<table style="width:100%;">
<colgroup>
<col style="width: 15%" />
<col style="width: 3%" />
<col style="width: 9%" />
<col style="width: 7%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 7%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 4%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 1%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="9" rowspan="4"><p>FORM CD-516 LF US DEPARTMENT OF
COMMERCE</p>
<p>(6-93)</p>
<p><strong>CLASSIFICATION AND</strong></p>
<p><strong>PERFORMANCE MANAGEMENT RECORD</strong></p></td>
<td></td>
<td colspan="7">NEW</td>
</tr>
<tr class="even">
<td></td>
<td colspan="7">I/A:</td>
</tr>
<tr class="odd">
<td colspan="8">MR#:</td>
</tr>
<tr class="even">
<td colspan="8">IP#:</td>
</tr>
<tr class="odd">
<td colspan="17"><strong>Performance Plan Performance Appraisal
Performance Recognition Progress Review Position
Description</strong></td>
</tr>
<tr class="even">
<td colspan="15">Employee’s Name:</td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="17">Position Title:</td>
</tr>
<tr class="even">
<td colspan="17">Pay Plan, Series, Grade/Step:</td>
</tr>
<tr class="odd">
<td>Organization:</td>
<td colspan="6">1.</td>
<td colspan="10">4.</td>
</tr>
<tr class="even">
<td></td>
<td colspan="6">2.</td>
<td colspan="10">5.</td>
</tr>
<tr class="odd">
<td></td>
<td colspan="6">3.</td>
<td colspan="10">6.</td>
</tr>
<tr class="even">
<td>Rating Period:</td>
<td colspan="16"></td>
</tr>
<tr class="odd">
<td>Covered by</td>
<td></td>
<td colspan="5">Senior Executive Service</td>
<td></td>
<td colspan="9">Demonstration Project</td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td colspan="5">General Workforce</td>
<td></td>
<td colspan="9">Other:</td>
</tr>
<tr class="odd">
<td colspan="17"><strong>PART A - POSITION DESCRIPTION</strong></td>
</tr>
<tr class="even">
<td colspan="17"><strong>POSITION CERTIFICATION</strong> – I certify
that this is an accurate statement of the major duties and
responsibilities 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.</td>
</tr>
<tr class="odd">
<td colspan="4">SUPERVISOR’S SIGNATURE</td>
<td colspan="2">DATE</td>
<td colspan="6">SECOND LEVEL SUPERVISOR</td>
<td colspan="5">DATE</td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="2"></td>
<td colspan="6"></td>
<td colspan="5"></td>
</tr>
<tr class="odd">
<td colspan="2" rowspan="2"><p><strong>CLASSIFICATION</strong></p>
<p><strong>CERTIFICATION</strong></p></td>
<td colspan="15">OFFICIAL TITLE:</td>
</tr>
<tr class="even">
<td>PP:</td>
<td colspan="2">SERIES:</td>
<td colspan="2">FUNC:</td>
<td colspan="3">GRADE:</td>
<td>I/A:</td>
<td></td>
<td>YES</td>
<td></td>
<td colspan="3">NO</td>
</tr>
<tr class="odd">
<td colspan="17">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.</td>
</tr>
<tr class="even">
<td colspan="6">NAME &amp; TITLE OF CLASSIFIER</td>
<td colspan="6">SIGNATURE</td>
<td colspan="5">DATE</td>
</tr>
<tr class="odd">
<td colspan="6"></td>
<td colspan="6"></td>
<td colspan="5"></td>
</tr>
<tr class="even">
<td colspan="17"><strong>PART B - PERFORMANCE PLAN</strong></td>
</tr>
<tr class="odd">
<td colspan="17"><strong>This plan is an accurate statement of the work
that will be the basis of the employee’s performance
appraisal.</strong></td>
</tr>
<tr class="even">
<td colspan="6">NAME &amp; TITLE OF FIRST LINE SUPERVISOR/RATING
OFFICIAL</td>
<td colspan="6">SIGNATURE</td>
<td colspan="5">DATE</td>
</tr>
<tr class="odd">
<td colspan="6"></td>
<td colspan="6"></td>
<td colspan="5"></td>
</tr>
<tr class="even">
<td colspan="17"><strong>APPROVAL</strong> – I agree with the
certification of the position description and approve the performance
plan.</td>
</tr>
<tr class="odd">
<td colspan="6">NAME &amp; TITLE OF APPROVING OFFICIAL OR SES APPOINTING
AUTHORITY</td>
<td colspan="6">SIGNATURE</td>
<td colspan="5">DATE</td>
</tr>
<tr class="even">
<td colspan="6"></td>
<td colspan="6"></td>
<td colspan="5"></td>
</tr>
<tr class="odd">
<td colspan="6" rowspan="2"><strong>EMPLOYEE ACKNOWLEDGMENT</strong> –
My signature acknowledges discussion of the position description and
receipt of the plan, and does not necessarily signify agreement.</td>
<td colspan="6">SIGNATURE</td>
<td colspan="5">DATE</td>
</tr>
<tr class="even">
<td colspan="6"></td>
<td colspan="5"></td>
</tr>
<tr class="odd">
<td colspan="17"><strong>PRIVACY ACT STATEMENT</strong> – Disclosure of
your social security number on this form is voluntary. The number 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.</td>
</tr>
</tbody>
</table>

