Sample Documents, Policies and Procedures

Bloodborne Pathogen Policy (City of Riverton, UT)

Document designed to eliminate or minimize occupational exposure to Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV), and other bloodborne pathogens that employees may encounter in the workplace.

Safety Committee Charter (City of Altamonte Springs, FL)

Safety committee charge outlining purpose, mission statement, roles and responsibilities, and meeting conduct.

Use of Personal Vehicles for County Business (County of Chippewa, WI)

Document providing insurance, reimbursement and additional details pertaining to using personal vehicles for county business.

Emergency Action Plan: Greer City Hall

Outline of emergency response plan. From City of Greer, SC.

Safety Committee Inspection Checklist (Dupage County, IL)

Checklist used to address needs/issues pertaining to a number of safety categories.

Anoka County Requirements for Small Contracts

Contract detailing insurance requirements for contracts $10,000 and under. From Anoka County, MN.

Swimming Pool Rules and Regulations (Montgomery County Recreation)

The following rules and regulations have been established for the benefit of all users of the swimming pool to assure the safe operation of the pool facilities and to provide enjoyable recreation for all.

Code Enforcement Officer Safety Guide

Safety guide for code enforcement officers. From California Association of Code Enforcement Officers

Comprehensive Loss Control Program Manual

Risk management services policy used to fully investigate any accident involving State of Georgia personnel and vehicles.

Vehicle Fleet Policy (City fo Columbus, GA)

Document designed to ability and maintain high standards and fiscal responsibility by reducing the number and severity of vehicle accidents and personal injuries the city incurs while employees operate City of Columbus vehicles.

City Vehicle/Car Allowance Policy (City of Columbus, GA)

City vehicle policy designed for employees of the Columbus Consolidated Government who are assigned a city-owned vehicle or who receive a car allowance to compensate them for providing their own transportation while on city business.

ERM Process Evaluation (NC State Univ.)

This evaluation tool is designed to assist senior executives and their boards of directors in better understanding the strength and relevance of their organization’s existing risk oversight processes.

ERM Maturity Tool for Higher Ed Programs

From United Educators, this tool allows you to qualitatively assess each aspect of ERM: purpose and scope, centralization and accountability, process and campus risk management culture.

Distracted Driving Prevention Policy (City of Jackson, MS)

This document establishes policy and procedures for employees of the City of Jackson regarding the use of wireless voice/data communication devices (department or privately owned) when operating department vehicles.

Accident Review Board Policies & Procedures (City of Flagstaff, AZ)

The purpose of this administrative policy is to reduce equipment accidents, to reduce accidents which cause bodily injury or damage to citizens' property, and to reduce employee injuries.

Accident Damage Report Guide (City of Flagstaff, AZ)

Accident damage report guide outlining procedures in the event of damage/theft to vehicle, city property, employees, citizens, etc. From City of Flagstaff, AZ.

Vehicle Incident Response Guidelines (Clayton County Water Authority)

Steps and guidelines in response to an incident involving a company vehicle. From Clayton County Water Authority (GA).

Medical Bill Review Company Questions

Sample questions for a medical bill review company RFP from Safety National.

Subcontractor Management Plan (City of Charlotte, NC)

Sample plan outlining the relationship between contractors while they are performing work for a certain project as well as the methods by which the primary contractor will ensure the production of quality deliverables from each of its subcontractors.

Competent Person Designation (City of Charlotte, NC)

Contractor safety checklist measuring contractor's knowledge of the systems, equipment, conditions and procedures, proper use, inspection, manufacturer’s recommendations and instructions, and maintenance. From the City of Charlotte, NC.

Request for Proposals (Santa Clara County Housing Authority)

Request for proposals for insurance brokerage and administrative services from Santa Clara County Housing Authority (CA).

Request for Qualifications (City of Maricopa, AZ)

Request for qualifications for employee benefits insurance broker and consulting services from the City of Maricopa, AZ.

Safety Work Shoe Guidelines and Reimbursement Procedure

Safety work shoe guidelines and reimbursement procedures from Metro Wastewater Reclamation District (Denver, CO).

Insurance Requirements Manual (Santa Clara County Housing Authority)

Document containing contract and insurance requirements in a number of categories for the Santa Clara County Housing Authority.

