* 1. What is your first name?

* 2. What is your last name?

* 3. What is your job title?

* 4. Company Name?

* 5. Who is your U.S. Water Representative?

* 7. Sales Representative:

  Strongly Agree Agree Disagree Strongly Disagree N/A
My Sales Representative is knowledgeable of my system.
My Sales Representative is knowledgeable about water treatment products & services
My Sales Representative provides specific suggestions for improvement.
My Sales Representative acts professionally at all times.
My Sales Representative keeps his/her promises and acts in an ethical manner.
My Sales Representative is accessible when needed.
My Sales Representative visits my facility as often as promised.
My Sales Representative acts in a safe manner.
My Sales Representative works well with all levels of personnel within my plant.
I am satisfied with my Sales Representative.

* 8. Ordering

  Strongly Agree Agree Disagree Strongly Disagree N/A
Customer Service Representatives are knowledgeable about water treatment products and services.
Customer Service Representatives act professionally at all times.
Customer Service Representatives are accessible when needed.
The ordering process is easy.
I am satisfied with the ordering process.

* 9. Chemical Delivery

  Strongly Agree Agree Disagree Strongly Disagree N/A
U.S. Water products are delivered in a timely manner as promised.
U.S. Water delivery personnel act in a safe manner.
I am satisfied with my product deliveries.

* 10. Chemical Products

  Strongly Agree Agree Disagree Strongly Disagree N/A
U.S. Water chemical program performs as promised.
The quality of U.S. Water chemicals is as good as promised.
I am satisfied with my U.S. Water chemical program.

* 11. Controllers, Pumps and Monitoring Equipment
(if you do not purchase equipment from U.S. Water, please skip to the next section.)

  Strongly Agree Agree Disagree Strongly Disagree N/A
Equipment provided by U.S. Water Engineering & Equipment Team performs as promised.
The equipment provided by U.S. Water Engineering & Equipment Team improves the performance of my water treatment program.
Equipment service personnel act in a professional manner at all times.
I am satisfied with the service and/or equipment I receive from U.S. Water.

* 12. Value

  Strongly Agree Agree Disagree Strongly Disagree N/A
The money spent with U.S. Water has given my organization a "Return on Investment".
U.S. Water costs are as promised.
U.S. Water performs extra services that provide value to my organization.
U.S. Water is viewed as a partner with my organization.
U.S. Water works to continuously improve my water treatment operation.
I am satisfied with the value U.S. Water brings to my organization.

* 13. Training

  Strongly Agree Agree Disagree Strongly Disagree N/A
U.S. Water provides operator training as needed.
U.S. Water provides safety training as needed.
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