MS Word Version, NOAA Performance Management Forms, 6/29/04: CD-516.wpd

+----------------------------------------+---------------+-----+-------+
| **PERFORMANCE PLAN, PROGRESS**         | Employee's    |     |       |
|                                        | Name:         |     |       |
| **REVIEW and APPRAISAL RECORD**        |               |     |       |
+========================================+===============+=====+=======+
|                                        |               |     |       |
+----------------------------------------+---------------+-----+-------+
| **PART I. PERFORMANCE PLAN**           |               |     |       |
+----------------------------------------+---------------+-----+-------+
| **A. CRITICAL ELEMENTS** *(LIST at     |               | *   |       |
| least **TWO** but no more than         |               | *B. |       |
| **FIVE**)*                             |               | RA  |       |
|                                        |               | TIN |       |
| > ( Expand size of blocks as desired)  |               | G** |       |
|                                        |               |     |       |
|                                        |               | **  |       |
|                                        |               | *(M |       |
|                                        |               | ark |       |
|                                        |               | O   |       |
|                                        |               | ne) |       |
|                                        |               | *** |       |
+----------------------------------------+---------------+-----+-------+
| **1**.                                 |               | **M | ***Do |
|                                        |               | eet | es*** |
|                                        |               | s** |       |
|                                        |               |     | ***N  |
|                                        |               | **o | ot*** |
|                                        |               | r** |       |
|                                        |               |     | ***Me |
|                                        |               | **  | et*** |
|                                        |               | Exc |       |
|                                        |               | eed |       |
|                                        |               | s** |       |
+----------------------------------------+---------------+-----+-------+
|                                        |               |     |       |
+----------------------------------------+---------------+-----+-------+
| **2**.                                 |               | **M | ***Do |
|                                        |               | eet | es*** |
|                                        |               | s** |       |
|                                        |               |     | ***N  |
|                                        |               | **o | ot*** |
|                                        |               | r** |       |
|                                        |               |     | ***Me |
|                                        |               | **  | et*** |
|                                        |               | Exc |       |
|                                        |               | eed |       |
|                                        |               | s** |       |
+----------------------------------------+---------------+-----+-------+
|                                        |               |     |       |
+----------------------------------------+---------------+-----+-------+
| **3**.                                 |               | **M | ***Do |
|                                        |               | eet | es*** |
|                                        |               | s** |       |
|                                        |               |     | ***N  |
|                                        |               | **o | ot*** |
|                                        |               | r** |       |
|                                        |               |     | ***Me |
|                                        |               | **  | et*** |
|                                        |               | Exc |       |
|                                        |               | eed |       |
|                                        |               | s** |       |
+----------------------------------------+---------------+-----+-------+
|                                        |               |     |       |
+----------------------------------------+---------------+-----+-------+
| **4**.                                 |               | **M | ***Do |
|                                        |               | eet | es*** |
|                                        |               | s** |       |
|                                        |               |     | ***N  |
|                                        |               | **o | ot*** |
|                                        |               | r** |       |
|                                        |               |     | ***Me |
|                                        |               | **  | et*** |
|                                        |               | Exc |       |
|                                        |               | eed |       |
|                                        |               | s** |       |
+----------------------------------------+---------------+-----+-------+
|                                        |               |     |       |
+----------------------------------------+---------------+-----+-------+
| **5**.                                 |               | **M | ***Do |
|                                        |               | eet | es*** |
|                                        |               | s** |       |
|                                        |               |     | ***N  |
|                                        |               | **o | ot*** |
|                                        |               | r** |       |
|                                        |               |     | ***Me |
|                                        |               | **  | et*** |
|                                        |               | Exc |       |
|                                        |               | eed |       |
|                                        |               | s** |       |
+----------------------------------------+---------------+-----+-------+
|                                        |               |     |       |
+----------------------------------------+---------------+-----+-------+

