Instructions: Use this form to evaluate and certify commercial motor vehicle (CMV) drivers according to Federal Motor Carriers Safety Association (FMCSA) requirements.

5 – Excellent / Exceeds Standard Performs the task safely, smoothly, and confidently | 4 – Meets Standard Performs the task safely and correctly | 3 – Needs Improvement (Coachable) Task completed but with noticeable errors | 2 – Unsatisfactory / Unsafe Multiple errors or poor judgment Instructor intervention required Automatic retraining required | 1 – Critical Safety Failure Serious safety violation Instructor must take control or terminate test Automatic failure. | Automatic Failure Criteria (Score of 1 in ANY category)

Automatic Failure (Score of 1 in ANY category). Collision or near-miss requiring intervention | Traffic signal or stop sign violation | Excessive speeding | Unsafe lane departure | Failure to yield right-of-way | Unsafe backing or maneuvering | Disregard for instructions or traffic laws.