City Council and Housing Authority
October 5, 2026

ELDERLY NUTRITION PROGRAM (ENP)
SUBAWARD PERIOD JULY 2025 - JUNE 2027
SUBAWARD NUMBER ENP252607

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

COUNTY OF LOS ANGELES THROUGH ITS

AGING & DISABILITIES DEPARTMENT
( Count D
510 South Vermont Avenue
Los Angeles, CA 90020
and

CITY OF POMONA
( Subrecipient )
Subrecipient usiness Address
505 S. Garey Ave.

Pomona, CA 91766
WHEREAS, reference is made to that certain document originally entitled "Elderly Nutrition Program (ENP) Subaward Number ENP252607 Subaward Period July 2025 - June 2026 dated July 1, 2025,
Subaward Number ENP252607 Subaward Period July 2025 and the Amendments thereto (hereafter collectively referred to a Contract 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, through the California Department of Aging (CDA), the Area Agencies on Aging (AAA) have received funds for local implementation in supporting expanding and modernizing supportive services for older adults, and pursuant to Program Memo No 23- 13 issued on June 20, 2023, the State of California is providing funding to support the modernization of Community Based Service Programs under the Mello-Granlund Older Californians Act (OCA); and"
ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 2
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 term of the Subaward for one (1) year commencing on July 1, 2026 through June 30, 2027; and WHEREAS, it is the intent of the parties to also amend this Subaward to increase the unit rates for contracted ENP Services, with a corresponding adjustment to the number of defined and contracted ENP Congregate Services to be provided by Subrecipient during Fiscal Year (FY) 2026-27, with no change to the maximum annual Subaward Sum or Maximum Subaward Sum, in response to increased operational costs; and WHEREAS, it is the intent of the parties to also amend this Subaward to allocate OAA Title III C1 (Nutrition Services) baseline funding in the amount of $109,000, which will be reimbursed to Subrecipient in exchange for defined and contracted ENP Congregate Meal Services as specified herein to be provided by Subrecipient during FY 2026-27; and WHEREAS, it is the intent of the parties to also amend this Subaward to allocate baseline Net County Cost (NCC) funding in the amount of $26,000, which will be reimbursed to Subrecipient in exchange for defined and contracted ENP Congregate Meal Services as specified herein to be provided by Subrecipient during FY 2026-27; and
WHEREAS, it is the intent of the parties to also amend this Subaward to allocate Modernizing Older Californians Act (MOCA) funding in the amount of $42,000, which will be reimbursed to Subrecipient in exchange for defined and contracted ENP Congregate Meal Services as specified herein to be provided by Subrecipient during FY 2026-27; and
WHEREAS, it is the intent of the parties to also amend this Subaward to allocate Nutrition Services Incentive Program (NSIP) C1 funding in the amount of $10,792, which will be reimbursed to Subrecipient to supplement the cost of food used for Congregate Meals during FY 2026-27; 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.

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 3
NOW THEREFORE, THE PARTIES HERETO AGREE AS FOLLOWS:

I. This Amendment will commence on July 1, 2026.

II. The title of this Subaward will be deleted in its entirety and replaced as follows:

Elderly Nutrition Program (ENP) Subaward Number ENP252607 Subaward Period July 2025 June 2027
III. Subparagraph 1.1 is deleted in its entirety and replaced as follows:

1.1 Exhibits A, B1.1, B1.2, B1.3, C1.1, C1.2, C1.3, D, E, F1, H, I, L, M, N, O, P, Q, R, S, T, and U 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 will be valid unless prepared pursuant to Subparagraph 8.1 (Amendments) and signed by both parties.

IV. Subparagraph 1.6 is deleted in its entirety and replaced as follows:

1.6 In the event of any conflict or inconsistency in the definition or interpretation of any word, responsibility, schedule, or the contents or description of any task, deliverable, goods, Service, or other work, or otherwise between the base Subaward and the Exhibits, or between Exhibits, such conflict or inconsistency will be resolved by giving precedence first to the terms and conditions of the Subaward and then to the Exhibits according to the following priority:

1.6.1 Exhibit A (Statement of Work and Attachments)

1.6.2 Exhibit B1.1 (Budget)

1.6.3 Exhibit B1.2 (Budget)

1.6.4 Exhibit B1.3 (Budget)

1.6.5 Exhibit C1.1 (Mandated Program Services)

1.6.6 Exhibit C1.2 (Mandated Program Services)

1.6.7 Exhibit C1.3 (Mandated Program Services)

1.6.8 Exhibit D (County's Administration)
ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 4

1.6.9 Exhibit E (Subrecipient's Administration)

1.6.10 Exhibit F1 (Subrecipient Acknowledgement and Confidentiality Agreement)

1.6.11 Exhibit H (Business Associate Agreement Under the Health Insurance Portability and Accountability Act of 1996
(HIPAA))

1.6.12 Exhibit I (Information Security and Privacy Requirements)

1.6.13 Exhibit L (California Civil Rights Laws Certification)

1.6.14 Exhibit M (FEMA Provisions)

1.6.15 Exhibit N (Criteria and Standards for Letters of Credit and Certificates of Deposit)

1.6.16 Exhibit O (Subrecipient's Compliance with Encryption Requirements)

1.6.17 Exhibit P (Definitions)

1.6.18 Exhibit Q (Accounting, Administration and Reporting Requirements)

1.6.19 Exhibit R (Joint Funding Revenue Disclosure)

1.6.20 Exhibit S (Purchase, Inventory and Disposal Requirements for Fixed Assets, Non-Fixed Assets and Supplies)

1.6.21 Exhibit T (List of Lower Tier Subawards)

1.6.22 Exhibit U
Property Tax Reduction Program)
V. Subparagraph 4.2.1 is added as follows:

4.2.1 The term of this Subaward will be extended for one (1) year commencing on July 1, 2026, through June 30, 2027, unless sooner terminated or extended, in whole or in part, as provided in this Subaward.

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 5
VI. Subparagraph 5.1.4 is added 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 statue(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 OAA Title III C1 (Nutrition Services) baseline funds

5.1.4.2.1 Subaward Sum: $ 109,000

5.1.4.2.2 Service Area: Supervisorial District 1

5.1.4.2.3 Period of Performance: July 1, 2026 June 30, 2027 (consistent with California Department of Aging
MOU #AAA-2425-19, Funding Revision # 2627-02)

5.1.4.2.4 Allocation Letter: Fiscal Year 2026-27 Funding Allocations for Elderly Nutrition Program Services

5.1.4.3 Baseline NCC funds 5.1.4.3.1 Subaward Sum: $ 26,000

5.1.4.3.2 Service Area: Supervisorial District 1

5.1.4.3.3 Period of Performance: July 1, 2026 June 30, 2027

5.1.4.3.4 Allocation Letter: Fiscal Year 2026-27 Funding Allocations for Elderly Nutrition Program Services

5.1.4.4 Modernizing Older Californians Act (MOCA) funds for ENP Congregate Meal Services

5.1.4.4.1 Subaward Sum: $42,000

5.1.4.4.2 Service Area: Supervisorial District 1

5.1.4.4.3 Period of Performance: July 1, 2026 June 30, 2027 (consistent with California Department of Aging
contract # NM-2324-19)
ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 6

5.1.4.4.4 Allocation Letter: Fiscal Year 2026-27 Funding Allocations for Elderly Nutrition Program Services

5.1.4.5 Nutrition Services Incentive Program (NSIP) C1 funds for ENP Congregate Meal Services

5.1.4.5.1 Subaward Sum: $10,792

5.1.4.5.2 Service Area: Supervisorial District 1

5.1.4.5.3 Period of Performance: July 1, 2026 June 30, 2027 (consistent with California Department of Aging
MOU #AAA-2425-19, Funding Revision # 2627-02)

5.1.4.5.4 Allocation Letter: Fiscal Year 2026-27 Funding Allocations for Elderly Nutrition Program Services
VII. 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 must 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 must 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 and Attachments), Attachment 7 (Site Summary); Budget exhibit(s); Mandated Program Services
exhibit(s); Exhibit E (Subrecipient's Administration); Exhibit F1 (Subrecipient Acknowledgement and Confidentiality
Agreement); Exhibit L (California Civil Rights Laws
Certification); Exhibit M (FEMA Provisions) (applicable only when Subaward Sums include FEMA funds); Exhibit O
(Subrecipient's Compliance with Encryption Requirements); Exhibit R (Joint Funding Revenue Disclosure); Exhibit T (List of Lower Tier Subawards); and Exhibit U (Certification of
Program).

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 7
VIII. Subparagraph 5.6 )) is deleted in its
entirety and replaced as follows:

5.6 UNRESOLVED DISALLOWED COSTS

5.6.1 Correspondingly, the Contractor must not have unresolved disallowed costs in excess of One Hundred Thousand Dollars ($100,000) that have been confirmed as disallowed costs by the contracting County department and remain unpaid for a period of six (6) months or more from the date of an Auditor-Controller (A-C) Report. Unless such disallowed costs are the subject of current good faith negotiations, as determined in the sole discretion of the County, non-compliance by Contractor
regarding this provision will constitute a material breach of Contract and may result in termination for default, in addition to any other remedies available to the County. Further, if Contractor has been determined to have unresolved disallowed costs in excess of $100,000 for longer than six months since the date of the A-C Report, they will be disqualified from future County solicitations unless such disallowed costs are the subject of good faith negotiations to resolve the disallowed costs, in the sole opinion of the County, or have been resolved.

IX. Subparagraph 5.7 (LIMITATIONS ON USE OF SUBAWARD SUMS) is deleted in its entirety and replaced as follows:

5.7 5.7.1 If requested by Subrecipient, prior to the renewal of a Subaward option year, the Subaward amount (hourly, daily, monthly or Unit Rate) for the additional option year periods identified in Subparagraph 4.2 (Term of Subaward) may, at the sole discretion of County, be increased annually based on the most recent published percentage change in the United States Department of Labor, Bureau of Labor Statistics' Consumer Price Index for Urban Consumers (CPI-U) for the Los AngelesLong Beach-Anaheim Area for the 12-month period preceding the Subaward commencement anniversary date, which will be the effective date for any Cost of Living Adjustment (COLA).

However, any increase must not exceed the general salary movement granted to County employees as determined by the Chief Executive Officer as of each July 1 for the prior 12-month period. Furthermore, should fiscal circumstances ultimately prevent the Board from approving any increase in County ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 8
employee salaries, no COLA will be granted. Before any COLA increase will take effect and become part of the Subaward, it will require a written amendment to the Subaward first, that has been formally approved and executed by the parties. To
request a COLA, Subrecipient must submit a written request along with appropriate justification to the Contract Analyst 60 days prior to exercising
the additional option year periods identified in Subparagraph

4.2 . At no time will any increase in the Subaward hourly, daily, monthly or Unit Rate amount, or COLA adjustment, ever result in the Subaward Sum exceeding the Subaward Sum or
Maximum Subaward Sum.

X. Subparagraph 5.8 (OTHER SUBAWARDS) is deleted in its entirety and replaced as follows:

5.8 DEFAULT METHOD OF PAYMENT: DIRECT DEPOSIT OR

ELECTRONIC FUNDS TRANSFER

5.8.1 County, at its sole discretion, has determined that the most efficient and secure default form of payment for goods and/or services provided under an agreement/Subaward (that is, "Contract") with County will be Electronic Funds Transfer (EFT) or direct deposit, unless an alternative method of payment is deemed appropriate by the Auditor-Controller (A-C).

5.8.2 Subrecipient (that is, "Contractor") must submit a direct deposit authorization request via the website
https://directdeposit.lacounty.gov with banking and Contractor information, and any other information that the A-C determines is reasonably necessary to process the payment and comply with all accounting, record keeping, and tax reporting
requirements.

5.8.3 Any provision of law, grant, or funding agreement requiring a specific form or method of payment other than EFT or direct deposit will supersede this requirement with respect to those payments.

5.8.4 At any time during the duration of the Contract, Contractor may submit a written request for an exemption to this requirement.

Such request must be based on specific legal, business, or operational needs and explain why the payment method
designated by the A-C is not feasible and an alternative is necessary. The A-C, in consultation with County, will decide whether to approve exemption requests.

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 9
XI. Subparagraph 5.9 (JOINT FUNDING REVENUES) is deleted in its entirety and replaced as follows:

5.9 LIMITATIONS ON USE OF SUBAWARD SUMS

5.9.1 Subaward Sums may only be used for the purposes set forth herein, and must be consistent with the statutory authority for the Program.

5.9.2 Expenditures made by Subrecipient in the operation of this Subaward must be in compliance and in conformity with Title 45 Code of Federal Regulations Part 75 et seq. and Title 2 Code of Federal Regulations Part 200 et seq. Subrecipient must comply with the Administrative Requirements and Cost Principles which are outlined in Exhibit Q (Accounting, Administration and Reporting Requirements), and must adhere to the strict administrative and fiscal standards described therein. Subrecipient will be responsible for obtaining Title 45 Code of Federal Regulations Part 75 et seq. and Title 2 Code of Federal Regulations Part 200 et seq., which are available via the Internet at eCFR :: 45 CFR Part 75 -- Uniform
Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards and eCFR :: Title 2 of the CFR -- Federal Financial Assistance. Subrecipient must also comply with the applicable requirements and standards
referred to in Title 45 Code of Federal Regulations Part 1321.5 (Grants to State and Community Programs on Aging).

5.9.3 Limitations on Subaward Sums

5.9.3.1 Subrecipient will not be paid for any Subaward
expenditures that exceed the Subaward Sum
allocated for any Fiscal Year under this Subaward.

County has no obligation, whatsoever, to pay for
any expenditures that exceed this Subaward Sum.

Any expenditures that exceed such Subaward
Sum will become the sole fiscal responsibility of
Subrecipient.

5.9.3.2 Subrecipient must only expend the Subaward Sum
during the Fiscal Year for which it is allocated.

Should County exercise its option to extend this
Subaward and Subrecipient does not expend
funding up to the Subaward Sum appropriated for
the Fiscal Year, that unspent amount will not carry
forward (or roll-over) to the following Fiscal Year.

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 10

5.9.4 Prohibitions on Subaward Sums

5.9.4.1 Subrecipient must comply with Public Law (PL)
101-121 (Title 31 United States Code Section
1352), its amendments or revisions, and any
implementing regulations, prohibiting the use of
Federal money to influence or attempt to influence
a member of Congress, Congressional staff, or a
Federal employee to award, make or amend any
Federal subaward, grant, loan, or cooperative
agreement. Subrecipient must also comply with all
certification and disclosure requirements of PL
101-121, its amendments, revisions, and
implementing regulations, and must provide
assurance that all Lower Tier Subrecipients under
this Subaward also fully comply with such
certification and disclosure requirements.

5.9.4.2 No materials, property, or Services contributed to County or Subrecipient under this Subaward will
be used in the performance of any of the following:
any political activity; the election of any candidate
or the defeat of any candidate for public office; and,
the transportation of any voters or prospective
voters to polls or other similar assistance in
connection with an election or any voter
registration activity.

5.9.4.3 Subaward Sums may not be used for matching
funds for any Federal, State, County, or local
grants/cooperative agreements, lobbying or
intervention in Federal regulatory or adjudicatory
proceedings.

5.9.4.4 Subaward Sums may not be used to sue the
Federal government or any other government
entity.

5.9.4.5 Pre-award costs are not an allowable use for
Subaward Sums.

5.9.4.6 Subrecipient and any approved Lower Tier
Subrecipient(s) must comply with Governor's
Executive Order 2-18-2011, which bans
expenditures on promotional and marketing items
colloquially known as "S.W.A.G." or "Stuff We All
Get".

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 11
XII. 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, 2025 June 30, 2026: 2501CAOACM-00; and 2501CAOANS-00

5.10.4.2 July 1, 2026 June 30, 2027: 2601CAOACM-00; and 2601CAOANS-00
XIII. Subparagraph 5.10.5 is deleted in its entirety and replaced as follows:

5.10.5 Federal Award Dates

5.10.5.1 July 1, 2025

5.10.5.2 July 1, 2026
XIV. Subparagraph 5.10.6 is deleted in its entirety and replaced as follows:

5.10.6 Subaward Period of Performance Start and End Dates

5.10.6.1 July 1, 2025 June 30, 2026

5.10.6.2 July 1, 2026 June 30, 2027
XV. 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: $462,500

5.10.7.1.1 Original baseline funds: $ $384,500

5.10.7.1.2 MOCA funds: $78,000 (State funds)

5.10.7.2 Amendment One: $35,790

5.10.7.3 Amendment Two: ($78,000) (State Funds)

5.10.7.4 Amendment Three: $187,792

5.10.7.4.1 OAA baseline funds: $109,000

5.10.7.4.2 NCC funds: $26,000

5.10.7.4.3 MOCA funds: $42,000 (State funds)
ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 12

5.10.7.4.4 NSIP funds: $10,792
XVI. 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: $420,290 (funds identified in Subparagraphs 5.10.7.1.2 and 5.10.7.3 are excluded)

5.10.8.2 Subaward Sum Year 2: $145,792 (funds identified in Subparagraph 5.10.7.4.3 are excluded)
XVII. Subparagraph 5.10.9 is deleted in its entirety and replaced as follows:

5.10.9 Total Amount of Federal Award (Maximum Subaward Sum): $566,082 (funds identified in Subparagraphs 5.10.7.1.2, 5.10.7.3, and

5.10.7.4.3 are excluded)
XVIII. 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, 2025 June 30, 2026: Federal Title IIIC1 3C1L; NSIP C1 NC1L

5.10.10.2 July 1, 2026 June 30, 2027: Federal Title IIIC1 3C1L; NSIP C1 NC1L
XIX. Subparagraph 5.13 (DEFAULT METHOD OF PAYMENT: DIRECT DEPOSIT OR ELECTRONIC FUNDS TRANSFER) is deleted in its entirety and replaced as follows:

5.13 OTHER SUBAWARDS

5.13.1 Subrecipient must immediately notify County's Contract Manager in writing of any contracts between Subrecipient and other public or private organizations which directly impact activities funded under this Subaward. A copy of any such contracts must be kept on file at Subrecipient's offices and must be provided to County upon request. Subrecipient must also immediately notify County's Contract Manager in writing of any default, termination, or finding of withheld payments under such contracts between Subrecipient and other public or private organizations which directly impact activities funded under this Subaward.

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 13

5.13.2 Subrecipient warrants that no other funding source will be billed for Services that are provided to and paid for by County under this Subaward.

XX. Subparagraph 5.14 (JOINT FUNDING REVENUES) is added as follows:

5.14 JOINT FUNDING REVENUES

5.14.1 Funds made available under this Subaward will supplement and not supplant any other Federal, State, or local funds expended by Subrecipient to provide Program Services.

Subrecipient certifies that it has applied, or expects to apply, to offset in whole or in part, any of the costs incurred by Subrecipient in conducting current or prospective projects or business activities, including, but not necessarily limited to, the project or business activity which is the subject of this Subaward. To this end, Subrecipient must complete Exhibit R (Joint Funding Revenue Disclosure) prior to the
commencement of this Subaward (and annually thereafter).

Subrecipient must submit the completed Exhibit R (Joint Funding Revenue Disclosure) to County's Contract Manager in the time and manner as designated by County.

XXI. Subparagraph 7.6.2 is deleted in its entirety and replaced as follows:

7.6.2 Subrecipient must indemnify, defend, and hold harmless County, its officers, employees, and agents, from and against any and all claims, demands, damages, liabilities, losses, costs and expenses, including, without limitation, defense costs and legal, accounting and other expert, consulting, or professional fees, arising from, connected with, or related to any failure by Subrecipient, its officers, employees, agents, or Lower Tier Subrecipients, to comply with this Subparagraph, Exhibit F1 (Subrecipient Acknowledgement and Confidentiality Agreement), and Exhibit H (Business Associate Agreement Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)), as determined by County in its sole judgment. Any legal defense pursuant to Subrecipient's indemnification obligations under this Subparagraph will be conducted by Subrecipient and performed by counsel selected by Subrecipient and approved by County. Notwithstanding the preceding sentence, County will have the right to participate in any such defense at its sole cost and expense, except that in the event Subrecipient fails to provide County with a full and adequate defense, as determined by County in its sole judgment, County will be entitled to retain its own counsel, including, without limitation, County Counsel, and to reimbursement from Subrecipient for all such costs and expenses incurred by County in doing so. Subrecipient ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 14
will not have the right to enter into any settlement, agree to any injunction, or make any admission, in each case, on behalf of County without County's prior written approval.

XXII.

HIRING COUNTY EMPLOYEES TARGETED FOR LAYOFFS OR WHO ARE ON A COUNTY RECOUNTY EMPLOYEES TARGETED FOR LAYOFFS OR ARE ON A COUNTY REremains unchanged and in full force and effect.

XXIII. Subparagraph 8.13 ( ACKNOWLEDGEMENT OF COUNTY'S
COMMITMENT TO THE SAFELY SURRENDERED BABY LAW) is deleted in its entirety and replaced as follows:

8.13 CONTRACTOR'S ACKNOWLEDGEMENT AND NOTICE TO ITS

EMPLOYEES OF THE SAFELY SURRENDERED BABY LAW

8.13.1 Subrecipient (that is, "Contractor") acknowledges that County places a high priority on the implementation of the Safely Surrendered Baby Law. Contractor must notify and provide to its employees and will require each Lower Tier Subrecipient a Fact Sheet regarding the Safely Surrendered Baby Law, its implementation in Los Angeles County, and information on where and how to safely surrender a baby. Additionally, all County contractors to volunt Safely
Surrendered Baby Law Poster
English/Spanish/Chinese/Korean) in a prominent position at any approved subcontractors, if any, to post this poster in a

8.13.2 Contractor and its subcontractor(s) can access posters and other program material at babysafela.org. XXIV. Subparagraph 8.14 (CONTRACTOR'S WARRANTY OF ADHERENCE TO COUNTY'S CHILD SUPPORT COMPLIANCE PROGRAM) is deleted in its entirety and replaced as follows:

8.14 CONTRACTOR'S WARRANTY OF ADHERENCE TO COUNTY'S CHILD

SUPPORT COMPLIANCE PROGRAM

8.14.1 Subrecipient (that is, "Contractor") acknowledges that County has established a goal of ensuring that all individuals who benefit ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 15
financially from County through contracts are in compliance with their court-ordered child, family and spousal support obligations in order to mitigate the economic burden otherwise imposed upon County and its taxpayers.

8.14.2 As required by County's Child Support Compliance Program (County Code Chapter 2.200) and without limiting Contractor's duty under this Subaward (that is, "Contract") to comply with all applicable provisions of law, Contractor warrants that it is now in compliance and will during the term of this Contract maintain compliance with employment and wage reporting requirements as required by the Federal Social Security Act (42 USC Section 653a) and California Unemployment Insurance Code Section 1088.5, and will implement all lawfully served Wage and Earnings Withholding Orders or Child Support Services Department Notices of Wage and Earnings Assignment for Child, Family or Spousal Support, pursuant to Code of Civil Procedure Section 706.031 and Family Code Section 5246(b).

XXV. Subparagraph 8.24.8 (Waivers of Subrogation) is deleted in its entirety and replaced as follows:

8.24.8 Waivers of Subrogation

8.24.8.1 To the fullest extent permitted by law, Subrecipient hereby waives its rights and its insurer(s)' rights of recovery against County under all the Required Insurance for any loss arising from or relating to this Subaward. Subrecipient must require its insurers to execute any waiver of subrogation
endorsements which may be necessary to effectuate such
waiver.

XXVI. Subparagraph 8.28.7 is deleted in its entirety and replaced as follows:

8.28.7 If County finds that any provisions of this Subparagraph 8.28 have been violated, such violation will constitute a material breach of this Contract upon which County may terminate or suspend this Contract. While County reserves the right to determine independently that the anti-discrimination provisions of this Contract have been violated, in addition, a determination by the California Civil Rights Department or the Federal Equal Employment Opportunity Commission that Contractor has violated Federal, or State anti-discrimination laws or regulations will constitute a finding by County that Contractor has violated the anti-discrimination provisions of this Contract.

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 16
XXVII. Subparagraph 8.33 (NOTICE TO EMPLOYEES REGARDING THE SAFELY SURRENDERED BABY LAW) is deleted in its entirety, and all subsequent subparagraphs are renumbered accordingly. All references thereto are revised to reflect such renumbering.

XXVIII. Subparagraph 8.36 (PUBLIC RECORDS ACT) is deleted in its entirety, replaced, and renumbered as follows:

8.35 PUBLIC RECORDS ACT

8.35.1 Any documents submitted by Subrecipient, all information obtained in connection with County's right to audit and inspect Subrecipient's documents, books, and accounting records pursuant to Subparagraph 8.37 (Record Retention, Inspection and Audit Settlement), as well as those documents which were required to be submitted in response to the solicitation used to procure this Subaward, become the exclusive property of County. All such documents become a matter of public record and will be regarded as public records except for those documents determined to be non-disclosable or exempt
pursuant to California Government Code Section 7921 et seq. and which are marked "trade secret", "confidential" or
"proprietary". County will not in any way be liable or
responsible for the disclosure of any such records including, without limitation, those so marked, if disclosure is required by law, or by an order issued by a court of competent jurisdiction.

