Enter Units]
[Enter Unit Rate]
Seven Modification Number: N/A
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
SSY2 (6)
(Cash Other)
SSY2
(Cash NSIP)
[Enter Units]
[Enter Units]
I. UNITS OF SERVICE SUMMARY
120
American Meals
Exhibit X1 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 712 of 1182
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
Equipment (Other) (9)
[Enter Units]
[Enter Units]
[Enter Units]
[Enter Amount]
Total (4)
[Enter Total
Unduplicated
Units]
[Enter Unit Rate]
SSY2
(Cash NSIP) [Enter Unit Rate]
$ - $ -
GRAND TOTAL SERVICES/FUNDING 120
SSY2 (6)
(Cash Other)
Subtotal SSY2
(Cash Other and Cash NSIP)
120
SF (7)
(Cash and In-Kind)
$ 262,601
[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.
(9) Enter the amount of equipment (other) that is reflected in Exhibit W1 (Budget). (6) SSY2: Subaward Sum Year 2
(7) SF: Subrecipient's Funds
(8) Enter the approved amount of equipment purchase(s) that is reflected in Exhibit W1 (Budget).

Exhibit X1 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 3 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 713 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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 90 7,000 7,000 7,000 7,000 7,000 35,000
2 30 490 429 480 490 470 2,359
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
120 0 0 0 0 0 0 0 7,490 7,429 7,480 7,490 7,470 37,359
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
Adult Recreation Center
Sparr Heigh Community Center
ENP202106
Congregate Meal Services
2021-2022
California Department of Aging (CDA) American Rescue Plan (ARP) N/A
Five
Subrecipient's Legal Name: ENP202106
Seven Modification Number: N/A
Exhibit X1 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 4 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 714 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

ENP202106
Seven Modification Number:

Congregate Meal Services
2021-2022
California Department of Aging (CDA) American Rescue Plan (ARP) N/A
Five
N/A
NOTE:

Grand Total
Subrecipient's Legal Name: ENP202106
[Select Ethnic Meal Style] III. SERVICES BY MONTH - ETHNIC MEALS (B)

SITE NAME
Exhibit X1 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 715 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

ENP202106
Seven Modification Number:

IV. SERVICES BY MONTH - ETHNIC MEALS [Select Ethnic Meal Style] N/A
Subrecipient's Legal Name: ENP202106
Congregate Meal Services
2021-2022
California Department of Aging (CDA) American Rescue Plan (ARP) N/A
Five
NOTE:
(B)

SITE NAME
Grand Total
Exhibit X1 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 716 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
[Enter]
Ext.
[Enter]
Phone Number Ext.
[Enter]
Phone Number Ext.

Seven Modification Number:

ENP202106
N/A
City of Glendale
Five
N/A
California Department of Aging (CDA) American Rescue Plan (ARP) 2021-22

HOME DELIVERED MEAL SERVICES
MPS Reviewed and Approved by: Sheri Stanton Date: 2/28/2022

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Irma Panosian
Senior Community Services Supervisor [email protected] Prefix Project Manager Job Title E-Mail Address
Ms. Maggie Kavarian 818-548-3715
Mr. Hanre Chang
[Enter Address]
Director Community Services & Parks [email protected] Prefix Authorized Representative Job Title E-Mail Address Mr. Onnig Bulanikian (818) 548-2000
Phone Number
State Zip Code
EXHIBIT X2 (MANDATED PROGRAM SERVICES)
AMENDMENT 7 {FY 2021-22 CDA ARP FUNDING}
Prefix Budget Analyst Job Title E-Mail Address
[Enter City] CA [Enter Zip]
Accountant I 818-551-3060 [email protected]
Mailing Address (if different from above) City
State Zip Code
613 E. Broadway Room 120 Glendale CA 91206
Main Administrative Office Address City
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 717 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Hot Meals
Subtotal SSY2
(Cash Other and Cash NSIP)
SSY2 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
SSY2 (6)
(Cash Other)
Frozen Meals
3,543
Total (4)
SF (7)
(Cash and In-Kind)
15 $ -
[Enter Unit Rate]
[Enter Total
Unduplicated
Units]
$ -

HOME DELIVERED MEAL SERVICES
2021-22
California Department of Aging (CDA) American Rescue Plan (ARP) N/A
Five
ENP202106
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

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

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
$ -
[Enter Unit Rate]
-
[Enter Units]
[Enter Units]
Total (4)
SSY2
(Cash NSIP)
Subtotal SSY2
(Cash Other and Cash NSIP)
$ 25,060
$ 3,060
$ 22,000
$ 6.21
$ 7.07
$ 6.21
$ 22,000
[Enter Unit Rate] SSY2
(Cash NSIP)
3,543
[Enter Units]
I. UNITS OF SERVICE SUMMARY
15 $ 0.86
Exhibit X2 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 718 of 1182
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
(B)

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
Equipment (Other) (9)
Emergency Meals
[Enter Units]
[Enter Units] SF (7)
(Cash and In-Kind)
Total (4)
[Enter Total
Unduplicated
Units]
$ -
SSY2
(Cash NSIP) [Enter Unit Rate]
$ -
GRAND TOTAL SERVICES/FUNDING 15
SSY2 (6)
(Cash Other)
Subtotal SSY2
(Cash Other and Cash NSIP)
15 $ 25,060
[Enter Amount]
(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.
(9) Enter the amount of equipment (other) that is reflected in Exhibit W2 (Budget). (6) SSY2: Subaward Sum Year 2
(7) SF: Subrecipient's Funds
(8) Enter the approved amount of equipment purchase(s) that is reflected in Exhibit W2 (Budget).

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

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

II. SERVICES BY MONTH - HOT MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2021-22
California Department of Aging (CDA) American Rescue Plan (ARP) City of Glendale
Seven Modification Number: N/A
N/A
Five
ENP202106
Exhibit X2 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 4 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 720 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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 4 120 200 120 200 250 890
2 3 120 200 120 200 250 890
3 4 120 200 120 200 250 890
4 4 120 183 120 200 250 873
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
15 0 0 0 0 0 0 0 480 783 480 800 1000 3543
(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:

Route 2
Route 3
Route 4
Route 1
III. SERVICES BY MONTH - FROZEN MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2021-22
California Department of Aging (CDA) American Rescue Plan (ARP) City of Glendale
N/A
Five
ENP202106
Seven Modification Number: N/A
Exhibit X2 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 721 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

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 0 0
2 0 0
3 0 0
4 0 0
5 0 0
6 0 0
7 0 0
8 0 0
9 0 0
10 0 0
11 0 0
12 0 0
13 0 0
14 0 0
15 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 ENP202106
Seven Modification Number: N/A
City of Glendale
NOTE:

Grand Total
(K)
FEB
(L)
MAR
(I)
DEC
(J)
JAN
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
N/A
Five

HOME DELIVERED MEAL SERVICES
2021-22
California Department of Aging (CDA) American Rescue Plan (ARP) Exhibit X2 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 722 of 1182
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

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

V. SERVICES BY MONTH - EMERGENCY MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2021-22
California Department of Aging (CDA) American Rescue Plan (ARP) City of Glendale
N/A
Five
ENP202106
Seven Modification Number: N/A
Exhibit X2 (Mandated Program Services) Amendment 7 {FY 2021-22 CDA ARP Funding} Page 7 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 723 of 1182
12/2021

EXHIBIT FF
(COVID-19 VACCINATION CERTIFICATION OF COMPLIANCE)
Urgency Ordinance, County Code Title 2 – Administration, Division 4 – Miscellaneous – Chapter 2.212 (COVID-19 Vaccinations of County Contractor Personnel) Select the response below (either Option A or Option B) that is applicable to Subrecipient’s organization:

OPTION A:
☐ All Subrecipient Personnel* on this Subaward are fully vaccinated as required by the Ordinance.

OPTION B:
☐ Most Subrecipient Personnel* on this Subaward are fully vaccinated as required by the Ordinance. The Subrecipient or its employer of record, has granted a valid medical or religious exemption to the below identified Subrecipient Personnel.

Subrecipient will certify weekly that the following unvaccinated Subrecipient Personnel have tested negative within 72 hours of starting their work week under the Subaward, unless the contracting County department requires otherwise.

Subrecipient Personnel who have been granted a valid medical or religious exemption are the following individuals:

Click here to enter text.

Click here to enter text.
*Subrecipient Personnel includes Lower Tier Subrecipients Declaration
I have reviewed the requirements above and further certify that I will comply with said requirements.

Click here to enter text. Click here to enter text.

Subrecipient’s Legal Name Subaward Number
Click here to enter text. Click here to enter text.

Name of Authorized Representative Title of Authorized Representative Click here to enter a date.

Authorized Representative’s Signature Date
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 724 of 1182
725 of 1182
726 of 1182
727 of 1182
728 of 1182
729 of 1182
730 of 1182
731 of 1182
732 of 1182
733 of 1182
734 of 1182
735 of 1182
736 of 1182
737 of 1182
738 of 1182
739 of 1182
740 of 1182
741 of 1182
742 of 1182
743 of 1182
744 of 1182
745 of 1182
746 of 1182
747 of 1182
748 of 1182
749 of 1182
750 of 1182
751 of 1182
752 of 1182
753 of 1182
754 of 1182
755 of 1182

EXHIBIT E
(COUNTY'S ADMINISTRATION)
FISCAL YEAR: 2022-2023
COUNTY’S DEPARTMENT HEAD
Name: Dr. Laura Trejo
Title: Executive Director
Address: 510 South Vermont Avenue
Los Angeles, CA 90020
Telephone: (213) 291-0028
E-Mail Address: [email protected]
COUNTY’S CONTRACT MANAGER
Name: Ms. Carol Domingo
Title: Program Manager
Address: 510 South Vermont Avenue
Los Angeles, CA 90020
Telephone: (213) 639-6339
E-Mail Address: [email protected]

COUNTY’S PROGRAM MANAGER
Name: Ms. Anna Avdalyan
Title: Assistant Director
Address: 510 South Vermont Avenue
Los Angeles, CA 90020
Telephone: (213) 738-4749
E-Mail Address: [email protected]
COUNTY’S COMPLIANCE MANAGER
Name: Mr. Syed Uraizee
Title: Administrative Services Manager II
Address: 510 South Vermont Avenue
Los Angeles, CA 90020
Telephone: (213) 709-7908
E-Mail Address: [email protected]
COUNTY’S EMERGENCY COORDINATOR
Name: Ms. Ellie Wolfe
Title: Program Manager
Address: 510 South Vermont Avenue
Los Angeles, CA 90020
Telephone: (213) 738-2681
E-Mail Address: [email protected]
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 756 of 1182
757 of 1182
758 of 1182
759 of 1182
760 of 1182
FY 2022-23

Revenue Source (Agency or Organization
Name, Contact Name and Phone Number)
Funding Amount Funding Period
Start Date End Date
WDACS Elderly Nutrition Program $354,000 7/1/2022 7/31/2023 City of Glendale General Fund $66,295 7/1/2022 7/31/2023 Congregate/Home Delivered Meals Donations
$39,000 7/1/2022 7/31/2023
Supportive Services Program $54,000 7/1/2022 7/31/2023
Federal ARPA Elderly Nutrition Program $247,000 7/1/2022 7/31/2023 Click here to enter text. Click here to enter amount.

