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{"sheet":"Overview","index":0,"n_rows":45,"n_cols":3,"rows_kept":45,"cut":false,"hidden":false,"merged":[[44,0,50,8],[0,0,0,9],[1,0,1,9],[22,0,22,9],[23,0,23,9]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Administrator Application Package Instructions"]
[]
["Included in this spreadsheet are:"]
[]
["Tab 1.     Administrator Criteria"]
["Tab 2.     Administrator Statement of Commitment"]
["Tab 3.     Administrator Information Form "]
["Tab 4A.  Coordinator Information Form - Coordinator 1"]
["Tab 4B.  Coordinator Information Form - Coordinator 2"]
["Tab 4C.  Coordinator Information Form - Coordinator 3"]
["Tab 4D.  Coordinator Information Form - Coordinator 4"]
["Tab 4E.  Coordinator Information Form - Coordinator 5"]
["Tab 4F.  Coordinator Information Form - Coordinator 6"]
["Tab 4G.  Coordinator Information Form - Coordinator 7"]
["Tab 4H.  Coordinator Information Form - Coordinator 8"]
["Tab 4I.  Coordinator Information Form - Coordinator 9"]
["Tab 4J.  Coordinator Information Form - Coordinator 10"]
[]
["To access these documents, please click on the tabs at the bottom of this form."]
[]
[]
["Please complete and return the Statement of Commitment, Administrator Information "]
["Form, and Coordinator Information Forms (one per Coordinator) to:"]
[]
[null,null,"OSHA Challenge Program Coordinator"]
[null,null,"Directorate of Cooperative and State Programs"]
[null,null,"Occupational Safety and Health Administration, Room N3700"]
[null,null,"U.S. Department of Labor "]
[null,null,"200 Constitution Ave., NW "]
[null,null,"Washington, DC  20210"]
[]
["You may submit this package electronically to Jim Boom via e-mail boom.lloyd @dol.gov"]
[]
[]
["You will also need to submit candidate packages (see Candidate Application Package "]
["Spreadsheet), for all organizations that will be participating with you."]
[]
[]
["Once your Administrator's Package is received, it will be reviewed by OSHA.  You will be"]
["contacted if any missing information needs to be provided.  Confirmation of your acceptance "]
["as an Challenge Pilot Administrator will be provided by mail.  Please allow a 45-day window "]
["for OSHA to complete the review process."]
[]
["OMB# 1218 – 0239                                                                                                                          Expires xx-xx-xxxx \nPublic reporting burden for this collection of information is voluntary and is estimated to average 5 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate, or any other aspect of this collection of information, including suggestions for reducing this burden to the Office of Partnerships and Recognition,  Department of Labor, Room N-3700, 200 Constitution Avenue, N.W., Washington, DC 20210\n"]

{"sheet":"1 - Administrator Criteria","index":1,"n_rows":29,"n_cols":2,"rows_kept":29,"cut":false,"hidden":false,"merged":[[22,0,28,0],[13,0,19,0],[0,0,0,1],[1,0,1,1]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Administrator Criteria"]
[]
[]
["Eligibility:","The role of a Challenge Pilot Administrator is available to any private corporation, federal agency or non-profit association that meets the eligibility criteria outlined below and meets OSHA’s selection process. Eligibility does not extend to private safety and health consultants or for-profit associations at this time."]
[]
[]
["Role of Challenge Pilot Administrators:","Challenge Pilot Administrator refers to the organization as a whole, such as a federal agency, corporation, or an association.   Administrators can administer the program to either their own worksites or members of other companies."]
[]
[]
["Role of Challenge Pilot Coordinator:","Coordinators are appointed by the Administrator to manage the program implementation for the Challenge Pilot Candidates."]
[]
[]
["Challenge Pilot Administrator Criteria: ","An Administrator must possess the following characteristics in order to be considered: "]
[]
[null,"Knowledge and Experience: Demonstrated knowledge and experience in safety and health management systems.  Experience may include involvement in other OSHA Cooperative Programs such as, VPP or Strategic Partnerships; and/or experience administering corporate-wide safety and health policies at the facility-level."]
[]
[null,"Resources:  Administrators must confirm the availability of resources including time, personnel and expertise to administer OSHA Challenge to its Candidate facilities or members."]
[]
[null,"Commitment:  Administrators must be committed to the Challenge Pilot and sponsor a minimum of ten (10) Challenge Pilot Candidates."]
[]
[]
["Challenge Pilot Individual Coordinator Criteria:","Criteria for individual coordinators include: "]
[]
[null,"Knowledge and Experience:  Knowledgeable safety and health professionals with experience in implementing and evaluating safety and health management systems."]
[]
[null,"Training:  Ideally, Challenge Pilot Coordinators will have completed the OSHA Special Government Employees (SGE) training or equivalent (i.e., corporate safety and health audit training)."]
[]
[null,"Evaluation Experience:  Ideally, Challenge Pilot Coordinators should have performed site safety and health management system reviews or VPP type onsite evaluations."]