Cybersecurity Frequently Asked Questions

Cybersecurity FAQ document submitted by PRIMA's Education Committee.

Cyber Executive Overview

Document containing a link to PRIMA's Cyber Task Force executive overview webinar.

Cloth Face Covering FAQ (Madison County, IL)

Frequently Asked Questions regarding cloth face mask application amidst COVID-19. Contributed by Madison County, IL.

Hearing Conservation Program (Town of Smyrna, TN)

Sample hearing conservation program packet provided by Town of Smyrna, TN.

Sample Youth Summer Camp Release Form

Sample release form pertaining to youth summer camps in response to COVID-19.

Common Area Cleaning Protocols (City of Altamonte Springs, FL)

Sanitizing procedures for common areas in the workplace amidst COVID-19. Provided by City of Altamonte Springs, FL.

Re-entry Guidelines (Sarasota County, FL)

COVID-19 reopening guidelines contributed by Sarasota County, FL.

Special Conditions of Employment: Non-Civilian Public Safety Employees

Policy outlining the prohibition of tobacco use and testing procedures. Provided by the City of Roanoke, VA.

Hand-Sewn Mask Instructions

Document from Johns Hopkins University detailing how to create a homemade respiratory mask.

Daily Fire-EMS Staff Health Screening

Health screening criteria provided by the Roanoke (VA) Fire-EMS Department.

What Water Professionals Need to Know About COVID-19

Guidance provided by the Water Environment Federation for water professionals who may encounter COVID-19.

Wastewater Monitoring for SARS-CoV-2 in Las Vegas

Document detailing how to monitor and detect COVID-19 during wastewater treatment. Contributed by Southern Nevada Water Authority

Off Duty and Extra Duty Policy (City of Roanoke, VA)

Policy used to establish guidelines concerning off duty and extra duty employment for sworn and non-sworn personnel employed by the Roanoke Police Department.

Breastfeeding Policy and Procedures (Coconino County, AZ)

This document contains a breastfeeding policy and procedures. Also included are forms used by the county to initiate a pilot work-site breastfeeding program.

Scooter Application Assessments (SFMTA)

An application assessment of various recreational vehicle-share companies. Provided by San Francisco Municipal Transportation Agency (SFMTA).

OC Spray Safety Data Sheet

Sample safety data sheet outlining various details of First Defense® .2 Percent MK-3 Stream OC Aerosol spray. From Las Vegas Valley Water District (NV).

Encroachment Permit & Temporary Lease

Encroachment permit and temporary lease form contributed by the CIty of Palo Alto, CA.

Dockless Bike Share & E-Scooter Share Guidelines

This document outlines a plan to launch a one-year dockless bike and e-scooter share pilot program. Contributed by the City of Palo Alto, CA.

Personal Electronic Device Use (City of Columbia)

Policy outlining personal electronic device use while operating a motor vehicle. From the City of Columbia, MO.

Onsite Medical Clinic RFP (Waukesha County)

Sample RFP for those seeking a provider to operate an onsite medical clinic. Provided by Waukesha County, WI.

Narcan Policy (Multnomah County)

Policy from Mulnomah County (OR) Sheriff's Office outlining the procedures that are to be followed by officers when utilizing Narcan/Naloxone in the event of opioid exposure or overdose. Also summarized in the policy are observable signs of an opioid overdose.

Severe Weather Safety (DuPage County)

The document from DuPage County, IL outlines precautions that are to be taken by county employees working in the field in the event of severe weather.

Golf Cart Vehicle Usage Guide

Document providing guidance regarding safe usage of golf cart vehicles at the University of Missouri.

Sick Leave Bank Policy - Cherokee County School District (GA)

Document outlining the sick leave bank policy for Cherokee County School District employees.

Early Return to Work Policy - Oneida Nation (WI)

A sample return-to-work policy provided by the Oneida Nation is Wisconsin.

Vendor Insurance Requirements

From the Albuquerque Bernalillo County Water Utility Authority (ABCWUA). This form also includes clauses regarding adjustments to insurance limit and type.

Seminole County (FL) Confined Space Policy

This policy is intended to reduce the risk of injury and other safety hazards while operating or entering into confined spaces.

