SHIP'S STAFF APPRAISAL REPORT (CONFIDENTIAL)

PART "A" - PARTICULARS OF APRAISEE

NAME: RUNI AMBONDALE RANK: SECOND ENGINEER
SHIP'S NAME: DOLPHIN 6
DATE SIGNED ON: NOVEMBER 28.2023 DATE SIGNED OFF:
PART "B" - TO BE COMPLETED BY APPRAISOR
[TICK " " APPROPRIATE BOX]
B.1 REASON FOR REPORT:
QUARTERLY REVIEW √ SIGNED OFF
DISMISSAL PROMOTION

B.2 I HAVE KNOWN HIM FOR YEARS/MONTHS.

B.3 ASSESSMENT OF PERFORMANCE: TOTAL POINTS SCORED (FROM PARTS "D" OR "E")

OUSTANDING = 85 POINTS & ABOVE AVERAGE = 51 TO 64 POINTS

VERY GOOD = 75 TO 84 POINTS BELOW AVERAGE = 41 TO 50 POINTS
GOOD = 65 TO 74 POINTS POOR = 40 POINTS & BELOW

B.4 COMMENTS: If not reflected above, please comment on any strong points, weaknesses, etc.

YES NO
B.5 IS HE RECOMMENDED FOR RE-EMPLOYMENT?

B.6 HAS HE LEARNED/PERFORMED THE DUTIES OF THE

NEXT RANK?

B.7 IS HE RECOMMENDED FOR PROMOTION?

NAME: RANK: DATE:

ADI IRAWAN CHIEF 01.10.2024
ENGINEER

PART "C" - TO BE COMPLETED BY TECH. DEPT./HSE DEPT./CREW DEPT.

C.1 TECH SUPERINTENDENT COMMENTS:

C.2 HSE SUPERINTENDENT COMMENTS:

C.3 CREW SUPERINTENDENT COMMENTS:

FLEET MANAGER: HSE DEPT. CREW DEPT. DATE:

Page 1 of 2
 ASSESSMENT OF PERFORMANCE

NAME: APPRAISAL DATE:

WHAT PERCENTAGE OF THIS APPRAISAL WAS BASED ON?

OWN OBSERVATION: % DISCUSSION WITH OTHER PEOPLE : %

PART "D" - APPRAISAL FOR OFFICERS & ENGINEERS (TO BE COMPLETED BY APPRAISOR)
ASPECTS POINTS SCORED MAXIMUM
1 Professional ability (job knowledge for his rank) 20
2 Work attitude 15
3 Reliability 10
4 Output/productivity 10
5 Safety Conciousness 10
6 Sobriety 5
7 Initiative 10
8 Organization Work 10
9 Relationship with other ship's staff 5
10 Appearance & behaviour 5
TOTAL POINTS SCORED (TO BE FILLED IN PART "B.3") 100

PART "E" - APPRAISAL FOR RATINGS (TO BE COMPLETED BY APPRAISOR)

ASPECTS POINTS SCORED MAXIMUM
1 Professional ability (job knowledge for his rank) 20
2 Work attitude 15
3 Reliability 10
4 Output/productivity 10
5 Safety Conciousness 10
6 Sobriety 5
7 Discipline 10
8 Punctuality 10
9 Relationship with other ship's staff 5
10 Appearance & behaviour 5
TOTAL POINTS SCORED (TO BE FILLED IN PART "B.3") 100

FOR OFFICE USE ONLY:

REVIEWED BY: RECORDED BY: DATE:

Page 2 of 2
Section 1 Appendix 1 Rev 0 DE 9 (02/03)
INSTRUCTIONS FOR COMPLETING FORM DE9 -
“SHIP’S STAFF APPRAISAL REPORT
(When rating a ship’s staff, you should recall instances that are representative of his work performance and behavior.
You should avoid being influenced by unusual cases or isolated instances which are not representative).