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]       |             |                   |        |     |     |
| {.underline} |             |                   |        |     |     |
| be provided  |             |                   |        |     |     |
| for each     |             |                   |        |     |     |
| review. A    |             |                   |        |     |     |
| summary of   |             |                   |        |     |     |
| comments is  |             |                   |        |     |     |
| optional     |             |                   |        |     |     |
| unless       |             |                   |        |     |     |
| expectations |             |                   |        |     |     |
| are not      |             |                   |        |     |     |
| being        |             |                   |        |     |     |
| met.***      |             |                   |        |     |     |
+--------------+-------------+-------------------+--------+-----+-----+
| Employee     | Date:       | Rating Official   | Co     | Yes | No  |
|              |             |                   | mments |     |     |
| Initials:    |             | Initials:         | Att    |     |     |
|              |             |                   | ached: |     |     |
+--------------+-------------+-------------------+--------+-----+-----+
| Employee     | Date:       | Rating Official   | Co     | Yes | No  |
|              |             |                   | mments |     |     |
| Initials:    |             | Initials:         | Att    |     |     |
|              |             |                   | ached: |     |     |
+--------------+-------------+-------------------+--------+-----+-----+
| Employee     | Date:       | Rating Official   | Co     | Yes | No  |
|              |             |                   | mments |     |     |
| Initials:    |             | Initials:         | Att    |     |     |
|              |             |                   | ached: |     |     |
+--------------+-------------+-------------------+--------+-----+-----+
| Employee     | Date:       | Rating Official   | Co     | Yes | No  |
|              |             |                   | mments |     |     |
| Initials:    |             | Initials:         | Att    |     |     |
|              |             |                   | ached: |     |     |
+--------------+-------------+-------------------+--------+-----+-----+

