Only feedback from customers and/or potential customers like you will tell us what we do well – and where we need to improve.

Please check the applicable response, fill out the form and click SUBMIT at the bottom of the page.

1) PLEASE RATE REMKE ON THESE FACTORS:

SATISFACTION Based on a 4 point scale, how well has Remke satisfied your needs?   Not      Satisfied   Very Satisfied    N/A Quote Response Time 1      2 3   4 Customer Service 1      2 3   4 Delivery 1      2 3   4 Product Quality 1      2 3   4 Engineering Support 1      2 3   4

2) PLEASE RATE REMKE'S TOP COMPETITORS ON THESE FACTORS:

Not      Satisfied   Very Satisfied    N/A Quote Response Time 1      2 3   4 Customer Service 1      2 3   4 Delivery 1      2 3   4 Product Quality 1      2 3   4 Engineering Support 1      2 3   4

3) OVERALL, HOW SATISFIED ARE YOU WITH REMKE'S PERFORMANCE      AS A BUSINESS PARTNER?

Not      Satisfied   Very Satisfied    N/A Performance 1      2 3   4

4) PLEASE SHARE WITH US ANY ADDITIONAL COMMENTS ABOUT REMKE:

5) WHERE CAN WE SEND YOUR THANK YOU GIFT?

Name * Company * Title Address * Address 2 City, State, Zip * Telephone E-mail Address * *Required Fields     Thank you for your feedback and time.

Form number: FM 8.2.1-1