GXI - Non-Driver Application for Employment 2026

200 Knox Road Tolar, TX 76476 817-579-0520

(Answer all questions – Please Print) In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status or non-job related disability.

Date of Application

DayMonthYear

Position(s) Applied for

Name (Last First Middle)

First NameLast Name

Date of Birth

DayMonthYear

Social Security

Email

Cell Phone Number

Area CodePhone Number

List your addresses of residency for the past 3 years:

Current Address (Street City State Zip Code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Previous Addresses 1 (Street City State Zip Code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Previous Addresses 2 (Street City State Zip Code)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Experience and Qualification – Driver List all States in which you have held a driver's license in the last 3 years

Driver Licenses – State

License Number

Type

Expiration Date

DayMonthYear

Are you now employed?

If not, how long unemployed?

Is there any reason you might be unable to perform the function or the job for which you have Applied?

If yes, explain.

EMPLOYMENT HISTORY All applicants must provide the following information on all employers during the preceding 10 years. List complete mailing address, street number, phone number, fax number, City, State, and Zip Codes. (Note: List employers in reverse order starting with the most recent. Add another sheet as necessary.)

─── Employer 1 ───

Employer 1 – NAME

Employer 1 – ADDRESS

Employer 1 – CITY

Employer 1 – STATE

Employer 1 – CONTACT PERSON

Employer 1 – PHONE #

Area CodePhone Number

Employer 1 – Fax Number

Area CodePhone Number

Employer 1 – FROM (MO/YR)

DayMonthYear

Employer 1 – TO (MO/YR)

DayMonthYear

Employer 1 – POSITION HELD

Employer 1 – SALARY/WAGE

Employer 1 – REASON FOR LEAVING

Employer 1 – WERE YOU SUBJECT TO DRUG TESTING WHILE EMPLOYED?

Employer 1 – EMPLOYER NOTES

─── Employer 2 ───

Employer 2 – NAME

Employer 2 – ADDRESS

Employer 2 – CITY

Employer 2 – STATE

Employer 2 – CONTACT PERSON

Employer 2 – PHONE #

Area CodePhone Number

Employer 2 – Fax Number

Area CodePhone Number

Employer 2 – FROM (MO/YR)

DayMonthYear

Employer 2 – TO (MO/YR)

DayMonthYear

Employer 2 – POSITION HELD

Employer 2 – SALARY/WAGE

Employer 2 – REASON FOR LEAVING

Employer 2 – WERE YOU SUBJECT TO DRUG TESTING WHILE EMPLOYED?

Employer 2 – EMPLOYER NOTES

─── Employer 3 ───

Employer 3 – NAME

Employer 3 – ADDRESS

Employer 3 – CITY

Employer 3 – STATE

Employer 3 – CONTACT PERSON

Employer 3 – PHONE #

Area CodePhone Number

Employer 3 – Fax Number

Area CodePhone Number

Employer 3 – FROM (MO/YR)

DayMonthYear

Employer 3 – TO (MO/YR)

DayMonthYear

Employer 3 – POSITION HELD

Employer 3 – SALARY/WAGE

Employer 3 – REASON FOR LEAVING

Employer 3 – WERE YOU SUBJECT TO DRUG TESTING WHILE EMPLOYED?

Employer 3 – EMPLOYER NOTES

─── Employer 4 ───

Employer 4 – NAME

Employer 4 – ADDRESS

Employer 4 – CITY

Employer 4 – STATE

Employer 4 – CONTACT PERSON

Employer 4 – PHONE #

Area CodePhone Number

Employer 4 – Fax Number

Area CodePhone Number

Employer 4 – FROM (MO/YR)

DayMonthYear

Employer 4 – TO (MO/YR)

DayMonthYear

Employer 4 – POSITION HELD

Employer 4 – SALARY/WAGE

Employer 4 – REASON FOR LEAVING

Employer 4 – WERE YOU SUBJECT TO DRUG TESTING WHILE EMPLOYED?

Employer 4 – EMPLOYER NOTES

─── Employer 5 ───

Employer 5 – NAME

Employer 5 – ADDRESS

Employer 5 – CITY

Employer 5 – STATE

Employer 5 – CONTACT PERSON

Employer 5 – PHONE #

Area CodePhone Number

Employer 5 – Fax Number

Area CodePhone Number

Employer 5 – FROM (MO/YR)

DayMonthYear

Employer 5 – TO (MO/YR)

DayMonthYear

Employer 5 – POSITION HELD

Employer 5 – SALARY/WAGE

Employer 5 – REASON FOR LEAVING

Employer 5 – WERE YOU SUBJECT TO DRUG TESTING WHILE EMPLOYED?

Employer 5 – EMPLOYER NOTES

Have you previously applied or been employed with Granbury Excavating, Inc.?

If so, when?

Are you related in any way to a current GXI employee?

If yes, to whom and what is the relation?

A. Do you have reliable transportation to and from work every day?

B. Has any license you held ever been suspended or revoked?

C. Have you ever been convicted of a felony offense? (Answering Yes to C does not necessarily disqualify the applicant)

If you answered yes to B or C, give details below.

Granbury Excavating, Inc. TO BE READ AND SIGNED BY THE APPLICANT

I authorize you to make such investigations and inquiries of my personal background, employment history, medical history, driving record, academic/professional credentials, military service, and other related matters as may be necessary in arriving at an employment decision and as necessary throughout the course of my employment. (Generally, inquiries regarding medical history will be made only after a conditional offer of employment has been extended.) I hereby release former employers, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application for employment. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate discharge. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my dates of employment, work performance, reason for separation and wage information as needed. I understand I have the right to: • Review information provided by previous employers; • Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and • Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. I am aware any offer of employment will be contingent upon satisfactory completion of a pre-employment drug screen and physical evaluation. The offer of employment will be withdrawn if the result of either is unsatisfactory. If you wish to review previous employer-provided investigative information, you must submit a written request to the Company, no later than 30 days after being employed or being notified of denial of employment. The Company will provide the requested investigative information to you within five (5) business days of receiving this written request, or five (5) business days of receipt of the requested information from the previous employer, whichever is later. 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.

Date

DayMonthYear

Applicant's Signature

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Granbury Excavating, Inc. NON - DRIVER APPLICATION FOR EMPLOYMENT