OSHA 12-10.9a Annual Alliance Evaluation Template

Annual Alliance Evaluation: National Alliances

Alliance Program participants agree to meet fundamental requirements as a condition of their participation in the Program. At the end of each fiscal year, the Alliance Coordinator uses the checklist below to evaluate and document the extent to which each Alliance fulfilled each requirement.

Directions: Mark whether the Alliance “Meets,” “Meets in Part” or “Did Not Meet” each item related to the nine fundamental requirements. Use the “Justification/Notes” section to support selections, and spotlight successes or opportunities for improvement, as appropriate.

Share the results of the evaluation with the Alliance participant(s) timely and use to facilitate a discussion about successes and opportunities for improvement in the next fiscal year. Where a trend needing improvement is noted from year to year, discuss and determine a course of action with the Alliance participant(s).

Alliance Name:

Alliance Signatory Organizations (if more than one):

Evaluation for Fiscal Year:

1. Commitment of time and resources: Participants must commit reasonable time and resources to achieve outreach and communication goals and objectives and complete any other mutually agreed-upon projects. During the previous fiscal year, did the Alliance participant(s):

Criteria	Meets	Meets in Part	Did Not Meet	N/A
Participate in implementation team and project meetings
Provide OSHA with opportunities to speak/exhibit/participate during industry meetings/conferences
Speak/participate in OSHA outreach efforts, meetings, forums, and conferences, as requested
Assist in alliance activity planning and complete or make significant progress towards mutually agreed projects/activities aligning with the agreement (and work plan, if applicable)
Participate in National Office meetings/conferences, e.g., the Alliance Program Forum (APF) and Construction Roundtable (CRT), and the biennial Consultation Conference, as appropriate

Justification/Notes

2. Communication with OSHA staff: Participants must assign a point-of-contact to OSHA who will communicate with OSHA. During the previous fiscal year, did the Alliance participant(s):

Criteria	Meets	Meets in Part	Did Not Meet	N/A
Respond consistently and timely to telephone/email inquiries from the OSHA Alliance Coordinator (AC) and other OSHA staff (e.g., on meetings, projects and action items)
Proactively provide project updates and respond on follow-up items from implementation and project meetings
Proactively inform the AC when key organizational contacts change
Update the AC on direct communication between their organization and OSHA leadership or staff (e.g., with OAS, RAs, national office, regional /area offices) or other parts of DOL (e.g., OSEC, other agencies)

Justification/Notes

3. Outreach and Dissemination: Participants must disseminate information to their members/stakeholders (e.g., via email blasts, websites, blog entries, newsletters, social media, etc.) about OSHA rulemakings/enforcement initiatives/compliance assistance resources/outreach campaigns & initiatives. During the previous fiscal year, did the Alliance participant(s):

Criteria	Meets	Meets in Part	Did Not Meet	N/A
Include the AC on distribution list(s) for key industry communications (e.g., newsletter or email blasts for members) and allow dissemination of this material to OSHA staff, as appropriate
Employ organizational communication channels (e.g., newsletters, email blasts, social media) to share timely, accurate information about primary outreach initiatives (e.g., Fall Prevention Campaign and the Annual Stand-Down, Heat Illness Prevention, Safe + Sound, etc.) and regulatory/policy information relevant to their industry sector (e.g., rulemaking notices, enforcement programs/initiatives)

Justification/Notes

4. Alliance Activity Reporting: Participants must work with their AC to compile information pertaining to Alliance-related dissemination efforts, events, speeches/presentations, and other activities as appropriate, for the AC to input into the OSHA Information System (OIS). During the previous fiscal year, did the Alliance participant(s):

Criteria	Meets	Meets in Part	Did Not Meet	N/A
Provide information (e.g., description, numbers reached) about events and activities at which OSHA representatives presented/exhibited
Provide information (e.g., description, numbers reached) about dissemination, outreach, and educational/training activities conducted by the Alliance participant organization in support of the Alliance, but independent of OSHA participation
Transmit alliance activity data for FY Q1/Q2, except web hits, using the Salesforce portal by deadline (typically April 15)
Transmit alliance activity data for FY Q3/Q4 and web hits for entire FY using the Salesforce portal by deadline (typically October 15)

