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Name of Bidder: <br />Sent To: <br />Name: <br />Address: <br />Phone: <br />Project: <br />APPENDIX "B" <br />SAFETY RECORD SURVEY <br />PROJECT #5 <br />U � - /L;_1 /LI _ 6_°1 P ` .. _.W.. _ ......- <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 4=Excellent <br />5. Did the bidder provide quality, availability and adaptability of the supplies, materials, equipment or <br />contractual services as required? <br />5 2 3 E .....4 % <br />2. Did the bidder perform the contract or provide services promptly, or within the time required, without delay <br />or interference? <br />6 l <br />1 2 3 <br />3. Did the bidder show character, responsibility, integ�,"` god reputation and experience? <br />l 2 3 (, 4 0 <br />Company Name: <br />Authorized Signature: <br />Date: <br />Page 26 of 26 <br />