List all addresses for the last 3 years
Class of Equipment
JR & CO is concerned with the health and safety of all its employees, as well as the safety of the general public. Therefore, we require, as one of the steps in the hiring process, that all otherwise qualified applicants for employment consent and submit to a drug screen. The drug screen will require the applicant to provide a urine sample, which will be tested for the presence of controlled substances, including but not limited to marijuana, cocaine, phencyclidine, amphetamines, and opiates.
I hereby give my consent to JR & CO to administer drug testing procedures to me and to use the results thereof in further determining my employ-ability with the company. A confirmed positive test result, or the refusal to submit a drug screen, will disqualify the applicant from further consideration for employment with JR & Company Roofing.
I agree and understand that JR & Company Roofing and/or its agents may investigate my safety performance history, driving record, background, and employment history to ascertain any and all information pertaining to my record, whether same is of record or not. I release employers and persons named herein from all liability for any and all damages resulting from the furnishing and release of such information.
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 safety performance history as required by 49 CFR 391.23(d) and (e). I understand that 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 erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
I understand and agree that this application for employment does not obligate JR & Company Roofing to employ me, and that any interviews granted may be at my expense.
Once a contingent offer of employment has been made, I agree to furnish any additional information and/or submit to oral, written, or physical examinations, including testing for the presence of controlled substances, bonding, and pre-employment processing as may be required to complete the employment file.
In consideration of my employment, I agree to conform to the rules and regulations of JR & Company Roofing, including signing an Employee or Executive Agreement and an Invention Agreement. I understand and agree that should I become employed by JR & Company Roofing, I will be an employee at will. My employment can be terminated, with or without notice, at any time, with or without cause, at the option of either the company or myself. I further understand that no representative of the company other than the President has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.
I understand that any misrepresentation, omission, or false statement by me in this application, in any supplement thereto, or in any other corporate records including those used in connection with JR & Company Roofing’ drug testing procedures, will be sufficient grounds for not employing me, and may result in dismissal without notice at any time during my employment.
I acknowledge that JR & Co. Inc. may perform criminal background investigation accordance with the Fair Credit Reporting Act if I am hired, and that my employment may be terminated if that investigation determines that I do not meet JR & Co., Inc. hiring criteria. I also agree that should I become employed by JR & Co., Inc. the company may investigate and monitor my motor vehicle record in accordance with the Fair Credit Reporting Act for the purpose of determining eligibility to operate a motor vehicle while performing services for JR & Co., Inc.
This authorization is valid as long as I am an employee or employee candidate and may only be rescinded in writing.
In case of emergency, please list a contact name and phone number.