ASPECTS POINTS ASPECTS POINTS

1 PROFESSIONAL ABILITY / JOB KNOWLEDGE (PART (PART "D") 7 INITIATIVE
"D"/"E"
Ÿ Quality of work is far above average. Very well informed Ÿ Extremely resourceful, anticipates problems and is able
of own and related work for his length of service and to suggest new and better solutions to problems and
applies it excellently. 15/20 initiates productive work. 10
Ÿ Consistently produces quality of work that is above Ÿ Resourceful and performs new job assignments without
average. Is well informed of his own job and has sufficient detailed instructions. 8
knowledge of related jobs and applies it well. 12/15 Ÿ Capable of independent action in normal situations. 5
Ÿ Quality of work is acceptable, but can still be improved. Ÿ Rarely demonstrates resourcefulness, makes effort to
Has adequate knowledge for his present job and applies it improve method only when directed. 3
satisfactorily. 8/10 Ÿ Does what he is told and no more. 1
Ÿ Often needs improvement in quality of work to meet
acceptable standards. Has enough knowledge to cope
with routine matters but knowledge is not always applied. 5/5 (PART "E") 7 DISCIPLINE
Ÿ Quality of work fails to meet acceptable standards.
Knows only the essentials of routine matters and applies Ÿ Accepts discipline well and gives no trouble. 5
it poorly. 1/1 Ÿ Accepts discipline favourable and rarely gives trouble. 4
Ÿ Often been in trouble but accepts discipline favourably. 3
Ÿ Resents discipline and carries a chip on his shoulder. 2
2 2 WORK ATTITUDE Ÿ Resents discipline and incites others to do likewise. 1

Ÿ Has been extremely willing and a hard worker at all times. 15

Ÿ Has always been a good worker. 12 (PART "D") 8 ORGANIZATION OF WORK
Ÿ Works well at times but slacks off at other times. 8
Ÿ Has had to be watched and pushed much of the time. 5 Ÿ An exceptionally effective organizer. 5
Ÿ Lazy and requires constant pushing 1 Ÿ Shows considerable organizing skill. 4
Ÿ Plans and organizes routine work well. 3
Ÿ Plans and organizes routine work satisfactorily. 2
3 3 RELIABILITY Ÿ Poor organizer. 1

Ÿ Completely dependable, highly responsible and

independent at all times. 10 (PART "E") 8 PUNCTUALITY
Ÿ Dependable and responsible in most situations. 8
Ÿ Dependable and accepts responsibility only when directed. 5 Ÿ Always early or on time and works considerable time in
Ÿ Requires close supervision and often needs to be pushed. 3 excess of call of duty. 5
Ÿ Undependable and avoids responsibility. 1 Ÿ Has always been punctual and will work willingly if required
to do so. 4
Ÿ Has never been late but is inclined to be a clock watcher. 3
4 4 OUTPUT / PRODUCTIVITY Ÿ Has occasionally has been late for duty. 2
Ÿ Has been frequently late for duty and is generally unreliable. 1
Ÿ Maintains high level of output 10
Ÿ Usually maintains a good output 8
Ÿ Maintains satisfactory output. 5 9 RELATIONSHIP WITH OTHER SHIP'S STAFF
Ÿ Output rather less than expected. 3
Ÿ Output regularly less. 1 Ÿ Maintains excellent relationship. 5
Ÿ Good team worker. 4
Ÿ Able to work reasonably well with most people. 3
5 5 SAFETY CONSCIOUSNESS Ÿ Does not give all possible cooperation. 2
Ÿ Generally uncooperative. 1
Ÿ Has good knowledge of safety and applies it excellently. 10
Ÿ Has adequate knowledge of safety and applies it well. 8
Ÿ Has acceptable knowledge of safety and applies it 10 APPEARANCE & BEHAVIOR
satisfactorily. 5
Ÿ Has enough knowledge of safety but knowledge not Ÿ Displays an excellent impression. Conduct has been
always applied. 3 exemplary. Has been a good influence. 5
Ÿ Displays poor knowledge of safety and works Ÿ Displays a good impression. Has given no cause for
dangerously. 1 complaint. 4
Ÿ Displays an acceptable impression, although,
occasionally guilty of minor offences. 3
6 SOBRIETY Ÿ Impression leaves something to be desired. Repeatedly
guilty of minor offences. 2
Ÿ Has never been drunk or suffering from a hangover. 10 Ÿ Carries himself sloppily. Has been guilty of serious
Ÿ Has never allowed alcohol to affect his work. 8 misconduct. 1
Ÿ His work has on occasion been adversely affected by
alcohol. 5
Ÿ His work and conduct has often been adversely affected
by alcohol. 3
Ÿ Repeatedly been drunk. Efficiency and conduct seriously
affected. 1
韦立(几内亚)船舶管理公司 Winning
(Guinea) Ship Management Company

