Department of Veterans Affairs Supplier Perception Survey (SPS)

Forms and Documents

Document Name	Status
Form VA Form 10165 Department of Veterans Affairs Supplier Perception Survey (SPS) Form and Instruction	Modified
2900-0751 30-Day FRN r4-28-15.doc Supplementary Document	2015-04-30
2900-0751 Enhancements to the Supplier Perception Survey Responder Analysis.doc Supplementary Document	2012-07-26
2900-0751 Q1 FY 2012 Supplier Perception Survey Responder Analysis.doc Supplementary Document	2012-07-26
VA 15000 Supplier Invitation Email.doc Supplementary Document	2010-01-11
VA 15000 MSU Email.doc Supplementary Document	2010-01-11
VA 400 Supplier Invitation Letter (2).doc Supplementary Document	2010-01-11
VA 400 MSU Email.doc Supplementary Document	2010-01-11
2900-0751_VA Supplier Survey Justification Part B r4-28.doc Supporting Statement B	2015-04-30
2900-0751 justification A_4-10-15 r4-28.docx Supporting Statement A	2015-05-15

IC Document Collections

IC ID	Document Title	Status
191046	Department of Veterans Affairs Supplier Perception Survey (SPS) Form and Instruction	Modified

ICR Details

OMB Control No: 2900-0751	ICR Reference No: 201503-2900-004
Status: Historical Inactive	Previous ICR Reference No: 201110-2900-018
Agency/Subagency: VA	Agency Tracking No: 2900-0751
Title: Department of Veterans Affairs Supplier Perception Survey (SPS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 01/26/2016
	Date Received in OIRA: 06/01/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	36 Months From Approved	01/31/2016
Responses	45,840	0	45,840
Time Burden (Hours)	35,100	0	35,100
Cost Burden (Dollars)	0	0	0

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Abstract: The SPS helps the VA further it goal of transforming the acquisition process to better service veterans. The results of the SPS will help VA to develop Key Performance Indicators (KPI) in acquisition and logistics operations across the VA that will make up a balanced scorecard. The potential survey respondents are drawn from suppliers in the VA supply base.

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Authorizing Statute(s): EO: EO 12682 Name/Subject of EO: Setting Customer Service Standards++++
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 17	01/27/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 94	05/15/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Department of Veterans Affairs Supplier Perception Survey (SPS)	VA Form 10165	U.S. Department of Veterans Affairs Supplier Perception Survey 2015

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This Program office is not conducting SRM Forums at this time. This act has attributed to the reduction in burden hours.

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Annual Cost to Federal Government: $668,139

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  Yes

Description/Changes for Common Form Usage: 

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/01/2015

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