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My Appraisal Form
Five Year Plan:
12th

Financial Year:
2019­2020

Section A: Employee Details

Employee ID: 200901090

Name: Rinchen

Position Title & Position Level: Asst. Engineer III (SS4)

Working Agency: Lingmethang,Regional Offices,Department of Roads,Ministry of Works &
Human Settlement

Section B: Performance

Output Activity Level 4 Level 3  Level 2  Level 1  Target Achieved (Copy the Justification (if any) Final Remarks 
[3.00­ [2.00­ [1.00­ [<=0.99] level you have achieved) Score Justificati
4.00] 2.99] 1.99]

Kms of Roads completed the monitoring 31st May 30th June Beyond Beyond

level 4 Enter Justification
resurfaced and inspection of Gangola­ 2020 2020 June june
Luntse SNH

Restores Completed restoration of April 2020 May 2020 June 2020 Beyond

level 2 Because of long tendering
Monsoon monsoon damages June 2020
process
damages including slip clearing and
structure construction

Provided Compilation of report Within one Within two Within Beyond

level 4 Enter Justification
Administration, submitted from Sub Division week after week after three week third week
Finance and and submission to reception reception after after
support headquarter from Sub from Sub reception reception
services Division Division from Sub from Sub
Division Division

Kms of roads Monitored and inspected 15th may 30th may within 15th 30th

level 4 Enter Justification
and nos of the maintenance of 16 2020 2020 June,2020 June,2020
bridges bridges under RO
maintained Lingmethang

supervised. Completed submission of 5th of 7th of 10th of Beyond

level 4 Enter Justification
monitored, monthly report,verification succeeding succeeding succeeding 10th of
Evaluate. of bills,Estimates and other month month month succeeding
procured, works month
Survey &
design of
works.

supervised. Issued and placed supply Within 2 Within 4 Within 6 Beyond 1

level 4 Enter Justification
monitored, order and deployment days of days of days of week of
Evaluate. order for local construction receiving receiving receiving receiving
procured, materials,vehicles,machinery requisition requisition requisition requisition
Survey & and hard ware. from Site from Site from Site from Site
design of
works.

supervised. Prepared SBDS,tendered Within 25 Within 1 Within 1.5 beyond

level 4 Enter Justification
monitored, and evaluated the bids for days after month months 1.5 month
Evaluate. works, goods and services tender after after after
procured, opening tender tender tender
Survey & opening opening opening
design of
works.

Final 0
Score:

Adhoc Activities
Section C: Competency Behavior

Potential Assessment Quality & Description Level 4  Level 3  Level 2  Level 1  Final Score

Area [3.00­4.00] [2.00­2.99] [1.00­1.99] [<=0.99]

1.Analytical Skills Demonstrates sense of Makes critical judgment Makes strong Makes judgements by Carries out work 0

understanding and on her/his contribution judgements based on using limited work activities without critical
appreciation of one's to organization based the work experiences knowledge and timely judgement and not
work to meet on independent thinking upon receiving the supervision required to putting the work
organizational objectives by making good use of guidance from carry the work activities knowledge in use
and results background knowledge supervisor to carry the
work activities

2. Planning & Organizing Demonstrates ability to Every day activities are Systematic work Work plan are Does not follow clear 0

plan and organize work guided by meticulous Planning on the work maintained but are not work plan and mostly
activities around work plans and activities are drawn followed and requires involved in ad hoc
organization's objectives demonstrates good clearly and needs extra resources to carry activities and work are
making optimum use of time management skills minimum supervision the activities and quality not up to the
resources and time to meet agency’s and resource and of work compromised expected quality
objectives by using maintain quality of the
available resources work
optimally to meet work
activities without
compromising the
quality of the work
output

3.Decisiveness Demonstrates sound ·         Submits Submits problems and Submits problems Waits for supervisory 0

judgment to identify problems and recommended solutions without intervention to resolve
and recognise problems recommended solutions on time for supervisory recommendation on issues
and solutions, and before time for advice time
escalate them to supervisory
appropriate authority intervention.

4.Leadership & Demonstrates urgency Initiates assigned works Work assigned are Any assigned work are Initiates assigned work 0

Influencing Skills and proactivelytakes proactively, identifies taken with strong done but requiring a with reminder only
lead in assigned work and tries to solve responsibility to be minimum supervision
activities and bottlenecks in his/her completed
solicitssupport. own area of work

5.Interpersonal Skill Demonstrates ability to Achieves individual Achieves individual Achieves individual works only to serve 0

work in teams and performance targets performance with good performance with limited self­interest and meet
garner supports, built while maintaining relationship within but relationship within and personal goals
relationship and develop friendly relationship limited level of outside agency
congenial work within and outside interpersonal skills
environment agency outside agency

6.Oral/Written Demonstrates ability to Articulates information Articulates information Articulates information to Does not articulate 0

communication articulate one's ideas, to others in language to other in languages other in limited language information that is clear
views and opinions that is clear, concise and that is understandable limited unto his/her level and concise
clearly and concisely easy to understand of understanding
both in oral and in
writing

Final Score: 0

Section D: Evaluation

Particular Score Received % Allocated Final Score Supervisor's Moderation Exercise Agency Head's

Comments Cat. Comment

B. Performance 0 70% 0 Not Rated

C. Competency 0 30% 0
Behaviors

Total Score: 0

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