+-------+--------------------------------------------------------------+
| ![]   | # **U.S. Department of Energy Senior Exec                    |
| (medi | utive Service Performance Appraisal** DOE F 331.2 (10-01-01) |
| a/ima |                                                              |
| ge1.w |                                                              |
| mf){w |                                                              |
| idth= |                                                              |
| "0.78 |                                                              |
| 75in" |                                                              |
| heigh |                                                              |
| t="0. |                                                              |
| 86944 |                                                              |
| 44444 |                                                              |
| 44444 |                                                              |
| 5in"} |                                                              |
+-------+--------------------------------------------------------------+

  --------------- ------- ------- ---------- ----- ------- ---------- ---------------------------
  Name:                                                    Title:          

  Organization:                                            Duty            
                                                           Station:   

  Performance             From:              To:                      
  Rating Period:                                                      
  --------------- ------- ------- ---------- ----- ------- ---------- ---------------------------

Performance Agreement Certification: *This is to verify that we have
met, discussed, and understand expectations for the established
performance appraisal period.*

  ---------------------- -- ---------- -- ---------------------- -- ------ -----------
                                                                                

  Rating Official's         Date          Executive's Signature     Date   
  Signature                                                                

                                                                           

  Rating Official's Name                  Executive's Name                 
  *(typed or printed)*                    *(typed or printed)*             
  ---------------------- -- ---------- -- ---------------------- -- ------ -----------

Privacy Act Statement

*This form is subject to the provisions of the Privacy Act. Copies will
be retained by the Executive and Technical Resources Division, Office of
Human Resources Management, and provided for review and retention as
required to appropriate management officials having a need to know, such
as the Performance Review Board or the Executive Resources Board.*

*This Senior Executive Service (SES) Performance Appraisal gathers and
records information on how Departmental executives are performing their
duties and responsibilities. The information will be used to determine
eligibility for retention in, or removal from, the SES, entitlement to
awards, and compensation benefits. The authority to collect this
information is contained in Title IV of the Civil Service Reform Act of
1978. The information will not be disclosed outside the Department
without prior consent except as required or permitted by law.*

