Directives - Table of Contents Directives - (Archived) Table of Contents
• Record Type: Notice
• Old Directive Number: 07-01 (CSP 02)
• Title: Federal On-site Consultation Cooperative Agreement Application for FY 2008
• Information Date: 04/12/2007
• Standard Number: 1908
• Status: Archived

Archive Notice - OSHA Archive

NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.


OSHA NOTICE

DIRECTIVE NUMBER: 07-01 (CSP 02) EFFECTIVE DATE: 4/12/07
SUBJECT: Federal On-site Consultation Cooperative Agreement Application for FY 2008


ABSTRACT

Purpose: This Notice contains instructions and forms to assist On-site Consultation Project Managers in Federal states and OSHA Regional staff in preparing the Federal On-site Consultation Cooperative Agreement Application.

Scope: This Notice applies to all Federal OSHA On-site Consultation Projects operating Cooperative Agreements under Section 21(d) of the OSH Act.

References: OSHA Instruction CSP 02-00-001 [TED 3.6], Consultation Policies and Procedures Manual (CPPM) and 29 Code of Federal Regulations (CFR) 1908, Cooperative Agreements.

Expiration Date: This Notice expires on September 30, 2008.

State Impact: On-site Consultation Projects operating Cooperative Agreements under Section 21(d) of the OSH Act in states under Federal enforcement jurisdiction and in the four states that have Public Employee Only Plans are required to follow the instructions outlined in this Notice.

Action Offices: National, Regional and State Offices.

Originating Office: Directorate of Cooperative and State Programs (DCSP).

Contacts: Office of Small Business Assistance (OSBA)
Frances Perkins Building, Room N-3660
200 Constitution Avenue, NW
Washington, DC 20210
(202) 693-2220


By and Under the Authority of

Edwin G. Foulke, Jr.
Assistant Secretary






Executive Summary

This Notice contains instructions and forms to assist On-site Consultation Project Managers in Federal states and Regional staff in preparing the Federal On-site Consultation Cooperative Agreement Application.

Significant Changes

  1. On-site Consultation Projects will have the opportunity to submit an electronic grant application using the Grants.gov system as part of a pilot project. See, VII.

  2. Requirement to submit all FY 2008 quarterly and close-out SF 269 – Financial Status Reports electronically using the DOL E-Grants System. See, Cooperative Agreement: Appendix A.

  3. Projects will ensure that employers granted extensions for the correction of serious hazards, demonstrate good faith; show evidence of steps taken towards correction of hazard(s) and show evidence of interim protection during the extended correction period. See, Cooperative Agreement: Restrictions and Conditions.

  4. Projects will ensure that the appropriate OSHA enforcement authority is notified, if an employer fails to take the action necessary to correct a serious hazard within the established time frame or any extensions granted. See, Cooperative Agreement: Restrictions and Conditions.

  5. Projects will ensure the confidentiality of employer information. See, Cooperative Agreement: Restrictions and Conditions.

  6. All new computers must be Microsoft (MS) Vista-ready and have MS Windows XP Professional operating system for desktops and laptops connected to the OSHANet. See, Cooperative Agreement: Restrictions and Conditions.

  7. Projects will configure all desktops and laptops that connect to the OSHANet with the OSHA image. Software that is not part of the OSHA standard image must be approved by the Directorate of Information Technology prior to purchase. See, Cooperative Agreement: Restrictions and Conditions.

  8. Project personnel will complete the Department of Labor Annual Computer Security Awareness Training (CSAT) within the timeframe allotted by the Directorate of Information Technology. See, Cooperative Agreement: Restrictions and Conditions.

  9. Projects agree to sign annual Rules of Behavior for use of the OSHANet and other OSHA applications. See, Cooperative Agreement: Restrictions and Conditions.

  10. All desktops, laptops and servers on the OSHANet are subject to an annual software audit. See, Cooperative Agreement: Restrictions and Conditions.

  11. Projects agree to pay OSHA for costs associated with the conduct of OSHA Training Institute (OTI) training courses conducted for the state at the state's request. See, Cooperative Agreement: Restrictions and Conditions.






TABLE OF CONTENTS

  1. Purpose

  2. Scope

  3. References

  4. Expiration Date

  5. Action Information

    1. Responsible Office

    2. Action Offices

      1. National Office

      2. Regional Offices

      3. States

  6. State Impact

  7. Significant Changes

  8. Submission Deadline and Approval Notification

  9. Funding Levels

  10. On-site Consultation Project Manager's Responsibilities

    1. Consultation Annual Project Plan (CAPP)

    2. Financial Documents

      1. Administrative Cap

      2. Salary Target

      3. Computer Purchases

      4. Minimum Staffing

      5. OSHA Restrictions and Conditions

  11. Regional Administrator's Responsibilities

    1. Consultation Annual Project Plan (CAPP)

    2. Financial Documents

  12. National Office Responsibilities

    1. Directorate of Cooperative and State Programs

    2. Directorate of Administrative Programs

    Appendix A: Cooperative Agreement for OSHA On-site Consultation under Sections 21(c) and 21(d) of the Occupational Safety and Health Act of 1970

    Appendix B: Checklist of Required Documents for the Federal On-site Consultation Cooperative Agreement

    Appendix C: Checklist of Required Components of the CAPP

    Appendix D: Staffing Chart

    Appendix E: Operational Description by Strategy, Activities and Outcomes

    Appendix F: Projected Program Activities

    Appendix G: Equipment Inventory

    Appendix H: Approved Equipment Procurement Listing FY 2008

    Appendix I: Annual Training Plan FY 2008

    Appendix J: Accompanied Visit Plan FY 2008

    Appendix K: FY 2007 Final Base Award Levels

    Appendix L: Cooperative Agreement Form OSHA-110

    Appendix M: Application for Federal Assistance and Budget Information - Non-Construction Programs (SF-424 and SF-424A)

    Appendix N: Supporting Details of Anticipated Costs - Part A: Consultation

    Appendix O: Supporting Details of Anticipated Costs - Part B: Administration






Federal On-site Consultation Cooperative Agreement Application for FY 2008

  1. Purpose. This Notice contains instructions and forms to assist On-site Consultation Project Managers and Regional staff in preparing the Federal On-site Consultation Cooperative Agreement Application. See Appendix B for a checklist of the required documents for the Agreement application package.

  2. Scope. This Notice applies to all Federal On-site Consultation Projects operating Cooperative Agreements under Section 21(d) of the OSH Act in states under Federal enforcement jurisdiction and in the four states that have 23(g) Public Employee Only Plans.

