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3. EMPLOYEE PERFORMANCE EVALUATION
5. EMPLOYEE:*
6. DATE:*
   DATE:
8. DEPARTMENT:*
9. JOB TITLE:*
10. PAY GRADE /STEP:
14. EVALUATION REASON:*

    1. SCHEDULED EVALUATION
    2. PROMOTION
    3. OTHER:
15. OVERALL CONFIDENCE RATING:

    1. Highest
    2. High
    3. Satisfactory
    4. Concerned
    5. No Confidence

    Overall confidence rating must be satisfactory or better to be eligible for merit increase.
19. DATE OF HIRE:*
20. DATE OF LAST REVIEW:*
21. DATE EMPLOYEE BEGAN CURRENT POSITION:
23. SUPERVISOR:
24. TRAINING RECEIVED:
26. Instructions: Employee performance should be evaluated using the following rating scales. Documentation should be provided in each category which refers to specific performance examples:
    (O) Outstanding: Employee consistently demonstrates high level of initiative and exceeds performance objectives. (A) Above Average: Employee performs duties better than expected and generally exceeds performance objectives (S) Satisfactory: Employee meets the performance standards of the position (N) Needs Improvement: Employee performance does not continually meet acceptable standards (U) Unacceptable: Employee needs to make immediate improvement in performance
30. I. RESPONSIBILITIES*
31. II. ACCOMPLISHMENTS*
33. III. DEPENDABILITY - Employee can be relied upon to complete assigned tasks, and is conscientious about their III. DEPENDABILITY - Employee can be relied upon to complete assigned tasks, and is conscientious about their attendance and timelinessss*
    -- Select One --(O) Outstanding(A) Above Average(S) Satisfactory(N) Needs Improvement(U) Unacceptable

    Overall Rating
34. IV. PRODUCTIVITY - (Quantitative) The employee demonstrates a commitment toward achieving results. Tasks are completed efficiently and effectively.*
    -- Select One --(O) Outstanding(A) Above Average(S) Satisfactory(N) Needs Improvement(U) Unacceptable

    Overall Rating
36. III. DEPENDABILITY-Comments:*
37. IV. PRODUCTIVITY -Comments:*
39. V. QUALITY OF WORK - Employee completes duties in a thorough, professional and accurate manner that is in compliance with governing regulations*
    -- Select One --(O) Outstanding(A) Above Average(S) SatisfactoryN) Needs Improvement(U) Unacceptable

    Overall Rating:
40. VI. ATTITUDE - Employee shows interest in work duties, voluntary efforts to improve, follows rules and regulations of the City and seeks to achieve departmental goals.
    -- Select One --(O) Outstanding(A) Above Average(S) Satisfactory(N) Needs Improvement(U) Unacceptable

    Overall Rating
42. V. QUALITY OF WORK -Comments:*
43. VI. ATTITUDE -Comments:*
45. VII. RELATIONSHIP WITH PUBLIC/STAKEHOLDERS - Employee has a positive working relationship with citizens and vendors. Promptly and accurately addresses public inquiries.*
    -- Select One --(O) Outstanding(A) Above Average(S) Satisfactory(N) Needs Improvement(U) Unacceptable

    Overall Rating:
46. VIII. RELATIONSHIP WITH CO-WORKERS -Ability to interact with fellow employees & supervisors to achieve goals. Accepts direction from supervisors.
    -- Select One --(O) Outstanding(A) Above Average(S) Satisfactory(N) Needs Improvement(U) Unacceptable

    Overall Rating
50. VII. RELATIONSHIP WITH PUBLIC/STAKEHOLDERS -Comments:*
51. VIII. RELATIONSHIP WITH CO-WORKERS -Comments:*
53. IX. APPEARANCE -*
    -- Select One --(O) Outstanding(A) Above Average(S) Satisfactory(N) Needs Improvement(U) Unacceptable

    Overall Rating
54. X. HOUSEKEEPING - Properly maintains equipment and work areas. Uses tools, machines or other equipment necessary to complete duties in a safe manner.*
    -- Select One --(O) Outstanding(A) Above Average(S) Satisfactory(N) Needs Improvement(U) Unacceptable

    Overall Rating
56. IX. APPEARANCE -Comments:*
57. X. HOUSEKEEPING -Comments:*
61. Action Plan:
65. Major strong points are:
67. Challenge areas for improvement (if necessary):
69. Goals and objectives for the next evaluation period:
71. Electronic Signature
    SUPERVISOR SIGNATURE:
72. DATE:
    DATE:
74. Electronic Signature
    DEPT. DIRECTOR SIGNATURE
75. DATE:
    DATE:
77. DEPARTMENT DIRECTOR RECOMMENDATIONS AND COMMENTS:
79. Electronic Signature
    HUMAN RESOURCES REVIEW
80. DATE:
    DATE:
82. Electronic Signature
    EMPLOYEE SIGNATURE
83. DATE:
    DATE:
85. EMPLOYEE’S COMMENTS:
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86. 1. Receive an email copy of this form.
87. Email address

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