# Element I • Key Programmatic Accomplishment

+------+----+---------------------+-----------------+-----------------+
| *    |    |                     |                 |                 |
| *Ins |    |                     |                 |                 |
| truc |    |                     |                 |                 |
| tion |    |                     |                 |                 |
| s:** |    |                     |                 |                 |
| At   |    |                     |                 |                 |
| the  |    |                     |                 |                 |
| b    |    |                     |                 |                 |
| egin |    |                     |                 |                 |
| ning |    |                     |                 |                 |
| of   |    |                     |                 |                 |
| the  |    |                     |                 |                 |
| per  |    |                     |                 |                 |
| form |    |                     |                 |                 |
| ance |    |                     |                 |                 |
| cy   |    |                     |                 |                 |
| cle, |    |                     |                 |                 |
| iden |    |                     |                 |                 |
| tify |    |                     |                 |                 |
| your |    |                     |                 |                 |
| key  |    |                     |                 |                 |
| per  |    |                     |                 |                 |
| form |    |                     |                 |                 |
| ance |    |                     |                 |                 |
| pri  |    |                     |                 |                 |
| orit |    |                     |                 |                 |
| ies. |    |                     |                 |                 |
| Be   |    |                     |                 |                 |
| as   |    |                     |                 |                 |
| spec |    |                     |                 |                 |
| ific |    |                     |                 |                 |
| and  |    |                     |                 |                 |
| me   |    |                     |                 |                 |
| asur |    |                     |                 |                 |
| able |    |                     |                 |                 |
| as   |    |                     |                 |                 |
| p    |    |                     |                 |                 |
| ossi |    |                     |                 |                 |
| ble, |    |                     |                 |                 |
| and  |    |                     |                 |                 |
| indi |    |                     |                 |                 |
| cate |    |                     |                 |                 |
| co   |    |                     |                 |                 |
| mple |    |                     |                 |                 |
| tion |    |                     |                 |                 |
| da   |    |                     |                 |                 |
| tes. |    |                     |                 |                 |
| Th   |    |                     |                 |                 |
| roug |    |                     |                 |                 |
| hout |    |                     |                 |                 |
| the  |    |                     |                 |                 |
| per  |    |                     |                 |                 |
| form |    |                     |                 |                 |
| ance |    |                     |                 |                 |
| cy   |    |                     |                 |                 |
| cle, |    |                     |                 |                 |
| t    |    |                     |                 |                 |
| rack |    |                     |                 |                 |
| your |    |                     |                 |                 |
| prog |    |                     |                 |                 |
| ress |    |                     |                 |                 |
| and  |    |                     |                 |                 |
| acc  |    |                     |                 |                 |
| ompl |    |                     |                 |                 |
| ishm |    |                     |                 |                 |
| ents |    |                     |                 |                 |
| and  |    |                     |                 |                 |
| mo   |    |                     |                 |                 |
| dify |    |                     |                 |                 |
| your |    |                     |                 |                 |
| per  |    |                     |                 |                 |
| form |    |                     |                 |                 |
| ance |    |                     |                 |                 |
| pr   |    |                     |                 |                 |
| iori |    |                     |                 |                 |
| ties |    |                     |                 |                 |
| as   |    |                     |                 |                 |
| ne   |    |                     |                 |                 |
| cess |    |                     |                 |                 |
| ary. |    |                     |                 |                 |
|      |    |                     |                 |                 |
| Keep |    |                     |                 |                 |
| in   |    |                     |                 |                 |
| mind |    |                     |                 |                 |
| that |    |                     |                 |                 |
| all  |    |                     |                 |                 |
| key  |    |                     |                 |                 |
| ob   |    |                     |                 |                 |
| ject |    |                     |                 |                 |
| ives |    |                     |                 |                 |
| sh   |    |                     |                 |                 |
| ould |    |                     |                 |                 |
| be   |    |                     |                 |                 |
| SM   |    |                     |                 |                 |
| ART: |    |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| *    | Yo |                     |                 |                 |
| *S** | ur |                     |                 |                 |
| peci | go |                     |                 |                 |
| fic: | al |                     |                 |                 |
|      | sh |                     |                 |                 |
|      | ou |                     |                 |                 |
|      | ld |                     |                 |                 |
|      | be |                     |                 |                 |
|      | f  |                     |                 |                 |
|      | oc |                     |                 |                 |
|      | us |                     |                 |                 |
|      | ed |                     |                 |                 |
|      | a  |                     |                 |                 |
|      | nd |                     |                 |                 |
|      | i  |                     |                 |                 |
|      | nc |                     |                 |                 |
|      | lu |                     |                 |                 |
|      | de |                     |                 |                 |
|      | en |                     |                 |                 |
|      | ou |                     |                 |                 |
|      | gh |                     |                 |                 |
|      | de |                     |                 |                 |
|      | ta |                     |                 |                 |
|      | il |                     |                 |                 |
|      | so |                     |                 |                 |
|      | t  |                     |                 |                 |
|      | he |                     |                 |                 |
|      | re |                     |                 |                 |
|      | is |                     |                 |                 |
|      | no |                     |                 |                 |
|      | c  |                     |                 |                 |
|      | on |                     |                 |                 |
|      | fu |                     |                 |                 |
|      | si |                     |                 |                 |
|      | on |                     |                 |                 |
|      | ar |                     |                 |                 |
|      | ou |                     |                 |                 |
|      | nd |                     |                 |                 |
|      | wh |                     |                 |                 |
|      | at |                     |                 |                 |
|      | e  |                     |                 |                 |
|      | xa |                     |                 |                 |
|      | ct |                     |                 |                 |
|      | ly |                     |                 |                 |
|      | y  |                     |                 |                 |
|      | ou |                     |                 |                 |
|      | a  |                     |                 |                 |
|      | re |                     |                 |                 |
