Common use of INTEREST EARNED Clause in Contracts

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from Office

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt. 1. I. Subrecipient’s Budget (July 1Budget: CARES Act Programs September 3, 2020 to June 30, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 ENPCARES Act: Home-Delivered Meals Cost Categories Budgeted Costs Personnel $384,031162,982 Food $247,108203,299 Other Costs $80,23524,417 Total Budgeted Costs $321,028 Matching Funds Match Amount 712,374391,699 CARES Act: Case Management Cost Categories Budgeted Costs Personnel $50,22415,484 Total Match Budgeted Costs $17,565 50,22415,484 CARES Act: In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount 39,016 CARES Act: Transportation Cost Categories Budgeted Costs Personnel $51,0200 Total Match Budgeted Costs $2,251 County of Orange 2 City of IrvineAge Well Senior Services51,0200 July 1, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 2021 to September 30, 2022): 20212022 CARES Act: Home-Delivered Meals Cost Categories Budgeted Costs Personnel $0221,649 Food $043,809 Other Costs $055,218 Total Budgeted Costs $0320,675 CARES Act: Case Management Transportation Cost Categories Budgeted Costs Personnel $034,740 Total Budgeted Costs $034,740 CARES Act: In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount 0 CARES Act: Transportation Cost Categories Budgeted Costs Personnel $051,020 Total Match Budgeted Costs $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No051,020 2. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. Chief Executive Officer 0.0501 Chief Operating Officer 0.0501 Accountants 0.0502 Grant Writer/Contract Manager 0.0501 Case Manager 0.2510 Assistant Case Manager 0.2508 Database Coordinator 0.0502 TOTAL: 0.250.75

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 FormattedDocuSign Envelope ID: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management 883ED907-9832-4150-BF5C-8CA4C64FA597 Cost Categories Budgeted Costs Total Budgeted Costs $22,066 335,550 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No39,492 2. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. DocuSign Envelope ID: 883ED907-9832-4150-BF5C-8CA4C64FA597 Supervising Attorney 1.00 Staff Attorney 0.27 Staff Attorney 0.58 Paralegal 1.00 I&A Paralegal 0.30 Legal Secretary 0.08 TOTAL: 3.23 *1.00 FTE = Full-Time Equivalent The substitution or addition of other key individuals in any given category or classification shall be allowed only with prior written pre-approval of the County Project Manager. The County may reserve the right to involve other personnel, as their services are required. The specific individuals will be assigned based on the need and time of the service/class required. Assignment of additional key personnel shall be subject to County approval pursuant to Paragraph 13 of the Contract. AGENCY NAME: COMMUNITY LEGAL AID SOCAL FISCAL YEAR: 2021-2022 PROGRAM SERVICE NUMBER OF ANNUAL SERVICE UNITS UNDUPLICATED PERSONS SERVED SERVICE CATEGORY DESCRIPTION OF SERVICE UNITS Legal Assistance 6,400 # of Legal Assistance Hours 2,000 Non-Registered Legal Assistance (1 Hour): Legal advice, counseling and representation by an attorney or other person acting under the supervision of an attorney. 70 # of Pro ▇▇▇▇ Hours 70 Non-Registered Pro-▇▇▇▇ (1 Hour): Contractor agrees to make a good faith effort to provide a minimum number of hours of pro ▇▇▇▇ legal services during each year of the contract equal to the lesser of 30 multiplied by the number of full time attorneys in the firm’s offices in the State, with the number of hours prorated on an actual day basis for any contract period of less than a full year or 10% of its contract. For Example: A legal provider with 3 full time attorneys will pledge to provide 90 hours of pro ▇▇▇▇ services if their contract is for a full year (or prorated otherwise). DocuSign Envelope ID: 883ED907-9832-4150-BF5C-8CA4C64FA597 DocuSign Envelope ID: 883ED907-9832-4150-BF5C-8CA4C64FA597 1. Federal Award Identification A. Subrecipient Name: Community Legal Aid SoCal B. Subrecipient’s Unique Identifier (DUNS): 081812315 C. Federal Award Identification Number (▇▇▇▇): D. Federal Award Date: 2021-2022 ▇. ▇▇▇▇▇▇▇▇ Period of Performance: July 1, 2021 to June 30, 2022 F. Total Amount of Federal Funds Obligated by the Action: $ 335,550 93.044 TBD 2021 Title III-B $167,775 93.044 TBD 2022 Title III-B $167,775 TOTAL: $335,550 G. Total Amount of Federal Funds Obligated to the Subrecipient: $335,550 H. Total Amount of the Federal Award: $335,550 I. Federal Award Project Description: Special Programs for the Aging, Title III, Part B, Grants for Supportive Services and Senior Centers J. Federal Awarding Agency: U.S. Department of Health and Human Services, Administration for Community Living K. Name of Pass Through Entity (PTE): California Department of Aging and County of Orange Office on Aging L. Contact Information for the Awarding Official: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Director (▇▇▇) ▇▇▇-▇▇▇▇, ▇▇▇▇▇▇.▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ M. CFDA Number and Name: #93.044 Special Programs for the Aging, Title III, Part B, Grants for Supportive Services and Senior Centers

