Directives - (Archived) Table of Contents|
| Record Type:||Direction|
| Old Directive Number:||DIR 01-03 (TED 3)|
| Title:||Fiscal Year 2002 Consultation Cooperative Aggreement Application|
| Information Date:||06/18/2001|
|DIRECTIVE NUMBER: DIR 01-03 (TED 3)||EFFECTIVE DATE: June 18, 2001|
|SUBJECT: Fiscal Year 2002 Consultation Cooperative Agreement Application|
|Purpose:||This Direction contains instructions and forms to assist Consultation Project Managers and Regional staff in preparing and reviewing the FY 2002 21(d) Consultation Cooperative Agreement application
|Scope:||This Direction applies OSHA-wide. It applies to all states operating Cooperative Agreements under Section 21(d) of the OSH Act
|Expiration Date:||This Direction expires on December 31, 2001
|Action Offices:||National Office, Regional Offices and States
|State Impact:||This Direction does not require a Federal Program Change for State Plans
|Originating Office:||Directorate of Federal-State Operations
|Contact:||E. Tyna Coles at 202-693-2213
Frances Perkins Building, Room N 3700
200 Constitution Ave
Washington, DC 20210
By and Under the Authority of
R. Davis Layne
Acting Assistant Secretary
Purpose. This Direction contains instructions and forms to assist Consultation Project Managers and Regional staff in preparing and reviewing the FY 2002 21(d) Consultation Cooperative Agreement application. See Appendix A for a checklist of the required components of the agreement application package.
Scope. This Direction applies OSHA-wide. It applies to all states operating Cooperative Agreements under Section 21(d) of the OSH Act.
Expiration Date. This Direction expires on December 31, 2001.
Responsible Office. Directorate of Federal State Operations, Office of Cooperative Programs.
The Division of Grants Management is responsible for reviewing financial documents and awarding monies.
The Division of Consultation Programs must review all components of the Cooperative Agreement application as detailed in this Direction.
Regional Offices. Regional Offices are required to provide technical assistance to the Consultation Projects and are required to follow the directions detailed in this Direction.
States. States operating Cooperative Agreements under Section 21(d) of the OSH Act are required to follow the directions detailed in this Direction.
Federal Program Change. This Direction does not require a Federal Program Change for State Plans.
The Consultation Annual Project Plan (CAPP) has been streamlined from previous years. It now includes only an organizational chart; staffing chart; a description of any changes in the Consultation Project's status; a detailed operational description identifying the year's strategies, activities, and their intended outcome; a projected visits chart; a description of its strategy and targets for promoting its recognition and exemption program; and a detailed description of changes to its Internal Quality Assurance program. If the Consultation Project is in a State plan State, the CAPP must also include a copy of the State's Annual Performance Plan.
The Projected Activities chart is revised to exclude "interventions" and the chart is renamed Projected Visits.
The Cooperative Agreement (Form OSHA-110) is attached to this Direction. Office of Management Budget (OMB) financial documents are now available online. The Application for Federal Assistance (SF-424/SF-424A) is available on the OMB website, accessible at http://www.whitehouse.gov/omb/grants/index.html#forms.
We have moved the Combined Assurances, Certifications, Conditions, and Restrictions to the Cooperative Agreement for OSHA Consultation. In addition, we have slightly modified the wording of Assurance and Certification 6.(i) on limited English proficiency.
In the past, review of cooperative agreement applications has been done separately by Regional and National personnel. Beginning this year we will conduct simultaneous review of the applications. Final approval letters will be sent by September 20 from the National Office.
States are now required to ensure basic computer literacy of the Consultation Project Manager and consultants. For the purposes of this requirement, "basic computer literacy" includes the following: satisfactorily operate Microsoft Windows, E-mail, a Windows based word processor (Word Perfect or Microsoft Word), a Windows based Internet engine (Internet Explorer or Netscape Navigator), Microsoft PowerPoint (if the individual conducts training), and the OSHA Consultation Standalone application if the state uses this application.
Funding Levels. All amounts entered in the Cooperative Agreement (OSHA Form 110), the Application for Federal Assistance (SF 424), and the related worksheet must be based on the FY 2001 authorized award levels. See Appendix G for FY 2002 Funding Levels.
Consultation Project Manager's Responsibilities. Office of Management and Budget (OMB) Circulars A-102 and A-110 require that Cooperative Agreement awards be made at least 10 days prior to the beginning of the Cooperative Agreement period. The Consultation Project Manager is responsible for completing the Consultation Agreement Application package and submitting it to the National Office and Regional Administrator by August 3, 2001. Two original signature agreement packages must be sent to the National Office and a copy of the package must be sent to the Regional Administrator. The National Office copies should be forwarded to the attention of:
U.S. Department of Labor
Occupational Safety and Health Administration
200 Constitution Avenue NW
Washington, DC 20210
The Consultation Project Manager must ensure that the completed Cooperative Agreement application package includes all of the following documents outline below. See Appendix A for a Cooperative Agreement application checklist.