  3. References.

    1. OSHA Instruction CSP 02-00-001 [TED 3.6], Consultation Policies and Procedures Manual (CPPM).

    2. 29 Code of Federal Regulations (CFR) 1908, Cooperative Agreements.

  4. Expiration Date. This Notice expires on September 30, 2008.

  5. Action Information.

    1. Responsible Offices. Directorate of Cooperative and State Programs (DCSP), Office of Small Business Assistance (OSBA) in consultation with the Assistant Secretary.

    2. Action Offices.

      1. National Office. National Office personnel are responsible for reviewing and approving the Cooperative Agreement applications and verifying that the applications satisfy all federally required financial, operational, and policy requirements.

        1. Directorate of Cooperative and State Programs. OSBA is responsible for the administration and review of all components and any deficiencies of the Cooperative Agreement applications as outlined in this Notice.

        2. The Directorate of Administrative Programs (DAP). The Division of Grants Management is responsible for reviewing financial documents for accuracy, posting funding award levels in the Payment Management System, transmitting the award letters to each recipient and administering the financial aspects of the Cooperative Agreement. The Division of Grants Management will provide copies of the application to OSBA.

      2. Regional Offices. Regional Administrators are required to provide technical assistance and to negotiate the proposed activity levels with the On-site Consultation Project Manager. Each Regional Consultation Officer should develop a timetable to discuss the On-site Consultation Annual Project Plan (CAPP) with National Office personnel assigned to review the CAPP.

      3. States. On-site Consultation Project Managers are responsible for the facilitation of discussions with the Regional Office regarding the content of the CAPP. On-site Consultation Project Managers are also responsible for the completion and submission of the On-site Consultation Agreement Application.

  6. State Impact. Federal States operating Cooperative Agreements under Section 21(d) of the OSH Act and the four states that have 23(g) Public Employee Only Plans, are required to follow the instructions outlined in this Notice.

  7. Significant Changes.

    1. On-site Consultation Projects will have the opportunity to submit electronic grant applications using Grants.gov as part of a pilot project. Instructions on electronic submission using Grants.gov will be provided to those states that agree to participate in the pilot. See, VIII.

    2. States are required to submit all FY 2008 quarterly and close-out SF 269 – Financial Status Reports electronically using the DOL E-Grants System regardless of whether they participate in the electronic grants submission pilot. See, Cooperative Agreement: Appendix A.

    3. Projects will ensure that employers granted extensions for the correction of serious hazards, demonstrate good faith; show evidence of steps taken towards correction of hazard(s) and show evidence of interim protection during the extended correction period. See, Cooperative Agreement: Restrictions and Conditions.

    4. Projects will ensure that the appropriate OSHA enforcement authority is notified, if an employer fails to take the action necessary to correct a serious hazard within the established time frame or any extensions granted. See, Cooperative Agreement: Restrictions and Conditions.

    5. Preserves the confidentiality of employer information. See, Cooperative Agreement: Restrictions and Conditions.

    6. All new computers must be Microsoft (MS) Vista-ready and have MS Windows XP Professional operating system for desktops and laptops connected to the OSHANet. See, Cooperative Agreement: Restrictions and Conditions.

    7. Projects will configure all desktops and laptops that connect to the OSHANet with the OSHA image. Software that is not part of the OSHA standard image must be approved by the Directorate of Information Technology prior to purchase. See, Cooperative Agreement: Restrictions and Conditions.

    8. Project personnel will complete the Department of Labor Annual Computer Security Awareness Training (CSAT) within the timeframe allotted by the Directorate of Information Technology. See, Cooperative Agreement: Restrictions and Conditions.

    9. Projects agree to sign annual Rules of Behavior for use of the OSHANet and other OSHA applications. See, Cooperative Agreement: Restrictions and Conditions.

    10. All desktops, laptops and servers on the OSHANet are subject to an annual software audit. See, Cooperative Agreement: Restrictions and Conditions.

    11. Projects agree to pay OSHA for costs associated with the conduct of OSHA Training Institute (OTI) training courses conducted for the state at the state's request. See, Cooperative Agreement: Restrictions and Conditions.

  8. Submission Deadline and Approval Notification. 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. It is the responsibility of the Regional Administrator to establish deadlines for CAPP submission, to facilitate National Office receipt of the On-site Consultation Agreement on or before August 15, 2007. Final Cooperative Agreement approval letters are to be anticipated by September 20, 2007.

    States wishing to participate in a pilot project to submit their grant applications electronically using the Grants.gov system must coordinate with their Regional Administrator and the Office of Grants Management to agree on a schedule that will allow electronic submission of the final grant package to the National Office by August 15, 2007. States participating in the pilot must also submit a hard copy of their final application to allow assessment of the electronic submission process. Instructions on electronic submission of grants will be provided separately to participating States and Regions.

  9. Funding Levels. All amounts entered in the Cooperative Agreement (Form OSHA-110), the Application for Federal Assistance (SF-424) and the related worksheet(s) must be based on the FY 2007 final base awards. States unable to meet the required matching funds for this award level should complete the application to reflect the award level which it can match.

  10. On-site Consultation Project Manager's Responsibilities. On-site Consultation Project Managers are responsible for the completion of the On-site Consultation Cooperative Agreement Application package and submission of two copies to the Regional Administrator and two copies with original signatures to the National Office on or before August 15, 2007. The copies to the National Office with original signatures should be forwarded to the attention of:
    Arlene Williams
    U.S. Department of Labor
    Occupational Safety and Health Administration
    200 Constitution Avenue, NW
    Room N-3419
    Washington, DC 20210
    The On-site Consultation Cooperative Agreement Application package consists of the following:

    1. Consultation Annual Project Plan (CAPP). The CAPP describes in detail how an On-site Consultation Project's activities will support the OSHA Strategic Management Plan (SMP) during the forthcoming year.

      1. The CAPP must address each area of emphasis in the SMP that the Project Manager in consultation with the Regional representative(s) will undertake, outlining both strategies and expected results, See Appendix E.

      2. The CAPP must include: a) an organizational chart, b) staffing chart, c) a description of any changes in the On-site Consultation Project's status, d) a detailed operational description identifying the year's strategies, activities and their intended outcomes, e) a projected program activities chart, f) a description of strategy and targets for promoting On-site Consultation and SHARP, and g) a detailed description of any changes to a Project's Internal Quality Assurance program. See Appendix B for a checklist of required documents.

      3. The On-site 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 this year. Further discussions or negotiations regarding the content of the CAPP must be managed to ensure consensus and submission of the CAPP on or before the designated deadline.