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt. 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract NoBudget: 2. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. I. Health Insurance Counseling and Advocacy Program (HICAP) – July 1, 2020 to June 30, 2020 Program Manager 1.00 Community Education/Outreach Specialist 0.75 Volunteer Coordinator and Community Outreach 0.83 Latino Community Education/Outreach Coordinator 0.95 Latino Staff Counselor 0.00 Vietnamese Community Education/Outreach 0.20 Vietnamese Staff Counselor – MT 0.15 Vietnamese Staff Counselor – TP 0.00 Operations Coordinator – RL 1.00 Volunteer Training Specialist – AS 0.25 Outreach 0.00 Administrative Team 0.61 TOTAL: 5.74

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 FormattedDocuSign Envelope ID: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 ptAF64C83D-20F1-46C9-96FB-60EED7B2B6EA 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract NoBudget: 2. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. DocuSign Envelope ID: AF64C83D-20F1-46C9-96FB-60EED7B2B6EA 1. Federal Award Identification A. Subrecipient Name: Council on Aging Southern California B. Subrecipient’s Unique Identifier (DUNS): 053284159 C. Federal Award Identification Number (▇▇▇▇): 1901CAOAEA-01, 1901CAOAOM-01, 1901CAOASS-01, 2001CAOAEA-00, 2001CAOAOM-00, and 2001CAOASS-00 D. Federal Award Date: 2020-2021 E. Subaward Period of Performance: July 1, 2020 to June 30, 2021 F. Total Amount of Federal Funds Obligated by the Action: $275,997

INTEREST EARNED. A. If Subrecipient Contractor earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient Contractor shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient Contractor is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by SubrecipientContractor; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient Contractor expects to receive under this Contract. Attachment C-67 FormattedOARR: Font: Legal Services Administrative Costs $0 Program Costs Total Match Funds (DefaultCash and/or In-Kind) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Not Applicable Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County 275,000 Budgets contained in Attachment C of Orange 1 City of IrvineAge Well Senior Services, Inc. this Agreement are high-level budgets. Upon approval by the Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 Board of Supervisors and/or the County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview but prior to submission of the actual first invoice, a detailed budget approved must be submitted to the Office on Aging office for approval. Budget templates will be provided by the Office on Aging. Invoices shall be submitted based upon these detailed budgets. Subrecipient may request to shift funds between programs, or between budgeted line items within a program, for the purpose of meeting specific program needs by utilizing a Budget/Staffing Revision Request form provided by Contract Administrator. Subrecipient must include a justification narrative specifying the purpose of the request, the amount of said funds to be shifted, and the sustaining annual impact of the shift as may be applicable to the current Fiscal Year Budget and/or future Fiscal Year Budgets. Subrecipient shall be responsible for and maintain the approved Budget Summary obtain written approval of any Budget/Staffing Revision Request(s) from Contract Administrator prior to implementation by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeSubrecipient.

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: Service Area 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 ptNorth Service Area 2 West Service Area 3 Central Service Area 4 Beach Cities 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 2024 – June 30, 20222025): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract NoENP: Congregate Meals II. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. III. The Budget Summary by Funding Source and Revenue Sources spreadsheet must set forth in detail the reimbursable items, unit rates and extended total amounts for each line item. The Subrecipient’s Budget Summary by Funding Source and Revenue Sources spreadsheet shall include, at a minimum, the following items when reimbursable and applicable under this Contract: A. Personnel Costs – annual Full-Time Equivalent (FTE) wage rates and personnel classifications specified for each program. B. Fringe Benefits – specified for each program. C. Staff Travel - mileage reimbursement, lodging, per diem and other travel costs, specified for each program. D. Staff Training – attendance cost for necessary training, specified for each program. E. Property/Equipment - detailed descriptions and unit costs, specified for each program. F. Supplies - to include items below the $5,000 equipment threshold, specified for each program. G. Consultant/Professional Services – specified for each program. H. Food – used in delivering Congregate and Home-Delivered Meals. I. Other - Facilities and other ordinary and necessary costs specified for each program.