Consultation Annual Project Plan (CAPP). The CAPP describes in detail how a Consultation Project's activities will support either the Federal or State annual performance plan in the coming program year. See Appendix B for a checklist of required components.
All activities outlined in the CAPP must fall within the annual performance goals identified in the Federal or State Strategic Plan and must be negotiated with the Regional Administrator or his/her representative. If the Consultation Project is in a State plan State, the CAPP must also include a copy of the State's Annual Performance Plan.
The CAPP must include an organizational chart; staffing chart; a description of any changes in the Consultation Project's status; a detailed operational description identifying the year's strategies, activities, and their intended outcome; a projected visits chart; a description of its strategy and targets for promoting its recognition and exemption program; and a detailed description of changes to its Internal Quality Assurance program.
The Consultation Project Manager should send a draft CAPP to the Region to facilitate a preliminary discussion, which should take place in the third quarter of each year. Further discussion or negotiation of the content of the CAPP must take place in time to meet the deadline for submission of the complete application package.
Financial Documents. The Cooperative Agreement (Form OSHA-110) and the Application for Federal Assistance (SF-424 and SF-424A) must be prepared using the FY 2001 base funding level. See Appendix G for FY 2002 Funding Levels. Any increase for FY 2002 funding for the program will be awarded through the amendment process.
Each Project must submit an original and one copy of the Cooperative Agreement application package with original signatures on each copy of the Cooperative Agreement and the Application for Federal Financial Assistance. Accuracy of the financial documents is critical to the timely award of the Cooperative Agreement. Applications containing significant deficiencies will not be approved. Any application which is not in substantial accord with the instructions will be returned to the recipient for modifications.
Administrative Cap. OSHA will continue the current 25 percent ceiling limitation on administrative costs. This limitation requires that no more than 25 percent of the 90 percent federal/10 percent recipient costs (including 100 percent federal monies) may be budgeted for administrative costs.
Salary Target. Each project must devote a minimum of 50 percent of its 90 percent federal/10 percent recipient funds (including 100 percent federal monies) to consultant salaries and fringe benefits. Projects unable to meet this target must provide an explanation of why they failed to meet their targeted goals.
Computer Purchases. Due to the rapidly changing industry standards, it is difficult to provide up-to-date specifications here. Consultation Project Managers may contact the Directorate of Information Technology, Office of Management Data Systems (OMDS) sixty or more days in advance of the purchase of new computer equipment for the latest specifications.
Minimum Staffing. At least four professional FTEs -- two full-time safety specialists and two full-time industrial hygienists or their equivalents -- must be included in each project's personnel plan. All of the Project's consultants and safety personnel must be employed at least 50% of their time in the Consultation Program and must spend at least 50% of their time engaged in consultation activity. Projects needing to deviate from this minimum must seek approval from the National Office.
OSHA Restrictions and Conditions. The State official with signature authority must sign the certifications, assurances, lobbying restrictions, and OSHA restrictions and conditions.
Regional Administrator's Responsibilities. The Regional Administrator is responsible for reviewing the Cooperative Agreement application concurrently with the National Office. After review is complete, the Regional Administrator must transmit a memorandumcontaining an assessment of the Cooperative Agreement application to the National Office. The memorandum must address, at a minimum, an evaluation of all of the required components outlined in Paragraph VIII above.
National Office Responsibilities. The National Office is responsible for reviewing and approving the Cooperative Agreement application, and verifying that the application meets all required financial, operational and policy requirements.
Directorate of Federal-State Operations. Consultation staff are responsible for conducting concurrent reviews of Consultation Agreement applications with Regional Offices and for completing the CAPP Checklist for each applicant. Consultation staff are responsible for contacting their Regional Office counterparts no later than 12 business days after the initial due date to discuss the Cooperative Agreement packages and identify any issues that need corrected. Consultation staff are responsible for contacting their Regional Office counterparts no later than 20 business days after the initial due dates to resolve and consolidate any issues which needed to be addressed.
Directorate of Administrative Programs. Grants Management staff are responsible for conducting concurrent reviews of Consultation Agreement applications with Regional Offices and for reviewing financial documents for accuracy, posting funding award levels on the Payment Management System, and transmitting the award letters for each recipient.
