CleanAir Team 90 Feedback Location __________________

Client or Partner ___________

Team 90 Project - Family Feedback

Value Indicators

Please use the following ranking system in your response to the questions. Leave blank any item which you are unaware of or you feel does not apply to you. Also, add any additional criteria which brings value to you, because we want to continually focus on what is important to you and CleanAir.

Importance to You	Satisfaction
A = Absolutely Critical	A = Completely Satisfied
B = Very Important	B = Very Satisfied
C = Moderately Important	C = Moderately Satisfied
D = Slightly Important	D = Slightly Satisfied
E = Not at all Important	E = Not at all Satisfied

Additional Comments

Family and Medical Leave

Importance to you A B C D E Satisfaction A B C D E

401(k) This is the CleanAir retirement benifit.  Participation is strongly encouraged. 

Importance to you A B C D E Satisfaction A B C D E

How can 401(k) be improved?

Accumulated Time Option (ATO)

Importance to you A B C D E Satisfaction A B C D E

Cafeteria or Flex Plan

Importance to you A B C D E Satisfaction A B C D E

Credit Union

Importance to you A B C D E Satisfaction A B C D E

Environmental Policy

Importance to you A B C D E Satisfaction A B C D E

Education Policy

Importance to you A B C D E Satisfaction A B C D E

Dental Insurance

Health Insurance

Holidays

Holidays Parties

Picnic

Representation on Health Insurance Committee

Sports Team Sponsorship

Life Insurance

Long-term Disability

Other Unpaid Leave

Paid Time Off (PTO)

Sam's Club

Short-term Disability

Stock Ownership

Tuition Reimbursement

Vacation

Well-Care Reimbursement

Worker's Compensation Insurance

Initial Project Planning

Additional Comments

Work

Additional Comments

Data

Additional Comments

Reporting of Results

Additional Comments

Administration and Checks

Handling of contract extras or changes

Importance to you A B C D E Satisfaction A B C D E

Contract terms and specification communication

Importance to you A B C D E Satisfaction A B C D E

Easily understood invoice

Importance to you A B C D E Satisfaction A B C D E

Accurate invoice

Importance to you A B C D E Satisfaction A B C D E

Professional invoice status call

Importance to you A B C D E Satisfaction A B C D E

Additional Comments

Listed below are additional services performed by CleanAir. Indicate which of these you would contact CleanAir
to perform.

How could we improve this survey?

Any additional comments?

Name:_________________________________________ Date:__________________

Thank you for sharing your opinions with us, and thank you for your business!

---