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt. 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract NoBudget: 2. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. Subrecipient may request to shift funds between programs, or between budgeted line items within a program, for the purpose of meeting specific program needs by utilizing a Budget/Staffing Revision Request form provided by Contract Administrator. Subrecipient must include a justification narrative specifying the purpose of the request, the amount of said funds to be shifted, and the sustaining annual impact of the shift as may be applicable to the current Fiscal Year Budget and/or future Fiscal Year Budgets. Subrecipient shall obtain written approval of any Budget/Staffing Revision Request(s) from Contract Administrator prior to implementation by Subrecipient. 3. The Budget Summary by Funding Source and Revenue Sources spreadsheet must set forth in detail the reimbursable items, unit rates and extended total amounts for each line item. The Subrecipient’s Budget Summary by Funding Source and Revenue Sources spreadsheet shall include, at a minimum, the following items when reimbursable and applicable under this Contract: a) Personnel Costs – monthly, weekly, or hourly rates, as appropriate, and personnel classifications together with the percentage of time to be charged to these programs. b) Fringe Benefits. c) Contractual Costs – subcontract and consultant cost detail. d) Indirect Costs – costs incurred for a common or joint purpose benefitting more than one cost objective and not readily assignable as a direct cost e) Rent – specify square footage and rate. f) Supplies. g) Equipment – detailed descriptions and total costs. h) In State Travel – mileage reimbursement rate, lodging, per diem, and other costs. i) Out of State Travel – any travel outside the State of California including mileage reimbursement rate, lodging, per diem, and other costs.

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 FormattedDocuSign Envelope ID: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management 7CAFB1BB-B16E-416A-A4D1-19CEF63155C6 Cost Categories Budgeted Costs Total Budgeted Costs $22,066 330,708 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No38,922 2. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. DocuSign Envelope ID: 7CAFB1BB-B16E-416A-A4D1-19CEF63155C6 Supervising Attorney 1.00 Staff Attorney 0.27 Staff Attorney 0.58 Paralegal 1.00 I&A Paralegal 0.30 Legal Secretary 0.08 TOTAL: 3.23 *1.00 FTE = Full-Time Equivalent The substitution or addition of other key individuals in any given category or classification shall be allowed only with prior written pre-approval of the County Project Manager. The County may reserve the right to involve other personnel, as their services are required. The specific individuals will be assigned based on the need and time of the service/class required. Assignment of additional key personnel shall be subject to County approval pursuant to Paragraph 13 of the Contract. DocuSign Envelope ID: 7CAFB1BB-B16E-416A-A4D1-19CEF63155C6 1. Federal Award Identification A. Subrecipient Name: Community Legal Aid SoCal B. Subrecipient’s Unique Identifier (DUNS): 081812315 C. Federal Award Identification Number (▇▇▇▇): 1901CAOASS-01 and 2001CAOASS-00 D. Federal Award Date: 2020-2021 E. Subaward Period of Performance: July 1, 2020 to June 30, 2021 F. Total Amount of Federal Funds Obligated by the Action: $ 330,708 93.044 1901CAOASS-01 and 2001CAOASS-00 2020 Title III-B $165,354 93.044 1901CAOASS-01 and 2001CAOASS-00 2021 Title III-B $165,354 TOTAL: $330,708 G. Total Amount of Federal Funds Obligated to the Subrecipient: $330,708 H. Total Amount of the Federal Award: $330,708 I. Federal Award Project Description: Special Programs for the Aging, Title III, Part B, Grants for Supportive Services and Senior Centers J. Federal Awarding Agency: U.S. Department of Health and Human Services, Administration for Community Living K. Name of Pass Through Entity (PTE): California Department of Aging and County of Orange Office on Aging L. Contact Information for the Awarding Official: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Director (▇▇▇) ▇▇▇-▇▇▇▇, ▇▇▇▇▇▇.▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ M. CFDA Number and Name: #93.044 Special Programs for the Aging, Title III, Part B, Grants for Supportive Services and Senior Centers

INTEREST EARNED. A. If Subrecipient Contractor earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient Contractor shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient Contractor is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by SubrecipientContractor; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient Contractor expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt. 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract NoBudget: 2. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget 3. The Budget Summary by Funding Source and Revenue Sources spreadsheet must set forth in detail the reimbursable items, unit rates and extended total amounts for each line item. The Subrecipient’s Budget Summary by Funding Source and Revenue Sources spreadsheet shall include, at a minimum, the following items when reimbursable and applicable under this Contract: a) Personnel Costs – annual Full-Time Equivalent (FTE) wage rates and personnel classifications specified for each program. b) Fringe Benefits – specified for each program. c) Staff Travel - mileage reimbursement, lodging, per diem and other travel costs, specified for each program. d) Staff Training – attendance cost for necessary training, specified for each program. e) Property/Equipment - detailed descriptions and unit costs, specified for each program. f) Supplies - to include items below the $5,000 equipment threshold, specified for each program. g) Consultant/Professional Services – specified for each program. h) Other - Facilities and other ordinary and necessary costs specified for each program.