Checklist of Required Components of the Cooperative Agreement Application
|The Consultation Annual Project Plan (CAPP):
|Overview of the Consultation Project
Changes in Project's Status (if any)
|Operational Description by Annual Performance Goal
|Strategy and Targets for Recognition and Exemption Program
|Changes to the Internal Quality Assurance Program
|State Annual Performance Plan (if the Consultation Project operates in a State plan state)
|Cooperative Agreement (Form OSHA-110)|
|Application for Federal Assistance (SF-424)|
|Budget Information - Non-Construction Programs (SF-424A)
|The Cooperative Agreement for OSHA Consultation:
|Cooperative Agreement for OSHA Consultation under Sections 21(c) and 21(d) of the Occupational Safety and Health Act of 1970, including:
Assurances and Certifications Non-Construction Programs
OSHA Restrictions and Conditions
|FY 2002 Approved Consultation Equipment Procurement Listing
|FY 2002 Training Plan
|FY 2002 Accompanied Visit Plan
Checklist of Required Components of the CAPP
|Staffing chart (See Appendix C) The chart must contain the number of full and part-time staff employed by the Consultation Project, expressed in full-time equivalents (FTEs), for each category of staff. All projects must have the equivalent of two safety and two health professionals, in addition to managerial and support personnel. The numbers in the chart in Appendix C are examples only.|
|Description of any changes in the Consultation Project's status. Change(s) in Project's Status. Any changes in the status of the Project, such as the organizational unit within which the Consultation Project is located or the structure of the unit or organization must be provided.|
Detailed operational description identifying the year's strategies, activities, and their intended outcomes. List and discuss each of the applicable Federal or State annual performance goals to be supported by the Project, local emphasis programs, and special initiatives, including a description of each of the following elements:
The tabular format in Appendix D contains all of the required information categories.
Projected visits chart. Estimate the total number of consultation activities to be performed during the year covered by the project plan, broken out by annual performance goal. Include the following information:
The tabular format in Appendix E contains all of the required information categories.
|Description of the Consultation Project's strategy and targets for promoting its recognition and exemption program|
|Detailed description of changes to its Internal Quality Assurance program|
|State's Annual Performance Plan, if the Consultation Project is in a State plan State|
|1. Managerial Staff||0.75|
|2. Consultants -- Safety||3.50|
|3. Consultants -- Health||2.00|
|4. 100% State-Funded Consultants -- Safety||0.50|
|5. 100% State-Funded Consultants -- Health||0.50|
|6. Clerical/data systems support||2.00|
|7. Marketing staff||0.25|
|Total Number of FTEs||10.50|
Operational Description by Annual Performance Goal
|Federal or State Performance Goal# and Statement||Consultation Strategy||Description of Planned Consultation Activities||Anticipated Impact of Consultation Activities|
|Activity 1 .....
Activity 2 .....
|Activity 1 .....
Activity 2 .....
|Local Emphasis Program|
|Annual Performance Goal#||Projected Visits|
|Initial Visits||Training/Assistance||Follow-Up||Combined Totals by Goal|
|Local Emphasis Program|
|Total by Safety or Health|
|Combined Safety and Health Activities|
|Note:||Interventions are no longer tracked on this form. Offsite technical training, speeches, and presentation to stakeholders must now be recorded on the Activity Hours for Compliance Assistance Web Application (OSHA Form 66).|
Cooperative Agreement for OSHA Consultation under Sections 21(c) and 21(d) of the Occupational Safety and Health Act of 1970
Between the State/Commonwealth/Jurisdiction of _________________________________ and the Occupational Safety and Health Administration (OSHA), United States Department of Labor.
AUTHORITY AND PARTIES TO AGREEMENT.
Pursuant to Sections 21(c) and 21(d) of the Occupational Safety and Health Act of 1970 (hereinafter called the Act), it is hereby agreed that the Assistant Secretary of Labor for Occupational Safety and Health (hereinafter called the Assistant Secretary) and the _________________________________ (hereinafter called the State) -- which affirms that it has been authorized by the Governor to enter into this agreement with full power to perform the obligations hereunder and to receive and expend Federal funds as well as state funds as required herein -- will execute all provisions of this agreement.
Nothing herein shall preclude the Assistant Secretary from exercising Federal responsibility and authority under the Act or preclude the State from exercising its responsibility and authority under state law when not in conflict with the Federal Act and the terms of this agreement.
Either party may terminate this agreement upon 30 days notice to the other party.
It is agreed by both parties that substantive work and costs incurred under this agreement will be managed and scheduled in a manner to assure adequate program coverage and activity throughout the entire 12 month performance period, without the necessity of requesting a budget modification to increase the amount of Federal funds authorized.
This agreement incorporates the following documents which the State has agreed to submit.
Any and all substantive modifications to the conditions and terms stated in this agreement shall be reduced to writing as amendments, numbered and signed by both principal parties to this agreement.
PURPOSE AND SCOPE.
The State shall provide consultation services, including training and education, whereby employers, particularly those with smaller businesses and with high hazard work places (as defined or approved by OSHA), receive assistance in:
Identifying any safety and health hazards in their workplaces.
Controlling or eliminating these hazards successfully.
Establishing or improving a workplace safety and health program.
Understanding all requirements of applicable Federal (or State) law and implementing regulations.
The statewide project operated under this agreement shall conform fully with the requirements in the Code of Federal Regulations (29 CFR 1908), all related formal directives issued by the Assistant Secretary and the appendices attached to this agreement.
The Assistant Secretary will reimburse the State one hundred percent (100%) of the allowable costs of all OSHA required or approved training and out-of-state travel. All other allowable training costs, and related travel and per diem, will be reimbursed at ninety percent (90%). All such training, travel and per diem must be directly related to the activity performed under this agreement.
