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APPENDIX "B" <br />SAFETY RECORD SURVEY <br />Name of Bidder: <br />Sent To: <br />Name: <br />Address: <br />Phone: <br />Project: <br />Please circle the number that best represents your rating of performance with regard <br />to the above "Bidder". <br />1=Poor 2=Average 3=Good 4=Excellent <br />1. Did the bidder provide quality, availability and adaptability of the supplies, <br />materials, equipment or contractual services as required? <br />1 2 3 4 <br />2. Did the bidder perform the contract or provide services promptly, or within <br />the time required, without delay or interference? <br />1 2 3 4 <br />3. Did the bidder show character, responsibility, integrity, good reputation and <br />experience? <br />1 2 3 4 <br />Company Name: <br />Authorized Signature: <br />Date: <br />