|      | tr |                     |                 |                 |
|      | yi |                     |                 |                 |
|      | ng |                     |                 |                 |
|      | to |                     |                 |                 |
|      | a  |                     |                 |                 |
|      | cc |                     |                 |                 |
|      | om |                     |                 |                 |
|      | pl |                     |                 |                 |
|      | is |                     |                 |                 |
|      | h. |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| **M  | Yo |                     |                 |                 |
| **ea | ur |                     |                 |                 |
| sura | go |                     |                 |                 |
| ble: | al |                     |                 |                 |
|      | sh |                     |                 |                 |
|      | ou |                     |                 |                 |
|      | ld |                     |                 |                 |
|      | be |                     |                 |                 |
|      | su |                     |                 |                 |
|      | ch |                     |                 |                 |
|      | th |                     |                 |                 |
|      | at |                     |                 |                 |
|      | wh |                     |                 |                 |
|      | en |                     |                 |                 |
|      | y  |                     |                 |                 |
|      | ou |                     |                 |                 |
|      | a  |                     |                 |                 |
|      | re |                     |                 |                 |
|      | th |                     |                 |                 |
|      | ro |                     |                 |                 |
|      | ug |                     |                 |                 |
|      | h, |                     |                 |                 |
|      | y  |                     |                 |                 |
|      | ou |                     |                 |                 |
|      | ha |                     |                 |                 |
|      | ve |                     |                 |                 |
|      | ta |                     |                 |                 |
|      | ng |                     |                 |                 |
|      | ib |                     |                 |                 |
|      | le |                     |                 |                 |
|      | ev |                     |                 |                 |
|      | id |                     |                 |                 |
|      | en |                     |                 |                 |
|      | ce |                     |                 |                 |
|      | of |                     |                 |                 |
|      | yo |                     |                 |                 |
|      | ur |                     |                 |                 |
|      | a  |                     |                 |                 |
|      | cc |                     |                 |                 |
|      | om |                     |                 |                 |
|      | pl |                     |                 |                 |
|      | is |                     |                 |                 |
|      | hm |                     |                 |                 |
|      | en |                     |                 |                 |
|      | t. |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| **A  | Yo |                     |                 |                 |
| **cc | ur |                     |                 |                 |
| epta | go |                     |                 |                 |
| ble: | al |                     |                 |                 |
|      | sh |                     |                 |                 |
|      | ou |                     |                 |                 |
|      | ld |                     |                 |                 |
|      | be |                     |                 |                 |
|      | s  |                     |                 |                 |
|      | et |                     |                 |                 |
|      | by |                     |                 |                 |
|      | y  |                     |                 |                 |
|      | ou |                     |                 |                 |
|      | a  |                     |                 |                 |
|      | nd |                     |                 |                 |
|      | ag |                     |                 |                 |
|      | re |                     |                 |                 |
|      | ed |                     |                 |                 |
|      | up |                     |                 |                 |
|      | on |                     |                 |                 |
|      | by |                     |                 |                 |
|      | yo |                     |                 |                 |
|      | ur |                     |                 |                 |
|      | ma |                     |                 |                 |
|      | na |                     |                 |                 |
|      | ge |                     |                 |                 |
|      | r. |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| **   | S  |                     |                 |                 |
| R**e | et |                     |                 |                 |
| alis | g  |                     |                 |                 |
| tic: | oa |                     |                 |                 |
|      | ls |                     |                 |                 |
|      | th |                     |                 |                 |
|      | at |                     |                 |                 |
|      | a  |                     |                 |                 |
|      | re |                     |                 |                 |
|      | a  |                     |                 |                 |
|      | ch |                     |                 |                 |
|      | ie |                     |                 |                 |
|      | va |                     |                 |                 |
|      | bl |                     |                 |                 |
|      | e. |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| **T  | In |                     |                 |                 |
| **im | di |                     |                 |                 |
| ely: | ca |                     |                 |                 |
|      | te |                     |                 |                 |
|      | wh |                     |                 |                 |
|      | en |                     |                 |                 |
|      | y  |                     |                 |                 |
|      | ou |                     |                 |                 |
|      | pl |                     |                 |                 |
|      | an |                     |                 |                 |
|      | to |                     |                 |                 |
|      | a  |                     |                 |                 |
|      | ch |                     |                 |                 |
|      | ie |                     |                 |                 |
|      | ve |                     |                 |                 |
|      | yo |                     |                 |                 |
|      | ur |                     |                 |                 |
|      | g  |                     |                 |                 |
|      | oa |                     |                 |                 |
|      | l. |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| Key  |    | Effectiveness And   | Execution       | Results         |
| Ob   |    | Efficiency          | Targets\        | Achieved\       |
| ject |    | Measures\           | *(i.e.,         | *(i.e., actual  |
| ives |    | *(i.e., specific    | timeframes,     | outcomes,       |
|      |    | expected outcomes;  | completion      | impacts,        |
|      |    | performance goals;  | dates,          | program         |
|      |    | and program         | implementation  | improvements,   |
|      |    | improvements, such  | strategies,     | etc.)*          |
|      |    | as cost reductions, | etc.)*          |                 |
|      |    | improved            |                 |                 |
|      |    | timeliness, output  |                 |                 |
|      |    | measures, etc.)*    |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| 1\.  |    |                     |                 |                 |
|      |    |                     |                 |                 |
|      |    |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| 2\.  |    |                     |                 |                 |
|      |    |                     |                 |                 |
|      |    |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| 3\.  |    |                     |                 |                 |
|      |    |                     |                 |                 |
|      |    |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| 4\.  |    |                     |                 |                 |
|      |    |                     |                 |                 |
|      |    |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+
| 5\.  |    |                     |                 |                 |
|      |    |                     |                 |                 |
|      |    |                     |                 |                 |
+------+----+---------------------+-----------------+-----------------+