    2. Financial Documents. The Cooperative Agreement (Form OSHA-110) and the Application for Federal Assistance and Budget Information Non-Construction Programs (SF-424 and SF-424A) must be prepared using the FY 2007 final base award level. If the state does not have the required matching funds for this award level, it should complete the application to reflect the level which it can match. Any change in FY 2008 funding for On-site Consultation will be processed through a Cooperative Agreement amendment. Additionally, the SF-424 must include a Dun and Bradstreet Data Universal Numbering System (DUNS) number for the Agreement application to be considered complete.

      The Application for Federal Financial Assistance and Budget Information Non-Construction Programs are available at:
      http://www.whitehouse.gov/omb/grants/sf424.pdf http://www.whitehouse.gov/omb/grants/sf424a.pdf
      The Cooperative Agreement form OSHA-110 is available at the Consultation Limited Access Page. Additionally, a courtesy copy of the OSHA-110 is provided in Appendix L of this Notice.

      Each On-site Consultation Project Manager must submit two copies of the Cooperative Agreement application package with original signatures on both copies of: 1) the Cooperative Agreement, 2) Assurances and Certifications; Lobbying Certification and OSHA Restrictions and Conditions, and 3) the Application for Federal Financial Assistance to the National Office. Accuracy of the financial documents is critical to the timely approval of the Cooperative Agreement. Applications containing significant deficiencies will not be approved. Any application which is not in substantial accord with this Notice will be returned for corrections.

      1. Administrative Cap. OSHA will continue the current 25 percent ceiling restriction on administrative costs. This requires that no more than 25 percent of the total funding amount may be budgeted toward administrative costs. Any deviation from this restriction requires prior approval from the Director of DCSP.

      2. Salary Target. Each project must devote a minimum of 50 percent of the grant amount (90/10 total) toward consultant salaries and fringe benefits. Project Managers unable to meet this target must provide a written explanation of why they cannot meet this goal and receive prior approval from the Director of DCSP.

      3. Computer Purchases. Projects must consult with the Directorate of Information Technology (DIT) prior to purchasing computers using 21(d) funds. Computers must conform to certain OSHA hardware and software specifications. It is the responsibility of the On-site Consultation Project Manager to contact the Directorate of Information Technology (DIT) sixty or more days in advance of the purchase of new computer equipment for the latest specifications or search the On-site Consultation Limited Access Page for up-to-date specifications.

      4. Minimum Staffing. At least four professional, full-time equivalents (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 must be employed at least 50 percent of their time in the On-site Consultation Program and must spend at least 50 percent of their time engaged in consultation activity. Any deviation from this minimum must receive prior approval from the Director of DCSP.

      5. OSHA Restrictions and Conditions. Only State officials with signature authority may sign the assurances and certifications, lobbying restrictions, and OSHA- specific restrictions and conditions.

  11. Regional Administrator's Responsibilities. The Regional Administrator (RA) is responsible for conducting a joint review of the CAPP with the National Office. After the review is complete, the RA must transmit a memorandum containing an assessment of the Cooperative Agreement application to Paula O. White, Attn: Francis Yebesi, with a courtesy copy furnished to Arlene Williams.

    In reviewing the application, the RA should pay particular attention to the following components:

    1. Consultation Annual Project Plan (CAPP)

      1. The RA should review the CAPP to ensure that the plan submitted by the Project Manager conforms to the previously agreed upon plan elements. The RA should be particularly sensitive to issues that have been discussed during the quarterly meetings and ensure that they are addressed satisfactorily.

      2. The RA should encourage and support the Project Manager in the marketing of the On-site Consultation Program by combining resources, where possible, to ensure that employers in the state are familiar with services provided by the On-site Consultation Program.

      3. The RA should include a statement of concurrence with the CAPP in the Region's cover memorandum.

    2. Financial Documents

      1. The RA should ensure that the Project has budgeted for the personnel requirements of two safety specialists and two industrial hygienists, or four full-time professional positions, and that all safety and health staff spend a minimum of 50 percent of their time working on consultation activities. A transmittal memorandum with detailed explanation(s) and a copy of DCSP approval of deviation must be provided if the Project budget does not meet personnel and staffing requirements.

      2. The RA should ensure that the appropriate State official has signed the Cooperative Agreement Form OSHA-110, Application for Federal Assistance SF-424, assurances and certifications, lobbying restrictions and OSHA-specific restrictions and conditions.

      3. The RA should include a statement of concurrence with financial documents in the Region's cover memorandum.

  12. National Office Responsibilities

    1. Directorate of Cooperative and State Programs (DCSP). OSBA staff will review and discuss any deficiencies in each CAPP with the Regional Consultation Officer. Additionally, the Director of DCSP will have approval authority relating to deviations from the Cooperative Agreement.

    2. Directorate of Administrative Programs (DAP). Financial Management staff will review and discuss any financial deficiencies with Regional financial staff. Additionally, DAP will post funding award levels in the Payment Management System and administer the financial aspects of the Cooperative Agreement.





APPENDIX A
Cooperative Agreement for OSHA On-site 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.

  1. AUTHORITY AND PARTIES TO AGREEMENT

    1. Pursuant to Sections 21(c) and 21(d) of the Occupational Safety and Health Act of 1970 (the Act), it is hereby agreed that the Assistant Secretary of Labor for Occupational Safety and Health (Assistant Secretary) and the _________________________________ (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.

    2. 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.

  2. AGREEMENT TERMS

    1. Either party may terminate this agreement upon 30 days notice to the other party.

    2. 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.

    3. This Agreement incorporates the following documents, which the State has agreed to submit.

      1. Application for Federal Assistance (SF-424)
      2. Budget Information--Non-Construction Programs (SF-424A)
      3. Cooperative Agreement (Form OSHA-110)
      4. Assurances and Certifications, Lobbying Restrictions, and OSHA Restrictions and Conditions
      5. Approved On-site Consultation Equipment Procurement Listing
      6. Performance Projections
      7. Annual Training Plan
      8. Accompanied Visit Plan
      9. Supporting Details of Anticipated Costs

    4. 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.
  3. PURPOSE AND SCOPE

    1. The State shall provide consultation services, including training and education, whereby employers, particularly those with smaller businesses and with high-hazard workplaces (as defined or approved by OSHA), receive assistance in:
      (1) Identifying any safety and health hazards in their workplaces,

      (2) Controlling or eliminating these hazards successfully,

      (3) Establishing or improving a workplace safety and health program,

      (4) Understanding all requirements of applicable Federal (or State) law and implementing regulations.
    2. 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.