ALLOCATION OF COSTS.
In order to ensure uniformity and comparability among agreement submissions, Consultation and Administration costs shall be determined and set forth as follows:
Consultation. Consultation costs consist of all direct costs associated with the immediate delivery of consultative services to employers and employees. Costs include but are not limited to: the salaries and fringe benefits of consultation staff engaged in promotion, scheduling, visit preparation, hazard identification, program assistance, training and education, offsite assistance, report preparation, correction verification and similar authorized consultative activities; and related materials, supplies, equipment and staff training. They also include the consultation portion of total ADP costs. (ADP costs should be distributed between consultation and administration in the proportion to which ADP services support each function.) Consultation staff include safety consultants, health consultants, consultant trainees and consultant trainers who meet the minimum qualifications defined in 29 CFR 1908.8(b). Also included are costs of immediate first-level consultant supervisors, except those costs associated with accompanied visit activity.
Additionally, costs of direct clerical support to consultants and first-level consultant supervisors are charged to Consultation.
Personnel costs shall include the salaries of positions identified in Part A: Consultation as safety consultant (S), safety consultant trainee (TS), safety supervisor (S/S), industrial hygiene consultant (H), industrial hygiene consultant trainee (TH), industrial hygiene supervisor (H/S) and direct clerical support (SEC) to these positions. For consultants and first-level consultant supervisors who also serve in a managerial capacity for the project, salary costs shall be distributed between Administration and Consultation in proportion to the percent of time spent in performing (1) program management and (2) consultant and/or (3) consultant supervisory activities. Salaries reflecting (a) consultant time should be listed separately from salaries reflecting (b) time providing first-level supervision to consultants and salaries of clerical staff who provide direct support to consultants and consultant supervisors.
Fringe Benefits shall include the costs of benefits for personnel identified in Part A: Consultation as safety consultant (S), safety consultant trainee (TS), safety supervisor (S/S), industrial hygiene consultant (H), industrial hygiene consultant trainee (TH), industrial hygiene supervisor (H/S) and direct clerical support (SEC) to these positions. Costs include payments for retirement, social security, workers' compensation, life insurance, medical insurance, etc. Include the cost formula for each fringe benefit. For consultants and first-level consultant supervisors who also serve in a managerial capacity for the project, fringe benefit costs shall be distributed between Administration and Consultation in proportion to the percent of time spent in performing (1) program management and (2) consultant and/or (3) consultant supervisory activities. Fringe benefits reflecting (a) consultant time should be listed separately from fringe benefits reflecting (b) time providing first-level supervision to consultants and fringe benefits of clerical staff who provide direct support to consultants and consultant supervisors.
Travel shall include the costs of authorized travel for personnel identified in Part A: Consultation as safety consultant (S), safety consultant trainee (TS), safety supervisor (S/S), industrial hygiene consultant (H), industrial hygiene consultant trainee (TH) and industrial hygiene supervisor (H/S). Costs shall include travel required to conduct promotional visits, onsite consultation visits and offsite assistance. Travel to attend professional development/training courses (e.g., OTI) and regional and national consultation meetings, except that costs of travel for all participants to the Annual Consultation Conference, must be charged to administration. Intra-agency travel, such as that related to flexi-place programs, must have prior approval from the Regional Administrator. Appropriate supporting details for out-of-state travel (per diem, airfare, registration fees, miscellaneous, etc.) must be reported in the Annual Training Plan. Deviations from this plan involving out-of-state travel to courses and/or locations other than those proposed must be approved in writing by the Regional Administrator prior to the actual travel. Travel for the purpose of performing accompanied visits shall be charged to Administration.
Attendance at professional development conferences such as AIHA, ASSE, and NSC is not considered OSHA-required training and therefore may not be funded with 100% federal funds. A Project Manager may use cooperative agreement funds to provide an opportunity for each professional safety or health employee to attend a professional development conference of three to five days' duration generally once every two years. However, the percentage of cooperative agreement funds used to pay for the individual's attendance at such a conference may not exceed the percentage of time for which that employee is dedicated to the cooperative agreement. For example, if a safety professional is dedicated at 0.5 FTE, then no more than 50% of the cost of attending the conference may be charged to the cooperative agreement.
Costs associated with attendance and travel to professional development conferences of individuals in positions that are not funded by the cooperative agreement may not be allocated to the cooperative agreement.
Equipment shall include the costs of consultant technical equipment having a useful life of more than one year and a unit acquisition cost of $5,000 or more, except as defined in Special Provisions VI.B. All equipment so defined shall be listed in the Approved Consultation Equipment Procurement Listing.
Supplies shall include the costs of all tangible consultant technical property and materials other than equipment as defined above. Please itemize and describe all supply costs.
Contracts shall include the costs of contracts with all sources, whether non-state government or state government sources, for the provision of services associated with consultant field activities (e.g., occupational health consultation, laboratory sample analysis in states having a Plan approved under Section 18 of the Act, and consultant health monitoring and medical examinations). The detail for laboratory sample analysis costs shall include the number of samples projected for the fiscal year.