Click here to
enter a date.

Click here to enter text. Click here to enter amount.

Click here to
enter a date.

PAGE TOTAL $760,295
GRAND TOTAL OF ALL PAGES $760,295
City of Glendale ENP202106
Subrecipient’s Legal Name Subaward Number
Aylin Isayan 7/1/2022
Name of Preparer (Print) Date Prepared
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 761 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
[Enter] [Enter] [Enter]
Federal American Rescue Plan Act (ARPA)
Five (5)
(3) The minimum required total mach is twelve percent (12%) of SSY3.

ALL COSTS REPORTED ON THIS BUDGET SHALL BE ALLOWABLE, NECESSARY, AND REASONABLE FOR THE PROGRAM SERVICES TO BE PROVIDED.

Igor Bagmanian Date: 9/22/2022
-$
[Enter] [Enter]
[Enter] $ - [Enter] [Enter]
$ - [Enter] [Enter]
[Enter]
Budget Reviewed and Approved by:

Equipment (Other) (7)
[Enter] [Enter]
Ethnic Meals (Indian/
Vegetarian)
(G)

UNIT RATE
City
[Enter Address] [Enter City]
(2)
SF (5)
$ 24,360 -$ $ 227,360
Ethnic Meals (Cambodian)
[Enter]
Prefix Ext. E-Mail Address
[Enter]
[Enter] [Enter] [Enter]
[Enter]
[Enter] [Enter]
American Meals
Ethnic Meals (Chinese) [Enter] [Enter] [Enter] [Enter]
[Enter]
EXHIBIT W1 (BUDGET)
AMENDMENT 8 {FY 2022-23 FEDERAL ARPA FUNDING}
CA 91206
State Zip Code
State
[Enter State] [Enter Zip]

CONGREGATE MEAL SERVICES
2022-2023
City of Glendale
ENP202106
Subrecipient's Legal Name:
613 E. Broadway Room 120
Main Administrative Office Address
Glendale
Mailing Address (if different from above) City Zip Code Eight Modification Number: N/A
Ext. E-Mail Address
-$ -$
Community Services Manager
(2)

IN-KIND
$ -
Phone Number
$ 227,360
(F)
TOTAL

FUNDING
(B+C+D+E)
[Enter]
818-548-3715 [email protected]

PROGRAM FUNDING SUMMARY
[Enter] [Enter] $ 7.93
(A)

SERVICE CATEGORY
(B)

SUBAWARD SUM
YEAR 1
(SSY3) (1)
(1)
CASH
OTHER
(2)
CASH
NSIP
203,000$
(1)
CASH
(1)
CASH
(3)
TOTAL

FUNDING
$ 0.85
(1)
SSY3 (4)
$ 24,360 $ 7.08
(2)

IN-KIND
(1)
CASH
[Enter]
Job Title
818-548-2000
Phone Number
[Enter]
[Enter] [email protected]
Prefix
Onnig Bulanikian
[Enter] [Enter] [Enter] [Enter]
Authorized Representative
Director of Community Services & Parks
Job Title
[Enter]
Mr.

SUBRECIPIENT'S FUNDS (SF) (2)
(C)
MATCH (3)
(D)

NON-MATCH
(E)

PROGRAM
INCOME
Maggie Kavarian
Project Manager
Ms.
$ -
[Enter] [Enter] -$
Grand Total (8)
[Enter]
203,000$ -$ -$
Equipment (Purchases) (6)
Ethnic Meals (Kosher) [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ - Hanre Chang Accountant 1 818-550-3060 [Enter] [email protected] Prefix Budget Analyst Job Title Phone Number Ext. E-Mail Address Mr.
(4) Enter the total unit rate for SSY3. The unit rate shall match the Subtotal SSY3 in Exhibit X1 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. (5) Enter the unit rate for SF. The unit rate shall match the unit rate for SF in Exhibit X1 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. [Enter] $ -
-$ -$

COUNTY USE ONLY
Assigned Program Analyst:

Assigned Contract Analyst:

Sheri Stanton Equipment Purchase(s) Approved by: N/A
Irma Panosian
[Enter]
NOTE:
(1) The SSY3 for each Service Category shall match the SSY3 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. (6) Funding Amount for Equipment (Purchase(s)) reflected under SSY3 and SF shall match the Equipment (Purchase(s)) Funding Amount reflected in Exhibit X1 (Mandated Program Services), Section I (Units of Service Summary).

DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 762 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
I. BUDGET DETAIL - PERSONNEL
DIRECT
Other Staff (Hourly City Worker) 100% $ 1,170 12 $ 14,040 $ 14,040 $ 14,040 $0

CONGREGATE MEAL SERVICES
2022-2023
Federal 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)
SSY3
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)
$ 14,040 $0
[Enter title]
Other Staff (Hourly City Worker) 100% $ 1,170 12 $ 14,040 $ 14,040 [Enter title]
[Enter title]
[Enter title]
[Enter title]
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 763 of 1182
764 of 1182
765 of 1182
766 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2022-2023
Federal American Rescue Plan Act (ARPA)
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale

CONGREGATE MEAL SERVICES
Elior Bateman (TRIO)
[Enter caterer's name] Select Description
[Enter caterer's name]
[Enter caterer's name] Select Description
$ 137,721 $ 24,360
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): Indirect costs are not allowable for Federal ARPA funding.

Do indirect costs exceed the ten percent (10%) maximum? Indirect Costs (Lower Tier Subawards for Catered Food)

TOTAL DIRECT LOWER TIER SUBAWARDS FOR
CATERED FOOD -$

GRAND TOTAL LOWER TIER SUBAWARDS FOR

CATERED FOOD
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]

GRAND TOTAL
(2)
NOTE:
-$ $ 162,081 $0
-$ $ 24,360 $ 162,081 $0
[Complete as
needed]
$ 162,081 $ 137,721 -$ $ 24,360 -$ -$ -$
-$ -$ -$

INDIRECT
$ 162,081 $ 137,721
IV. BUDGET DETAIL - LOWER TIER SUBAWARDS FOR CATERED FOOD (A)

LOWER TIER SUBRECIPIENT'S NAME
(1)
(C)

UNIT COST
(D)
NO. OF
UNITS
(E)
NO. OF
MONTHS
(C*D*E) (F - K)
American Meals 4.35$ 3,105 12 $ 162,081 $ 162,081 $0
(J)

PROGRAM
INCOME
(1)
CASH
(B)

SERVICE CATEGORY
(G)
SSY3
(F) SF

TOTAL COSTS
(K)

TOTAL FUNDING
(L)

VARIANCE
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 767 of 1182
768 of 1182
769 of 1182
770 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
VIII. BUDGET DETAIL - OTHER COSTS

CONGREGATE MEAL SERVICES
2022-2023
Federal American Rescue Plan Act (ARPA)
(A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY3
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 $0
DIRECT
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 2,000.00$ 1 12 $ 24,000 $ 24,000 1 1 $ 360 $ 360 $ 360 $0
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Training and Education (2 CFR 200.472 & 45 CFR 75.472) 360.00$ 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)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 10 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 771 of 1182
772 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 Cash (SF) In-Kind (SF) $ -
$ -
In-Kind (SF)
$ -
Cash (SF) $ -
Cash NSIP
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
5 Raw Food
Cash Other
(SSY3) $ -
3 Non-Match
6 Space
Cash Other
(SSY3) $ -
2 Subtotal $ 203,000
4 Lower Tier Subawards for Catered Food
Cash Other
(SSY3) $ 137,721
Cash NSIP
(SSY3) $ -
Cash (SF)
$ 24,360
Match
In-Kind (SF)
$ -
Cash (SF) $ 24,360
In-Kind (SF) $ -
Cash Other
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
City of Glendale
IX. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
Cash NSIP
(SSY3) $ -
(1)
Total Budgeted
Costs
DIRECT
1 Personnel
Cash Other
(SSY3) $ 40,919
1 SSY3
Cash Other
(SSY3) $ 203,000
Volunteers In-Kind (SF)
$ -
3 Volunteer Expenses

CONGREGATE MEAL SERVICES
2022-2023
Federal American Rescue Plan Act (ARPA)
Five (5)
ENP202106
Eight Modification Number: N/A
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 12 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 773 of 1182
IX. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
11 13 Lower Tier Subawards for Catered Food
Cash Other
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
7 Match
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ -
In-Kind (SF) $ -
Cash (SF) $ -
10 Personnel
Cash Other
(SSY3) $ -
Volunteers 6 SSY3
12 Volunteer Expenses Cash (SF)
Variance (Costs-Funding)
Cash
In-Kind

INDIRECT
Cash (SF)
$ 24,360
In-Kind (SF)
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ 203,000
Cash NSIP
(SSY3) $ -
Cash NSIP
(SSY3) $ -
9 Subtotal Direct Costs
Cash Other
(SSY3) $ 203,000
5 Subtotal Funding for
Direct Costs
Cash (SF)
$ 24,360
Cash (SF) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ 24,360
Cash (SF)
$ -
7 Equipment
Cash Other
(SSY3) $ -
4 Program Income
8 Other Costs
In-Kind (SF)
$ -
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 13 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 774 of 1182
IX. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
21 12
Cash NSIP
(SSY3) $ -
Cash (SF)
$ 24,360
Cash (SF)
$ 24,360