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 FormattedDocuSign Envelope ID: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt1283719B-5166-4237-A813-DB0FFE541458 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract NoElder Abuse Prevention VII-A 2. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. DocuSign Envelope ID: 1283719B-5166-4237-A813-DB0FFE541458 Program Director 0.43 Program Coordinator 0.25 CEO 0.01 CFO 0.01 Finance Assistants/Office Manager 0.02 Executive Assistant 0.01 Receptionists (2 Part Time Staff) 0.01 Marketing 0.01 Data Communications 0.00 TOTAL: 0.75

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt. 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract NoBudget: 2. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. I. Health Insurance Counseling and Advocacy Program (HICAP) – July 1, 2020 2021 to June 30, 20212022 Program Manager 1.00 Community Education/Outreach Specialist 0.75 Volunteer Coordinator and Community Outreach 0.83 Latino Community Education/Outreach Coordinator 0.95 Latino Staff Counselor 0.00 Vietnamese Community Education/Outreach 0.20 Vietnamese Staff Counselor – MT 0.15 Vietnamese Staff Counselor – TP 0.00 Operations Coordinator – RL 1.00 Volunteer Training Specialist – AS 0.25 Outreach 0.00 Administrative Team 0.61 TOTAL: 5.74 II. Medicare Improvements for Patients and Providers Act (MIPPA) – July 1, 2020 2021 to September August 2931, 20202021 Program Director 0.00 Program Manager 0.00 Community Education/Outreach Coordination 0.00 Community Education/Outreach Specialist 0.05 Latino Community Education/Outreach 0.05 Latino Staff Counselor 0.15 Volunteer Specialist 0.00 Vietnamese Community Education/Outreach 0.05 Vietnamese Staff Counselor 0.00 Vietnamese Staff Counselor 0.00 Operations Coordinator 0.00 Training Specialist 0.00 Administrative Team 0.03 TOTAL: 0.33 III. Medicare Improvements for Patients and Providers Act (MIPPA) – October 1, 2020 to June 30, 2021 Program Manager 0.00 Community Education/Outreach Specialist 0.14 Volunteer Coordinator/Community Outreach 0.04 Latino Community Education/Outreach 0.56 Latino Staff Counselor 0.00 Vietnamese Community Education/Outreach 0.04 Vietnamese Staff Counselor 0.15 Vietnamese Staff Counselor 0.18 Operations Coordinator 0.21 Volunteer Training Specialist 0.00 New Counselor – Spanish PT 0.15 New Outreach PT (March-June) 0.15 Administrative Team 0.23 TOTAL: 1.85 IVIII. Financial Alignment (FA) – November July 17, 2020 2021 to June October 3031, 2021 Program Manager 0.00 Community Education/Outreach Specialist 0.00 Volunteer Coordinator/Community Outreach 0.00 Latino Community Education/Outreach 0.34 Latino Staff Counselor 0.00 Vietnamese Community Education/Outreach 0.21 Vietnamese Staff Counselor 0.05 Vietnamese Staff Counselor 0.00 Operations Coordinator 0.00 Volunteer Training Specialist 0.00 New Counselor – Spanish PT 0.05 New Outreach PT 0.05 Administrative Team 0.10 TOTAL: 0.80 *1.00 FTE = Full-Time Equivalent The substitution or addition of other key individuals in any given category or classification shall be allowed only with prior written pre-approval of the County Project Manager. The County may reserve the right to involve other personnel, as their services are required. The specific individuals will be assigned based on the need and time of the service/class required. Assignment of additional key personnel shall be subject to County approval pursuant to Paragraph 13 of the Contract. FISCAL YEAR: 20202021-20212022 PROGRAM SERVICE NUMBER OF ANNUAL SERVICE UNITS UNDUPLICATED PERSONS SERVED SERVICE CATEGORY DESCRIPTION OF SERVICE UNITS HICAP 6,992 # of Participants Counseled (Closed Intakes) N/A Participants Counseled: Number of finalized intakes for all participants/beneficiaries that received counseling services (aka contacts). Intakes must have at least one Medicare topic selected and dates entered on form are limited to one calendar month through finalization and review. 325 # of Public and Media Events N/A Public and Media Events: Number of completed ▇▇▇ forms for all events categorized as “Interactive.” Interactive events include, but not limited to electronic/digital and/or tele-conferences, when attendance is monitored to justify true encounters. ▇▇▇ forms must have at least one Medicare topic selected for Primary Focus, Target Beneficiary Group, and Intended Audience. 19,247 # of Participant Contacts (Interactions) N/A All Participant Contacts: Number of total Counseling Services (aka contacts) from finalized Intakes, regardless of mode (i.e., telephone, in person site, in person home, email, fax, other). “General HICAP/SHIP” topics are no longer counted; therefore, Quick Calls are excluded, and all intakes must have at least one Medicare topic selected. 13,739 # of Persons Reached at Public & Media Events (Interactive) N/A Public and Media Events Outreach: Number of total Estimated persons reached or received enrollment assistance at public events reported for COMPLETED ▇▇▇ forms categorized as “Interactive”; documented by Attendance Logs at Exhibits, Fairs or Special Events; or Dedicated Enrollments of events where attendance is either tracked/monitored per direct application assistance; Interactive Presentations to Public in Person (including electronic/digital and/or tele-conferences, when attendance is monitored to justify true encounters); or where HICAP/SHIP and Medicare information was transferred to the public with participant opportunity to ask questions and get answers. “General HICAP/SHIP” topics are no longer counted; therefore, Quick Calls are excluded, and all intakes must have at least one Medicare topic selected. 1,379 # of Contacts with Medicare Clients Under 65 N/A Medicare Beneficiaries Under 65: Number of all Counseling Services (aka contacts) from finalized Intakes, regardless of mode (i.e., telephone, in person site, in person home, email, fax, or other), where the beneficiary is 64 or younger and is receiving or applying for Social Security Disability or Medicare Disability (R/A-DIS). DOB and R/A-DIS fields are required to avoid record submission errors but measure no longer includes Quick Calls. 10,249 # of Hard to Reach Contacts N/A Hard to Reach Contacts: Number of total sum for all Counseling Services (aka contacts) from finalized intakes, regardless of mode (i.e., telephone, in person site, in person home, e- mail) where Medicare beneficiaries are designated as “hard-to-reach” per the following categories: • Contacts with Low Income Beneficiaries • English as a Second Language Contacts 3,686 # of Contacts with Low Income Beneficiaries N/A Contacts with Low-Income Beneficiaries: Contacts with beneficiaries whose Income Level indicates below 150% of the Federal Poverty Level. 6,563 # of English as a Second Language Contacts N/A English as a Second Language Contacts: Contacts with clients whose primary language is not English. 13,848 # of Qualifying Enrollment Contacts N/A Target Qualifying Enrollments: Number of total Counseling Services (aka contacts) from Intakes regardless of mode (i.e., telephone, in person site, in person home, e-mail, fax, other) with one or more of the following qualifying enrollment topics discussed: • Medicare A/B • Medigap/Supplement/SELECT • Medicare Advantage (e.g., MSA, HMO, PPO, Specialty Plan) • Medi-Cal • Part D Medicare Prescription Drug Coverage • Part D Plan Problems (Non- Compliance Services Unmet) • Part D Low Income Subsidy 1. Federal Award Identification A. Subrecipient Name: Council on Aging Southern California B. Subrecipient’s Unique Identifier (DUNS): 053284159 C. Federal Award Identification Number (▇▇▇▇): 90SAPG0094-01-00, 1801CAMISH, 1801CAMIAA, 1801CAMIDR, 2001CAMISH-00, 2001CAMIAA- 00, 2001CAMIDR-00, and CMS-1J1-19-001 D. Federal Award Date: 20202021-20212022 E. Subaward Period of Performance: July 1, 2020 2021 to June 30, 20212022 F. Total Amount of Federal Funds Obligated by the Action: $214,161342,438 93.324 90SAPG0094-01-00TBD 20202021 HICAP $36,080.7585,344 93.324 90SAPG0094-01-00TBD 20212022 HICAP $134,804.2585,344 93.626 CMS-1J1-19-001 CMS-1J1- 19-001 20202021 Financial Alignment $8,752.7517,505 93.626 CMS-1J1-19-001TBD 20212022 Financial Alignment $26,258.250.00

