Customer Feedback Questionnaire

CUSTOMER FEEDBACK QUESTIONNAIRE AND FEEDBACK AGREEMENT

Recitals

WHEREAS, Company Name: provides products and services to clients; and Customer Name: has received or evaluated the Company's product(s) or service(s);

WHEREAS, the parties wish to record Customer feedback, ratings, and any related observations, and to set forth the terms by which such feedback may be collected, used, retained, or treated as confidential.

WHEREAS, the parties agree that feedback provided may have value to both parties and that the collection and use of such feedback shall be governed by the terms below.

Customer & Service Details

Date of Experience:

Scope of Work

Describe the scope of services or the transaction that gave rise to this feedback. Include dates, deliverables, or service levels relevant to the feedback.

Payment Terms (if applicable)

If any fee is associated with the evaluation or follow-up services, state the agreed amount and schedule.

Term and Termination

This Feedback Agreement begins on Start Date: and continues until End Date: unless earlier terminated as provided below.

Either party may terminate this Agreement for convenience upon providing the other party the notice period specified above. Termination shall not relieve either party of obligations accrued prior to the effective date of termination, including payment obligations and confidentiality obligations that survive termination as set forth below.

Confidentiality

Confidential Information means non-public information disclosed by either party in connection with the services or feedback, including business processes, pricing, technical data, and customer identities. The recipient shall: (a) use Confidential Information solely for purposes of evaluating or responding to feedback; (b) protect Confidential Information with at least the same degree of care used to protect its own confidential information, but no less than reasonable care; and (c) not disclose Confidential Information to third parties except as required by law or with prior written consent of the disclosing party.

Exceptions: Confidential Information does not include information that is (i) publicly available through no fault of the recipient; (ii) rightfully obtained from a third party without breach of any obligation; or (iii) independently developed without use of the other party’s Confidential Information. The confidentiality obligations set forth herein shall survive termination or expiration of this Agreement for a period of three (3) years.

Feedback Use and Permissions

Customer grants Company a perpetual, worldwide, royalty-free, non-exclusive license to use, reproduce, modify, display, and publish aggregated or anonymized feedback for internal improvement, marketing, and promotional purposes, except where feedback is designated as Confidential in writing. Customer may indicate that feedback is confidential by checking the box below and providing a brief justification.

Feedback Questionnaire

Please rate the following on a scale of 1 (Poor) to 5 (Excellent). Check one box per line.

Overall satisfaction: 1 2 3 4 5

Quality of product/service: 1 2 3 4 5

Responsiveness / support: 1 2 3 4 5

Governing Law & Entire Agreement

This Agreement shall be governed by and construed in accordance with the laws of the state of:

Entire Agreement: This document, together with any written attachments executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, whether written or oral. Any amendment must be in writing and signed by authorized representatives of both parties.

Certification and Consent

By signing below, Customer certifies that the feedback provided is their honest assessment and that they have authority to provide such feedback. Customer further grants the permissions described above, except to the extent feedback is expressly designated as confidential in writing.

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