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
$ 227,360

GRAND TOTAL FUNDING
$ 227,360
20 Total Costs
Cash Other
(SSY3) $ 203,000
11 Total Funding
Cash Other
(SSY3) $ 203,000
Cash NSIP
(SSY3)
Variance (Costs-Funding) $0
$ -
Cash Other
(SSY3) $ -
Cash (SF)
$ -
Cash (SF)
$ -
17 Subtotal Indirect Costs
Cash Other
(SSY3) $ -
10 Subtotal Funding for
Indirect Costs
In-Kind (SF)
$ -
Cash (SF) Cash (SF) $ -
$ -
In-Kind (SF)
$ -
16 Other Costs
Cash Other
(SSY3) $ -
9 Program Income
Cash (SF) In-Kind (SF) $ -
$ -
In-Kind (SF)
$ -
Cash (SF) Cash (SF) $ -
$ -
In-Kind (SF)
$ -
14 Raw Food
Cash Other
(SSY3) $ -
8 Non-Match
15 Space
Cash Other
(SSY3) $ -
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 14 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 775 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
(4) Enter the total unit rate for SSY3. The unit rate shall match the Subtotal SSY3 in Exhibit X1 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. (5) Enter the unit rate for SF. The unit rate shall match the unit rate for SF in Exhibit X1 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. [Enter] $ -
$ 27,090 -$

COUNTY USE ONLY
Assigned Program Analyst:

Assigned Contract Analyst:

Hanre Chang Accountant I 818 5503060 [Enter] [email protected] Prefix Budget Analyst Job Title Phone Number Ext. E-Mail Address Mr.
$ -
[Enter] [Enter] -$
Grand Total (8)
[Enter]
318,500$ 35,500$ $ 35,000
Equipment (Purchases) (6)
Ethnic Meals (Kosher) [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] [Enter] $ - Job Title
(818) 548-2000
Phone Number
[Enter]
[Enter] [email protected]
Prefix
Onnig Bulanikian
[Enter] [Enter] [Enter] [Enter]
Authorized Representative
Director
Job Title
[Enter]
Mr.

SUBRECIPIENT'S FUNDS (SF) (2)
(C)
MATCH (3)
(D)

NON-MATCH
(E)

PROGRAM
INCOME
Maggie Kavarian
Project Manager
Ms.
(1)
CASH
(3)
TOTAL

FUNDING
$ 2.57
(1)
SSY3 (4)
$ 66,295 $ 7.08
(2)

IN-KIND
(1)
CASH
$ 35,000
Ext. E-Mail Address
-$ -$
Community Services Manager
(2)

IN-KIND
$ -
Phone Number
$ 482,385
(F)
TOTAL

FUNDING
(B+C+D+E)
[Enter]
(818) 548-3715 [email protected]

PROGRAM FUNDING SUMMARY
$ 27,090 [Enter] $ 9.65
(A)

SERVICE CATEGORY
(B)

SUBAWARD SUM
YEAR 1
(SSY3) (1)
(1)
CASH
OTHER
(2)
CASH
NSIP
318,500$
(1)
CASH
EXHIBIT W1 (BUDGET)
AMENDMENT 8 {FY 2022-23 BASELINE FUNDING}
CA 91206
State Zip Code
State
[Enter State] [Enter Zip]

CONGREGATE MEAL SERVICES
2022-2023
City of Glendale
ENP202106
Subrecipient's Legal Name:
613 E Broadway Room 120
Main Administrative Office Address
Glendale
Mailing Address (if different from above) City Zip Code Eight Modification Number: N/A
[Enter] [Enter]
American Meals
Ethnic Meals (Chinese) [Enter] [Enter] [Enter] [Enter]
35,500$
[Enter] [Enter]
Ethnic Meals (Indian/
Vegetarian)
(G)

UNIT RATE
City
[Enter Address] [Enter City]
(2)
SF (5)
$ 66,295 -$ $ 482,385
Ethnic Meals (Cambodian)
[Enter]
Prefix Ext. E-Mail Address
[Enter]
[Enter] [Enter] [Enter]
[Enter] [Enter] [Enter] [Enter]
Older Americans Act Title III C-1
Five (5)
(3) The minimum required total mach is twelve percent (12%) of SSY3.

ALL COSTS REPORTED ON THIS BUDGET SHALL BE ALLOWABLE, NECESSARY, AND REASONABLE FOR THE PROGRAM SERVICES TO BE PROVIDED.

Igor Bagmanian Date: 9/22/2022
-$
[Enter] [Enter]
[Enter] $ - [Enter] [Enter]
$ - [Enter] [Enter]
[Enter]
Budget Reviewed and Approved by:

Equipment (Other) (7)
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 776 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Meal Site Coordinator (Hourly City
Worker) Weekend ARC 100% $ 600 12 $ 7,200 $ 7,200 $ 7,200 $0 12 $ 22,464 $ 22,464 $ 22,464
$0
Food Services Manager (Comm.

Services Specialist) 100% $ 4,326 12 $ 51,912 $ 51,912
Meal Site Coordinator (Hourly City
Worker) ARC 100% $ 1,820 12 $ 21,840 $ 21,840
Meal Driver (Hourly City Worker) 100% $ 1,872 $0
Meal Site Coordinator (Hourly City
Worker) Pacific 100% $ 670 12 $ 8,040 $ 8,040 $ 8,040 $0 $ 51,912 $0
Meal Site Coordinator (Hourly City
Worker) Sparr 100% $ 1,560 $ 18,720
$ 21,840 $0
12 $ 18,720 $ 18,720

CONGREGATE MEAL SERVICES
2022-2023
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)
SSY3
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 (Comm. Services
Supervisor) 25% $ 8,242 12 $ 24,726 $ 24,726 $ 24,726 $0 [Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 777 of 1182
778 of 1182
779 of 1182
780 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

IV. BUDGET DETAIL - LOWER TIER SUBAWARDS FOR CATERED FOOD (A)

LOWER TIER SUBRECIPIENT'S NAME
(1)
(C)

UNIT COST
(D)
NO. OF
UNITS
(E)
NO. OF
MONTHS
(C*D*E) (F - K)
American Meals 4.36$ 4,167 12 $ 217,999 35,000$ $ 217,999 $0 (J)

PROGRAM
INCOME
(1)
CASH
(B)

SERVICE CATEGORY
(G)
SSY3
(F) SF

TOTAL COSTS
(K)

TOTAL FUNDING
(L)

VARIANCE
$ 35,500 $ 41,569
[Complete as
needed]
$ 217,999 $ 105,930 $ 35,500 $ 41,569 -$ -$ -$ -$ -$ -$

INDIRECT
$ 217,999 $ 105,930
(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 (SSY3 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 for Catered Food)

TOTAL DIRECT LOWER TIER SUBAWARDS FOR
CATERED FOOD 35,000$

GRAND TOTAL LOWER TIER SUBAWARDS FOR

CATERED FOOD
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]

GRAND TOTAL
(2)
NOTE:
35,000$ $ 217,999 $0
$ 217,999 $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
Select Description
Select Description
[Enter caterer's name] Select Description
[Enter caterer's name]
[Enter caterer's name]
Select Description

CONGREGATE MEAL SERVICES
Elior TRIO
[Enter caterer's name] Select Description
[Enter caterer's name]
[Enter caterer's name] Select Description
$ 105,930 $ 35,500 $ 41,569
DIRECT
2022-2023
Older Americans Act Title III C-1
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 781 of 1182
782 of 1182
783 of 1182
784 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

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)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
2,151$ $ 4,000 $0
Maintenance and Repairs (2 CFR 200.452 & 45 CFR

75.452) 4,763.00$ 1 1 $ 4,763 $ 4,763 $ 4,763 $0
1 12 $ 40,933 $ 40,933
Training and Education (2 CFR 200.472 & 45 CFR 75.472) 1,000.00$ 1 4 $ 4,000 $ 1,849 Memberships, Subscriptions and Professional Activities (2 CFR 200.454 & 45 CFR 75.454) 1,000.00$ 1 1 $ 1,000 $ 1,000 Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 3,411.08$ $ 1,000 $0
$ 40,933 $0
$ 14,506 $0
DIRECT
Maintenance and Repairs (2 CFR 200.452 & 45 CFR

75.452) 1,208.83$ 1 12 $ 14,506 $ 14,506
(A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY3
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)
ENP202106
Eight Modification Number: N/A
City of Glendale
VIII. BUDGET DETAIL - OTHER COSTS

CONGREGATE MEAL SERVICES
2022-2023
Older Americans Act Title III C-1
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 10 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 785 of 1182
786 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 CONGREGATE MEAL SERVICES
2022-2023
Older Americans Act Title III C-1
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
IX. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
Cash NSIP
(SSY3) $ 35,500
(1)
Total Budgeted
Costs
DIRECT
1 Personnel
Cash Other
(SSY3) $ 149,519
1 SSY3
Cash Other
(SSY3) $ 318,500
Volunteers In-Kind (SF)
$ -
3 Volunteer Expenses
Cash (SF)
$ 49,665
In-Kind (SF)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
2 Subtotal $ 354,000
4 Lower Tier Subawards for Catered Food
Cash Other
(SSY3) $ 105,930
Cash NSIP
(SSY3) $ 35,500
Cash (SF)
$ 76,569
Match
In-Kind (SF)
$ -
Cash (SF) $ 66,295
In-Kind (SF) $ -
Cash Other
(SSY3) $ -
5 Raw Food
Cash Other
(SSY3) $ -
3 Non-Match
6 Space
Cash Other
(SSY3) $ -
Cash (SF) In-Kind (SF) $ -
$ -
In-Kind (SF)
$ -
Cash (SF) $ 27,090
Cash NSIP
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 12 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 787 of 1182
IX. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
11 7 Equipment
Cash Other
(SSY3) $ -
4 Program Income
8 Other Costs
In-Kind (SF)
$ -
Cash (SF) $ 35,000
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ 63,051
Cash (SF)
$ 2,151
Cash Other
(SSY3) $ 318,500
Cash NSIP
(SSY3) $ 35,500
Cash NSIP
(SSY3) $ 35,500 9 Subtotal Direct Costs
Cash Other
(SSY3) $ 318,500
5 Subtotal Funding for
Direct Costs
Cash (SF)
$ 128,385
Variance (Costs-Funding)
Cash
In-Kind