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 ptATTACHMENT C BUDGET SCHEDULE 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Budget: II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. III. The Budget Summary by Funding Source and Revenue Sources spreadsheet must set forth in detail the reimbursable items, unit rates and extended total amounts for each line item. The Subrecipient’s Budget Summary by Funding Source and Revenue Sources spreadsheet shall include, at a minimum, the following items when reimbursable and applicable under this Contract: A. Personnel Costs – monthly, weekly, or hourly rates, as appropriate, and personnel classifications together with the percentage of time to be charged to these programs. B. Fringe Benefits. C. Contractual Costs – subcontract and consultant cost detail. D. Indirect Costs. E. Rent – specify square footage and rate. F. Supplies. G. Equipment – detailed descriptions and unit costs. H. In State Travel – mileage reimbursement rate, lodging, per diem, and other costs. I. Out of State Travel – any travel outside the State of California including mileage reimbursement rate, lodging, per diem, and other costs. J. Other Costs – a detailed list of other operating expenses.

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt 1. I. Subrecipient’s Budget (July 1, 2021 2022 2023 – June 30January 1730, 202220232024): Case Management Cost Categories Budgeted Administrative Costs $0 Program Costs Total Match Funds (Cash and/or In-Kind) $44,885 Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County 381,377 Budgets contained in Attachment C of Orange 1 City of IrvineAge Well Senior Services, Inc. this Agreement are high-level budgets. Upon approval by the Orange County Community Resources Sixth Seventh Amendment Contract NoBoard of Supervisors and/or the County – but prior to submission of July 2022 2023 invoices, a detailed budget must be submitted to the Office on Aging office for approval. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved templates will be provided by the Office on Aging. Invoices shall be submitted based upon these detailed budgets. Subrecipient may request to shift funds between programs, or between budgeted line items within a program, for the purpose of meeting specific program needs by utilizing a Budget/Staffing Revision Request form provided by Contract Administrator. Subrecipient must include a justification narrative specifying the purpose of the request, the amount of said funds to be shifted, and the sustaining annual impact of the shift as may be applicable to the current Fiscal Year Budget and/or future Fiscal Year Budgets. Subrecipient shall be responsible for and maintain the approved Budget Summary obtain written approval of any Budget/Staffing Revision Request(s) from Contract Administrator prior to implementation by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeSubrecipient.

INTEREST EARNED. A. If Subrecipient Contractor earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient Contractor shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient Contractor is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. 1. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by SubrecipientContractor; or ii2. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient Contractor expects to receive under this Contract. Attachment C-67 FormattedATTACHMENT C BUDGET SCHEDULE I. Contractor’s Budget: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge The following is the Pre-Approved Expenditure Plan for Age Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract NoInc.’ Nutrition Infrastructure Program. 20The items listed below were submitted to and approved by the California Department of Aging (CDA) for purchase using the Nutrition Infrastructure funds. Refrigerated Van 1 $100,000 Large Insulated Food Delivery Bags 50 $9,000 Small Insulated Food Delivery Bags 25 $3,200 Commercial Two-27Section Refrigerator 1 $8,000 Commercial Upright One-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs Section Freezers 2 $321,028 Matching Funds Match Amount Total Match 14,000 Commercial Dishwasher with Sterilizer 1 $17,565 25,000 Commercial In-Home Services Sink Garbage Disposer 1 $3,500 Portable Dishwasher 1 $800 9” Round White Coupe Melamine Plates 600 $2,000 12oz Round White Coupe Porcelain Bowls 600 $2,500 12.6oz Clear Customizable SAN Plastic Tumbler 600 $725 Set of Four Stainless Steel Flatware 600 $2,500 Stacked Commercial Washer and Dryer 1 $5,000 Commercial Ice Machine 1 $3,000 60” Round Dining Room Tables 20 $30,000 Stackable Chairs 300 $45,000 Accordion Storage Wall 1 $11,000 Room Divider Panels 26 $7,000 Chair Dollies 10 $2,000 Window Coverings 28 $28,000 Podium 1 $1,000 Card Tables 10 $500 Emergency Light Fixtures 3 $2,000 Ceiling Light Fixtures 3 $2,000 II. Capital Expenditures List The list of equipment below are approved to be purchased using the Nutrition Infrastructure funds for the Title IIIC Older Californians Nutrition Program only. Type of Equipment Categories Refrigerator and Freezer *Note: Walk-in refrigerators and walk-in freezers are excluded Blast Chiller Cam Chiller Side by Side Glass Door Ice Chest Milk Cooler Mobile Reach-In Roll-In Undercounter Work-Top Type of Equipment Categories Oven/Range/Stove, Steamer, Gas or Electric Combination Convection Conventional Conveyor Countertop Double Stack Griddle Heat-n-Hold Holding Unit Induction Cooktop Range Top Reel Rotating Rack Hood Exhaust Condensate Mixer Countertop Floor Type of Equipment Categories Kitchen Sink Compartment Hand Utility Type of Equipment Categories Cart/Cabinet, Hot