船员考核报告

PART "A" - 被考核人信息：

姓名: 职务:
船舶名称:
上船日期: 下船日期：

PART "B" - 由考核人完成D后填写（普通船员由船长/轮机长考核，船长/轮机长由机务，海务和船员部主管考核)

[在相应方格内打对号]
B.1 :报告原因
季度考核 √ 休假考核
解雇 晋级提升

B.2 在船工作时间 年/月

B.3 评估总得分 分 (根据PART"D"和“E")

非常突出 = 85 - 100分 一般 = 51 - 64 分
很好 = 75 - 84 分 一般以下 = 41 - 50 分
好 = 65 - 74 分 不胜任 = 0 - 40 分

B.4 备注: 如果上面没有反映，请针对其任何的优缺点等做出评论

是 否
B.5 是否建议继续雇佣?

B.6 是否已掌握上一级业务?

B.7 是否推荐提升?

签名: 职务: 日期:

PART "C" -
C1.机务主管意见:

C2.海务主管意见 :

C3.船员主管意见:

机务经理： HSE主管： 船员部主管： 日期：

Page 1 of 2
 韦立(几内亚)船舶管理公司 Winning
(Guinea) Ship Management Company

考核报告

被考核人姓名： 填写日期：

本次考核的百分比是基于?
自己的观察: % 他人讨论: %

PART "D" - 职务船员考核 （高级船员和岸基人员考核项目，由考核人填写）

考核指标 得分 总分
1 专业能力（对于他的等级岗位专业知识） 20
2 工作态度 15
3 可靠性 10
4 工作效益 10
5 安全意识 10
6 酒精饮品控制 5
7 工作主动性 10
8 管理能力 10
9 团结同事 5
10 行为举止 5
总分（有待填补部分“B.3”） 100

PART "E" - 普通船员考核 （普通船员考核项目，由考核人填写）

考核指标 得分 总分
1 专业能力（对于他的等级岗位知识） 20
2 工作态度 15
3 可靠性 10
4 工作效益 10
5 安全意识 10
6 酒精饮品控制 5
7 纪律性 10
8 工作准时 10
9 团结同事 5
10 言行举止 5

总分（有待填补部分“B.3”） 100

备注：（需要说明项目）

考核人签字: 职务： 日期：

Page 2 of 2
 INSTRUCTIONS FOR COMPLETING FORM DE9 -
“SHIP’S STAFF APPRAISAL REPORT
(When rating a ship’s staff, you should recall instances that are representative of his work performance and behavior.
You should avoid being influenced by unusual cases or isolated instances which are not representative).
考核指标 分值 考核指标 分值

1 3 专业能力/工作技能 满分20分 (PART "D") 7 3 工作主动性 满分10分

（高级船员）
Ÿ 工作质量远超平均水平。在职期间能够非常灵活的处理本职工作及相关工作，并表现优秀 15-20分 Ÿ 能够积极的提出问题，面对问题，能够运用自己的能力提出新的或者更好的解决方案，并投入到工作中去。 8-10分

Ÿ 工作质量高于平均水平，在职期间能够充分了解工作职责，其他相关工作能够很好的应对。 10-15分 Ÿ 能够在没有详细说明的情况下，能够运用自己的能力，胜任新的工作。 5-8分

Ÿ 正常情况下，能够运用自身能力，独立的完成工作。 3-5分
Ÿ 工作质量尚可，仍有提升空间；在职期间能够处理好本职工作。 5-10分 Ÿ 很少展现出自己的能力，只有当涉及自身工作时，才会改善工作方式。 1-3分