8.35.2 In the event County is required to defend an action on a Public Records Act request for any of the aforementioned documents, information, books, records, and/or contents of a proposal marked "trade secret", "confidential" or "proprietary", Subrecipient agrees to defend and indemnify County from all costs and expenses, including reasonable attorney's fees, in an action or liability arising under the California Public Records Act.

XXIX. Subparagraph 8.41 (TERMINATION FOR BREACH OF WARRANTY TO PROGRAM) is deleted in its entirety, replaced, and renumbered as follows:

8.40 TERMINATION FOR BREACH OF WARRANTY TO MAINTAIN

COMPLIANCE WITH COUNTY'S CHILD SUPPORT COMPLIANCE

PROGRAM

8.40.1 Failure of Subrecipient (that is, "Contractor") to maintain compliance with the requirements set forth in Subparagraph ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 17

8.14 (Contractor's Warranty of Adherence to County's Child Support Compliance Program), will constitute default under this Subaward (that is, "Contract"). Without limiting the rights and remedies available to County under any other provision of this Contract, failure of Contractor to cure such default within ninety (90) calendar days of written notice will be grounds upon which County may terminate this Contract pursuant to Subparagraph

8.42 (Termination for Default) and pursue debarment of
Contractor, pursuant to County Code Chapter 2.202.

XXX. Subparagraph 8.42 (TERMINATION FOR CONVENIENCE) is deleted in its entirety, replaced, and renumbered as follows:

8.41 TERMINATION FOR CONVENIENCE

8.41.1 County may terminate this Subaward, in whole or in part, from time to time or permanently, when such action is deemed by County, in its sole discretion, to be in its best interest.

Termination of Work hereunder will be effectuated by notice of termination to Subrecipient specifying the extent to which performance of Work is terminated and the date upon which such termination becomes effective. The date upon which such termination becomes effective will be no less than thirty (30) calendar days after the notice is sent.

8.41.2 After receipt of a notice of termination and except as otherwise directed by County, Subrecipient must:

8.41.2.1 Stop Work under this Subaward on the date and to the extent specified in such notice;

8.41.2.2 Transfer title and deliver to County all completed Work and Work in progress.

8.41.3 All material including books, records, documents, or other evidence bearing on the costs and expenses of Subrecipient under this Subaward must be maintained by Subrecipient in accordance with Subparagraph 8.37 (Record Retention,
Inspection and Audit Settlement).

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 18
XXXI. Subparagraph 8.43 (TERMINATION FOR DEFAULT) is deleted in its entirety, replaced, and renumbered as follows:

8.42 TERMINATION FOR DEFAULT

8.42.1 County may, by written notice to Subrecipient, terminate the whole or any part of this Subaward, if, in the judgment of County:

8.42.1.1 Subrecipient has materially breached this Subaward; or

8.42.1.2 Subrecipient fails to timely provide and/or
satisfactorily perform any task, deliverable, Service,
or other work required under this Subaward; or

8.42.1.3 Subrecipient fails to demonstrate a high probability of timely fulfillment of performance requirements under
this Subaward, or of any obligations of this Subaward
and in either case, fails to demonstrate convincing
progress toward a cure within five (5) business days
(or such longer period as County may authorize in
writing) after receipt of written notice from County
specifying such failure.

8.42.2 In the event that County terminates this Subaward in whole or in part as provided in Subparagraph 8.42.1, County may
procure, upon such terms and in such manner as County may deem appropriate, goods and Services similar to those so terminated. Subrecipient will be liable to County for any and all excess costs incurred by County, as determined by County, for such similar goods and Services. Subrecipient will continue the performance of this Subaward to the extent not terminated under the provisions of this Subparagraph 8.42.

8.42.3 Except with respect to defaults of any Lower Tier Subrecipient, Subrecipient will not be liable for any such excess costs of the type identified in Subparagraph 8.42.2 if its failure to perform this Subaward arises out of causes beyond the control and without the fault or negligence of Subrecipient. Such causes may include, but are not limited to acts of nature or of the public enemy, acts of County in either its sovereign or contractual capacity, acts of Federal or State governments in their sovereign capacities, fires, floods, epidemics, quarantine restrictions, strikes, freight embargoes, and unusually severe weather; but in every case, the failure to perform must be beyond the control and without the fault or negligence of ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 19
Subrecipient. If the failure to perform is caused by the default of a Lower Tier Subrecipient, and if such default arises out of causes beyond the control of both Subrecipient and Lower Tier Subrecipient, and without the fault or negligence of either of them, Subrecipient will not be liable for any such excess costs for failure to perform, unless the goods or Services to be furnished by the Lower Tier Subrecipient were obtainable from other sources in sufficient time to permit Subrecipient to meet the required performance schedule. As used in this
Subparagraph 8.42, the term "Lower Tier Subrecipient(s)" means Lower Tier Subrecipient(s) at any tier.

8.42.4 If, after County has given notice of termination under the provisions of this Subparagraph 8.42, it is determined by County that Subrecipient was not in default under the provisions of this Subparagraph 8.42, or that the default was excusable under the provisions of Subparagraph 8.42.3, the rights and obligations of the parties will be the same as if the notice of termination had been issued pursuant to Subparagraph 8.41 (Termination for Convenience).

8.42.5 The rights and remedies of County provided in this Subparagraph 8.42, will not be exclusive and are in addition to any other rights and remedies provided by law or under this Subaward.

XXXII. Subparagraph 8.49 (WAIVER) is deleted in its entirety, replaced, and renumbered as follows:

8.48 WAIVER

8.48.1 No waiver by the County of any breach of any provision of this Subaward will constitute a waiver of any other breach or of such provision. Failure of the County to enforce at any time, or from time to time, any provision of this Subaward will not be construed as a waiver thereof. The rights and remedies set forth in this Subparagraph 8.48 will not be exclusive and are in addition to any other rights and remedies provided by law or under this Subaward.

XXXIII. Subparagraph 8.56 (COMPLIANCE WITH FAIR CHANCE EMPLOYMENT PRACTICES) is deleted in its entirety, replaced, and renumbered as follows:

8.55 COMPLIANCE WITH FAIR CHANCE EMPLOYMENT HIRING

PRACTICES
ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 20

8.55.1 Subrecipient (that is, "Contractor"), and its Lower Tier Subrecipient(s) must comply with fair chance employment hiring practices set forth in California Government Code Section 12952, the California Code of Regulations Section 11017.1, and County Code Chapter 8.300 (Fair Chance
Ordinance for Employers). Contractor, and its subcontractor(s), can access fair chance employment resources, including a Fair Chance Fact Sheet and Workplace Posters (English/Spanish), and other program material at
https://dcba.lacounty.gov/fairchance/. Additional compliance resources, including an Employer Toolkit (Fair Chance Hiring:
-Impacted Individuals),
can be accessed at https://opportunity.lacounty.gov/fairchance-hiring-campaign/. 8.55.2 may constitute a material breach of the Subaward. In the event of such material breach, County may, in its sole discretion, issue administrative penalties and/or seek additional remedies as provided within Section 8.300.100 of the Fair Chance Ordinance for Employers, and/or terminate the Subaward.

XXXIV. Subparagraph 8.59 (INJURY AND ILLNESS PREVENTION PROGRAM) is deleted in its entirety, replaced, and renumbered as follows:

8.58 INJURY AND ILLNESS PREVENTION PROGRAM

8.58.1 Subrecipient will be required to comply with the State of California Code of
Regulations Title 8 Section 3203 requires all California employers to have a written, effective Injury and Illness Prevention Program (IIPP) that addresses hazards pertaining to the particular workplace covered by the program.

XXXV. Subparagraph 8.60 (COMPAIGN CONTRIBUTION PROHIBITION FOLLOWING FINAL DECISION IN SUBAWARD PROCEEDING) is deleted in its entirety, replaced, and renumbered as follows:

8.59 CAMPAIGN CONTRIBUTION PROHIBITION FOLLOWING FINAL

DECISION IN SUBAWARD PROCEEDING

8.59.1 Pursuant to Government Code Section 84308, Subrecipient and its Lower Tier Subrecipients, are prohibited from making a contribution of more than $500 to a County officer for twelve (12) months after the date of the final decision in the proceeding involving this Subaward. Failure to comply with the ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 21
provisions of Government Code Section 84308 and of this Subparagraph, may be a material breach of this Subaward as determined in the sole discretion of the County.

XXXVI. Subparagraph 9.3 (C Charitable Activities Compliance) is deleted in its entirety and replaced as follows:

9.3 CONTRACTOR'S CHARITABLE ACTIVITIES COMPLIANCE

9.3.1 County seeks to ensure that all County contractors which receive or raise charitable contributions comply with California and codified in California Government Code, Sections 12580- 12599.10, in order to protect the County and its taxpayers. The Supervision of Trustees and Fundraisers for Charitable
Purposes Act regulates entities receiving or raising charitable contributions.
receives or raises charitable contributions without complying with its obligations under California law commits a material breach subjecting it to either
termination or debarment proceedings or both. (County Code Chapter 2.202)
XXXVII. Subparagraph 9.4 (HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA) is deleted in its entirety and replaced as follows:

9.4 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA)

9.4.1. The County is subject to the Administrative Simplification requirements and prohibitions of the Health Insurance
Portability and Accountability Act of 1996, Public Law 104-191 (HIPAA), and regulations promulgated thereunder, including the Privacy, Security, Breach Notification, and Enforcement Rules at 45 Code of Federal Regulations (C.F.R.) Parts 160 and tract, the
Contractor provides services to the County and the Contractor creates, has access to, receives, maintains, or transmits Protected Health Information as defined in Exhibit H (Business Associate Under Health Insurance Portability and
Accountability Act of 1996 ("HIPAA")) in order to provide those services. The County and the Contractor therefore agree to the terms of Exhibit H (Business Associate Under Health Insurance Portability and Accountability Act of 1996 ("HIPAA")).

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 22
XXXVIII.Subparagraph 9.17.1 is deleted in its entirety and replaced as follows:

9.17.1 In the course of completing the Work and providing Services under this Subaward, Subrecipient must use any Information Technology Systems (ITS) developed for or by Subrecipient, as required by County in order to provide any and all services under this Subaward. This Subparagraph 9.17 and Exhibit I (Information Security and Privacy Requirements) set forth the requirements for the ITS which Subrecipient must use. This Subparagraph 9.17 and Exhibit I (Information Security and Privacy Requirements) also set forth the security procedures for these systems which Subrecipient must have in place by the effective date of this Subaward and which Subrecipient must maintain throughout the Subaward term. They present a minimum standard only. Subrecipient must implement appropriate administrative, physical, and technical measures to secure its systems and data to protect and ensure the privacy, confidentiality, integrity, and availability of County Information Assets (PSCI) as defined in Subparagraph 9.17.5 (County Information Assets) against internal and external threats, vulnerabilities, and risks. Subrecipient must also continuously review and revise those measures to address ongoing threats, vulnerabilities, and risks.

XXXIX. Subparagraph 9.17.2 is deleted in its entirety and replaced as follows:

9.17.2 Subrecipient must comply with the requirements set forth in Exhibit I (Information Security and Privacy Requirements). Subrecipient's failure to comply with the minimum standards set forth herein will constitute a material, non-curable breach of this Subaward, entitling County, in addition to and cumulative of all other remedies available to it at law, in equity, or under this Subaward, to immediately terminate this Subaward.

XL. Subparagraph 9.17.10 is deleted in its entirety and replaced as follows:

9.17.10 Subrecipient must ensure that any approved Lower Tier Subrecipient(s) adheres to all of the provisions included in this Subparagraph 9.17 and Exhibit I (Information Security and Privacy Requirements).

XLI. Subparagraph 9.25 is added as follows:

9.25 Space Use Agreements (For Third-Party Events)

9.25.1 Subrecipient will comply with the zero waste events requirements in Board Policy 3.185, Reduce Single Use
Plastics.

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 23
XLII. Paragraph 10.0 (SURVIVAL) is deleted in its entirety and replaced as follows:

10.0 SURVIVAL

10.1 In addition to any terms and conditions of this Subaward that expressly survive expiration or termination of this Subaward by their terms, the following provisions will survive the expiration or termination of this Subaward for any reason:

Paragraph 1.0 (Applicable Documents)
Paragraph 2.0 (Definitions and Headings)
Paragraph 3.0 (Work)
Subparagraph 5.4 (No Payment for Services Provided
Following Expiration or Termination of
Subaward)
Subparagraph 7.6 (Confidentiality)
Subparagraph 8.1 (Amendments)
Subparagraph 8.2 (Assignment and Delegation/Mergers or
Acquisitions)
Subparagraph 8.6 (Compliance with Applicable Laws)
Subparagraph 8.19 (Fair Labor Standards)
Subparagraph 8.20 (Force Majeure)
Subparagraph 8.21 (Governing Law, Jurisdiction, and
Venue)
Subparagraph 8.23 (Indemnification)
Subparagraph 8.24 (General Provisions for all Insurance Coverage)
Subparagraph 8.25 (Insurance Coverage)
Subparagraph 8.26 (Liquidated Damages)
Subparagraph 8.37 (Record Retention and Inspection and
Audit Settlement)
Subparagraph 8.41 (Termination for Convenience)
Subparagraph 8.42 (Termination for Default)
ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 24
Subparagraph 8.47 (Validity)
Subparagraph 8.48 (Wavier)
Subparagraph 8.57 (Prohibition from Participation in Future Solicitation(s))
Subparagraph 8.59 (Campaign Contribution Prohibition
Following Final Decision in Subaward
Proceeding)
Subparagraph 9.11 (Ownership of Materials, Software and Copyright)
Subparagraph 9.12 (Patent, Copyright and Trade Secret
Indemnification)
Subparagraph 9.17 (Information Technology, Security and Privacy Requirements)
Subparagraph 9.17.5 (Data Destruction)
Paragraph 10.0 (Survival)
XLIII. Exhibit A (Statement of Work and Attachments), Subparagraph 10.6.6 is deleted in its entirety and replaced as follows:

10.6.6 Quality Assurance meetings can also be included to discuss Congregate Meal site audits, Home-Delivered Meal route audits, Caterer audits, central kitchen audits, menu changes, suggested voluntary contributions, and problems occurring at Congregate Meal sites.

XLIV. Exhibit A (Statement of Work and Attachments), Subparagraph 10.17.1.11 is deleted in its entirety and replaced as follows:

10.17.1.11 Subrecipient must not use any of the following practices as it relates to voluntary contributions and/or share of costs.

10.17.1.11.1 Requesting Clients to assist in the share of cost to the Program.

10.17.1.11.2 Tracking voluntary contributions by accounts receivable.

10.17.1.11.3 Tracking voluntary contributions by individual Clients.

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 25

10.17.1.11.4 Using pamphlets and websites stating that
payment is required for Services or stating a
monetary amount for Services.

10.17.1.11.5 Employing tactics, in any way, that could be viewed as embarrassing and/or obligatory
requests for voluntary contributions.

10.17.1.11.6 Employing tactics such as allowing Volunteers to guard the collection boxes or having Clients sign
in and pay before receiving Services.

10.17.1.11.7 At the time of the Initial Assessment, compelling Client to pledge a particular amount as an agreed
upon voluntary contribution.

10.17.1.11.8 Using coercion to solicit voluntary contributions.

10.17.1.11.9 Using a voluntary contribution request resembling a billing statement or invoice.

10.17.1.11.10 Imposing a suggested contribution rate based on an e.

XLV. Exhibit A (Statement of Work and Attachments), Subparagraph 10.17.2.5 is deleted in its entirety and replaced as follows:

10.17.2.5 Subrecipient must separate collected contributions (voluntary contributions/fees) from Subaward funding. All contributions must be identified as Program Income and used to: increase the number of meals served, facilitate access to such meals, and to provide nutrition-related supportive services.

XLVI. A (Statement of Work and Attachments), Amendment 2 (Performance Requirements Summary) Revised 06/2026
"Exhibit A (Statement of Work and Attachments), Amendment 2 (Performance and is incorporated herein by reference.

XLVII. 1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding as an addendum to "Exhibit B1.1 (Budget) is incorporated herein by reference.

XLVIII. 3 {FY 2026-27 MOCA Funding
as an addendum to "Exhibit B1.2 (Budget) is incorporated herein by reference.

XLIX. (Budget) Amendment 3 {FY 2026-27 NSIP as
an addendum to "Exhibit B1.3 (Budget) and is incorporated herein by reference.

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 26
L. 1 (Mandated Program Services) Amendment 3 {FY 2026-27 Baseline Funding as an addendum to "Exhibit C1.1 (Mandated Program Service) is incorporated herein by reference.

LI. 3 {FY 2026-27 MOCA
Funding
Service) is incorporated herein by reference.

LII. 1.3 (Mandated Program Services) Amendment 3 {FY 2026-27 NSIP Funding 1.3 (Mandated Program
Service) is incorporated herein by reference.

LIII. deleted in its entirety and replaced with
the attached (Revised 01/2026) , which is
incorporated herein by reference.

LIV. 6-27 is added as an
herein by reference.

LV. G (Safety Surrendered Baby Law and replaced
with
herein by reference.

LVI.

H (Business Associate Agreement Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
herein by reference.

LVII.

Portability and Accountability Act of 1996 (HIPAA))
I (Information Security and Privacy
Requirements
LVIII. is deleted in its entirety and
incorporated herein by reference.

LIX.

Intentionally Omitted
is incorporated herein by reference.

LX. 6-27 is added as an
incorporated herein by reference.

ATTACHMENT NO. 2
Elderly Nutrition Program
Subaward Number ENP252607
Amendment Three Page 27
LXI. Lower Tier Subawards 6-27 is added as an
Lower Tier Subawards
herein by reference.

LXII. The Fiscal Year 2026-27 Funding Allocations for Elderly Nutrition Program Services funding allocation letter is incorporated herein by reference.

All other terms and conditions of the Subaward will remain in full force and effect. //
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ATTACHMENT NO. 2
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 Director of Aging & Disabilities Department, and the Subrecipient has subscribed the same through its Authorized Representative. The Authorized Representative(s) signing on behalf of Subrecipient warrants under penalty of perjury that he or she is authorized to bind Subrecipient.

COUNTY OF LOS ANGELES
By
Maral V. Karaccusian, Director Date
County of Los Angeles
Aging & Disabilities Department

SUBRECIPIENT
City of Pomona
Subrecipient’s Legal Name
ENP252607
Subaward Number
By
Name of Authorized Date
Representative
Title
Approved as to Form:

Signature OFFICE OF COUNTY COUNSEL
Dawyn R. Harrison, County Counsel
By
Name of Authorized Representative Date
By
Airionna S. Whitaker
Deputy County Counsel
Title