{"sheet":"2 - Statement of Commitment","index":2,"n_rows":37,"n_cols":2,"rows_kept":37,"cut":false,"hidden":false,"merged":[[16,0,16,8],[18,0,18,8],[34,0,34,8],[0,0,0,8],[1,0,1,8],[3,0,3,8]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Administrator Statement of Commitment"]
[]
["Sample Letter Only "]
[]
["Cathy Oliver, Director "]
["Office of Partnerships and Recognition"]
["Directorate of Cooperative and State Programs"]
["U.S. Department of Labor, OSHA"]
["200 Constitution Avenue, North West"]
["Room N3700 "]
["Washington, DC 20210"]
["Attention:  Cathy C. Oliver"]
[]
["Dear Ms. Oliver: "]
[]
["I am writing to inform you of [insert name of company, association, or federal agency’s] intent to participate in the Challenge Pilot Program as a Challenge Pilot Administrator.  We have reviewed the program and believe [insert name of company, association, or federal agency’s] meets the Administrator criteria you are seeking.  "]
[]
["I can assure you that [insert name of company, association, or federal agency] is committed to assisting our potential candidates in progressing through the Challenge Pilot stages towards health and safety excellence.   Initially we agree to have a minimum of ten (10) Candidates in the Challenge Pilot. "]
[]
["Attached please find our: (if submitting at this time).  "]
[]
[null,"Administrator Information Sheet"]
[null,"Coordinator Information Sheet"]
[null,"Candidate Package(s)"]
[]
["Should you have any questions or need additional information, please contact: "]
[]
[null,"Name "]
[null,"Title "]
[null,"Address "]
[null,"Phone "]
[null,"E-mail "]
[]
["[Insert name of company, association, or federal agency] looks forward to working together to bring the principles and benefits of VPP to more facilities throughout the country. "]
[]
["Sincerely, "]

{"sheet":"3 - Administrator Info Form","index":3,"n_rows":50,"n_cols":6,"rows_kept":50,"cut":false,"hidden":false,"merged":[[4,0,4,1],[13,0,13,1],[21,0,21,1],[10,0,10,1],[0,0,0,1],[1,0,1,1],[44,0,44,1],[45,0,49,1],[32,0,32,1],[33,0,33,1],[34,0,39,1],[43,0,43,1],[22,0,22,1],[23,0,29,1]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Administrator Information Form"]
[]
[]
["Section 1.  Administrator Information"]
["Name",{"$nulls":4},"Private Company"]
["Site Address",{"$nulls":4},"Federal Agency"]
[{"$nulls":5},"Non-profit Association"]
[]
["Type of Administrator","Private Company"]
[]
[]
[]
["Section 2.  Administrator Contact Information"]
["Administrator Contact Name"]
["Administrator Contact Title"]
["Administrator Contact Phone Number"]
["Administrator Contact Fax Number"]
["Administrator Contact E-mail Address",null,null," "]
[]
[]
["Section 3.  Knowledge and Experience"]
["Please describe your organization’s knowledge and experience in safety and health management systems.  Experience may include involvement in other OSHA Cooperative Programs such as, VPP or Strategic Partnerships; and/or experience in administering corporate-wide safety and health policies at the facility-level. [250 words or less]",null,null," "]
{"$rows_empty":9}
["Section 4.  Resources"]
["Please confirm the availability of resources including time and personnel to administer the Challenge Pilot to the Candidate facilities or members. [100 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
[]
[]
["Section 5.  Process"]
["Please provide a description of your organization’s internal processes to collect baseline and quarterly/annual data for each Challenge Pilot Candidate and ensure its accuracy.  (See Candidate’s Package for baseline data requirements and the following Evaluation Report Template for quarterly/annual requirements) [250 words or less]",null,null," "]
[]
[]
[]
[]
[null,null," "]

