Template Utility Cost Data Survey (Req-21)

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 3090-0297)

(Request No. 21)

TITLE OF INFORMATION COLLECTION: Utility Cost Data for Fully Serviced and Net of Electric Leases (from NCR Offerors)

PURPOSE: Gather comparative data to help identify the differences in utility costs for fully serviced versus net of electric lease options. Currently, most (95%) of GSA’s leases are Fully Serviced. As one of the Office of Leasing’s Sustainability initiatives, we are exploring if the use of Net of Electric leases can result in net cost savings.

DESCRIPTION OF RESPONDENTS: Respondents will be Landlords in Metropolitan Washington who respond to government space requests (from August 2015 through FY 2016).

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software) [ ] Small Discussion Group

[ ] Focus Group [ X] Other: Cost Data Questionnaire

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Alexandra Kosmides: [email protected] – Phone: 240- 535-3971

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [ X] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ X ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ X ] No

If PII is collected, please provide a brief statement regarding why PII is necessary, how it will be stored and for how long, and how it will be destroyed once the collection is over.

Gifts or Payments:

None

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Private Sector (Landlords)	200	10 minutes (.17 hours)	2,000 minutes (34 hours)
Totals			34 hours

FEDERAL COST: The estimated annual cost to the Federal government is $0.00.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X ] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

Respondents will be landlords with property in Metropolitan Washington who respond to government space requests submitted during Sept. 2015 and FY 2016. Respondents will only be landlords who have available space that matches NCR’s space needs.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[X ] Mail (email) The attached survey (via e-mail) asks offerors of leased space to submit estimated utility rates for both Fully Serviced and Net of Electric lease structures.

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [X ] No

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