  4. REIMBURSEMENT

    The Assistant Secretary will reimburse the State 100 percent 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 90 percent. All such training, travel and per diem must be directly related to the activity performed under this agreement.

  5. ALLOCATION OF COSTS

    The Supporting Details of Anticipated Costs that itemizes the costs by category (Consultation and Administration) and object class shall be submitted with the application (a sample outline is provided in Appendices N and O of this Notice). The Supporting Details of Anticipated Costs should correspond to the information on the Application for Federal Assistance and Budget Information -- Non-Construction Programs (SF-424 and SF-424A). In order to ensure uniformity and comparability among agreement submissions, Consultation and Administration costs shall be determined and set forth as follows:

    1. 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 On-site Consultation staff engaged in promotion, scheduling, visit preparation, hazard identification, program assistance, training and education, off-site 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 computer costs (computer costs should be distributed between consultation and administration in the proportion to which computer services support each function). On-site 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.

    2. Administration. Administrative costs consist of all direct costs and indirect costs associated with the management and support of the On-site Consultation Program. 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, related materials, supplies, equipment and staff training. They also include the administration portion of total computer costs (computer costs should be distributed between consultation and administration in the proportion to which computer services support each function). In addition, 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.

    3. C. The chart below should be used as a framework to correctly itemize anticipated costs within the appropriate category. The anticipated costs are to be listed under the categories below and charged as follows:

    Anticipated Cost Consultation Administration
    POSITIONS COVERED 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. Salaries of positions for management (MGT) and direct clerical support (SEC) to these positions.
    PERSONNEL Salaries for positions listed in Consultation:

    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, (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 that provide direct support to consultants and consultant supervisors.
    Salaries for positions listed in Administration:

    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, (2) consultant duties, and/or (3) supervision of consultants.
    FRINGE BENEFITS Fringe Benefits for positions listed in Consultation:

    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 that provide direct support to consultants and consultant supervisors.
    Fringe benefits for positions listed in Administration:

    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.

    Anticipated Cost Consultation Administration
    CERTIFICATION COSTS: Contact Henry Payne at Payne.Henry@dol.gov with questions regarding certification. For Consultants seeking professional certification in safety or health, Cooperative Agreement funds may be used to pay for the costs associated with a professional certification examination preparation course approved by the project manager, including travel and per diem. Additionally, if needed, a Project Manager may use Cooperative Agreement funds to pay for the costs associated with applying for and taking a professional certification examination, including travel and per diem.

    Project Managers may not use Cooperative Agreement funds to pay for costs associated with a second preparation course for those Consultants who fail on their first attempt at a professional certification examination. However, a Project Manager may use Cooperative Agreement funds to pay for the travel and/or per diem related to taking the professional certification examination a second time, and if needed, costs associated with taking of the professional certification examination a second time.

    For those Consultants who fail to pass a professional certification examination on their second attempt, a Project Managers may not use Cooperative Agreement funds to pay for any additional costs related to that employee seeking that specific professional certification.

    A Project Manager may not use Cooperative Agreement funds to pay for any costs associated with seeking professional certification for any certifying organization that is not accredited by a nationally recognized accrediting organization. Additionally, Project Managers are not authorized to pay annual maintenance fees for maintaining professional certifications from Cooperative Agreement funds.

    Project Managers must use 90/10 funds for employee preparation or certification. The Cooperative Agreement cannot pay for certification costs that exceed the percent 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 percent of the cost of the examination preparation or examination fees may be charged to the Cooperative Agreement.
    For Project Managers seeking professional certification in safety or health, Cooperative Agreement funds may be used to pay for the costs associated with a professional certification examination preparation course approved by the employee's supervisor, including travel and per diem. Additionally, if needed, Cooperative Agreement funds may be used to pay for the costs associated with applying for and taking a professional certification examination, including travel and per diem.

    Cooperative Agreement funds may not be used to pay for costs associated with a second preparation course for those Managers who fail on their first attempt at a professional certification examination. However, Cooperative Agreement funds may be used to pay for the travel and/or per diem related to taking the professional certification a second time, and if needed, costs associated with taking of the professional certification examination a second time.

    For those Managers who fail to pass a professional certification examination on their second attempt, Cooperative Agreement funds may not be used to pay for any additional costs related to that employee seeking that specific professional certification.

    Cooperative Agreement funds may not be used to pay for any costs associated with seeking professional certification for any certifying organization that is not accredited by a nationally recognized accrediting organization. Additionally, Project Administrators are not authorized to pay annual maintenance fees for maintaining professional certifications from Cooperative Agreement funds.

    Projects must use 90/10 funds for Managerial preparation or certification. The Cooperative Agreement cannot pay for certification costs that exceed the percent of time for which that Manager is dedicated to the Cooperative Agreement. For example, if a Manager is dedicated at 0.5 FTE, then no more than 50 percent of the cost of the examination preparation or examination fees may be charged to the Cooperative Agreement.

    Anticipated Cost Consultation Administration
    TRAVEL Travel for positions listed in Consultation:

    Costs shall include travel required to conduct promotional visits, onsite consultation visits, off-site assistance, and travel to OTI courses, regional and national On-site Consultation Program meetings. 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 Voluntary Protection Program Participants Association (VPPPA), American Industrial Hygiene Association (AIHA), American Society of Safety Engineers (ASSE), and National Safety Council (NSC) are 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.

    Note: 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.
    Travel for positions listed in Administration: For management personnel and all staff 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 On-site Consultation Program meetings and professional development/training courses. 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.

    Attendance at the Annual On-site Consultation Training Conference is required for all Project Managers, and to the extent that funds are available for the safety health supervisors and senior consultants. The conference is considered required federal travel and therefore may be funded 100% with federal funds. The cost of travel for all participants to the Annual On-site Training Conference must be charged to administration.

    Anticipated Cost Consultation Administration
    EQUIPMENT Includes 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.
    Includes 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 Includes the costs of all tangible consultant technical property and materials other than equipment as defined above. Please itemize and describe all supply costs. Includes the costs of all tangible office property and desk top materials other than equipment as defined in this section. Please itemize and describe all supply costs.
    CONTRACTS Includes the costs of contracts with all sources, whether non state government, state government or private 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. Include the costs of contracts with all sources, whether non state government, state government or private sources, for the provision of administrative support services (e.g., service contracts for maintenance of office equipment, leasing of photocopiers, fiscal services, etc.).
    OTHER COSTS/CHARGES Includes 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 On-site Consultation staff; subscriptions to safety and health journals; and training aids, instructional programs and promotional materials which are used by on-site consultants to perform consultation activities. Includes 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 that 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 On-site Consultation Program by administrative staff.
    TOTAL DIRECT CHARGES The total of all of the costs for Consultation. The total of all of the direct costs for Administration.
    INDIRECT CHARGES N/A Includes charges based on an approved indirect cost rate agreement for the grant period.

