I certify that I am physically capable with or without accommodations to perform the job functions of any work for you are being considered.
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application may result in dismissal. I authorize investigation of all information concerning my previous employment and any pertinent information, personal and otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. A copy of the authorization may be relied upon as if it were the original document.
I agree that in the event I am hired and leave the employee of the Holes Companies for any reason wherein I am indebted to the Holes Companies for any sums whatsoever, the Holes Companies is hereby authorized to deduct or offset any amounts due and owing by me from the amount owed to me by the Holes Companies up to the maximum amount permitted by law.
I understand that the Holes Companies will not tolerate the use or possession of non-prescription drugs and/or alcohol by its employees, nor does the Holes Companies permit the possession of weapons of any kind or unauthorized possession of Holes Companies property. I realize that in order to insure compliance with these policies and with other policies, which the Holes Companies may decide to take certain security measures, which include searches of lockers and desks, purses, coats or other items in which material could be stored including automobiles parked on the Holes Companies premises. Furthermore, I understand that I may be subject to hair, blood and/or urine tests, and that I will be required to comply with any security measures, including but not limited to those mentioned above, which may be introduced by the Holes Companies.
I further understand that if my assigned duties require driving a Holes Companies or personal vehicle, that the Holes Companies ability to obtain insurance coverage for me is very important, and that I will be subject to termination upon becoming uninsurable at standard rates due to traffic violations received on or off the job (and prior to becoming employed) and irrespective of fault.
I understand that in the course of my employment with the Holes Companies, I may have access to, or knowledge of, information that the Holes Companies considers confidential. I further understand that it is important that the Holes Companies protect its confidential information. Therefore, I agree, as a pre-condition of employment, to enter into a Confidentiality Agreement with the Company, if such is required.
It is further understood that, once hired, my employment is for no definite period and may regardless of the date of payment of my wages, be terminated at any time by me or the Holes Companies, with or without reason and with or without prior notice.
As a condition of employment with HOLES COMPANIES, I agree that I will not release or divulge any information gained by me by any means to any one, except as required by law and directed by proper legal authority. Such information included, but is not limited to customer lists, bids, information regarding special fabrication or processing of materials, computer data, etc. I understand that if I fail to comply with this requirement, I am subject to being sued and subjected to a cause of action for a temporary restraining order, injunction, breach of contract and other remedies and may be subjected to a judgement in favor of HOLES COMPANIES to recover any damages they suffer as a result of information lost, it’s attorneys fees and costs. I also understand any (3rd) party to whom I divulge such confidential information may also be held liable to HOLES COMPANIES for any damages they suffer as a result of my actions.
COSUMER REPORT DISCLOSURE
Holes Companies may obtain a “consumer report” including but not limited to your personal background and credit information through credit agencies, records search, or other sources for purposes related to your application for employment or continued employment Holes Incorporated including hiring, promotion, reassignment, or retention. Holes Companies may also obtain an “investigative consumer report” as defined by the Fair Credit Reporting Act (FCRA), to evaluate your personal background including character, general reputation, personal characteristics, and mode of living through personal interviews with neighbors, friends, or other sources for purposes related to your application for employment or continued employment with Holes Companies. The Fair Credit Reporting Act required that this disclosure inform you of your rights which are enclosed in Attachment A hereto titled “A Summary of your Rights Under the Fair Credit Reporting Act.”
CONSUMER REPORT AND INVESTIGATIVE CONSUMER REPORT
The undersigned authorizes Holes Incorporated to obtain background and credit information through credit agencies, records search, or other sources for purposes related to the undersigned’s application for employment or continued employment with Holes Incorporated including hiring, promotion, reassignment, or retention. The undersigned also authorizes Holes Incorporated to obtain an “investigative consumer report” as defined by the FCRA, to evaluate my personal background including character, general reputation, personal characteristics, and mode of living through personal interviews with neighbors, friends, associates, or other sources for purposes related to my application for employment or continued employment with Holes Incorporated. This authorization shall automatically remain effective throughout the application process and employment relationship, should one exist. A copy of the report will be provided to you upon request.
Before taking adverse action with respect to the applicant, Holes Incorporated will do the following as set forth in Section 615(b)(2) of the FCRA:
Notify the applicant of the action, including a statement that the applicant may obtain the information upon a written request from the applicant received within 60 days after
transmittal of the notice required by clause
Disclose to the applicant the nature of the information upon which the action is based by no later
than 30 days after receipt of the request.
NORTH AMERICAN BACKGROUND SCREENING CONSORTIUM #1 OBJECTIVE
The participating industrial facility Owners recognize the benefits of Contractor Employee background
screening in identifying individuals who may pose a risk to Owner financial assets and the people working
at Owner facilities through behavior that may cause serious safety incidents, workplace violence,
domestic terrorist acts, and theft of materials, equipment or technology.
The target population for the Program includes Contractor Employees providing maintenance construction and operational support services at petrochemical facilities such as chemical plants and refineries, energy production and utility facilities, and other industrial manufacturers. For more information visit: www.nabsc.org
I understand that by executing this document, I am consenting to submit to a pre-employment/pre-access drug/alcohol test.
I further acknowledge that consenting to such testing, testing negative for drug use, and otherwise complying with the Substance Abuse Policy are conditions of employment with Holes Incorporated. As such, refusal to consent to testing or testing positive will automatically terminate the application process.
Furthermore, by signing this Substance Abuse Policy Acknowledgement. I consent to the release of all testing results to Holes Incorporated management. I further release and hold harmless Holes Incorporated and the testing laboratory from any and all claims or causes of action based on any action taken in connection with such results.
A copy of this Substance Abuse Policy Acknowledgement may be used in lieu of the original for all purposes.