# Progress Review

  ------- ------------------- --------------- ---------------- --------- ---------------
  Name:                       Organization:                    Rating         
                                                               Period:   

  ------- ------------------- --------------- ---------------- --------- ---------------

**Instructions:** Discuss and provide comments on progress achieved
and/or performance improvement needed in the below areas. Consider
ongoing priorities as well as projects completed during the performance
period to date. Focus on the priorities, projects, and accomplishments
you have been tracking and those that you have discussed with your
manager throughout this rating period.

  ----------------------------------- -----------------------------------
  Key Programmatic Objectives         Comments On Progress

                                           

                                           

                                           

                                           

                                           

                                           
  ----------------------------------- -----------------------------------

  ---------------------- ------------------------------------------------
  Key Leadership         Comments On Progress
  Attributes             

  1\) Demonstrates            
  Functional Competence  

  2\) Exhibits                
  Analytical Ability and 
  Solves Problems        

  3\) Builds Diversity        

  4\) Serves Customers        
  and Builds             
  Partnerships           

  5\) Communicates            
  Effectively            

  6\) Innovates               

  7\) Demonstrates            
  Personal Leadership    

  8\) Creates Effective       
  Operating Plans        

  9\) Builds Capability       

  10\) Coaches,               
  Motivates, Develops    
  and Mentors            
  ---------------------- ------------------------------------------------

  ------------- ------------------ -- ---------- -- ---------------------- -- ------ -----------
  **Mark (X)                                                                         
  the                                                                                
  appropriate                                                                        
  box.**                                                                             

  ** **         Performance, if                                                      
                continued, will                                                      
                result in at least                                                   
                a "Meets                                                             
                Expectations"                                                        
                rating                                                               
                recommendation.                                                      
                Comments                                                             
                concerning                                                           
                performance,                                                         
                including                                                            
                performance                                                          
                improvement needs,                                                   
                have been                                                            
                discussed with the                                                   
                executive.                                                           

  ** **         Performance, if                                                      
                continued, will                                                      
                result in less                                                       
                than a "Meets                                                        
                Expectations"                                                        
                rating                                                               
                recommendation.                                                      
                Specific                                                             
                performance                                                          
                deficiencies are                                                     
                documented in the                                                    
                performance plan                                                     
                and, as                                                              
                applicable,                                                          
                attached                                                             
                documentation.                                                       
                Deficiencies have                                                    
                been discussed                                                       
                with the executive                                                   
                and timely                                                           
                assistance will be                                                   
                conducted at                                                         
                regular internals                                                    
                throughout the                                                       
                remaining                                                            
                appraisal period.                                                    

  ** **         Performance                                                          
                expectations need                                                    
                updating.                                                            
                Necessary changes                                                    
                have been                                                            
                discussed with the                                                   
                executive.                                                           

  ** **         No change in                                                         
                performance                                                          
                expectations since                                                   
                establishment of                                                     
                performance plan.                                                    

                                                                                          

  Rating                              Date          Executive's Signature     Date   
  Official's                                                                         
  Signature                                                                          

                                                                                     

  Rating                                            Executive's Name                 
  Official's                                        *(typed or printed)*             
  Name *(typed                                                                       
  or printed)*                                                                       
  ------------- ------------------ -- ---------- -- ---------------------- -- ------ -----------

# Annual Summary Rating

## Element I -- Key Programmatic Accomplishment

  ------- ------------------- --------------- ---------------- --------- ---------------
  Name:                       Organization:                    Rating         
                                                               Period:   

  ------- ------------------- --------------- ---------------- --------- ---------------

  ------------------- ----------- --------------- ----- -- ------ ------- ---------- --------------------------------
  **Instructions:**                                                                  
  Refer to current                                                                   
  SES appraisal                                                                      
  guidance for                                                                       
  completion.                                                                        

  Exceeds                         Clearly exceeds                                    
  Expectations (O):               performance                                        
                                  expectations. A                                    
                                  model executive                                    
                                  who sets an                                        
                                  example for                                        
                                  others, while                                      
                                  consistently                                       
                                  making                                             
                                  outstanding                                        
                                  contributions                                      
                                  to the                                             
                                  Department.                                        
                                  This rating                                        
                                  level is                                           
                                  reserved for                                       
                                  top performing                                     
                                  executives.                                        

  Meets Expectations              Consistently                                       
  (ME):                           meets all                                          
                                  performance                                        
                                  requirements. A                                    
                                  solid                                              
                                  performer.                                         

  Needs Improvement               Occasionally                                       
  (NI):                           does not meet                                      
                                  performance                                        
                                  requirements.                                      

  Fails to Meet (U):              Regularly does                                     
                                  not follow                                         
                                  through with                                       
                                  meeting                                            
                                  performance                                        
                                  requirements.                                      
                                  Job performance                                    
                                  is below an                                        
                                  acceptable                                         
                                  standard and                                       
                                  corrective                                         
                                  action is                                          
                                  required.                                          

  Key Programmatic                                                        Ratings    Comments
  Objectives                                                                         

  1\.                                                                                     

  2\.                                                                                     

  3\.                                                                                     

  4\.                                                                                     

  5\.                                                                                     

  ***Overall Rating                                                                  
  for Element I:***                                                                  

                                                                                     

  Rating Official's                                        Date                      
  Signature                                                                          

                                                                                     

  Rating Official's                                                                  
  Name *(typed or                                                                    
  printed)*                                                                          
  ------------------- ----------- --------------- ----- -- ------ ------- ---------- --------------------------------