  6. SPECIAL PROVISIONS

    1. A listing of approved positions is contained in Appendix D: Staffing Chart for this Agreement. Key personnel include the project manager, supervisors, and consultants. Any changes in these positions must be approved by the Regional Administrator.

    2. Microcomputer equipment (hardware and software), regardless of unit cost, requires prior written approval of DCSP and must be listed in the Approved Equipment Procurement Listing in Appendix H.

    3. Unless a State has made special provisions for such, substantive programmatic work may not be transferred to another agency (sub-recipient) under this agreement.

    4. The laboratory designated by OSHA to provide analysis of samples for all projects shall be:
      WISCONSIN OCCUPATIONAL HEALTH LABORATORY
      2601 Agriculture Drive
      Madison, Wisconsin 53718
      Telephone: (608) 224-6210
      Fax: 608) 224-6213
      Contact: Mr. Terry Burk
    5. The federal cost principles applicable to this project are:

      1. Cost Principles for State and Local Governments
        (OMB Circular A-87)

      2. Cost Principles for Educational Institutions
        (OMB Circular A-21)

    6. Financial reporting forms required of all projects and their frequencies of submission are:

      1. Department of Health and Human Services - Payment Management System Federal Cash Transactions Report (PSC 272, PSC 272A through E) is due in the Regional Office 30 days after the end of each federal fiscal quarter. Recipients are to submit two signed copies of the report.

      2. Financial Status Report (SF-269) is due 30 days after the end of each Federal fiscal quarter with the close-out report due 90 days after the end of the performance period. All reports will be electronically submitted via the DOL E-Grants System to report the status of all funds awarded.
        (a) 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.

        (b) Close-out Reporting. All agreements must be closed 90 days after the end of the performance period (generally December 31) using the DOL E-Grants system for electronic transmittal.

        (c) 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 close-out extensions must be coordinated in advance and transmitted to the National Office for inclusion in the official file, and any extensions beyond February 28 must be approved by the National Office.
      3. Cooperative Agreement (Form OSHA-110) must accompany the Application for Federal Assistance (SF-424). This is the only time this form is completed.

      4. Cooperative Agreement Amendment (Form OSHA-113) may be required to amend the Cooperative Agreement as a result of congressional action.

      5. Other performance reports and copies of forms that may be required for program management purposes will be distributed as necessary.

    7. Unless different instructions are provided by the Director of DCSP 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.

    8. It is agreed that OSHA may unilaterally modify this agreement whenever necessary to conform to new regulations, new applications, or official interpretations of Department of Labor or Office of Management and Budget regulations.

  7. ADDITIONAL SPECIAL PROVISIONS

    The following special provisions are added to this agreement:

    1. Approval of this agreement is contingent upon Congressional action on the Department of Labor's appropriation for FY 2008.

    2. It is hereby certified by the State that matching state funds are or will be available during the tenure of this agreement.

    3. In no case shall the State be liable for more than 10 percent of actual expenditures (exclusive of 100 percent Federal funds) under this agreement.

    4. Where appropriate, restrictions to the agreement may be added by the Assistant Secretary to ensure that the recipient fully complies with specific terms and condi¬tions of the Cooperative Agreement, Department of Labor 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 time frame.

    5. 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. Additionally, cost of living increases will be based on executed award amounts, not proposed funding levels.

OPTIONAL INSERT(S) TO THE COOPERATIVE AGREEMENT

Below are formats for "Additional Special Provisions" which, if appropriate, would be inserted in the Agreement following §VII.E.

  1. Provisions below pertain to Items VI.C-D of the Agreement:

    Substantive programmatic work is being transferred to another agency (sub-recipient) under this Agreement, as follows:

    1. Scope of transfer:

    2. Agency name:

    3. Address:

    4. Telephone number: (    )

    5. Contact person:

  2. 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
Non-Construction Programs

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:

  1. 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.

  2. 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.

  3. 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.

  4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.

  5. 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 the Office of Personnel Management's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).

  6. 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. 290dd 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.

  7. 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.

  8. 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.

  9. 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.

  10. Will comply, as applicable, with the provisions of the Davis Bacon Act (40 U.S.C. §§ 276a to 276a¬7), 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 sub-agreements.

  11. 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.

  12. 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 (Clean Air) Implementation Plans under Section 176(c) of the Clean 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).

  13. 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.

  14. 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.).

  15. 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.

  16. 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.

  17. Will comply with the Lead Based 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.

  18. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, "Audits of States, Local Governments, and Non-Profit Organizations."

  19. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program.

  20. 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.

  21. In accordance with the Drug Free Workplace Act of 1988, the grantee certifies that it will provide a drug free workplace by:
    (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, pos¬session, 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;

    (b) Establishing a drug free awareness program to inform employees about:
    (1) The dangers of drug abuse in the workplace;
    (2) The grantee's policy of maintaining a drug free workplace;
    (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;
    (c) 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);

    (d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will:
    (1) Abide by the terms of the statement; and
    (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction;
    (e) Notifying the agency within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction;

    (f) 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:
    (1) Taking appropriate personnel action against such an employee, up to and including termination; or
    (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency;
    (g) Making a good faith effort to continue to maintain a drug free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f).
    Lobbying Certification

  22. The undersigned certifies, to the best of his or her knowledge and belief, that:
    (a) 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.

    (b) 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.

    (c) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants) and that all sub-recipients 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.

    (d) 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.
    1) This is to certify that we are_____/are not_____ an IRS 501(c)(4) entity.
    2) 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:

  1. 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.

  2. Explains to employers that the employer receiving On-site Consultation services remains under statutory obligation to provide safe and healthful working conditions to their employees.

  3. Explains to employers that no referrals will be made to enforcement unless the employer fails to eliminate a serious hazard identified by a consultant.

  4. Explains to the employer the requirements for participation in the Safety and Health Achievement Recognition Program (SHARP).

  5. Explains to employers requirements for attainment of Pre-SHARP status.

  6. 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.

  7. Prepares appropriately for visits including making the appropriate provisions for the personal safety and health of the consultant(s) conducting the visit or activity.

  8. Conducts an initial on-site 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.

  9. Retains the right to confer with employees during an on-site visit and explains this provision to the requesting employer.

