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["Challenge Pilot"]
["Administrator's Quarterly Report Instructions"]
[]
["Included in this spreadsheet is:"]
[]
["Tab 1.  Administrator's Quarterly Report "]
[]
["To access this document, please click on the tab at the bottom of this form."]
[]
[]
["The Challenge Pilot Administrator must prepare the Administrator's Quarterly Report"]
["only if there have been significant changes to any of its participant sites.  The following"]
["are examples of changes that would require the completion of a Quarterly Report: "]
[]
[null,"1) Changes in Administrator or Participant contact information"]
[" ","2) The addition of new participants into the Pilot"]
[" ","3)  Participants removing themselves from the Pilot."]
[]
["The Administrator's Quarterly Report is due according to the following schedule:"]
[]
["Quarter","Months Covered ",null,null,"Type of Report Due",null,null,null,"Due Date"]
["1st  ","January - March",null,null,"Quarterly if changes",null,null,null,"April 15"]
["2nd","April - June",null,null,"Quarterly if changes, plus OCTPS ",null,null,null,"July 15"]
["3rd ","July - September",null,null,"Quarterly if changes",null,null,null,"October 15"]
["4th","October - December",null,null,"Annual, plus OCTPS",null,null,null,"February 15"]
[]
["The Administrator must also prepare an Annual Report at the end of the year (due February 15th"]
["each year).  This report summarizes the Challenge sites' progress throughout the course  "]
["of the year.  Please refer to the Challenge Pilot Administrator's Annual Report Spreadsheet "]
["for instructions on preparing this report. "]
[]
["The OSHA Challenge - Tracking Participant Status (OCTPS) form for each Challenge "]
["Pilot Participant is due every six months -- to be submitted by July 15th each year (with the"]
["Administrator's Quarterly Report, if one is prepared) and at the end of the year (due Feburary"]
["15th) along with the Annual Report."]
[]
["The Quarterly report should be submitted to: "]
[]
[]
[null,"Challenge Pilot Program Coordinator"]
[null,"Directorate of Cooperative and State Programs"]
[null,"Occupational Safety and Health Administration, Room N3700"]
[null,"U.S. Department of Labor"]
[null,"200 Constitution Ave., NW"]
[null,"Washington, DC  20210"]
[]
["As an option, you may submit your Quarterly Reports electronically to:  "]
["kim.jennifer@dol.gov."]
[]
[]
[]
[]
[]
[]
["  "]

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["Challenge Pilot"]
["Administrator's Quarterly Report"]
[]
[]
["Administrator Name",null,null,null,"Report Period"]
["[Fill in Administrator Name Here]",null,null,null,"Quarter",null,"Q1"]
[{"$nulls":4},"Year",null,2008]
[]
["Section 1.  Administrator Information Update"]
["(If there were any changes)"]
["Name"]
["Site Address ",{"$nulls":8}," "]
[]
[]
[]
[]
["Section 2.  Administrator Contact Information Update"]
["(If there were any changes)"]
["Administrator Contact Name",null,null,null," ",{"$nulls":5},2004,"Q1"]
["Administrator Contact Title",null,null,null," ",{"$nulls":5},2005,"Q2"]
["Administrator Contact Phone Number",null,null,null," ",{"$nulls":5},2006,"Q3"]
["Administrator Contact Fax Number",null,null,null," ",{"$nulls":5},2007,"Q4"]
["Administrator Contact E-mail Address",null,null,null," ",{"$nulls":5},2008]
[]
["Section 3.  Coordinator Contact Information Update"]
["(If there were any changes)"]
["Coordinator Contact Name",null,null,null," ",{"$nulls":5}," "]
["Coordinator Contact Title",null,null,null," ",{"$nulls":7}," "]
["Coordinator Contact Phone Number",null,null,null," "]
["Coordinator Contact Fax Number",null,null,null," "]
["Coordinator Contact E-mail Address",null,null,null," "]
[]
["Section 4.  Candidate Information Update"]
["Please list any Candidates who have dropped out or have been added since the last progress report.  You must submit a Candidate Information Package for all new Candidates."]
["Form Approved OMB# 1218 – 0239      Expired xx-xx-xxxx\nPublic reporting burden for this collection of information is voluntary and is estimated to average 5 hours per response, including the time for reviewing instruction, searching existing data sources, gathering and  maintaining the data needed, and completing and reviewing the collection 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. "]