Signature
ATTACHMENT NO. 2
Performance Requirement Reference Standard(s) Monitoring Method Acceptable Quality Level (AQL) Meals must meet a minimum one-third (1/3) of Dietary Reference Intakes. Exhibit A (Statement of Work and Attachments), Section 10.1 (General ENP Requirements) Each meal provided by Subrecipient must provide a minimum of one-third (1/3) of the current Dietary Reference Intakes (DRI) established by the Food and Nutrition Board, Institute of Medicine, National Academy of Sciences for the elderly population, and follow the most recent Dietary Guidelines for Americans published by the United States Department of Health and Human Services and the United States Department of Agriculture (USDA). Review of the Menu Meal Component Analysis, Los Angeles County AAA Title IIIC Menu Pattern Cover Sheet, Menu Pattern, Dietary Administrative Support Services Program (DASSP) Monthly Nutrition Site Facility Audit Reports, and Monthly Summary Reports to verify meals meet the required Dietary Reference Intakes (DRI), menu standards, and applicable nutritional requirements. 100% By the end of the initial Fiscal Year, twenty one percent (21%) of Congregate Meal Clients will have been determined to have the greatest need and highest overall score through the use of the Universal Intake Form, Section 5 (Nutritional Risk Factors). 100% By the end of the initial Fiscal Year, 65% of Home-Delivered Meal Clients will have been determined to have the greatest need and highest overall score through the use of the Universal Intake Form, Section 5 (Nutritional Risk Factors). 100% ATTACHMENT 2 (PERFORMANCE REQUIREMENTS SUMMARY) Remedy(ies) for Non-Compliance For non-compliance with the AQL, County, at its sole discretion, has the option to apply the remedy(ies) listed and Subrecipient must adhere to the remedy(ies) as follows: 1) Corrective Action Plan, 2) Probation, 3) Suspend payment(s), 4) Suspend Subaward, 5) Liquidated damages, 6) Reduce and reallocate funds, 7) Terminate Subaward, and/or 8) Placement in County's Subrecipient Alert Reporting Database. The Performance Requirements Summary (PRS) Chart provides a listing of the minimum requirements that Subrecipient must adhere to, and it reflects the performances that will be monitored during the Subaward term. The PRS also lists examples of the types of documents that will be used during monitoring, as well as the standards of performance and the acceptable quality level of performance. All listings of required services or standards used in this PRS Chart are intended to be completely consistent with the terms and conditions of this Subaward and Exhibit A (Statement of Work and Attachments), and are not meant in any case to create, extend, revise or expand any obligation of Subrecipient beyond that defined in the terms and conditions of the Subaward and Exhibit A (Statement of Work and Attachments). In any case of apparent inconsistency between required services or standards as stated in the terms and conditions of this Subaward, Exhibit A (Statement of Work and Attachments) and this Attachment 2, the terms and conditions of the Subaward and Exhibit A (Statement of Work and Attachments) will prevail in that order. The PRS Chart reflects the areas that will be evaluated based on the criteria outlined herein. Performance Requirement This is the outcome that Subrecipient must achieve as a result of providing of Program Services to Clients. These outcomes will be analyzed by County to measure the quality and effectiveness of Subrecipient's Program Services, which may affect the availability for future Program funding (i.e., if Subrecipient does not meet an outcome and does not correct deficiency(ies), County will remedy the non-compliance according to the method indicated as Remedy(ies) for Non-Compliance). Reference The document or source of information from which the Performance Requirement is derived. Standard(s) This is the benchmark that the Performance Requirement will be measured against and Subrecipient must not deviate from this without providing a remedy as requested by County. Acceptable Quality Level This is the minimum level (measured as a percentage of the Standard(s)) that is used to compare Subrecipient's actual performance against the Standard(s). During the term of the Subaward, Subrecipient must achieve, at a minimum, the Acceptable Quality Level (AQL) when completing the Performance Requirement. The AQL for each Performance Requirement is established by County and it provides an assurance to County that Subrecipient is satisfactorily providing Program Services. The AQL is used to determine whether Subrecipient is achieving the Performance Requirement in accordance with the Subaward and Exhibit A (Statement of Work and Attachments). Any deviation from the Standard will result in non-compliance of that Performance Requirement (i.e., Subrecipient is not providing Program Services according to this Subaward). Monitoring Method This is the processes or activities used to verify that Subrecipient is complying with Subaward requirements and meeting performance standards. Provide ENP Services to the most Vulnerable and High-Risk Clients. Exhibit A (Statement of Work and Attachments), Section 10.1.5 (Minimum Services for Vulnerable and High-Risk Clients) Review of corresponding Management Information System (MIS) records, client records, Universal Intake Forms (UIFs), and supporting documentation to verify nutritional risk assessments are completed and eligible clients meeting the greatest need are identified in accordance with subaward requirements. Attachment 2 (Performance Requirements Summary) Page 1 ATTACHMENT NO.
2 Performance Requirement Reference Standard(s) Monitoring Method Acceptable Quality Level (AQL) Exhibit A (Statement of Work and Attachments), Section 10.2.4 (Client Assessment for Congregate Meal Services) Assess the eligibility for all Congregate Meal Clients ten (10) business days before or after Service first begins. Enter Assessment data into Management Information System within two (2) weeks of the initial contact with the client. Review of corresponding Management Information System (MIS) records, client records, Universal Intake Forms (UIFs), and supporting documentation to verify client assessments are completed within required timeframes, entered into the MIS, and documented in accordance with program requirements. 100% Exhibit A (Statement of Work and Attachments), Section 10.3.3 (Client Assessment for Home-Delivered Meal Services) Conduct in-home assessment of the needs for all Home-Delivered Meal Clients ten business days before or after Service first begins. Enter Assessment data into Management Information System within two (2) weeks of the intial contact with the client. In-Home Assessment also required for all potential Clients that require placement on the Home-Delivered Meal Services Waitlist. Review of corresponding Management Information System (MIS) records, client records, Universal Intake Forms (UIFs), in-home assessment documentation, and supporting documentation to verify assessments are completed within required timeframes, entered into the MIS, and documented in accordance with program requirements, including assessments for clients placed on the waitlist. 100% Exhibit A (Statement of Work and Attachments), Section 10.2.4.2 (Congregate Meal Reassessment Requirements) Reassessment must be conducted annually for each Congregate Meal Client. A reassessment must be conducted and entered into the Management Information System during the first quarter (July 1st to September 30th) of each Fiscal Year for all continuing Clients who will receive services that Fiscal Year, regardless of when the last assessment or reassessment was completed. 100% Exhibit A (Statement of Work and Attachments), Section 10.3.3.2 (Home-Delivered Meal Reassessment Requirements) Reassessment must be conducted for every Home-Delivered Meal Client four (4) times per year on a quarterly basis (i.e., every three (3) months). A reassessment must be conducted and entered into the Management Information System during first quarter (July 1st to September 30) of each Fiscal Year for all continuing Clients who will receive services that Fiscal Year, regardless of when the last assessment or reassessment was completed. 100% Maintain current Home-Delivered Meals Waiting List Exhibit A (Statement of Work and Attachments), Section 10.3.4 (Home-Delivered Meal Wait List Requirements) Subrecipient must establish and maintain a monthly Home-Delivered Meal Waiting List in the Management Information System. Required completion of the Home-Delivered Meal Program Priority of Service Screening Tool to determine priority placement on the Home-Delivered Meal Waiting List. Review of corresponding Management Information System (MIS) records, Home-Delivered Meal Program Priority of Service Screening Tools, waitlist records, and supporting documentation to verify the waitlist is maintained accurately, priority rankings are documented, and clients are managed in accordance with subaward requirements. 100% Provide Emergency Meals to all Home- Delivered Meal Services Clients. Exhibit A (Statement of Work and Attachments), Section 10.4 (Emergency Meal Services Requirements for Home-Delivered Meal Clients); Provide a minimum of three (3) shelf-stable meals, per fiscal year, to Home-Delivered Meal Clients sixty (60) years of age or older who are frail and homebound by reason of illness, disability, or isolation. Review of corresponding Management Information System (MIS) records, client records, Annual Nutrition Assessments, meal distribution records, and supporting documentation to verify emergency meals are provided in accordance with subaward requirements and documented appropriately. 100% Call every Home-Delivered Meal Client, age 60 or older, receiving Home-Delivered Frozen Meals once per week. Telephonic attempts or leaving voicemail messages does not qualify as Telephone Reassurance Services. 100% Call every potential Home-Delivered Meal Client, age 60 or older, on Waiting List once per month. Telephonic attempts or leaving voicemail messages does not qualify as Telephone Reassurance Services. All potential HDM clients are to be contacted regardless of time on wait list. 100% Conduct required Client Assessments. Conduct administrative reviews and auditing of corresponding Management Information System (MIS) records and client records to verify services are being delivered in accordance with program requirements. This includes but not limited to confirming documentation of client assessments, care plan development, service coordination, logs, staff qualifications and training documentation, and authorization, and follow-up or reassessment activities, as applicable. Conduct client calls to verify the services have been rendered. Provide telephone reassurance to Home- Delivered Meal Clients. Exhibit A (Statement of Work and Attachments), Section 10.5 (Telephone Reassurance Services Requirements for Home-Delivered Meal Clients) Conduct required Client Reassessments. Review of corresponding Management Information System (MIS) records, client records, reassessment documentation, Universal Intake Forms (UIFs), and supporting documentation to verify reassessments are completed and entered into the MIS within required timeframes in accordance with program requirements Review of corresponding Management Information System (MIS) records, client records, telephone reassurance logs, call documentation, and supporting documentation to verify required telephone reassurance contacts are completed and documented in accordance with subaward requirements. A sample of client interviews or telephone verification may be conducted to confirm services were received. Attachment 2 (Performance Requirements Summary) Page 2 ATTACHMENT NO.
2 Performance Requirement Reference Standard(s) Monitoring Method Acceptable Quality Level (AQL) Food Protection Manager/Food Handler Certificates must be current. Exhibit A (Statement of Work and Attachments), Section 10.16 (Licenses and Certifications for Services) Current certification as a Food Protection Manager by the National Restaurant Association - ServSafe® or other recognized organization. Subrecipient must ensure that required Employees attend ServSafe training and successfully pass examination. Subrecipient must absorb cost of training for Employees that fail examination and are required to take a remedial course. Employees that are involved in preparation, storage or service in a food facility must possess a current Food Handler’s Certificate issued by an American National Standards Institute (ANSI) accredited training provider that meets ASTM International E2659-09 Standard Practice for Certificate Programs. (CFH card only required if a retail provider – exempt if only providing to senior meal programs). Review of Food Protection Manager and Food Handler certificates, ServSafe® training records, certificates of completion, DASSP Caterer/Central Facility Audit Reports, and supporting documentation to verify required certifications remain current and employees have completed required food safety training. 100% Voluntary Contributions Exhibit A (Statement of Work and Attachments), Section 10.17 (Voluntary Contributions) Subrecipient will develop and implement a method to enable Clients to contribute to the cost of the Program voluntarily, without coercion, and confidentially. Subrecipient must develop suggested contribution amount with input from Quality Assurance Committee and post near contribution container. Client must not be denied Services because of failure or inability to contribute. Review of written policies and procedures, posted notices, and financial records documenting that voluntary contributions are properly administered and not required as a condition of service. 100% Grievance Process Exhibit A (Statement of Work and Attachments), Section 10.18 (Grievance Process) Subrecipient must develop, implement and maintain a formal procedure for the resolution of complaints from Clients or a Client’s Responsible Other. The grievance process must be consistent with the procedures required in Paragraph 7400 of Title 22 of the California Code of Regulations. Review of written policies and procedures, posted/client-facing materials, staff training records, and supporting documentation to confirm the process is implemented and available to clients. 100% Collaborations Exhibit A (Statement of Work and Attachments), Subparagraph 10.19 (Collaborations) Subrecipient must form collaborations with County and City of Los Angeles, network of providers and other similar community organizations, Adult Protective Services agencies, law enforcement agencies, and legal services providers in order to ensure comprehensive and coordinated Service Delivery and to prevent unnecessary duplication of Services. Review of memoranda of understanding (MOUs), partnership agreements, meeting agendas and minutes, coordination logs, and related correspondence documenting collaboration with community partners. 100% Community Outreach Exhibit A (Statement of Work and Attachments), Section 10.20 (Community Outreach) Subrecipient must provide Community Outreach, which is defined as actively providing and disseminating Program information to the public on available Services for potential Clients countywide.Subrecipient’s outreach efforts must include, but are not limited to, distribution of information about Services to community members; developing referral sources among providers and community based organizations who work directly with target groups Review of outreach plans and materials, including but not limited to, event documentation, flyers, sign-in sheets, activity reports, and outreach logs. 100% Customer Satisfaction Surveys Exhibit A (Statement of Work and Attachments), Section 10.21 (Customer Satisfaction Surveys) Subrecipient must conduct ongoing Customer Satisfaction Surveys with Clients for each fiscal year and retain all surveys on file and accessible to County for review. The results of the surveys will be used by Subrecipient to make quality improvements in Services provided to Clients. Review of annual customer satisfaction survey results, corrective actions (if applicable), and documentation demonstrating follow-up on identified concerns. 100% Emergency Disaster Plan Exhibit A (Statement of Work and Attachments), Section 10.23 (Emergency an Disaster Preparedness) Subrecipient must have a written Emergency and Disaster Plan on file describing how Services will be maintained during and following the event of a disaster or emergency. The Emergency and Disaster Plan Basic Requirements (Attachment 5 of this Exhibit A) details the minimum requirements of the plan. Subrecipient must update the Emergency and Disaster Plan and submit it to County’s Emergency Coordinator as indicated in Exhibit D (County’s Administration) of the Subaward. Review of documented emergency disaster plan to confirm alignment with Statement of Work requirements. 100% Business Continuity Plan Exhibit A (Statement of Work and Attachments), Section 10.23.10 (Business Continuity Plan) Subrecipient must develop and have on file a written Business Continuity Plan (BCP) that describes how Subrecipient will reduce the adverse impact of any emergency event or disruption to normal Service delivery, as referenced in Section 10.23.10, to Clients as determined by both the scope of the event (e.g., who and what it affects, and to what extent), and also its duration (e.g., hours, days, months). Subrecipient must make the BCP available to its Staff and any County-approved Lower Tier Subrecipients for reference before, during, and after such emergency event disruption. Review of the Business Continuity Plan to verify procedures for maintaining essential operations during service disruptions in accordance with contract requirements. 100% Attend County meetings. Exhibit A (Statement of Work and Attachments), Section 4.1 (Meetings) Subrecipient must attend all meetings called by County or its authorized designee. Review of attendance records, sign-in sheets, and related correspondence documenting participation in required County meetings. 100% Attachment 2 (Performance Requirements Summary) Page 3 ATTACHMENT NO.
2 Performance Requirement Reference Standard(s) Monitoring Method Acceptable Quality Level (AQL) Ensure that Subrecipient's staff, including employees and volunteers, both existing and new, are properly trained in all areas related to providing ENP Services. 100% Implement a yearly internal staff training plan developed by the DASSP Subrecipient and approved by County. 100% Adhere to the mandatory hours of operation. Exhibit A (Statement of Work and Attachments), Section 7.0 (Hours/Days of Work) Subrecipient's staff must be available to all Clients, potential Clients, referral sources, as well as County at a minimum during normal business hours - five (5) day-a-week (Monday through Friday), eight (8) hours per day for the hours of 8:00 a.m. to 5:00 p.m. (not including County recognized holidays). Review quarterly staffing schedules and policy and procedures describing business hours coverage requirements, including procedures for emergencies, call escalation and holiday coverage. 100% Comply with Integrated Pest Management (“IPM”) requirements. Exhibit A (Statement of Work and Attachments), Section 6.8.8 (Integrated Pest Management) and Section 10.13 (Central Kitchen/Caterer); Los Angeles County Area Agency on Aging Foodservice Standard Operating Procedures manual Subrecipient must adhere to all Integrated Pest Management regulations/instructions in the Los Angeles County Area Agency on Aging Foodservice Standard Operating Procedures manual. Subrecipient must ensure that a pest control operator inspects the facility on a monthly basis. Subrecipient must keep written Pest Control Reports and weekly pest control activity logs on file and made available for review by County and DASSP Subrecipient. Review of Caterer/Central Kitchen Audit Reports, Nutrition Site Facility Audit Reports, pest control reports, weekly pest control logs, invoices, treatment records, and supporting documentation to verify compliance with Integrated Pest Management (IPM) requirements. 90% Congregate Meal site(s) is in compliance with the HACCP safety and sanitation standards outlined in the Los Angeles County Area Agency on Aging Foodservice Standard Operating Procedures manual and the requirements of the California Retail Food Code. Exhibit A (Statement of Work and Attachments) Section 10.1.1 and Section 10.13; Los Angeles County Area Agency on Aging Foodservice Standard Operating Procedures manual Subrecipient must provide Services that adhere to California Retail Food Code regulations. Subrecipient must ensure that the requirements of HACCP and quality assurance programs are enforced at all Congregate Meal Sites. Review of Nutrition Site Facility Audit Reports, Dietary Administrative Support Services Program (DASSP) Monthly Summary Reports, Los Angeles County AAA Annual Nutrition Assessments, and supporting documentation to verify compliance with HACCP standards, California Retail Food Code requirements, and applicable food safety procedures. 95% Home-Delivered Meal route HACCP safety and sanitation standards are met and are in compliance with the requirements of the California Retail Code. Exhibit A (Statement of Work and Attachments), Section 10.1.1, Section 10.13, Section 10.3.7 and Section 10.3.8; Los Angeles County Area Agency on Aging Foodservice Standard Operating Procedures manual Subrecipient must provide Services that adhere to California Food Code regulations. Subrecipient must ensure that the requirements of HACCP and quality assurance programs are enforced at all central kitchens and caterer kitchens. Meals must be delivered to Client in a manner that that maintains appropriate temperatures and protects them from contamination and within timeframes specified in Exhibit A (Statement of Work and Attachments) and the Los Angeles County Area Agency on Aging Foodservice Standard Operating Procedures manual. Review of Home-Delivered Meal Route Monitoring Reports, Dietary Administrative Support Services Program (DASSP) Monthly Summary Reports, Los Angeles County AAA Annual Nutrition Assessments, meal temperature logs, and supporting documentation to verify meals are transported and delivered in accordance with HACCP standards, California Retail Food Code requirements, and subaward timeframes. 90% Provide Program Services and expend Subaward Sums. Subaward, Paragraph 3.0 (Work) Subrecipient must provide at least 95% of Services and expend at least 95% of the Subaward Sum allocated for any Fiscal Year under this Subaward as stated in: Paragraph 5.0 (Subaward Sum); Exhibit A (Statement of Work and Attachments), Attachment 2 (Performance Requirements Summary Chart); Budget exhibits; and Mandated Program Services exhibits. Review of program records, fiscal records, invoices, expenditure reports, supporting documentation, and monitoring reports to verify services were provided and funds were expended in accordance with the Subaward 95% Submit Budget(s) and Mandated Program Services documents by County's due date. Subaward, Paragraph 3.0 (Work) At County's request, Subrecipient must complete the Budget and Mandated Program Services documents and submit these documents by the due date as prescribed by County. Review of submission records, completed Budget/MPS documents, email correspondence and any applicable supporting documentation. 100% Notify County in writing of any change in name or address of Subrecipient's Project Manager. Subaward, Subparagraph 7.2 (Subrecipient's Project Manager) Immediately notify County in writing of any change in name or address of Subrecipient's Project Manager or provide such notification within five (5) business days after the change is effective. Verify written notifications and related correspondence. 100% Maintain current insurance certifications, inspection reports, permits, licenses, etc. and submit to County prior to expiration. Subaward, Subparagraphs 8.24 (General Provisions for all Insurance Coverage), 8.25 (Insurance Coverage) and 9.20.3 (Subaward Compliance Documents) Maintain proof of all current and required insurance certifications for Subrecipient and any approved Lower Tier Subrecipient(s), inspection reports, permits and licenses. Review of insurance certificates, inspection reports, permits, licenses, and related documentation. 100% Provide training to Subrecipient's staff. Exhibit A (Statement of Work and Attachments), Section 6.7 (Training) Review and approval of annual written internal Staff training plan. Review written training documentation, including agenda, topics, training materials, training evaluations/certificates, attendance/sign- in sheets, and other related correspondence. Attachment 2 (Performance Requirements Summary) Page 4 ATTACHMENT NO.
2 Performance Requirement Reference Standard(s) Monitoring Method Acceptable Quality Level (AQL) Maintain accurate records related to the Subaward and Program Services. Subaward, Subparagraph 8.38 (Record Retention, Inspection and Audit Settlement) Subrecipient to maintain all required financial records; employment records; supporting Program documents; proprietary data; information related to its performance of the Subaward; the Subaward; Subaward amendments, addendums and/or modifications; and, all applicable laws, regulations, directives, change notices and guidance. Review of program and financial records, employment records, supporting Program documentation, Subaward records, and related documentation. 100% Obtain prior approval before entering into Lower Tier Subaward(s). Subaward, Subparagraph 8.40 (Lower Tier Subawards) Obtain County's advance written approval prior to entering into a Lower Tier Subaward for any Work by providing a draft copy of the proposed Lower Tier Subaward to County's Contract Manager and allowing County a minimum of two (2) months to complete its review process. Review of County approved documentation, proposed Lower Tier Subaward agreements/amendments, budget exhibit and related correspondence. 100% Submit Closeout Reports within due date. Subaward, Subparagraph 9.21.2 (Closeout Reporting Requirements) The Closeout Report must include the reporting of expenses and accruals incurred through the last day of the Fiscal Year or Program Year. County will notify Subrecipient of the deadline for submission of the Closeout Report. Review of final invoices, closeout documentation, including final invoice closeout report, supporting expenditure records, equipment records, correspondence, and submission timeliness. 100% Prepare and submit corrective action plan(s). 2 CFR 200.511 AD Directive CCD-18-03 (Resolution Procedures) AD Directive CCD-18-09 (Contractor Alert Reporting Database Procedures) Submit a corrective action plan(s) at the direction of County and/or County's duly authorized representatives (including, but not limited to, Federal, State and other County agents) within the prescribed timeline. Review of corrective action plans, supporting documentation, correspondence, and submission timeliness. 100% Prepare and submit audit engagement letter. 2 CFR 200.501 AD Directive CCD-18-09 (Contractor Alert Reporting Database Procedures) AD Directive CCD-18-05 (Audit Requirements) Submit the audit engagement letter for the single audit by the deadline directed by County. Review of audit engagement letter, supporting documentation, and submission timeliness. 100% Prepare and submit cost allocation plan. 2 CFR 200.4 AD Directive CCD-18-09 (Contractor Alert Reporting Database Procedures) AD Directive CCD-18-01 (Cost Allocation and Indirect Cost Requirements for AD Subawards) Submit a cost allocation plan which adheres to the requirements outlined in AD directive CCD-18-01 (Cost Allocation and Indirect Cost Requirements for ADSubawards) within the prescribed timeline. Review of cost allocation plan, supporting fiscal documentation, and submission timeliness. 100% Attachment 2 (Performance Requirements Summary) Page 5 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: (5) Funding Amount for Equipment (Other) reflected as SF must match the Equipment (Other) Funding Amount reflected in Exhibit C1.1 (Mandated Program Services), Section I (Units of Service Summary). (6) Grand Total Funding Amount under Column (F) Total Funding Amount must match Grand Total Funding Amount reflected in Exhibit C1.1 (Mandated Program Services), Section I (Units of Service Summary), Column (E) Funding Amount. [Enter] $ - $ - $ - COUNTY USE ONLY Assigned Program Analyst: Assigned Contract Analyst: Jorge Peña Jessica Palafox [Enter] NOTE: (1) The SSY2 for each Service Category must match the SSY2 Cash Other reflected in Exhibit C1.1 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. (2) The SF for each Service Category must match the SF reflected in Exhibit C1.1 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. $ 135,000 $ - Equipment Purchase(s) Approved by: Date: Community Services Manager (2) IN-KIND Phone Number $ 281,603 (F) TOTAL FUNDING (B+C+D+E) [Enter] (2) IN-KIND Project Manager (1) CASH OTHER (2) CASH NSIP $ 135,000 [Enter] [Enter] [Enter] (4) Funding Amount for Equipment (Purchase(s)) reflected under SSY2 and SF must match the Equipment (Purchase(s)) Funding Amount reflected in Exhibit C1.1 (Mandated Program Services), Section I (Units of Service Summary). Grand Total (6) $ 36,600 (3) The minimum required total mach is twelve percent (12%) of SSY2. Equipment (Purchases) (4) 7/10/2026 $ - Mike Osoff 909-620-2039 2039 [email protected] $ 110,003 2005 [email protected] Phone Number Ext. E-Mail Address PROGRAM FUNDING SUMMARY [Enter] [Enter] $ 10.56 Job Title Ms. (1) CASH Mr. Prefix Budget Analyst Job Title (A) SERVICE CATEGORY (B) SUBAWARD SUM YEAR 2 (SSY2) (1) (1) CASH 2052 [email protected] Prefix Anita Scott Authorized Representative Ext. E-Mail Address City Manager Job Title Ms. 99-620-2311 Phone Number Management Analyst 909-620-2005 (3) TOTAL FUNDING [Enter] (1) SSY2 $ 10.56 Stephanie Carbajal [Enter] SUBRECIPIENT'S FUNDS (SF) (2) (C) MATCH (3) (D) NON-MATCH (E) PROGRAM INCOME [Enter] EXHIBIT B1.1 (BUDGET) AMENDMENT 3 {FY 2026-27 BASELINE FUNDING} Ca 91766 State Zip Code State CA 91767 CONGREGATE MEAL SERVICES 2026-2027 Select Region City of Pomona ENP252607 Subrecipient's Legal Name: 505 S Garey Ave Main Administrative Office Address Pomona Mailing Address (if different from above) City Zip Code Three Modification Number: N/A ALL COSTS REPORTED ON THIS BUDGET MUST BE ALLOWABLE, NECESSARY, AND REASONABLE FOR THE PROGRAM SERVICES TO BE PROVIDED. Budget Reviewed and Approved by: Jessica Palafox Equipment (Other) (5) (G) UNIT RATE City P.O Box 660 Pomona (2) SF $ 110,003 $ - $ 281,603 (1) CASH $ 36,600 Older Americans Act Title III C-1 and Net County Cost (NCC) One (1) Prefix Ext. E-Mail Address All Congregate Meals ATTACHMENT NO.
2 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] [Enter title] Community Service Specialist I 100% $ - 12 $ - $ - $ - $0 $ 22,500 $ 22,500 $ 20,100 $ 20,100 12 $ 22,500 $0 Recreation Supervisor 10% $ 9,200 12 $ 11,040 $ 11,040 $ - Recreation Coordinator 20% $ 6,302 12 $ 15,125 $0 Site Manager-Community Service Specialist II 100% $ 1,875 Site Manager-Community Service Specialist II 100% $ 1,875 12 $ 22,500 $ 22,500 $ 22,500 $0 $ 11,040 $0 Community Service Specialist III 100% $ 2,045 $ 24,540 $ 15,125 $ 15,125 $0 12 $ 24,540 $ 24,540 CONGREGATE MEAL SERVICES 2026-2027 Older Americans Act Title III C-1 and Net County Cost (NCC) (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 Community Service Manager-Project Manager 2% $ 20,834 12 $ 5,000 $ 5,000 $ 5,000 $0 Community Service Specialist I 100% $ 1,675 12 $ 20,100 [Enter title] Office Assitant I 100% $ 1,980 12 $ 23,760 [Enter title] $ - [Enter title] [Enter title] Select Region One (1) ENP252607 Three Modification Number: N/A $0 $ 23,760 $ 23,760 $0 City of Pomona Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 2 ATTACHMENT NO.
2 (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 (2): If an individual's time is allocated to multiple Program Services, that individual's time must not exceed 100% when his/her time is totaled for Congregate Meal Services, Home-Delivered Meal Services, and Telephone Reassurance Services. [Complete as needed] [Complete as needed] [Complete as needed] $ - Do indirect costs exceed the fifteen percent (15%) maximum? (5): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). $ 151,793 $0 NOTE: (1): Enter the title of each position. List all mandatory staffing positions noted in Exhibit A (Statement of Work and Attachments). If a mandatory position is performed by staff under a different position/payroll title then list both the position title noted in Exhibit A (Statement of Work and Attachments) and the payroll title (e.g., Project Director/Recreation Director). (3): Enter the amount of funding that Subrecipient will use to fund any portion of the total cost for taxes. (4): Enter the amount of funding that Subrecipient will use to fund any portion of the total cost for benefits. GRAND TOTAL GRAND TOTAL PERSONNEL $ 151,793 $ 16,842 $ 110,003 $ - $ - $ 24,948 - $ Indirect Costs (Personnel) [Complete as needed] (5) [Complete as needed] [Complete as needed] $ 144,565 $0 $ - $ 24,948 - $ $ 151,793 $0 INDIRECT (4) $ - $ 1,188 $ 7,228 $0 TOTAL DIRECT PERSONNEL $ 151,793 $ 16,842 $ 110,003 $ 7,228 $ 802 $ 5,238 (4) Taxes [Enter Rate] (3) (3) SUBTOTAL DIRECT PERSONNEL $ 144,565 $ 16,040 $ 104,765 $ - (3) (3) (3) (3) $ - $ 23,760 - $ [Enter title] $ - Benefits 5.00% [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 3 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: NOTE: (1): When using volunteer services as an in-kind match to meet the minimum required match, this in-kind match must 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 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 (1) (H) NON-MATCH DIRECT City of Pomona [Enter title] [Enter title] CONGREGATE MEAL SERVICES Three Modification Number: 2026-2027 (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 (D) MONTHLY SALARY EQUIVALENT (E) NO. OF MONTHS (F) TOTAL SALARY EQUIVALENT SF (I) TOTAL IN-KIND Older Americans Act Title III C-1 and Net County Cost (NCC) Select Region One (1) ENP252607 N/A (J) VARIANCE Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 4 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: (1) Effective January 1, 2025 - December 31, 2025, County's approved mileage rate is $0.66 per mile. Effective January 1, 2026, County’s approved mileage rate is $0.685 per mile and State's mileage rate is available online at: http://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx. Reimbursement for mileage must not exceed the lesser of County's rate and State's rate. (2): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) 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 fifteen percent (15%) 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) 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) ENP252607 Three Modification Number: N/A City of Pomona III. BUDGET DETAIL - VOLUNTEER EXPENSES CONGREGATE MEAL SERVICES 2026-2027 Older Americans Act Title III C-1 and Net County Cost (NCC) Select Region One (1) Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 5 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: CONGREGATE MEAL SERVICES Older Americans Act Title III C-1 and Net County Cost (NCC) 2026-2027 Select Region One (1) ENP252607 N/A City of Pomona IV. BUDGET DETAIL - SUBAWARD(S)/SUBCONTRACT(S) FOR CATERED FOOD Three Modification Number: (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 $ - $ - [Complete as needed] $ 118,158 $ 118,158 $ - $ - $ - $ - $ - $ - $ - $ - INDIRECT $ 118,158 $ 118,158 (1): Use this Budget Detail to report Lower Tier Subaward(s)/Subcontract(s) with caterers by entering the name of the caterer. The information provided herein must be included in Exhibit T (List of Lower Tier Subawards). Subrecipient must obtain prior written approval from County before executing Subaward(s). (2): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column G (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) 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 fifteen percent (15%) maximum? Indirect Costs (Lower Tier Subaward(s)/Subcontract(s) for Catered Food) TOTAL DIRECT LOWER TIER SUBAWARD(S)/SUBCONTRACT(S) FOR CATERED FOOD $ - GRAND TOTAL LOWER TIER SUBAWARD(S)/SUBCONTRACT(S) FOR CATERED FOOD [Complete as needed] [Complete as needed] [Complete as needed] [Complete as needed] GRAND TOTAL (2) NOTE: $ - $ 118,158 $0 $ 118,158 $0 DIRECT (A) LOWER TIER SUBRECIPIENT'S/SUBCONTRACTOR(S) NAME (1) (C) UNIT COST (D) NO. OF UNITS (E) NO. OF MONTHS (C*D*E) (F - K) Trio Community Meals All Congregate Meals $ 1,600 4.91 $ 23,568 $ 23,568 $0 (J) PROGRAM INCOME (1) CASH (B) SERVICE CATEGORY (G) SSY2 (F) SF TOTAL COSTS (K) TOTAL FUNDING (L) VARIANCE [Enter caterer's name] [Enter caterer's name] Select Description Select Description [Enter caterer's name] Select Description [Enter caterer's name] Select Description Everytable [Enter caterer's name] Select Description All Congregate Meals $ 6.56 1,602 $ 94,590 $ 94,590 $0 3 $ 23,568 9 $ 94,590 Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 6 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: NOTE: Do indirect costs exceed the fifteen percent (15%) maximum? (1) TOTAL DIRECT RAW FOOD $ - DIRECT All Congregate Meals (1): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY1 Cash Other). Indirect costs in excess of the fifteen percent (15%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). INDIRECT GRAND TOTAL Indirect Costs (Raw Food) GRAND TOTAL RAW FOOD $ - $ - $ - $ - $ - $ - $ - $ - $ - $0 [Complete as needed] $ - $0 [Complete as needed] [Complete as needed] [Complete as needed] $ - $ - $ - $ - $ - $ - $ - [Complete as needed] CONGREGATE MEAL SERVICES (2) IN-KIND (1) CASH (F+G+H+I) (E - J) V. BUDGET DETAIL - RAW FOOD (A) SERVICE CATEGORY (B) UNIT COST (C) NO. OF UNITS (D) NO. OF MONTHS (2) IN-KIND (1) CASH (G) MATCH (H) NON-MATCH (I) PROGRAM INCOME (E) TOTAL COSTS (F) SF SSY1 (J) TOTAL FUNDING (K) VARIANCE (B*C*D) (1) CASH OTHER (2) CASH NSIP (1) CASH 2026-2027 Older Americans Act Title III C-1 and Net County Cost (NCC) Three Modification Number: Select Region One (1) ENP252607 N/A City of Pomona Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 7 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: [Enter name and description] [Enter name and description] (1): Please submit supporting documentation with this Budget for any unit cost, which exceeds $2.00 per square foot, that will be supported by the SSY2. (2): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) 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 fifteen percent (15%) maximum? GRAND TOTAL GRAND TOTAL SPACE $ - $ - $ - $ - [Complete as needed] [Complete as needed] [Complete as needed] [Complete as needed] [Complete Indirect Costs (Space) (2) as needed] $ - $ - $ - $ - $0 INDIRECT TOTAL DIRECT SPACE $ - $ - $ - $ - [Enter name and description] [Enter name and description] [Enter name and description] [Enter name and description] [Enter name and description] [Enter name and description] DIRECT (A) NAME OF LOCATION AND DESCRIPTION (B) UNIT COST (1) (C) NO. OF UNITS (D) NO. OF MONTHS (E) TOTAL COSTS (F) 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) Three Modification Number: VI. BUDGET DETAIL - SPACE CONGREGATE MEAL SERVICES 2026-2027 Older Americans Act Title III C-1 and Net County Cost (NCC) Select Region One (1) ENP252607 N/A City of Pomona Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 8 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: 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 (1) CASH (2) IN-KIND (1) CASH [Enter description] Select Select CONGREGATE MEAL SERVICES 2026-2027 Older Americans Act Title III C-1 and Net County Cost (NCC) Select Region One (1) ENP252607 N/A City of Pomona (J) TOTAL FUNDING (G) MATCH (H) NON-MATCH (I) PROGRAM INCOME (A) DESCRIPTION (1) (B) EQUIPMENT TYPE (2) or (3) (C) UNIT COST (D) NO. OF UNITS (E) TOTAL COSTS (F) SSY2 SF (C*D) (1) (F+G+H+I) CASH OTHER (1) CASH (2) IN-KIND (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 drive and portable hard drives), and/or when Subrecipient will use $500 or more of the SSY2 to purchase the Equipment/Asset. Subrecipient must 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 SSY2 and no later than March 31st of the Fiscal Year. Equipm 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) SSY2 must 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 must report this using any combination of SSY2, 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 must report this using any combination of Match In-kind and/or Non-match In-kind. Three Modification Number: VII. BUDGET DETAIL - EQUIPMENT (K) VARIANCE (E - J) DIRECT [Enter description] Select [Enter description] Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 9 ATTACHMENT NO.
2 Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(4): Effective January 1, 2025 - December 31, 2025, County's approved mileage rate is $0.66 per mile. Effective January 1, 2026, County’s approved mileage rate is $0.685 per mile and State's mileage rate is available online at:
http://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx. Reimbursement for mileage must not exceed the lesser of County's rate and State's rate. (5): Subrecipient must obtain prior written approval from County if utilizing SSY2 for Travel (Other). (6): Subrecipient must contact their assigned Contract Analyst if there is a cost(s) that Subrecipient would like to add that is not included in the drop down list. Subrecipient must provide detailed explanation of the cost to County (7): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). (6)
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete as
Indirect Costs (Other Costs) needed] NOTE:
(6)
(6)
(6)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
(1): Allowable costs are identified in accordance with Title 2 Code of Federal Regulations (CFR) Part 200 and Title 45 Code of Federal Regulations (CFR) Part 75. (2): Subrecipient must obtain prior written approval from County if utilizing SSY2 for Conferences. (3): Subrecipient must provide the following information to your assigned Contract Analyst: (a) Kind of equipment, (b) Indicate whether the equipment lease is program specific or a shared cost, (c) If a shared cost, provide the cost distribution methodology for County review and (d) Length of the lease. $ - - $ 12,900 $ $ 12,900 $0
Do indirect costs exceed the fifteen percent (15%) maximum? GRAND TOTAL GRAND TOTAL OTHER COSTS $ 12,900 $ - - $ - $ [Complete
(7) as needed]
$ - - $ 12,900 $ $ 12,900 $0