## Element II -- Key Leadership Attributes

  --------------------- --- -- --------- -- -------------------- ------------- -- ------- ------- ------- ------- -------
  **Instructions:**                                                                                               
  Rate the employee.                                                                                              
  Refer to DOE F 331.2B                                                                                           
  for rating                                                                                                      
  definitions. The                                                                                                
  Department of Energy                                                                                            
  believes that                                                                                                   
  practicing the Key                                                                                              
  Leadership Attributes                                                                                           
  will enable                                                                                                     
  executives to be                                                                                                
  successful.                                                                                                     
  Therefore, as part of                                                                                           
  the performance                                                                                                 
  review, proficiency                                                                                             
  on DOE's Key                                                                                                    
  Leadership Attributes                                                                                           
  will be rated. All                                                                                              
  DOE senior executive                                                                                            
  performance will be                                                                                             
  evaluated on the 10                                                                                             
  attributes.                                                                                                     

  **TN:** *Too New to                                                                                             
  Rate***; L:** *Low                                                                                              
  Performance***; M:**                                                                                            
  *Mixed                                                                                                          
  Performance***; S:**                                                                                            
  *Solid                                                                                                          
  Performance***; E:**                                                                                            
  *Excellent                                                                                                      
  Performance***; O:**                                                                                            
  *Outstanding                                                                                                    
  Performance*                                                                                                    

  Name of Executive:                                             Supervisor                                       
                                                                 Rating\                                          
                                                                 Mark (X) the                                     
                                                                 appropriate                                      
                                                                 box.                                             

                                                                 TN               L       M       S       E       O

  1\. Demonstrates                                               ** **            ** **   ** **   ** **   ** **   ** **
  Functional Competence                                                                                           
  -- Maximizes personal                                                                                           
  productivity and                                                                                                
  effectiveness by                                                                                                
  ensuring that                                                                                                   
  functional and                                                                                                  
  professional skills                                                                                             
  are continually                                                                                                 
  upgraded and                                                                                                    
  utilized.                                                                                                       

  2\. Exhibits                                                   ** **            ** **   ** **   ** **   ** **   ** **
  Analytical Ability                                                                                              
  and Solves Problems                                                                                             
  -- Critically and                                                                                               
  thoroughly evaluates                                                                                            
  issues despite                                                                                                  
  incomplete or                                                                                                   
  ambiguous                                                                                                       
  information; takes                                                                                              
  appropriate action to                                                                                           
  design pragmatic                                                                                                
  solutions.                                                                                                      

  3\. Builds Diversity                                           ** **            ** **   ** **   ** **   ** **   ** **
  -- Promotes,                                                                                                    
  develops, applies and                                                                                           
  evaluates approaches                                                                                            
  to achieving and                                                                                                
  maintaining workforce                                                                                           
  diversity and                                                                                                   
  positive workforce                                                                                              
  relations within                                                                                                
  his/her organization.                                                                                           

  4\. Serves Customers                                           ** **            ** **   ** **   ** **   ** **   ** **
  and Builds                                                                                                      
  Partnerships --                                                                                                 
  Treats internal and                                                                                             
  external customers                                                                                              
  and partners with                                                                                               
  care, consideration,                                                                                            
  and respect; seeks to                                                                                           
  understand their                                                                                                
  needs and exceeds                                                                                               
  their expectations.                                                                                             

  5\. Communicates                                               ** **            ** **   ** **   ** **   ** **   ** **
  Effectively --                                                                                                  
  Creates understanding                                                                                           
  and commitment to                                                                                               
  action by presenting                                                                                            
  ideas and facts --                                                                                              
  both orally and in                                                                                              
  writing -- in a                                                                                                 
  clear, concise                                                                                                  
  manner; listens to                                                                                              
  others and checks for                                                                                           
  understanding; uses                                                                                             
  different forms of                                                                                              
  communication                                                                                                   
  appropriately.                                                                                                  

  6\. Innovates --                                               ** **            ** **   ** **   ** **   ** **   ** **
  Improves results by                                                                                             
  actively generating,                                                                                            
  encouraging, and                                                                                                
  supporting new ideas                                                                                            
  or approaches.                                                                                                  

  7\. Demonstrates                                               ** **            ** **   ** **   ** **   ** **   ** **
  Personal Leadership                                                                                             
  -- Demonstrates high                                                                                            
  levels of                                                                                                       
  productivity and                                                                                                
  quality;                                                                                                        
  accountability;                                                                                                 
  consistently looks                                                                                              
  for new ways to apply                                                                                           
  skills and get work                                                                                             
  done; treats                                                                                                    
  co-workers and                                                                                                  
  customers with                                                                                                  
  respect and dignity.                                                                                            

