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1Vkk <br /> cb INDIAN RIVER COUNTY <br /> Purchasing Division <br /> * + * (772)226-1575 <br /> Purchasing@ircgov.com <br /> Past Performance Reference Survey <br /> The firm below has listed you as a performance reference. We would appreciate your time in completing <br /> this survey to assist us in evaluation of the firm's qualifications. <br /> Firm Name <br /> Type of Service <br /> Your Project Name <br /> Name of Your Organization <br /> Name of Person Completing Form <br /> Title <br /> Has he listed firm completed work for your organization in the past? Yes ❑ No ❑ <br /> Has the work of the firm been consistently thorough,acceptable and professional? Yes ❑ No ❑ <br /> Did this firm complete the work in a timely manner? Yes ❑ No ❑ <br /> How many change orders were incorporated in this project? <br /> Please describe any problems with this firm's work, product or conduct, if applicable. <br /> I <br /> Were there any disputes regarding their work? Yes ❑ No ❑ <br /> If so, please describe. <br /> N <br /> Would you utilize this firm in the future should you have the opportunity? Yes ❑ No ❑ <br /> Please rate the Contractor's overall job performance. <br /> IExcellent ❑ Very Good ❑ Good ❑ Fair ❑ Poor ❑ <br /> Please return by e-mail to purchasing@ircgov.com or fax to(772)770-5140 <br /> 172 <br />