INDIRECT
TOTAL DIRECT OTHER COSTS $ 12,900 $ - - $ - $
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Professional Services (2 CFR 200.459 & 45 CFR 75.459) 83.33 $ 1 12 $ 1,000 $ 1,000 $ 1,000 $0 $ 7,000 $ 7,000 $0
Maintenance and Repairs (2 CFR 200.452 & 45 CFR

75.452) $ 100 1 70.00 $ 7,000
$ 1,100 $ 1,100 $0
Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 112.50 $ 1 12 $ 1,350 $ 1,350 $ 1,350 $0 101 12 $ 800 Materials and Supplies (2 CFR 200.453 & 45 CFR 75.453) 91.67 $ 1 12 $ 1,100 Memberships, Subscriptions and Professional Activities (2 CFR 200.454 & 45 CFR 75.454) $ 200.00 2 1 $ 400 Travel (Mileage) (2 CFR 200.474 & 45 CFR 75.474) (4) $ 0.66 $ 400 $ 400 $0
$ 800 $ 800 $0
$ 1,250 $ 1,250 $0 DIRECT Publication and Printing (2 CFR 200.461 & 45 CFR 75.461) $ 416.67 1 3 $ 1,250 (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)
Three Modification Number:

VIII. BUDGET DETAIL - OTHER COSTS

CONGREGATE MEAL SERVICES
2026-2027
Older Americans Act Title III C-1 and Net County Cost (NCC) Select Region
One (1)
ENP252607
N/A
City of Pomona
Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 10 ATTACHMENT NO. 2
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 CONGREGATE MEAL SERVICES
2026-2027
Older Americans Act Title III C-1 and Net County Cost (NCC) Select Region
One (1)
ENP252607
Three Modification Number: N/A
City of Pomona
IX. BUDGET SUMMARY
(A) COST CATEGORIES(B) COSTS (1)(C) FUNDING CATEGORIES(D) FUNDING (1) (1)
Total Budgeted Costs Cash NSIP
(SSY2) $ -
(1)
Total Budgeted Costs
DIRECT
1 Personnel Cash Other
(SSY2) $ 16,842
1 SSY2 Cash Other
(SSY2) $ 135,000 Volunteers In-Kind (SF) $ - 3 Volunteer Expenses Cash (SF) $ 134,951
In-Kind (SF) $ - Cash (SF) $ -
In-Kind (SF) $ - 2 Subtotal $ 135,000
4 Lower Tier Subaward(s)/Subcontract(s) for Catered Food Cash Other (SSY2) $ 118,158 Cash NSIP
(SSY2) $ - Cash (SF) $ - Match
In-Kind (SF) $ - Cash (SF) $ 110,003
In-Kind (SF) $ - Cash Other
(SSY2) $ -
5 Raw Food Cash Other
(SSY2) $ - 3 Non-Match
6 Space Cash Other
(SSY2) $ - Cash (SF) In-Kind (SF) $ - $ -
In-Kind (SF) $ - Cash (SF) $ - Cash NSIP
(SSY2) $ - Cash (SF) $ -
In-Kind (SF) $ - 7 Equipment Cash Other
(SSY2) $ - 4 Program Income
8 Other Costs
In-Kind (SF) $ - Cash (SF) $ 37,848
Cash (SF) $ -
In-Kind (SF) $ - Cash Other
(SSY2) $ - Cash (SF) $ 12,900 Cash Other
(SSY2) $ 135,000 Cash NSIP
(SSY2) $ - Cash NSIP(SSY2) $ - 9 Subtotal Direct Costs Cash Other (SSY2) $ 135,000
5 Subtotal Funding for Direct Costs Cash (SF) $ 147,851 Variance (Costs-Funding)
Cash
In-Kind

INDIRECT
Cash (SF) $ 147,851
In-Kind (SF) $ -In-Kind (SF) $ - Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 11 ATTACHMENT NO. 2
IX. BUDGET SUMMARY
(A) COST CATEGORIES(B) COSTS (1)(C) FUNDING CATEGORIES(D) FUNDING (1) (1)
Total Budgeted Costs
(1)
Total Budgeted Costs
11 21 12
10 Personnel Cash Other
(SSY2) $ - Volunteers 6 SSY2
12 Volunteer Expenses Cash (SF) Match
$ -
In-Kind (SF) $ - Cash Other
(SSY2) $ - Cash (SF) $ -
In-Kind (SF) $ -
In-Kind (SF) $ - Cash Other
(SSY2) $ -
In-Kind (SF) $ - Cash (SF) $ - 13 Lower Tier Subaward(s)/Subcontract(s) for Catered Food Cash Other (SSY2) $ - Cash (SF) $ -
In-Kind (SF) $ - 7
14 Raw Food Cash Other
(SSY2) $ - 8 Non-Match
15 Space Cash Other
(SSY2) $ - 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
(SSY2) $ - 9 Program Income Cash Other
(SSY2) $ - Cash (SF) $ - Cash (SF) $ - 17 Subtotal Indirect Costs Cash Other(SSY2) $ - 10 Subtotal Funding for Indirect Costs
In-Kind (SF) $ - Subrecipeint meets minimum match requirement. Match Met NOTE:
(1): Costs and Funding must match.

In-Kind (SF) $ -In-Kind (SF) $ - GRAND TOTAL COSTS
$ 282,851 GRAND TOTAL FUNDING$ 282,851
20 Total Costs Cash Other
(SSY2) $ 135,000
11 Total Funding Cash Other
(SSY2) $ 135,000 Cash NSIP
(SSY2)
Variance (Costs-Funding) $0
$ - Cash NSIP
(SSY2) $ - Cash (SF) $ 147,851 Cash (SF) $ 147,851

GRAND TOTAL
In-Kind (SF) $ - Variance (Costs-Funding)
Cash
In-Kind
Exhibit B1.1 (Budget) Amendment 3 {FY 2026-27 Baseline Funding} Page 12 ATTACHMENT NO. 2
Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: (5) Funding Amount for Equipment (Other) reflected as SF must match the Equipment (Other) Funding Amount reflected in Exhibit C1.2 (Mandated Program Services), Section I (Units of Service Summary). (6) Grand Total Funding Amount under Column (F) Total Funding Amount must match Grand Total Funding Amount reflected in Exhibit C1.2 (Mandated Program Services), Section I (Units of Service Summary), Column (E) Funding Amount. [Enter] $ - $ - $ - COUNTY USE ONLY Assigned Program Analyst: Assigned Contract Analyst: Jorge Peña Jessica Palafox [Enter] NOTE: (1) The SSY2 for each Service Category must match the SSY2 Cash Other reflected in Exhibit C1.2 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. (2) The SF for each Service Category must match the SF reflected in Exhibit C1.2 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. $ 42,000 $ - Equipment Purchase(s) Approved by: Date: Community Service Manager (2) IN-KIND Phone Number $ 42,000 (F) TOTAL FUNDING (B+C+D+E) [Enter] (2) IN-KIND Project Manager (1) CASH OTHER (2) CASH NSIP $ 42,000 [Enter] [Enter] [Enter] (4) Funding Amount for Equipment (Purchase(s)) reflected under SSY2 and SF must match the Equipment (Purchase(s)) Funding Amount reflected in Exhibit C1.2 (Mandated Program Services), Section I (Units of Service Summary). Grand Total (6) $ - (3) Match is optional and is not required for MOCA funding. Equipment (Purchases) (4) 7/10/2026 $ - Mike Osoff 909-620-2039 2039 [email protected] [Enter] 2005 [email protected] Phone Number Ext. E-Mail Address PROGRAM FUNDING SUMMARY [Enter] [Enter] $ 10.56 Job Title Ms. (1) CASH Mr. Prefix Budget Analyst Job Title (A) SERVICE CATEGORY (B) SUBAWARD SUM YEAR 2 (SSY2) (1) (1) CASH 2052 [email protected] Prefix Anita Scott Authorized Representative Ext. E-Mail Address City Manager Job Title Ms. 909-620-2052 Phone Number Management Analyst 909-620-2005 (3) TOTAL FUNDING $ - (1) SSY2 $ 10.56 Stephanie Carbajal [Enter] SUBRECIPIENT'S FUNDS (SF) (2) (C) OPTIONAL MATCH (3) (D) NON-MATCH (E) PROGRAM INCOME [Enter] EXHIBIT B1.2 (BUDGET) AMENDMENT 3 {FY 2026-27 MOCA FUNDING} CA 91766 State Zip Code State CA 91769 CONGREGATE MEAL SERVICES 2026-2027 Select Region City of Pomona ENP252607 Subrecipient's Legal Name: 505 S Garey Ave Main Administrative Office Address Pomona Mailing Address (if different from above) City Zip Code Three Modification Number: N/A ALL COSTS REPORTED ON THIS BUDGET MUST BE ALLOWABLE, NECESSARY, AND REASONABLE FOR THE PROGRAM SERVICES TO BE PROVIDED. Budget Reviewed and Approved by: Jessica Palafox Equipment (Other) (5) (G) UNIT RATE City P.O. Box 660 Pomona (2) SF $ - $ - $ 42,000 (1) CASH [Enter] Modernizing Older Californians Act (MOCA) Select Supervisorial District Prefix Ext. E-Mail Address All Congregate Meals ATTACHMENT NO.
2 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] [Enter title] [Enter title] Community Service Specialist I 100% $ 1,667 12 $ 20,000 $ 20,000 [Enter title] [Enter title] [Enter title] $ 20,000 $0 [Enter title] CONGREGATE MEAL SERVICES 2026-2027 Modernizing Older Californians Act (MOCA) (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 Community Service Specialist I 100% $ 1,667 12 $ 20,000 $ 20,000 $ 20,000 $0 [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] Select Region Select Supervisorial District ENP252607 Three Modification Number: N/A City of Pomona Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 2 ATTACHMENT NO.
2 (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 (2): If an individual's time is allocated to multiple Program Services, that individual's time must not exceed 100% when his/her time is totaled for Congregate Meal Services, Home-Delivered Meal Services, and Telephone Reassurance Services. [Complete as needed] [Complete as needed] [Complete as needed] $ - Do indirect costs exceed the fifteen percent (15%) maximum? (5): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). $ 42,000 $0 NOTE: (1): Enter the title of each position. List all mandatory staffing positions noted in Exhibit A (Statement of Work and Attachments). If a mandatory position is performed by staff under a different position/payroll title then list both the position title noted in Exhibit A (Statement of Work and Attachments) and the payroll title (e.g., Project Director/Recreation Director). (3): Enter the amount of funding that Subrecipient will use to fund any portion of the total cost for taxes. (4): Enter the amount of funding that Subrecipient will use to fund any portion of the total cost for benefits. GRAND TOTAL GRAND TOTAL PERSONNEL $ 42,000 $ 42,000 $ - $ - $ - $ - $ - Indirect Costs (Personnel) [Complete as needed] (5) [Complete as needed] [Complete as needed] $ 40,000 $0 $ - $ - $ - $ 42,000 $0 INDIRECT (4) (4) (4) $ 2,000 $0 TOTAL DIRECT PERSONNEL $ 42,000 $ 42,000 $ - $ 2,000 $ 2,000 (4) (4) Taxes [Enter Rate] (3) (3) SUBTOTAL DIRECT PERSONNEL $ 40,000 $ 40,000 $ - $ - (3) (3) (3) (3) $ - $ - $ - [Enter title] $ - Benefits 5.00% [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 3 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: NOTE: (1): When using volunteer services as an in-kind match to meet the minimum required match, this in-kind match must 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 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 (1) (H) NON-MATCH DIRECT City of Pomona [Enter title] [Enter title] CONGREGATE MEAL SERVICES Three Modification Number: 2026-2027 (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 (D) MONTHLY SALARY EQUIVALENT (E) NO. OF MONTHS (F) TOTAL SALARY EQUIVALENT SF (I) TOTAL IN-KIND Modernizing Older Californians Act (MOCA) Select Region Select Supervisorial District ENP252607 N/A (J) VARIANCE Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 4 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: (1) Effective January 1, 2025 - December 31, 2025, County's approved mileage rate is $0.66 per mile. Effective January 1, 2026, County’s approved mileage rate is $0.685 per mile and State's mileage rate is available online at: http://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx. Reimbursement for mileage must not exceed the lesser of County's rate and State's rate. (2): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) 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 fifteen percent (15%) 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) 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) ENP252607 Three Modification Number: N/A City of Pomona III. BUDGET DETAIL - VOLUNTEER EXPENSES CONGREGATE MEAL SERVICES 2026-2027 Modernizing Older Californians Act (MOCA) Select Region Select Supervisorial District Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 5 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: CONGREGATE MEAL SERVICES Modernizing Older Californians Act (MOCA) 2026-2027 Select Region Select Supervisorial District ENP252607 N/A City of Pomona IV. BUDGET DETAIL - SUBAWARD(S)/SUBCONTRACT(S) FOR CATERED FOOD Three Modification Number: (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 $ - $ - [Complete as needed] $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - INDIRECT $ - $ - (1): Use this Budget Detail to report Lower Tier Subaward(s)/Subcontract(s) with caterers by entering the name of the caterer. The information provided herein must be included in Exhibit T (List of Lower Tier Subawards). Subrecipient must obtain prior written approval from County before executing Subaward(s). (2): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column G (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) 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 fifteen percent (15%) maximum? Indirect Costs (Lower Tier Subaward(s)/Subcontract(s) for Catered Food) TOTAL DIRECT LOWER TIER SUBAWARD(S)/SUBCONTRACT(S) FOR CATERED FOOD $ - GRAND TOTAL LOWER TIER SUBAWARD(S)/SUBCONTRACT(S) FOR CATERED FOOD [Complete as needed] [Complete as needed] [Complete as needed] [Complete as needed] GRAND TOTAL (2) NOTE: $ - $ - $0 $ - $0 DIRECT (A) LOWER TIER SUBRECIPIENT'S/SUBCONTRACTOR(S) NAME (1) (C) UNIT COST (D) NO. OF UNITS (E) NO. OF MONTHS (C*D*E) (F - K) [Enter caterer's name] Select Description (J) PROGRAM INCOME (1) CASH (B) SERVICE CATEGORY (G) SSY2 (F) SF TOTAL COSTS (K) TOTAL FUNDING (L) VARIANCE [Enter caterer's name] [Enter caterer's name] Select Description Select Description [Enter caterer's name] Select Description [Enter caterer's name] Select Description [Enter caterer's name] [Enter caterer's name] Select Description Select Description Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 6 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: NOTE: Do indirect costs exceed the fifteen percent (15%) maximum? (1) TOTAL DIRECT RAW FOOD $ - DIRECT All Congregate Meals (1): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY1 Cash Other). Indirect costs in excess of the fifteen percent (15%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). INDIRECT GRAND TOTAL Indirect Costs (Raw Food) GRAND TOTAL RAW FOOD $ - $ - $ - $ - $ - $ - $ - $ - $ - $0 [Complete as needed] $ - $0 [Complete as needed] [Complete as needed] [Complete as needed] $ - $ - $ - $ - $ - $ - $ - [Complete as needed] CONGREGATE MEAL SERVICES (2) IN-KIND (1) CASH (F+G+H+I) (E - J) V. BUDGET DETAIL - RAW FOOD (A) SERVICE CATEGORY (B) UNIT COST (C) NO. OF UNITS (D) NO. OF MONTHS (2) IN-KIND (1) CASH (G) MATCH (H) NON-MATCH (I) PROGRAM INCOME (E) TOTAL COSTS (F) SF SSY1 (J) TOTAL FUNDING (K) VARIANCE (B*C*D) (1) CASH OTHER (2) CASH NSIP (1) CASH 2026-2027 Modernizing Older Californians Act (MOCA) Three Modification Number: Select Region Select Supervisorial District ENP252607 N/A City of Pomona Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 7 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: [Enter name and description] [Enter name and description] (1): Please submit supporting documentation with this Budget for any unit cost, which exceeds $2.00 per square foot, that will be supported by the SSY2. (2): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) 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 fifteen percent (15%) maximum? GRAND TOTAL GRAND TOTAL SPACE $ - $ - $ - $ - [Complete as needed] [Complete as needed] [Complete as needed] [Complete as needed] [Complete Indirect Costs (Space) (2) as needed] $ - $ - $ - $ - $0 INDIRECT TOTAL DIRECT SPACE $ - $ - $ - $ - [Enter name and description] [Enter name and description] [Enter name and description] [Enter name and description] [Enter name and description] [Enter name and description] DIRECT (A) NAME OF LOCATION AND DESCRIPTION (B) UNIT COST (1) (C) NO. OF UNITS (D) NO. OF MONTHS (E) TOTAL COSTS (F) 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) Three Modification Number: VI. BUDGET DETAIL - SPACE CONGREGATE MEAL SERVICES 2026-2027 Modernizing Older Californians Act (MOCA) Select Region Select Supervisorial District ENP252607 N/A City of Pomona Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 8 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: 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 (1) CASH (2) IN-KIND (1) CASH [Enter description] Select Select CONGREGATE MEAL SERVICES 2026-2027 Modernizing Older Californians Act (MOCA) Select Region Select Supervisorial District ENP252607 N/A City of Pomona (J) TOTAL FUNDING (G) MATCH (H) NON-MATCH (I) PROGRAM INCOME (A) DESCRIPTION (1) (B) EQUIPMENT TYPE (2) or (3) (C) UNIT COST (D) NO. OF UNITS (E) TOTAL COSTS (F) SSY2 SF (C*D) (1) (F+G+H+I) CASH OTHER (1) CASH (2) IN-KIND (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 drive and portable hard drives), and/or when Subrecipient will use $500 or more of the SSY2 to purchase the Equipment/Asset. Subrecipient must 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 SSY2 and no later than March 31st of the Fiscal Year. Equipm 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) SSY2 must 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 must report this using any combination of SSY2, 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 must report this using any combination of Match In-kind and/or Non-match In-kind. Three Modification Number: VII. BUDGET DETAIL - EQUIPMENT (K) VARIANCE (E - J) DIRECT [Enter description] Select [Enter description] Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 9 ATTACHMENT NO.
2 Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(4): Effective January 1, 2025 - December 31, 2025, County's approved mileage rate is $0.66 per mile. Effective January 1, 2026, County’s approved mileage rate is $0.685 per mile and State's mileage rate is available online at:
http://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx. Reimbursement for mileage must not exceed the lesser of County's rate and State's rate. (5): Subrecipient must obtain prior written approval from County if utilizing SSY2 for Travel (Other). (6): Subrecipient must contact their assigned Contract Analyst if there is a cost(s) that Subrecipient would like to add that is not included in the drop down list. Subrecipient must provide detailed explanation of the cost to County (7): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). (6)
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete as
Indirect Costs (Other Costs) needed] NOTE:
(6)
(6)
(6)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
(1): Allowable costs are identified in accordance with Title 2 Code of Federal Regulations (CFR) Part 200 and Title 45 Code of Federal Regulations (CFR) Part 75. (2): Subrecipient must obtain prior written approval from County if utilizing SSY2 for Conferences. (3): Subrecipient must provide the following information to your assigned Contract Analyst: (a) Kind of equipment, (b) Indicate whether the equipment lease is program specific or a shared cost, (c) If a shared cost, provide the cost distribution methodology for County review and (d) Length of the lease. $ - - $ $ - $ - $0
Do indirect costs exceed the fifteen percent (15%) maximum? GRAND TOTAL GRAND TOTAL OTHER COSTS $ - $ - - $ - $ [Complete
(7) as needed]
$ - - $ $ - $ - $0