+--------------------------------------------------+----------+--------+
| **PART III. SUMMARY LEVEL**                      |          |        |
+==================================================+==========+========+
| NOTE: If any ***one or more*** of the Critical   |          |        |
| Elements in Part I above is marked "**Does Not   |          |        |
| Meet**" Expectations, the below Summary of       |          |        |
| Expectations must also be marked **"Does Not     |          |        |
| Meet."**                                         |          |        |
|                                                  |          |        |
| > Also, a written explanation must be            |          |        |
| > attached.\*                                    |          |        |
+--------------------------------------------------+----------+--------+
| **Summary**                                      | *        | **     |
|                                                  | *MEETS** | DOES** |
|                                                  |          |        |
|                                                  | **OR**   | *      |
|                                                  |          | *NOT** |
|                                                  | **E      |        |
|                                                  | XCEEDS** | **MEET |
|                                                  |          | \***   |
+--------------------------------------------------+----------+--------+
| ***Mark one of the following \-\--\>***          |          |        |
+--------------------------------------------------+----------+--------+
|                                                  |          |        |
+--------------------------------------------------+----------+--------+
| ***Check under "Yes" column if:***               | **YES**  |        |
+--------------------------------------------------+----------+--------+
| **1. Written comments or explanations are        |          |        |
| attached.\***                                    |          |        |
+--------------------------------------------------+----------+--------+
| **2. A Quality Step Increase is recommended**    |          |        |
|                                                  |          |        |
| **(narrative justification attached)**           |          |        |
+--------------------------------------------------+----------+--------+

+--------------------------------------------------+--------------------+
| **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.)***                                        |                    |
+--------------------------------------------------+--------------------+
| **Rating Official Signature:**                   | Date:              |
+--------------------------------------------------+--------------------+
| **Reviewing Official Signature:**                | Date:              |
|                                                  |                    |
| **(If Applicable)**                              |                    |
+--------------------------------------------------+--------------------+
| **Employee Signature:**                          | Date:              |
+--------------------------------------------------+--------------------+

NOAA 2-Level Performance Form, 11/97 See NAO 202-430 for Instructions

Appendix B

+------------------------------------------------------------+---------+
| **PERFORMANCE INDICATORS**                                 |         |
+============================================================+=========+
| ***For each Performance Indicator listed below, circle the | **Appli |
| number of each Critical Element (from Part I) that is      | cable** |
| applicable, in the right column:***                        |         |
|                                                            | **Cri   |
|                                                            | tical** |
|                                                            |         |
|                                                            | **Ele   |
|                                                            | ments** |
+------------------------------------------------------------+---------+
| **I. QUALITY**                                             |         |
+------------------------------------------------------------+---------+
| **A. Knowledge of Field or Profession:**                   | **All 1 |
|                                                            | 2 3 4   |
| Maintains and demonstrates technical competence and/or     | 5**     |
| experience in areas of assigned responsibility.            |         |
+------------------------------------------------------------+---------+
| **B. Accuracy and Thoroughness of Work:**                  | **All 1 |
|                                                            | 2 3 4   |
| Plans, organizes, and executes work logically. Anticipates | 5**     |
| and analyzes problems clearly and determines appropriate   |         |
| solutions. Work is correct and complete.                   |         |
+------------------------------------------------------------+---------+
| **C. Soundness of Judgment and Decisions:**                | **All 1 |
|                                                            | 2 3 4   |
| Documents assignments carefully. Weighs alternative        | 5**     |
| courses of action, considering long- and short-term        |         |
| implications. Makes and executes timely decisions.         |         |
+------------------------------------------------------------+---------+
| **D. Effectiveness of Written Decisions:**                 | **All 1 |
|                                                            | 2 3 4   |
| Presentation meets objectives, is persuasive, tactful, and | 5**     |
| appropriate to audience. Demonstrates attention, courtesy  |         |
| and respect for other points of view.                      |         |
+------------------------------------------------------------+---------+
| **E. Timeliness in Meeting Deadlines**. **:** Completes    | **All 1 |
| work in accordance with established deadlines              | 2 3 4   |
|                                                            | 5**     |
+------------------------------------------------------------+---------+
| **F. Use of Information Technology:**                      | **All 1 |
|                                                            | 2 3 4   |
| Work effectively uses IT resources and follows applicable  | 5**     |
| IT policies and procedures including both security and     |         |
| appropriate use policies.                                  |         |
+------------------------------------------------------------+---------+
| **G. Other (Specify):**                                    | **All 1 |
|                                                            | 2 3 4   |
|                                                            | 5**     |
+------------------------------------------------------------+---------+

