Agency Safety Plan Template

Public Transportation Agency Safety
Plan Template for Bus Transit
Version 2, Issued 09/09/19

The Federal Transit Administration (FTA) is providing the Public Transportation Agency Safety Plan
Template for Bus Transit and accompanying Reference Guide to assist with the development of a Public
Transportation Agency Safety Plan (Safety Plan) for bus transit modes. Use of this template is voluntary.
The template and reference guide are intended for use by States and operators of public transportation
systems that are required to draft a Safety Plan in accordance with 49 C.F.R. Part 673 (Part 673). The full
text of Part 673 is available at http://www.transit.dot.gov/PTASP.
Certain requirements in Part 673 do not apply to small public transportation providers. 1 The relevant
sections in this template are noted in red to indicate where requirements differ. Transit operators that are
subject to Part 673 may choose to include additional sections beyond what is required in Part 673.
Under Part 673, a transit agency is required to maintain documents that describe its Safety Plan,
including those related to implementation and results from processes and activities. Also, a transit
operator may have existing documentation that describes processes, procedures, and other information
required in Part 673. You may reference these documents in your Safety Plan by specifying the document
names and locations within the appropriate sections of the plan.

1. Transit Agency Information
Transit Agency Name
Transit Agency Address
Name and Title of
Accountable Executive
Name of Chief Safety
Officer or SMS
Executive
Mode(s) of Service
Covered by This Plan

List All FTA Funding
Types (e.g., 5307, 5337,
5339)

Mode(s) of Service
Provided by the Transit
Agency (Directly
operated or contracted
service)
Part 673 defines small public transportation provider as a recipient or subrecipient of Federal financial assistance under 49 U.S.C. § 5307 that has
one hundred (100) or fewer vehicles in peak revenue service and does not operate a rail fixed guideway public transportation system. (49 C.F.R. §
673.5). This includes bus transit systems with one hundred (100) or fewer vehicles in revenue service during peak regular service across all nonrail fixed route modes or in any one non-fixed route mode.
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Version 2, Published 09/09/19
The guidance in this document is not legally binding in its own right and will not be relied upon by the Federal Transit Administration as a separate basis for affirmative
enforcement action or other administrative penalty. Compliance with the guidance in this document (as distinct from existing statutes and regulations) is voluntary only, and
noncompliance will not affect rights and obligations under existing statutes and regulations.

1

Does the agency
provide transit services
on behalf of another
transit agency or entity?

Yes

No

Description of
Arrangement(s)

Name and Address of
Transit Agency(ies) or
Entity(ies) for Which
Service Is Provided

2. Plan Development, Approval, and Updates
Name of Entity That
Drafted This Plan
Signature by the
Accountable Executive

Approval by the Board
of Directors or an
Equivalent Authority

Signature of Accountable Executive

Date of Signature

Name of Individual/Entity That Approved This
Plan

Date of Approval

Relevant Documentation (Title and Location)

Name of Individual/Entity That Certified This
Plan
Certification of
Compliance

Date of Certification

Relevant Documentation (Title and Location)

Version Number and Updates
Record the complete history of successive versions of this plan.
Version
Number

Section/Pages Affected

Reason for Change

Date Issued

Version 2, Published 09/09/19
The guidance in this document is not legally binding in its own right and will not be relied upon by the Federal Transit Administration as a separate basis for affirmative
enforcement action or other administrative penalty. Compliance with the guidance in this document (as distinct from existing statutes and regulations) is voluntary only, and
noncompliance will not affect rights and obligations under existing statutes and regulations.

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Annual Review and Update of the Public Transportation Agency Safety Plan
Describe the process and timeline for conducting an annual review and update of the Public
Transportation Agency Safety Plan.

3. Safety Performance Targets
Safety Performance Targets
Specify performance targets based on the safety performance measures established under the National
Public Transportation Safety Plan.
Mode of Transit
Service

Fatalities
(Total)

Fatalities
(Rate)

Injuries
(Total)

Injuries
(Rate)

Safety
Events
(Total)

Safety
Events
(Rate)

System
Reliability

Safety Performance Target Coordination
Describe the coordination with the State and Metropolitan Planning Organization(s) (MPO) in the selection
of State and MPO safety performance targets.