Confined Spaces Program (Appendix E9)

From the Albuquerque Bernalillo County Water Utility Authority (ABCWUA). This document serves as an appendix to the ABCWUA's confined spaces program document. Pertains specifically to its wastewater treatment facility.

Confined Space Program

From the Albuquerque Bernalillo County Water Utility Authority (ABCWUA). This document outlines health and safety procedures for employees that enter confined spaces or who serve as attendants and entry supervisors.

IFB - Vehicle Body Repair

Invitation for bids for auto body repair services for city-owned vehicles. From the City of Charlottesville (VA).

Authorization and Operation of City-Owned and Leased Motor Vehicles Policy

Document provided by the City of Santa Fe (NM). Contains policies and procedures regarding the use of city-owned, leased, or rented vehicles and/or equipment. Also contains GPS tracking considerations.

Vehicle GPS Tracking System

Policy and procedures associated with GPS tracking systems installed in Palm Beach County vehicles.

Vehicle Safety Program - Palm Beach County (FL)

Fleet management policies and procedures developed to ensure the safe operation of Palm Beach County vehicles.

Aviation Insurance Policy (UAS)

Zurich's insurance policy for unmanned aircraft systems.

Office Safety Policy - Broward County (FL)

Policy that establishes protocol to reduce the potential for injuries and other hazards that may occur in the office. Applicable for employees that work in administrative areas.

Parks Division - Recreational Drone & Unmanned Aerial Systems (UAS) Policy

From the City of Pinellas Park (FL). Document outlining the policy pertinent to operating unmanned aircraft.

Unmanned Aircraft Systems Permit - City of Orlando (FL)

Document outlining polices and procedures pertinent to operating unmanned aircraft per the city code of Orlando, FL.

Fentanyl Briefing Guide

A briefing guide containing recommendations on potential best practices for first responders that may encounter, test and transport exhibits that could contain fentanyl‐related substances. It also contains recommendations for handling and processing of crime scenes and non‐drug evidence that could be contaminated. Provided by the U.S Department of Justice Drug Enforcement Administration.

Police Department Assigned Vehicle SOP

Document provided by the Cocoa Beach Police Department detailing the department's standard operation procedures for assigned vehicle use.

Risk Management Consultant RFP - Howard County

Request for proposals document from Howard County, Maryland. Among the items included in the document: general conditions and specifications surrounding scope of work, submission requirements, sample invoice, etc.

Template Risk Assessment Report

A sample risk assessment report. The purpose of this sample report is to help entities prioritize risks based on probable organizational impact.

Risk Assessment Tool

This document consists of a risk assessment worksheet and management plan template.

Public Works Best Practices

Guide describing the safety exposures surrounding equipment and work tasks common in public works departments.

Solid Waste Management Best Practices

Guide describing safety exposures surrounding equipment and work tasks common in solid waste management.

Respiratory Protection for Pesticides

Guideline for respirator use during the pesticide application process. This document also provides detail regarding respiratory hazards and selection of respirator type.

Marijuana Grow Operations Entry Safe Practices

This document is intended to provide guidance to employees when they must enter either a residential or commercial marijuana grow facility to perform official city business. From the City and County of Denver.

Marijuana Cultivation Facility Pesticide Investigations Policy and Procedure

This document provides information pertaining to the State of Colorado's marijuana facility inspections policy. Among the information included: Additions to the policy, worker safety procedures, and investigation processes.

Sample Cyber Incident Response Plan

Outline of a cyber incident response plan from the State of Tennessee Treasury Department.

Commitment to Excellence Best Practices Guide - Joint Powers Insurance Authority (JPIA)

This guide includes the loss reduction and risk management focus areas for each of the following categories: Vehicle Operations Construction Infrastructure Employment Practices Ergonomics/Falls

City Vehicle Accident Procedures

Sample policy from the City of Newport News, Virginia outlining procedures that its employees should follow in the event of a vehicular accident.

School Volunteers Policy - Shelby County Board of Education

Shelby County Board of Education School Volunteer Policy. This document encourages the participation of volunteers in Shelby County Schools and provides guidance to ensure the safety of students.

Employee Breastfeeding Policy Draft - Coconino County Department of Health Serices

This is a draft employee breastfeeding policy for the Coconino County Department of Health Services, Health Education and Promotion Unit.

