CC_10062026_Exhibit 1_10a — Glendale City Council, October 6, 2026 (part 3 of 4)

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

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

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

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 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 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 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

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

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

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

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 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 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 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 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 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 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
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 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.
//
//
//
//
//
DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 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

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

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

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 (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

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

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

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 (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

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 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 (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 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 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.

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 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 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 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 (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).

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. $ 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 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 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
(1) Grand Total Units under column (P) Total shall match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total II. SERVICES BY MONTH - HOT MEALS
(B)

ROUTE NAME

HOME DELIVERED MEAL SERVICES
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 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 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 N/A
Five

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 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

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

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 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 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 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 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 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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//
//
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//
//
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//
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DocuSign Envelope ID: 8FB56A48-20D0-4175-B0D0-4E5093D54FDE 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

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

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

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 (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

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 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 (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 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 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 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

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 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 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 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 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 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

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 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 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 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 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 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 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 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 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 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 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 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

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

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

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 (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

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

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

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 (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

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 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 (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 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 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 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 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 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 (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 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 Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

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 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 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

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

FY 2022-23

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
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 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 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

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

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

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 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 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 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 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

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

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

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 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 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 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 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

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

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 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

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 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 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 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 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

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 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 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

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

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 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 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 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 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

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 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

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

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 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 (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 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 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 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 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 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 (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 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 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 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 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 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 (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 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 Program Services:

Fiscal Year:

Funding Type:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:

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 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 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 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 (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 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 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 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 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 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 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

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

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
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