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    Are you authorized to work in the U.S.?

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    WHICH LOCATION ARE YOU APPLYING FOR?
    PERSONAL INFORMATION
    Have you ever applied for employment or been employed by Spike Enterprise, Inc?
    Choose from list below.
    Skip this question if not referred by a Spike Enterprise employee.
    PERSONAL INFORMATION
    Are you willing to submit to take a drug test if required as part of your application, if you have received a conditional offer of employment?
    PERSONAL INFORMATION
    If you receive a conditional offer of employment, will you submit to a medical examination and/or answer a medical questionnaire (after a hiring decision is made)?
    Enter as: street address, city, state, zip code.
    Skip this question if you have lived at your current address for at least three years.
    PERSONAL INFORMATION
    Have you ever been convicted of, or been on probation for DWI or DUI?
    Skip this question if you did not choose "Other".
    EMPLOYMENT HISTORY
    The Federal Motor Carrier Safety Regulations ("FMCSA") (49 CFR 391.21) requires that all applicants wishing to drive a commercial motor vehicle list all employment for the last three years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for and additional 7 years (for a total of ten years). Any gaps in employment in excess of one month must be explained.

    Start with the last or current position, including any military experience, and work backwards. You are required to list the complete mailing address, including: street number, city, state, zip, and complete all other information and questions.

    * Any gaps in employment in excess of one month and/or unemployment must be explained *
    EMPLOYMENT HISTORY JOB #1
    May we contact employer prior to hiring?
    EMPLOYMENT HISTORY JOB #1
    While employed here, were you subject to the Federal Motor Carrier Safety Regulations?
    EMPLOYMENT HISTORY JOB #1
    Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?
    Employment history for jobs #2 through #4 are required only if your most recent employment was less than three years.
    EMPLOYMENT HISTORY JOB #2
    May we contact employer prior to hiring?
    EMPLOYMENT HISTORY JOB #2
    While employed here, were you subject to the Federal Motor Carrier Safety Regulations?
    EMPLOYMENT HISTORY JOB #2
    Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?
    EMPLOYMENT HISTORY JOB #3
    May we contact employer prior to hiring?
    EMPLOYMENT HISTORY JOB #3
    While employed here, were you subject to the Federal Motor Carrier Safety Regulations?
    EMPLOYMENT HISTORY JOB #3
    Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?
    Provide additional information if you meet any of these criteria:

    1) If you have previously driven a motor vehicle, you must provide employment history for an additional seven years (for a total of 10 years).

    2) If you have had more than 3 jobs in the three years prior to this application, you must provide your employer information for these additional jobs.

    3) If you have had any gaps in employment in excess of one month in the three years (or 10 years, if applicable) prior to this application, you must explain.
    QUALIFICATIONS
    Do you have tractor trailer driving experience?
    QUALIFICATIONS
    Do you have any experience in the waste and/or recycling industry?
    CDL ENDORSEMENTS
    Select the CDL endorsements that apply to you.
    List any driver's licenses held in the last three years.
    Include:
    State, license number, type, expiration date for each commercial motor vehicle or CDL license or permit issued to you.
    DRIVING EXPERIENCE
    Select any of the following classes of equipment that apply to your driving experience.
    DRIVING EXPERIENCE
    Select your "Straight Truck" transmission type experience.
    Skip question if no Straight Truck experience.
    DRIVING EXPERIENCE
    Select your "Tractor and/or Semi Trailer" transmission type experience.
    Skip question if no Tractor and Semi Trailer experience.
    DRIVING EXPERIENCE
    Select your "Tractor and/or Two Trailers" transmission type experience.
    Skip question if no Tractor and Two Trailers experience.
    DRIVING EXPERIENCE
    Select your "Tractor and/or Tanker" transmission type experience.
    Skip question if no Tractor and Tanker experience.
    Skip this question if you did not choose "Other" as a class of equipment driving experience.
    DRIVING EXPERIENCE
    Select your "Other Class" transmission type experience.
    Skip this question if you did not choose "Other" as a class of equipment driving experience.
    Skip this question if you did not choose "Other" as a class of equipment driving experience.
    Select years below.
    Select number of accidents below.
    Select number of fatalities below.
    Select number of injuries below.
    Skip question if you have not had any accidents in the three years preceding this application.
    Select number of violations below.
    Skip this question if you have not had any violations with three years of this application.
    Skip this question if you have not had any violations with three years of this application.
    Skip this question if you have not had any violations with three years of this application.
    Skip this question if you have not had any violations with three years of this application.
    Skip this question if you have not had any violations with three years of this application.
    Skip this question if you have not had any violations with three years of this application.
    Skip this question if you have not had any violations with three years of this application.
    Skip this question if you have not had any violations with three years of this application.
    Skip this question if you have not had any violations with three years of this application.
    VIOLATIONS - MOTOR VEHICLE OPERATIONS
    Have you ever had a license, permit, or privilege to operate a motor vehicle denied, revoked or suspended?
    Skip this question if your license, permit or privilege has never been revoked or suspended.
    The Federal Motor Carrier Safety Regulations (49 CFR 391 Subpart E) require that all driver applicants pass certain medical examinations before they are hired to drive a motor vehicle.

