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1. Last Year Individual Objective Assessment1.1 Main objectives (past period) Results Self N+1

1.2 Support used to achieve objectives (including training received)

1.3 Employee self assessment on most significant results during past period, strengths and areas forimprovement

1.4 CODE OF ETHICSI declare for the year for which I am being reviewed, I have complied with Bureau Veritas Code of Ethics"

YES / NO

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Performance Management Process Template(Review Period : Jan Dec 2012)

Date of Interview with N+1:

First name and LastName

: Employee code :

Position : BU/ BL / Function: :

Date of Joining : Date of appointmentto present role

:

Location : CAREER REVIEW (last 3 positions & dates in BV)

Name of LineManager (N+1)

: Position Date

Name of thesecondary reviewer *

: 1

* if applicable 2

3

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2 .Last year Assessment of behaviour and results by Manager (N+1)

2.1 CORE VALUES - FIXEDANDABSOLUTE YES NO

Integrity and ethics

Impartial counsel and validation

Respect for the individual

Social & Environmental Responsibility

2.2 BUSINESS VALUES - SUBJECTTOMEASURABLEPROGRESS*

KINDLY PUTA B+ B C

Outstanding Strong Fair RequiresImprovement

Customer Focus

Entrepreneurship and Leadership

Share collective knowledge and constant learning

Local actions and global contribution

Transparency

Teamwork and Solidarity

*See Section 3.2 for personal improvement targets

2.3 FEEDBACKFROMBUSINESSLINE / FUNCTION* RESULTS, STRENGTHSANDAREASFORIMPROVEMENT. Completedby N+1 after feedback from Business Line/Functional Manager

2.4 N+1 MANAGER ASSESSMENTOFRESULTS, STRENGTHSANDAREASFORIMPROVEMENT

2.5 OVERALL PERFORMANCE RATING (CIRCLE RATING)

RATING DISTRIBUTION DESCRIPTION

A Outstanding

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3.1 ROLE & JOB DEFINITION

3.2 OBJECTIVES* THEREMUSTBEATLEAST 1 OBJECTIVEONYOURPERSONALPROGRESSON BV BUSINESSVALUESAND

BEHAVIOURS

PERFORMANCE INDICATORSANDDUEDATES

* Make sure these personal objectives align perfectly with those set for the Bonus. Pl. attach a separate sheet, if required.

4. SUPPORTNEEDED FORACHIEVINGAGREEDOBJECTIVES ( INCLUDINGTRAININGACTIONSIFAPPROPRIATE)Ways/Means to meet key objectives Expected results

5. SUCCESSIONANDDEVELOPMENT(specify area or type of function, and new skills to acquire and/or develop)

BESTNEXTROLE* TIMING MOBILITY** LOCATIONPREFERENCES

MANAGERS COMMENTS

*For many people, continuing to develop in the current job may be the best next role.** i: anywhere within the next 18 months

ii: within current or a specific zone within 18 monthsiii: remain in the same country

6. Comments6.1 EMPLOYEESCOMMENTSONASSESSMENTANDPLANS

6.2 N+2 LINE MANAGERSCOMMENTS

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