Other shall include the costs of equipment calibration and repair services for equipment which cannot be serviced by the OSHA Cincinnati Laboratory (list all equipment), non-travel costs of required or approved training for consultants (limited to tuition fees, registration fees, textbooks, course materials, etc.) and costs of all other miscellaneous consultative items which are not allocated above. Miscellaneous costs include but are not limited to: the proportion of rent, utilities, communications, data processing, postage, freight, etc. associated with the delivery of consultative services by consultation staff; subscriptions to safety and health journals; and training aids, instructional programs and promotional materials which are used by consultants to perform consultation activities.
Total Direct Charges shall consist of the total of the above costs (Items 1. - 7.) for Consultation.
Administration. Administrative costs consist of all direct costs associated with the management and support of the consultation program and all indirect costs. These costs include but are not limited to: the salaries and fringe benefits of personnel engaged in executive, fiscal, data collection, personnel, legal, audit, procurement, data processing, communications, maintenance and similar functions; and related materials, supplies, equipment and staff training. They also include the administration portion of total ADP costs. (ADP costs should be distributed between consultation and administration in the proportion to which ADP services support each function.) Additional administrative costs extend to the salaries and fringe benefits of direct program management positions such as project directors, program monitors and program review officers; and costs of direct clerical support to these positions.
Personnel shall include the salaries of positions identified in Part B: Administration as management (MGT) and direct clerical support (SEC) to these positions. For management personnel who also serve as consultants and/or consultant supervisors, salary costs must be distributed between Administration and Consultation in proportion to the percentage of time spent in performing (1) program management, consultant duties, and/or (3) supervision of consultants.
Fringe Benefits shall include the costs of benefits for personnel identified in Part B: Administration as management (MGT) and direct clerical support (SEC) to these positions. Costs include payments for retirement, social security, workers' compensation, life insurance, medical insurance, etc. Include the cost formula for each fringe benefit. For management personnel who also serve as consultants and/or first-level consultant supervisors, fringe benefit costs shall be distributed between Administration and Consultation in proportion to the percentage of time spent in performing (1) program management, (2) consultant duties, and/or (3) supervision of consultants.
Travel shall include the costs of authorized travel for personnel identified in Part B: Administration as management (MGT) personnel and for all personnel conducting accompanied visits. Costs shall include travel required to attend safety and health conferences (subject to the restrictions in V.A.3., above), regional and national consultation meetings and professional development/training courses. Appropriate supporting details for out-of-state travel (per diem, airfare, registration fees, miscellaneous, etc.) shall be reported in the Annual Training Plan. Deviations from this plan involving out-of-state travel to courses and/or locations other than those proposed must be approved in writing by the Regional Administrator prior to the actual travel.
Equipment shall include the costs of office equipment and machinery having a useful life of more than one year and a unit acquisition cost of $5,000 or more, except as defined in the Special Provisions VI.B. All equipment so defined shall be listed in the Approved Consultation Equipment Procurement Listing.
Supplies shall include the costs of all tangible office property and desk-top materials other than equipment as defined in this section. List supply costs by major category.
Contracts shall include the costs of contracts with all sources, whether non-state government or state government sources, for the provision of administrative support services (e.g., service contracts for maintenance of office equipment, leasing of photocopiers, fiscal services, etc.).
Other shall include non-travel costs of required or approved training for management personnel (limited to tuition fees, registration fees, textbooks, course materials, etc.) and costs of all other miscellaneous administrative items which are not allocated above. These costs include but are not limited to: the proportion of rent, utilities, communications, data processing, postage, freight, etc. associated with the management of the consultation program by administrative staff.
Total Direct Charges shall consist of the total of the above costs (Items 1. through 7.) for Administration.
A listing of approved positions is contained in the FY 2001 Supporting Details of Anticipated Costs of this agreement. Key personnel include project managers, supervisors, and consultants. Any changes in these positions must be approved by the Regional Administrator.
Microcomputer equipment (hardware and software), regardless of unit cost, requires the written prior approval of FSO and must be listed in the Approved Consultation Equipment Procurement Listing (Part II, Section B).
Unless a State has made special provisions for such, substantive programmatic work may not being transferred to another agency (subrecipient) under this agreement.
Unless a State having a Plan approved under Section 18 of the Act has designated a State agency/facility for this purpose, the laboratory designated by OSHA to provide analysis of samples for all projects shall be:
WISCONSIN OCCUPATIONAL HEALTH LABORATORY
979 Jonathon Drive
Madison, Wisconsin 53713
Telephone: (608) 263-8807
Fax: (608) 263-6551
Contact: Mr. Terry Burk
The federal cost principles applicable to this project are:
Cost Principles for State and Local Governments
(OMB Circular A-87)
Cost Principles for Educational Institutions
(OMB Circular A-21)
Financial reporting forms required of all projects and their frequency of submission are:
Department of Health and Human Services - Payment Management System Federal Cash Transactions Report (PMS 272), pages 1 and 2, is due in the Regional Office 30 days after the end of each federal fiscal quarter. Only signed copies of the report will be accepted and the data submitted should reflect exactly what is being reported to the Department of Health and Human Services.
