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| Safety Performance (STEP) | | |
| Speeding Violations (Last 3 Months) (NUMBER) | | |
| Near Miss Incidents (Last 3 Months) (NUMBER) | | |
| Seatbelt Usage Consistency (SELECTION options: Always, Frequently, Sometimes, Rarely, Never) | | |
| Following Distance Maintained (SELECTION options: Excellent, Good, Fair, Needs Improvement) | | |
| Description of Any Safety Concerns Observed (TEXT) | | |
| Mirror Usage (Frequency & Effectiveness) (SELECTION options: Excellent - Constant Monitoring, Good - Regular Checks, Fair - Occasional Checks, Needs Improvement) | | |
| Awareness of Surroundings (SELECTION options: Excellent, Good, Fair, Needs Improvement) | | |
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| Vehicle Operation & Maintenance (STEP) | | |
| Pre-Trip Inspection Score (0-10) (NUMBER) | | |
| Describe any vehicle defects noted during pre/post-trip inspections. (TEXT) | | |
| Fuel Efficiency (MPG) (NUMBER) | | |
| Vehicle Cleanliness (Interior) (SELECTION options: Excellent, Good, Fair, Poor) | | |
| Tire Condition (Overall) (SELECTION options: Excellent, Good, Fair, Needs Attention) | | |
| Upload Photo of Vehicle Condition (Optional) (UPLOAD) | | |
| Any corrective maintenance performed during the review period? If so, describe. (TEXT) | | |
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| Route Adherence & Efficiency (STEP) | | |
| Average Speed (MPH) (NUMBER) | | |
| Miles Driven per Day (NUMBER) | | |
| Fuel Consumption (MPG) (NUMBER) | | |
| Route Deviation Occurrences (SELECTION options: None, Minor (less than 5 miles), Moderate (5-10 miles), Significant (over 10 miles)) | | |
| Reason for Route Deviation (if applicable) (TEXT) | | |
| Adherence to Scheduled Delivery Times (SELECTION options: Always, Mostly, Sometimes, Rarely, Never) | | |
| Average Delivery Time Variance (minutes) (NUMBER) | | |
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| Professionalism & Customer Service (STEP) | | |
| Customer Interaction Quality (SELECTION options: Excellent, Good, Fair, Needs Improvement) | | |
| Describe a specific positive interaction with a customer. (TEXT) | | |
| Describe any instances of customer complaints or concerns. (TEXT) | | |
| Appearance and Demeanor (SELECTION options: Professional and Neat, Generally Presentable, Needs Improvement, Unsatisfactory) | | |
| Communication Skills (Clarity & Respect) (SELECTION options: Excellent, Good, Fair, Needs Improvement) | | |
| Notes on Driver's attitude and overall demeanor. (TEXT) | | |
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| Compliance & Regulatory Adherence (STEP) | | |
| Hours of Service (HOS) Violations (if any) (NUMBER) | | |
| Compliance with Load Securement Procedures (SELECTION options: Fully Compliant, Minor Deviation, Significant Deviation, Not Compliant) | | |
| DOT Physical Card Expiration Date Verified? (SELECTION options: Yes, No, N/A - Card Not Required) | | |
| Last DOT Physical Date (DATE) | | |
| Vehicle Inspection Report (VIR) Completion & Accuracy (SELECTION options: Completed Accurately, Minor Discrepancy, Significant Discrepancy, Not Completed) | | |
| Details of any compliance issues encountered (if applicable) (TEXT) | | |
| Adherence to Speed Limits (SELECTION options: Always Compliant, Occasionally Exceeded, Frequently Exceeded) | | |
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| Communication & Reporting (STEP) | | |
| Briefly describe any incidents reported during this evaluation period (accidents, near misses, mechanical issues). (TEXT) | | |
| Number of times communication delays/issues were reported. (NUMBER) | | |
| Describe the clarity and effectiveness of the driver's communication regarding delivery status updates. (TEXT) | | |
| How would you rate the driver’s responsiveness to dispatch communications? (SELECTION options: Excellent, Good, Fair, Needs Improvement) | | |
| Date of last incident report submitted. (DATE) | | |
| Any comments regarding the driver's reporting practices. (TEXT) | | |
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