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ATTACHMENT_A_-_Customer_Satisfaction_Survey

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					               ATTACHMENT A – Customer Satisfaction Survey

                                   Customer Satisfaction Survey


______________________(Contractor Name) is submitting a proposal on a Federal Aviation
Administration solicitation(DTFANM-11-R-00028) and provided your name as a customer reference. Part
of our evaluation process requires information on the firm’s past performance. Your input is important to
us and responses are required by 12/17/2010_(date & time) for inclusion of this evaluation. Once you have
completed the survey, please return directly to:

FAA                  or         Email: Angela.Mihalek@faa.gov       or    Fax: (425) 227-1055
Attn: Angela Mihalek
1601 Lind Ave. S.W.
Renton, WA 98057

Evaluator: (The following information will assist in the analysis of the data. Information will be
kept confidential)
Project (location, description):
Name of Evaluator:
Address:
Phone Number:
Position held or function in relation to project:
Rating: Please evaluate the past performance using only the following ratings without variation. DO NOT
RATE ON A “+” OR “-“ SCALE. If a “+” or “-“ is used, the rating without the "+" or "-" will be applied.
If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block
or in the remarks section of this form.
“5”          Outstanding            Performance greatly exceeded the contract requirements.
“4”          Above Average          Performance exceeded the contract requirements.
“3”          Satisfactory           Performance met the contract requirements.
“2”          Marginal               Performance met the minimum contract requirements but some
                                    material aspects of the contractor’s performance were less than
                                    satisfactory.
“1”          Unacceptable           Performance was poor and/or did not satisfy contract requirements.

Please rate and provide any supporting information/comments for the following:
1. The relationship between the Offeror and client’s/customer’s:
                                                                                          5     4   3       2   1
2. The Offeror’s management and coordination of subcontractors:
                                                                                          5     4   3       2   1
3. Quality of work:
                                                                                          5     4   3       2   1
4. Quality control:
                                                                                          5     4   3       2   1
5. Ability to meet the performance schedule:
                                                                                          5     4   3       2   1
6. Ability/actions to improve schedule problems, if applicable:
                                                                                          5     4   3       2   1
7. Key personnel assigned to the project (Site-Superintendent, Project Manager,
Quality Control Manager):                                                                 5     4   3       2   1
8. Compliance with safety standards and/or number of safety related incidents,
code compliance, as applicable:                                                     5       4       3       2       1
9. Contractor’s responsiveness (timeliness) to contract change orders, if
applicable:                                                                         5       4       3       2       1
10. Were any cure notices, show cause letters, letter of reprimand, suspension of
payment, or terminations issued? If yes, please explain
                                                                                            Yes             No




11. Was the customer satisfied with the end product? If no, please explain.
                                                                                            Yes             No




12. Would you award another contract to the contractor? If no, please explain.
                                                                                                Yes         No




13. Additional Remarks:




14. Overall rating for this firm:
                                                                                        5       4       3       2       1




______________________________________________________                        _______________________
                 Signature of Evaluator                                                 Date

				
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