Employee Breastfeeding Policy - Coconino County Department of Health Serices (Part 2)

This policy provides support for breastfeeding employees to bring their infant to work until the baby reaches three (3) months of age.

Employee Breastfeeding Policy - Coconino County Department of Health Services (Part 1)

This policy provides support for breastfeeding employees to bring their infant to work until the baby reaches three (3) months of age.

MOU for Emotional Support Animal Services

This is a memorandum of understanding template for emotional support dog services during a trial between two counties.

Sample Whistleblower Policy

Sample whistleblower policy from Pitt County, North Carolina.

Sample Whistleblower Protection Policy

Sample whistleblower protection policy from the National Council of Nonprofits.

RFP for Third Party Claims Administration (TPA)

The purpose of this Request for Proposal (RFP) is to obtain competitive proposals from qualified individuals and firms interested in providing Property and Casualty Third Party Claims Administration Services.

City of Issaquah Agreement Processing Form

A form from the city's risk management process that that outlines the city's contract/agreement process in order to mitigate risks and exposures to the city.

Social Media Policy

Sarasota (FL) County's social media policy.

Preventable Accident Ordinance

This Preventable Accident Ordinance from Aiken County, South Carolina allows the county to dock an employee's future annual leave accrual if the county's safety committee determines that the accident was preventable by the county employee.

Application for Fireworks Permit

A permit application from the City of Saratoga Springs (NY) that also outlines basic guidelines for fireworks usage.

Working Hours Before and/or After School (Department) Protocol

This is a draft protocol from Norfolk (VA) Public Schools designed to limit the potential for injury or exposure to workplace violence or school staff who work substantially after regular school operational hours and/or arrive at school/facility substantially earlier than normal hours.

City of Rapid City Sewer Backup Policy

This is a city resolution amending the policy of the city of Rapid City to reimburse owners for the cost of commercial cleaning of property damaged by sewer backups.

Risk Ranking Criteria

Example and template of risk ranking criteria reference table.

Using a Risk Map to Guide Mitigation Efforts

Based on a three-point rating scale. This guide is from Gallagher.

International standard makes risk management easier

This is an article from Business Insurance magazine about the ISO 31000 international risk management standard.

Enterprise Risk Management in the Public Sector

This is an article that was published in PRIMA's Public Risk magazine in 2007. The information in this article pertaining to ISO 31000 is out of date, however the history and overview are still instructive.

Overview of ISO 31000: The International Standard on Risk Management

This is a PowerPoint presentation from Gallagher that goes over the evolution of risk management, key concepts and definitions, components of the standard and implementation advice and resources. Check out the notes field in the presentation to get even more out of this presentation.

General Fleet Safety Program

General fleet safety policy from the City of Saratoga Springs, New York.

Risk and Safety Agreement for Professional Services

This contract template from the City of Saratoga Springs, New York requires that consultants have specific insurance coverage and that they adhere to this agreement.

Threat Incident Response Flow Diagram and Charts

Threat incident response flow diagram from the Oregon Department of Human Services

Transportation Safety Guide

University of Alaska's transportation safety guide

Vehicle Safety Policy

Princeton City Schools' vehicle safety policy defines standards of conduct and establishes mandatory traning for faculty and staff who operate vehicles while conducting school business

Vehicle Safety Review Board Policy

Rockingham County's vehicle safety review board policy was established to determine the cause and preventability of any vehicle accident occuring in the performance of county employees' duties through investigation

Wildlife Hazard Management at Airports

A manual for airport personnel on wildlife hazard management at airports

Sewer Backup Exposure Reduction Program

A guide for public works managers: sewer backup exposure reduction porgram

Guidelines for Entrapment Hazards: Making Pools and Spas Safer

Guidelines for making pools and spas safer from the U.S. Consumer Product Safety Commission

Forklift Checklist

Forklist checklist from the City of Columbia

Fleet Safety Best Practices Guide

Maine Municipal Association Risk Management Services' best practices guide for fleet safety program development.

Fleet Safety Program

Univeristy of Miami's fleet safety program helps minimize injuries and losses associated with motor vehicle accidents.

Fleet Safety Policy Manual

Tarrant County College District's fleet safety policies and procedures

Fleet Operations Management

This section of Alachua County's administrative procedures manual establishes procedures and policies to ensure that vehicles and motorized equipment are selected, acquired, utilized and maintained in a manner that provides the best possible support to county operations through economical and environmentally responsible fleet management.