or Cold Beverage Service Buffet Holding Mobile Proofing Retherm Rolling Self-Serve Serving Warming Type of Equipment Categories Individual Equipment Items Barbecue (allowable when serving meals to older adults in Older Californians Nutrition Program) Bagging Machine Braising Pan Broiler Cold Pan Serving Counter Cook/Chill System Depositor and Filling Machine Dishwasher ▇▇▇▇▇ ▇▇▇▇▇▇▇ Drawer Warmer Food Display (Hot or Cold) Food Processor Food Slicer, Chopper, Dicer, etc. Fryer Griddle Menu Boards (Kitchen/Serving Area) Microwave Plate/Tray Dispenser Produce Washers Salad Bar Serving Equipment Serving Line System (Hot or Cold) Shrink Wrapper Machine Tray Sealer Machine Speed Line (Hot or Cold) Stainless Steel Worktables/Steam Table Styrofoam Recycling Machine Tilt Skillet Attachment B Contractor Name: Contract Number: Fiscal Year: Item Description Item Model Serial Number Date Purchased Purchase Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 Fund Source Tag # Property Location Subcontractor The Contractor or grant recipient named above hereby certifies compliance with Government Code 8355 in matters relating to providing a drug-free workplace. The above-named Contractor will: 1. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance is prohibited in the person’s or organization’s workplace and specifying the actions to be taken against employees for violations of the prohibitions, as required by Government Code Section 8355(a). 2. Establish a Drug Free Awareness Program as required by Government Code Section 8355(b), to inform employees about all of the following: A. The dangers of drug abuse in the workplace, B. The person’s or organization’s policy of maintaining a drug-free workplace, C. Any available drug counseling, rehabilitation and employee assistance programs, and D. Penalties that may be imposed upon employees for drug abuse violations 3. Provide as required by Government code Section 8355I that every employee who works on the proposed contract or grant A. Will receive a copy of the company’s drug-free policy statement described in paragraph (1) above, and B. Will agree to abide by the terms of the company’s statement as a condition of employment in the contract or grant. ▇▇▇▇▇ ▇▇▇▇▇ Official’s Name 2/24/2023 ▇.▇. ▇▇▇▇▇▇▇▇ 2/24/2023 Orange Date Executed Executed in the County of Orange 2 City Secretary Contractor or Grantee Recipient Signature and Title This certification is required by the regulations implementing Executive Order 12549, Debarment and suspension, 29 CFR Part 98.510, Participants’ responsibilities. The regulations were published as Part VII of IrvineAge Well Senior Servicesthe May 26, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No1988 Federal Register (pages 19160-19211) (1) The contractor or grant recipient of Federal assistance funds certifies, by submission of this exhibit document, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the contractor or grant recipient of Federal assistance funds is unable to certify to any of the statements in this certification, the contractor or grant recipient shall attach an explanation to this exhibit document. 20-27-0042 Attachment C-67 Formatted: Font: ▇▇▇▇▇ ▇▇▇▇▇ Name CEO ▇.▇. ▇▇▇▇▇▇▇▇ Secretary Title 2/24/2023 Authorized Signature 2/24/2023 Date 1. By signing and submitting this exhibit document, the contractor or grant recipient of Federal assistance funds is providing the certification as set out below. 2. The certification in the clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the contractor or grant recipient of Federal assistance funds knowingly rendered an erroneous certification in addition to other remedies available to the Federal Government, the Department of Labor (DefaultDOL) Times New Romanmay pursue available remedies, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" IIincluding suspension and/or debarment. 3. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 The contractor recipient of Federal assistance funds shall provide immediate written notice to the County of Orange 3 City Orange/Workforce Investment Board to which this certification document is submitted if at any time the contractor or grant recipient of IrvineAge Well Senior ServicesFederal assistance funds learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The contractor or grant recipient of Federal assistance funds agrees by submitting this certification document that, Inc. Orange County Community Resources Sixth Seventh Amendment Contract Noshould the covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the DOL. 5. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0The contractor or grant recipient of Federal assistance funds further agrees by submitting this certification document that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," County without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 6. The contractor or grant recipient in a covered transaction may rely upon a certification of Orange 4 City a contractor or grant recipient in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. The contractor or grant recipient may decide the method and frequency by which it determines the eligibility of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract Noits principals. 7. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The above Cost Categories is an overview knowledge and information of the actual budget approved contractor or grant recipient is not required to exceed that which is normally possessed by a prudent person in the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from Officeordinary course of business dealings.

