Performance Evaluation Exempt Annual

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					                                                                                                                EXEMPT / MANAGEMENT

Employee Name                                                                                5   Outstanding Performance
                                                                                             4   Exceeds Performance Standards
                                                                                             3   Meets Performance Standards
Position Title                                           Hire Date                           2   Inconsistently Meets Performance Standards
                                                                                             1   Below Minimum Performance Standards
Department Name/#                                        Review Period                           1         2       3        4       5         N/A
                                                         From:        To:

MEETING COMMITMENTS AND OBJECTIVES: Effectively measures accomplishments
against objectives. Meets objectives in a timely manner. Consider the ability to use
resources productively and efficiently, and increase productivity and reduce cost
through development and introduction of improved methods, procedures and

POSITION KNOWLEDGE AND SKILLS: Consider the breadth of knowledge, depth of
understanding and level of competency demonstrated. Also consider the adaptability
and versatility on new and different assignments, effectiveness of oral and written
communications and ability to work independently.

PLANNING, ORGANIZATION AND CONTROL: Consider the ability to establish goals,
develop action plans, set realistic timetables and monitor progress toward completion.
Also consider skills in organizing resources and information, and ability to control these
elements to achieve the desired results.

QUALITY: Consider accuracy, thoroughness, neatness, effectiveness, and application of
sound judgment for those jobs in which decisions and actions must be made on
reasoning and weighing of alternatives. Consider the quality of work produced for
amount of time and resources expended, and commitment to rise to challenges when

PROBLEM SOLVING AND DECISION MAKING: Consider the ability to identify, define
and resolve problems. Consider ability to gather pertinent date necessary to effectively
formulate alternative solutions. Also consider ability to use logical reasoning and
common sense to arrive at solid business decisions, and willingness to make decisions
in a decisive manner.
COOPERATION: Consider interaction with all levels of the organization, including
external vendors, and willingness to work with and assist others, carrying a full share of
the responsibility. Also consider ability to work as an effective team member,
demonstrating sensitivity, collaboration, assertiveness, and conflict resolution skills.

INITIATIVE: Consider degree of creativity, resourcefulness, and self-reliance exercised,
willingness to seek out and accept new challenges and develop new techniques and

BUDGETARY RESPONSIBILITY: Consider ability to work within the defined resources
available, document necessity to for adjustments, and suggest areas of cost savings in
the department of responsibility.

LEADERSHIP: Consider the ability to use interpersonal skills in the direction of others
to achieve the desired results. Also consider the ability to provide constructive
guidance and to inspire others to work toward specific objectives, as well as effectively
communicating ideas and directions.

STAFFING AND DEVELOPMENT: Consider the ability to select, orient, and develop
competent staff members, including delegation of responsibilities, on-the-job training
and career coaching. Also consider the ability to create an atmosphere conducive to
building a dedicated, motivated and productive staff through actively listening and
responding to issues.

                           OVERALL JOB PERFORMANCE                                           AVERAGE SCORE:

STRENGTHS AND ACCOMPLISHMENTS: List specific achievements and indicate why they were important. Also match
accomplishments during the review period against objectives. Also list projects that were left unfinished, why they were not
completed, and expected timeframes.

DEVELOPMENT NEEDS, TRAINING AND ACTION PLANS: List specific areas or functions where improvement is needed. Include
objectives for the next review period, and the steps to be taken to achieve the desired outcome.
DEPARTMENT OBJECTIVES FOR NEXT REVIEW PERIOD: List measurable personal, departmental or company objectives to be
achieved during the next review period. Include staff qualifications or abilities that are not being fully utilized.

Employee Signature                                                                                   Date

Supervisor/Manager Signature                                                                         Date

Content reviewed by HR prior to delivery                                                             Date

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