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["Challenge Pilot"]
["Coordinator Information Form"]
["(Please complete forms for each Coordinator)"]
[]
["Section 1.  Coordinator Information"]
["Company Name"]
["Coordinator Contact Name"]
["Coordinator Contact Title"]
["Coordinator Contact Phone Number"]
["Coordinator Contact Fax Number"]
["Coordinator Contact E-mail Address",null,null," "]
[]
["Administrator Name"]
[]
[]
["Section 2.  Knowledge and Experience"]
["Please describe your knowledge and experience in safety and health program management. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null,null," "]
[]
[]
["Section 3.  Training"]
["Please describe any relevant safety and health training you have completed. [150 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
["Section 4.  Evaluation Experience"]
["Please describe all relevant experience you have in evaluating safety and health management systems. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null," "]

{"sheet":"4B - Coordinator Info Form - 2","index":5,"n_rows":42,"n_cols":4,"rows_kept":42,"cut":false,"hidden":false,"merged":[[0,0,0,1],[1,0,1,1],[2,0,2,1],[16,0,16,1],[17,0,23,1],[4,0,4,1],[15,0,15,1],[13,0,13,1],[35,0,35,1],[36,0,41,1],[25,0,25,1],[26,0,26,1],[27,0,32,1],[34,0,34,1]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Coordinator Information Form"]
["(Please complete forms for each Coordinator)"]
[]
["Section 1.  Coordinator Information"]
["Company Name"]
["Coordinator Contact Name"]
["Coordinator Contact Title"]
["Coordinator Contact Phone Number"]
["Coordinator Contact Fax Number"]
["Coordinator Contact E-mail Address",null,null," "]
[]
["Administrator Name"]
[]
[]
["Section 2.  Knowledge and Experience"]
["Please describe your knowledge and experience in safety and health program management. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null,null," "]
[]
[]
["Section 3.  Training"]
["Please describe any relevant safety and health training you have completed. [150 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
["Section 4.  Evaluation Experience"]
["Please describe all relevant experience you have in evaluating safety and health management systems. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null," "]

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["Challenge Pilot"]
["Coordinator Information Form"]
["(Please complete forms for each Coordinator)"]
[]
["Section 1.  Coordinator Information"]
["Company Name"]
["Coordinator Contact Name"]
["Coordinator Contact Title"]
["Coordinator Contact Phone Number"]
["Coordinator Contact Fax Number"]
["Coordinator Contact E-mail Address",null,null," "]
[]
["Administrator Name"]
[]
[]
["Section 2.  Knowledge and Experience"]
["Please describe your knowledge and experience in safety and health program management. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null,null," "]
[]
[]
["Section 3.  Training"]
["Please describe any relevant safety and health training you have completed. [150 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
["Section 4.  Evaluation Experience"]
["Please describe all relevant experience you have in evaluating safety and health management systems. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null," "]

{"sheet":"4D - Coordinator Info Form - 4","index":7,"n_rows":42,"n_cols":4,"rows_kept":42,"cut":false,"hidden":false,"merged":[[0,0,0,1],[1,0,1,1],[2,0,2,1],[16,0,16,1],[17,0,23,1],[4,0,4,1],[15,0,15,1],[13,0,13,1],[35,0,35,1],[36,0,41,1],[25,0,25,1],[26,0,26,1],[27,0,32,1],[34,0,34,1]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Coordinator Information Form"]
["(Please complete forms for each Coordinator)"]
[]
["Section 1.  Coordinator Information"]
["Company Name"]
["Coordinator Contact Name"]
["Coordinator Contact Title"]
["Coordinator Contact Phone Number"]
["Coordinator Contact Fax Number"]
["Coordinator Contact E-mail Address",null,null," "]
[]
["Administrator Name"]
[]
[]
["Section 2.  Knowledge and Experience"]
["Please describe your knowledge and experience in safety and health program management. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null,null," "]
[]
[]
["Section 3.  Training"]
["Please describe any relevant safety and health training you have completed. [150 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
["Section 4.  Evaluation Experience"]
["Please describe all relevant experience you have in evaluating safety and health management systems. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null," "]