    Please enter your date of last Department of Transportation medical examination below.
    PHYSICAL HISTORY
    Can you provide a copy of your last D.O.T. medical examination?
    PHYSICAL HISTORY
    Have you ever been granted a waiver under section 391.49 of the Federal Motor Carrier Safety Regulations pertaining to the loss of a limb (i.e, foot, leg, hand, or arm)?
    DRUGS AND ALCOHOL
    The Federal Motor Carrier Safety Regulations (49 CFR 40.25) requires all persons applying for a driving position requiring a commercial driver's license to answer the following question:

    Within the last two years, have you ever tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety-sensitive transportation work?
    DRUGS AND ALCOHOL
    Within the last two years, have you ever tested positive, or refused to test, on any type of drug or alcohol test administered by an employer for which you performed safety-sensitive transportation work?
    APPLICANT FCRA DISCLOSURE STATEMENT
    In connection with your employment or application for employment (or contract for services) and any future employment (or contract for services) with Spike Enterprise, Inc. ("Spike Enterprise") and any subsidiary, you may have information requested about you from a consumer reporting agency in connection with your application, employment, promotion, reassignment or retention as an employee, for employment purposes. This information may be obtained in the form of background reports and/or investigative reports. These reports may be obtained at any time after receipt of your signed authorization and, if you are hired by Spike Enterprise, throughout your employment if permissible under applicable Spike Enterprise policy and/or state law.

    These reports may contain information about your character, general reputation and/or mode of living. The types of information that may be obtained include, but are not limited to: social security number verifications, address history, criminal records checks, public court records checks, driving records checks, employment history verifications: and professional licensing/certification checks. This information may be obtained from private and/or public records sources, including, as appropriate, governmental agencies and courthouses: educational institutions: former employers; or other information sources.

    (End of disclosure statement)
    AUTHORIZATION OF BACKGROUND INVESTIGATION
    I have carefully read, and understand, this Authorization of Background Investigation form and further acknowledge receipt of the separate document entitled "A Summary of Your Rights under the Fair Credit Reporting Act" (a copy provided by Spike Enterprise or at https://www.comsumer.ftc.gov/articles/pdf-0096-fair-credit-reporting-act.pdf) and the "Applicant FCRA Disclosure Statement" and certify that I have read and understand both documents. By my signature below, I consent to the release of background reports and/or investigative background reports prepared by a consumer reporting agency, to Spike Enterprise and its designated representatives and agents for the purposes of determining my eligibility for employment, retention, or other lawful employment purposes. I further consent to the release of such background reports and/or investigative background reports to essential partners of Spike Enterprise, including but not limited to: industrial safety councils, and owners and/or operators of industrial facilities for which I may be asked to work on the premises of such industrial facility. I understand that if Spike Enterprise offers me a conditional offer of employment, my consent will apply, and Spike Enterprise may obtain background reports throughout my employment if permissible under applicable Spike Enterprise policy and consistent with applicable state and federal law.