Financial Status Report (SF-269) is due in the Regional Office 30 days after the end of each federal fiscal quarter.
Quarterly Reporting. Recipients which have accounting systems that prohibit them from meeting the Office of Management and Budget (OMB) requirements on the submission of financial reports, as outlined in this section, must have written approval from the Regional Administrator to establish an alternative schedule for submission of financial reports. The approved state specific schedule must also be submitted to the National Office for inclusion in the official file.
Close-out Reporting. All agreements must be closed 90 days after the end of the performance period (generally December 31). A copy of the Financial Status Report must accompany the recipient's close-out documents.
Close-out Extensions. Recipients unable to close out by December 31 are required to request a close-out extension in writing by December 1, providing an explanation of why they cannot close-out in a timely manner. An interim (preliminary) Financial Status Report (covering October - December) is due in the Regional Office on January 31, even when a close-out extension has been approved. All requests for close-out extensions must be transmitted to the National Office for inclusion in the official file, and any extensions beyond February 28 must be approved by the National Office.
Cooperative Agreement (Form OSHA-110) must accompany the Application for Federal Assistance (SF-424). This is the only time this form is completed.
Other performance reports and copies of forms as may be required for program management purposes will be distributed as necessary.
Unless different instructions are provided by the Director of FSO or through the OSHA Directives system, all reports required under this agreement, and all requests for agreement modification, shall be delivered (or mailed) to the Regional Administrator.
It is agreed that OSHA may unilaterally modify this agreement whenever necessary to conform to new regulations, new applications, or official interpretations of DOL or OMB regulations.
ADDITIONAL SPECIAL PROVISIONS.
The following special provisions are added to this agreement.
Approval of this agreement depends upon Congressional action on the Department of Labor's appropriation for FY 2002.
It is hereby certified by the State that matching state funds are or will be available during the tenure of this agreement.
In no case shall the State be liable for more than 10 percent of actual expenditures (exclusive of one hundred percent [100%] Federal-funds) under this agreement.
Where appropriate, restrictions to the agreement may be added by the Assistant Secretary to ensure that the recipient fully complies with specific terms and conditions of the Cooperative Agreement, DOL administrative requirements set forth at 29 CFR Parts 95 and 97 (Institutions of Higher Education), or provisions set forth in 29 CFR 1908. When an agreement is approved subject to the inclusion of one or more restrictions, it is hereby understood by the recipient that such approval is granted contingent upon meeting the conditions specified within the prescribed timeframe.
Recipients shall prepare their agreement packages for the maximum amount they can match within the authorized amount. If a recipient is unable to match the authorized award, the award amount will be reduced to reflect the amount the recipient is able to match. These reductions will carry-over into subsequent years. In addition, cost-of-living increases will be based on the executed award amount, not proposed funding levels.
OPTIONAL INSERT(S) TO THE COOPERATIVE AGREEMENT
Below are formats for four "Additional Special Provisions" which, if appropriate, would be inserted in the agreement following paragraph VII.E.
Two provisions pertain to Items VI.C. and D. of the agreement:
Substantive programmatic work is being transferred to another agency (sub-recipient) under this agreement, as follows:
As a State having a Plan approved under Section 18 of the Act, ____________ designates the following State laboratory to provide analysis of samples:
One provision pertains to paragraph V., "Allocation of Costs."
Allowable travel costs and per diem expenses related to travel, but not salaries or other costs, for _______ will be reimbursed to the State under the terms of this agreement when the following conditions are met:
The travel is intended for the purposes of properly administering the agreement or furthering consultation operations.
The travel was approved in the initial agreement or received the prior written approval of the Regional Administrator.
For some States, the following provision applies (insert "Safety" or "Health" as appropriate):
This agreement covers consultation for _______ only; a separate agreement between OSHA and the state will cover ________.
Assurances and Certifications
Note: Certain of these assurances may not be applicable to your project. If you have questions, please contact the awarding agency. Some Federal awarding agencies may require applicants to certify to additional assurances. If this is the case, you will be notified.
As the duly authorized representative of the applicant I certify that the applicant:
Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project costs) to ensure proper planning, management and completion of the project described in this application.
Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives.
Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal gain.
Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C §§ 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352), which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L.92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§ 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C § 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d) and section 188 of the Workforce Investment Act of 1998 (P.L. 105-220), as it relates to the prohibition against national origin discrimination for persons with limited English proficiency (pursuant to Executive Order 13166 issued August 11, 2000); (j) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and (k) the requirements of any other nondiscrimination statute(s) which may apply to the application.
