ATTACHMENT B

S/K Cracker Project

VERBAL REPRIMAND RECORD
Employee Name: ID/Passport Number: Badge Number: Date of Reprimand:

Department/Craft: Position: Length of Service: Time in present position:

Ensure the following objectives were achieved: (Supervisor Checklist)

* The counseling were conducted in private.

* The project discipline policy was explained to the employee.
* The action is consistent with the established discipline policy.
* The action is consistent with previous discipline practices in the project.
* The employee was informed that this infraction was recorded as a verbal reprimand.
* The employee was informed why a verbal reprimand for this infraction was warranted.

What is the employee being reprimanded for?

(Give dates and details of specific incident(s)so that employee knows what behavior needs to be corrected.)

What policy/procedure or other conduct rule has been violated?

If conduct is repeated or other disciplinary problems develop, what additional action will likely result?
(Be specific, e.g. .written reprimand, put on probation, reprimand, termination, etc.)

Restate, for the employee's benefit, the expected performance standards which must be met in order to
correct the problem.

Supervisor's Name/Title Supervisor's Signature and Date

Employee's Comments: (Employee may separate sheet if necessary).

Review by Manager (Review for consistent application Manager's Signature and Date
of discipline action)

Review by HR Manager Signature and Date Witness (If required) Signature and Date

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