  10. During the opening conference, explains the relationship between On-site Consultation and Enforcement and also explains the employer's obligation to protect employees if certain hazardous conditions are identified.

  11. Focuses on-site activity primarily on those areas, conditions, or hazards within the requested scope of the visit.

  12. During on-site activity, advises the employer of the employer's obligations and responsibilities under applicable Federal or State law and implementing regulations.

  13. When identifying hazards, indicates to the employer, using the consultant's best judgment, whether the situation would be classified as a "serious" or "other-than-serious" hazard.

  14. Informs the employer that the employer is obligated to take immediate action to eliminate hazards that pose an imminent danger.

  15. Establishes a time frame for the correction of each hazard identified during on-site activity, and provides the employer with a "List of Hazards," and advises the employer to post the "List" until the hazard is corrected or three days, whichever is longer.

  16. Ensures that employers granted extensions for the correction of serious hazards, demonstrate having made a good faith effort to correct the hazard within the established time frame; show evidence that correction has not been completed because of factors beyond the employer's control; and show evidence that the employer is taking all available interim steps to safeguard the employees against the hazard(s) during the correction period.

  17. Informs the employer that the employer's failure to correct an identified serious hazard within the established time frame (or extension of the time frame) results in notification of the appropriate OSHA enforcement authority.

  18. Ensures that the appropriate OSHA enforcement authority is notified, if an employer fails to take the action necessary to correct a serious hazard within the established time frame or any extensions granted.

  19. Prepares and sends to the employer a written report containing substantive findings or recommendations.

  20. Preserves the confidentiality of information which identifies employers who have requested the services of the On-site Consultation Program as well as information pertaining to and/ or obtained during an on-site visit, such as the employers written report.

  21. Preserves the confidentiality of information pertaining to commercial or trade secrets that may have been obtained during an on-site visit.

  22. Conducts consultative activity independently of any OSHA enforcement activity.

  23. Does not provide to OSHA the identity of, or files pertaining to, employers requesting On-site Consultation services for any compliance inspection or scheduling activity, except in cases where the employer has failed to eliminate an imminent danger, failed to correct or eliminate a serious hazard, or where the employer has elected to participate in SHARP or a cooperative program that permits an exemption or deferral from enforcement inspections.

  24. Assures that on-site consultation visits already in progress have priority over OSHA compliance inspections except in the cases of imminent danger, fatality/catastrophe investigations, complaint investigations, or other investigations deemed critical by the Assistant Secretary.

  25. Terminates on-site visits in cases of imminent danger, fatality/catastrophe investigations, complaint investigations, or other investigations deemed critical by the Assistant Secretary.

  26. Does not conduct on-site consultation visits while OSHA enforcement inspections are in progress. On-site consultations shall only take place with regard to those citation items, which have become final orders.

  27. Explains to the employer that requirements pertaining to "serious" hazards apply equally to "other-than-serious" hazards for participation in SHARP.

  28. Uses consultants who are employees of the State and are qualified under State requirements for employment in the field of occupational safety and health.

  29. 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.

  30. Maintains an organized system for monitoring the performance of consultants.

  31. Submits narrative reports and compiles and submits data, such as Integrated Management Information System (IMIS) data, that is needed for monitoring and evaluation purposes, as required, to the Regional Administrator.

  32. Agrees to pay OSHA for mainframe processing services provided through IMIS, based on quarterly bills. The fourth quarter payment will be based on an estimated bill. All bills must be paid upon receipt but no later than September 15th. Any adjustments between actual charges and estimates will be made in the first quarter of the following fiscal year, as necessary.

  33. If participating in OSHANet, agrees to adhere to all requirements for such participation (including hardware and software specifications) and to pay OSHA for certain services provided, including telecommunication charges, an annual service fee for operation and maintenance costs, and annual user fees for remote access. (For items billed quarterly, the fourth quarter payment will be based on an estimated bill. All bills must be paid upon receipt no later than September 15th. Any adjustments between actual charges and estimates will be made in the first quarter of the following fiscal year, as necessary.)

  34. If not participating in OSHANet, agrees to consult with the Directorate of Information Technology, and obtain written approval from DCSP, prior to expending Federal or State matching funds for the purchase of any data processing/computer equipment or software that will be used to connect (locally or remotely) to or provide information to OSHA. Desktop or laptop computers and software that will be used to access OSHA systems including the CSHO and On-site Consultation PC and other applications, etc., must meet the minimum OSHA specifications. Specifications will be posted under the IT Help Desk on the Limited Access Page.

  35. Agrees that all new desktop and laptop computers must be Microsoft (MS) Vista-ready but have MS Windows XP Professional operating system installed.

  36. Agrees that all desktops and laptops that connect to the OSHANet must be configured with the OSHA image. Software that is not part of the OSHA standard image must be approved by the Directorate of Information Technology prior to purchase and once received must be approved for installation.

  37. Agrees that all OSHA system users will complete the Department of Labor Annual Computer Security Awareness Training (CSAT) within the timeframe prescribed by the Directorate of information Technology.

  38. Agrees that all users of the OSHANet and other OSHA applications will sign annual Rules of Behavior.

  39. Understands that all desktops, laptops and servers connected to the OSHANet are subject to an annual software audit to ensure compliance with Executive Order 13103, "computer Software Piracy," the U.S. Copyright Act, title 17 U.S.C., Department of Labor software management and acceptable use policy, and vendor software license agreements.

  40. No Section 21(d) or matching State funds may be expended for the purchase of internal peripherals or other modifications, except replacement parts, in conjunction with the NCR equipment, without prior approval from the Directorate of Information Technology. States must maintain an appropriate maintenance and repair contract for their NCR equipment.

  41. Will not expend any 21(d) or matching state funds from this agreement to fund activities or provide services to farms with ten or fewer employees where there has been no temporary labor camp in the previous twelve months. (Only state plan states may conduct visits on these farms, provided that 100 percent state funds are used, and the state has an accounting system in place to assure that no section 21(d) or matching funds are expended on these activities.)

  42. Will not expend any 21(d) or matching state funds from this agreement to fund the purchase of equipment and/or to provide training for programmatic efforts under the jurisdiction of and/or funded by another federal agency.

  43. Will ensure that any funding provided by another Federal agency related to safety and health training and/or equipment will not undermine 21(d) On-site Consultation activity.

  44. States are encouraged to promote safety or health professional certification of their employees by a nationally recognized accrediting organization. Cooperative Agreement funds may be used to pay for the costs associated with a professional certification preparation course and the examination, including travel and per diem. No Section 21(d) or matching State funds may be expended for costs associated with a second or subsequent attempt to obtain certification by employees who fail on their first attempt, except for the cost of the examination itself and related travel and/or per diem for a second attempt only. Certification costs cannot exceed the percentage of time for which an employee is dedicated to the grant/cooperative agreement.