  8\. Creates Effective                                          ** **            ** **   ** **   ** **   ** **   ** **
  Operating Plans --                                                                                              
  Develops and                                                                                                    
  implements an                                                                                                   
  operating plan with                                                                                             
  clear objectives and                                                                                            
  performance metrics                                                                                             
  that support the                                                                                                
  organization's                                                                                                  
  direction/strategy.                                                                                             
  Holds staff                                                                                                     
  accountable for                                                                                                 
  performance results.                                                                                            

  9\. Builds Capability                                          ** **            ** **   ** **   ** **   ** **   ** **
  -- Recognizes the                                                                                               
  specific competencies                                                                                           
  or capabilities                                                                                                 
  needed and hires,                                                                                               
  develops, and retains                                                                                           
  talent necessary to                                                                                             
  execute the vision                                                                                              
  and mission of the                                                                                              
  organization;                                                                                                   
  promotes team                                                                                                   
  building.                                                                                                       

  10\. Coaches,                                                  ** **            ** **   ** **   ** **   ** **   ** **
  Motivates, Develops                                                                                             
  and Mentors --                                                                                                  
  Conveys and instills                                                                                            
  in others a strong                                                                                              
  sense of energy,                                                                                                
  excitement,                                                                                                     
  ownership, and                                                                                                  
  personal investment                                                                                             
  in their work; gives                                                                                            
  people the                                                                                                      
  opportunity and                                                                                                 
  latitude to exercise                                                                                            
  authority and run                                                                                               
  their areas of                                                                                                  
  responsibility; and                                                                                             
  actively coaches and                                                                                            
  mentors employees for                                                                                           
  assuming greater                                                                                                
  responsibilities and                                                                                            
  to develop their full                                                                                           
  potential.                                                                                                      

  ***Overall Rating for                                                                                           
  Element II:***                                                                                                  

                                                                                                                  

  Rating Official's            Date         Rating Official's                                                     
  Signature                                 Name *(typed or                                                       
                                            printed)*                                                             
  --------------------- --- -- --------- -- -------------------- ------------- -- ------- ------- ------- ------- -------

# Annual Summary Rating and Signatory Approvals

  ------- ------------------- --------------- ---------------- --------- ---------------
  Name:                       Organization:                    Rating         
                                                               Period:   

  ------- ------------------- --------------- ---------------- --------- ---------------

### Step 1. Initial Summary Rating

  ----------------- ------------- -------- ------- ----------- ---------------- -- ---------- ----------------- ------------- ------- ------- -------
  A.                Rating                                                                                      Summary                       
                    Official                                                                                    Rating\                       
                                                                                                                Mark (X) the                  
                                                                                                                appropriate                   
                                                                                                                box.                          

                                                                                                                O             ME      NI      U

  1\. Key                                                                                                       ** **         ** **   ** **   ** **
  Programmatic                                                                                                                                
  Accomplishments                                                                                                                             

  2\. Key                                                                                                       ** **         ** **   ** **   ** **
  Leadership                                                                                                                                  
  Attributes                                                                                                                                  

  Initial Summary                                                                                               ** **         ** **   ** **   ** **
  Rating (*The                                                                                                                                
  recommended                                                                                                                                 
  rating is based                                                                                                                             
  on the lowest                                                                                                                               
  common                                                                                                                                      
  denominator of                                                                                                                              
  the Critical                                                                                                                                
  Elements (e.g.,                                                                                                                             
  if one element is                                                                                                                           
  a "Needs                                                                                                                                    
  Improvement" and                                                                                                                            
  the other is at                                                                                                                             
  "Meets                                                                                                                                      
  Expectations"                                                                                                                               
  level, the                                                                                                                                  
  overall rating is                                                                                                                           
  "Needs                                                                                                                                      
  Improvement."*)                                                                                                                             

                                                                                                                                              

  Rating Official's                                                                Date                                                       
  Signature                                                                                                                                   

                                                                                                                                              

  Rating Official's                                                                                                                           
  Name *(typed or                                                                                                                             
  printed)*                                                                                                                                   

  B.                Higher Level                                                                                                              
                    Review --                                                                                                                 
                    Mark (X) the                                                                                                              
                    appropriate                                                                                                               
                    box.                                                                                                                      

                    ** **         Concur   ** **   Nonconcur   ...with Rating                                                                 
                                                               Official's                                                                     
                                                               recommendation                                                                 
                                                               for current                                                                    
                                                               rating cycle.                                                                  
                                                               (*Note: if                                                                     
                                                               nonconcurring,                                                                 
                                                               attach a written                                                               
                                                               justification                                                                  
                                                               explaining                                                                     
                                                               reasons*)                                                                      

                                                                                                                                              

  Higher Level                                                                     Date                                                       
  Reviewer's                                                                                                                                  
  Signature                                                                                                                                   

                                                                                                                                              

  Higher Level                                                                                                                                
  Reviewer's Name                                                                                                                             
  *(typed or                                                                                                                                  
  printed)*                                                                                                                                   
  ----------------- ------------- -------- ------- ----------- ---------------- -- ---------- ----------------- ------------- ------- ------- -------