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files file’s full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of exceeding $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: Administrative Costs $216,363 Program Costs $2,163,637 I. The maximum reimbursement amount allowable for indirect costs is ten percent (Default10%) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt 1. I. of the Subrecipient’s Budget Modified Total Direct Costs (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County MTDC) excluding in-kind contributions and nonexpendable equipment. Indirect costs shall not exceed 10% of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. the Subrecipient’s Budget MTDC per funding category. Modified Total Direct Cost (January 18MTDC) means all direct salaries and wages, 2022 – June 30applicable fringe benefits, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs materials and supplies, travel and up to the first $25,009 Matching Funds Match Amount Total Match 25,000 of each Subrecipient’s subcontractor. MTDC excludes in-kind contributions, equipment, capital expenditures, charges for patient care, rental costs, tuition remission, scholarships and fellowships, participant support costs and the portion of each Subrecipient’s subcontractor in excess of $2,943 County 25,000. Other items may be excluded when necessary to avoid a serious inequity in the distribution of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget indirect costs as determined and approved by the Office County. [45 CFR 75.2]. Subrecipients requesting reimbursement for indirect costs exceeding the maximum ten percent (10%) shall retain on Aging. Subrecipient shall be responsible for and maintain the file an approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from Officenegotiated indirect cost rate or cost allocation plan.

