Please provide a complete record of all employment for the last three (3) years, including any unemployment or self-employment periods, and all commercial driving experience for the past ten (10) years.

It is agreed and understood that any misrepresentation on this application shall be considered an act of dishonesty and that any false information in support of my application may subject me to discharge at any time during the period of my employment. I agree that either party may terminate employment relationship, with or without cause, at any time, and I further agree that this arrangement may only be altered in writing directed to me personally and signed by the president of the firm or an authorized representative. I agree that I shall be bound by the other rules, policies, regulations and terms and conditions of employment of the firm as they are from time to time changed, and no additional obligations can be imposed on the firm except those which have been acknowledged in writing by the president or his designated representatives.

I agree that any action or suit against the firm, its agents or employees, arising out of my employment or termination of employment, including, but not limited to, claims arising under State and Federal law, but not Federal civil rights statutes containing a separate limitations period, must be brought within 180 days of the event giving rise to the claims or be forever barred unless the applicable statute of limitations period is shorter than 180 days in which case I will continue to be bound by that shorter limitations period. I wave any limitation periods to the contrary. I further agree that if I should bring any non-statutory action or claim arising out of my employment against the firm, in which case the firm prevails, I will pay to the firm any and all such costs incurred by the firm in defense of said claims or actions, including attorney fees.

It is agreed and understood that the motor carrier or his agents may investigate the applicant’s background to obtain any and all information of concern to the applicant’s record, whether some is of record or not, and applicant releases employers and persons named herein from all liability for any damages on account of his furnishing such information.

It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigating Consumer Report, including information regarding my character, general reputation, personal characteristics and mode of living. I agree to furnish such additional information and complete such examinations as may be required to compete my application file. It is agreed and understood that this application in no way obligates the motor carrier to employ or hire the applicant.

It is agreed and understood that if qualified and hired, I may be on a probationary person during which time I may be disqualified without recourse. This certifies that this application was completed by me, and all entries on it and information in it are true and complete to the best of my knowledge.