INDIRECT
TOTAL DIRECT OTHER COSTS $ - $ - - $ - $
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) 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)
Three Modification Number:

VIII. BUDGET DETAIL - OTHER COSTS

CONGREGATE MEAL SERVICES
2026-2027
Modernizing Older Californians Act (MOCA)
Select Region
Select Supervisorial District
ENP252607
N/A
City of Pomona
Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 10 ATTACHMENT NO. 2
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 CONGREGATE MEAL SERVICES
2026-2027
Modernizing Older Californians Act (MOCA)
Select Region
Select Supervisorial District
ENP252607
Three Modification Number: N/A
City of Pomona
IX. BUDGET SUMMARY
(A) COST CATEGORIES(B) COSTS (1)(C) FUNDING CATEGORIES(D) FUNDING (1) (1)
Total Budgeted Costs Cash NSIP
(SSY2) $ -
(1)
Total Budgeted Costs
DIRECT
1 Personnel Cash Other
(SSY2) $ 42,000
1 SSY2 Cash Other
(SSY2) $ 42,000 Volunteers In-Kind (SF) $ - 3 Volunteer Expenses Cash (SF) $ -
In-Kind (SF) $ - Cash (SF) $ -
In-Kind (SF) $ - 2 Subtotal $ 42,000
4 Lower Tier Subaward(s)/Subcontract(s) for Catered Food Cash Other (SSY2) $ - Cash NSIP
(SSY2) $ - Cash (SF) $ - Match
In-Kind (SF) $ - Cash (SF) $ -
In-Kind (SF) $ - Cash Other
(SSY2) $ -
5 Raw Food Cash Other
(SSY2) $ - 3 Non-Match
6 Space Cash Other
(SSY2) $ - Cash (SF) In-Kind (SF) $ - $ -
In-Kind (SF) $ - Cash (SF) $ - Cash NSIP
(SSY2) $ - Cash (SF) $ -
In-Kind (SF) $ - 7 Equipment Cash Other
(SSY2) $ - 4 Program Income
8 Other Costs
In-Kind (SF) $ - Cash (SF) $ - Cash (SF) $ -
In-Kind (SF) $ - Cash Other
(SSY2) $ - Cash (SF) $ - Cash Other
(SSY2) $ 42,000 Cash NSIP
(SSY2) $ - Cash NSIP(SSY2) $ - 9 Subtotal Direct Costs Cash Other (SSY2) $ 42,000
5 Subtotal Funding for Direct Costs Cash (SF) $ - Variance (Costs-Funding) Cash
In-Kind

INDIRECT
Cash (SF) $ -
In-Kind (SF) $ -In-Kind (SF) $ - Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 11 ATTACHMENT NO. 2
IX. BUDGET SUMMARY
(A) COST CATEGORIES(B) COSTS (1)(C) FUNDING CATEGORIES(D) FUNDING (1) (1)
Total Budgeted Costs
(1)
Total Budgeted Costs
11 21 12
10 Personnel Cash Other
(SSY2) $ - Volunteers 6 SSY2
12 Volunteer Expenses Cash (SF) Match
$ -
In-Kind (SF) $ - Cash Other
(SSY2) $ - Cash (SF) $ -
In-Kind (SF) $ -
In-Kind (SF) $ - Cash Other
(SSY2) $ -
In-Kind (SF) $ - Cash (SF) $ - 13 Lower Tier Subaward(s)/Subcontract(s) for Catered Food Cash Other (SSY2) $ - Cash (SF) $ -
In-Kind (SF) $ - 7
14 Raw Food Cash Other
(SSY2) $ - 8 Non-Match
15 Space Cash Other
(SSY2) $ - 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
(SSY2) $ - 9 Program Income Cash Other
(SSY2) $ - Cash (SF) $ - Cash (SF) $ - 17 Subtotal Indirect Costs Cash Other(SSY2) $ - 10 Subtotal Funding for Indirect Costs
In-Kind (SF) $ - NOTE:
(1): Costs and Funding must match.

In-Kind (SF) $ -In-Kind (SF) $ - GRAND TOTAL COSTS
$ 42,000 GRAND TOTAL FUNDING$ 42,000
20 Total Costs Cash Other
(SSY2) $ 42,000
11 Total Funding Cash Other
(SSY2) $ 42,000 Cash NSIP
(SSY2)
Variance (Costs-Funding) $0
$ - Cash NSIP
(SSY2) $ - Cash (SF) $ - Cash (SF) $ - GRAND TOTAL
In-Kind (SF) $ - Variance (Costs-Funding)
Cash
In-Kind
Exhibit B1.2 (Budget) Amendment 3 {FY 2026-27 MOCA Funding} Page 12 ATTACHMENT NO. 2
Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Grand Total (6) $ 10,792 - $ $ - (3) No match requirement for NSIP funds. [Enter] Equipment Purchase(s) Approved by: Date: 7/10/2026 [Enter] [Enter] $ - Stephanie Carbajal Prefix Budget Analyst (5) Funding Amount for Equipment (Other) reflected as SF must match the Equipment (Other) Funding Amount reflected in Exhibit C1.3 (Mandated Program Services), Section I (Units of Service Summary). (6) Grand Total Funding Amount under Column (F) Total Funding Amount must match Grand Total Funding Amount reflected in Exhibit C1.3 (Mandated Program Services), Section I (Units of Service Summary), Column (E) Funding Amount. [Enter] $ - $ - $ - COUNTY USE ONLY Assigned Program Analyst: Assigned Contract Analyst: Jorge Peña Jessica Palafox [Enter] NOTE: (1) The SSY2 for each Service Category must match the SSY2 Cash Other reflected in Exhibit C1.3 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. (2) The SF for each Service Category must match the SF reflected in Exhibit C1.3 (Mandated Program Services), Section I (Units of Service Summary) for each Service Category. (4) Funding Amount for Equipment (Purchase(s)) reflected under SSY2 and SF must match the Equipment (Purchase(s)) Funding Amount reflected in Exhibit C1.3 (Mandated Program Services), Section I (Units of Service Summary). $ 1.00 Job Title Ms. Equipment (Purchases) (4) 909-620-2052 Phone Number Community Service Manager (2) IN-KIND Phone Number $ 10,792 (F) TOTAL FUNDING (B+C+D+E) [Enter] (2) IN-KIND Project Manager Mr. SUBRECIPIENT'S FUNDS (SF) (2) (C) MATCH (3) (D) NON-MATCH (E) PROGRAM INCOME [Enter] [Enter] [Enter] (A) SERVICE CATEGORY (B) SUBAWARD SUM YEAR 2 (SSY2) (1) (1) CASH [Enter] 2005 [email protected] E-Mail Address 909-620-2039 2039 [email protected] Job Title (1) CASH Management Analyst 909-620-2005 (3) TOTAL FUNDING $ - (1) SSY2 $ 1.00 (1) CASH OTHER (2) CASH NSIP $ 10,792 - $ Mike Osoff PROGRAM FUNDING SUMMARY EXHIBIT B1.3 (BUDGET) AMENDMENT 3 {FY 2026-27 NSIP FUNDING} CA 91766 State Zip Code State CA 91769 CONGREGATE MEAL SERVICES 2026-2027 Select Region City of Pomona ENP252607 Subrecipient's Legal Name: 505 S Garey Ave Prefix Pomona Mailing Address (if different from above) City Zip Code Three Modification Number: N/A ALL COSTS REPORTED ON THIS BUDGET MUST BE ALLOWABLE, NECESSARY, AND REASONABLE FOR THE PROGRAM SERVICES TO BE PROVIDED. Nutrition Services Incentive Program (NSIP) C1 Select Supervisorial District Anita Scott 2052 [email protected] Authorized Representative Ext. E-Mail Address City Manager Job Title Ms. Budget Reviewed and Approved by: Jessica Palafox Equipment (Other) (5) (G) UNIT RATE City P.O. Box 660 Pomona (2) SF $ - $ - $ 10,792 (1) CASH [Enter] Prefix Ext. E-Mail Address All Congregate Meals Main Administrative Office Address Phone Number Ext.

ATTACHMENT NO.
2 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] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] CONGREGATE MEAL SERVICES 2026-2027 Nutrition Services Incentive Program (NSIP) C1 (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 [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] Select Region Select Supervisorial District ENP252607 Three Modification Number: N/A City of Pomona Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 2 ATTACHMENT NO.
2 (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 (2): If an individual's time is allocated to multiple Program Services, that individual's time must not exceed 100% when his/her time is totaled for Congregate Meal Services, Home-Delivered Meal Services, and Telephone Reassurance Services. [Complete as needed] [Complete as needed] [Complete as needed] $ - Do indirect costs exceed the fifteen percent (15%) maximum? (5): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) 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: (1): Enter the title of each position. List all mandatory staffing positions noted in Exhibit A (Statement of Work and Attachments). If a mandatory position is performed by staff under a different position/payroll title then list both the position title noted in Exhibit A (Statement of Work and Attachments) and the payroll title (e.g., Project Director/Recreation Director). (3): Enter the amount of funding that Subrecipient will use to fund any portion of the total cost for taxes. (4): Enter the amount of funding that Subrecipient will use to fund any portion of the total cost for benefits. GRAND TOTAL GRAND TOTAL PERSONNEL $ - $ - $ - $ - $ - $ - $ - Indirect Costs (Personnel) [Complete as needed] (5) [Complete as needed] [Complete as needed] $ - $0 $ - $ - $ - $ - $0 INDIRECT (4) (4) (4) TOTAL DIRECT PERSONNEL $ - $ - $ - (4) (4) (4) Taxes [Enter Rate] (3) (3) SUBTOTAL DIRECT PERSONNEL $ - $ - $ - $ - (3) (3) (3) (3) $ - $ - $ - [Enter title] $ - Benefits [Enter Rate] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] [Enter title] Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 3 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: NOTE: (1): When using volunteer services as an in-kind match to meet the minimum required match, this in-kind match must 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 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 (1) (H) NON-MATCH DIRECT City of Pomona [Enter title] [Enter title] CONGREGATE MEAL SERVICES Three Modification Number: 2026-2027 (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 (D) MONTHLY SALARY EQUIVALENT (E) NO. OF MONTHS (F) TOTAL SALARY EQUIVALENT SF (I) TOTAL IN-KIND Nutrition Services Incentive Program (NSIP) C1 Select Region Select Supervisorial District ENP252607 N/A (J) VARIANCE Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 4 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: (1) Effective January 1, 2025 - December 31, 2025, County's approved mileage rate is $0.66 per mile. Effective January 1, 2026, County’s approved mileage rate is $0.685 per mile and State's mileage rate is available online at: http://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx. Reimbursement for mileage must not exceed the lesser of County's rate and State's rate. (2): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) 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 fifteen percent (15%) 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) 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) ENP252607 Three Modification Number: N/A City of Pomona III. BUDGET DETAIL - VOLUNTEER EXPENSES CONGREGATE MEAL SERVICES 2026-2027 Nutrition Services Incentive Program (NSIP) C1 Select Region Select Supervisorial District Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 5 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: CONGREGATE MEAL SERVICES Nutrition Services Incentive Program (NSIP) C1 2026-2027 Select Region Select Supervisorial District ENP252607 N/A City of Pomona I. BUDGET DETAIL - SUBAWARD(S)/SUBCONTRACT(S) FOR CATERED FOOD Three Modification Number: (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 $ 10,792 $ - [Complete as needed] $ 10,792 $ - $ 10,792 $ - $ - $ - $ - $ - $ - $ - INDIRECT $ 10,792 $ - (1): Use this Budget Detail to report Lower Tier Subaward(s)/Subcontract(s) with caterers by entering the name of the caterer. The information provided herein must be included in Exhibit T (List of Lower Tier Subawards). Subrecipient must obtain prior written approval from County before executing Subaward(s). (2): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column G (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) 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 fifteen percent (15%) maximum? Indirect Costs (Lower Tier Subaward(s)/Subcontract(s) for Catered Food) TOTAL DIRECT LOWER TIER SUBAWARD(S)/SUBCONTRACT(S) FOR CATERED FOOD $ - GRAND TOTAL LOWER TIER SUBAWARD(S)/SUBCONTRACT(S) FOR CATERED FOOD [Complete as needed] [Complete as needed] [Complete as needed] [Complete as needed] GRAND TOTAL (2) NOTE: $ - $ 10,792 $0 $ 10,792 $0 DIRECT (A) LOWER TIER SUBRECIPIENT'S/SUBCONTRACTOR(S) NAME (1) (C) UNIT COST (D) NO. OF UNITS (E) NO. OF MONTHS (C*D*E) (F - K) Everytable, PBC All Congregate Meals $ 899 1.00 $ 10,792 $ 10,792 $0 (J) PROGRAM INCOME (1) CASH (B) SERVICE CATEGORY (G) SSY2 (F) SF TOTAL COSTS (K) TOTAL FUNDING (L) VARIANCE [Enter caterer's name] [Enter caterer's name] Select Description Select Description [Enter caterer's name] Select Description [Enter caterer's name] Select Description [Enter caterer's name] [Enter caterer's name] Select Description Select Description 12 $ 10,792 Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 6 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: NOTE: Do indirect costs exceed the fifteen percent (15%) maximum? (1) TOTAL DIRECT RAW FOOD $ - DIRECT All Congregate Meals (1): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). INDIRECT GRAND TOTAL Indirect Costs (Raw Food) GRAND TOTAL RAW FOOD $ - $ - $ - $ - $ - $ - $ - $ - $ - $0 [Complete as needed] $ - $0 [Complete as needed] [Complete as needed] [Complete as needed] $ - $ - $ - $ - $ - $ - $ - [Complete as needed] CONGREGATE MEAL SERVICES (2) IN-KIND (1) CASH (F+G+H+I) (E - J) II. BUDGET DETAIL - RAW FOOD (A) SERVICE CATEGORY (B) UNIT COST (C) NO. OF UNITS (D) NO. OF MONTHS (2) IN-KIND (1) CASH (G) MATCH (H) NON-MATCH (I) PROGRAM INCOME (E) TOTAL COSTS (F) SF SSY2 (J) TOTAL FUNDING (K) VARIANCE (B*C*D) (1) CASH OTHER (2) CASH NSIP (1) CASH 2026-2027 Nutrition Services Incentive Program (NSIP) C1 Three Modification Number: Select Region Select Supervisorial District ENP252607 N/A City of Pomona Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 7 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Subrecipient's Legal Name: [Enter name and description] [Enter name and description] (1): Please submit supporting documentation with this Budget for any unit cost, which exceeds $2.00 per square foot, that will be supported by the SSY2. (2): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) 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 fifteen percent (15%) maximum? GRAND TOTAL GRAND TOTAL SPACE $ - $ - $ - $ - [Complete as needed] [Complete as needed] [Complete as needed] [Complete as needed] [Complete Indirect Costs (Space) (2) as needed] $ - $ - $ - $ - $0 INDIRECT TOTAL DIRECT SPACE $ - $ - $ - $ - [Enter name and description] [Enter name and description] [Enter name and description] [Enter name and description] [Enter name and description] [Enter name and description] DIRECT (A) NAME OF LOCATION AND DESCRIPTION (B) UNIT COST (1) (C) NO. OF UNITS (D) NO. OF MONTHS (E) TOTAL COSTS (F) 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) Three Modification Number: VI. BUDGET DETAIL - SPACE CONGREGATE MEAL SERVICES 2026-2027 Nutrition Services Incentive Program (NSIP) C1 Select Region Select Supervisorial District ENP252607 N/A City of Pomona Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 8 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: 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 (1) CASH (2) IN-KIND (1) CASH [Enter description] Select Select CONGREGATE MEAL SERVICES 2026-2027 Nutrition Services Incentive Program (NSIP) C1 Select Region Select Supervisorial District ENP252607 N/A City of Pomona (J) TOTAL FUNDING (G) MATCH (H) NON-MATCH (I) PROGRAM INCOME (A) DESCRIPTION (1) (B) EQUIPMENT TYPE (2) or (3) (C) UNIT COST (D) NO. OF UNITS (E) TOTAL COSTS (F) SSY2 SF (C*D) (1) (F+G+H+I) CASH OTHER (1) CASH (2) IN-KIND (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 drive and portable hard drives), and/or when Subrecipient will use $500 or more of the SSY2 to purchase the Equipment/Asset. Subrecipient must 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 SSY2 and no later than March 31st of the Fiscal Year. Equipm 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) SSY2 must 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 must report this using any combination of SSY2, 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 must report this using any combination of Match In-kind and/or Non-match In-kind. Three Modification Number: VII. BUDGET DETAIL - EQUIPMENT (K) VARIANCE (E - J) DIRECT [Enter description] Select [Enter description] Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 9 ATTACHMENT NO.
2 Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
(4): Effective January 1, 2025 - December 31, 2025, County's approved mileage rate is $0.66 per mile. Effective January 1, 2026, County’s approved mileage rate is $0.685 per mile and State's mileage rate is available online at:
http://www.calhr.ca.gov/employees/Pages/travel-reimbursements.aspx. Reimbursement for mileage must not exceed the lesser of County's rate and State's rate. (5): Subrecipient must obtain prior written approval from County if utilizing SSY2 for Travel (Other). (6): Subrecipient must contact their assigned Contract Analyst if there is a cost(s) that Subrecipient would like to add that is not included in the drop down list. Subrecipient must provide detailed explanation of the cost to County (7): The maximum reimbursable amount allowable for indirect costs is fifteen percent (15%) of Subrecipient's modified total direct cost reflected under Column F (SSY2 Cash Other). Indirect costs in excess of the fifteen percent (15%) maximum may be budgeted as a match in-kind contribution and used to meet the match requirement (subject to County's prior written approval). (6)
[Complete
as needed]
[Complete
as needed]
[Complete
as needed]
[Complete as
Indirect Costs (Other Costs) needed] NOTE:
(6)
(6)
(6)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
Select Description (2) (3) (4) (5)
(1): Allowable costs are identified in accordance with Title 2 Code of Federal Regulations (CFR) Part 200 and Title 45 Code of Federal Regulations (CFR) Part 75. (2): Subrecipient must obtain prior written approval from County if utilizing SSY2 for Conferences. (3): Subrecipient must provide the following information to your assigned Contract Analyst: (a) Kind of equipment, (b) Indicate whether the equipment lease is program specific or a shared cost, (c) If a shared cost, provide the cost distribution methodology for County review and (d) Length of the lease. $ - - $ $ - $ - $0
Do indirect costs exceed the fifteen percent (15%) maximum? GRAND TOTAL GRAND TOTAL OTHER COSTS $ - $ - - $ - $ [Complete
(7) as needed]
$ - - $ $ - $ - $0

INDIRECT
TOTAL DIRECT OTHER COSTS $ - $ - - $ - $
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) 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)
Three Modification Number:

VIII. BUDGET DETAIL - OTHER COSTS

CONGREGATE MEAL SERVICES
2026-2027
Nutrition Services Incentive Program (NSIP) C1
Select Region
Select Supervisorial District
ENP252607
N/A
City of Pomona
Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 10 ATTACHMENT NO. 2
Program Services:

Fiscal Year:

Funding Type:

Los Angeles County Region:

Supervisorial District:

Subaward Number:

Amendment Number:

Subrecipient's Legal Name:
2 CONGREGATE MEAL SERVICES
2026-2027
Nutrition Services Incentive Program (NSIP) C1
Select Region
Select Supervisorial District
ENP252607
Three Modification Number: N/A
City of Pomona
IX. BUDGET SUMMARY
(A) COST CATEGORIES(B) COSTS (1)(C) FUNDING CATEGORIES(D) FUNDING (1) (1)
Total Budgeted Costs Cash NSIP
(SSY2) $ 10,792
(1)
Total Budgeted Costs
DIRECT
1 Personnel Cash Other
(SSY2) $ - 1 SSY2 Cash Other
(SSY2) $ - Volunteers In-Kind (SF) $ - 3 Volunteer Expenses Cash (SF) $ -
In-Kind (SF) $ - Cash (SF) $ -
In-Kind (SF) $ - 2 Subtotal $ 10,792
4 Lower Tier Subaward(s)/Subcontract(s) for Catered Food Cash Other (SSY2) $ - Cash NSIP
(SSY2) $ 10,792
Cash (SF) $ - Match
In-Kind (SF) $ - Cash (SF) $ -
In-Kind (SF) $ - Cash Other
(SSY2) $ -
5 Raw Food Cash Other
(SSY2) $ - 3 Non-Match
6 Space Cash Other
(SSY2) $ - Cash (SF) In-Kind (SF) $ - $ -
In-Kind (SF) $ - Cash (SF) $ - Cash NSIP
(SSY2) $ - Cash (SF) $ -
In-Kind (SF) $ - 7 Equipment Cash Other
(SSY2) $ - 4 Program Income
8 Other Costs
In-Kind (SF) $ - Cash (SF) $ - Cash (SF) $ -
In-Kind (SF) $ - Cash Other
(SSY2) $ - Cash (SF) $ - Cash Other
(SSY2) $ - Cash NSIP
(SSY2) $ 10,792 Cash NSIP(SSY2) $ 10,792 9 Subtotal Direct Costs Cash Other (SSY2) $ - 5 Subtotal Funding for Direct Costs Cash (SF) $ - Variance (Costs-Funding) Cash
In-Kind

INDIRECT
Cash (SF) $ -
In-Kind (SF) $ -In-Kind (SF) $ - Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 11 ATTACHMENT NO. 2
IX. BUDGET SUMMARY
(A) COST CATEGORIES(B) COSTS (1)(C) FUNDING CATEGORIES(D) FUNDING (1) (1)
Total Budgeted Costs
(1)
Total Budgeted Costs
11 21 12
10 Personnel Cash Other
(SSY2) $ - Volunteers 6 SSY2
12 Volunteer Expenses Cash (SF) Match
$ -
In-Kind (SF) $ - Cash Other
(SSY2) $ - Cash (SF) $ -
In-Kind (SF) $ -
In-Kind (SF) $ - Cash Other
(SSY2) $ -
In-Kind (SF) $ - Cash (SF) $ - 13 Lower Tier Subaward(s)/Subcontract(s) for Catered Food Cash Other (SSY2) $ - Cash (SF) $ -
In-Kind (SF) $ - 7
14 Raw Food Cash Other
(SSY2) $ - 8 Non-Match
15 Space Cash Other
(SSY2) $ - 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
(SSY2) $ - 9 Program Income Cash Other
(SSY2) $ - Cash (SF) $ - Cash (SF) $ - 17 Subtotal Indirect Costs Cash Other(SSY2) $ - 10 Subtotal Funding for Indirect Costs
In-Kind (SF) $ - NOTE:
(1): Costs and Funding must match.

