NCSA Government Reference Form – First Responder Supplies and Equipment

Reference Name:

First

Last

Reference Job Title:

Reference Agency/Company Name:

Are you a government agency?

Yes

No

State where your Agency/Company is located:

Reference Email Address:

Reference Phone Number

Please select the name of the company in which you are a reference:

Is this vendor a current provider for your agency/company?

Yes

No

When did you last work with this vendor?

On a scale of 1-5, how would you rate the vendor’s knowledge of their product?

On a scale of 1-5, how would you rate the vendor’s staff?

On a scale of 1-5, what is your overall experience in doing business with the vendor in terms of reliability and trustworthiness?

What have you found to be the best features of doing business with the vendor?

What have you found to be the vendor’s limitations?

On a scale of 1-5 what is the vendor’s responsiveness to issues such as repairs, follow-up service, and warranty work?

On a scale of 1-5 what are your thoughts on the ability of the vendor to satisfy large government/fleet orders?

Please complete the box below with any additional feedback or concerns you would like to provide the Association regarding this vendor.