I hereby certify that all of the information given herein is complete, made truthfully, without evasion. If found to be false or made with deliberate omission, it will be a sufficient reason for dismissal. I understand that all information I have furnished may be investigated and hereby authorize Heritage Products, Inc. to reproduce this signed statement as authorization of former employers or other individuals to give information concerning me. I hereby release from liability or damage those individuals who may provide such information relating to my prior record. I understand that upon request I will furnish to the employer a copy of my birth certificate and a copy of my military discharge papers. I understand that failure to pass a drug test as part of the employment medical evaluation will result in denial of consideration for employment. In consideration of my employment, I agree to conform to the rules and regulations of Heritage Products, Inc. My employment can be terminated, with or without cause, and with or without notice, at any time, at the option of either the company or myself. I understand that no representative of the company other than the Chief Executive Officer has the authority to enter into an employment agreement for any specified period of time or to make any agreement contrary to the foregoing. Any such agreement must be in writing signed by the Chief Executive officer and me.