| CONTACT INFORMATION |
| Your Name: | |
| Company name: | |
| Street Address: | |
| Address (cont): | |
| City: | |
| State: | Zip/Postal code: | Country: |
| Phone: | Fax: |
| E-mail: |
Please give us your rating on job name/number or invoice number:
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| CUSTOMER SERVICE |
| | Excellent | Acceptable | Unacceptable |
| Phone Service: | | | |
| Personal Service: | | | |
| Courtesy: | | | |
| Product Knowledge: | | | |
| Advised of Cost/Payment terms: | | | |
| Comments: | |
| PRODUCT SERVICE |
| | Excellent | Acceptable | Unacceptable |
| Were your instructions followed?: | | | |
| Product quality: | | | |
| Packaging: | | | |
| Comments: | |
| DELIVERY SERVICE |
| | Excellent | Acceptable | Unacceptable |
| On time?: | | | |
| Comments | |
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