Targets
Transmitted to the
State

State Entity Name

Date Targets Transmitted

Targets
Transmitted to the
Metropolitan
Planning
Organization(s)

Metropolitan Planning Organization Name

Date Targets Transmitted

4. Safety Management Policy
Safety Management Policy Statement
Use the written statement of safety management policy, including safety objectives.

Version 2, Published 09/09/19
The guidance in this document is not legally binding in its own right and will not be relied upon by the Federal Transit Administration as a separate basis for affirmative
enforcement action or other administrative penalty. Compliance with the guidance in this document (as distinct from existing statutes and regulations) is voluntary only, and
noncompliance will not affect rights and obligations under existing statutes and regulations.

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Safety Management Policy Communication
Describe how the safety management policy is communicated throughout the agency. Include dates where
applicable.

Authorities, Accountabilities, and Responsibilities
Describe the role of the following individuals for the development and management of the transit agency’s
Safety Management System (SMS).
Accountable Executive

Chief Safety Officer or
SMS Executive
Agency Leadership and
Executive Management

Key Staff

Employee Safety Reporting Program
Describe the process and protections for employees to report safety conditions to senior management.
Describe employee behaviors that may result in disciplinary action (and therefore, are excluded from
protection).

5. Safety Risk Management
Safety Risk Management Process
Describe the Safety Risk Management process, including:
•

Safety Hazard Identification: The methods or processes to identify hazards and consequences of
the hazards.

•

Safety Risk Assessment: The methods or processes to assess the safety risks associated with
identified safety hazards.

•

Safety Risk Mitigation: The methods or processes to identify mitigations or strategies necessary as
a result of safety risk assessment.

Version 2, Published 09/09/19
The guidance in this document is not legally binding in its own right and will not be relied upon by the Federal Transit Administration as a separate basis for affirmative
enforcement action or other administrative penalty. Compliance with the guidance in this document (as distinct from existing statutes and regulations) is voluntary only, and
noncompliance will not affect rights and obligations under existing statutes and regulations.

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6. Safety Assurance
Safety Performance Monitoring and Measurement
Describe activities to monitor the system for compliance with procedures for operations and maintenance.

Describe activities to monitor operations to identify any safety risk mitigations that may be ineffective,
inappropriate, or were not implemented as intended.

Describe activities to conduct investigations of safety events, including the identification of causal factors.

Describe activities to monitor information reported through internal safety reporting programs.

Management of Change (Not Required for Small Public Transportation Providers)
Describe the process for identifying and assessing changes that may introduce new hazards or impact
safety performance.

Continuous Improvement (Not Required for Small Public Transportation Providers)
Describe the process for assessing safety performance. Describe the process for developing and carrying
out plans to address identified safety deficiencies.

Version 2, Published 09/09/19
The guidance in this document is not legally binding in its own right and will not be relied upon by the Federal Transit Administration as a separate basis for affirmative
enforcement action or other administrative penalty. Compliance with the guidance in this document (as distinct from existing statutes and regulations) is voluntary only, and
noncompliance will not affect rights and obligations under existing statutes and regulations.

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7. Safety Promotion
Competencies and Training
Describe the safety training program for all agency employees and contractors directly responsible for
safety.

Safety Communication
Describe processes and activities to communicate safety and safety performance information throughout
the organization.

Additional Information
Supporting Documentation
Include or reference documentation used to implement and carry out the Safety Plan that are not included
elsewhere in this Plan.

Definitions of Special Terms Used in the Safety Plan
Term

Definition

List of Acronyms Used in the Safety Plan
Acronym

Word or Phrase

Version 2, Published 09/09/19
The guidance in this document is not legally binding in its own right and will not be relied upon by the Federal Transit Administration as a separate basis for affirmative
enforcement action or other administrative penalty. Compliance with the guidance in this document (as distinct from existing statutes and regulations) is voluntary only, and
noncompliance will not affect rights and obligations under existing statutes and regulations.

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