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt. 1. I. Subrecipient’s Budget (July 1, 2021 2022 – June 30January 1730, 202220222023): Case Management Elder Abuse Prevention VII-A Cost Categories Budgeted Costs Total Budgeted Costs $22,066 92,863 Matching Funds – No Match Required Match Amount Total Match $2,597 ENP: Congregate Meals 0 Ombudsman III-B Cost Categories Budgeted Costs Total Budgeted Costs $240,476 816,137 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 2011,266 Ombudsman VII-27-0042 Attachment C-67 ENP: Home-Delivered Meals A Cost Categories Budgeted Costs Total Budgeted Costs $321,028 120,249 Matching Funds – No Match Required Match Amount Total Match $17,565 In-Home Services 0 Ombudsman Special Initiative Cost Categories Budgeted Costs Total Budgeted Costs $19,124 368,513 Matching Funds – No Match Required Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No0 2. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements.

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt. 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract NoBudget: 2. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. 1. Federal Award Identification A. Subrecipient Name: Council on Aging Southern California B. Subrecipient’s Unique Identifier (DUNS): 053284159 C. Federal Award Identification Number (▇▇▇▇): 1901CAOAEA-01, 1901CAOAOM-01, 1901CAOASS-01, 2001CAOAEA-00, 2001CAOAOM-00, and 2001CAOASS-00 D. Federal Award Date: 2020-2021 E. Subaward Period of Performance: July 1, 2020 to June 30, 2021 F. Total Amount of Federal Funds Obligated by the Action: $275,997210,418

INTEREST EARNED. A. If Subrecipient earns interest on funds received pursuant to this Contract, that interest shall be identified as income to the program(s) for which this Contract provides and shall be used and expended only for said program(s). Subrecipient shall maintain in its files full documentation of such interest earnings and expenditures. B. If Subrecipient is a nonprofit, it shall maintain any advances of funds or contributions received under this Contract in interest-bearing accounts, unless “a” or “b” below apply: i. The best reasonably available interest-bearing account would not be expected to earn interest in excess of $500 per year on the funds deposited pursuant to this Contract combined with other federal cash balances, if any, maintained by Subrecipient; or ii. The depository would require an average or minimum balance so high that it would not be feasible within the expected cash resources Subrecipient expects to receive under this Contract. Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" Formatted: Font: (Default) Times New Roman, 12 pt. 1. I. Subrecipient’s Budget (July 1, 2021 – June 30January 17, 2022): Budget: Case Management Cost Categories Budgeted Costs Total Budgeted Costs $22,066 Matching Funds Match Amount Total Match $2,597 ENP: Congregate Meals Cost Categories Budgeted Costs Total Budgeted Costs $240,476 Matching Funds Match Amount Total Match $21,707 County of Orange 1 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract NoManagement 2. 20-27-0042 Attachment C-67 ENP: Home-Delivered Meals Cost Categories Budgeted Costs Total Budgeted Costs $321,028 Matching Funds Match Amount Total Match $17,565 In-Home Services Cost Categories Budgeted Costs Total Budgeted Costs $19,124 Matching Funds Match Amount Total Match $2,251 County of Orange 2 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Font: (Default) Times New Roman, 12 pt Formatted: List Paragraph, Numbered + Level: 1 + Numbering Style: I, II, III, … + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Indent at: 0.75" II. Subrecipient’s Budget (January 18, 2022 – June 30, 2022): Case Management Transportation Cost Categories Budgeted Costs Total Budgeted Costs $25,009 Matching Funds Match Amount Total Match $2,943 County of Orange 3 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: Indent: Left: 0" County of Orange 4 City of IrvineAge Well Senior Services, Inc. Orange County Community Resources Sixth Seventh Amendment Contract No. 20-27-0042 Attachment C-67 Formatted: List Paragraph Formatted: Font: (Default) Times New Roman, 12 pt Formatted: No bullets or numbering The above Cost Categories is an overview of the actual budget approved by the Office on Aging. Subrecipient shall be responsible for and maintain the approved Budget Summary by Funding Source and Revenue Sources spreadsheet that is provided to Subrecipient from OfficeOffice on Aging. The Budget Summary by Funding Source and Revenue Sources spreadsheet shall be maintained and completed in accordance with the Office on Aging policies and processes. Any deviation from the Office on Aging approved budget, may and can delay acceptance of budgets and/or reimbursements. I. Case Management II. ENP: Congregate Meals III. ENP: Home-Delivered Meals IV. In-Home Services V. Transportation 1. Federal Award Identification A. Subrecipient Name: City of Irvine B. Subrecipient’s Unique Identifier (DUNS): 072511363 C. Federal Award Identification Number (▇▇▇▇): 1901CAOASS-01, 1901CAOACM-01, 1901CAOAHD-01, 1901CAOANS-00, 2001CAOASS-00, 2001CAOACM-00, 2001CAOHD-00, and 2001CAOANS-00 D. Federal Award Date: 2020-2021 E. Subaward Period of Performance: July 1, 2020 to June 30, 2021 F. Total Amount of Federal Funds Obligated by the Action: $457,075435,232 93.044 1901CAOASS-01 and 2001CAOASS-00 2020 Title III-B $14,797.5034,069.50