1. Page 1 of 5
Date
7/24/2014
Associate's Title
Input both the associate and supervisor's name, title, etc. in the fields above.
The associate should be assessed on the basis of their performance during the immediate past
assessment period.
An assessment of each applicable performance characteristic should then be made using the
following rating scale.
to forwarding to your designated Human Resources Representative.
NOTE: Specific comments should be noted in the space provided to elaborate on assessments.
Goldsberry, Suzanne 6/17/2013 1/1/13 - 12/31/13
Department/Region
PERFORMANCE ASSESSMENT
Associate's Name (Last, First, Middle) Date Of Hire Period Covered
Office / Jacksonville Executive Administrative Assistant
Completing the Performance Assessment
Rating
Scale
Performance
Assessment Definitions
Bill Mazar Regional President
Supersvisor's Name Supervisor's Title:
Both the associate and supervisor should sign the completed Performance Assessment prior
5
Consistently Exceeds
Expectations (CE)
Results have consistently exceeded job standards / expectations. Associates at
this performance level have demonstrated / achieved the highest standard of
performance for mutually agreed upon objectives.
4
Meets & Exceeds Expectations
(ME)
Results have exceeded job standards / expectations. Individuals rated at this
level have made contributions significantly above what would be expected of the
majority of the Associates doing similar work.
1
Fails To Meet Expectations
(FM)
Results fail to consistently meet minimum job standards / expecations. The
Associate has been counseled with regard to his/her performance and how that
performance must be improved within a given time limit. Corrective action is
required.
3
Successfully Meets
Expectations (SM)
Results have consistently met job standards / expectations. This rating
represents good solid performance and may cover a broad range of Associates,
including those who are close to exceeding job standards.
2
Meets Some Expectations
(MS)
Results meet some of the job standards / expectations. Associate's
performance needs improvement. Closer supervision is needed in comparison to
that required by others performing similar functions in the organization.

2. 4.0O. Quantity of Work x
N. Quality of Work x
4
3.0
4 4.0
M. Safety Awareness x 3
L. Supporting Equal Opportunity/Affirmative Action x 3 3.0
K. Sensitivity to Security and Confidentiality x
5 5.0x
5 5.0
J. Planning and Organizing Own Work x 4 4.0
I. Interacting with Others
3 3.0
H. Initiative and Self-Monitoring x 4 4.0
G. Decision Making and Business Judgment x
F. Customer Service x 5 5.0
x 4 4.0E. Coordination and Teamwork
D. Comprehension and Analytical Skills x 4 4.0
Communication Skills x 4C. 4.0
B. Adaptability to Time Pressures & Changing Priorities x 5 5.0
Acquiring & Maintaining Job & Professional
Knowledge
xA. 4.04
Department/Region Associate's Title
Office / Jacksonville Executive Administrative Assistant
WeightedValue
Comments
Include specific work examples for each "Performance Characteristic" where
applicable.
The characteristics in Part 1 pertain to any executive,
managerial, professional, or technical job. For each
performance characteristic, input an "X" in the appropriate
column in order to identify whether the characteristic is a
"Major" or "Minor" part of the associate's job. Then, rate the
associate's performance using a rating scale of 1- 5.
Major
Minor
Job
Profile
(Part of
Job)
Rating
Performance Characteristics
Part 1 of 2
Goldsberry, Suzanne 6/17/2013 1/1/13 - 12/31/13 7/26/2014
PERFORMANCE ASSESSMENT
Page 3 of 5
Associate's Name (Last, First, Middle) Date Of Hire Period Covered Date

4. It s a pleasure working with Sue and I feel confident that when given a task Sue will complete it with little supervision.
General Comments:
Recommended Training and Development Experience (e.g., formal, informal, on-the-job experience, etc.):
Sue gets along with everyone.
It would be good for Sue to cross train with HR.
Office / Jacksonville Executive Administrative Assistant
Areas of Improvement:
Sue is willing to work long hours and weekends.
Outline the Associate's Main Assignments and Accomplishments During Assessment Period:
Sue's duties consist as the Regional Admin.
Sue has been able to negotiate other departments.
Sue has been able to work with little supervision.
Strengths:
Sue is always ready to assist anyone or department.
Goldsberry, Suzanne 6/17/2013 1/1/13 - 12/31/13 7/26/2014
Department/Region Associate's Title
PERFORMANCE ASSESSMENT
Page 5 of 5
Associate's Name (Last, First, Middle) Date Of Hire Period Covered Date