Ÿ 只按照要求做事，从不主动承担工作。 0分
Ÿ 工作质量不能满足要求，在职期间仅能够处理日常性工作，知识储备不足。 1-5分

(PART "E") 7 3 纪律性 满分10分

Ÿ 工作毫无质量，日常性工作处理不完善。 0分 （普通船员）
Ÿ 纪律性很好，从未引起事故。 8-10分
Ÿ 纪律性好，很少引起事故。 5-8分
Ÿ 经常引起事故，但是能遵守纪律。 3-5分
Ÿ 不遵守纪律，并且满腹牢骚。 1-3分
2 2 工作态度 满分15分 Ÿ 不遵守纪律，并且鼓动他人不遵守纪律。 0分

Ÿ 工作欲望强烈，工作努力。 12-15分
Ÿ 工作认真负责。 8-12分 (PART "D") 8 3 组织管理能力 满分5分
Ÿ 部分工作认真负责。 5-8分 （高级船员）
Ÿ 大部分时间需要督促才能完成工作。 1-5分 Ÿ 非常高效的组织者。 5分
Ÿ 懒惰，需要监督才能工作。 0分 Ÿ 表现出良好的组织能力。 3-4分
Ÿ 日常性工作能够组织的良好。 2分
Ÿ 日常性工作能够组织的合乎要求。 1分
3 3 可靠性 满分10分 Ÿ 毫无组织能力。 0分

Ÿ 8-10分 (PART "E") 8 3 工作准时 满分5分

具有高度责任心，任何时候都完全可靠。任何时候都能独立完成工作。 （普通船员）
Ÿ 大部分工作可以独立完成。 5-8分 Ÿ 能够提早或按时工作，经常主动加班。 5分
Ÿ 只有涉及到自身工作才能可靠。 3-5分
Ÿ 需要密切监督，经常需要督促。 1-3分 Ÿ 能够准时工作，需要时可以加班。 3-4分
Ÿ 不可靠，毫无责任感。 0分
Ÿ 从未迟到，从未加班。 2分
Ÿ 偶尔迟到。 1分
4 4 工作效益 满分10分 Ÿ 经常迟到，及不可靠。 0分

Ÿ 能够保持高水准的效益。 8-10分
Ÿ 通常能够保证良好的效益。 5-8分
Ÿ 能够保证符合要求的效益。 3-5分 9 3 团结同事 满分5分
Ÿ 工作效益低于预期水平。 1-3分
Ÿ 工作毫无效益。 0分 Ÿ 与同事保持良好的关系。 5分
Ÿ 良好的团队工作者。 3-4分
Ÿ 能够与大多数同事理性的工作。 2分
5 5 安全意识 满分10分 Ÿ 很少与同事合作。 1分
Ÿ 不与人沟通。 0分
Ÿ 具有丰富的安全认识，并能极好的运用。 8-10分
Ÿ 具有足够的安全知识，并能良好的运用。 5-8分
Ÿ 具备的安全知识及其运用能够满足工作要求。 3-5分 10 3 言行举止 满分5分

Ÿ 具有足够的安全知识，但是不能很好的运用。 1-3分 Ÿ 言行举止令人印象深刻，具有模范作用，产生积极的影响。 5分

Ÿ 不具备足够的安全知识，工作中存在安全隐患。 0分 Ÿ 言行举止合乎规范，不会令人产生不适。 3-4分

Ÿ 言行举止可以令人接受，偶尔会有小的错误。 2分

6 酒精饮品控制 满分10分 Ÿ 言行举止令人不适，多次触犯小错误。 1分

Ÿ 从未出现过醉酒及宿醉现在 8-10分 Ÿ 举止散漫，行为严重不当。 0分

Ÿ 从未因饮酒影响工作 5-8分
Ÿ 工作有时会因饮酒而产生不良影响。 3-5分

Ÿ 工作经常会因饮酒而产生不良影响。 1-3分

Ÿ 经常醉酒，工作受到严重影响。 0分