###  Step 1. Initial Summary Rating (continued)

  ----------------- ------------------------- -- ---------- -------------------------------
  C.                Executive                               

  I have reviewed                                           
  and discussed                                             
  this appraisal                                            
  with my                                                   
  supervisor. My                                            
  signature does                                            
  not necessarily                                           
  imply that I                                              
  agree with the                                            
  appraisal                                                 
  recommendation.                                           
  (Attach comments,                                         
  as applicable.)                                           

                                                            

  Executive's                                    Date       
  Signature                                                 

                                                            

  Executive's Name                                          
  *(typed or                                                
  printed)*                                                 

  Response to lower                                         
  rating                                                    
  recommendation by                                         
  reviewing                                                 
  official: (Attach                                         
  comments as                                               
  applicable.)                                              
  ----------------- ------------------------- -- ---------- -------------------------------

### Step 2.

  ----------------- ------- -------- ------- ------------ ------- -- ---------- -------------------------------
  Performance                                                                   
  Review Board                                                                  
  (PRB) Chair: Mark                                                             
  (X) the                                                                       
  appropriate box.                                                              

                    ** **   Concur   ** **   Nonconcur                          

  Recommendation,                                                               
  if different than                                                             
  Rating Official:                                                              

                                                                                

  PRB Chair's                                                        Date       
  Signature                                                                     

                                                                                

  PRB Chair's Name                                                              
  *(typed or                                                                    
  printed)*                                                                     
  ----------------- ------- -------- ------- ------------ ------- -- ---------- -------------------------------

### Step 3.

  ---------------- ------- -------------- ------- -- -------------- ---------- ------- -- ------------- ------- -----------------
  Annual Summary                                                                                                
  Rating: Mark (X)                                                                                              
  the appropriate                                                                                               
  box.                                                                                                          

  Determination:   ** **   Exceeds        ** **      Meets                     ** **      Needs         ** **   Fails to Meet
                           Expectations              Expectations                         Improvement           

                                                                                                                

  Secretary of                                                      Date                                        
  Energy's or                                                                                                   
  Designee's                                                                                                    
  Signature                                                                                                     

                                                                                                                

  Secretary of                                                                                                  
  Energy's or                                                                                                   
  Designee's Name                                                                                               
  *(typed or                                                                                                    
  printed)*                                                                                                     
  ---------------- ------- -------------- ------- -- -------------- ---------- ------- -- ------------- ------- -----------------

# Peer Feedback (Optional): Key Leadership Attributes

  --------------------- --- -- --------- -- -------------------- ------------- ------- ------- ------- ------- -------
  **Instructions:** The                                                                                        
  DOE believes that                                                                                            
  practicing the Key                                                                                           
  Leadership Attributes                                                                                        
  will enable employees                                                                                        
  and managers to be                                                                                           
  successful.                                                                                                  
  Therefore, in support                                                                                        
  of your peer's                                                                                               
  continuous growth                                                                                            
  towards performance                                                                                          
  excellence, you are                                                                                          
  requested to provide                                                                                         
  honest feedback on                                                                                           
  his/her demonstrated                                                                                         
  leadership                                                                                                   
  capabilities. Please                                                                                         
  provide an assessment                                                                                        
  of each of the 10                                                                                            
  "Key Leadership                                                                                              
  Attributes" listed                                                                                           
  below in comparison                                                                                          
  with the prescribed                                                                                          
  rating criteria (see                                                                                         
  scale below and refer                                                                                        
  to DOE F 331.2b for                                                                                          
  rating definitions).                                                                                         
  Upon completion,                                                                                             
  please forward the                                                                                           
  form to the                                                                                                  
  designated source for                                                                                        
  the executive's                                                                                              
  supervisor's                                                                                                 
  consideration in                                                                                             
  conducting his/her                                                                                           
  annual evaluations                                                                                           
  and/or Progress                                                                                              
  Reviews.                                                                                                     

  **TN:** *Too New to                                                                                          
  Rate***; L:** *Low                                                                                           
  Performance***; M:**                                                                                         
  *Mixed                                                                                                       
  Performance***; S:**                                                                                         
  *Solid                                                                                                       
  Performance***; E:**                                                                                         
  *Excellent                                                                                                   
  Performance***; O:**                                                                                         
  *Outstanding                                                                                                 
  Performance*                                                                                                 

  Name of Executive:                                             Peer Rating\                                  
                                                                 Mark (X) the                                  
                                                                 appropriate                                   
                                                                 box.                                          

                                                                 TN            L       M       S       E       O

  1\. Demonstrates                                               ** **         ** **   ** **   ** **   ** **   ** **
  Functional Competence                                                                                        
  -- Maximizes personal                                                                                        
  productivity and                                                                                             
  effectiveness by                                                                                             
  ensuring that                                                                                                
  functional and                                                                                               
  professional skills                                                                                          
  are continually                                                                                              
  upgraded and                                                                                                 
  utilized.                                                                                                    

