Performance Management System Executive Performance Agreement Part 1. Consultation. I have reviewed this plan and have been consulted on its development. Executive’s Name (Last, First, MI): Appraisal Pd. - Executive’s Signature: Date: Title: Organization: Rating Official’s Name (Last, First, MI): CA NC LT/LE Rating Official’s Signature: Date: Part 2. Progress Review Executive’s Signature: Date: Rating Official’s Signature: Date: Reviewing Official’s Signature (Optional): Date: Part 3. Summary Rating Level 5 Level 4 Level 3 Level 2 Level 1 Initial Summary Rating Outstanding Exceeds Fully Fully Successful Minimally Unsatisfactory Successful Satisfactory Rating Official’s Name (Last, First, MI): Rating Official’s Signature: Date: Executive’s Signature: Date: Reviewing Official’s Signature (Optional): Date: Higher Level Review (if applicable) I request a higher level review. Executive’s Initials: Date: Higher Level Review Completed Date: Higher Level Reviewer Signature: Performance Review Board Recommendation Level 5 Level 4 Level 3 Level 2 Level 1 Chair Signature: Date: Annual Summary Rating Level 5 Level 4 Level 3 Level 2 Level 1 Appointing Authority Signature: Date: Part 4. Derivation Formula and Calculation of Annual Summary Rating Element Rating Score Final Final Critical Element Initial (if changed) Weight Initial (if changed) Summary Level Ranges 1. Leading Change 475-500 = Level 5 2. Leading People 400-474 = Level 4 3. Business Acumen 300-399 = Level 3 4. Building Coalitions 200-299 = Level 2 5. Results Driven Any CE rated Level 1 = Level 1 Total 100%
Performance Management System Executive Performance Agreement Part 1. Consultation. I have reviewed this plan and have been consulted on its development. Executive’s Name (Last, First, MI): Appraisal Pd. - Executive’s Signature: Date: Title: Organization: Rating Official’s Name (Last, First, MI): CA NC LT/LE Rating Official’s Signature: Date: Part 2. Progress Review Executive’s Signature: Date: Rating Official’s Signature: Date: Reviewing Official’s Signature (Optional): Date: Part 3. Summary Rating Initial Summary Rating Level 5 Outstanding Level 4 Exceeds Fully Successful Level 3 Fully Successful Level 2 Minimally Satisfactory Level 1 Unsatisfactory Rating Official’s Name (Last, First, MI): Rating Official’s Signature: Date: Executive’s Signature: Date: Reviewing Official’s Signature (Optional): Date: Higher Level Review (if applicable) I request a higher level review. Executive’s Initials: Date: Higher Level Review Completed Date: Higher Level Reviewer Signature: Performance Review Board Recommendation Level 5 Level 4 Level 3 Level 2 Level 1 Chair Signature: Date: Annual Summary Rating Level 5 Level 4 Level 3 Level 2 Level 1 Appointing Authority Signature: Date: Part 4. Derivation Formula and Calculation of Annual Summary Rating Critical Element Element Rating Weight Score Summary Level Ranges Initial Final (if changed) Initial Final (if changed) 1. Leading Change 475-500 = Level 5 400-474 = Level 4 300-399 = Level 3 200-299 = Level 2 Any CE rated Level 1 = Level 1 2. Leading People 3. Business Acumen 4. Building Coalitions 5. Results Driven Total 100%
ExecPerfAgreement_Attach_A.docx