We appreciate your feedback. Flo-Tech is continually looking for ways to improve the programs, products and level of service we provide to our clients and we value your input.

1. Please rate your experience with Flo-Tech's performance in the following areas: (please rate all the apply)

	Extremely Satisfied	Very Satisfied	Satisfied	Unsatisfied	N/A
Service Response Time	*Please rate your experience with Flo-Tech's performance in the following areas: (please rate all the apply) Service Response Time Extremely Satisfied	Service Response Time Very Satisfied	Service Response Time Satisfied	Service Response Time Unsatisfied	Service Response Time N/A
Preventative Maintenance	Preventative Maintenance Extremely Satisfied	Preventative Maintenance Very Satisfied	Preventative Maintenance Satisfied	Preventative Maintenance Unsatisfied	Preventative Maintenance N/A
Technical Support	Technical Support Extremely Satisfied	Technical Support Very Satisfied	Technical Support Satisfied	Technical Support Unsatisfied	Technical Support N/A
Equipment Delivery and Installation	Equipment Delivery and Installation Extremely Satisfied	Equipment Delivery and Installation Very Satisfied	Equipment Delivery and Installation Satisfied	Equipment Delivery and Installation Unsatisfied	Equipment Delivery and Installation N/A
Fleet Management and on-going support	Fleet Management and on-going support Extremely Satisfied	Fleet Management and on-going support Very Satisfied	Fleet Management and on-going support Satisfied	Fleet Management and on-going support Unsatisfied	Fleet Management and on-going support N/A
Supplies	Supplies Extremely Satisfied	Supplies Very Satisfied	Supplies Satisfied	Supplies Unsatisfied	Supplies N/A
Customer Service	Customer Service Extremely Satisfied	Customer Service Very Satisfied	Customer Service Satisfied	Customer Service Unsatisfied	Customer Service N/A

Please provide any additional comments/feedback:

2. Please rate your overall satisfaction with Flo-Tech's performance:

Please rate your overall satisfaction with Flo-Tech's performance: Extremely Satisfied	Very Satisfied	Satisfied	Unsatisfied
Comments:

3. Please rate your overall satisfaction with Flo-Tech's performance compared to that of your other suppliers:

Please rate your overall satisfaction with Flo-Tech's performance compared to that of your other suppliers: Extremely Satisfied	Very Satisfied	Satisfied	Unsatisfied
Comments:

4. Would you recommend Flo-Tech to others?

Would you recommend Flo-Tech to others? Yes

*
5. Please provide your company name:

Please provide your company name: Company Name:

6. I would like to be contacted for follow up:

I would like to be contacted for follow up: Yes

7. Please provide your contact information:

Please provide your contact information: Name:
Title:
Phone:
Email: