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pdfSOCIAL SECURITY
Office of Budget, Finance and Management
October 15, 2012
Contractor Contact Name
XYZ Company
TBD
TBD
Subject: Contractor Survey
Dear SSA Contractor:
The Social Security Administration, Office of Acquisition and Grants (OAG) regularly assesses
the effectiveness of its acquisition operations. An important part of the assessment is OAG’s
quality and professionalism in dealing with our contractors. We value your ideas and opinions
about how well we are meeting the needs of those with whom we do business.
Our records indicate we awarded your firm at least one contract during the period October 1,
2011 through September 30, 2012. Please assess our services during this period by completing
the attached survey and returning it in the enclosed envelope. If you have any questions about
completing the survey, please contact Bob Wilson, of my staff, at 410-966-6702. When
completing the survey, please follow these directions:
Place an X in the appropriate box.
Base your responses on experiences with OAG during the above-specified period. Give
an overall assessment of OAG’s performance if we awarded you several acquisitions
during the period.
Answer both the “Agreement” and “Importance” sections of each statement, unless you
check the N/A block. Do not complete these sections if N/A is checked.
Use the N/A block only if the statement does not apply to you or if you cannot decide if
you agree or disagree with the statement.
Add comments, suggestions, or recommendations in the comments section.
Do not include your firm’s name, as responses are anonymous (we will report only
aggregate survey results). The number at the bottom of the survey is for tracking
purposes, and we will not use it to associate responses with your firm. We will use it
only to follow-up with companies who do not return the survey.
SOCIAL SECURITY ADMINISTRATION
BALTIMORE, MD 21235-0001
2
Complete questions 15-17, as this information is essential for sorting and analyzing
survey data.
Thank you for participating in this survey. We look forward to working with you in the future.
Seth Binstock
Associate Commissioner
for Acquisition and Grants
Approved, OMB Number 0960-0788, Expires 9/31/15
OAG CONTRACTOR SURVEY - FY 2012
AGREEMENT
AGREE
DISAGREE
STRONGLY DISAGREE
VERY IMPORTANT
IMPORTANT
NOT IMPORTANT
4
3
2
1
3
2
1
N/A
STRONGLY AGREE
CONTRACTOR SURVEY FY 2012
IMPORTANCE
COOPERATION AND COMMUNICATION
1
THIS ACQUISITION OFFICE NEGOTIATES FAIRLY WITH MY
FIRM.
4
3
2
1
3
2
1
2
MY COMPANY IS TREATED FAIRLY IN THE ACQUISITION
PROCESS.
4
3
2
1
3
2
1
3
THIS ACQUISITION OFFICE DEALS WITH MY FIRM IN A
COURTEOUS, BUSINESSLIKE MANNER.
4
3
2
1
3
2
1
4
THIS ACQUISITION OFFICE ADEQUATELY COMMUNICATES
WITH MY FIRM.
4
3
2
1
3
2
1
5
THIS ACQUISITION OFFICE RESOLVES ISSUES/CONCERNS IN A
TIMELY MANNER.
4
3
2
1
3
2
1
6
THIS ORGANIZATION OPERATES WITH INTEGRITY, FAIRNESS,
AND OPENNESS.
4
3
2
1
3
2
1
7
THIS ACQUISITION OFFICE UNDERSTANDS THE BUSINESS
ASPECTS OF THE MARKETPLACE IN WHICH MY FIRM
OPERATES.
4
3
2
1
3
2
1
8
THIS ACQUISITION OFFICE APPLIES CURRENT ACQUISITION
POLICIES, PROCEDURES, AND STRATEGIES.
4
3
2
1
3
2
1
9
SSA REQUIREMENTS ARE DESCRIBED IN CLEAR AND CONCISE
LANGUAGE.
4
3
2
1
3
2
1
10
THIS ACQUISITION OFFICE ANSWERS MY CONTRACTING
QUESTIONS IN A SATISFACTORY MANNER.
4
3
2
1
3
2
1
11
THIS ACQUISITION OFFICE ADMINISTERS MY CONTRACTS
EFFECTIVELY.
4
3
2
1
3
2
1
QUALITY
200
SSA Confidential
FY 2012 -OAG Contractor Survey
Page1
Approved, OMB Number 0960-0788, Expires 9/31/15
AGREEMENT
AGREE
DISAGREE
STRONGLY DISAGREE
VERY IMPORTANT
IMPORTANT
NOT IMPORTANT
4
3
2
1
3
2
1
4
3
2
1
3
2
1
4
3
2
1
3
2
1
4
3
2
1
3
2
1
N/A
STRONGLY AGREE
CONTRACTOR SURVEY FY 2012
IMPORTANCE
OTHER
12
THIS ACQUISITION OFFICE PROVIDES ADEQUATE AND TIMELY
ACQUISITION INFORMATION.
WHERE EVALUATIONS OF CONTRACTOR PERFORMANCE ARE
13 PERFORMED UNDER ONGOING CONTRACTS, THIS
INFORMATION IS SHARED WITH MY FIRM.
14
ACQUISITION OPERATIONS ARE CONDUCTED IN AN ETHICAL
MANNER, FREE FROM CONFLICTS OF INTEREST.
OVERALL RATING AND BACKGROUND INFORMATION
15 WHICH RATING WOULD YOU GIVE THIS ACQUISITION OFFICE FOR OVERALL PERFORMANCE? (Check one)
EXCELLENT
5
ABOVE AVERAGE
AVERAGE
BELOW AVERAGE
UNSATISFACTORY
4
3
2
1
16 WHICH CATEGORIES BEST DESCRIBE YOUR BUSINESS ORGANIZATION? (Check one or more)
SMALL BUSINESS
9
SMALL DISADVANTAGED BUSINESS
8
8(a) BUSINESS
7
WOMEN-OWNED BUSINESS
6
NIB/NISH WORKSHOP
5
LARGE BUSINESS
4
STATE GOVERNMENT
NON-PROFIT
3
OTHER (Please explain)
SSA Confidential
2
1
FY 2012 -OAG Contractor Survey
Page2
OMB Number: 0960-0788
Paperwork Reduction Act Statement
This information collection meets the clearance requirements of 44 U.S.C. § 3507, as amended
by Section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these
questions unless we display a valid Office of Management and Budget control number. We
estimate that it will take about 15 minutes to read the instructions, gather the facts, and answer
the questions. You may send comments on our estimate of the time needed to complete the form
to: SSA, 1338 Annex Building, Baltimore, MD 21235-0001.
File Type | application/pdf |
File Modified | 2012-05-03 |
File Created | 2012-05-03 |