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Household Goods Shipment Service Evaluation

Verizon Employee: Please note that Verizon requires evaluations for all shipments. This information is used to substantiate payment to the van line, develop semi-annual quality reviews, and determine carrier selection. Please help us by completing this form within 5 days of the services provided. Thank you!

*required fields

* Employee Name (Last, First, MI):
New Business Unit:
Pickup Date:

Delivery Date:
Booking Agent:
Origin Agent:
Destination Agent:
Origin Location:
Destination Location:
Bill of Lading #

Total Overall Evaluation: Please note that Verizon's Household Goods Program is a "pay for performance" program. Your rating will determine the amount Verizon will pay the van lines for this portion of your relocation. Your right to file an insurance claim for loss or damage is in no way limited or enhanced by the rating provided in this section.

	Excellent	Good	Fair	Poor
* TOTAL OVERALL EVALUATION:

If you move again, would you use this carrier? Yes No
MOVE COORDINATOR SERVICES:
* Was pre-move consultation made? Yes No
* Was move process explained to you? Yes No
* Was your coordinator helpful in answering questions? Yes No
* Was post-move call made to you? Yes No

	Excellent	Good	Fair	Poor
* Overall Move Coordinator Services Evaluation:

ORIGIN SERVICES:
Was premove survey made?: Yes No
If Yes: By Phone In Person
Was Pick up made on date promised? Yes No
If No, No. of Days Late:

	Excellent	Good	Fair	Poor
Packing Service:
Loading Service:
Appliance Servicing:
Appearance of Moving Personnel:
Courtesy of moving Personnel:
Overall Origin Services Evaluation:

STORAGE:
Was shipment placed in storage? Yes No
DESTINATION SERVICES:
Was delivery made within the dates promised? Yes No
If No, No. of Days Late:
Was delivery made within the dates promised? Yes No

	Excellent	Good	Fair	Poor
Unloading/Unpacking Service:
Appliance Servicing:
Appearance of Moving Personnel:
Courtesy of Moving Personnel:
Condition of Property on Delivery:
Overall Destination Services Evaluation:

AUTO SERVICES:
Was pickup made on date promised? Yes No
If No, No. of Days Late:
Was delivery made within the dates promised? Yes No
If No, No. of Days Late:
Number of days from Pickup to Delivery?
Vehicle 1:
Vehicle 2:

	Excellent	Good	Fair	Poor
Auto Services Evaluation:

Comments:

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