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I certify that the facts contained in this
application are true and complete to the best of
my knowledge. I understand that any false statement,
omission, or misrepresentation in this application is
sufficient cause for refusal to hire or dismissal if
I have been hired regardless of date of discovery by
Adams Resources & Energy, Inc. and its subsidiaries
(the Company). I authorize the company to thoroughly
investigate all statements contained in this application
or resume, and I authorize my former employers to
disclose information regarding my former employment,
character and general reputation with them to the Company
without giving me prior notice to such disclosure.
In addition, I release the Company and any former
employers from any claims, demands, or liabilities
arising out of or related to such investigation
and/or disclosure. I understand and agree that
nothing contained in this application, or conveyed
during any interview, is intended to create any
employment contract. I further understand and agree
that if I am hired any employment will be “AT WILL”
and without fixed term and may be terminated at any
time, with or without cause and without prior notice,
at the option of either myself or the Company. No
promises regarding employment have been made to me
and I understand that no such promise or guarantee
is binding upon the Company unless made in writing.
I understand that completion of this application does
not indicate employment availability and does not
obligate the Company to hire me. I agree to adhere
to all Company work rules, policies and procedures.
Adams Resources & Energy, Inc. and its subsidiaries
reserve the right to revise its policies or procedures,
in whole or in part at any time.
When the application for employment is submitted by
mail, telephone, computer, or other similar means,
if the Company uses any information it obtains from a
consumer reporting agency, including FMCSA, in a
decision to not hire you or to make any other adverse
employment decision regarding you, the Company must
provide you within three business days of taking adverse
action oral, written or electronic notification: that
adverse action has been taken based in whole or in part
on information obtained from a consumer reporting agency;
the name, address, and the toll free telephone number of
consumer reporting agency; that the consumer reporting
agency did not make the decision to take the adverse
action and is unable to provide you the specific reasons
why the adverse action was taken; and that you may, upon
providing proper identification, request a free copy of
the report and may dispute with the consumer reporting
agency the accuracy or completeness of any information
or report. If you request a copy of any consumer report
from the Company who procured the report, then, within 3
business days of receiving your request, together with
proper identification, the Company must send or provide
to you a copy of your report and a summary of your rights
under the Fair Credit Reporting Act.
Adams Resources & Energy, Inc. and its subsidiaries
does not discriminate in hiring or employment on the
basis of race, color, creed, national origin, sex, age,
sexual orientation, disability, or status as a disabled
veteran or a veteran of the Vietnam Era, or any basis
prohibited by state or federal law. No question on your
application is intended to secure information used for
such discrimination. All applicants and employees will
be treated equally in conformity with all existing laws.
HIRERIGHT, INC. AUTHORIZATION
I understand that Adams Resources & Energy, Inc. and
subsidiaries (the Company) may request, for lawful
purposes, background information about me from a consumer
reporting agency, i.e., Hire Right, Inc., in connection
with my employment or application for employment. This
information may be obtained in the form of consumer
reports and/or investigative consumer reports (commonly
known as “background reports”). These background reports
may be obtained at any time after receipt of your authorize
and, if you are hired, or engaged by the Company,
throughout your employment or your contract period.
The background reports may contain information concerning
my character, general reputation, personal characteristics,
mode of living, and credit standing. The types of
information that may be obtained include, but are not
limited to: social security number verifications; address
history; credit reports and history; criminal records and
history; public court records; driving records; accident
history; worker’s compensation claims; bankruptcy filings;
educational history verifications (e.g., dates of
attendance, degrees obtained); employment history
verifications (e.g., dates of employment, salary
information, reasons for termination, etc.); personal
and professional reference checks; professional licensing
and certification checks; drug/alcohol testing results,
and drug/alcohol history in violation of law and/or
company policy; and other information bearing on your
character, general reputation, personal characteristics,
mode of living and credit standing.
This information may be obtained from private and public
record sources, including, as appropriate: government
agencies and courthouses; educational institutions;
former employers; personal interviews with sources such
as neighbors, friends and associates; and other
information sources. If the Company should obtain
information bearing on your credit worthiness, credit
standing or credit capacity for reasons other than as
required by law, the Company will use such credit
information to evaluate whether you would present an
unacceptable risk of theft or other dishonest behavior
in the job for which you are being evaluated.
I consent to the preparation of background reports by a
consumer reporting agency such as HireRight, Inc. and
to the release of such background reports to the Company
and its designated representatives and agents, for the
purpose of assisting the Company in making a determination
as to my eligibility for employment (including independent
contractor assignments, as applicable), promotion,
retention or for other lawful employment purposes.
I understand that if the Company hires me or contracts
for my services, my consent will apply, and the Company
may obtain background reports, throughout my employment
or contract period.
I understand that the information contained in my
employment or contractor application, or otherwise
disclosed by me before or during my employment or
contract assignment, if any, may be used for the purpose
of obtaining and evaluating background reports on me.
PSP AUTHORIZATION
I hereby authorize law enforcement agencies, learning
institutions (including public and private schools and
universities), information service bureaus, credit bureaus,
record/data repositories, courts (federal, state and
local), motor vehicle records agencies, my past or
present employers, the military, and other individuals
and sources to furnish any and all information on me that
is requested by the consumer reporting agency.
I understand Adams Resources & Energy, Inc. and
subsidiaries (the Company) may obtain one or more reports
regarding my driving and safety inspection history from
the Federal Motor Carrier Safety Administration (FMCSA).
I authorize the Company to access the FMCSA Pre-Employment
Screening Program (PSP) system to seek information
regarding my commercial driving safety record and
information regarding my safety inspection history.
I understand that I am consenting to the release of
safety performance information including crash data from
the previous five (5) years and inspection history from
the previous three (3) years. I understand and acknowledge
that this release of information may assist the Company to
make a determination regarding my suitability as an
employee.
I further understand that neither the Company nor the
FMCSA contractor supplying the crash and safety information
has the capability to correct any safety data that appears
to be incorrect. I understand that I may challenge the
accuracy of the data by submitting a request to
https://dataqs.fmcsa.dot.gov. If I am challenging crash
or inspection information reported by a State, FMCSA
cannot change or correct this data. I understand my
request will be forwarded by the DataQs system to the
appropriate State for adjudication.
Please note: Any crash or inspection in which you were
involved will display on your PSP report. Since the PSP
report does not report, or assign, or imply fault, it
will include all Commercial Motor Vehicle (CMV) crashes
where you were a driver or co-driver and where those
crashes were reported to FMCSA, regardless of fault.
Similarly, all inspections, with or without violations,
appear on the PSP report. State citations associated
with FMCSR violations that have been adjudicated by a
court of law will also appear, and remain, on a PSP
report.
I HAVE READ AND UNDERSTOOD THIS AGREEMENT AND BY MY
ELECTRONIC SIGNATURE BELOW INDICATE MY ACCEPTANCE OF
THIS AGREEMENT AND AUTHORIZE ANY BACKGROUND REPORTS
THAT MAY BE REQUESTED BY OR ON BEHALF OF THE COMPANY.
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