Extension without change of a currently approved collection
No
Regular
07/29/2025
Requested
Previously Approved
36 Months From Approved
09/30/2025
22,824
25,000
5,706
6,250
358,109
248,625
Information collected through the
Contractor Information Worksheet is necessary to meet: ● The Office
of Management and Budget (OMB) Guidance M-05-24 for Homeland
Security Presidential Directive (HSPD) 12 which authorizes Federal
departments and agencies to ensure that contractors/their employees
have limited/controlled access to facilities and information
systems, and ● GSA Directive CIO P 2181.1 Homeland Security
Presidential Directive-12 Personal Identity Verification and
Credentialing which states that GSA contractors/their employees
must undergo a minimum of a FBI National Criminal Information Check
(NCIC) to receive unescorted physical access. GSA requires the
collection of the information in the Contractor Information
Worksheet to authorize and initiate background check requests for
GSA contractor employees and for them to obtain a GSA access card.
The background checks are carried out by the Office of Personnel
Management, Facilities, Security & Contracting-Personnel
Security (OPM FSC) and the credentialing process is carried out by
the GSA’s Managed Service Office (MSO) in accordance with the terms
and conditions of separate Memoranda of Agreement (MOAs). 2. Use of
the Information. The GSA requesting official, referred to as
“Sponsor,” collects and inputs the Contractor Information Worksheet
data into the GSA Credential and Identity Management System
(GCIMS). GSA Office of Mission Assurance (OMA) Identity, Credential
and Access Management (ICAM) Division then uploads the relevant
contractor data from GCIMS to the OPM e-QIP system for initiation
of the contractor background investigation process. GCIMS
automatically sends relevant data to the MSO for enrollment,
including digital fingerprints for investigation and GSA access
card, if needed. The OPM FSC performs the required background
checks for GSA contractor employees once the applicant completes
the e-QIP and fingerprinting process. The requesting official is
responsible for requesting the investigation and/or GSA access
card. Often the GSA requesting official is the Contracting
Officer’s Representative (COR) for the contract, but this role may
be fulfilled by a project manager, Public Buildings Service (PBS)
building manager, or local Access Card Point of Contact (POC) as
appropriate. If the applicant has a prior background check, OPM FSC
uses the information in e-QIP to verify the prior determination.
When OPM FSC makes an access determination, they notify the OMA
ICAM Division. The OMA ICAM Division will input the results into
GCIMS and notify the applicant, GSA sponsor, GSA POCs, and
contractor’s point of contact.
For Items 12 & 14, an
updated estimated # of respondents per year/responses per year was
used. This number was calculated by adding the estimated total
number of respondents/responses received over the past two fiscal
years and then dividing that number by 2 (if necessary, the number
was then rounded to the nearest whole number). The change in this
number can be attributed to using updated data. Specifically, the
updated data reflects estimated data for fiscal years 2024 and
2023, whereas the prior data reflected estimated data for fiscal
years 2012 through 2015. For Item 12, an updated estimated cost per
hour was used. This number is based on the Office of Personnel
Management (OPM) GS-11, Step 10 salary of $46.05 per hour (see OPM
Salary Table 2025-RUS, Effective January 2025), plus a fringe
factor of 36.25% ($16.69) (see OMB Memo M-08-13 for use in
public-private competition). The change can be attributed to using
current data (i.e., the previous extension used an amount of $39.78
and mentions using data from fiscal years Fiscal Years 2012-2015.
There was no mention of fringe being applied).
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:
(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;
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.
Form GSA 850 Contractor Information Worksheet, GSA Form 850
3090-0283-Supporting Statement (4).docx
Contractor Information Worksheet, GSA Form 850