DER PERFORMANCE EVALUATION FORM
#:_________________________ (PRINT: Prefix, Last Name, First Name, Middle Name, Suffix)
TEL. #:______________________________________ FAX
__ (Structures, Systems, Propulsion, Adm., etc.)
? Yes ? No EXECUTIVE LEVEL DER’S ONLY: Has the DER’s title/position adversely affected the ability to
perform delegated functions objectively and independently? (Written summary attached)
EVALUATION: FROM ____________________________ TO
ACO/BRANCH____________________________________________________________ For the above named DER, rate performance in each of the following categories by placing an "X" under column SAT for Satisfactory, column NEEDS IMPR for Needs Improvement, column UNSAT for Unsatisfactory, or column N/OB for Not Observed. For any rating other than Satisfactory, the FAA evaluator is required to contact the DER directly, and to document in the "REMARKS" section how the concern has been or will be resolved. Resolution action may range from a recommendation for non-renewal to an indication that the DER has agreed to work closely with the FAA during the next evaluation period to resolve the concern. Indicate your recommendation for renewal at the bottom of the form above your signature.
SAT IMPR UNSAT N/OB
1. ACTIVITY LEVEL ? ? ? ?
2. DIRECT FAA CONTACT ? ? ? ?
3. DER/FAA INTERACTION TRACKING FORM ? ? ? ?
4. APPLICATION OF REGULATIONS, POLICY, AND GUIDANCE ? ? ? ?
5. ADHERENCE TO DER PROCEDURES ? ? ? ?
6. SHOWS INTEGRITY, SOUND JUDGMENT, COOPERATIVE ATTITUDE ? ? ? ?
7. SHOWS TECHNICAL COMPETENCE IN AREA OF APPOINTMENT ? ? ? ?
8. ATTENDANCE AT REQUIRED TRAINING ? ? ? ?
9. ABILITY TO COMMUNICATE CLEARLY ? ? ? ? 10. QUALITY OF SUBMITTALS ? ? ? ? 11. TIMELY IDENTIFICATION OF SIGNIFICANT ISSUES ? ? ? ? 12. TIMELY SUBMITTAL OF DATA ? ? ? ? REMARKS: (Explain all Needs Impr, Unsat, N/Ob evaluations and provide resolution; Attach additional pages as required)
Recommend Renewal? ? Yes ? No ? Change authorization as noted in Remarks
FAA Form 8110-30 (6/00) Supersedes Previous Edition NSN: 0052-00-919-7000
COMPLETION OF THIS FORM IS MANDATORY FOR DER RENEWAL FOR OFFICIAL USE ONLY PUBLIC AVAILABILITY TO BE DETERMINED UNDER TITLE 5, UNITED STATES CODE, SECTION 552
PERFORMANCE ELEMENT DEFINITIONS
1. ACTIVITY LEVEL: The DER is actively utilizing the delegated authority. Typical indication would be the
submittal of completed FAA Form 8110-3 (8110-3s) in the delegated area. If 8110-3s are not submitted, the DER
may be actively assisting the FAA in other ways such as witnessing testing or identifying and resolving certification
issues, although the authority itself is not utilized.
2. DIRECT FAA CONTACT: In the delegated area, the DER has direct contact with the FAA on technical and
project issues. The DER keeps the FAA informed of activities. Indicators would be office visits, phone calls,
attendance at project meetings, or attendance at Designee Conferences.
3. DER/FAA INTERACTION TRACKING FORM: The DER submitted the required key interaction form. Indicator would be a complete, accurate, and timely interaction form.
4. APPLICATION OF REGULATIONS, POLICY , AND GUIDANCE: The DER properly applied
airworthiness requirements and technical or administrative policy and guidance. Indicators may include a showing
of understanding and proper application of regulations etc. during the course of certification projects, including
meetings with the FAA, and appropriate compliance findings.
5. ADHERENCE TO DER PROCEDURES: The DER followed the DER handbook and other national or local directives in performing DER functions. Indicators would be submittal of properly completed 8110-3s, coordinating
with FAA on unique and novel design features, receiving permission to witness or conduct tests, verification of
conformity prior to witnessing tests, properly utilizing authority, etc. DER procedures require coordination with FAA
Engineering on unique or novel designs, generation of Certification Plans, appropriate and timely requests for
conformity, generation of tests plans, verification of satisfactory conformity findings prior to witnessing certification
tests when delegated by the FAA and approval of compliance data in a timely and correct sequential manner. The
DER should have a good understanding of when the DER may "Approve" vs. "Recommend Approval" for a
compliance submittal (8110-3) and a clear understanding of the discrete areas of delegation that the DER may
6. SHOWS INTEGRITY, SOUND JUDGMENT AND COOPERATIVE ATTITUDE: The DER was honest,
complete, and forthcoming with information in all dealings with the FAA. The DER exercised sound judgment in
making technical and project decisions. Conduct was professional, and the DER fully cooperated with the FAA in
resolving technical and program issues. Indicators may be direct experience with the DER, including participation
in certification meetings, where the DER is forthcoming and cooperatively seeks resolution of issues.
7. SHOWS TECHNICAL COMPETENCE IN AREA OF APPOINTMENT: The DER's technical work and
interaction with the FAA, particularly on complex technical issues, shows the DER's competence in the delegated
area. Indicators of competence would include properly developed test plans, appropriate compliance findings, and
technically accurate and complete substantiation and test reports.
8. ATTENDANCE AT REQUIRED TRAINING: The DER attended any training required by the Agency, including that which may be required by the administering ACO. Indicator would be attendance at required training,
seminars, conferences, etc.
9. ABILITY TO COMMUNICATE CLEARLY: The DER communicated effectively, both orally and in writing, such that technical and administrative issues are clearly understood. Indicators would be effective oral
communications during certification meetings, telephone conversations, and other direct contacts with FAA
employees. Written reports, substantiation, and communications are complete and well organized.
10. QUALITY OF SUBMITTALS: The DER's data submittals are complete, logically arranged, legible, accurate, and clearly establish compliance with the applicable airworthiness requirements such that review by the
FAA may be minimal. Indicators would be test plans, test reports, substantiation, drawings, etc. that meet the
11. TIMELY IDENTIFICATION OF SIGNIFICANT ISSUES: As early as practical in the program, the DER
identified to the FAA areas of new technology, unusual design features, or those areas requiring special guidance
or direct FAA involvement. Indicators would include timely informal contacts to alert the FAA to areas of concern
and participation in certification meetings to identify significant technical issues for Issue Papers.
12. TIMELY SUBMITTAL OF DATA: DER submittal of compliance data was in a time frame consistent with program schedule and required FAA review. DER consistently avoids last minute "data dumps," thus allowing
adequate time for FAA actions prior to critical program milestones.