    I understand that information contained in my employment application, or otherwise disclosed by me before, or during, my employment, if any, may be used for the purpose of obtaining background reports and/or investigative background reports. I also understand that nothing herein shall be construed as an offer of employment. I hereby authorize law enforcement agencies, educational institutions (including public and private schools/universities), information service bureaus, consumer reporting agencies, record/data repositories, courts (federal, state, and local), motor vehicle records agencies, my past or present employers, the military, and other information sources to furnish any, and all, information on me that is requested by the consumer reporting agency.

    California Applicants Only:
    I acknowledge receipt of a copy of California Civil Code 1786.22.
    Pursuant to Section 1786.22 of the California Civil Code, you may view the file maintained on you by the consumer reporting agency during normal business hours. You may also obtain a copy of this file, upon submitting proper identification by appearing at the consumer reporting agency's offices in person, during normal business hours and on a reasonable notice, or by mail. You may also receive a summary of the file by telephone, upon submitting proper identification. The consumer reporting agency will have trained personnel available to explain your file to you, including any coded information. By signing below, you acknowledge receipt of California Civil Code 1786.22, available from Spike Enterprise Human Resources Department or
    http://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CIV&sectionNum=1786.22

    New York Applicants Only:
    I acknowledge receipt of a copy of Article 23-A of New York Correction Law.
    By signing below, you acknowledge receipt of Article 23-A of the New York Correction Law, available from Spike Enterprise Human Resources Department or at
    https://www.labor.ny.gov/formsdocs/wp/correction-law-article-23a.pdf

    By my signature below, I certify the information I provided on, and in connection with, this form is true, accurate, and complete. I agree that this Authorization form in original, facsimile, photocopy, or electronic (including electronically signed) formats, will be valid for any reports that may be requested by, or on my behalf of, Spike Enterprise.

    California, Oklahoma and Minnesota:
    You have the right to receive a copy of your background/investigative report by checking the box on the Authorization of Background Investigation form.

    Massachusetts and New Jersey:
    If we request an investigative background report, you have the right, upon written request, to a copy of the report.

    Minnesota and Washington State:
    If Spike Enterprise requests an investigative background report, you have the right, upon written request made within a reasonable period of time after your receipt of this disclosure, to receive from Spike Enterprise a complete and accurate disclosure of the nature and scope of the investigation requested by Spike Enterprise. Spike Enterprise will provide the disclosure of the nature and scope of the investigation either in five days after receiving your request or after requesting the investigative consumer report, whichever is later.
    AUTHORIZATION OF BACKGROUND INVESTIGATION
    *New York and Washington State Applicants Only
    New York Applicants Only:
    You have the right to request whether Spike Enterprise requested an investigative consumer report and, if so, Spike Enterprise will give you the name and address of the report's provider if other than the consumer reporting agency identified above. You have the right to inspect and receive a copy of any investigative consumer report requested by Spike Enterprise by contacting the consumer reporting agency identified above (or another organization identified by Spike Enterprise as the provider of an investigative consumer report) directly.

    Washington State:
    If Spike Enterprise requests an investigative background report, you have the right, up written request made within a reasonable period of time after your receipt of this disclosure, to receive from Spike Enterprise a complete and accurate disclosure of the nature and scope of the investigation requested by Spike Enterprise. You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act.
    AUTHORIZATION OF BACKGROUND INVESTIGATION
    *California, Minnesota or Oklahoma applicants only.
    California, Minnesota or Oklahoma applicants may receive a free copy of any consumer report or investigative consumer report obtained on you if you check the box below.
    To receive a free copy of any consumer report or investigative consumer report obtained on you enter your first name, middle initial, and last name below.
    To receive a free copy of any consumer report or investigative consumer report obtained on you enter your street address, city, state, and zip below.
    To receive a free copy of any consumer report or investigative consumer report obtained on you enter your social security number below.
    To receive a free copy of any consumer report or investigative consumer report obtained on you enter your date of birth below.
    To receive a free copy of any consumer report or investigative consumer report obtained on you enter your driver's license number followed by state of issue below.
    To receive a free copy of any consumer report or investigative consumer report obtained on you enter your email address below.
    AUTHORIZATION OF BACKGROUND INVESTIGATION
    *Utah applicants only.
    Utah:
    The Company will obtain written authorization from you before each time the Company obtains a separate or new consumer or investigative consumer report.
    HIPAA RELEASE OF INFORMATION
    Authorization Form