{"sheet":"4E - Coordinator Info Form - 5","index":8,"n_rows":42,"n_cols":4,"rows_kept":42,"cut":false,"hidden":false,"merged":[[35,0,35,1],[36,0,41,1],[25,0,25,1],[26,0,26,1],[27,0,32,1],[34,0,34,1],[17,0,23,1],[4,0,4,1],[15,0,15,1],[13,0,13,1],[0,0,0,1],[1,0,1,1],[2,0,2,1],[16,0,16,1]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Coordinator Information Form"]
["(Please complete forms for each Coordinator)"]
[]
["Section 1.  Coordinator Information"]
["Company Name"]
["Coordinator Contact Name"]
["Coordinator Contact Title"]
["Coordinator Contact Phone Number"]
["Coordinator Contact Fax Number"]
["Coordinator Contact E-mail Address",null,null," "]
[]
["Administrator Name"]
[]
[]
["Section 2.  Knowledge and Experience"]
["Please describe your knowledge and experience in safety and health program management. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null,null," "]
[]
[]
["Section 3.  Training"]
["Please describe any relevant safety and health training you have completed. [150 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
["Section 4.  Evaluation Experience"]
["Please describe all relevant experience you have in evaluating safety and health management systems. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null," "]

{"sheet":"4F - Coordinator Info Form - 6","index":9,"n_rows":42,"n_cols":4,"rows_kept":42,"cut":false,"hidden":false,"merged":[[0,0,0,1],[1,0,1,1],[2,0,2,1],[16,0,16,1],[17,0,23,1],[4,0,4,1],[15,0,15,1],[13,0,13,1],[35,0,35,1],[36,0,41,1],[25,0,25,1],[26,0,26,1],[27,0,32,1],[34,0,34,1]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Coordinator Information Form"]
["(Please complete forms for each Coordinator)"]
[]
["Section 1.  Coordinator Information"]
["Company Name"]
["Coordinator Contact Name"]
["Coordinator Contact Title"]
["Coordinator Contact Phone Number"]
["Coordinator Contact Fax Number"]
["Coordinator Contact E-mail Address",null,null," "]
[]
["Administrator Name"]
[]
[]
["Section 2.  Knowledge and Experience"]
["Please describe your knowledge and experience in safety and health program management. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null,null," "]
[]
[]
["Section 3.  Training"]
["Please describe any relevant safety and health training you have completed. [150 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
["Section 4.  Evaluation Experience"]
["Please describe all relevant experience you have in evaluating safety and health management systems. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null," "]

{"sheet":"4G - Coordinator Info Form - 7","index":10,"n_rows":42,"n_cols":4,"rows_kept":42,"cut":false,"hidden":false,"merged":[[35,0,35,1],[36,0,41,1],[25,0,25,1],[26,0,26,1],[27,0,32,1],[34,0,34,1],[17,0,23,1],[4,0,4,1],[15,0,15,1],[13,0,13,1],[0,0,0,1],[1,0,1,1],[2,0,2,1],[16,0,16,1]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Coordinator Information Form"]
["(Please complete forms for each Coordinator)"]
[]
["Section 1.  Coordinator Information"]
["Company Name"]
["Coordinator Contact Name"]
["Coordinator Contact Title"]
["Coordinator Contact Phone Number"]
["Coordinator Contact Fax Number"]
["Coordinator Contact E-mail Address",null,null," "]
[]
["Administrator Name"]
[]
[]
["Section 2.  Knowledge and Experience"]
["Please describe your knowledge and experience in safety and health program management. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null,null," "]
[]
[]
["Section 3.  Training"]
["Please describe any relevant safety and health training you have completed. [150 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
["Section 4.  Evaluation Experience"]
["Please describe all relevant experience you have in evaluating safety and health management systems. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null," "]