  45. Will not expend Cooperative Agreement funds for annual maintenance fees associated with maintaining professional certifications.

  46. States agree to pay OSHA for costs associated with the conduct of OSHA Training Institute (OTI) training courses conducted for the State at the State's request. The State will pay for travel and per diem for OTI instructors, shipping charges, consultant trainer fees, equipment rental and training facility rental. All bills must be paid upon receipt but no later than September 15th. Any adjustments between actual charges and estimates will be made in the first quarter of the following fiscal year, as necessary.

    SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
    APPLICANT ORGANIZATION DATE SUBMITTED





APPENDIX B
Checklist of Required Documents for the Federal On-site Consultation Cooperative Agreement

The Consultation Annual Project Plan (CAPP):

     qOverview of the On-site Consultation Project

          q Organizational Chart
          q Staffing Chart
          q Changes in Project's Status (if any)

     q Operational Description by Annual Performance Goal

     q Projected Program Activities

     q Strategy and Targets for SHARP

     q Changes to the Internal Quality Assurance Program

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:

     q Assurances and Certifications Non-Construction Programs
     q Lobbying Certifications
     q OSHA Restrictions and Conditions
     q Equipment Inventory
     q Approved Consultation Equipment Procurement Listing
     q Training Plan
     q Accompanied Visit Plan

Financial Forms:

     q Cooperative Agreement, (Form OSHA-110)
     q Application for Federal Assistance, (SF-424)
     q Budget Information - Non-Construction Programs, (SF-424A)
     q Supporting Details of Anticipated Costs





APPENDIX C
Checklist of Required Components of the CAPP

q Organizational chart
q Staffing chart (See Appendix D). The chart must contain the number of full and part-time staff employed by the On-site 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 D are examples only.
q Description of any changes in the On-site 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 On-site Consultation Project is located or the structure of the unit or organization must be provided.
q Detailed operational description identifying the year's strategies, activities, and their intended outcomes. List and discuss each of the applicable SMP area of emphasis to be supported by the Project, local emphasis programs and special initiatives, including a description of each of the following elements:

  1. Strategies. Describe the specific strategies that will be used to target results for that performance goal (for example, developing and promoting a Web-based chat room for discussion of safety and health program issues, or partnering with other State agencies to promote training around the State).

  2. Activities. List the type and projected number of activities. These should correspond to the activities listed in the Projected Activity Chart.

  3. Impact. Describe the anticipated impact of performing the activities described.

The tabular format in Appendix E contains the categories of all required information.
q Projected Program Activities chart. Estimate the total number of On-site consultation activities to be performed during the year covered by the project plan, broken out by annual performance goal. Include the following information:

1. Visits
2. Combined Total visits
3. SHARP
4. Pre-SHARPs
5. Interventions/Other Non-Visit Related Activities


The tabular format in Appendix F contains the categories of all required information.
q Description of the On-site Consultation Project's strategy and targeted industries for marketing On-site consultation services and SHARP.
q Detailed description of changes to its Internal Quality Assurance program.





APPENDIX D
Staffing Chart (Sample)

On-site Consultation Project
Staff Category
Number of
FTEs
1.        Managerial Staff 0.75
2.        Consultants-Safety*** 1.50
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
8.        Trainers 1.00
9.         Other (identify) .25
Total Number of FTEs 8.75
*** Prior Approval received from Director of DCSP




APPENDIX E
Operational Description by Strategy, Activities and Outcomes

Federal
Area of Emphasis Statement
On-site Consultation Strategy Description of Planned
On-site Consultation Activities
Anticipated Impact of On-site Consultation Activities
Area of Emphasis

EXAMPLE:


Reduce occupational hazards through direct interventions.
EXAMPLE:

1-1    Improve targeting to maximize the impact of direct interventions.

a. Annually analyze data to identify best targets for direct interventions.

b. Annually communicate priorities and effective intervention approaches.

1-2    Reduce hazards by intervening at targeted worksites.

a. Provide consultation services to high hazard worksites.

1-3 Improve effectiveness of direct interventions.

a. Analyze results and effectiveness of direct interventions to determine their impact on fatality, injury and illness rates.

b. Identify and implement adjustments, including targeting new areas that will increase the impact of direct intervention activities.
Activity 1 ....

EXAMPLE:

Provide info. here on # visits; will eventually be looking for # of hazards abated, if available.

Activity 2 ....
Result 1

EXAMPLE:

Reduction of occupational hazards through direct interventions.

Result 2
Area of Emphasis   Activity 1.....
Activity 2.....
Result 1
Result 2
Area of Emphasis      
Local Emphasis Program      
Special Initiative      





APPENDIX F
PROJECTED PROGRAM ACTIVITIES

Appendix F is currently only available in:          PDF




APPENDIX G
EQUIPMENT INVENTORY

A complete and current equipment inventory is required of each On-site Consultation Project. The inventory should include information regarding 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 2007 is required in the FY 2008 Agreement package.


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 





APPENDIX H
APPROVED EQUIPMENT PROCUREMENT LISTING
FY 2008


Federal Catalog # 17.504 State: Date:


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.

Item Description
(include brand and model)
Number Cost per Unit Total Cost National Office Use Only
  On Hand For Purchase     Approved Title Transfer Remarks
          Yes No Yes Initials  
EXAMPLE:

Laptop: Toshiba Satellite Pro
4 2 $2,300 $4,600          
                   
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




APPENDIX I
ANNUAL TRAINING PLAN

State: ___________  FY 2008 Date: ___________


List Personnel by ID Number and Type
(Mgt/S/IH/etc.)
Training Activity & Location. Per Diem/Airfare/Reg. Fee/Misc./etc. list for Out-of-state training. Indicate by Number the Competency Area that Training Will Address.*


















* 1. Hazard Identification
2. Assessment of Risk and Exposure
3. Knowledge of Standards
4. Hazard Correction Techniques
5. Safety and Health Program Requirements
6. Effective Communications
7. Other (specify)

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 Director of the Office of Small Business Assistance.




APPENDIX J
Accompanied Visit Plan FY 2007

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.