  -----------------------------------------------------------------------
  **II. TEAMWORK**                                             
  ------------------------------------------------------------ ----------
  **A. Participation:** Willingly participates in group        **All 1 2
  activities, performing in a thorough and complete fashion.   3 4 5**
  Communicates regularly with team members. Seeks team         
  consensus.                                                   

  **B. Cooperation:** Supports team initiatives. Demonstrates  **All 1 2
  respect for team members. Seeks team consensus.              3 4 5**

  **C. Leadership:** Provides encouragement, guidance, and     **All 1 2
  direction to team members as needed. Adjusts leadership      3 4 5**
  style to fit situation.                                      

  **D. Safety:** Maintains a safe work environment, including  **All 1 2
  keeping the work area free of known hazards. Complies with   3 4 5**
  all occupational safety rules and regulations and encourages 
  safe behavior in fellow workers.                             

  **D. Other (Specify):**                                      **All 1 2
                                                               3 4 5**
  -----------------------------------------------------------------------

+-----------------------------------------------------------+----------+
| **III. CUSTOMER SERVICE**                                 |          |
+===========================================================+==========+
| **A. Quality of Service:** Delivers high quality products | **All 1  |
| and services to both external and internal customers      | 2 3 4    |
| Initiates and responds to suggestions for improving       | 5**      |
| service.                                                  |          |
+-----------------------------------------------------------+----------+
| **B. Timeliness of Service:**                             | **All 1  |
|                                                           | 2 3 4    |
| > Delivers quality products and services in accordance    | 5**      |
| > with time schedules agreed upon with customer.          |          |
+-----------------------------------------------------------+----------+
| **C. Courtesy:** Treats external and internal customers   | **All 1  |
| with courtesy and respect. Customer satisfaction is high  | 2 3 4    |
| priority.                                                 | 5**      |
+-----------------------------------------------------------+----------+
| **D. Other (Specify):**                                   | **All 1  |
|                                                           | 2 3 4    |
|                                                           | 5**      |
+-----------------------------------------------------------+----------+

NOAA 2-Level Performance Form, 02/03 See NAO 202-430 for Instructions

> Attachment
>
> [***(Due December 1 of each year***)]{.underline}
>
> TO: Director for Human Resources Management
>
> FROM: Assistant Administrator
>
> Program Director
>
> Staff Office Director
>
> SUBJECT: Annual Certification of Compliance with
>
> Performance Management Responsibilities
>
> I certify that all employees within the Line/Staff/Program Office have
> received performance appraisals for the rating cycle ending September
> 30.
>
> **Not Rated**. The following employees were not rated:
>
> [Organization Code]{.underline} [Employee Names]{.underline} [Reason
> for No Appraisal]{.underline}
>
> **Extensions**. The following employees did not complete the minimum
> 120 days work under a performance plan to be rated as of September
> 30th. They will complete 120 days under their current performance
> standards and will be rated on the date shown:
>
> [Organization Code]{.underline} [Employee Names]{.underline}
> [Scheduled Date of 120 Day Rating]{.underline}
>
> **Unratables**. The following employees cannot be rated for the reason
> shown (such as: time in a non-pay status; long-term training; service
> on a Federally sponsored program \[such as an Intergovernmental
> Personnel Act or President's Executive Exchange assignment\] for which
> appraisal information is not available; service on detail to another
> Federal agency for which performance appraisal information is not
> available; or approved absence):
>
> [Organization Code]{.underline} [Employee Names]{.underline} [Reason
> for No Rating]{.underline}
>
> **New Plan Certification.** I also certify that all employees within
> [the Line/Staff/Program Office]{.underline} who are in covered
> positions and are not exceptions as noted above, have received
> performance plans for the new appraisal cycle. This includes employees
> on time-limited appointments which are projected to extend beyond the
> first 119 days of the rating cycle.