  2\. Exhibits                                                   ** **         ** **   ** **   ** **   ** **   ** **
  Analytical Ability                                                                                           
  and Solves Problems                                                                                          
  -- Critically and                                                                                            
  thoroughly evaluates                                                                                         
  issues despite                                                                                               
  incomplete or                                                                                                
  ambiguous                                                                                                    
  information; takes                                                                                           
  appropriate action to                                                                                        
  design pragmatic                                                                                             
  solutions.                                                                                                   

  3\. Builds Diversity                                           ** **         ** **   ** **   ** **   ** **   ** **
  -- Promotes,                                                                                                 
  develops, applies and                                                                                        
  evaluates approaches                                                                                         
  to achieving and                                                                                             
  maintaining workforce                                                                                        
  diversity and                                                                                                
  positive workforce                                                                                           
  relations within                                                                                             
  his/her organization.                                                                                        

  4\. Serves Customers                                           ** **         ** **   ** **   ** **   ** **   ** **
  and Builds                                                                                                   
  Partnerships --                                                                                              
  Treats internal and                                                                                          
  external customers                                                                                           
  and partners with                                                                                            
  care, consideration,                                                                                         
  and respect; seeks to                                                                                        
  understand their                                                                                             
  needs and exceeds                                                                                            
  their expectations.                                                                                          

  5\. Communicates                                               ** **         ** **   ** **   ** **   ** **   ** **
  Effectively --                                                                                               
  Creates understanding                                                                                        
  and commitment to                                                                                            
  action by presenting                                                                                         
  ideas and facts --                                                                                           
  both orally and in                                                                                           
  writing -- in a                                                                                              
  clear, concise                                                                                               
  manner; listens to                                                                                           
  others and checks for                                                                                        
  understanding; uses                                                                                          
  different forms of                                                                                           
  communication                                                                                                
  appropriately.                                                                                               

  6\. Innovates --                                               ** **         ** **   ** **   ** **   ** **   ** **
  Improves results by                                                                                          
  actively generating,                                                                                         
  encouraging, and                                                                                             
  supporting new ideas                                                                                         
  or approaches.                                                                                               

  7\. Demonstrates                                               ** **         ** **   ** **   ** **   ** **   ** **
  Personal Leadership                                                                                          
  -- Demonstrates high                                                                                         
  levels of                                                                                                    
  productivity and                                                                                             
  quality;                                                                                                     
  accountability;                                                                                              
  consistently looks                                                                                           
  for new ways to apply                                                                                        
  skills and get work                                                                                          
  done; treats                                                                                                 
  co-workers and                                                                                               
  customers with                                                                                               
  respect and dignity.                                                                                         

  8\. Creates Effective                                          ** **         ** **   ** **   ** **   ** **   ** **
  Operating Plans --                                                                                           
  Develops and                                                                                                 
  implements an                                                                                                
  operating plan with                                                                                          
  clear objectives and                                                                                         
  performance metrics                                                                                          
  that support the                                                                                             
  organization's                                                                                               
  direction/strategy.                                                                                          
  Holds staff                                                                                                  
  accountable for                                                                                              
  performance results.                                                                                         

  9\. Builds Capability                                          ** **         ** **   ** **   ** **   ** **   ** **
  -- Recognizes the                                                                                            
  specific competencies                                                                                        
  or capabilities                                                                                              
  needed and hires,                                                                                            
  develops, and retains                                                                                        
  talent necessary to                                                                                          
  execute the vision                                                                                           
  and mission of the                                                                                           
  organization;                                                                                                
  promotes team                                                                                                
  building.                                                                                                    

  10\. Coaches,                                                  ** **         ** **   ** **   ** **   ** **   ** **
  Motivates, Develops                                                                                          
  and Mentors --                                                                                               
  Conveys and instills                                                                                         
  in others a strong                                                                                           
  sense of energy,                                                                                             
  excitement,                                                                                                  
  ownership, and                                                                                               
  personal investment                                                                                          
  in their work; gives                                                                                         
  people the                                                                                                   
  opportunity and                                                                                              
  latitude to exercise                                                                                         
  authority and run                                                                                            
  their areas of                                                                                               
  responsibility; and                                                                                          
  actively coaches and                                                                                         
  mentors employees for                                                                                        
  assuming greater                                                                                             
  responsibilities and                                                                                         
  to develop their full                                                                                        
  potential.                                                                                                   

  ***Overall Rating for                                                                                        
  Element II:***                                                                                               

                                                                                                               

  Rating Official's            Date         Rating Official's                                                  
  Signature                                 Name *(typed or                                                    
                                            printed)*                                                          
  --------------------- --- -- --------- -- -------------------- ------------- ------- ------- ------- ------- -------