INDIRECT
Cash (SF)
$ 128,385
In-Kind (SF)
$ -
In-Kind (SF)
$ -
10 Personnel
Cash Other
(SSY3) $ -
Volunteers 6 SSY3
12 Volunteer Expenses Cash (SF)
Match
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ -
In-Kind (SF) $ -
Cash (SF) $ -
13 Lower Tier Subawards for Catered Food
Cash Other
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
7 Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 13 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 788 of 1182
IX. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
21 12
14 Raw Food
Cash Other
(SSY3) $ -
8 Non-Match
15 Space
Cash Other
(SSY3) $ -
Cash (SF) In-Kind (SF) $ -
$ -
In-Kind (SF)
$ -
Cash (SF) Cash (SF) $ -
$ -
In-Kind (SF)
$ -
Cash (SF) Cash (SF) $ -
$ -
In-Kind (SF)
$ -
16 Other Costs
Cash Other
(SSY3) $ -
9 Program Income
Cash Other
(SSY3) $ -
Cash (SF)
$ -
Cash (SF)
$ -
17 Subtotal Indirect Costs
Cash Other
(SSY3) $ -
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
$ 482,385

GRAND TOTAL FUNDING
$ 482,385
20 Total Costs
Cash Other
(SSY3) $ 318,500
11 Total Funding
Cash Other
(SSY3) $ 318,500
Cash NSIP
(SSY3)
Variance (Costs-Funding) $0
$ 35,500
Cash NSIP
(SSY3) $ 35,500
Cash (SF)
$ 128,385
Cash (SF)
$ 128,385

GRAND TOTAL
In-Kind (SF)
$ -
Variance (Costs-Funding)
Cash
In-Kind
Exhibit W1 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 14 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 789 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
(6) Funding Amount for Equipment (Purchase(s)) reflected under SSY3 and SF shall match the Equipment (Purchase(s)) Funding Amount reflected in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary). (1)
SSY3 (4)
[Enter] [Enter]
(2)

IN-KIND
(1)
CASH
(7) 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). (8) Gr nd Total F ding Amount nder Col mn (F) Tot Fund ng Am nt hall match Grand l Fund g Am unt reflected n Exh b X2 (Manda ed Pr gram Serv es), Se ion I (Un s f Se vice Summ y), ( ) g Amount.
[Enter] $ -
$ 144 -$

COUNTY USE ONLY
Assigned Program Analyst:

Assigned Contract Analyst:

Sheri Stanton Equipment Purchase(s) Approved by: N/A
Irma Panosian
[Enter]
NOTE:
(4) Enter the total unit rate for SSY3. The unit rate shall match the Subtotal SSY3 in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. (5) Enter the unit rate for SF. The unit rate shall match the unit rate for SF in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. $ -
Grand Total (8)
[Enter]
44,000$ -$ -$
Equipment (Purchases) (6)
(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.

Budget Reviewed and Approved by: Igor Bagmanian Date: 9/22/2022 Equipment (Other) (7)
$ 5,280
(3) The minimum required total mach is twelve percent (12%) of SSY3. $ 49,424
[Enter]
(1) The SSY3 for each Service Category shall match the SSY3 Cash Other reflected in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category.

Emergency Meals 2,000$
Phone Number
$ -
(F)
TOTAL

FUNDING
(B+C+D+E)
$ 7.39
Prefix Ext. E-Mail Address
[Enter]
SUBRECIPIENT'S FUNDS (SF) (2)
(C)
MATCH (3)
Hot Meals

PROGRAM FUNDING SUMMARY
-$
(A)

SERVICE CATEGORY
$ 144
Project Manager
Hanre Chang Accountant I
(1)
CASH
$ 5,280
Main Administrative Office Address
Glendale
ALL COSTS REPORTED ON THIS BUDGET SHALL BE ALLOWABLE, NECESSARY, AND REASONABLE FOR THE PROGRAM SERVICES TO BE PROVIDED.

City
[Enter Address] [Enter City]
[Enter]
[Enter]
Ext. E-Mail Address
Community Services Manager
obulanikian
Prefix
Onnig Bulanikian
Authorized Representative
Director of Community Services and Parks
Job Title
Mr.

Ms. Maggie Kavarian 818-548-3771 [email protected] EXHIBIT W2 (BUDGET)
AMENDMENT 8 {FY 2022-23 FEDERAL ARPA FUNDING}
CA 91206
State Zip Code
State
[Enter State] [Enter Zip]

HOME DELIVERED MEAL SERVICES
2022-2023
City of Glendale
ENP202106
Subrecipient's Legal Name:
613 E. Broadway , Room 120
Federal American Rescue Plan Act (ARPA)
Five (5)
Mailing Address (if different from above) City Zip Code Eight Modification Number: N/A
[Enter]
(2)

IN-KIND
Job Title
[Enter]
Prefix Budget Analyst Job Title
Mr.

Frozen Meals
[Enter]
-$
818-548-2000
Phone Number
(G)

UNIT RATE
$ 8.34
(3)
TOTAL

FUNDING
[Enter] [Enter] $ 9.70
(B)

SUBAWARD SUM
YEAR 1
(SSY3) (1)
(1)
CASH
OTHER
(2)
CASH
NSIP
[Enter]
(1)
CASH
42,000$
[Enter]
818-550-3060 [Enter] [email protected]
Phone Number Ext. E-Mail Address
[Enter] [Enter]
[Enter]
(2)
SF (5)
$ 2,000 $ 9.70 [Enter]
$ 0.95
[Enter] [Enter]
(D)

NON-MATCH
(E)

PROGRAM
INCOME
[Enter]
[Enter] [Enter] $ 47,424
[Enter] [Enter] [Enter]
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 790 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
Home Delivered Meal Services
2022-2023
Federal 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)
SSY3
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
Meal Driver (Hourly City Worker) 100% $ 1,560 12 $ 18,720 $ 18,576 $ 18,720 $0 [Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
$ 144
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 791 of 1182
792 of 1182
793 of 1182
794 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

IV. BUDGET DETAIL - LOWER TIER SUBAWARDS FOR CATERED FOOD (A)

LOWER TIER SUBRECIPIENT'S NAME
(1)
(C)

UNIT COST
(D)
NO. OF
UNITS
(E)
NO. OF
MONTHS
(C*D*E) (F - K)
Frozen Meals 4.26$ 474 12 $ 24,211 $ 24,211 $0
(J)

PROGRAM
INCOME
(1)
CASH
(B)

SERVICE CATEGORY
(G)
SSY3
(F) SF

TOTAL COSTS
(K)

TOTAL FUNDING
(L)

VARIANCE
-$ $ 5,280
[Complete as
needed]
$ 26,211 $ 20,931 -$ $ 5,280 -$ -$ -$
-$ -$ -$

INDIRECT
$ 26,211 $ 20,931
(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): Indirect costs are not allowable for Federal ARPA funding.

Do indirect costs exceed the ten percent (10%) maximum? Indirect Costs (Lower Tier Subawards for Catered Food)

TOTAL DIRECT LOWER TIER SUBAWARDS FOR
CATERED FOOD -$

GRAND TOTAL LOWER TIER SUBAWARDS FOR

CATERED FOOD
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]

GRAND TOTAL
(2)
NOTE:
-$ $ 26,211 $0
$ 26,211 $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
Emergency Meals 10.00$
Select Description
[Enter caterer's name] Select Description
[Enter caterer's name]
[Enter caterer's name]
Select Description
50 4 $ 2,000
Home Delivered Meal Services
Elior (TRIO)
$ 2,000 $0
[Enter caterer's name] Select Description
City of Glendale
[Enter caterer's name] Select Description
$ 5,280
$ 2,000
$ 18,931
DIRECT
2022-2023
Federal American Rescue Plan Act (ARPA)
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 795 of 1182
796 of 1182
797 of 1182
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)
SSY3
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 drives and portable hard drives), and/or when Subrecipient will use $500 or more of the SSY3 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 SSY3 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) SSY3 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 SSY3, 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. 2022-2023
Federal American Rescue Plan Act (ARPA)
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
VII. BUDGET DETAIL - EQUIPMENT
(K)

VARIANCE
(E - J)
DIRECT
[Enter description] Select
[Enter description]
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 9 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 798 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY3
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)
ENP202106
Eight Modification Number: N/A
City of Glendale
VIII. BUDGET DETAIL - OTHER COSTS
Home Delivered Meal Services
2022-2023
Federal American Rescue Plan Act (ARPA)
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 10 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 799 of 1182
800 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 Home Delivered Meal Services
2022-2023
Federal American Rescue Plan Act (ARPA)
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
IX. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
Cash NSIP
(SSY3) $ -
(1)
Total Budgeted
Costs
DIRECT
1 Personnel
Cash Other
(SSY3) $ 23,069
1 SSY3
Cash Other
(SSY3) $ 44,000
Volunteers In-Kind (SF)
$ -
3 Volunteer Expenses
Cash (SF)
$ 144
In-Kind (SF)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
2 Subtotal $ 44,000
4 Lower Tier Subawards for Catered Food
Cash Other
(SSY3) $ 20,931
Cash NSIP
(SSY3) $ -
Cash (SF)
$ 5,280
Match
In-Kind (SF)
$ -
Cash (SF) $ 5,280
In-Kind (SF) $ -
Cash Other
(SSY3) $ -
5 Raw Food
Cash Other
(SSY3) $ -
3 Non-Match
6 Space
Cash Other
(SSY3) $ -
Cash (SF) In-Kind (SF) $ -
$ -
In-Kind (SF)
$ -
Cash (SF) $ 144
Cash NSIP
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 12 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 801 of 1182
IX. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
11 7 Equipment
Cash Other
(SSY3) $ -
4 Program Income
8 Other Costs
In-Kind (SF)
$ -
Cash (SF) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ -
Cash (SF)
$ -
Cash Other
(SSY3) $ 44,000
Cash NSIP
(SSY3) $ -
Cash NSIP
(SSY3) $ -
9 Subtotal Direct Costs
Cash Other
(SSY3) $ 44,000
5 Subtotal Funding for
Direct Costs
Cash (SF)
$ 5,424
Variance (Costs-Funding)
Cash
In-Kind

INDIRECT
Cash (SF)
$ 5,424
In-Kind (SF)
$ -
In-Kind (SF)
$ -
10 Personnel
Cash Other
(SSY3) $ -
Volunteers 6 SSY3
12 Volunteer Expenses Cash (SF)
Match
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ -
In-Kind (SF) $ -
Cash (SF) $ -
13 Lower Tier Subawards for Catered Food
Cash Other
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
7 Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 13 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 802 of 1182
IX. BUDGET SUMMARY
(A)

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

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

GRAND TOTAL COSTS
$ 49,424

GRAND TOTAL FUNDING
$ 49,424
20 Total Costs
Cash Other
(SSY3) $ 44,000
11 Total Funding
Cash Other
(SSY3) $ 44,000
Cash NSIP
(SSY3)
Variance (Costs-Funding) $0
$ -
Cash NSIP
(SSY3) $ -
Cash (SF)
$ 5,424
Cash (SF)
$ 5,424

GRAND TOTAL
In-Kind (SF)
$ -
Variance (Costs-Funding)
Cash
In-Kind
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 14 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 803 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

COUNTY USE ONLY
Assigned Program Analyst:

Assigned Contract Analyst:

Irma Panosian Equipment Purchase(s) Approved by: N/A
Sheri Stanton
[Enter]
NOTE:
(4) Enter the total unit rate for SSY3. The unit rate shall match the Subtotal SSY3 in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. (5) Enter the unit rate for SF. The unit rate shall match the unit rate for SF in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. $ -
Grand Total (8)
[Enter]
68,756$ 7,244$ $ 4,000
Equipment (Purchases) (6)
(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.