In-Kind (SF) $ -In-Kind (SF) $ - GRAND TOTAL COSTS
$ 10,792 GRAND TOTAL FUNDING$ 10,792
20 Total Costs Cash Other
(SSY2) $ - 11 Total Funding Cash Other(SSY2) $ - Cash NSIP (SSY2)
Variance (Costs-Funding) $0
$ 10,792 Cash NSIP
(SSY2) $ 10,792
Cash (SF) $ - Cash (SF) $ - GRAND TOTAL
In-Kind (SF) $ - Variance (Costs-Funding)
Cash
In-Kind
Exhibit B1.3 (Budget) Amendment 3 {FY 2026-27 NSIP Funding} Page 12 ATTACHMENT NO. 2
Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: 2052 Ext. 2039 Phone Number Ext. 2005 Phone Number Ext. MPS Reviewed and Approved by: Jorge Peña Date: 7/9/2026 COUNTY USE ONLY Assigned Program Analyst: Jorge Peña Assigned Contract Analyst: Jessica Palafox Community Services Manager [email protected] Prefix Project Manager Job Title E-Mail Address Mr. Mike Osoff 909-620-2039 Ms. Stephanie Carbajal Prefix E-Mail Address Ms. Anita Scott 909-620-2311 Phone Number EXHIBIT C1.1 (MANDATED PROGRAM SERVICES) AMENDMENT 3 {FY 2026-27 BASELINE FUNDING} Subrecipient's Legal Name: P.O. Box 660 City Manager [email protected] State Zip Code 505 S Garey Ave Pomona CA 91766 Main Administrative Office Address Budget Analyst Job Title E-Mail Address Pomona CA 91769 Management Analyst 909-620-2005 [email protected] Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title City Congregate Meal Services 2026-27 Older Americans Act Title III C-1 and Net County Cost (NCC) Select Region ENP252607 City of Pomona Three Modification Number: N/A Select Supervisorial District ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Equipment (Other) (9) SSY2 (6) (Cash Other) 12,784 $ 281,603 $ 10.56 $ 11.47 $ 146,603 Congregate Meal Services 2026-27 Older Americans Act Title III C-1 and Net County Cost (NCC) Select Region ENP252607 Select Supervisorial District Three Modification Number: N/A (E) FUNDING AMOUNT (5) (F) NO. OF UNDUPLICATED CLIENTS (1) (C) UNITS OF SERVICE (3) (D) UNIT RATE (2) (A) SERVICE CATEGORY (B) FUNDING SOURCE Subrecipient's Legal Name: City of Pomona (5) The Total and Grand Total amounts under column (E) Funding Amount must match the Total and Grand Total amounts reflected in Exhibit B1.1 (Budget) (cover page) column (F) Total Funding. (9) Enter the amount of equipment (other) that is reflected in Exhibit B1.1 (Budget). I. UNITS OF SERVICE SUMMARY (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 B1.1 (Budget). Equipment (Purchases) (8) [Enter Approved Amount] (2) Please Enter the Unit Rates: a) for SSY2 (Cash Other) (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 the Service Category to be provided using SSY2 (Cash Other) and SF. (4) The Total Unduplicated Units for the Service Category under column (C) Units of Service must match the corresponding Total Units reflected in Section II, (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 and Attachments). These individuals are counted only once within a FY for reporting purposes. All Congregate Meals [Enter Approved Amount] 12,784 12,784 $ 135,000 $ 22.03 120 GRAND TOTAL SERVICES/FUNDING 12,784 $ 281,603 120 SF (7) (Cash and In-Kind) Total (4) Exhibit C1.1 (Mandated Program Services) Amendment 3 {FY 2026-27 Baseline Funding} Page 2 ATTACHMENT NO.
2 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) 1 120 1,065 1,065 1,065 1,065 1,065 1,065 1,065 1,065 1,065 1,065 1,065 1,065 12,784 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 0 120 1,065 1,065 1,065 1,065 1,065 1,065 1,065 1,065 1,065 1,065 1,065 1,065 12,784 NOTE: (1) The Grand Total Units under column (P) Total must match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total. Grand Total II. SERVICES BY MONTH - ALL CONGREGATE MEALS (B) SITE NAME All Congregate Meals ENP252607 Congregate Meal Services 2026-27 Older Americans Act Title III C-1 and Net County Cost (NCC) Select Region Select Supervisorial District Subrecipient's Legal Name: City of Pomona Three Modification Number: N/A Exhibit C1.1 (Mandated Program Services) Amendment 3 {FY 2026-27 Baseline Funding} Page 3 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: 2052 Ext. 2039 Phone Number Ext. 2005 Phone Number Ext. City Congregate Meal Services 2026-27 Modernizing Older Californians Act (MOCA) Select Region ENP252607 City of Pomona Three Modification Number: N/A Select Supervisorial District Budget Analyst Job Title E-Mail Address Pomona CA 91769 Management Analyst 909-620-2005 [email protected] Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title EXHIBIT C1.2 (MANDATED PROGRAM SERVICES) AMENDMENT 3 {FY 2026-27 MOCA FUNDING} Subrecipient's Legal Name: P.O. Box 660 City Manager [email protected] State Zip Code 505 S Garey Ave Pomona CA 91767 Main Administrative Office Address E-Mail Address Ms. Anita Scott 909-620-2311 Phone Number Community Service Manager [email protected] Prefix Project Manager Job Title E-Mail Address Mr. Mike Osoff 909-620-2039 Ms. Stephanie Carbajal Prefix MPS Reviewed and Approved by: Jorge Peña Date: 7/9/2026 COUNTY USE ONLY Assigned Program Analyst: Jorge Peña Assigned Contract Analyst: Jessica Palafox ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Equipment (Other) (9) 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 and Attachments). These individuals are counted only once within a FY for reporting purposes. All Congregate Meals [Enter Approved Amount] 3,977 - $ 42,000 $ 10.56 120 GRAND TOTAL SERVICES/FUNDING 3,977 $ 42,000 120 SF (7) (Cash and In-Kind) Total (4) (5) The Total and Grand Total amounts under column (E) Funding Amount must match the Total and Grand Total amounts reflected in Exhibit B1.2 (Budget) (cover page) column (F) Total Funding. (9) Enter the amount of equipment (other) that is reflected in Exhibit B1.2 (Budget). I. UNITS OF SERVICE SUMMARY (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 B1.2 (Budget). Equipment (Purchases) (8) [Enter Approved Amount] (2) Please Enter the Unit Rates: a) for SSY2 (Cash Other) (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 the Service Category to be provided using SSY2 (Cash Other) and SF. (4) The Total Unduplicated Units for the Service Category under column (C) Units of Service must match the corresponding Total Units reflected in Section II, (Services by Month) column (P) Total. Three Modification Number: N/A (E) FUNDING AMOUNT (5) (F) NO. OF UNDUPLICATED CLIENTS (1) (C) UNITS OF SERVICE (3) (D) UNIT RATE (2) (A) SERVICE CATEGORY (B) FUNDING SOURCE Subrecipient's Legal Name: City of Pomona Congregate Meal Services 2026-27 Modernizing Older Californians Act (MOCA) Select Region ENP252607 Select Supervisorial District SSY2 (6) (Cash Other) 3,977 $ 42,000 $ 10.56 $ - $ - Exhibit C1.2 (Mandated Program Services) Amendment 3 {FY 2026-27 MOCA Funding} Page 2 ATTACHMENT NO.
2 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) 1 120 331 331 331 331 331 331 331 331 331 331 331 331 3,977 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 0 120 331 331 331 331 331 331 331 331 331 331 331 331 3,977 NOTE: (1) The Grand Total Units under column (P) Total must match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total. Subrecipient's Legal Name: City of Pomona Three Modification Number: N/A ENP252607 Congregate Meal Services 2026-27 Modernizing Older Californians Act (MOCA) Select Region Select Supervisorial District II. SERVICES BY MONTH - ALL CONGREGATE MEALS (B) SITE NAME All Congragate Meals Grand Total Exhibit C1.2 (Mandated Program Services) Amendment 3 {FY 2026-27 MOCA Funding} Page 3 ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: 2052 Ext. 2039 Phone Number Ext. 2005 Phone Number Ext. MPS Reviewed and Approved by: Jorge Peña Date: 7/9/2026 COUNTY USE ONLY Assigned Program Analyst: Jorge Peña Assigned Contract Analyst: Jessica Palafox Community Service Manager [email protected] Prefix Project Manager Job Title E-Mail Address Mr. Mike Osoff 909-620-2039 Ms. Stephanie Carbajal Prefix E-Mail Address Ms. Anita Scott 909-620-2311 Phone Number EXHIBIT C1.1 (MANDATED PROGRAM SERVICES) AMENDMENT 3 {FY 2026-27 NSIP FUNDING} Subrecipient's Legal Name: P.O. Box 660 City Manager [email protected] State Zip Code 505 S Garey Ave Pomona CA 91767 Main Administrative Office Address Budget Analyst Job Title E-Mail Address Pomona CA 91769 Management Analyst 909-620-2005 [email protected] Mailing Address (if different from above) City State Zip Code Prefix Authorized Representative Job Title City Congregate Meal Services 2026-27 Nutrition Services Incentive Program (NSIP) C1 Select Region ENP252607 City of Pomona Three Modification Number: N/A Select Supervisorial District ATTACHMENT NO.
2 Program Services: Fiscal Year: Funding Type: Los Angeles County Region: Supervisorial District: Subaward Number: Amendment Number: Equipment (Other) (9) $ 10,792 $ 1.00 SF (7) (Cash and In-Kind) [Enter Units] [Enter Unit Rate] Congregate Meal Services 2026-27 Nutrition Services Incentive Program (NSIP) C1 Select Region ENP252607 Select Supervisorial District Three Modification Number: N/A (E) FUNDING AMOUNT (5) (F) NO. OF UNDUPLICATED CLIENTS (1) (C) UNITS OF SERVICE (3) (D) UNIT RATE (2) (A) SERVICE CATEGORY (B) FUNDING SOURCE Subrecipient's Legal Name: City of Pomona (5) The Total and Grand Total amounts under column (E) Funding Amount must match the Total and Grand Total amounts reflected in Exhibit B1.3 (Budget) (cover page) column (F) Total Funding. (9) Enter the amount of equipment (other) that is reflected in Exhibit B1.3 (Budget). I. UNITS OF SERVICE SUMMARY (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 B1.3 (Budget). Equipment (Purchases) (8) [Enter Approved Amount] (2) Please Enter the Unit Rates: a) 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 the Service Category to be provided using SSY2 (Cash NSIP) and SF. (4) The Total Unduplicated Units for the Service Category under column (C) Units of Service must match the corresponding Total Units reflected in Section II, (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 and Attachments). These individuals are counted only once within a FY for reporting purposes. All Congregate Meals [Enter Approved Amount] 10,792 $ 10,792 $ 1.00 120 GRAND TOTAL SERVICES/FUNDING - $ 10,792 120 Total (4) SSY2 (6) (Cash NSIP) [Enter Total Unduplicated Units] Exhibit C1.3 (Mandated Program Services) Amendment 3 {FY 2026-27 NSIP Funding} Page 2 ATTACHMENT NO.
2 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) 1 120 899 899 899 899 899 899 899 899 899 899 899 899 10,792 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 0 120 899 899 899 899 899 899 899 899 899 899 899 899 10,792 NOTE: (1) The Grand Total Units under column (P) Total must match the Total reflected in Section I (Units of Service Summary) column (C) Units of Service Total. Grand Total II. SERVICES BY MONTH - ALL CONGREGATE MEALS (B) SITE NAME All Congregate Meals ENP252607 Congregate Meal Services 2026-27 Nutrition Services Incentive Program (NSIP) C1 Select Region Select Supervisorial District Subrecipient's Legal Name: City of Pomona Three Modification Number: N/A Exhibit C1.3 (Mandated Program Services) Amendment 3 {FY 2026-27 NSIP Funding} Page 3 ATTACHMENT NO.
2 EXHIBIT D
(COUNTY'S ADMINISTRATION)
FISCAL YEAR: 202 -2

COUNTY DEPARTMENT HEAD
Name: Maral Karaccusian
Title: Director
Address: 510 South Vermont Avenue
Los Angeles, Ca 90020
Telephone: (213) 716-9002
E-Mail Address: [email protected]

COUNTY CONTRACT MANAGER
Name: Ms. Irma Panosian
Title: Administrative Services Manager III
Address: 510 South Vermont Avenue
Los Angeles, Ca 90020
Telephone: (323) 336-5426
E-Mail Address: [email protected]

COUNTY PROGRAM MANAGER
Name: Mr. Miguel Robleto
Title: Program Manager
Address: 510 South Vermont Avenue
Los Angeles, Ca 90020
Telephone: (213) 738-2737
E-Mail Address: [email protected]

COUNTY COMPLIANCE MANAGER
Name: Ms. Susana Ortega
Title: Program Manager
Address: 510 South Vermont Avenue
Los Angeles, Ca 90020
Telephone: (323) 459-9141
E-Mail Address: [email protected]

COUNTY EMERGENCY COORDINATOR
Name: Mr. Henry Lopez
Title: Program Manager
Address: 510 South Vermont Avenue
Los Angeles, Ca 90020
Telephone: (213) 738-2337
E-Mail Address: [email protected]
ATTACHMENT NO. 2
ATTACHMENT NO. 2
ATTACHMENT NO. 2
ATTACHMENT NO. 2
ATTACHMENT NO. 2

EXHIBIT
(INTENTIONALLY OMITTED)
ATTACHMENT NO. 2

EXHIBIT H
(BUSINESS ASSOCIATE AGREEMENT

UNDER THE HEALTH INSURANCE PORTABILITY
AND ACCOUNTABILITY ACT OF 1996 ("HIPAA"))
County is a Covered Entity as defined by, and subject to the requirements and prohibitions of, the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, Public Law 104- omulgated
thereunder, including the Privacy, Security, Breach Notification, and Enforcement Rules at 45 Code of Federal Regulations (C.F.R.) Parts 160 and 164 (collectively, the "HIPAA Rules").

Contractor performs or provides functions, activities or services to County that require Contractor in order to provide such functions, activities or services to create, access, receive, maintain, and/or transmit information that includes or that may include Protected Health Information, as defined by the HIPAA Rules. As such, Contractor is a Business Associate, as defined by the HIPAA Rules, and is therefore subject to those provisions of the HIPAA Rules that are applicable to Business Associates.

The HIPAA Rules require a written agreement ("Business Associate Agreement") between County and Contractor in order to mandate certain protections for the privacy and security of Protected Health Information, and these HIPAA Rules prohibit the disclosure to or use of Protected Health Information by Contractor if such an agreement is not in place.

This Business Associate Agreement and its provisions are intended to protect the privacy and provide for the security of Protected Health Information disclosed to or used by Contractor in compliance with the HIPAA Rules.

Therefore, the parties agree as follows:

1. DEFINITIONS

1.1 "Breach" has the same meaning as the term "breach" at 45 C.F.R. § 164.402.

1.2 "Business Associate" has the same meaning as the term "business associate" at 45 C.F.R. § 160.103. For the convenience of the parties, a "business associate" is a person or entity, other than a member of the workforce of covered entity, who performs functions or activities on behalf of, or provides certain services to, a covered entity that involve access by the business associate to Protected Health Information. A "business associate" also is a subcontractor that creates, receives, maintains, or transmits Protected Health Information on behalf of another business associate. And in reference to the party to this Business Associate Agreement "Business Associate" shall mean Contractor.

ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 2

1.3 C.F.R. § 160.103, and in reference to the party to this Business Associate Agreement, "Covered Entity" shall mean County.

1.4 "Data Aggregation" has the same meaning as the term "data aggregation" at 45 C.F.R. § 164.501.

1.5 "De-identification" refers to the de-identification standard at 45 C.F.R. § 164.514.

1.6 "Designated Record Set" has the same meaning as the term "designated record set" at 45 C.F.R. § 164.501.

1.7 Information, the release, transfer, provision of access to, or divulging in any other manner of Protected Health Information
internal operations or to other than its workforce. (See 45 C.F.R. § 160.103.)

1.8 -related
information on an individual that is created, gathered, managed, and consulted by authorized health care clinicians and staff. (See 42 U.S. C. § 17921.)

1.9 45 C.F.R. § 160.103. For the convenience of the parties, electronic media means (1) Electronic storage material on which data is or may be recorded electronically, including, for example, devices in computers (hard drives) and any removable/transportable digital memory medium, such as magnetic tape or disk, optical disk, or digital memory card; (2) Transmission media used to exchange information already in electronic storage media.

Transmission media include, for example, the Internet, extranet or intranet, leased lines, dial-up lines, private networks, and the physical movement of removable/transportable electronic storage media. Certain transmissions, including of paper, via facsimile, and of voice, via telephone, are not considered to be transmissions via electronic media if the information being exchanged did not exist in electronic form immediately before the transmission.

1.10 limited to Protected Health Information created or received by Business Associate from or on behalf of Covered Entity. For the convenience of the parties, Electronic Protected Health Information means Protected Health Information that is (i) transmitted by electronic media; (ii) maintained in electronic media.

ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 3

1.11 "Health Care Operations" has the same meaning as the term "health care operations" at 45 C.F.R. § 164.501.

1.12 160.103. For the convenience of the parties, Individual means the person who is the subject of Protected Health Information and shall include a person who qualifies as a personal representative in accordance with 45 C.F.R. § 164.502 (g).

1.13 "Law Enforcement Official" has the same meaning as the term "law enforcement official" at 45 C.F.R. § 164.103.

1.14 "Minimum Necessary" refers to the minimum necessary standard at 45 C.F.R. § 164.502 (b).

1.15 information created or received by Business Associate from or on behalf of Covered Entity. For the convenience of the parties, Protected Health Information includes information that (i) relates to the past, present or future physical or mental health or condition of an Individual; the provision of health care to an Individual, or the past, present or future payment for the provision of health care to an Individual; (ii) identifies the Individual (or for which there is a reasonable basis for believing that the information can be used to identify the Individual); and (iii) is created, received, maintained, or transmitted by Business Associate from or on behalf of Covered Entity, and includes Protected Health Information that is made accessible to Business Associate by C
Electronic Protected Health Information.

1.16 45 C.F.R. § 164.103.

1.17 "Secretary" has the same meaning as the term "secretary" at 45 C.F.R. § 160.103

1.18 45 C.F.R. § 164.304.

1.19 services in the applicable underlying Agreement, Contract, Master Agreement, Work Order, or Purchase Order or other service arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate.

ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 4

1.20 "Subcontractor" has the same meaning as the term "subcontractor" at 45 C.F.R. § 160.103.

1.21 "Unsecured Protected Health Information" has the same meaning as the

1.22 sharing, employment, application, utilization, examination or analysis of C.F.R § 164.103.)

1.23 Terms used, but not otherwise defined in this Business Associate Agreement, have the same meaning as those terms in the HIPAA Rules.

2. PERMITTED AND REQUIRED USES AND DISCLOSURES OF PROTECTED

HEALTH INFORMATION

2.1 Business Associate may only Use and/or Disclose Protected Health Information as necessary to perform Services, and/or as necessary to comply with the obligations of this Business Associate Agreement.

2.2 Business Associate may Use Protected Health Information for deidentification of the information if de-identification of the information is required to provide Services.

2.3 Business Associate may Use or Disclose Protected Health Information as Required by Law.

2.4 Business Associate shall make Uses and Disclosures and requests for applicable Minimum Necessary policies and procedures.

2.5 Business Associate may Use Protected Health Information as necessary for the proper management and administration of its business or to carry out its legal responsibilities.

2.6 Business Associate may Disclose Protected Health Information as necessary for the proper management and administration of its business or to carry out its legal responsibilities, provided the Disclosure is Required by Law or Business Associate obtains reasonable assurances from the person to whom the Protected Health Information is disclosed (i.e., the recipient) that it will be held confidentially and Used or further Disclosed only as Required by Law or for the purposes for which it was disclosed to the recipient and the recipient notifies Business Associate of any instances of which it is aware in which the confidentiality of the Protected Health Information has been breached.

ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 5

2.7 Business Associate may provide Data Aggregation services relating to Covered Entity's Health Care Operations if such Data Aggregation services are necessary in order to provide Services.

3. PROHIBITED USES AND DISCLOSURES OF PROTECTED HEALTH

INFORMATION

3.1 Business Associate shall not Use or Disclose Protected Health Information other than as permitted or required by this Business Associate Agreement or as Required by Law.

3.2 Business Associate shall not Use or Disclose Protected Health Information in a manner that would violate Subpart E of 45 C.F.R. Part 164 if done by Covered Entity, except for the specific Uses and Disclosures set forth in Sections 2.5 and 2.6.

3.3 Business Associate shall not Use or Disclose Protected Health Information for de-identification of the information except as set forth in section 2.2.

4. OBLIGATIONS TO SAFEGUARD PROTECTED HEALTH INFORMATION

4.1 Business Associate shall implement, use, and maintain appropriate safeguards to prevent the Use or Disclosure of Protected Health Information other than as provided for by this Business Associate Agreement.

4.2 Business Associate shall comply with Subpart C of 45 C.F.R Part 164 with respect to Electronic Protected Health Information, to prevent the Use or Disclosure of such information other than as provided for by this Business Associate Agreement.

5. REPORTING NON-PERMITTED USES OR DISCLOSURES, SECURITY

INCIDENTS, AND BREACHES OF UNSECURED PROTECTED HEALTH

INFORMATION

5.1 Business Associate shall report to Covered Entity any Use or Disclosure of Protected Health Information not permitted by this Business Associate Agreement, any Security Incident, and/ or any Breach of Unsecured Protected Health Information as further described in Sections 5.1.1, 5.1.2, and 5.1.3.

5.1.1 Business Associate shall report to Covered Entity any Use or Disclosure of Protected Health Information by Business Associate, its employees, representatives, agents or Subcontractors not provided for by this Agreement of which Business Associate becomes aware.

ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 6

5.1.2 Business Associate shall report to Covered Entity any Security Incident of which Business Associate becomes aware.

5.1.3. Business Associate shall report to Covered Entity any Breach by Business Associate, its employees, representatives, agents, workforce members, or Subcontractors of Unsecured Protected Health Information that is known to Business Associate or, by exercising reasonable diligence, would have been known to Business Associate. Business Associate shall be deemed to have knowledge of a Breach of Unsecured Protected Health Information if the Breach is known, or by exercising reasonable diligence would have been known, to any person, other than the person committing the Breach, who is an employee, officer, or other agent of Business Associate, including a Subcontractor, as determined in accordance with the federal common law of agency.

5.2 Except as provided in Section 5.3, for any reporting required by Section 5.1, Business Associate shall provide, to the extent available, all information required by, and within the times frames specified in, Sections 5.2.1 and

5.2.2. 5.2.1 Business Associate shall make an immediate telephonic report upon discovery of the non-permitted Use or Disclosure of Protected Health Information, Security Incident or Breach of Unsecured Protected Health Information to (562) 940-3335 that minimally includes:
(a) A brief description of what happened, including the date of the non-permitted Use or Disclosure, Security Incident, or Breach and the date of Discovery of the non-permitted Use or
Disclosure, Security Incident, or Breach, if known;
(b) The number of Individuals whose Protected Health
Information is involved;
(c) A description of the specific type of Protected Health Information involved in the non-permitted Use or Disclosure, Security Incident, or Breach (such as whether full name, social security number, date of birth, home address, account
number, diagnosis, disability code or other types of
information were involved);
(d) The name and contact information for a person highly knowledge of the facts and circumstances of the nonpermitted Use or Disclosure of PHI, Security Incident, or Breach
ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 7

5.2.2 Business Associate shall make a written report without unreasonable delay and in no event later than three (3) business days from the date of discovery by Business Associate of the non-permitted Use or Disclosure of Protected Health Information, Security Incident, or Breach of Unsecured Protected Health Information and to the HIPAA Compliance Officer at: Hall of Records, County of Los Angeles, Chief Executive Office, Risk Management Branch-Office of Privacy, 320 W. Temple Street, 7th Floor, Los Angeles,
California 90012, [email protected], that includes, to the extent possible:
(a) A brief description of what happened, including the date of the non-permitted Use or Disclosure, Security Incident, or Breach and the date of Discovery of the non-permitted Use or
Disclosure, Security Incident, or Breach, if known;
(b) The number of Individuals whose Protected Health
Information is involved;
(c) A description of the specific type of Protected Health Information involved in the non-permitted Use or Disclosure, Security Incident, or Breach (such as whether full name, social security number, date of birth, home address, account
number, diagnosis, disability code or other types of
information were involved);
(d) The identification of each Individual whose Unsecured Protected Health Information has been, or is reasonably believed by Business Associate to have been, accessed,
acquired, Used, or Disclosed;
(e) Any other information necessary to conduct an assessment of whether notification to the Individual(s) under 45 C.F.R. § 164.404 is required;
(f) Any steps Business Associate believes that the Individual(s) could take to protect him or herself from potential harm from the non-permitted Use or Disclosure, Security Incident, or Breach;
(g) A brief description of what Business Associate is doing to investigate, to mitigate harm to the Individual(s), and to protect against any further similar occurrences; and
(h) The name and contact information for a person highly knowledge of the facts and circumstances of the nonATTACHMENT NO. 2 Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 8
permitted Use or Disclosure of PHI, Security Incident, or Breach.

5.2.3 If Business Associate is not able to provide the information specified in Section 5.2.1 or 5.2.2 at the time of the required report, Business Associate shall provide such information promptly thereafter as such information becomes available.

5.3 Business Associate may delay the notification required by Section 5.1.3, if a law enforcement official states to Business Associate that notification would impede a criminal investigation or cause damage to national security.

5.3.1 If the law enforcement official's statement is in writing and specifies the time for which a delay is required, Business Associate shall delay its reporting and/or notification obligation(s) for the time period specified by the official.

5.3.2 If the statement is made orally, Business Associate shall document the statement, including the identity of the official making the statement, and delay its reporting and/or notification obligation(s) temporarily and no longer than 30 days from the date of the oral statement, unless a written statement as described in Section 5.3.1 is submitted during that time.

6. WRITTEN ASSURANCES OF SUBCONTRACTORS

6.1 In accordance with 45 C.F.R. § 164.502 (e)(1)(ii) and § 164.308 (b)(2), if applicable, Business Associate shall ensure that any Subcontractor that creates, receives, maintains, or transmits Protected Health Information on behalf of Business Associate is made aware of its status as a Business Associate with respect to such information and that Subcontractor agrees in writing to the same restrictions, conditions, and requirements that apply to Business Associate with respect to such information.

