Complete this Appendix only if your agency has a as Safety & Health Committee” “Certified described in 29 CFR Part 1960, Subpart F, and approved by the Secretary of Labor. Please address all items as completely as possible. Agency Name: Does your agency have an Occupational Safety and Health Committee (OSHC) at the National Yes No If please do not complete this form. “No,” General Information Are any of your agency’s employees covered under a collective bargaining agreement? Yes No Name(s) of the signatory that cover any or all of your agency’s employees under a collective bargaining agreement: Name and Title of the National OSHC Chairperson: When did your agency initiate its National OSHC? Committee Organization In the past six how many individuals have held the Chairperson position? How many Managers have held the How many Non-Managers have held the In the past six Chairperson position? Chairperson position? Please provide the names of your agency’s current National OSHC members, the organizational subdivision (agency, bureau, etc.) the member represents (if applicable), along with his or her managerial status and title. For non-managers, please list the Union the member represents, if any. Please duplicate as needed. Organization Union Member Name Manager Title Subdivision Represented
Complete this Appendix only if your agency has a “Certified Safety & Health Committee” as described in 29 CFR Part 1960, Subpart F, and approved by the Secretary of Labor. Please address all items as completely as possible. Agency Name: Does your agency have an Occupational Safety and Health Committee (OSHC) at the National Yes No If “No,” please do not complete this form. General Information Are any of your agency’s employees covered under a collective bargaining agreement? Yes No Name(s) of the signatory that cover any or all of your agency’s employees under a collective bargaining agreement: Name and Title of the National OSHC Chairperson: When did your agency initiate its National OSHC? Committee Organization In the past six how many individuals have held the Chairperson position? In the past six How many Managers have held the Chairperson position? How many Non-Managers have held the Chairperson position? Please provide the names of your agency’s current National OSHC members, the organizational subdivision (agency, bureau, etc.) the member represents (if applicable), along with his or her managerial status and title. For non-managers, please list the Union the member represents, if any. Please duplicate as needed. Member Name Organization Subdivision Manager Title Union Represented
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