CONFIDENTIAL

Employee Performance Evaluation

Employee's Name _______________________________________Title __________________ Office/Dept. _________________________Date of Evaluation __________________________ PERFORMANCE DEFINITIONS *3 2 1 STEP I COMMENDABLE ACCEPTABLE MARGINAL Performs beyond specified requirements within job description Meets the specified requirements of job description Corrective action and/or release from job may be required

EVALUATE THE ELEMENTS OF PERFORMANCE. Evaluate all factors indicated below by checking the appropriate space and commenting where applicable. *3 _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ 2 _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ 1 _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____

QUALITY - Performs work thoroughly effectively accurately QUANTITY - Completes the necessary amount of work Is able to prioritize tasks KNOWLEDGE - Is capable in handling all phases and details within job specifications HUMAN RELATIONS - Is willing to work with others Is able to work with others COMMUNICATION SKILLS - Effectively presents written ideas and information to others JUDGEMENT - Is able to make decisions based on sound reasoning

JOB DEPENDABILITY - Is honest and reliable in carrying out instructions _____ Observes Personnel Policies _____ Complies with established working hours _____ ATTITUDE - Accepts procedures Is discrete in speech and action Is enthusiastic Exhibits a sense of loyalty INITIATIVE - Is a self starter Shows originality Makes decisions when required Initiates action _____ _____ _____ _____ _____ _____ _____ _____

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* Attach Job Description to Evaluation Form COMMENTS: _____________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ STEP II OVERALL PERFORMANCE RATING. Considering all of the above accomplishments, check the appropriate space below to indicate the overall performance rating. Take into account results achieved during the rating period compared to the expectations of the supervisor as to how well the standards for the position are being met, exceeded or to the degree the employee's performance falls short of expectations. OVERALL EVALUATION ___________________________________ (commendable - acceptable - marginal)

STEP III

FOLLOWING THE PERFORMANCE EVALUATION REVIEW WITH INDIVIDUAL, COMPLETE THE FOLLOWING:

A. Describe any goals or objectives established for the period between this and next review. _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ B. Describe other functions or areas, if any, for which this individual should be considered. Include a description of any unusual skills or abilities that could contribute to this or potential assignments. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ C. Record the person's comments regarding the performance evaluation, the present assignment, or other comments. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ___________________________________________________________________________

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