Budget Reviewed and Approved by: Igor Bagmanian Date: 9/28/2022 Equipment (Other) (7)
$ 11,400
(3) The minimum required total mach is twelve percent (12%) of SSY3. $ 173,357
[Enter]
(1) The SSY3 for each Service Category shall match the SSY3 Cash Other reflected in Exhibit X2 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category.

Emergency Meals 2,371$
Phone Number
$ -
(F)
TOTAL

FUNDING
(B+C+D+E)
$ 7.39
Prefix Ext. E-Mail Address
7,056$
SUBRECIPIENT'S FUNDS (SF) (2)
(C)
MATCH (3)
Hot Meals

PROGRAM FUNDING SUMMARY
-$
(A)

SERVICE CATEGORY
$ 81,957
Project Manager
Hanre Chang Accountant I
(1)
CASH
$ 11,400
Main Administrative Office Address
Glendale
ALL COSTS REPORTED ON THIS BUDGET SHALL BE ALLOWABLE, NECESSARY, AND REASONABLE FOR THE PROGRAM SERVICES TO BE PROVIDED.

City
[Enter Address] [Enter City]
[Enter]
[Enter]
Ext. E-Mail Address
Community Services Manager
[email protected]
Prefix
Onnig Bulanikian
Authorized Representative
Director
Job Title
Mr.

Ms. Maggie Kavarian 818 5483715 [email protected] EXHIBIT W2 (BUDGET)
AMENDMENT 8 {FY 2022-23 BASELINE FUNDING}
CA 91206
State Zip Code
State
[Enter State] [Enter Zip]

HOME DELIVERED MEAL SERVICES
2022-2023
City of Glendale
ENP202106
Subrecipient's Legal Name:
613 East Broadway Room 120
Older Americans Act Title III C-2
Five (5)
Mailing Address (if different from above) City Zip Code Eight Modification Number: N/A
[Enter]
(2)

IN-KIND
Job Title
[Enter]
Prefix Budget Analyst Job Title
Ms.

Frozen Meals
[Enter]
-$
(818) 548-2000
Phone Number
(G)

UNIT RATE
$ 17.19
(3)
TOTAL

FUNDING
$ 188 [Enter] $ 9.70
(B)

SUBAWARD SUM
YEAR 1
(SSY3) (1)
(1)
CASH
OTHER
(2)
CASH
NSIP
[Enter]
(1)
CASH
66,385$
[Enter]
(818) 550-3060 [Enter] [email protected]
Phone Number Ext. E-Mail Address
[Enter] [Enter]
[Enter]
(2)
SF (5)
$ 2,559 $ 9.70 [Enter]
$ 9.80
[Enter] [Enter]
(D)

NON-MATCH
(E)

PROGRAM
INCOME
[Enter]
[Enter] $ 4,000 $ 170,798
[Enter] [Enter] [Enter]
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 804 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
[Enter title]
$0
Home Delivered Meal Case Worker
(Community Services Specialist) 50% $ 4,326 12 $ 25,956 $ 11,400 Home Delivered Meal Coordinator
(Community Services Specialist) 50% $ 4,326 12 $ 25,956 [Enter title]
[Enter title]
$ 25,956 $0
Home Delivered Meal Driver (Hourly
City Worker) 100% $ 2,244 $ 26,928
$ 25,956 $ 25,956 $0
12 $ 26,928 $ 26,928
Home Delivered Meal Services
2022-2023
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)
SSY3
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
$ 14,556
Project Manager (Community Services
Supervisor) 20% $ 8,242 12 $ 19,781 $ 19,781 $0
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
$ 19,781
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 805 of 1182
806 of 1182
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, HomeDelivered 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 Glendale
[Enter title]
[Enter title]
Home Delivered Meal Services
Eight Modification Number:
2022-2023
(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)
ENP202106
N/A
(J)

VARIANCE
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 4 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 807 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(1) Effective January 1, 2022, County’s approved mileage rate is $0.545 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 (SSY3 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
Indirect Costs (Volunteer Expenses) (2) as needed]
$ - $ - $ - $ - $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)
SSY3
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)
ENP202106
Eight Modification Number: N/A
City of Glendale
III. BUDGET DETAIL - VOLUNTEER EXPENSES
Home Delivered Meal Services
2022-2023
Older Americans Act Title III C-2
Five (5)
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 808 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

IV. BUDGET DETAIL - LOWER TIER SUBAWARDS FOR CATERED FOOD (A)

LOWER TIER SUBRECIPIENT'S NAME
(1)
(C)

UNIT COST
(D)
NO. OF
UNITS
(E)
NO. OF
MONTHS
(C*D*E) (F - K)
Frozen Meals 4.26$ 828 12 $ 42,336 4,000$ $ 42,336 $0
(J)

PROGRAM
INCOME
(1)
CASH
(B)

SERVICE CATEGORY
(G)
SSY3
(F) SF

TOTAL COSTS
(K)

TOTAL FUNDING
(L)

VARIANCE
$ 7,244 -$
[Complete as
needed]
$ 44,895 $ 32,587 $ 7,244 -$ -$ $ 1,064 -$ -$ $ 1,064 -$

INDIRECT
$ 44,895 $ 32,587
(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 (SSY3 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 for Catered Food)

TOTAL DIRECT LOWER TIER SUBAWARDS FOR
CATERED FOOD 4,000$

GRAND TOTAL LOWER TIER SUBAWARDS FOR

CATERED FOOD
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]
[Complete as
needed]

GRAND TOTAL
(2)
NOTE:
4,000$ $ 44,895 $0
$ 44,895 $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
Emergency Meals 9.70$
Select Description
[Enter caterer's name] Select Description
[Enter caterer's name]
[Enter caterer's name]
Select Description
88 3 $ 2,559
Home Delivered Meal Services
Elior (TRIO)
$ 2,559 $0
[Enter caterer's name] Select Description
City of Glendale
[Enter caterer's name] Select Description
$ 1,064
$ 2,371 $ 188
$ 30,216 $ 7,056
DIRECT
2022-2023
Older Americans Act Title III C-2
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 809 of 1182
810 of 1182
811 of 1182
812 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

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)
Select Description (2) (3) (4) (5)
1 3 $ 3,000 $ 3,000
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) $ 1,000.00 $ 3,000 $0 $ 2,187 $0
DIRECT
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 546.70$ 1 4 $ 2,187 $ 239 1,948$ (A)
DESCRIPTION (1)
(B)

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY3
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)
ENP202106
Eight Modification Number: N/A
City of Glendale
VIII. BUDGET DETAIL - OTHER COSTS
Home Delivered Meal Services
2022-2023
Older Americans Act Title III C-2
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 10 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 813 of 1182
814 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 Home Delivered Meal Services
2022-2023
Older Americans Act Title III C-2
Five (5)
ENP202106
Eight Modification Number: N/A
City of Glendale
IX. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
Cash NSIP
(SSY3) $ 7,244
(1)
Total Budgeted
Costs
DIRECT
1 Personnel
Cash Other
(SSY3) $ 32,929
1 SSY3
Cash Other
(SSY3) $ 68,755
Volunteers In-Kind (SF)
$ -
3 Volunteer Expenses
Cash (SF)
$ 90,347
In-Kind (SF)
$ -
Cash (SF)
$ -
In-Kind (SF)
$ -
2 Subtotal $ 75,999
4 Lower Tier Subawards for Catered Food
Cash Other
(SSY3) $ 32,587
Cash NSIP
(SSY3) $ 7,244
Cash (SF)
$ 5,064
Match
In-Kind (SF)
$ -
Cash (SF) $ 11,400
In-Kind (SF) $ -
Cash Other
(SSY3) $ -
5 Raw Food
Cash Other
(SSY3) $ -
3 Non-Match
6 Space
Cash Other
(SSY3) $ -
Cash (SF) In-Kind (SF) $ -
$ -
In-Kind (SF)
$ -
Cash (SF) $ 81,959
Cash NSIP
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 12 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 815 of 1182
IX. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (1)
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
11 7 Equipment
Cash Other
(SSY3) $ -
4 Program Income
8 Other Costs
In-Kind (SF)
$ -
Cash (SF) $ 4,000
Cash (SF)
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ 3,239
Cash (SF)
$ 1,948
Cash Other
(SSY3) $ 68,755
Cash NSIP
(SSY3) $ 7,244
Cash NSIP
(SSY3) $ 7,244 9 Subtotal Direct Costs
Cash Other
(SSY3) $ 68,755
5 Subtotal Funding for
Direct Costs
Cash (SF)
$ 97,359
Variance (Costs-Funding)
Cash
In-Kind

INDIRECT
Cash (SF)
$ 97,359
In-Kind (SF)
$ -
In-Kind (SF)
$ -
10 Personnel
Cash Other
(SSY3) $ -
Volunteers 6 SSY3
12 Volunteer Expenses Cash (SF)
Match
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
In-Kind (SF)
$ -
Cash Other
(SSY3) $ -
In-Kind (SF) $ -
Cash (SF) $ -
13 Lower Tier Subawards for Catered Food
Cash Other
(SSY3) $ -
Cash (SF)
$ -
In-Kind (SF)
$ -
7 Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 13 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 816 of 1182
IX. BUDGET SUMMARY
(A)

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

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

GRAND TOTAL COSTS
$ 173,358

GRAND TOTAL FUNDING
$ 173,358
20 Total Costs
Cash Other
(SSY3) $ 68,755
11 Total Funding
Cash Other
(SSY3) $ 68,755
Cash NSIP
(SSY3)
Variance (Costs-Funding) $0
$ 7,244
Cash NSIP
(SSY3) $ 7,244
Cash (SF)
$ 97,359
Cash (SF)
$ 97,359

GRAND TOTAL
In-Kind (SF)
$ -
Variance (Costs-Funding)
Cash
In-Kind
Exhibit W2 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 14 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 817 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
(6) Grand Total Funding Amount under Column (F) Total Funding Amount shall match Grand Total Funding Amount reflected in Exhibit X3 (Mandated Program Services), Section I (Service Unit Summary), Column (E) Funding Amount.
(4) Enter the total unit rate for SSY3. The unit rate shall match the Subtotal SSY3 in Exhibit X3 (Mandated Program Services), Section I (Units of Service Summary). (5) Enter the unit rate for SF. The unit rate shall match the unit rate for SF in Exhibit X3 (Mandated Program Services), Section I (Units of Service Summary).