6.2 Business Associate shall take reasonable steps to cure any material breach or violation by Subcontractor of the agreement required by Section 6.1.

6.3 If the steps required by Section 6.2 do not cure the breach or end the violation, Contractor shall terminate, if feasible, any arrangement with Subcontractor by which Subcontractor creates, receives, maintains, or transmits Protected Health Information on behalf of Business Associate.

6.4 If neither cure nor termination as set forth in Sections 6.2 and 6.3 is feasible, Business Associate shall immediately notify County.

ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 9

6.5 Without limiting the requirements of Section 6.1, the agreement required by Section 6.1 (Subcontractor Business Associate Agreement) shall require Subcontractor to contemporaneously notify Covered Entity in the event of a Breach of Unsecured Protected Health Information.

6.6 Without limiting the requirements of Section 6.1, agreement required by Section 6.1 (Subcontractor Business Associate Agreement) shall include a provision requiring Subcontractor to destroy, or in the alternative to return to Business Associate, any Protected Health Information created, received, maintained, or transmitted by Subcontractor on behalf of Business Associate so as to enable Business Associate to comply with the provisions of Section 18.4.

6.7 Business Associate shall provide to Covered Entity, at Covered Entity's request, a copy of any and all Subcontractor Business Associate Agreements required by Section 6.1.

6.8 Sections 6.1 and 6.7 are not intended by the parties to limit in any way the scope of Business Associate's obligations related to Subcontracts or Subcontracting in the applicable underlying Agreement, Contract, Master Agreement, Work Order, Purchase Order, or other services arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate.

7. ACCESS TO PROTECTED HEALTH INFORMATION

7.1 To the extent Covered Entity determines that Protected Health Information is maintained by Business Associate or its agents or Subcontractors in a Designated Record Set, Business Associate shall, within two (2) business days after receipt of a request from Covered Entity, make the Protected Health Information specified by Covered Entity available to the Individual(s) identified by Covered Entity as being entitled to access and shall provide such Individuals(s) or other person(s) designated by Covered Entity with a copy the specified Protected Health Information, in order for Covered Entity to meet the requirements of 45 C.F.R. § 164.524.

7.2 If any Individual requests access to Protected Health Information directly from Business Associate or its agents or Subcontractors, Business Associate shall notify Covered Entity in writing within two (2) days of the receipt of the request. Whether access shall be provided or denied shall be determined by Covered Entity.

7.3 To the extent that Business Associate maintains Protected Health Information that is subject to access as set forth above in one or more Designated Record Sets electronically and if the Individual requests an electronic copy of such information, Business Associate shall provide the ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 10
Individual with access to the Protected Health Information in the electronic form and format requested by the Individual, if it is readily producible in such form and format; or, if not, in a readable electronic form and format as agreed to by Covered Entity and the Individual.

8. AMENDMENT OF PROTECTED HEALTH INFORMATION

8.1 To the extent Covered Entity determines that any Protected Health Information is maintained by Business Associate or its agents or Subcontractors in a Designated Record Set, Business Associate shall, within ten (10) business days after receipt of a written request from Covered Entity, make any amendments to such Protected Health Information that are requested by Covered Entity, in order for Covered Entity to meet the requirements of 45 C.F.R. § 164.526.

8.2 If any Individual requests an amendment to Protected Health Information directly from Business Associate or its agents or Subcontractors, Business Associate shall notify Covered Entity in writing within five (5) days of the receipt of the request. Whether an amendment shall be granted or denied shall be determined by Covered Entity.

9. ACCOUNTING OF DISCLOSURES OF PROTECTED HEALTH INFORMATION

9.1 Business Associate shall maintain an accounting of each Disclosure of Protected Health Information made by Business Associate or its employees, agents, representatives or Subcontractors, as is determined by Covered Entity to be necessary in order to permit Covered Entity to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 C.F.R. § 164.528.

9.1.1 Any accounting of disclosures provided by Business Associate under Section 9.1 shall include:
(a) The date of the Disclosure;
(b) The name, and address if known, of the entity or person who received the Protected Health Information;
(c) A brief description of the Protected Health Information Disclosed; and
(d) A brief statement of the purpose of the Disclosure.

9.1.2 For each Disclosure that could require an accounting under Section

9.1, Business Associate shall document the information specified in Section 9.1.1, and shall maintain the information for six (6) years from the date of the Disclosure.

ATTACHMENT NO. 2

9.2 Business Associate shall provide to Covered Entity, within ten (10) business days after receipt of a written request from Covered Entity, information collected in accordance with Section 9.1.1 to permit Covered Entity to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 C.F.R. § 164.528

9.3 If any Individual requests an accounting of disclosures directly from Business Associate or its agents or Subcontractors, Business Associate shall notify Covered Entity in writing within five (5) days of the receipt of the request, and shall provide the requested accounting of disclosures to the Individual(s) within 30 days. The information provided in the accounting shall be in accordance with 45 C.F.R. § 164.528.

10. COMPLIANCE WITH APPLICABLE HIPAA RULES

10.1 To the extent Business Associate is to carry out one or more of Covered Entity's obligation(s) under Subpart E of 45 C.F.R. Part 164, Business Associate shall comply with the requirements of Subpart E that apply to Covered Entity's performance of such obligation(s).

10.2 Business Associate shall comply with all HIPAA Rules applicable to Business Associate in the performance of Services.

11. AVAILABILITY OF RECORDS

11.1 Business Associate shall make its internal practices, books, and records relating to the Use and Disclosure of Protected Health Information received from, or created or received by Business Associate on behalf of Covered Entity available to the Secretary for purposes of determining Covered

11.2 Unless prohibited by the Secretary, Business Associate shall immediately notify Covered Entity of any requests made by the Secretary and provide Covered Entity with copies of any documents produced in response to such request.

12. MITIGATION OF HARMFUL EFFECTS

12.1 Business Associate shall mitigate, to the extent practicable, any harmful effect of a Use or Disclosure of Protected Health Information by Business Associate in violation of the requirements of this Business Associate Agreement that is known to Business Associate.

13. BREACH NOTIFICATION TO INDIVIDUALS

13.1 Business Associate shall, to the extent Covered Entity determines that there has been a Breach of Unsecured Protected Health Information by Business Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 11
ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 12
Associate, its employees, representatives, agents or Subcontractors, provide breach notification to the Individual in a manner that permits Covered Entity to comply with its obligations under 45 C.F.R. § 164.404.

13.1.1 Business Associate shall notify, subject to the review and approval of Covered Entity, each Individual whose Unsecured Protected Health Information has been, or is reasonably believed to have been, accessed, acquired, Used, or Disclosed as a result of any such Breach.

13.1.2 The notification provided by Business Associate shall be written in plain language, shall be subject to review and approval by Covered Entity, and shall include, to the extent possible:
(a) A brief description of what happened, including the date of the Breach and the date of the Discovery of the Breach, if known; (b) A description of the types of Unsecured Protected Health Information that were involved in the Breach (such as whether full name, social security number, date of birth, home address, account number, diagnosis, disability code, or other types of information were involved);
(c) Any steps the Individual should take to protect him or herself from potential harm resulting from the Breach;
(d) A brief description of what Business Associate is doing to investigate the Breach, to mitigate harm to Individual(s), and to protect against any further Breaches; and
(e) Contact procedures for Individual(s) to ask questions or learn additional information, which shall include a toll-free telephone number, an e-mail address, Web site, or postal address.

13.2 Covered Entity, in its sole discretion, may elect to provide the notification required by Section 13.1 and/or to establish the contact procedures described in Section 13.1.2.

13.3 Business Associate shall reimburse Covered Entity any and all costs incurred by Covered Entity, in complying with Subpart D of 45 C.F.R. Part 164, including but not limited to costs of notification, internet posting, or media publication, as a result of Business Associate's Breach of Unsecured Protected Health Information; Covered Entity shall not be responsible for any costs incurred by Business Associate in providing the notification ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 13
required by 13.1 or in establishing the contact procedures required by Section 13.1.2.

14. INDEMNIFICATION

14.1 Business Associate shall indemnify, defend, and hold harmless Covered Entity, its Special Districts, elected and appointed officers, employees, and agents from and against any and all liability, including but not limited to demands, claims, actions, fees, costs, expenses (including attorney and expert witness fees), and penalties and/or fines (including regulatory penalties and/or fines), arising from or connected with Business Associate's acts and/or omissions arising from and/or relating to this Business Associate Agreement, including, but not limited to, compliance and/or enforcement actions and/or activities, whether formal or informal, by the Secretary or by the Attorney General of the State of California.

14.2 Section 14.1 is not intended by the parties to limit in any way the scope of Business Associate's obligations related to Insurance and/or Indemnification in the applicable underlying Agreement, Contract, Master Agreement, Work Order, Purchase Order, or other services arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate.

15. OBLIGATIONS OF COVERED ENTITY

15.1 Covered Entity shall notify Business Associate of any current or future restrictions or limitations on the Use or Disclosure of Protected Health Services, and Business Associate shall thereafter restrict or limit its own Uses and Disclosures accordingly.

15.2 Covered Entity shall not request Business Associate to Use or Disclose Protected Health Information in any manner that would not be permissible under Subpart E of 45 C.F.R. Part 164 if done by Covered Entity, except to the extent that Business Associate may Use or Disclose Protected Health Information as provided in Sections 2.3, 2.5, and 2.6.

16. TERM

16.1 Unless sooner terminated as set forth in Section 17, the term of this Business Associate Agreement shall be the same as the term of the applicable underlying Agreement, Contract, Master Agreement, Work Order, Purchase Order, or other service arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate.

ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 14

16.2 Sections 11, 14, and 18 shall survive the termination or expiration of this Business Associate Agreement.

17. TERMINATION FOR CAUSE

17.1 In addition to and notwithstanding the termination provisions set forth in the applicable underlying Agreement, Contract, Master Agreement, Work Order, Purchase Order, or other services arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate, if either party determines that the other party has violated a material term of this Business Associate Agreement, and the breaching party has not cured the breach or ended the violation within the time specified by the nonbreaching party, which shall be reasonable given the nature of the breach and/or violation, the non-breaching party may terminate this Business Associate Agreement.

17.2 In addition to and notwithstanding the termination provisions set forth in the applicable underlying Agreement, Contract, Master Agreement, Work Order, Purchase Order, or other services arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate, if either party determines that the other party has violated a material term of this Business Associate Agreement, and cure is not feasible, the nonbreaching party may terminate this Business Associate Agreement immediately.

18. DISPOSITION OF PROTECTED HEALTH INFORMATION UPON

TERMINATION OR EXPIRATION

18.1 Except as provided in Section 18.3, upon termination for any reason or expiration of this Business Associate Agreement, Business Associate shall return or, if agreed to by Covered entity, shall destroy as provided for in Section 18.2, all Protected Health Information received from Covered Entity, or created, maintained, or received by Business Associate on behalf of Covered Entity, that Business Associate, including any Subcontractor, still maintains in any form. Business Associate shall retain no copies of the Protected Health Information.

18.2 Destruction for purposes of Section 18.2 and Section 6.6 shall mean that media on which the Protected Health Information is stored or recorded has been destroyed and/or electronic media have been cleared, purged, or destroyed in accordance with the use of a technology or methodology specified by the Secretary in guidance for rendering Protected Health Information unusable, unreadable, or indecipherable to unauthorized individuals.

ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 15

18.3 Notwithstanding Section 18.1, in the event that return or destruction of Protected Health Information is not feasible or Business Associate determines that any such Protected Health Information is necessary for Business Associate to continue its proper management and administration or to carry out its legal responsibilities, Business Associate may retain that Protected Health Information for which destruction or return is infeasible or that Protected Health Information which is necessary for Business Associate to continue its proper management and administration or to carry out its legal responsibilities and shall return or destroy all other Protected Health Information.

18.3.1 Business Associate shall extend the protections of this Business Associate Agreement to such Protected Health Information, including continuing to use appropriate safeguards and continuing to comply with Subpart C of 45 C.F.R Part 164 with respect to Electronic Protected Health Information, to prevent the Use or Disclosure of such information other than as provided for in Sections

2.5 and 2.6 for so long as such Protected Health Information is retained, and Business Associate shall not Use or Disclose such Protected Health Information other than for the purposes for which such Protected Health Information was retained.

18.3.2 Business Associate shall return or, if agreed to by Covered entity, destroy the Protected Health Information retained by Business Associate when it is no longer needed by Business Associate for Business Associate's proper management and administration or to carry out its legal responsibilities.

18.4 Business Associate shall ensure that all Protected Health Information created, maintained, or received by Subcontractors is returned or, if agreed to by Covered entity, destroyed as provided for in Section 18.2.

19. AUDIT, INSPECTION, AND EXAMINATION

19.1 Covered Entity reserves the right to conduct a reasonable inspection of the facilities, systems, information systems, books, records, agreements, and policies and procedures relating to the Use or Disclosure of Protected Health Information for the purpose determining whether Business Associate is in compliance with the terms of this Business Associate Agreement and any non-compliance may be a basis for termination of this Business Associate Agreement and the applicable underlying Agreement, Contract, Master Agreement, Work Order, Purchase Order or other services arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate, as provided for in section 17.

ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 16

19.2 Covered Entity and Business Associate shall mutually agree in advance upon the scope, timing, and location of any such inspection.

19.3 At Business Associate's request, and to the extent permitted by law, Covered Entity shall execute a nondisclosure agreement, upon terms and conditions mutually agreed to by the parties.

19.4 That Covered Entity inspects, fails to inspect, or has the right to inspect as provided for in Section 19.1 does not relieve Business Associate of its responsibility to comply with this Business Associate Agreement and/or the HIPAA Rules or impose on Covered Entity any responsibility for Business Associate's compliance with any applicable HIPAA Rules.

19.5 Covered Entity's failure to detect, its detection but failure to notify Business Associate, or its detection but failure to require remediation by Business Associate of an unsatisfactory practice by Business Associate, shall not constitute acceptance of such practice or a waiver of Covered Entity's enforcement rights under this Business Associate Agreement or the applicable underlying Agreement, Contract, Master Agreement, Work Order, Purchase Order or other services arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate.

19.6 Section 19.1 is not intended by the parties to limit in any way the scope of Business Associate's obligations related to Inspection and/or Audit and/or similar review in the applicable underlying Agreement, Contract, Master Agreement, Work Order, Purchase Order, or other services arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate.

20. MISCELLANEOUS PROVISIONS

20.1 Disclaimer. Covered Entity makes no warranty or representation that compliance by Business Associate with the terms and conditions of this Business Associate Agreement will be adequate or satisfactory to meet the business needs or legal obligations of Business Associate.

20.2 HIPAA Requirements. The Parties agree that the provisions under HIPAA Rules that are required by law to be incorporated into this Amendment are hereby incorporated into this Agreement.

20.3 No Third Party Beneficiaries. Nothing in this Business Associate Agreement shall confer upon any person other than the parties and their respective successors or assigns, any rights, remedies, obligations, or liabilities whatsoever.

ATTACHMENT NO. 2
Exhibit H (Business Associate Agreement Under the Health Insurance Rev. 11/2025 Page 17

20.4 Construction. In the event that a provision of this Business Associate Agreement is contrary to a provision of the applicable underlying Agreement, Contract, Master Agreement, Work Order, Purchase Order, or other services arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate, the provision of this Business Associate Agreement shall control. Otherwise, this Business Associate Agreement shall be construed under, and in accordance with, the terms of the applicable underlying Agreement, Contract, Master Agreement, Work Order, Purchase Order or other services arrangement, with or without payment, that gives rise to Contractor's status as a Business Associate.

20.5 Regulatory References. A reference in this Business Associate Agreement to a section in the HIPAA Rules means the section as in effect or as amended.

20.6 Interpretation. Any ambiguity in this Business Associate Agreement shall be resolved in favor of a meaning that permits the parties to comply with the HIPAA Rules.

20.7 Amendment. The parties agree to take such action as is necessary to amend this Business Associate Agreement from time to time as is necessary for Covered Entity or Business Associate to comply with the requirements of the HIPAA Rules and any other privacy laws governing Protected Health Information.

ATTACHMENT NO. 2

EXHIBIT I
(INFORMATION SECURITY AND PRIVACY REQUIREMENTS)
The County of Los Angeles (“County”) is committed to safeguarding the Integrity of the County systems, Data, Information and protecting the privacy rights of the individuals that it serves. This Information Security and Privacy Requirements Exhibit (“Exhibit”) sets forth the County and the Subrecipient’s commitment and agreement to fulfill each of their obligations under applicable state or federal laws, rules, or regulations, as well as applicable industry standards concerning privacy, Data protections, Information Security, Confidentiality, Availability, and Integrity of such Information. The Information Security and privacy requirements and procedures in this Exhibit are to be established by the Subrecipient before the Effective Date of the Subaward and maintained throughout the term of the Subaward.

These requirements and procedures are a minimum standard and are in addition to the requirements of the underlying base agreement between the County and Subrecipient (the “Subaward”) and any other agreements between the parties. However, it is the Subrecipient's sole obligation to: (i) implement appropriate and reasonable measures to secure and protect its systems and all County Information against internal and external Threats and Risks; and (ii) continuously review and revise those measures to address ongoing Threats and Risks. Failure to comply with the minimum requirements and procedures set forth in this Exhibit will constitute a material, non-curable breach of Subaward by the Subrecipient, entitling the County, in addition to the cumulative of all other remedies available to it at law, in equity, or under the Subaward, to immediately terminate the Subaward. To the extent there are conflicts between this Exhibit and the Subaward, this Exhibit will prevail unless stated otherwise.

1. DEFINITIONS
Unless otherwise defined in the Subaward, the definitions herein contained are specific to the uses within this exhibit.
a. Availability: the condition of Information being accessible and usable upon demand by an authorized entity (Workforce Member or process). b. Confidentiality: the condition that Information is not disclosed to system entities (users, processes, devices) unless they have been authorized to access the Information.
c. County Information: all Data and Information belonging to the County. d. Data: a subset of Information comprised of qualitative or quantitative values. e. Incident: a suspected, attempted, successful, or imminent Threat of unauthorized electronic and/or physical access, use, disclosure, breach, modification, or destruction of information; interference with Information Technology operations; or significant violation of County policy.
f. Information: any communication or representation of knowledge or understanding such as facts, Data, or opinions in any medium or form, including electronic, textual, numerical, graphic, cartographic, narrative, or audiovisual.

ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 2
g. Information Security Policy: high level statements of intention and direction of an organization used to create an organization’s Information Security Program as formally expressed by its top management.
h. Information Security Program: formalized and implemented Information Security Policies, standards and procedures that are documented describing the program management safeguards and common controls in place or those planned for meeting the County’s information security requirements.
i. Information Technology: any equipment or interconnected system or subsystem of equipment that is used in the automatic acquisition, storage, manipulation, management, movement, control, display, switching, interchange, transmission, or reception of Data or Information.
j. Integrity: the condition whereby Data or Information has not been improperly modified or destroyed and authenticity of the Data or Information can be ensured. k. Mobile Device Management (MDM): software that allows Information Technology administrators to control, secure, and enforce policies on smartphones, tablets, and other endpoints.
l. Privacy Policy: high level statements of intention and direction of an organization used to create an organization’s Privacy Program as formally expressed by its top management.
m. Privacy Program: A formal document that provides an overview of an organization’s privacy program, including a description of the structure of the privacy program, the resources dedicated to the privacy program, the role of the organization’s privacy official and other staff, the strategic goals and objectives of the Privacy Program, and the program management controls and common controls in place or planned for meeting applicable privacy requirements and managing privacy risks. n. Risk: a measure of the extent to which the County is threatened by a potential circumstance or event, Risk is typically a function of: (i) the adverse impacts that would arise if the circumstance or event occurs; and (ii) the likelihood of occurrence. o. Threat: any circumstance or event with the potential to adversely impact County operations (including mission, functions, image, or reputation), organizational assets, individuals, or other organizations through an Information System via unauthorized access, destruction, disclosure, modification of Information, and/or denial of service. p. Vulnerability: a weakness in a system, application, network or process that is subject to exploitation or misuse.
q. Workforce Member: employees, volunteers, and other persons whose conduct, in the performance of work for Los Angeles County, is under the direct control of Los Angeles County, whether or not they are paid by Los Angeles County. This includes, but may not be limited to, full and part time elected or appointed officials, employees, affiliates, associates, students, volunteers, and staff from third party entities who provide service to the County.

ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 3

2. INFORMATION SECURITY AND PRIVACY PROGRAMS
a. Information Security Program. The Subrecipient must maintain a company-wide Information Security Program designed to evaluate Risks to the Confidentiality, Availability, and Integrity of the County Information covered under this Subaward.

Subrecipient’s Information Security Program must include the creation and maintenance of Information Security Policies, standards, and procedures. Information Security Policies, standards, and procedures will be communicated to all Subrecipient employees in a relevant, accessible, and understandable form and will be regularly reviewed and evaluated to ensure operational effectiveness, compliance with all applicable laws and regulations, and addresses new and emerging Threats and Risks.

The Subrecipient must exercise the same degree of care in safeguarding and protecting County Information that the Subrecipient exercises with respect to its own Information and Data, but in no event less than a reasonable degree of care. The Subrecipient will implement, maintain, and use appropriate administrative, technical, and physical security measures to preserve the Confidentiality, Integrity, and Availability of County Information.

The Subrecipient’s Information Security Program must:

Protect the Confidentiality, Integrity, and Availability of County Information in the Subrecipient’s possession or control;
Protect against any anticipated Threats or hazards to the Confidentiality, Integrity, and Availability of County Information;
Protect against unauthorized or unlawful access, use, disclosure, alteration, or destruction of County Information;
Protect against accidental loss or destruction of, or damage to, County Information; and
Safeguard County Information in compliance with any applicable laws and regulations which apply to the Subrecipient.
b. Privacy Program. The Subrecipient must establish and maintain a company-wide Privacy Program designed to incorporate Privacy Policies and practices in its business operations to provide safeguards for Information, including County Information. The Subrecipient’s Privacy Program must include the development of, and ongoing reviews and updates to Privacy Policies, guidelines, procedures and appropriate workforce privacy training within its organization. These Privacy Policies, guidelines, procedures, and appropriate training will be provided to all Subrecipient employees, agents, and volunteers. The Subrecipient’s Privacy Policies, guidelines, and procedures must be continuously reviewed and updated for effectiveness and compliance with applicable laws and regulations, and to appropriately respond to new and emerging Threats and Risks. The Subrecipient’s Privacy Program must perform ongoing monitoring and audits of operations to identify and mitigate privacy Threats.

ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 4
The Subrecipient must exercise the same degree of care in safeguarding the privacy of County Information that the Subrecipient exercises with respect to its own Information, but in no event less than a reasonable degree of care. The Subrecipient will implement, maintain, and use appropriate privacy practices and protocols to preserve the Confidentiality of County Information.

The Subrecipient’s Privacy Program must include:

A Privacy Program framework that identifies and ensures that the Subrecipient complies with all applicable laws and regulations;
External Privacy Policies, and internal privacy policies, procedures and controls to support the privacy program;
Protections against unauthorized or unlawful access, use, disclosure, alteration, or destruction of County Information;
A training program that covers Privacy Policies, protocols and awareness; A response plan to address privacy Incidents and privacy breaches; and Ongoing privacy assessments and audits.

3. PROPERTY RIGHTS TO COUNTY INFORMATION
All County Information is deemed property of the County, and the County will retain exclusive rights and ownership thereto. County Information must not be used by the Subrecipient for any purpose other than as required under this Subaward, nor will such or any part of such be disclosed, sold, assigned, leased, or otherwise disposed of, to third parties by the Subrecipient, or commercially exploited or otherwise used by, or on behalf of, the Subrecipient, its officers, directors, employees, or agents. The Subrecipient may assert no lien on or right to withhold from the County, any County Information it receives from, receives addressed to, or stores on behalf of, the County. Notwithstanding the foregoing, the Subrecipient may aggregate, compile, and use County Information in order to improve, develop or enhance the System Software and/or other services offered, or to be offered, by the Subrecipient, provided that (i) no County Information in such aggregated or compiled pool is identifiable as originating from, or can be traced back to the County, and (ii) such Data or Information cannot be associated or matched with the identity of an individual alone, or linkable to a specific individual. The Subrecipient specifically consents to the County's access to such County Information held, stored, or maintained on any and all devices Subrecipient owns, leases or possesses.

4. SUBRECIPIENT’S USE OF COUNTY INFORMATION
The Subrecipient may use County Information only as necessary to carry out its obligations under this Subaward. The Subrecipient must collect, maintain, or use County Information only for the purposes specified in the Subaward and, in all cases, in compliance with all applicable local, state, and federal laws and regulations governing the collection, maintenance, transmission, dissemination, storage, use, and destruction of County Information, including, but not limited to, (i) any state and federal law governing the protection of personal Information, (ii) any state and federal security breach ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 5
notification laws, and (iii) the rules, regulations and directives of the Federal Trade Commission, as amended from time to time.

