Attachment
F-2
Form Approved
OMB No. XXXX-XXXX
Exp. Date XX/XX/XXXX
Carrier Administrative Cost data
Company records on number of workers’ compensation claims
Company record on amount of workers’ compensation payment
Company record on number of drivers who left the company and date of leaving
Company record on number of new drivers and date of joining the company
Company record on vehicle miles traveled by vehicle if possible
Company record on fuel costs by vehicle if possible
Company record on vehicle maintenance costs
Company record on number of sick leave days
Company record on on-time delivery rate
Company record on truck crash costs
Number of hours that were used by drivers for NAFMP training
Number of hours that were used to implement NAFMP program by manager
Public reporting burden of this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Chen, Guang-Xiang (CDC/NIOSH/DSR/AFEB) |
| File Modified | 0000-00-00 |
| File Created | 2021-01-13 |