Will comply with Executive orders 12876, 12900, 12928, and 13021 by strongly encouraging contractors to provide subcontracting opportunities to Historically Black Colleges and Universities, Hispanic Serving Institutions, and Tribal Colleges and Universities.
Will comply, or has already complied, with the requirements of Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646), which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases.
Will comply with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and 7324-7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds.
Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. §§ 276a to 276a7), the Copeland Act (40 U.S.C. § 276c and 18 U.S.C. §§ 874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§ 327-333), regarding labor standards for federally assisted construction subagreements.
Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234), which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance, if the total cost of insurable construction and acquisition is $10,000 or more.
Will comply with environmental standards which may be prescribed pursuant to the following (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in flood plains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§ 1451 et seq.); (f) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§ 1271 et seq.), related to protecting components or potential components of the national wild and scenic rivers system.
Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a-1 et seq.).
Will comply with P.L. 93-348, regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance.
Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance.
Will comply with the Lead-Base Paint Poisoning Prevention Act (42 U.S.C. §§ 4801 et seq.), which prohibits the use of lead-based paint in construction or rehabilitation of residence structures.
Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act of 1984.
Will comply with all applicable requirements of all other Federal laws, executive accordance, regulations and policies governing this program.
In accordance with Section 516 of the 1989 Department of Labor Appropriation Act, the grantee agrees that when issuing statements, press releases, requests for proposals, bid solicitations or other documents describing the grant project or program the grantee shall clearly state (1) the percentage of the total costs of the program or project which will be or is being financed with Federal money; and (2) the dollar amount of Federal funds for the project or program.
In accordance with the Drug-Free Workplace Act of 1988, the grantee certifies that it will provide a drug-free workplace by:
Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition;
Establishing a drug-free awareness program to inform employees about:
Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a);
Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will --
Notifying the agency within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction;
Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted --
Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f).
The undersigned certifies, to the best of his or her knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or an employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal award, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal award, grant, loan, or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activity," in accordance with its instructions.
The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each failure.
Section 18. Of the "Lobbying Disclosure Act of 1995", signed by the President on December 19, 1995, requires that any organization described in section 501(c)(4) of the Internal Revenue Code of 1986 which engages in lobbying activities shall not be eligible for the receipt of Federal funds constituting an award, grant or loan.
This is to certify that we are_____/are not_____ an IRS 501(c)(4) entity.
As an IRS (501(c)(4) entity, we have______/have not_____ engaged in lobbying activities.
OSHA Restrictions and Conditions
As the duly authorized representative of the applicant I certify that the applicant:
Takes responsibility for encouraging employers to request consultative assistance and shall publicize the availability of its consultative service and the scope of the service that will be provided.
Explains to employers that the employer receiving consultation services remains under statutory obligation to provide safe and healthful working conditions to their employees.
Explains to employers that no referrals will be made to enforcement unless the employer fails to eliminate a serious hazard identified by a consultant.
Explains to the employer the requirements for participation in the Safety and Health Achievement Recognition Program (SHARP).
Assigns priority in scheduling to requests from businesses with the most hazardous operations, with primary attention to smaller businesses. Preference is given to the smaller businesses that are in higher hazard industries or that have the most hazardous conditions at issue in the request.
Prepares appropriately for visits.
Conducts an initial onsite visit consisting of an opening conference, an examination of those aspects of the employer's safety and health program that relate to the scope of the visit, a walk through the workplace, and a closing conference.
Retains the right to confer with employees during an onsite visit.
During the opening conference, explains the relationship between consultation and enforcement and also explains the employer's obligation to protect employees if certain hazardous conditions are identified.
Focuses onsite activity primarily on those areas, conditions, or hazards within the requested scope of the visit.
During onsite activity, advises the employer of the employer's obligations and responsibilities under applicable Federal or State law and implementing regulations.
When identifying hazards, indicates to the employer, using the consultant's best judgement, whether the situation would be classified as a "serious" or "other-than-serious" hazard.
Informs the employer that the employer is obligated to take immediate action to eliminate employee exposure to a hazard that, in the best judgement of the consultant, poses an imminent danger.
Establishes a time frame for the correction of each hazard identified during onsite activity.
Informs the employer that the employer's failure to abate an identified hazard within the established time frame (or extension of the timeframe) results in notification of the appropriate OSHA enforcement authority.
Prepares and sends to the employer a written report containing substantive findings or recommendations.
Preserves the confidentiality of information pertaining to trade secrets that may have been obtained during an onsite visit.
Conducts consultative activity independently of any OSHA enforcement activity.
Does not provide to OSHA the identity of, or files pertaining to, employers requesting consultation services for any compliance inspection or scheduling activity, except in cases where the employer has failed to abate a hazard or the employer has elected to participate in the Safety and Health Achievement Recognition Program.
Assures that onsite consultation visits already in progress have priority over OSHA compliance inspections except in the case of imminent dangers, fatality/catastrophe investigations, complaint investigations, or other investigations deemed critical by the Assistant Secretary.
Terminates onsite visits for imminent dangers, fatality/catastrophe investigations, complaint investigations, or other investigations deemed critical by the Assistant Secretary.
