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NOAA
Administrative Orders
NAO
202-430
Appendix A
PERFORMANCE PLAN, PROGRESS
REVIEW and APPRAISAL RECORD
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Employee's
Name:
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PART I.
PERFORMANCE PLAN |
A. CRITICAL ELEMENTS (LIST at least TWO but
no more than FIVE)
( Expand size of blocks as desired)
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B. RATING
(Mark One)
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1. |
Meets
or
Exceeds
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Does
Not
Meet
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2.
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Meets
or
Exceeds
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Does
Not
Meet
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3.
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Meets
or
Exceeds
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Does
Not
Meet
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4.
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Meets
or
Exceeds
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Does
Not
Meet
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5.
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Meets
or
Exceeds
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Does
Not
Meet
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NOAA 2-Level Performance
Form, 11/97 See NAO 202-430 for Instructions
PART II. PROGRESS REVIEW
COMMENTS |
Date(s) of review and initials of employee
and rating official must be provided
for each review. A summary of comments is
optional unless expectations are not being
met.
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Employee
Initials:
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Date: |
Rating Official
Initials:
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Comments Attached: |
Yes
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No
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Employee
Initials:
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Date: |
Rating Official
Initials:
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Comments Attached: |
Yes
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No
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Employee
Initials:
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Date: |
Rating Official
Initials:
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Comments Attached: |
Yes
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No
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Employee
Initials:
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Date: |
Rating Official
Initials:
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Comments Attached: |
Yes
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No
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PART III. SUMMARY LEVEL |
NOTE: If any one or more of the Critical Elements in Part
I above is marked ADoes
Not Meet@ Expectations,
the below Summary of Expectations must also be marked ADoes
Not Meet.@
Also, a written explanation must be attached.*
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Summary |
MEETS
OR
EXCEEDS
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DOES
NOT
MEET *
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Mark one of the following
---> |
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Check under AYes@ column
if: |
YES
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1. Written comments or explanations are
attached.* |
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2. A Quality Step Increase is recommended
(narrative justification attached)
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PART IV. PERFORMANCE CERTIFICATION |
(Employee=s
signature certifies review and discussion
with the Rating Official.
It does not necessarily
mean that the employee concurs with the information
on this form.)
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Rating Official Signature: |
Date: |
Reviewing Official Signature:
(If Applicable)
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Date: |
Employee Signature: |
Date: |
NOAA 2-Level Performance
Form, 11/97 See NAO 202-430 for Instructions
Appendix B
PERFORMANCE INDICATORS
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For each Performance Indicator listed
below, circle the number of each Critical
Element (from Part I) that is applicable,
in the right column:
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Applicable
Critical
Elements
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I. QUALITY |
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A. Knowledge of Field or Profession:
Maintains and demonstrates technical competence
and/or experience in areas of assigned responsibility.
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All 1 2 3 4 5
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B. Accuracy and Thoroughness of Work:
Plans, organizes, and executes work logically.
Anticipates and analyzes problems clearly
and determines appropriate solutions. Work
is correct and complete.
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All 1 2 3 4 5
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C. Soundness of Judgment and Decisions:
Documents assignments carefully. Weighs
alternative courses of action, considering
long and shortterm implications. Makes
and executes timely decisions.
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All 1 2 3 4 5
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D. Effectiveness of Written Decisions:
Presentation meets objectives, is persuasive,
tactful, and appropriate to audience. Demonstrates
attention, courtesy and respect for other
points of view.
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All 1 2 3 4 5
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E. Timeliness in Meeting Deadlines: Completes
work in accordance with established deadlines. |
All 1 2 3 4 5
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F. Other (specify): |
All 1 2 3 4 5
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II. TEAMWORK |
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A. Participation: Willingly participates
in group activities, performing in a thorough
and complete fashion. Communicates regularly
with team members. Seeks team consensus. |
All 1 2 3 4 5 |
B. Cooperation: Supports team initiatives.
Demonstrates respect for team members. Seeks
team consensus. |
All 1 2 3 4 5 |
C. Leadership: Provides encouragement,
guidance, and direction to team members as
needed. Adjusts leadership style to fit situation. |
All 1 2 3 4 5 |
D. Other (Specify): |
All 1 2 3 4 5 |
III. CUSTOMER SERVICE |
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A. Quality of Service: Delivers high
quality products and services to both external
and internal customers. Initiates and responds
to suggestions for improving service. |
All 1 2 3 4 5 |
B. Timeliness of Service:
Delivers quality products and services
in accordance with time schedules agreed
upon with customer.
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All 1 2 3 4 5 |
C. Courtesy: Treats external and internal
customers with courtesy and respect. Customer
satisfaction is high priority. |
All 1 2 3 4 5 |
D. Other (Specify): |
All 1 2 3 4 5 |
NOAA 2-Level Performance
Form, 11/97 See NAO 202-430 for Instructions
Appendix
C
FORM CD-516
LF US DEPARTMENT OF COMMERCE
(6-93)
CLASSIFICATION
AND
PERFORMANCE
MANAGEMENT RECORD
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NEW |
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I/A: |
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MR#: |
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IP#: |
Ž Performance
Plan Ž Performance
Appraisal Ž Performance
Recognition Ž Progress
Review Ž Position
Description |
Employee=s
Name: |
Social Security
No. |
000B00-0000 |
Position Title: |
Pay Plan, Series,
Grade/Step: |
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Organization: |
1. |
4. |
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2. |
5. |
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3. |
6. |
Rating Period: |
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Covered by |
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Senior Executive
Service |
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Demonstration
Project |
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General Workforce |
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Other: |
PART
A - POSITION DESCRIPTION |
POSITION
CERTIFICATION B I
certify that this is an accurate statement
of the major duties and respons ibilities
of the position and its organization relationships
and that the position is necessary to carry
out Government functions for which I am responsible.
This certification is made with the knowledge
that this information is to be used for statutory
purpose relating to appointment and payment
of public funds and that false or misleading
statements may constitute violation of such
statute or their implementing regulations. |
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SUPERVISOR=S
SIGNATURE |
DATE |
SECOND LEVEL
SUPERVISOR |
DATE |
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CLASSIFICATION
CERTIFICATION
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OFFICIAL TITLE: |
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PP: |
SERIES: |
FUNC: |
GRADE: |
I/A: |
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YES |
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NO |
I certify that
this position has been classified as required
by Title 5, US Code, in conformance with
standards published by the OPM or, if no
published standard applies directly, consistently
with the most applicable published standards. |
NAME & TITLE
OF CLASSIFIER |
SIGNATURE |
DATE |
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PART
B - PERFORMANCE PLAN |
This plan
is an accurate statement of the work that
will be the basis of the employee=s
performance appraisal. |
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NAME & TITLE
OF FIRST LINE SUPERVISOR/RATING OFFICIAL |
SIGNATURE |
DATE |
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APPROVAL B I
agree with the certification of the position
description and approve the performance pla
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NAME & TITLE
OF APPROVING OFFICIAL OR SES APPOINTING AUTHORITY |
SIGNATURE |
DATE |
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EMPLOYEE
ACKNOWLEDGMENT B My
signature acknowledges discussion of the
position description and receip t of the
plan, and does not necessarily signify agreement. |
SIGNATURE |
DATE |
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PRIVACY
ACT STATEMENT B Disclosure
of your social security number on this form
is voluntary. The num ber is linked with
your name in the official personnel records
system to ensure unique identification of
your records. The social security number
will be used solely to ensure accurate entry
of your performance rating into the automated
record system. |
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