DEPARTMENT OF VETERANS AFAIRS
VA
2016-2017
Acquisition 360 Survey
The
Paperwork Reduction Act of 1995: This
information is collected in accordance with section 3507 of the
Paperwork Reduction Act of 1995. Accordingly, we may not conduct or
sponsor and you are not required to respond to, a collection of
information unless it displays a valid OMB number. We anticipate
that the time expended by all individuals who complete this survey
will average 15 minutes. This includes the time it will take to
follow instructions, gather the necessary facts and respond to
questions asked. Customer satisfaction is used to gauge customer
perceptions of VA services as well as customer expectations and
desires. The results of this in-person survey will lead to
improvements in the quality of service delivery by helping to
achieve improved admission processes and services. Participation in
this survey is voluntary and failure to respond will have no impact
on benefits to which you may be entitled.
What is the award number (PIID) for the procurement being surveyed? No dashes or spaces please. Please enter the award number (PIID) as provided to you by the contracting officer.
What is the predominate Product Service Code (PSC) associated with this award? Please enter the four (4) character PSC associated with this award in FPDS or as provided to you by the contracting officer.
What is the Activity Address Code (AAC or DoDAAC) for the office issuing this contract? Please enter the AAC (or DoDAAC) as provided to you without dashes or spaces.
Which one of the following roles did you play in the acquisition?
Vendor Who Submitted A Proposal/Bid
Government Contracting Office
Government Program Office (Customer)
Attachment A – “Rate the Agency” Survey
Pre-Award & Debriefing Satisfaction Survey
Please provide us with your feedback on the acquisition process. Your answers will help us assess our performance and identify our strengths and weaknesses. The survey should take no more than 10 minutes to complete. The survey will be issued after any and all debriefings have been conducted and therefore cannot impact the award decision in any way. The results from the survey will not be published or made publicly available.
Please submit your response within the next thirty days to: [insert agency contact information here].
Please rate your level of satisfaction on a scale of 1 to 5, with 5 being “Very Satisfied” and 1 being “Very Dissatisfied”
|
![]() Very Satisfied |
|
Very Dissatisfied |
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Requirements Development Process - How satisfied were you: |
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5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
Solicitation Phase - How satisfied were you: |
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5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
Award Execution and Debriefings- How satisfied were you: |
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|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
|
|||||
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Yes |
No |
[Insert agency PRA notice here.]
The
Paperwork Reduction Act of 1995: This
information is collected in accordance with section 3507 of the
Paperwork Reduction Act of 1995. Accordingly, we may not conduct or
sponsor and you are not required to respond to, a collection of
information unless it displays a valid OMB number. We anticipate
that the time expended by all individuals who complete this survey
will average 15 minutes. This includes the time it will take to
follow instructions, gather the necessary facts and respond to
questions asked. Customer satisfaction is used to gauge customer
perceptions of VA services as well as customer expectations and
desires. The results of this in-person survey will lead to
improvements in the quality of service delivery by helping to
achieve improved admission processes and services. Participation in
this survey is voluntary and failure to respond will have no impact
on benefits to which you may be entitled.
Attachment B – Evaluation of the Contracting Operation
As you recently worked with the _______ procurement office on solicitation #____________ in making an award, please evaluate your experience.
Please rate your level of satisfaction on a scale of 1 to 5, with 5 being “Very Satisfied” and 1 being “Very Dissatisfied”
|
Very Satisfied |
|
Very Dissatisfied |
|
||
Planning - How satisfied were you: |
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|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
Communication - How satisfied were you: |
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|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
|
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Yes |
No |
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Reminder: After one year, or completion of performance, work with your Contracting Officer (CO) to evaluate the contract awardee’s performance in CPARS |
Attachment C – Evaluation of the Program Office’s Participation in the Procurement
As you recently worked with ________ program office on solicitation #____________, please evaluate your experience.
Please rate your level of satisfaction on a scale of 1 to 5, with 5 being “Very Satisfied” and 1 being “Very Dissatisfied”
|
|
|
Very Dissatisfied |
N/A |
||
Planning - How satisfied were you: |
||||||
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
Communication - How satisfied were you: |
||||||
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
|
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Reminder: After one year, or completion of performance, work with your Contracting Officer’s Representative (COR) to evaluate the contract awardee’s performance in CPARS. |
For awards made using Government-wide Acquisition Contracts (GWACs) or GSA Schedules |
|
|
Very Dissatisfied |
N/A |
||
|
5 |
4 |
3 |
2 |
1 |
N/A |
|
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Glock, Porter |
File Modified | 0000-00-00 |
File Created | 2021-01-23 |