Disclosure and Authorization to Release Information

As part of our contract and background and Investigation, we may obtain consumer reports, prepare an investigative consumer report and/or to conduct a criminal background report. The investigative consumer report may consist of contacting all listed prior employers or contractors to verify your history. It may also include, but not limited to, credit information reports, criminal history reports and driving history records. The information contained in these reports may affect decisions relating to your contract. Under the provisions of the Fair Credit Reporting Act (15 USC at 1681-1681u) as amended, before we can seek such reports, we must have your written permission to obtain the information. You the right upon written request, to a complete and accurate discloser of the nature and scope of the investigation. You are also entitled to a copy of your rights under the Fair Credit Reporting Act. I understand that the complete and final results of the company's investigation of my background check may not be available to the company before my contract, if any, with the company commences. I also understand that the results of the company's investigation into my background may affect my ability to contract or continuance to be able to hold a contract with company.

do hereby authorize verification of all information in my contract application from all sources of employment, contracts, education, motor vehicle, financial history, criminal history, personal character or an agent of CUI to obtain the information referred to herein, whether the said records are public or private, and including those which may be deemed to be privileged or confidential in nature. Information appearing on this Authorization will be used exclusively by CUI for identification purposes and for the release of information which will be considered in determining any suitability for contract. I authorize without reservation any individual, corporation or other private or public entity to furnish or any of its agents the , its agents and any and all individuals, corporations, or other private or public entities providing information from any liability for damages that may result to me as a result of furnishing or attempting to furnish such information. I certify that I have made true, correct, and complete answers and statements on my contract application, any supplements to it and any interview in the knowledge that they will be relied upon in considering my application for employment. I agree to provide additional information that may be requested to process my employment application. I authorize without reservation, any part or agency or any agent of CUI, to furnish the above-mentioned contacted by information. This authorization is valid during the course of my contract to the extent permitted by law.

information referred herein. I release

I understand and agree that any omission, false statement, misleading statement, or answer made by me on my application or any supplements to it and in any interviews will be sufficient grounds for rejection of contract and my discharge of contract.

Contract Drug Testing Agreement

I hereby consent to submit urinalysis and/or other tests as shall be determined by

in the selection process of applicants for contracting for the purpose

I agree that them to Laboratory for analysis.

may collect these specimens for the tests and forward

I further agree to, and hereby authorize, the release of the results of said tests to

designated Medical Review Officer (MRO), and from the MRO to the

contractor. Positive results may be reported to the company by the MRO.

I understand that the current use of drugs and/or alcohol shall prohibit me from contracting for . I further agree to hold harmless this company and its agents, Laboratory, and Medical Review Officer from any liability arising in whole or in part from the collection of specimens, testing, and use of the results from said tests in connection with the company's consideration of my application for contract.

Ifurther agree that a reproduced copy of this Contract consent and release form shall have the same

force and effect as the original. I have carefully read the forgoing and fully understand its contents. I acknowledge that my signing of this consent and release form is a voluntary act on my part and that I have not been coerced by anyone to sign this document.

benefit plans' sponsors, fiduciaries,

i) the right to have the party's claim consolidated or to seek to have the party's claim consolidated with the claims of other persons or

to as "Applicable Substantive Law"

hat Arbitrator Decide "Gateway" Questions of Arbitrability

The parties expressly agree and acknowledge their "clear and unmistakable" intent,

all "Gateway" questions of arbitrability. Accordingly, the parties agree that

she incurs as a result of Arbitration, specifically including a party's own attorney's

Arbitrator's fees) or establishes a per se prohibition on the total amount of imposed