Does not conduct onsite consultation visits while OSHA enforcement inspections are in progress.
Explains to the employer that a condition of participation in the Safety and Health Achievement Recognition Program is that requirements pertaining to "serious" hazards apply equally to "other-than-serious" hazards.
Uses consultants who are employees of the State and are qualified under State requirements for employment in the field of occupational safety and health.
Applies minimum requirements for consultants that include the ability to recognize hazards and assess employee exposure and risk, knowledge of OSHA standards, knowledge of hazard correction techniques and practices, knowledge of workplace safety and health program requirements, skill in effective written and oral communication, and any additional degrees or experience required by the Assistant Secretary.
Maintains an organized system for monitoring the performance of consultants.
Submits narrative reports and compiles and submits data such as IMIS that is needed for monitoring and evaluation purposes, as required, to the Regional Administrator.
Will not expend any 21(d) or matching state funds from this agreement to fund activities or provide services to employers in SIC Codes listed in Appendix A of the current OSHA Instruction CPL 2.51J (Enforcement Exemptions and Limitations under the Appropriations Act), or in Appendix A of same said instruction that will be renamed CPL 2-0.128 under the new OSHA Directives system.
Provides a List of Hazards to every employer who receives a hazard survey and instructs the employer that they must post the List of Hazards for three days or until the hazard is corrected, whichever is longer.
|SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL||TITLE|
|APPLICANT ORGANIZATION||DATE SUBMITTED|
A complete and current equipment inventory is required of each consultation project. The inventory should include information on the description, manufacturer, model number, serial number (if applicable), location, condition, acquisition date and acquisition cost of each item of equipment.
Only a list of changes (deletions and additions) to the initial equipment inventory submitted in FY 2001 is required in the FY 2002 agreement package.
|Federal Catalog # 17.504||Date: ____________|
|OSHA Consultation Programs||State: ____________|
FY 2002 APPROVED CONSULTATION
EQUIPMENT PROCUREMENT LISTING
List all non-expendable, personal property having a useful life of more than one year and a unit acquisition cost of $5,000 or more, and all computer-related equipment. Ref: CFR 97.32(g) & OMB Circular A-87, Attachment B, C.1.
(include brand and model)
|Number||Cost per Unit||Total Cost||National Office Use Only|
|On Hand||For Purchase||Approved||Title Transfer||Remarks|
Laptop: Toshiba Satellite Pro
|NOTE:||List equipment by category: technical; office/administrative. Equipment which was requested and approved-but not procured-in the previous award year should be clearly identified.|
|ANNUAL TRAINING PLAN||Date: ____________|
|FY 2002||State: ____________|
|List Personnel by ID Number and Type (Mgt/S/IH/etc.)||Training Activity & Location. List Per Diem/Airfare/Reg. Fee/Misc/etc. for Out-of-state training.||Indicate by Number the Competency Area that Training will Address*|
|*1. Hazard Identification||5. Safety and Health Program Requirements|
|2. Assessment of Risk and Exposure||6. Effective Communications|
|3. Knowledge of Standards||7. Other (specify)|
|4. Hazard Correction Techniques|
|NOTE:||Funds sufficient to cover travel requirements to conduct proposed training should be budgeted in Part A: Consultation and Part B: Administration. These costs must be specific to the activities identified as determined by the location and duration of the training. All training included in the plan is eligible for 100% Federal funding, subject to the approval by the FSO Director|
FY 2002 Accompanied Visit Plan
The plan for accompanied visits should state the policies which will govern activity for the fiscal year, rather than who will be accompanied by whom on specific visits.
Funds sufficient to cover travel for these activities should be budgeted in Part B: Administration, under Item c.2, Travel, unless the project indicates that travel is local and the costs are nominal in amount.
Application for Federal Assistance (SF-424)
Budget Information - Non-Construction Projects (SF-424A)
These forms are available on the Internet at http://www.whitehouse.gov/omb/grants/index.html#forms.
Cooperative Agreement (Form OSHA-110)
|FY 2002 Proposed Initial Base Awards for OSHA 21(d) Consultation Program|
|Recipient||Region||FY 2002 Proposed Initial Base Award||Recipient||Region||FY 2002 Proposed Initial Base Award|
|Rhode Island *||1||$422,000||Texas||6||$2,306,000|
|District of Columbia||3||$425,000||Colorado State U||8||$804,000|
|Pennsylvania, IU||3||$1,466,000||North Dakota||8||$256,000|
|Mississippi State U||4||$530,000||Hawaii||9||$435,000|
|Tennessee||4||$805,000||Idaho, Boise State U||10||$438,000|
|Wisconsin Health||5||$911,000||U of Alabama Training||$129,000|
|' * FY 2001 Amendments presently outstanding for these states. Projected FY 2001 Final Base Award funding level shown assumes the state will fully match the FY 2001 Amended Base Award.|
|Directives - (Archived) Table of Contents|
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