Justification/Notes

5. Alliance Projects: For Alliance activities beyond outreach and dissemination, Alliance Program participants must follow the Guidelines for OSHA's Alliance Program Participants: Alliance Products and Other Alliance Projects. During the previous fiscal year, did the Alliance participant(s):

Criteria	Meets	Meets in Part	Did Not Meet	N/A
Generally follow process outlined in the Guidelines, including developing and sharing a proposal with OSHA before proceeding, and using approved disclaimers
Incorporate OSHA’s comments/requests in a reasonable fashion, and with a reasonable effort on OSHA’s part (i.e., without multiple rounds of review and discussion)
Ensure that Alliance products/projects are available free to the public, not maintained behind a member firewall
For completed products, review and update products in a timely manner at the request of the agency, and as needed following changes in related policy, regulatory requirements, or industry recognized practices

Justification/Notes

6. Worker Representation: When participants are employers and/or employer groups (e.g., trade associations), they must make a reasonable effort to secure meaningful worker participation in the Alliance. During the previous fiscal year, did the Alliance participant(s):

Criteria	Meets	Meets in Part	Did Not Meet	N/A
Encourage worker participation in Alliance activities through one of the methods noted in section VIII.G.6 of the directive (note manner or progress in Justification)

Justification/Notes

7. Potential Conflicts of Interest: Participants must not use the Alliance or relationship with OSHA to promote or to imply the agency’s endorsement of their policies, products, or services; and must acknowledge they will not receive preferential treatment related to any statutory function of the agency. During the previous fiscal year, did the Alliance participant(s) refrain from:

Criteria	Meets	Meets in Part	Did Not Meet	N/A
Implying OSHA’s review, approval, or endorsement of their organization or its policies, products, or services, e.g., by, for example: Suggesting that a service, product, or tool has been reviewed or approved by OSHA Mentioning the Alliance on an organization’s member/ product marketing materials (webpage, flyer, brochure, etc.) other than to objectively state that an Alliance exists
Suggesting or requesting any preferential treatment related to any statutory function of the agency e.g., by, for example: Stating in marketing materials/on website/in communications that the organization has sway with OSHA or that members may receive favor regarding enforcement policy/inspections or regulatory activities Pressing for non-public information on enforcement policy/ inspections, or regulatory activities. Note: AC may share public information to improve understanding/ awareness. Additional requests may be accommodated at the discretion of SMEs

Justification/Notes

8. Logo Use: Participants must abide by all terms and conditions for the use of the Alliance Program logo as specified in OSHA’s Guidelines for Use of the Alliance Logo and may not use the OSHA logo on Alliance products or any other materials. During the previous fiscal year, did the Alliance participant(s):

Criteria	Meets	Meets in Part	Did Not Meet	N/A
Confirm planned use of Alliance logo with Alliance Coordinator
Share products affixed with logo publicly (e.g., on website, through dissemination) only after they have been cleared by OSHA
Use the Alliance logo only on products developed in consultation with OSHA through the Alliance Program (examples noted here)
Refrain from all use of the OSHA logo, which is prohibited by DOL policy
Confirm planned use of Alliance logo with Alliance Coordinator

Justification/Notes

9. Alliance Webpage: Each participant must develop, publish, and maintain a stand-alone webpage devoted to the Alliance, which should include information and links to resources, including those developed by the Alliance, on safety and health issues affecting workers in the participant’s industry, as well as worker and employer rights and responsibilities. During the previous fiscal year, did the Alliance participant(s):

Criteria	Meets	Meets in Part	Did Not Meet	N/A
Develop/maintain a stand-alone webpage devoted to 1) the Alliance, or 2) workplace safety and health, on which the Alliance is featured prominently
Include on the webpage information and links for resources on: Safety and health issues affecting workers in the Alliance Program participant’s industry, including those developed by the Alliance, and Worker and employer rights and responsibilities

Justification/Notes

Additional Accomplishments: Please provide below any additional accomplishments that are not already highlighted as successes in the preceding sections in a short, bulleted list. For example, if the organization(s) conducted training, provided technical expertise, and developed a product that is not noted above, please note it here.

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OSHA 12-10.9a