Name: Designation: Department:

Performance Rating

Muammar bin Hassan Safety and Health Officer (SHO) HSSE

Assessment Period: Division:

EMPLOYEE PERFORMANCE APPRAISAL FORM

01st January until 10th Dec 2013 Labuan

(Rate Scale: 5 : Significantly Above Target (Exceeding)/ 4 : Above Target/ 3 : On Target / 2 : Threshold / 1 : Not Performing

Above Expectations (4)

Below Expectations (2)

Evaluation MidYear Assess ment

Rating
Meet Expectations (3) Not Performinv (1)

Performance Targets

End-Year Assessment

Key Results Area Objectives (60%) Financial/Operational Performance

To sustain zero LTI

15%

To conduct HSE training onboard - 6 vessels/year

HSE training was conducted onboard ISMSB vessels in Labuan. The following vessels have been visited - Omni Anteia, TH, TPiai1, SK 75,TP1 & TBr2. As of end of Nov 2013, the total UCUX received was 10044. Estimated to reach 11000 by end of Dec2013. The following vessels were visited and walkabout inspection conducted during their stay in Labuan. They were SK 70, TPu1, TDH2, Omni Gagah, Omni Perkasa & Omni Solaris. Random D&A test has been conducted onboard the following vessels whilst they were at Labuan. Minimum 4 crews were randomly selected to undertake the D&A test. The vessels involved were TH, Omni Gagah, Omni Perkasa, TPiai1, Omni Anteia, TPu1. The submission of monthly HSE Statistics to SSB and PMO PIC was carried out before 05th of each month.

Target achieved

Exceeding (5)

Task - Goals to Achieve

Weightage

Goals Achieved

Score

3
As end of Nov'13 UCUX recvd 9983

0.45

To enhance HSE awareness among the crew

10%

To achieve 9,000 UCUX submission

0.40

Ship visit and walkabout inspection

10%

to conduct ship visit / walkabout inspection - 6 vessels/year

More than 6 vessels visited for the year 2013

0.30

Compliance with company drug & alcohol policy

15%

To conduct D&A test for 6 vessels/ year

11 vessels have been conducted the D&A test (Kmn & Lbn)

0.60

Compliance to Charterer HSE Monthly submission

10%

To submit the HSE Statistics to clients before 7th of the month

The requirement has been fulfilled

4 Personal Objectives (40%) Behavioural / Operational Outcome

Commited to creating value

0.40

20%

To organise the HSSE Day Once a year

Joined lead the Hazard Hunt program for the HSSE day. The program was executed successfully.

Target achieved

0.80

Operate as one - Teamwork

20%

Involve with Operation team to close the To assist the Operation team in obtaining green of OSVIS - 3 OSVIS observation for the following vessels TP1, TPu1 & Omni Gagah. vessels/year

Target achieved

Total

100%

Combine Rating (All Sections)

Final Score (Calibration)

0.60 0.00 3.55 4

Development Planning Development Objective

Action Plans (Projects, OJT, coaching, specific

Timeline

Year-End Outcome (were action plans conducted?)

To complete 30pts CEP per year Enhance English Language

Attend various CEP training program Attend English Presentation course

31 Dec 2014 31 Dec 2014

Employee Comments

Signatures Employee

Date

Manager Comments

Immediate Manager

Date

Entitle for a promotion and salary increase by January 2014.

Immediate Manager's Manager Date

Select 2 Behaviours to focus on for the year and set key intiatives to be undertaken to demonstrate behaviours = 40%
ICON VALUES I - INTEGRITY & MUTUAL RESPECT Description Observable Behaviors 1. Adherence to moral principles; honesty 1. Understands & respects companies policies & ethical standards. Ensures 2. Mutual respect is the proper regard for an individual's dignity that is reciprocated. It 2. Build positive relationships and understanding with colleagues. Able to get is usually visible in their relationship and interactions with each other. cooperation from others. 1. Genuine interest in reaching objectives effectively and efficiently. 2. Tasks completed impacts the organization positively 1. Plans all tasks by taking into account datelines and its impact on others.

C - COMMITTED TO CREATING VALUE O - OPERATE AS ONE TEAMWORK

1. Team Work is a group of two or more persons who carry out some work related tasks, interact dynamically, work collaboratively with one another to achieve a set goal / task

1. The individual will cooperate, using their different individual skills and

N - NAVIGATE THE EXTRA MILE

1. Taking the initiative to understand an issue or a task at a deeper level than 1. To do something more than what is required in order to deliver quality work.