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APPENDIX `B" <br />SAFETY RECORD SURVEY <br />Please circle the number that best represents your rating of performance with regard to the above "Bidder". <br />l=Poor 2=Average 3=Good "°,...W4=Ex0lj011t-) <br />1. Did the bidder provide quality, availability and adaptability of the supplies, materials, equipment or <br />contractual services as required? <br />1 2 3 <br />2. Did the bidder perform the contract or provide services promptly, or within the time required, without delay <br />or interference? <br />1 2 3 <br />3. Did the bidder show character, rosponsibiiity, integrityood reputation and experience? <br />1 2 3 l 4 J <br />Company Name: <br />Authorized Signature: <br />Date: <br />ww. � <br />a ', . <br />Page 22 of 26 <br />1QVtSi0l1 <br />