NCI OSFM Express Services Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0642 ExpDate:05/2020)

TITLE OF INFORMATION COLLECTION: NCI OSFM Express Services Survey

PURPOSE:

The Express Services team of the Office of Space and Facilities Management oversees facilities management, handling tenants and infrastructure for 17 Campus and Lease Facilities. The Express Service team is also in charge of the Document Shredding/Achieve Drop-off, Furniture Reutilization Project (PropShop), NCI Handyman Services, A/V Installation, Conference Room Services Support, Small Renovations and Ergonomic Office Solutions. This survey will be sent out to customers who submitted service tickets for the above-mentioned services. Sending out this survey will allow OSFM to receive customer feedback on our Express Services to better service delivery.

DESCRIPTION OF RESPONDENTS:

The NCI OSFM Express Services Survey will be sent to all employees who submitted Express Services tickets during the survey period. Surveys are sent to federal employees, contractors and fellows. This information collection request is for approval to collect information from non-federal employees.

TYPE OF COLLECTION: (Check one)

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

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

[ ] Focus Group [ ] Other: ______________________ ______

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: Harley James, Supervisory Building Facilities Specialist

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

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

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

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Individual	432	1	2/60	14
Totals	432	432		14

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
Individual	14	23.23	325.22
Totals	14		325.22

*Bureau of Labor Statistics Occupation Title “All Occupations” Code 00-0000 http://www.bls.gov/oes/current/oes_nat.htm#00-0000.

FEDERAL COST: The estimated annual cost to the Federal government is $2,539.16

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Supervisory Building Facilities Specialist	14/5	126,958	2		2,539.16
Contractor Cost
Travel	0				0
Other Cost	0				0

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? [ ] Yes [x ] 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?

Administration of the Instrument

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

[ x ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

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