Driving Policy and State Driver Program

San Mateo County's policy promotes the safety of drivers and protects employees and the public from vehicular harm or incident.

Contractors OCIP Health and Safety Plan

Minimum guidelines for contractor OCIP health and safety plan from the New Jersey Turnpike Authority

Contagious Temporary Illness Policy

The purpose of this policy from Cherokee County is to offer guidance to employees and supervisors in the event of an employee's contagious temporary illness.

School Indoor Air Quality Program

Indoor air quality (IAQ) coordinator's guide to implementing an IAQ program

Safety Policy and Procedure Manual

Kegonsa research campus safety policy and procedures manual

Safety Incident Plan

The City of Waco's plan provides a systematic way to minimize incident frequency and severity, contribute to positive morale, effectively maintain city resources, and increase operational efficiency.

Risk Management Guidelines for Fitness Facilities

Risk management guideline recommendations from the fitness standards council

Radiation Safety Manual

Radiation safety manual for Duke University and Duke University Medical Center

Pre-Trip Checklist

The City of Columbia's sold waste refuse collection pre-trip inspection

Pandemic Influenza-Attendance Policy

Pima County's adopted temporary attendance procedures specific to employees who exhibit flu symptoms during a pandemic Influenza outbreak.

Pandemic Influenza Planning Checklist

A checklist provided by the Department of Health and Human Services and the Center for Disease Control that identifies specific activities large businesses can do to prepare for an influenza pandemic.

General RFP Template

General RFP template from the City of Minneapolis, Minnesota

RFP for Telecommunication Cabling Installation

RFP for telecommunication cabling installation from the County of Volusia

Cold Stress Administrative Policy

The purpose of this program from the University of Alaska is to provide guidance for protecting employees from hazards of cold environmental conditions and to provide information on engineering, administrative and personal protective equipment (PPE) controls.

Aquatics Safety Program

An outline of an aquatics safety program that details the program mission, overview, job duties, pool rules and regulations and more.

Chaperone Guidelines

This guide from the University of Alaska includes some of the basic considerations when developing a program where chaperones are going to be utilized. However, some programs may need more or less structure and detail depending upon the nature

Building Fixed Equipment and Nonstructural Checklist Assessement

A checklist that assists in the assessment of general items that exist within a building's structure.

Bomb Threat Standoff Distances

A table detailing bomb threat stand-off distances for general emergency planning.

Bomb Threat Call Checklist

A checklist of questions to ask individuals who call in a bomb threat.

Bomb Threat Call Form

A form to use when an individual calls in a bomb threat that details the exact message, questions to ask the caller and information about the caller.

Bloodborne Pathogen Administrative Policy

Bloodborne pathogen administrative policy from the University of Alaska

RFP for Risk Management Services

RFP for risk management services from the Association of Bay Area Governments risk pool.

Active Shooter on Campus Protocol

Active shooter protocal from the UAA University Police

Citizen Ride Along Hold Harmless Agreement

Citizen Ride Along Hold Harmless Agreement from the Tulsa, Oklahoma Police Department

Club Sports Waiver, Release and Hold Harmless Agreement

Completion of this form is required by Kent State University for all club sports members and guests prior to participation in club activities

Data Disclosure Policy

Policy specifies how information collected by Safe Harbors HMIS will be shared or disclosed and under what conditions the information may be accessedor disclosed.

Public Records Disclosure Policy

Public records disclosure policy for the City of Yakima

Request to Review Public Records

Form to request to review public records form for the City of Seattle

SEC Security Portable Computing Devices

Minnesota government standard that prevents the unauthorized disclosure of not public data on portable computing devices.

Hold Harmless Agreement Filming

Hold Harmless Agreement Filming form from the City of Richmond

Hold Harmless Agreement

Hold Harmless Agreement from Orange County Recreation

Standard Tort Claim Form Package

Standard Tort Claim Form Package from Washington State. Includes instructions for completing the tort claim form, the tort claim form, medical authorization and vehicle collision form.

