| S I R |
| Significant Incident Record |
| P E P |
| Performance Evaluation Program |
| Billery Sample |
| 03/21/2001 |
| Health Benefit Rep |
| Job Category: |
| Factor: |
| Employee: |
| Date: |
| ADAPTABILITY |
| Evaluator: |
| 12/02/2001 |
| Printed: |
| 11/4/01 12:38 am |
| Mary Knowalot |
| Store Time: |
| 5 |
| Billery, you exceeded our expectations yesterday when you were able to continue working |
| productively despite the network system failure. You were able to accommodate our customers' |
| needs. Your efforts are greatly appreciated. |
| Performance Level |
| Employee Signature: _______________________________________________Date: ____________________ |
| Evaluator Signature: _______________________________________________Date: ____________________ |
| Witness Signature: _______________________________________________Date: ____________________ |
| Copyright 1991, 93, 95, 98, 2000, 2001 Clyde Johnson |
| Page 1 of 1 |