{"sheet":"4H - Coordinator Info Form - 8","index":11,"n_rows":42,"n_cols":4,"rows_kept":42,"cut":false,"hidden":false,"merged":[[0,0,0,1],[1,0,1,1],[2,0,2,1],[16,0,16,1],[17,0,23,1],[4,0,4,1],[15,0,15,1],[13,0,13,1],[35,0,35,1],[36,0,41,1],[25,0,25,1],[26,0,26,1],[27,0,32,1],[34,0,34,1]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Coordinator Information Form"]
["(Please complete forms for each Coordinator)"]
[]
["Section 1.  Coordinator Information"]
["Company Name"]
["Coordinator Contact Name"]
["Coordinator Contact Title"]
["Coordinator Contact Phone Number"]
["Coordinator Contact Fax Number"]
["Coordinator Contact E-mail Address",null,null," "]
[]
["Administrator Name"]
[]
[]
["Section 2.  Knowledge and Experience"]
["Please describe your knowledge and experience in safety and health program management. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null,null," "]
[]
[]
["Section 3.  Training"]
["Please describe any relevant safety and health training you have completed. [150 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
["Section 4.  Evaluation Experience"]
["Please describe all relevant experience you have in evaluating safety and health management systems. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null," "]

{"sheet":"4I - Coordinator Info Form - 9","index":12,"n_rows":42,"n_cols":4,"rows_kept":42,"cut":false,"hidden":false,"merged":[[35,0,35,1],[36,0,41,1],[25,0,25,1],[26,0,26,1],[27,0,32,1],[34,0,34,1],[17,0,23,1],[4,0,4,1],[15,0,15,1],[13,0,13,1],[0,0,0,1],[1,0,1,1],[2,0,2,1],[16,0,16,1]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Coordinator Information Form"]
["(Please complete forms for each Coordinator)"]
[]
["Section 1.  Coordinator Information"]
["Company Name"]
["Coordinator Contact Name"]
["Coordinator Contact Title"]
["Coordinator Contact Phone Number"]
["Coordinator Contact Fax Number"]
["Coordinator Contact E-mail Address",null,null," "]
[]
["Administrator Name"]
[]
[]
["Section 2.  Knowledge and Experience"]
["Please describe your knowledge and experience in safety and health program management. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null,null," "]
[]
[]
["Section 3.  Training"]
["Please describe any relevant safety and health training you have completed. [150 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
["Section 4.  Evaluation Experience"]
["Please describe all relevant experience you have in evaluating safety and health management systems. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null," "]

{"sheet":"4J - Coordinator Info Form - 10","index":13,"n_rows":42,"n_cols":4,"rows_kept":42,"cut":false,"hidden":false,"merged":[[0,0,0,1],[1,0,1,1],[2,0,2,1],[16,0,16,1],[17,0,23,1],[4,0,4,1],[15,0,15,1],[13,0,13,1],[35,0,35,1],[36,0,41,1],[25,0,25,1],[26,0,26,1],[27,0,32,1],[34,0,34,1]],"flags":["formulas_cached_only"]}
["Challenge Pilot"]
["Coordinator Information Form"]
["(Please complete forms for each Coordinator)"]
[]
["Section 1.  Coordinator Information"]
["Company Name"]
["Coordinator Contact Name"]
["Coordinator Contact Title"]
["Coordinator Contact Phone Number"]
["Coordinator Contact Fax Number"]
["Coordinator Contact E-mail Address",null,null," "]
[]
["Administrator Name"]
[]
[]
["Section 2.  Knowledge and Experience"]
["Please describe your knowledge and experience in safety and health program management. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null,null," "]
[]
[]
["Section 3.  Training"]
["Please describe any relevant safety and health training you have completed. [150 words or less]",null,null," "]
[" "]
[]
[]
[]
[null,null," "]
[]
[null,null,null," "]
["Section 4.  Evaluation Experience"]
["Please describe all relevant experience you have in evaluating safety and health management systems. [200 words or less]",null,null," "]
[" "]
[]
[]
[]
[]
[null,null," "]