Video Production fast track template

Request for Approval Under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0642; Exp. Date: 05/31/2020)

TITLE OF INFORMATION COLLECTION:

NIH Events Management – Video Production Survey

PURPOSE:

The NIH Office of Research Services (ORS) NIH Events Management (EM) conducts an on-going survey of its Video Production services customers. The electronic survey is hosted by NIH behind its firewall using a software tool, (SPSS) purchased and maintained by UNICOM.

The survey asks a series of questions about customer perceptions of specific aspects of service they received. Customers are also asked to identify strengths and weaknesses of our services. Results are utilized in Contractor’s quarterly Quality Assurance Surveillance Plan (QASP) evaluations.

DESCRIPTION OF RESPONDENTS:

Customers include NIH employees and contractors who have recently used EM Video Production services.

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 [ ] 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: Kathleen Eastberg

Director, Office of Administrative Management

Office of Research Services

National Institutes of Health

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

Personally Identifiable Information:

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

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents (annually)	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Individuals (Federal Government Contractors) using EM Audio Visual services	60	1	5/60	5
Totals	60	60		5

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost (Annually)
Individuals (Federal Government Contractors) using EM Audio Visual services	5	$49.11	$2,050
Totals			$2,050

* http://www.federalpay.org/employees/occupations/contracting

Average federal contractor salary at NIH in 2016 was $102,499.28 annually

FEDERAL COST: The estimated annual cost to the Federal government is $11,188.

Staff	Grade/Step	Salary	% of Effort (Annually)	Fringe (if applicable)	Total Cost to Gov’t (Annually)
Federal Oversight
Industrial Psychologist	13/5	$107,435	.02		$2,149
Quality Assurance Specialist	12/10	$100,000	.02		$2,000
Program Support Assistant	7/8	$55,431	.09		$4,989
Contractor Cost			.02		$2,050
Travel					N/A
Other Cost					N/A
Total					$11,188

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 [ ] 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?

Events Management staff will send an email with survey link to quarterly customers of EM Video Production services.

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

[ ] Mail

[ ] Other, Explain

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

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