Vendor Services Feedback Form

Name *

E-Mail *

Phone

Name of Vendor *

Date of Service *

Service Requested/Performed *

Was this Vendor from the PORA list? *-YesNo

Have you used the PORA vendor program before? *-YesNo

Did you have a contract with the Vendor *-YesNo

Were you pleased with the services provided? *-YesNo

Would you use this vendor again? *-YesNo

Rate the vendor on a scale of 1 to 5. • 1 = poor , 5 = excellent *-54321

Comments? *