AMENDMENT 8 {FY 2022-23 BASELINE FUNDING}

TELEPHONE REASSURANCE SERVICES
2022-2023
Older Americans Act Title III B
Five
ENP202106
Eight Modification Number: N/A
(1) The SSY3 for each Service Category shall match the SSY3 reflected in Exhibit X3 (Mandated Program Services), Section I (Service Unit Summary) for each Service Category. (3) The minimum required total match is twelve percent (12%) of SSY3.

Grand Total (6) $ 1,000 $ 126 -$ -$ -$ -$ $ 1,126
Assigned Contract Analyst:

Budget Reviewed and Approved by:

COUNTY USE ONLY
Assigned Program Analyst:

Irma Panosian
Igor Bagmanian Date: 9/22/2022
Sheri Stanton Equipment Purchase(s) Approved by: N/A
(2) The SF for each Service Category shall match the SF reflected in Exhibit X3 (Mandated Program Services), Section I (Service Unit Summary) for each Service Category.

EXHIBIT W3 (BUDGET)
ALL COSTS REPORTED ON THIS BUDGET SHALL BE ALLOWABLE, NECESSARY, AND REASONABLE FOR THE PROGRAM SERVICES TO BE PROVIDED.

Telephone Calls
Ms.

SUBRECIPIENT'S FUNDS (SF) (2)
(C)
MATCH (3)
(1)
CASH
[Enter]
(2)

IN-KIND
(3)

TOTAL FUNDING

0.68 (1)
SSY3 (4)

0.68 (2)
SF (5)
[email protected]
Budget Analyst Job Title Phone Number Ext. E-Mail Address [Enter
Ext.]
Zip Code
Mr.

State Zip Code
Subrecipient's Legal Name:

Main Administrative Office Address City
City of Glendale
$ 1,000 $ 126 [Enter]
[Enter Address] [Enter City]
613 East Broadway Room 120 Glendale CA 91206
Phone Number Ext. E-Mail Address
City State
(818) 548-2000
[Enter
Ext.] [email protected]
[Enter State]
818 5503060
[Enter Zip]
Mailing Address (if different from above)
Prefix Authorized Representative
Prefix
Mr.

Onnig Bulanikian Director
Maggie Kavarian Community Services Manager (818) 548-3715 [Enter
Ext.] [email protected]
Job Title
[Enter] $ 1.36
Phone Number Ext. E-Mail Address
(D)

NON-MATCH
(E)

PROGRAM
INCOME
(G)

UNIT RATE
[Enter] $ 1,126
(F)

TOTAL FUNDING

PROGRAM FUNDING SUMMARY
(A)

SERVICE CATEGORY
(B)

SUBAWARD SUM
YEAR 3
(SSY3) (1)
Prefix Project Manager
(1)

CASH OTHER
(1)
CASH
(2)

IN-KIND
(1)
CASH
(B+C+D+E)
Job Title
Hanre Chang Accountant I
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 818 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number: Modification Number:

Subrecipient's Legal Name:

TELEPHONE REASSURANCE SERVICES
Five
ENP202106
Eight
City of Glendale
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
[Enter title]
DIRECT
Hourly City Worker 5% $ 1,200 12 $ 720 $ 720 $ 720 $0
[Enter title]
(A)
POSITION TITLE (1)
(B)
% OF TIME
ON

PROGRAM
(2)
(C)

MONTHLY
SALARY
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY3
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)
[Enter title]
I. BUDGET DETAIL - PERSONNEL
N/A
2022-2023
Older Americans Act Title III B
[Enter title]
Exhibit W3 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 819 of 1182
820 of 1182
821 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

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
Indirect Costs (Volunteer Expenses) (2) as needed]
$ - $ - $ - $ - $0

INDIRECT

DESCRIPTION
(B)

UNIT COST
(C)

NUMBER OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY3
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)
III. BUDGET DETAIL - VOLUNTEER EXPENSES
Older Americans Act Title III B
Eight Modification Number:

TELEPHONE REASSURANCE SERVICES
2022-2023
Five
ENP202106
N/A
City of Glendale
Exhibit W3 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 822 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

UNIT COST
(C)
NO. OF
UNITS
(D)
NO. OF
MONTHS
(E)

TOTAL COSTS
(F)
SSY3
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)
IV. BUDGET DETAIL - OTHER COSTS
Older Americans Act Title III B
Eight Modification Number:

TELEPHONE REASSURANCE SERVICES
2022-2023
Five
ENP202106
N/A
City of Glendale
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Exhibit W3 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 823 of 1182
824 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 Five
ENP202106
Eight Modification Number: N/A
City of Glendale

TELEPHONE REASSURANCE SERVICES
2022-2023
Older Americans Act Title III B
Variance (Costs-Funding)
Cash Other
(SSY3)
Cash (SF)
In-Kind (SF)
$ 1,000
Cash (SF) $ 126Cash (SF) $ 126
In-Kind (SF) $ -In-Kind (SF) $ -
5 Subtotal Funding for
Direct Costs
Cash Other
(SSY3)
5 Subtotal Direct Costs
Cash Other
(SSY3) $ 1,000
4 In-Kind (SF) $ -
Cash Other
(SSY3) $ -
4 Other Costs Program Income Cash (SF)
In-Kind (SF)
$ -
Cash (SF) $ 50
3 Volunteer Expenses
Cash Other
(SSY3) $ -
In-Kind (SF) $ -
$ -
In-Kind (SF) $ -
Cash (SF) $ -
3 Non-Match
Cash (SF) $ -
Volunteers In-Kind (SF) $ -
2 Match
Cash (SF) $ 126
V. BUDGET SUMMARY
(A)

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

FUNDING CATEGORIES
(D)
FUNDING (2)
(1)
Total Budgeted
Costs
(1)
Total Budgeted
Costs
DIRECT
1 Personnel
Cash Other
(SSY3) $ 1,000
1 SSY3 Cash Other (SSY3)
$ 1,000
Cash (SF) $ 76
In-Kind (SF) $ -
Exhibit W3 (Budget) Amendment 8 {FY 2022-23 Baseline Funding} Page 8 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 825 of 1182
826 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
[Enter]
Ext.
[Enter]
Ext.
[Enter]
Ext. E-Mail Address
9/7/2022

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

Prefix Budget Analyst Job Title Phone Number
(818) 548-2000
Phone Number
Ms. Cathy Liang Kwan
Phone Number
Community Services Manager [email protected]
Prefix Project Manager Job Title E-Mail Address
Ms. Maggie Kavarian (818) 548-3715
EXHIBIT X1 (MANDATED PROGRAM SERVICES)
AMENDMENT 8 {FY 2022-23 FEDERAL ARPA FUNDING}
Subrecipient's Legal Name:
[Enter Address]
Director [email protected]
State Zip Code
613 East Broadway Room 120 Glendale CA 91206
Main Administrative Office Address
[Enter City] CA [Enter Zip]
Accountant II (818) 548-2151 [email protected]
Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title E-Mail Address Mr. Onnig Bulanikian
City
Congregate Meal Services
2022-2023
Federal American Rescue Plan Act (ARPA)
Five
ENP202106
City of Glendale
Eight Modification Number: N/A
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 827 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subtotal SSY3
(Cash Other and Cash NSIP)
Total (4)
SSY3
(Cash NSIP)
Subtotal SSY3
(Cash Other and Cash NSIP)
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
[Select Ethnic
Meal Style]
SF (7)
(Cash and In-Kind)
$ -
[Enter Unit Rate]
28,672
[Enter Units]
28,672
[Enter Unit Rate]
$ -
$ 203,000
$ 7.93 $ 227,360
[Enter Unit Rate]
28,672
$ 7.08 $ 203,000
$ 7.08
$ 0.85 $ 24,360
Subrecipient's Legal Name:

Congregate Meal Services
2022-2023
Federal American Rescue Plan Act (ARPA)
Five
ENP202106
City of Glendale
Ethnic Meals
Total (4)
SSY3 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
[Enter Total
Unduplicated
Units]
[Enter Units]
[Enter Unit Rate]
Eight Modification Number: N/A
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
SSY3 (6)
(Cash Other)
SSY3
(Cash NSIP)
[Enter Units]
[Enter Units]
I. UNITS OF SERVICE SUMMARY
110
American Meals
Exhibit X1 (Mandated Program Services) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 828 of 1182
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
Equipment (Other) (9)
[Enter Units]
[Enter Units]
[Enter Units]
[Enter Amount]
Total (4)
[Enter Total
Unduplicated
Units]
[Enter Unit Rate]
SSY3
(Cash NSIP) [Enter Unit Rate]
$ - $ -
GRAND TOTAL SERVICES/FUNDING 110
SSY3 (6)
(Cash Other)
Subtotal SSY3
(Cash Other and Cash NSIP)
28,672
SF (7)
(Cash and In-Kind)
$ 227,360
[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. (9) Enter the amount of equipment (other) that is reflected in Exhibit W1 (Budget). (6) SSY3: 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 SSY3 (Cash Other) and for SSY3 (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 SSY3 (Cash Other), SSY3 (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.

