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Performance Survey Form A. GENERAL INFORMATION: Offeror must submit Survey Forms,fully completed by the project owners,and Company Specialized Experience forms with their initial offers. Contractor's Name: Ceres Environmental Services,Inc. Address: 552i 85°'Avenue North Telephone Number: 800-218-4424 Brooklyn Park, MN 55443 .__ Point of Contact: David Preus Name/Location of Project: Hurricanes Francis and Jeanne Debris Haul in Palm Beach County,FL Contractor Performed as the _ Prime Contractor, the X Sub-Contractor. B. RESPONDENT INFORMATION: • Name of Respondent:_///GiV ff vi Z Title: FE/-,) �cRWC1= /1761? Address: PSG SOLO/1/215!6 AU/NOR/i/ Telephone Number: SG/'617.2700 x q7/-5- 7.5-0/ /i/, c/vG ROA/7 Fax Number: y r%-6/7%-O/4/7-- WcSr A9441 i Aci/,Pi- 3 P-1/.2-• C. PERFORMANCE INFORMATION: Choose the number on the scale of I to,6 that most accurately describes the contractor's performance or situation. l 2 3 4 5 6 Unsatisfactory Marginal None Satisfactory Very Good Exceptional Performance Performance Norecordof Performance Performance Performance did not meet did not meet past met contract met all contract met all contract most some performance or requirements. requirements requirements contractual contractual the record is There were and exceeded and exceeded requirements. requirements. inconclusive. some minor some to the many to the There were There were problems and government's government's serious problems, corrective benefit.There benefit. problems and some of a actions taken were a few Problems,if the contractor's serious nature, by the minor any,were corrective for which contractor were problems negligible and actions were corrective I satisfactory. which the were resolved inelic�t,• aetiuu 1,.e,t,,i contractor in a timely, marginally I resolved in a highly etlective. timely, effective effective Manner. — — -- _ manner. 410 Ceres Environmental Services, Inc. Page 6-27