Reports Schedule and Instructions - Home : State of Oregon



Periodic Reports PacketOccupational Safety And HealthTraining And Education Grant2023-2024Package Contents REF _Ref138680987 \h \* MERGEFORMAT Reports Schedule and Instructions REF _Ref138680995 \h \* MERGEFORMAT Form G – Quarterly Detail of Grant Expenditures REF _Ref138681009 \h \* MERGEFORMAT Form E – Quarterly Record of Individual Training Classes REF _Ref138681019 \h \* MERGEFORMAT Form F – Quarterly Training Summary REF _Ref138681025 \h \* MERGEFORMAT Form H – Travel Log REF _Ref138681033 \h \* MERGEFORMAT Form I – Financial Summary of Grant ExpendituresReports Schedule and InstructionsScheduleQuarterly Reports are due according to this scheduleFunds AllocatedBegin QuarterEnd QuarterReport DueDecember 20, 2023December 20, 2023February 29, 2024March 6, 2024March 13, 2024March 1, 2024May 31, 2024June 5, 2024June 12, 2024June 1, 2024August 31, 2024September 4, 2024September 11, 2024September 1, 2024November 30, 2024Final Report and product due to Oregon OSHA December 4, 2024InstructionsComplete the copy of the Quarterly Detail of Grant expenditures (Form G) and if applicable to your grant, Forms E, F, and H.Attach copies of invoices, bills, canceled checks, etc., that support the incurred expenses. Invoices are needed for all expenditures on Form G.Include a one page synopsis of the grant activities that have occurred that quarter and a description summary indicating if the project is progressing according to plan or whether there are significant changes, delays, or problems with project completion.Final report: when submitting the final quarterly report, follow the above steps 1-4 and include a completed copy of the Financial Summary of Grant Expenditures (Form I).At the end of the performance period for the grant, you must submit one copy of the final product to Oregon OSHA. These reports may be mailed, emailed, or faxed.Mailing address: Matt KaiserTraining and Education GrantsOregon OSHAPO Box 14480Salem, OR 97309-0405Email: Matthew.C.KAISER@dcbs.Fax: (503) 947-7461 Form G – Quarterly Detail of Grant ExpendituresInstructions: Provide actual expenditures in each category for the quarter. Include invoices, receipts, etc., to support expenditures.Grantee: FORMTEXT ????? Quarter/Year FORMTEXT ?????Administration Salary & FringeCategory Total FORMTEXT =AdmP1total+AdmP2total+AdmP3total+AdmP4total+AdmP5total $0.00$0.00Line Item DetailPositionSalary Per WeekNo. of WeeksTotal Charged1. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =AdmP1Salary*AdmP1Weeks $0.00$0.00 2. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =AdmP2Salary*AdmP2Weeks $0.00$0.00 3. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =AdmP3Salary*AdmP3Weeks $0.00$0.00 4. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =AdmP4Salary*AdmP4Weeks $0.00$0.00 5. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =AdmP5Salary*AdmP5Weeks $0.00$0.00 Training and Development Personnel Salary & FringeCategory Total FORMTEXT =TrainP1total+TrainP2total+TrainP3total+TrainP4total+TrainP5total $0.00$0.00Line Item DetailPositionSalary Per WeekNo. of WeeksTotal Charged1. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =TrainP1salary*TrainP1weeks $0.00$0.00 2. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =TrainP2salary*TrainP2weeks $0.00$0.00 3. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =TrainP3salary*TrainP3weeks $0.00$0.00 4. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =TrainP4salary*TrainP4weeks $0.00$0.00 5. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =TrainP5salary*TrainP5weeks $0.00$0.00 Office SuppliesCategory Total FORMTEXT =OSPrintTotal + OSGenTotal + OSPostTotal $0.00$0.00Line Item DetailType of SuppliesCost Per UnitTotal UnitsTotal Charged1. Printing FORMTEXT ????? FORMTEXT ????? FORMTEXT =OSPrintCost * OSPrintUnit $0.00$0.002. General SuppliesAttach details of items greater than $100.00 FORMTEXT ????? FORMTEXT ????? FORMTEXT =OSGenCost * OSGenUnit $0.00$0.003. Postage FORMTEXT ????? FORMTEXT ????? FORMTEXT =OSPostCost * OSPostUnit $0.00$0.00Operations and FacilitiesLimited to 20% of Grant Funds RequestedCategory Total FORMTEXT =OpsRentTotal+OpsUtilityTotal+OpsPhoneTotal+OpsService1+OpsService2+OpsService3+OpsGen1+OpsGen2+OpsGen3+OpsGen4 $0.00$0.00Line Item DetailNo. of MonthsMonthly AmountTotal ChargedRent FORMTEXT ????? FORMTEXT ????? FORMTEXT =OpsRentMonths*OpsRent $0.00$0.00Utilities FORMTEXT ????? FORMTEXT ????? FORMTEXT =OpsUtilityMonths*OpsUtility $0.00$0.00Telephone FORMTEXT ????? FORMTEXT ????? FORMTEXT =OpsPhoneMonths*OpsPhone $0.00$0.00Support ServicesType of Service FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????General AdministrationDescription FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Travel for Grantee StaffCategory Total FORMTEXT =POVTotal +LodgeTotal + TravelMealsTotal $0.00$0.00Line Item DetailMust comply with current per diem/mileage rates found at Per Mile FORMTEXT ????? Total ChargedNo. of Miles FORMTEXT ????? FORMTEXT =TravelMiles * TravelPOV $0.00$0.00Lodging Amount Per Night FORMTEXT ????? Total ChargedNo. of Nights FORMTEXT ????? FORMTEXT =TravelNights * TravelLodgePerDiem $0.00$0.00Meals & IncidentalsM&I FORMTEXT ????? Total ChargedNo. of Meals FORMTEXT ????? FORMTEXT =TravelMeals * TravelMealsPerDiem $0.00$0.00Training MaterialsCategory Total FORMTEXT =Train1total + Train2total + Train3total + Train4total + Train5total $0.00$0.00Line Item DetailType of Good/ ServiceCost Per UnitTotal UnitsTotal Charged1. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =Train1cost * Train1units $0.00$0.002. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =Train2cost * Train2units $0.00$0.003. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =Train3cost * Train3units $0.00$0.004. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =Train4cost * Train4units $0.00$0.005. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =Train5cost * Train5units $0.00$0.00Equipment(Limited to 20% of grant funds requested)Category Total FORMTEXT =Equip1total + Equip2total + Equip3total + Equip4total + EquipRent1total + EquipRent2total + EquipRent3total + EquipRent4total $0.00$0.00Line Item DetailType of PurchaseCost Per UnitTotal UnitsTotal Charged1. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =Equip1cost * Equip1units $0.00$0.002. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =Equip2cost * Equip2units $0.00$0.003. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =Equip3cost * Equip3units $0.00$0.004. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =Equip4cost * Equip4units $0.00$0.00Type of RentalCost Per UnitTotal UnitsTotal Charged1. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =EquipRent1cost * EquipRent1units $0.00$0.002. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =EquipRent2cost * EquipRent2units $0.00$0.003. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =EquipRent3cost * EquipRent3units $0.00$0.004. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =EquipRent4cost * EquipRent4units $0.00$0.00ContractualInclude All Subcontractors and Costs(Limited to 40% of grant funds requested)Category Total FORMTEXT =Contract1total + Contract2total+Contract3total+Contract4total $0.00$0.00Line Item DetailContractor Company NameTotal Charged FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????OtherCategory Total FORMTEXT =OtherSubTotal+OtherSubTotal2 $0.00$0.00Line Item DetailDescriptionTotal Charged FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Report Total - All Categories FORMTEXT =AdministrationTotal + TrainingDevelopTotal + OSTotal + OpsTotal + TravelTotal + TrainingTotal + EquipmentTotal + ContractualTotal + OtherTotal $0.00$0.00Form E – Quarterly Record of Individual Training ClassesInstructions: Provide the following detail for each training program conducted.1. Grantee FORMTEXT ????? 2. Quarter/Year FORMTEXT ????? 3. Program or activity title FORMTEXT ????? 4. Date FORMTEXT ????? 5. Training Site FORMTEXT ????? 6. Type of Training FORMCHECKBOX Lecture FORMCHECKBOX Workshop FORMCHECKBOX Seminar FORMCHECKBOX Other FORMTEXT ????? Person Hours 7. Instruction Hours FORMTEXT ????? X Attendees FORMTEXT ????? = FORMTEXT =instructorhours*attendees 00Of Training8. Attendance8-1 Participants: Workers FORMTEXT ????? Management/Supervisors FORMTEXT ????? Total FORMTEXT =attendworkers+attendmanager 00 8-2 Industry: Type FORMTEXT ????? SIC Code FORMTEXT ????? FORMCHECKBOX Union FORMCHECKBOX Non-Union 8-3 Size of Workforce: FORMCHECKBOX Small (50 or less) FORMCHECKBOX Medium (51-249) FORMCHECKBOX Large (250+) (if specific worksite)9. Instructors Comments (Attach extra sheets if necessary) FORMTEXT ?????10. Instructor Name(s) FORMTEXT ????? 