Pay for Performance Worksheet

(This form is to be completed for employees who have not reached the top of their schedule, and are eligible for advancement)

Employee Name: ______Supervisor: ______

1.  Attach completed performance evaluation.

2.  Send to Human Resources by June 1st.

Section I. Individual Job Specific Goals: Weight: 40%

Year-end Assessment / Needs Improvement / Effective / Highly Effective
Rate the quality and percentage of the planned outcomes that were completed and within the employee’s control. / Fulfilled less than 70% of planned outcomes. / Fulfilled 70% - 84% of planned outcomes in a fully satisfactory manner. / Fulfilled 85% - 100% of planned outcomes and frequently exceeded expectations.
Points assigned : / 1 point / 2 points / 3 points

Section II: Professional Development. (Pro-rate for new hires or part time employees): Weight: 10%

Completed Less than 6 hours / Completed 6 but less than 9 hours / Completed 9 hours or more.
Points assigned: / 1 point / 2 points / 3 points

Section III. Top Priority Job Responsibilities and Professional Skills: Weight: 50%

Needs Improvement / Effective / Highly Effective
Job Knowledge evaluation results at end of year (take an average of the ratings you assigned to the nearest whole number): / Does not consistently fulfill the requirements of the job and needs to improve. / Fulfills requirements of the job description in a fully satisfactory manner. / Frequently achieves outstanding results. Accomplishments and professional skills often exceed requirements of the job.
Points assigned: / 1 point / 2 points / 3 points

Calculating recommended pay increase percentage: (Fill in table below)

Score received / Points
(whole numbers only) / Weight / Equals total weighted points
Section I / X / 40%
Section II / X / 10%
Section III / X / 50%
Total points

·  The employee must demonstrate overall substantial performance of the areas assessed in this performance evaluation.

·  Substantial performance for the purposes of this document means a weighted average score of 2.0 or higher.

1.  Was this employee on a Performance Improvement Plan as of June 1st, 2018? ______: If yes, employee is not eligible for a step advancement for 2017-2018.

2.  Did the supervisor meet with the employee for the mid - year check in?______: If no, answer a & b

  1. Did the employee receive a corrective action notice during 2017-2018? ______
  2. Was the employee on a PIP as of June 1st, 2018? ______

If answers to 2, a, and b are all no, then a step advancement for 2017/2018 is automatic, per the contract.

3.  Did the employee achieve a score of 2.0 or higher, and was not on a PIP as of June 1st, 2018?: ______: if yes, employee will receive a step advancement for 2017-2018.*

Supervisor Date Employee Date

Executive Budget Control Officer Date

*If the employee did not receive a step advancement, please ensure that the performance evaluation goals and professional development goals address areas of deficiency.