5. SHARING COUNTY INFORMATION AND DATA
The Subrecipient must not share, release, disclose, disseminate, make available, transfer, or otherwise communicate orally, in writing, or by electronic or other means, County Information to a third party for monetary or other valuable consideration.

6. CONFIDENTIALITY
a. Confidentiality of County Information. The Subrecipient agrees that all County Information is Confidential and proprietary to the County regardless of whether such Information was disclosed intentionally or unintentionally or marked as "confidential". b. Disclosure of County Information. The Subrecipient may disclose County Information only as necessary to carry out its obligations under this Subaward, or as required by law, and is prohibited from using County Information for any other purpose without the prior express written approval of the County’s Contract Administrator in consultation with the County’s Chief Information Security Officer and/or Chief Privacy Officer. If required by a court of competent jurisdiction or an administrative body to disclose County Information, the Subrecipient must notify the County’s Contract Administrator immediately and prior to any such disclosure, to provide the County an opportunity to oppose or otherwise respond to such disclosure, unless prohibited by law from doing so.
c. Disclosure Restrictions of Non-Public Information. While performing work under the Subaward, the Subrecipient may encounter County Non-public Information (“NPI”) in the course of performing this Subaward, including, but not limited to, licensed technology, drawings, schematics, manuals, sealed court records, and other materials described and/or identified as “Internal Use”, “Confidential” or “Restricted” as defined in Board of Supervisors Policy 6.104 – Information Classification Policy as NPI. The Subrecipient must not disclose or publish any County NPI and material received or used in performance of this Subaward. This obligation is perpetual. d. Individual Requests. The Subrecipient must acknowledge any request or instructions from the County regarding the exercise of any individual’s privacy rights provided under applicable federal or state laws. The Subrecipient must have in place appropriate policies and procedures to promptly respond to such requests and comply with any request or instructions from the County within seven (7) calendar days. If an individual makes a request directly to the Subrecipient involving County Information, the Subrecipient must notify the County within five (5) calendar days and the County will coordinate an appropriate response, which may include instructing the Subrecipient to assist in fulfilling the request. Similarly, if the Subrecipient receives a privacy or security complaint from an individual regarding County Information, the Subrecipient must notify the County as described in Section 14 SECURITY AND PRIVACY INCIDENTS, and the County will coordinate an appropriate response.

ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 6
e. Retention of County Information. The Subrecipient must not retain any County Information for any period longer than necessary for the Subrecipient to fulfill its obligations under the Subaward and applicable law, whichever is longest.

7. SUBRECIPIENT EMPLOYEES
The Subrecipient must perform background and security investigation procedures in the manner prescribed in this section unless the Subaward prescribes procedures for conducting background and security investigations and those procedures are no less stringent than the procedures described in this section. To the extent permitted by applicable law, the Subrecipient must screen and conduct background investigations on all Subrecipient employees and Lower Tier Subrecipients as appropriate to their role, with access to County Information for potential security Risks.

Such background investigations must be obtained through fingerprints submitted to the California Department of Justice to include State, local, and federal-level review and conducted in accordance with the law, may include criminal and financial history to the extent permitted under the law, and will be repeated on a regular basis. The fees associated with the background investigation will be at the expense of the Subrecipient, regardless of whether the member of the Subrecipient’s staff passes or fails the background investigation. The Subrecipient, in compliance with its legal obligations, must conduct an individualized assessment of their employees, agents, and volunteers regarding the nature and gravity of a criminal offense or conduct; the time that has passed since a criminal offense or conduct and completion of the sentence; and the nature of the access to County Information to ensure that no individual accesses County Information whose past criminal conduct poses a risk or threat to County Information.

The Subrecipient must require all employees, agents, and volunteers to abide by the requirements in this Exhibit, as set forth in the Subaward, and sign an appropriate written Confidentiality/non-disclosure agreement with the Subrecipient.

The Subrecipient must supply each of its employees with appropriate, annual training regarding Information Security procedures, Risks, and Threats. The Subrecipient agrees that training will cover, but may not be limited to the following topics:
a) Secure Authentication: The importance of utilizing secure authentication, including proper management of authentication credentials (login name and password) and multi-factor authentication.
b) Social Engineering Attacks: Identifying different forms of social engineering including, but not limited to, phishing, phone scams, and impersonation calls. c) Handling of County Information: The proper identification, storage, transfer, archiving, and destruction of County Information.
d) Causes of Unintentional Information Exposure: Provide awareness of causes of unintentional exposure of Information such as lost mobile devices, emailing Information to inappropriate recipients, etc.

ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 7
e) Identifying and Reporting Incidents: Awareness of the most common indicators of an Incident and how such indicators should be reported within the organization. f) Privacy: The Subrecipient’s Privacy Policies and procedures as described in Section 2b. Privacy Program.

The Subrecipient must have an established set of procedures to ensure the Subrecipient’s employees promptly report actual and/or suspected breaches of security.

8. LOWER TIER SUBRECIPIENTS AND THIRD PARTIES
The County acknowledges that in the course of performing its services, the Subrecipient may desire or require the use of goods, services, and/or assistance of Lower Tier Subrecipients or other third parties or suppliers. The terms of this Exhibit will also apply to all Lower Tier Subrecipients and third parties. The Subrecipient or third party will be subject to the following terms and conditions: (i) each Lower Tier Subrecipient and third party must agree in writing to comply with and be bound by the applicable terms and conditions of this Exhibit, both for itself and to enable the Subrecipient to be and remain in compliance with its obligations hereunder, including those provisions relating to Confidentiality, Integrity, Availability, disclosures, security, and such other terms and conditions as may be reasonably necessary to effectuate the Subaward including this Exhibit; and (ii) the Subrecipient will be and remain fully liable for the acts and omissions of each Lower Tier Subrecipient and third party, and fully responsible for the due and proper performance of all Subrecipient obligations under this Subaward.

The Subrecipient must obtain advanced approval from the County’s Chief Information Security Officer and/or Chief Privacy Officer prior to subcontracting services subject to this Exhibit.

9. STORAGE AND TRANSMISSION OF COUNTY INFORMATION
All County Information must be rendered unusable, unreadable, or indecipherable to unauthorized individuals. Without limiting the generality of the foregoing, the Subrecipient will encrypt all workstations, portable devices (such as mobile, wearables, tablets,) and removable media (such as portable or removable hard disks, floppy disks, USB memory drives, CDs, DVDs, magnetic tape, and all other removable storage media) that store County Information in accordance with Federal Information Processing Standard (FIPS) 140-2 or otherwise approved by the County’s Chief Information Security Officer.

The Subrecipient will encrypt County Information transmitted on networks outside of the Subrecipient’s control with Transport Layer Security (TLS) or Internet Protocol Security (IPSec), at a minimum cipher strength of 128 bit or an equivalent secure transmission protocol or method approved by County’s Chief Information Security Officer.

In addition, the Subrecipient must not store County Information in the cloud or in any other online storage provider without written authorization from the County’s Chief Information Security Officer. All mobile devices storing County Information must be managed by a Mobile Device Management system. Such system must provide provisions to enforce a password/passcode on enrolled mobile devices. All workstations/Personal Computers ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 8
(including laptops, 2-in-1s, and tablets) will maintain the latest operating system security patches, and the latest virus definitions. Virus scans must be performed at least monthly.

Request for less frequent scanning must be approved in writing by the County’s Chief Information Security Officer.

10. RETURN OR DESTRUCTION OF COUNTY INFORMATION
The Subrecipient must return or destroy County Information in the manner prescribed in this section unless the Subaward prescribes procedures for returning or destroying County Information and those procedures are no less stringent than the procedures described in this section.
a. Return or Destruction. Upon County’s written request, or upon expiration or termination of this Subaward for any reason, Subrecipient must (i) promptly return or destroy, at the County’s option, all originals and copies of all documents and materials it has received containing County Information; or (ii) if return or destruction is not permissible under applicable law, continue to protect such Information in accordance with the terms of this Subaward; and (iii) deliver or destroy, at the County’s option, all originals and copies of all summaries, records, descriptions, modifications, negatives, drawings, adoptions and other documents or materials, whether in writing or in machine-readable form, prepared by the Subrecipient, prepared under its direction, or at its request, from the documents and materials referred to in Subsection (i) of this Section. For all documents or materials referred to in Subsections (i) and (ii) of this Section that the County requests be returned to the County, the Subrecipient must provide a written attestation on company letterhead certifying that all documents and materials have been delivered to the County. For documents or materials referred to in Subsections (i) and (ii) of this Section that the County requests be destroyed, the Subrecipient must provide an attestation on company letterhead and certified documentation from a media destruction firm consistent with subdivision b of this Section. Upon termination or expiration of the Subaward or at any time upon the County’s request, the Subrecipient must return all hardware, if any, provided by the County to the Subrecipient. The hardware should be physically sealed and returned via a bonded courier, or as otherwise directed by the County. b. Method of Destruction. The Subrecipient must destroy all originals and copies by (i) cross-cut shredding paper, film, or other hard copy media so that the Information cannot be read or otherwise reconstructed; and (ii) purging or destroying electronic media containing County Information consistent with NIST Special Publication 800- 88, “Guidelines for Media Sanitization” such that the County Information cannot be retrieved. The Subrecipient will provide an attestation on company letterhead and certified documentation from a media destruction firm, detailing the destruction method used and the County Information involved, the date of destruction, and the company or individual who performed the destruction. Such statement will be sent to the designated County’s Contract Manager within ten (10) days of termination or expiration of the Subaward or at any time upon the County’s request. On termination or expiration of this Subaward, the County will return or destroy all Subrecipient’s Information marked as confidential (excluding items licensed to the County hereunder, or that provided to the County by the Subrecipient hereunder), at the County’s option.

ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 9

11. PHYSICAL AND ENVIRONMENTAL SECURITY
All Subrecipient facilities that process County Information will be located in secure areas and protected by perimeter security such as barrier access controls (e.g., the use of guards and entry badges) that provide a physically secure environment from unauthorized access, damage, and interference.

All Subrecipient facilities that process County Information will be maintained with physical and environmental controls (temperature and humidity) that meet or exceed hardware manufacturer’s specifications.

12. OPERATIONAL MANAGEMENT, BUSINESS CONTINUITY, AND DISASTER

RECOVERY
The Subrecipient must: (i) monitor and manage all of its Information processing facilities, including, without limitation, implementing operational procedures, change management, and Incident response procedures consistent with Section 14 SECURITY AND PRIVACY INCIDENTS; and (ii) deploy adequate anti-malware software and adequate back-up systems to ensure essential business Information can be promptly recovered in the event of a disaster or media failure; and (iii) ensure its operating procedures are adequately documented and designed to protect Information and computer media from theft and unauthorized access.

The Subrecipient must have business continuity and disaster recovery plans. These plans must include a geographically separate back-up data center and a formal framework by which an unplanned event will be managed to minimize the loss of County Information and services. The formal framework includes a defined back-up policy and associated procedures, including documented policies and procedures designed to: (i) perform backup of data to a remote back-up data center in a scheduled and timely manner; (ii) provide effective controls to safeguard backed-up data; (iii) securely transfer County Information to and from back-up location; (iv) fully restore applications and operating systems; and (v) demonstrate periodic testing of restoration from back-up location. If the Subrecipient makes backups to removable media (as described in Section 9 STORAGE AND TRANSMISSION OF COUNTY INFORMATION), all such backups must be encrypted in compliance with the encryption requirements noted above in Section 9 STORAGE AND TRANSMISSION OF COUNTY INFORMATION.

13. ACCESS CONTROL
Subject to and without limiting the requirements under Section 9 STORAGE AND TRANSMISSION OF COUNTY INFORMATION, County Information (i) may only be made available and accessible to those parties explicitly authorized under the Subaward or otherwise expressly approved by the County’s Contract Manager or Program Manager in writing; and (ii) if transferred using removable media (as described in Section 9 STORAGE AND TRANSMISSION OF COUNTY INFORMATION) must be sent via a bonded courier and protected using encryption technology designated by the Subrecipient and approved by the County’s Chief Information Security Officer in writing.

ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 10
The foregoing requirements will apply to back-up media stored by the Subrecipient at offsite facilities.

The Subrecipient must implement formal procedures to control access to County systems, services, and/or Information, including, but not limited to, user account management procedures and the following controls:
a. Network access to both internal and external networked services must be controlled, including, but not limited to, the use of industry standard and properly configured firewalls;
b. Operating systems will be used to enforce access controls to computer resources including, but not limited to, multi-factor authentication, use of virtual private networks (VPN), authorization, and event logging;
c. The Subrecipient will conduct regular, no less often than semi-annually, user access reviews to ensure that unnecessary and/or unused access to County Information is removed in a timely manner;
d. Applications will include access control to limit user access to County Information and application system functions;
e. All systems will be monitored to detect deviation from access control policies and identify suspicious activity. The Subrecipient must record, review and act upon all events in accordance with Incident response policies set forth in Section 14 SECURITY AND PRIVACY INCIDENTS; and
f. In the event any hardware, storage media, or removable media (as described in Section 9 STORAGE AND TRANSMISSION OF COUNTY INFORMATION) must be disposed of or sent off-site for servicing, the Subrecipient must ensure all County Information, has been eradicated from such hardware and/or media using industry best practices as discussed in Section 9 STORAGE AND TRANSMISSION OF COUNTY INFORMATION.

14. SECURITY AND PRIVACY INCIDENTS
In the event of a Security or Privacy Incident, the Subrecipient must:
a. Promptly notify the County’s Chief Information Security Officer, the Departmental Information Security Officer, and the County’s Chief Privacy Officer of any Incidents involving County Information, within twenty-four (24) hours of detection of the Incident.

All notifications must be submitted via encrypted email and telephone.

County Chief Information Security Officer and Chief Privacy Officer email [email protected]
Chief Information Security Officer:

James Thurmond
Acting Chief Information Security Officer
320 West Temple Street, 7th Floor
Los Angeles, CA 90012
ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 11
(213) 253-5660
[email protected]
Chief Privacy Officer:

Lillian Russell
Chief Privacy Officer
320 West Temple Street, 7th Floor
Los Angeles, CA 90012
(213) 253-5363
[email protected]
Departmental Information Security Officer:

Ivan Pacheco
Departmental Chief Information Officer
510 South Vermont Avenue, 11th Floor
Los Angeles, CA 90020
(323) 356-4672
[email protected]
b. Include the following Information in all notices:
i. The date and time of discovery of the Incident,
ii. The approximate date and time of the Incident,
iii. A description of the type of County Information involved in the reported Incident, and
iv. A summary of the relevant facts, including a description of measures being taken to respond to and remediate the Incident, and any planned corrective actions as they are identified.
v. The name and contact information for the organizations official representative(s), with relevant business and technical information relating to the incident.
c. Cooperate with the County to investigate the Incident and seek to identify the specific County Information involved in the Incident upon the County’s written request, without charge, unless the Incident was caused by the acts or omissions of the County. As Information about the Incident is collected or otherwise becomes available to the Subrecipient, and unless prohibited by law, the Subrecipient must provide Information regarding the nature and consequences of the Incident that are reasonably requested by the County to allow the County to notify affected individuals, government agencies, and/or credit bureaus.
d. Immediately initiate the appropriate portions of their Business Continuity and/or Disaster Recovery plans in the event of an Incident causing an interference with Information Technology operations.
e. Assist and cooperate with forensic investigators, the County, law firms, and and/or law enforcement agencies at the direction of the County to help determine the nature, ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 12
extent, and source of any Incident, and reasonably assist and cooperate with the County on any additional disclosures that the County is required to make as a result of the Incident.
f. Allow the County or its third-party designee at the County’s election to perform audits and tests of the Subrecipient's environment that may include, but are not limited to, interviews of relevant employees, review of documentation, or technical inspection of systems, as they relate to the receipt, maintenance, use, retention, and authorized destruction of County Information.

Notwithstanding any other provisions in this Subaward and Exhibit, The Subrecipient will be (i) liable for all damages and fines, (ii) responsible for all corrective action, and (iii) responsible for all notifications arising from an Incident involving County Information caused by the Subrecipient’s weaknesses, negligence, errors, or lack of Information Security or privacy controls or provisions.

15. NON-EXCLUSIVE EQUITABLE REMEDY
The Subrecipient acknowledges and agrees that due to the unique nature of County Information there can be no adequate remedy at law for any breach of its obligations hereunder, that any such breach may result in irreparable harm to the County, and therefore, that upon any such breach, the County will be entitled to appropriate equitable remedies, and may seek injunctive relief from a court of competent jurisdiction without the necessity of proving actual loss, in addition to whatever remedies are available within law or equity. Any breach of Section 6 CONFIDENTIALITY will constitute a material breach of this Subaward and be grounds for immediate termination of this Subaward in the exclusive discretion of the County.

16. AUDIT AND INSPECTION
a. Self-Audits. The Subrecipient must periodically conduct audits, assessments, testing of the system of controls, and testing of Information Security and privacy procedures, including penetration testing, intrusion detection, and firewall configuration reviews.

These periodic audits will be conducted by staff certified to perform the specific audit in question at Subrecipient’s sole cost and expense through either (i) an internal independent audit function, (ii) a nationally recognized, external, independent auditor, or (iii) another independent auditor approved by the County.

The Subrecipient must have a process for correcting control deficiencies that have been identified in the periodic audit, including follow up documentation providing evidence of such corrections. The Subrecipient must provide the audit results and any corrective action documentation to the County promptly upon its completion at the County’s request. With respect to any other report, certification, or audit or test results prepared or received by the Subrecipient that contains any County Information, the Subrecipient must promptly provide the County with copies of the same upon the County’s reasonable request, including identification of any failure or exception in the Subrecipient’s Information systems, products, and services, and the corresponding steps taken by the Subrecipient to mitigate such failure or exception. Any reports and related materials provided to the County pursuant to this Section must be provided at no additional charge to the County.

ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 13
b. County Requested Audits. At its own expense, the County, or an independent thirdparty auditor commissioned by the County, will have the right to audit the Subrecipient’s infrastructure, security and privacy practices, Data center, services and/or systems storing or processing County Information via an onsite inspection at least once a year. Upon the County’s request the Subrecipient must complete a questionnaire regarding Subrecipient’s Information Security and/or program. The County will pay for the County requested audit unless the auditor finds that the Subrecipient has materially breached this Exhibit, in which case the Subrecipient must bear all costs of the audit; and if the audit reveals material non-compliance with this Exhibit, the County may exercise its termination rights underneath the Subaward.

Such audit will be conducted during the Subrecipient’s normal business hours with reasonable advance notice, in a manner that does not materially disrupt or otherwise unreasonably and adversely affect the Subrecipient’s normal business operations.

The County's request for the audit will specify the scope and areas (e.g., Administrative, Physical, and Technical) that are subject to the audit and may include, but are not limited to physical controls inspection, process reviews, policy reviews, evidence of external and internal Vulnerability scans, penetration test results, evidence of code reviews, and evidence of system configuration and audit log reviews.

It is understood that the results may be filtered to remove the specific Information of other Subrecipient customers such as IP address, server names, etc. The Subrecipient must cooperate with the County in the development of the scope and methodology for the audit, and the timing and implementation of the audit. This right of access will extend to any regulators with oversight of the County. The Subrecipient agrees to comply with all reasonable recommendations that result from such inspections, tests, and audits within reasonable timeframes.

When not prohibited by regulation, the Subrecipient will provide to the County a summary of: (i) the results of any security audits, security reviews, or other relevant audits, conducted by the Subrecipient or a third party; and (ii) corrective actions or modifications, if any, the Subrecipient will implement in response to such audits.

17. CYBER LIABILITY INSURANCE
Subrecipient must secure and maintain cyber liability insurance coverage in the manner prescribed in this Section unless the Contract prescribes cyber liability insurance coverage provisions, and those provisions are no less stringent than those described in this Section.

Subrecipient must secure and maintain cyber liability insurance coverage with limits of at least $3,000,000 (3 million) per occurrence and in the aggregate during the term of the Subaward, including coverage for: network security liability; privacy liability; privacy 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 ATTACHMENT NO. 2
Exhibit I (Information Security and Privacy Requirements) Rev. 12/2025 Page 14
business interruption; any other liability or risk that arises out of the Subaward.

Subrecipient must 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, must 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.

18. PRIVACY AND SECURITY INDEMNIFICATION
In addition to the indemnification provisions in the Subaward, the Subrecipient agrees to indemnify, defend, and hold harmless the County, its Special Districts, elected and appointed officers, agents, employees, and volunteers from and against any and all claims, demands liabilities, damages, judgments, awards, losses, costs, expenses or fees including reasonable attorneys’ fees, accounting and other expert, consulting or professional fees, and amounts paid in any settlement arising from, connected with, or relating to:

The Subrecipient’s violation of any federal and state laws in connection with its accessing, collecting, processing, storing, disclosing, or otherwise using County Information;
The Subrecipient’s failure to perform or comply with any terms and conditions of this Subaward or related agreements with the County; and/or, Any Information loss, breach of Confidentiality, or Incident involving any County Information that occurs on the Subrecipient’s systems or networks (including all costs and expenses incurred by the County to remedy the effects of such loss, breach of Confidentiality, or Incident, which may include (i) providing appropriate notice to individuals and governmental authorities, (ii) responding to individuals’ and governmental authorities’ inquiries, (iii) providing credit monitoring to individuals, and (iv) conducting litigation and settlements with individuals and governmental authorities).

Notwithstanding the preceding sentences, the County will have the right to participate in any such defense at its sole cost and expense, except that in the event Subrecipient fails to provide County with a full and adequate defense, as determined by County in its sole judgment, County will be entitled to retain its own counsel, including, without limitation, County Counsel, and to reimbursement from Subrecipient for all such costs and expenses incurred by County in doing so. Subrecipient will not have the right to enter into any settlement, agree to any injunction or other equitable relief, or make any admission, in each case, on behalf of County without County’s prior written approval.

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EXHIBIT
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EXHIBIT
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ATTACHMENT NO. 2
ATTACHMENT NO. 2

BOARD OF SUPERVISORS
Hilda L. Solis
Holly J. Mitchell
Lindsey P. Horvath
Janice Hahn
Kathryn Barger

EXECUTIVE LEADERSHIP
Maral V. Karaccusian
Director
Victoria Jump
Acting Chief Deputy Director
Susan Huff
Administrative Deputy II
Anna Avdalyan
Assistant Director
Ivan Pacheco
Chief Information Officer

GET I N TOUCH
510 S. Vermont Avenue, Suite 1100
Los Angeles, CA 90020
ad.lacounty. gov
[email protected]
Aging & Adult Information & Assistance Line:
(800) 510-2020
Report Elder Abuse:
(877) 477-3646
Community & Senior Centers:
(800) 689-8514
REVISED 8/11/26
May 28, 2026
City of Pomona
Attention: Anita Scott
505 S. Garey Ave.

Pomona, CA 91766
FISCAL YEAR 2026-27 FUNDING ALLOCATIONS FOR

ELDERLY NUTRITION PROGRAM SERVICES
Dear Ms. Scott:

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

Purpose:
o Subrecipient will utilize Older Americans Act (OAA) Title III C1, baseline funding to provide defined and contracted
ENP Congregate Meal during Fiscal Year (FY) 2026-27.
o Subrecipient will utilize Net County Cost (NCC) funding to provide defined and contracted ENP Congregate Meal
Services during FY 2026-27.
o Subrecipient will utilize Modernizing Older Californians Act (MOCA) funding to provide defined and contracted ENP
Congregate Meal during FY 2026-27.
o Subrecipient will utilize Nutrition Services Incentive Program (NSIP) funding to supplement food costs
associated with ENP Congregate Meals during FY 2026-

27. Subaward Number: ENP252607
Amendment Number: Three
Subaward Term: July 1, 2026 through June 30, 2027
ATTACHMENT NO. 2
FY 2026-27 Funding Allocation
Elderly Nutrition Program
City of Pomona

Total Funding Allocation: $187,792
o OAA funds: $109,000
o NCC funds: $26,000
o MOCA funds: $42,000
o NSIP funds: $10,792
Period Funds are available for use (Subject to execution of Amendment): July 1, 2026 – June 30, 2027
Service Area: Supervisorial District 1
Funding Source(s) and Service Category(ies) are as follows:

Funding
Source Service Category Unit Rate Eff. 7/1/26
Allocation Amount
3 Mos 9 Mos 7 Mos 2 Mos Total
OAA Title III
C1 Congregate Meals $10.56 $18,530 $90,470 $109,0001
NCC Congregate Meals $10.56 $26,0001
MOCA Congregate Meals $10.56 $42,0004
NSIP C1 Congregate Meals $1.00 $3,180 $7,155 $457 $10,7926 Subaward Sum Year 2 (SSY2) $187,792
1Complete one (1) budget and one (1) MPS for each allocation amount. 2-7 Complete one (1) budget and one (1) MPS for each allocation amount.

If you have any questions, please contact Jessica Palafox of my staff by phone at (213) 762- 4106 or by e-mail at [email protected]. Thank you.

Irma Panosian
Irma Panosian, Administrative Services Manager III
Contracts Management Division
ATTACHMENT NO. 2