RFP for Broker Services

RFP from the New Jersey Turnpike Authority

Standard Insurance Requirements

Standard rnsurance requirements of the City of Sunrise, Florida

Sample Releases, Waviers and Exculpatory Agreements

Sample releases, waivers and exculpatory agreements from the Palm Beach County-Board of County Commissioners

Insurance Coverage and Limits Matrix

Matrices list the type of service and/or contractor up against minimum limits of general liability, auto liability, workers' compensation and other special insurance requirements

Loss Payee Endorsement Form

Loss payee endorsement form for property insurance

Release and Hold Harmless Agreement

Release and hold harmless agreement from the City of Newport

Release on Behalf of Minor and Hold Harmless Agreement

Release on behalf of minor and hold harmless agreement from a youth community service rrogram

Sample Contractual Risk Transfer Language

Sample contractual risk transfer language for various exposures including aircraft, pollution, watercraft, etc.

Sample Personal Services Contract

Sample sersonal services contract from the City of Eugene Oregon

Emergency Management Plan

The City of Houston's strategic gide for a citywide response to and recovery from major emergencies and disasters

Emergency Procedures One Page Reference Sheet

One-page, color-coded guide to the University of Alaska-Anchorage's emergency procedures

Emergency Response Guide

Emergency response guide for the University of Illinois at Urbana-Champaign

Emergency Resposne Plan

Campus-wide emergency response plan for the University of Arizona

Evacuation Plan

City-wide evacutation plan for the City of Houston, Texas.

How to Distribute Public Information in a Crisis

Information dissemination guidelines for the City of Houston, Texas to help minimize confusion, misinformation and rumors in the event of an emergency.

Managing Spontaneous Volunteers in Times of Disaster

Comprehensive guide on how to manage volunteers in times of a spontaneous disater

Emergency Operations Plan

Emergency operations plan from the University of Alaska-Anchorage

Uniform School Bus Accident Template

Illinois State Board of Education uniform school bus accident report

School Emergency Response Plan and Management Guidelines

This School Emergency Response Plan and Management Guide establishes the framework for creating, reviewing, or updating the emergency and crisis response plans for participating school buildings in the District of Columbia.

Accident and Incident Reporting

Procedures developed by the City of Duluth to report accidents/incidents that occur on the job

Claims Reporting Handbook

Instruction packet from the City of Ocean City, New Jersey is designed to help individuals understand their responsibilities when an accident happens.

No Fault Utilities Claims Ordinance

Request for council action regarding West Jordan City's No Fault Utilities Claim Ordinance

Property Loss Claim Form

Property loss claim form from the University of Alaska

School Bus Accident Procedures

School bus accident procedures from a policy manual

Long Term Recovery Manual

The National Voluntary Organizations Active in Disaster (NVOAD)'s manual gives a quick overview of the major players in a community's disaster response and recovery.

Organizational Manual

Manual has background and history of the VOAD movement, discusses how NVOAD operates, and details several of the major aspects of state and local VOADs.

Disaster Recovery Sample Plan

Disaster response and recovery guide for local government

Human Resources Policy Manual

OMB's human resource policy manual provides direction in those areas of human resource management important to the operation of the organization.

Performance Management Handbook

City of American Canyon's performance management handbook outlines four components of their performance management model.

Personnel Procedures Manual

Mahoning County's personnel policies manual.

Volunteer Program Protocol Template

Document outlines basic precautions for safeguarding schools, students, teachers, staff and volunteers.

Volunteer Registration Form

Sample volunteer regsitration form includes volunteer preferences, availability, experience and interests

ERM Guidelines

This document from the British Columbia government outlines recommended practices to apply in public sector seetings.

Pandemic Flu Plan

Tacoma and Pierce County's Pandemic Flu Plan

Sample Diaster Procedure

Colorado disaster emergency procedures handbook for local government

School Earthquake Safety Guidebook

A safety program for schools regarding the risk of earthquakes

Shelter and Mass Care

This document outlines organizational arrangements, operational concepts,responsibilities, and procedures to protect evacuees and others from the effects of an emergency situation by providing shelter and mass care for the City of Houston, Texas.

Task Analysis for Emergency Responders at Roadway Incidents

This report discusses the process utilized, outlines the specific job performance requirements for critical positions assigned to emergency responders and provided guidance on the use of the requirements by potential users and training organizations.
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