APPENDIX K
FY 2007 BASE AWARD LEVELS (Pending)

Recipient Region FY 2007
Base Award
  Recipient Region FY 2007
Base Award
Connecticut 1 $991,000   Wisconsin 5 $1,699,000
Maine 1 $458,000   Wisconsin Laboratory 5 $1,834,000
Massachusetts 1 $1,382,000   Arkansas 6 $974,000
New Hampshire 1 $424,000   Louisiana 6 $776,000
Rhode Island 1 $448,000   Oklahoma 6 $1,180,000
New Jersey 2 $1,834,000   Texas 6 $2,574,000
New York 2 $3,561,000   Kansas 7 $579,000
Virgin Islands 2 $249,000   Missouri 7 $880,000
Delaware 3 $428,000   Nebraska 7 $551,000
District of Columbia 3 $456,000   Colorado State Univ. 8 $964,000
Pennsylvania, IU 3 $1,648,000   Montana 8 $424,000
West Virginia 3 $460,000   North Dakota 8 $289,000
Alabama University 4 $1,031,000   South Dakota 8 $415,000
Florida 4 $1,977,000   Guam 9 $273,000
Georgia Tech 4 $1,240,000   Northern Mariana Islands 9 $199,000
Mississippi State Univ. 4 $569,000   Idaho, Boise State Univ. 10 $465,000
Univ. of Alabama Training 4 $142,000        
Illinois 5 $1,868,000        
Ohio 5 $1,600,000        





Appendix L
Cooperative Agreement Form OSHA-110

U.S. DEPARTMENT OF LABOR

Occupational Safety and Health Administration

COOPERATIVE
AGREEMENT

OSHA 21(d) ON-site CONSULTATION
PROGRAM
(1) Page 1 of 1
Region: ________________________
State: ________________________
Grantee: ________________________
Grant Number: E9F8_________________

Starting Date: October 1, 2007
Ending Date: September 30, 2008
(2) Recipient

Name:

Address:

_________________________________________
Recipient Liaison Representative _________________________________________
Area Code and Telephone Number
(3) U.S. Department of Labor





_________________________________________
OSHA Liaison Representative _________________________________________
Area Code and Telephone Number
(4) Authorized under P.L. 105-197, under Section 21(d)
Percent Total Funds
(Nearest 0.1%)
1. Federal Base Award Amount: _________________________ ____.____%
2. 100% Federal Funds for Travel and Training:
(Please include in line 1)
_________________________  
3. Total Recipient Share: _________________________ ____.____%
4. Recipient 100% Funding:
(Please include in line 3)
_________________________  
5. Total State and Federal Funds Allocated to This Agreement
(Line 1 plus Line 3)
_________________________  
Terms and Conditions of the Cooperative Agreement
This COOPERATIVE AGREEMENT consists of the entire application,
Including all attachments, exhibits, enclosures, etc.
 
(5) Recipient Approval

(6) Federal Approval

Signature                                  Date _________________________________________
Type Name and Title
Signature                                  Date _________________________________________
Administrative Programs
    Form OSHA 110
Revised February 2001





APPENDIX M
Application for Federal Assistance and Budget Information-
Non-Construction Programs (SF-424 and SF-424A)

Forms SF-424 and SF-424A are available on the OMB website, accessible at:
http://www.whitehouse.gov/omb/grants/sf424.pdf
http://www.whitehouse.gov/omb/grants/sf424a.pdf
Note: The Application for Federal Assistance (SF-424) has been revised to comply with Federal Register Notice [68 FR 38402]. Agreement applications will not be considered complete without providing the information requested in the 7-97 version of the SF-424.





APPENDIX N
SUPPORTING DETAILS OF ANTICIPATED COSTS

PART A: CONSULTATION
A. PERSONNEL: (List all positions having salary charged to Consultation.) Total ________
Position       Type1     Status2 Cond.3 Location       % Time 21(d)     Salary
1. Consultant Subtotal: ________    
2. Supervisory consultant/clerical Subtotal:  ________    
B. FRINGE BENEFITS: (List Cost Formula[s])   Total ________
1. Consultant Subtotal:  ________    
2. Supervisory consultant/clerical Subtotal:  ________    
C. TRAVEL:  (100% Describe in Training Plan)   Total ________
1. Out-of-State (100% Federal) Subtotal:  ________    
     Training        
     Other (specify)        
2. Within State (90% Federal) Subtotal:  ________    
     Training        
     Promotion        
     Consultative Visits        
     Other (specify)        
D. EQUIPMENT:  (tech/list in Equipment Listing)   Total ________
E. SUPPLIES:  (tech/itemize & describe)   Total ________
F. CONTRACTS:  (all sources)     Total ________
1. Lab Analysis (include #samples) Subtotal:  ________    
2. Industrial Hygiene Services Subtotal:  ________    
3. Other (specify) Subtotal:  ________    
G. OTHER (items not covered elsewhere)   Total ________
1. 100% non-travel costs of training Subtotal ________    
2. Other (itemize and describe) Subtotal ________    
H. TOTAL OF DIRECT CHARGES:
(A. through G.)
  Total ________
___________________________
1 S-TS-S/S-H-TH-H/S-SEC

2 Encumbered/Vacant

3 Previously Approved/New





APPENDIX O
SUPPORTING DETAILS OF ANTICIPATED COSTS

PART B: ADMINISTRATION

A. PERSONNEL: (List all positions having salary charged to Administration.) Total  
      Position       Type1   Status2 Cond.3 Location       % Time 21(d)   Salary
B. FRINGE BENEFITS: (List Cost Formula[s])   Total ________
C. TRAVEL:  (100% Describe in Training Plan)   Total ________
1. Out-of-State (100% Federal) Subtotal:  ________    
    Training        
    Annual Consultation Conference        
    Other (specify)        
2. Within State (90% Federal) Subtotal:  ________    
   Training        
   Promotion        
   Accompanied visits        
   Other (specify)        
D. EQUIPMENT: (office/list in Equipment Listing)   Total ________
E. SUPPLIES: (office/itemize & describe)   Total ________
F. CONTRACTS: (all sources)     Total ________
1. Computer Costs Subtotal ________    
2. Lease of office equipment Subtotal ________    
3. Service of office equipment Subtotal ________    
4. Other (specify) Subtotal ________    
G. OTHER (items not covered elsewhere)   Total ________
1. 100% non-travel costs of training Subtotal ________    
2. Other (itemize and describe) Subtotal ________    
H. TOTAL OF DIRECT CHARGES: (A. through G.)   Total ________
I. INDIRECT CHARGES     Total ________
J. TOTAL ADMINISTRATION (H. plus I.)   Total ________
___________________________
1 MGT – SEC
2 Encumbered/Vacant
3 Previously Approved/New


Archive Notice - OSHA Archive

NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.


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