11. Primary Instructor Signature FORMTEXT ????? 12. Date FORMTEXT ????? 13. Grantee Signature FORMTEXT ????? 14. Date FORMTEXT ????? Form F – Quarterly Training SummaryInstructions: Provide summary of training sessions conducted for every quarter.Grantee: FORMTEXT ????? Quarter / YearQ1/ FORMTEXT ????Q2/ FORMTEXT ????Q3/ FORMTEXT ????Q4/ FORMTEXT ????Total1. Training sessionsLecture FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =lectureQ1+lectureQ2+lectureQ3+lectureQ4 00Workshop FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =workshopsQ1+workshopsQ2+workshopsQ3+workshopsQ4 00Other (as described on Form E) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =otherQ1+otherQ2+otherQ3+otherQ4 00Total worker training sessions FORMTEXT =lectureQ1+workshopsQ1+otherQ1 00 FORMTEXT =lectureQ2+workshopsQ2+otherQ2 00 FORMTEXT =lectureQ3+workshopsQ3+otherQ3 00 FORMTEXT =lectureQ4+workshopsQ4+otherQ4 00 FORMTEXT =lecturetotal+workshopstotal+othertotal 002. Workers trainedNumber of workers from small workforce (50 or less) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =smallworkforceQ1+smallworkforceQ2+smallworkforceQ3+smallworkforceQ4 00Number of workers from medium workforce (51 - 249) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =mediumworkforceQ1+mediumworkforceQ2+mediumworkforceQ3+mediumworkforceQ4 00Number of workers from large workforce (250+) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =largeworkforceQ1+largeworkforceQ2+largeworkforceQ3+largeworkforceQ4 00Total workers trained3. Total workers training hours FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =totalworkershoursQ1+totalworkershoursQ2+totalworkershoursQ3+totalworkershoursQ4 004. Management/supervisors FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =totalmanagehoursQ1+totalmanagehoursQ2+totalmanagehoursQ3+totalmanagehoursQ4 005. Total employers trained FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT =totalemphoursQ1+totalemphoursQ2+totalemphoursQ3+totalemphoursQ4 00Comments FORMTEXT ?????Grantee Signature FORMTEXT ????? Date FORMTEXT ?????Form H – Travel LogGrantee: FORMTEXT ????? Quarter/Year FORMTEXT ?????Month: FORMTEXT ?????DateDestination/Purpose of TripDriverMileageMeals/Misc.Lodging FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? Monthly Totals FORMTEXT =Mileage1+Mileage2+Mileage3+Mileage4+Mileage5+Mileage6+Mileage7+Mileage8+Mileage9+Mileage10+Mileage11+Mileage12 0$0.00 FORMTEXT =Meals1+Meals2+Meals3+Meals4+Meals5+Meals6+Meals7+Meals8+Meals9+Meals10+Meals11+Meals12 0$0.00 FORMTEXT =Lodge1+Lodge2+Lodge3+Lodge4+Lodge5+Lodge6+Lodge7+Lodge8+Lodge9+Lodge10+Lodge11+Lodge12 0$0.00Maximum Allowable Charges must comply with current per diem/mileage rates found at I – Financial Summary of Grant ExpendituresInstructions: Summarize budgeted and actual expenses for all quarters. If budgeted expenses are greater than actual expenses, please remit payment* for the difference.Grantee: FORMTEXT ????? Quarter/Year: FORMTEXT ?????CategoryBudgeted Expenses Actual Expenses 1. Administration Salaries & Fringe Benefits FORMTEXT ????? FORMTEXT ????? 2. Training Development Personnel Salaries & Fringe Benefits FORMTEXT ????? FORMTEXT ????? 3. Office Supplies FORMTEXT ????? FORMTEXT ????? 4. Operations/Facilities FORMTEXT ????? FORMTEXT ????? 5. Travel FORMTEXT ????? FORMTEXT ????? 6. Training Materials FORMTEXT ????? FORMTEXT ????? 7. Equipment FORMTEXT ????? FORMTEXT ????? 8. Contractual FORMTEXT ????? FORMTEXT ????? 9. Other FORMTEXT ????? FORMTEXT ????? Total FORMTEXT =financebudget1+financebudget2+financebudget3+financebudget4+financebudget5+financebudget6+financebudget7+financebudget8+financebudget9 $0.00$0.00 FORMTEXT =actualbudget1+actualbudget2+actualbudget3+actualbudget4+actualbudget5+actualbudget6+actualbudget7+actualbudget8+actualbudget9 $0.00$0.00 *Make check payable to Department of Consumer and Business Services, and mail to Oregon OSHA, DCBS, PO Box 14480, Salem, OR 97309-0405 and email matthew.c.kaiser@dcbs. when a check has been mailed. ................
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