Exhibit X1 (Mandated Program Services) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 3 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 829 of 1182
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 80 1,900 1,900 1,900 2,000 1,900 1,900 1,912 1,900 1,900 1,900 1,900 1,900 22,912 2 20 450 450 450 450 450 450 450 450 450 450 450 450 5,400 3 10 30 30 30 30 30 30 30 30 30 30 30 30 360
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
110 2,380 2,380 2,380 2,480 2,380 2,380 2,392 2,380 2,380 2,380 2,380 2,380 28,672 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
Adult Recreation Center
Sparr Community Center
Pacific Community Center
ENP202106
Congregate Meal Services
2022-2023
Federal American Rescue Plan Act (ARPA)
Five
Subrecipient's Legal Name: City of Glendale
Eight Modification Number: N/A
Exhibit X1 (Mandated Program Services) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 4 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 830 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

ENP202106
Eight Modification Number:

Congregate Meal Services
2022-2023
Federal American Rescue Plan Act (ARPA)
Five
N/A
NOTE:

Grand Total
Subrecipient's Legal Name: City of Glendale
[Select Ethnic Meal Style] III. SERVICES BY MONTH - ETHNIC MEALS (B)

SITE NAME
Exhibit X1 (Mandated Program Services) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 831 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

ENP202106
Eight Modification Number:

IV. SERVICES BY MONTH - ETHNIC MEALS [Select Ethnic Meal Style] N/A
Subrecipient's Legal Name: City of Glendale
Congregate Meal Services
2022-2023
Federal American Rescue Plan Act (ARPA)
Five
NOTE:
(B)

SITE NAME
Grand Total
Exhibit X1 (Mandated Program Services) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 832 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
[Enter]
Ext.
[Enter]
Ext.
[Enter]
Ext. E-Mail Address
9/7/2022

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

Prefix Budget Analyst Job Title Phone Number
(818) 548-2000
Phone Number
Ms. Cathy Liang Kwan
Phone Number
Community Services Manager [email protected]
Prefix Project Manager Job Title E-Mail Address
Ms. Maggie Kavarian (818) 548-3715
EXHIBIT X1 (MANDATED PROGRAM SERVICES)
AMENDMENT 8 {FY 2022-23 BASELINE FUNDING}
Subrecipient's Legal Name:
[Enter Address]
Director [email protected]
State Zip Code
613 East Broadway Room 120 Glendale CA 91206
Main Administrative Office Address
[Enter City] CA [Enter Zip]
Accountant II (818) 548-2161 [email protected]
Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title E-Mail Address Mr. Onnig Bulanikian
City
Congregate Meal Services
2022-2023
Older Americans Act Title III C-1
Five
ENP202106
City of Glendale
Eight Modification Number: N/A
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 833 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subtotal SSY3
(Cash Other and Cash NSIP)
Total (4)
SSY3
(Cash NSIP)
Subtotal SSY3
(Cash Other and Cash NSIP)
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
[Select Ethnic
Meal Style]
SF (7)
(Cash and In-Kind)
$ -
$ -
50,000
50,000
50,000
[Enter Unit Rate]
$ -
$ 318,500
$ 9.65 $ 482,385
$ 0.71 $ 35,500
50,000
$ 7.08 $ 354,000
$ 6.37
$ 2.57 $ 128,385
Subrecipient's Legal Name:

Congregate Meal Services
2022-2023
Older Americans Act Title III C-1
Five
ENP202106
City of Glendale
Ethnic Meals
Total (4)
SSY3 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
[Enter Total
Unduplicated
Units]
[Enter Units]
[Enter Unit Rate]
Eight Modification Number: N/A
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
SSY3 (6)
(Cash Other)
SSY3
(Cash NSIP)
[Enter Units]
[Enter Units]
I. UNITS OF SERVICE SUMMARY
400
American Meals
Exhibit X1 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 834 of 1182
(E)
FUNDING AMOUNT (5)
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
Equipment (Other) (9)
[Enter Units]
[Enter Units]
[Enter Units]
[Enter Amount]
Total (4)
[Enter Total
Unduplicated
Units]
[Enter Unit Rate]
SSY3
(Cash NSIP) [Enter Unit Rate]
$ - $ -
GRAND TOTAL SERVICES/FUNDING 400
SSY3 (6)
(Cash Other)
Subtotal SSY3
(Cash Other and Cash NSIP)
50,000
SF (7)
(Cash and In-Kind)
$ 482,385
[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. (9) Enter the amount of equipment (other) that is reflected in Exhibit W1 (Budget). (6) SSY3: 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).

Exhibit X1 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 3 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 835 of 1182
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)
1 280 3,800 3,800 3,800 3,800 3,600 3,800 3,800 3,000 3,800 3,800 3,800 3,800 44,600 2 100 400 400 400 400 400 400 400 400 400 400 400 400 4,800 3 20 50 50 50 50 50 50 50 50 50 50 50 50 600
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
400 4,250 4,250 4,250 4,250 4,050 4,250 4,250 3,450 4,250 4,250 4,250 4,250 50,000 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
Adult Recreation Center
Sparr Heights Community Center
Pacific Community Center
ENP202106
Congregate Meal Services
2022-2023
Older Americans Act Title III C-1
Five
Subrecipient's Legal Name: City of Glendale
Eight Modification Number: N/A
Exhibit X1 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 4 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 836 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

ENP202106
Eight Modification Number:

Congregate Meal Services
2022-2023
Older Americans Act Title III C-1
Five
N/A
NOTE:

Grand Total
Subrecipient's Legal Name: City of Glendale
[Select Ethnic Meal Style] III. SERVICES BY MONTH - ETHNIC MEALS (B)

SITE NAME
Exhibit X1 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 837 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
(A)
LINE
NO.
(C)
NO. OF
UNDUP.

ENP202106
Eight Modification Number:

IV. SERVICES BY MONTH - ETHNIC MEALS [Select Ethnic Meal Style] N/A
Subrecipient's Legal Name: City of Glendale
Congregate Meal Services
2022-2023
Older Americans Act Title III C-1
Five
NOTE:
(B)

SITE NAME
Grand Total
Exhibit X1 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 838 of 1182
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.

Eight Modification Number:

ENP202106
N/A
City of Glendale
Five
Federal American Rescue Plan Act (ARPA)
2022-23

HOME DELIVERED MEAL SERVICES
MPS Reviewed and Approved by: Sheri Stanton Date: 9/7/2022

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Irma Panosian
Community Services Manager [email protected]
Prefix Project Manager Job Title E-Mail Address
Ms. Maggie Kavarian (818) 548-3715
Ms. Cathy Liang Kwan
[Enter Address]
Director [email protected]
Prefix Authorized Representative Job Title E-Mail Address Mr. Onnig Bulanikian (818) 548-2000
Phone Number
State Zip Code
EXHIBIT X2 (MANDATED PROGRAM SERVICES)
AMENDMENT 8 {FY 2022-23 FEDERAL ARPA FUNDING}
Prefix Budget Analyst Job Title E-Mail Address
[Enter City] CA [Enter Zip]
Accountant II 818548 2151 [email protected]
Mailing Address (if different from above) City
State Zip Code
613 East Broadway Room 120 Glendale CA 91206
Main Administrative Office Address City
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 839 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

Hot Meals
Subtotal SSY3
(Cash Other and Cash NSIP)
SSY3 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
SSY3 (6)
(Cash Other)
Frozen Meals
5,683
Total (4)
SF (7)
(Cash and In-Kind)
5,683
[Enter Unit Rate]
[Enter Total
Unduplicated
Units]
$ -

HOME DELIVERED MEAL SERVICES
2022-23
Federal American Rescue Plan Act (ARPA)
Five
ENP202106
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

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

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
$ -
[Enter Unit Rate]
[Enter Unit Rate]
[Enter Units]
[Enter Units]
[Enter Units]
Total (4)
SSY3
(Cash NSIP)
Subtotal SSY3
(Cash Other and Cash NSIP)
$ 47,424
$ 5,424
$ 42,000
$ 7.39
$ 8.34
$ 7.39
$ 42,000
[Enter Unit Rate] SSY3
(Cash NSIP)
5,683
[Enter Units]
I. UNITS OF SERVICE SUMMARY
24 $ 0.95
Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 840 of 1182
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
(B)

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
Equipment (Other) (9)
Emergency Meals
206
[Enter Units]
206 SF (7)
(Cash and In-Kind)
Total (4) 206 $ 9.70 $ 2,000
$ 9.70 $ 2,000
SSY3
(Cash NSIP) [Enter Unit Rate]
$ 9.70 $ 2,000
GRAND TOTAL SERVICES/FUNDING 24
SSY3 (6)
(Cash Other)
Subtotal SSY3
(Cash Other and Cash NSIP)
5,889 $ 49,424
[Enter Amount]
(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. (9) Enter the amount of equipment (other) that is reflected in Exhibit W2 (Budget). (6) SSY3: Subaward Sum Year 3
(7) SF: Subrecipient's Funds
(8) Enter the approved amount of equipment purchase(s) that is reflected in Exhibit W2 (Budget).

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

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

II. SERVICES BY MONTH - HOT MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2022-23
Federal American Rescue Plan Act (ARPA)
City of Glendale
Eight Modification Number: N/A
Five
ENP202106
Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 4 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 842 of 1182
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 6 119 125 102 125 99 119 125 119 125 119 125 119 1421 2 6 119 125 102 125 99 119 125 119 125 119 125 119 1421 3 6 119 125 102 125 99 119 125 119 125 119 125 119 1421 4 6 119 125 101 125 99 119 125 119 125 119 125 119 1420 5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
24 476 500 407 500 396 476 500 476 500 476 500 476 5683 (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:

Route 2
Route 3
Route 4
Route 1
III. SERVICES BY MONTH - FROZEN MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2022-23
Federal American Rescue Plan Act (ARPA)
City of Glendale
Five
ENP202106
Eight Modification Number: N/A
Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 843 of 1182
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 0 0
2 0 0
3 0 0
4 0 0
5 0 0
6 0 0
7 0 0
8 0 0
9 0 0
10 0 0
11 0 0
12 0 0
13 0 0
14 0 0
15 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 ENP202106
Eight Modification Number: N/A
City of Glendale
NOTE:

Grand Total
(K)
FEB
(L)
MAR
(I)
DEC
(J)
JAN
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
2022-23
Federal American Rescue Plan Act (ARPA)
Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 844 of 1182
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 6 4 5 4 5 4 4 4 4 5 4 4 4 51
2 6 4 5 4 5 4 4 4 4 5 4 4 4 51
3 6 5 5 4 5 4 4 4 4 5 4 4 4 52
4 6 5 5 4 5 4 4 4 4 5 4 4 4 52
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
24 18 20 16 20 16 16 16 16 20 16 16 16 206
(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:

Route 2
Route 3
Route 4
Route 1
V. SERVICES BY MONTH - EMERGENCY MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2022-23
Federal American Rescue Plan Act (ARPA)
City of Glendale
Five
ENP202106
Eight Modification Number: N/A
Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Federal ARPA Funding} Page 7 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 845 of 1182
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
613 East Broadway Room 120 Glendale CA 91206
Main Administrative Office Address City
EXHIBIT X2 (MANDATED PROGRAM SERVICES)
AMENDMENT 8 {FY 2022-23 BASELINE FUNDING}
Prefix Budget Analyst Job Title E-Mail Address
[Enter City] CA [Enter Zip]
Accountant II (818) 548-2161 [email protected]
Mailing Address (if different from above) City
[Enter Address]
Director [email protected]
Prefix Authorized Representative Job Title E-Mail Address Mr. Onnig Bulanikian (818) 548-2000
Phone Number
State Zip Code
Community Services Manager [email protected]
Prefix Project Manager Job Title E-Mail Address
Ms. Maggie Kavarian (818) 548-3715
Ms. Cathy Liang Kwan
MPS Reviewed and Approved by: Sheri Stanton Date: 9/26/2022

COUNTY USE ONLY
Assigned Program Analyst: Sheri Stanton
Assigned Contract Analyst: Irma Panosian
Five
Older Americans Act Title III C-2
2022-23

HOME DELIVERED MEAL SERVICES
Eight Modification Number:

ENP202106
N/A
City of Glendale
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 846 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

SSY3
(Cash NSIP)
9,938
9,938
I. UNITS OF SERVICE SUMMARY
60 $ 9.80
$ 170,799
$ 97,358
$ 73,442
$ 6.68
$ 17.19
$ 7,056
$ 7.39
$ 66,386
$ 0.71
$ -
[Enter Unit Rate]
[Enter Unit Rate]
[Enter Units]
[Enter Units]
[Enter Units]
Total (4)
SSY3
(Cash NSIP)
Subtotal SSY3
(Cash Other and Cash NSIP)

HOME DELIVERED MEAL SERVICES
2022-23
Older Americans Act Title III C-2
Five
ENP202106
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

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

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
Hot Meals
Subtotal SSY3
(Cash Other and Cash NSIP)
SSY3 (6)
(Cash Other)
SF (7)
(Cash and In-Kind)
SSY3 (6)
(Cash Other)
Frozen Meals
9,938
Total (4)
SF (7)
(Cash and In-Kind)
9,938
[Enter Unit Rate]
[Enter Total
Unduplicated
Units]
$ -
Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 847 of 1182
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
(D)
UNIT RATE (2)
(B)

FUNDING SOURCE
(A)

SERVICE CATEGORY
(E)
FUNDING AMOUNT (5)
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. (9) Enter the amount of equipment (other) that is reflected in Exhibit W2 (Budget). (6) SSY3: Subaward Sum Year 3
(7) SF: Subrecipient's Funds
(8) Enter the approved amount of equipment purchase(s) that is reflected in Exhibit W2 (Budget).

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. [Enter Unit Rate]
$ 173,358
[Enter Amount]
Total (4) 264 $ 9.70
$ 8.99 $ 2,371
SSY3
(Cash NSIP) $ 0.71 $ 188
$ 9.70 $ 2,558
GRAND TOTAL SERVICES/FUNDING 60
SSY3 (6)
(Cash Other)
Subtotal SSY3
(Cash Other and Cash NSIP)
10,202
Emergency Meals
264
264
[Enter Units] SF (7)
(Cash and In-Kind)
Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 3 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 848 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

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

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2022-23
Older Americans Act Title III C-2
City of Glendale
Eight Modification Number: N/A
Five
ENP202106
Grand Total
NOTE:

Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 4 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 849 of 1182
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 15 209 209 195 209 195 209 209 209 210 209 212 210 2485 2 15 209 209 195 209 195 209 209 209 210 209 212 210 2485 3 15 209 209 195 209 195 209 209 209 210 209 212 209 2484 4 15 209 209 195 209 195 209 209 209 210 209 212 209 2484 5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
60 836 836 780 836 780 836 836 836 840 836 848 838 9938 (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 Route 1
III. SERVICES BY MONTH - FROZEN MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2022-23
Older Americans Act Title III C-2
City of Glendale
Five
ENP202106
Eight Modification Number: N/A
Route 2
Route 3
Route 4
Grand Total
NOTE:

Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 5 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 850 of 1182
Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

HOME DELIVERED MEAL SERVICES
2022-23
Older Americans Act Title III C-2
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
(K)
FEB
(L)
MAR
(I)
DEC
(J)
JAN
Grand Total
NOTE:

ENP202106
Eight Modification Number: N/A
City of Glendale
Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 6 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 851 of 1182
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 15 15 6 15 15 15 66
2 15 15 6 15 15 15 66
3 15 15 6 15 15 15 66
4 15 15 6 15 15 15 66
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
60 0 0 60 0 24 0 60 0 0 60 0 60 264
(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 Route 1
V. SERVICES BY MONTH - EMERGENCY MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
2022-23
Older Americans Act Title III C-2
City of Glendale
Five
ENP202106
Eight Modification Number: N/A
Route 2
Route 3
Route 4
Grand Total
NOTE:

Exhibit X2 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 7 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 852 of 1182
Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
[Enter]
Ext.
[Enter]
Phone Number Ext.
[Enter]
Phone Number Ext.
[Enter Address] [Enter City]
613 East Broadway Room 120 Glendale CA 91206
CA
City State Zip Code
[Enter Zip]
Main Administrative Office Address
EXHIBIT X3 (MANDATED PROGRAM SERVICES)
2022-23
Older Americans Act Title III B
Subrecipient's Legal Name: City of Glendale
Five
Program Services:

ENP202106
Eight Modification Number: N/A
AMENDMENT 8 {FY 2022-23 BASELINE FUNDING}

TELEPHONE REASSURANCE SERVICES
Mailing Address (if different from above) City State Zip Code Prefix
Mr. Onnig Bulanikian Director (818) 548-2000 [email protected] Authorized Representative Job Title Phone Number E-Mail Address Ms. Maggie Kavarian Community Services Manager (818) 548-3715 [email protected] Prefix Budget Analyst Job Title E-Mail Address
Prefix Project Manager Job Title E-Mail Address
Mr. Hanre Chang Accountant I (818) 550-3060 [email protected]

COUNTY USE ONLY
Assigned Program Analyst:

Assigned Contract Analyst:

MPS Reviewed and Approved by:

Sheri Stanton
Irma Panosian
Sheri Stanton Date: 9/7/2022
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 853 of 1182
Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:
(6) SSY3: Subaward Sum Year 3
(7) SF: Subrecipient's Funds
(2) Please Enter the Unit Rate for both the SSY3 (i.e., approved rate to be reimbursed by County as reflected in the funding allocation letter) and SF (amount of Match, Non-Match, and Program Income - reflected as a rate - that will be funded by Subrecipient for the Services). (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), Subsection 1.4 (Client Eligibility Criteria). These individuals are counted only once within a FY for reporting purposes. (3) Please enter the number of Units for each Service Category to be provided using SSY3, NSIP, and SF. If SSY3 and SF will both be used to provide the same Units then enter the number of Units for SSY3 only. If additional Units will be provided using SF then enter the number of SF Units. (4) The Total Units for each Service Category under column (C) Units of Service shall match the Total Units reflected in Section II (Services by Month) column (P) Total. (5) The Grand Total Funding Amount under column (E) Total shall match the Grand Total Funding Amount reflected in the Budget (cover page) column (G) Total Funding.

NOTE:

GRAND TOTAL SERVICES/FUNDING (4) 1,656 $ 1,126 80
Program Services:

Eight Modification Number: N/A
1,656
$ 0.68
$ 0.68 $ 126
SSY3 (6)
(Cash Other) $ 1,000
(F)
NO. OF UNDUPLICATED
CLIENTS (1)
(C)

UNITS OF
SERVICE (3)
80 Total
SF (7)
(Cash and In-Kind)
1,471
185
Subrecipient's Legal Name:

I. UNITS OF SERVICE SUMMARY
(A)

SERVICE CATEGORY
(B)

FUNDING SOURCE
City of Glendale
(D)
UNIT RATE (2)
(E)
FUNDING AMOUNT (5)
Telephone Calls
$ 1.36 $ 1,126
ENP202106

TELEPHONE REASSURANCE SERVICES
2022-23
Five
Older Americans Act Title III B
Exhibit X3 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 2 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 854 of 1182

TELEPHONE REASSURANCE 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 20 34 34 34 34 34 34 34 34 34 34 34 34 408
2 20 35 35 35 35 35 35 35 35 35 35 35 35 420
3 20 34 34 34 34 34 34 34 34 34 34 34 34 408
4 20 35 35 35 35 35 35 35 35 35 35 35 35 420
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
80 138 138 138 138 138 138 138 138 138 138 138 138 1656 NOTE:
(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 Program Services:
2022-23
Older Americans Act Title III B
Five
Grand Total
II. SERVICES BY MONTH - TELEPHONE CALLS
Thursday
(B)

ROUTE NAME
Monday
Tuesday
Wednesday
ENP202106
N/A
Subrecipient's Legal Name: City of Glendale
Eight Modification Number:

Exhibit X3 (Mandated Program Services) Amendment 8 {FY 2022-23 Baseline Funding} Page 3 DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 855 of 1182

Lower Tier Subrecipient Description of Services
to be Performed Legal Name Address Contact Person’s Name and Phone Number
Bateman Community
Living, LLC. Dba Trio
Communiy Meals
101 Pine Park Drive
Lafayette, CA 70508
Magi Brettler
☒ Congregate Meal Services (American Meals)
☐ Congregate Meal Services (Ethnic Meals)
☐ Home-Delivered Meal Services (Hot Meals)
☒ Home-Delivered Meal Services (Frozen Meals)
☐ Home-Delivered Meal Services (Emergency
Meals)
☐ Other (if applicable): Click here to enter text.
337-593-0433 X3
If you need to report additional Lower Tier Subrecipients, use this Exhibit Y and include page numbers on each completed Exhibit Y as follows: Page 1 of X, Page 2 of X, Page 3 of X, etc. (where ‘X’ represents the total number of completed forms).

Page 1 of 1 ends

Glendale City CouncilOctober 6, 2026

Glendale City Council
October 6, 2026