AVIDA LAND CORP.

CUSTOMER FEEDBACK FORM

NAME OF RATEE: ZARI MAE DELA CRUZ

*Kindly use additional pages if needed

1. Please cite the nature of your dealings with the Ratee:

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2. Degree and Frequency of Dealings (Please Check):

LENGTH OF DEALINGS FREQUENCY

□ Less than 6 mos. Daily
□ 6 mos. To 1 year Weekly
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More than 1 year Monthly

Occasionally
Rarely

3. What factors are applicable given the nature of your dealings with the
Ratee (Please check):
□ Service Delivery □ Commitment & □ Pro-activeness
Consistency
□ Courtesy □ Technical □ Others:
Knowledge ________________
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4. In general terms, how was the Ratee in meeting your expectations?

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5. Over-all Rating: (Kindly check the appropriate box):

Inadequately Met Partially Met Fully Met Exceeded
Exceptional
Expectations Expectations Expectations Expectations

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CUSTOMER FEEDBACK PROVIDED BY: _____________________________
(Signature over Printed Name / Date)