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Van Fleet Water Production Facility Improvements BVP 13-196 <br /> SURVEY QUESTIONNAIRE <br /> Survey ID <br /> To: <br /> (Nance ojperson completing survey) <br /> Phone: Fax: <br /> Subject: Past Performance Survey of: <br /> (Name ojContractar) <br /> (Critical Team Firinaf!am Member)) <br /> The County is implementing a process that collects past performance information on contractors and their key <br /> personnel. The firm/individual listed above has listed you as a client for which they have previously performed work <br /> on. The County appreciates your time in completing this survey. Rate each of the criteria on a scale of I to 10,with <br /> 10 representing that you were very satisfied and 1 representing that you were very unsatisfied. Please use whole <br /> numbers for the rating scale. Fractions will be round to the next whole number. Please rate each of the criteria to the <br /> best of your knowledge(you may leave a question blank if you don't have adequate knowledge). <br /> Client Name: <br /> Project <br /> No CRITERIA UNIT RATING <br /> I Ability to manage the Project cost (1-10) <br /> 2 Ability to maintain Project schedule (1-10) <br /> 3 Quality of workmanship (1-10) <br /> 4 Ability to manage and overall professionalism (1-10) <br /> (includes responses and prompt payment to suppliers and subcontractors) <br /> 5 Close out process (no punch list upon turnover,warranties,as-builts, operating (1-10) <br /> manuals, etc.) <br /> 6 Ability to communicate and document risks on the Project <br /> 7 Ability to follow the users rules, regulations,and requirements <br /> 8 Overall customer satisfaction (1-10) <br /> 9 Is the Project completed (Y/N) Y/N <br /> (has the firm/individual completed all work required under contract) <br /> Printed Name(of Evaluator) Signature(of Evaluator) <br /> Thank you for your time and effort in assisting the County in this important endeavor. <br /> Please fax the completed survey to: [<<Contractor's fax#>>] <br /> 36 <br /> 159 <br />