Number 6

Created by Breadbox Viper

Appraisal form ratings

FM2 Shipboard administration

Number: FM2S2-13

Appraisal Form – Ratings

Vessel: Breadbox Viper

Date 24 Jun 2023

Location: At Sea

Name rating: Kozhukhar Pavlo

Rank rating: AB/Navigator

Date sign on: 05.02.2023

Type of evaluation (please cross 1)

:

¨First impression after 2/3 weeks

¨Signing off

¨On request Master handover

Appraisal by: Oleg Kostiukhin

Rank: Master

Date report: 24 Jun 2023

Overall Impression  P
 CD
 FC
 S
 E

Quality / Quantity of work  P

 CD
 FC
 S
 E

Self discipline  P
 CD
 FC
 S

Printed on: 24-06-2023 1 /1

4
  E

Responsibility and reliability  P

 CD
 FC
 S
 E

Teamwork  P
 CD
 FC
 S
 E

Attitude towards colleagues  P

 CD
 FC
 S
 E

Attitude towards seniors  P

 CD
 FC
 S
 E

Communication  P
 CD
 FC
 S
 E

QHSE awareness  P
 CD
 FC
 S
 E

English language  P
 CD
 FC
 S
 E

(Chemical) Cargo knowledge and  P

handling  CD
 FC
 S
 E

Watchkeeping  P
 CD
 FC
 S
 E

Seamanship and handling of  P

vessel equipment  CD
 FC
 S

Printed on: 24-06-2023 2 /2

4
  E

Maintenance safety equipment  P

 CD
 FC
 S
 E

Following procedures and  P

instructions  CD
 FC
 S
 E

Organisation of deck crew (bosun  P

only)  CD
 FC
 S
 E

For Cook

Quality & variety of meals  P

 CD
 FC
 S
 E

Preparation of food  P
 CD
 FC
 S
 E

Stock control  P
 CD
 FC
 S
 E

Hygiene of the galley  P

 CD
 FC
 S
 E

Coding:
Exceptional (E) (clearly outstanding performance). Performance falls within top 5 – 10 % of employees in this
rank/position
Strong (S) (excellent performance). Performance falls within top 15% of the employees in this rank/position.
Fully Competent (FC) (solid performance). Consistently meets job requirements and expectations.
Continued Development (CD) Needs development in current position. Overall performance is somewhat lower than
expected for the current position
Poor (P) (unsatisfactory performance). Performance is clearly below what is expected in current position.

Training / Actions Not needed

Printed on: 24-06-2023 3 /3

4
 Career Ambitions / Suitable for Yes.
promotion

Remarks/Comments Master (or Good AB/Navigator. Showed proper knowledge of navigation/radio equipment,
C/O) electronic charts, COLREG regulation and computer skill. Recommended for
promotion and next re-employment company fleet vessel as OOW

Remarks/Comments Rating

Name and Signature master (or Oleg Kostiukhin

C/O)

Signature

Name and Signature Rating Kozhukhar Pavlo

Signature

Printed on: 24-06-2023 4 /4

4