I hereby authorize anyone to furnish SITE SAFE any information as may be required on drug and alcohol testing, my personal record and/or character without recourse. I understand that if employed, any misrepresentation or false statement on this application revealed at a later date shall be considered sufficient cause for disqualification. I also understand this application in no way assures the applicant a position with SITE SAFE.

I also understand that a consumer report, which may contain public record information, is being requested from HireRight services. This report may include the following types of information: names and dates of previous employers, reason for termination of employment, work experience, accidents, driving record, worker compensation claims, credit bankruptcy proceedings, criminal records from federal, state and other agencies which maintain such records, driving records requests from such state agencies, state provided driving records, claims involving me in the files of insurance.

I further authorize SITE SAFE to supply the information listed above to include items of information as described in the federal motor carrier safety regulations to HireRight services and to other companies which subscribe to HireRight services or companies that request my work history listed above.

The applicant agrees to furnish such additional information and complete such examinations as may be required to complete his or her file. It is agreed and understood that if hired, the employee may be placed on a trial basis during which time he or she may be discharged without recourse.

This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.