    I hereby authorize Spike Enterprise and its affiliates, its employees, collectively to release to my employer Spike Enterprise, Inc., my personal health information maintained by your office (e.g., information relating to the diagnosis, treatment, physical, drug and alcohol testing results, and health care services provided or to be provided to me and which identifies my name, address, social security number, Member ID number).

    This authorization is valid from the date of my signature below and shall expire the day of my separation from employment with Spike Enterprise, Inc.

    I understand that I have the right to revoke this authorization by providing written notice to your company or agency. I also understand that I have a right to have a copy of this authorization.

    I further understand that this authorization is voluntary and that I may refuse to sign this authorization.
    DEPARTMENT OF TRANSPORTATION NOTICE
    Employee drivers who are regulated by the Department of Transportation ("DOT") in the three (3) years preceding this Application have the following rights regarding the investigative information that will be provided to Spike Enterprise pursuant to FMCS Regulations:

    1) The right to review information provided by previous employers;
    2) The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to Spike Enterprise or other prospective employers;
    3) The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.

    If you have DOT regulated employment history in the previous three (3) years and wish to review previous employer-provided investigative information, you must submit a written request to Spike Enterprise, no later than thirty (30) days after your date of denial of employment or date of hire. Spike Enterprise will provide the information within five (5) business days of receiving the request. If the Company has not yet received the requested information, the five (5) business days does not begin until receipt of the information from your former employer. If you do not receive or pick up the requested records within thirty (30) days of the Company making the records available, your request to review the records will be deemed waived.
    FAIR CREDIT REPORTING ACT DISCLOSURE STATEMENT
    In accordance with the provisions of the Fair Credit Reporting Act (Public La 91-508) as amended by the Consumer Credit Reporting Act of 1996. I have been informed the Company will procure a motor vehicle report (MVR), criminal background check and reference checks, all of which are defined as a consumer report regarding my driving and background record to determine my suitability for work at the Company.

    I understand that I have rights to request, in writing, the information pertaining to the nature and scope of the inquiry and a written summary of my rights under the Fair Credit Reporting Act. I understand that I may have additional rights under applicable state and federal laws.

    I hereby authorize the Company to obtain this information. This authorization shall remain on file and shall serve as ongoing authorization for the Company to procure a motor vehicle report (MVR) and a criminal check which is defined as a consumer report at any time during my employment period. Any copy of this authorization shall have the same authority as the original.
    EMPLOYEE CONFIDENTIALITY AGREEMENT
    Provision of employment restricting employee from divulging employer's trade secrets, vendor, customer, financial, and any other employee's confidential information.

    I, (Employee) agree that any and all knowledge or information that may be obtained in the course of my employment with Spike Enterprise, Inc. with respect to the conduct and details of the business including all trade secrets, vendor, customer, financial, and any other employee's confidential information and including but not limited to the secret processes, formulas, machinery, etc. used by Spike Enterprise, Inc. in manufacturing its products will be forever held in confidence and be concealed from any competitor and all other person. That I, Employee, will not impart the knowledge acquired during my employment to anybody if I should at any time leave Spike Enterprise, Inc. If I, Employee, do so in violation Spike Enterprise, Inc. shall be entitled to an injunction by any competent court of equity enjoining and restraining him [her] and each and every other person concerned from continuance of employment, services or other acts in aid for the business of the rival company or concern. Nothing shall prevent him [her], upon the termination of the employment, in engaging in any occupation in which the processes, formulas, and other secrets of the employer will not be directly or indirectly involved.
    AT WILL EMPLOYMENT
    In the event that the applicant agrees to accept a position with Spike Enterprise, Inc., the applicant and Spike Enterprise, Inc. agree that the employment relationship between Spike Enterprise, Inc. and the employee is in at "at will" relationship and that the employment relationship and compensation can be terminated, with or without cause, and with or without notice at any time, at the option of either Spike Enterprise, Inc. or the employee.
    PRE-HIRING POLICY
    It is the policy of Spike Enterprise that after making a conditional offer of employment, but prior to an offer of employment the corporate office will check and verify the following information is correct and all necessary tests have been passed:
    Pre-hire medical physical
    Drug screen
    Breathe alcohol test
    Professional references
    Education credentials
    Employment history and past performance
    Professional license or certification (if required)

