1. Responsible Office
   
   
2. Action Offices
   
   
   1. National Office
      
      
   2. Regional Offices
      
      
   3. States
      
      

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
      
      

1. Consultation Annual Project Plan (CAPP)
   
   
2. Financial Documents
   
   

1. Directorate of Cooperative and State Programs
   
   
2. Directorate of Administrative Programs
   
   

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.
   
   

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.
      
      

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.
    
    

Arlene Williams
U.S. Department of Labor
Occupational Safety and Health Administration
200 Constitution Avenue, NW
Room N-3419
Washington, DC 20210

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.
      
      

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.
      
      

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.

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.
   
   

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.

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.
   
   

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:
   
   

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.
   
   

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.
   
   

1. Scope of transfer:
   
   
2. Agency name:
   
   
3. Address:
   
   
4. Telephone number: (    )
   
   
5. Contact person:
   
   

(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).

(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.