THOME OFFSHORE Quality Assurance into the

MANAGEMENT PTE LTD

Evaluation Form – Officers 21st Century and Beyond

TOM Form
No.072A

Vessel : Kreuz Challenger Date : 14Click For Date ☐ Owner

DD/MM/YY

Krystian Filipski
☐ Operational Area
Name :
Family Name First Name(s)
2nd.Off/DPO
Rank :

10.04.2018 Disembarked Click For Date

Embarked :
DD/MM/YY DD/MM/YY

Reason for Disembarking: End of Contract

x☐ End of Contract ☐ Compassionate Leave ☐ Resigned ☐ Sick / Injured ☐ Dismissed

A. Performance
Above Below
Item Excellent Average Unsatisfactory
Average Average

Professional Knowledge ☐ X ☐ ☐ ☐
Ability to perform his shipboard duties ☐ X ☐ ☐ ☐
Personal Effort ☐ X ☐ ☐ ☐
Safety, Health, Security and Environmental
competence
☐ X ☐ ☐ ☐
QA-Knowledge & understanding ☐ X ☐ ☐ ☐
Socialising, liaison & cooperation with shore /
crew ☐ ☐ X ☐ ☐
Liaison with client/construction crew (if
applicable) ☐ X ☐ ☐ ☐
Company Loyalty & Discretion ☐ X ☐ ☐ ☐
English Language ☐ X ☐ ☐ ☐
B. Recommendations
1. If his marks are below average, do you think he will be able to improve?

☐ Definitely ☐ Needs More ☐ Doubtful ☐ Shows No Interest

Area of Improvement:
2. Recommendation for Continued Service / Re-hire

Yes. X ☐ No

CONTROLLED Revision: 22 Mar 2016

Approved by DPA/DMR
Page 1 of 3
THOME OFFSHORE TOM FORM 072A
MANAGEMENT PTE LTD Evaluation Form – Officers

3. Recommendation for Promotion – Refer to Item 4 Below

☐ Yes X Didn’t thick for promotion due a limited time spent

together. (1 months) But during this time he perform very good
and If he delivers full contract on the same level I’ll do.,
4. Any specific good qualities or performances you would like to emphasize?
General seamanship knowledge, very good DPO.
5. Any recommendations for training
ECDIS Foruno specific training, to obtain Cert.
C. Comments of the Officer
1. Do you agree with the evaluation?
     
2. Do you have any general comments related to your period of service onboard?
     
3. Do you have any specific personal training and development issues that needs to be addressed
during your next leave period
     
4. Do you have any additional comments?
     

S.Drozina

Name of Evaluator Signature of Evaluator Signature – Officer

Click here to enter a date.

Received by Crew Department
Reviewed by Crew Department
Entered in Crew Management System:
Training Requirements Effected
Report Copied to Manning Agent
Training Requirements Completed :
:
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CONTROLLED Revision: 22 Mar 2016

Approved by DPA/DMR
Page 2 of 3
THOME OFFSHORE TOM FORM 072A
MANAGEMENT PTE LTD Evaluation Form – Officers

Click here to enter a date.

DNV Sea Skill Updated :
Date Person In Charge

CONTROLLED Revision: 22 Mar 2016

Approved by DPA/DMR
Page 3 of 3