    Following records will be checked:
    Criminal background check for last 7 years
    Driving record
    Commercial driver's license (if applicable)

    Any material misrepresentation or omission on any employment application materials, including but not limited to the job application, or resume may be grounds for rejection of the application or termination of any subsequent employment with Spike Enterprise.
    JOB SAFETY
    Have you had Three Rivers Manufacturing Association safety training?
    JOB SAFETY
    Do you understand the importance of a safe workplace?
    You are required to enter your social security number in this location as part of the Applicant Certification process.

    Authorization

    APPLICANT'S STATEMENT AND CERTIFICATION
    I understand and agree that:

    1. The information that I have provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interviews, can be justification of refusal of employment, or if employed, termination from Spike Enterprise's employ.

    2. This Application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

    3. Any offer of employment I may receive from Spike Enterprise is contingent upon my successful completion of the company's total U.S. Department of Transportation ("DOT") preemployment screening process, including, but not limited to my completion and passing of the following:

    - Receiving the DOT Conditional Offer to Hire
    - DOT required background checks;
    - DOT pre-employment drug and alcohol testing;
    - DOT physical examination;
    - Signing the Applicant's Authorization to Obtain Past Drug and Alcohol Test Results;
    - Signing the Consent to Release Drug and Alcohol Tests Results;
    - Signing the Authorization of Background Investigation;
    - Signing the Criminal History Disclosure Statement;
    Receiving DOT drug and alcohol educational materials and signing the Driver Receipt of Drug and Alcohol Educational Materials;

    I also agree, if employed, to submit to a medical examination at any time at the company's request. I hereby consent to having the results of any post-offer preemployment or post-employment medical exams I may be required to take disclosed to Spike Enterprise.

    4. I understand that as a condition of employment, I may be required to undergo and successfully pass a non-DOT screening for alcohol and/or drugs. I also understand and agree that, if employed, I may be required to submit to a non-DOT alcohol or drug screening at any time in accordance with Spike Enterprise's non-DOT drug and alcohol testing policies. I hereby consent to having the results of any such non-DOT alcohol or drug screening I may be required to undergo disclosed to Spike Enterprise. I further understand that my offer of employment is contingent upon my successful completion of Spike Enterprise's non-DOT drug and alcohol screening.

    5. I authorize and request that all of my present and former employers and those individuals I have listed as personal references furnish information about my employment record, including a statement of the reason for the termination of my employment, work performance, abilities, and other qualities pertinent to my qualifications for employment, and my rate of pay at the time of my termination of employment, and I hereby release these individuals and my present and former employers from any and all liability for damages arising from furnishing the requested information.

    6. In consideration of my employment, I agree to comply with the policies, rules, regulations, and procedures of the company, as may be amended from time to time. I understand that my employment and compensation can be terminated with or without cause or advanced notice, at any time, at the option of either the company or myself. I further understand that no manager or representative of the company, other than the President and CEO, has any authority to enter into any agreement with me for employment for any specified period of time or to make any agreement with me for employment for any specified period of time or to make any agreement different from or contrary to the foregoing. I further understand that any such agreement, if made, shall not be enforceable unless it is in writing and signed by me and by one of the individuals designated above.

    Digital Signature