877-356-3450

*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

†The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a Motor Vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 lbs. or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

I CERTIFY THAT THE RESPONSES GIVEN BY ME ON THIS APPLICATION ARE TRUE, CORRECT, AND COMPLETE TO THE BEST OF MY KNOWLEDGE, AND I UNDERSTAND THAT ANY FALSIFICATION OR MISREPRESENTATION IS GROUNDS FOR REJECTION OR DISMISSAL. I FURTHER UNDERSTAND THAT THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT, AND THAT IF HIRED BY INDUSTRY SPECIFIC SOLUTIONS, MY EMPLOYMENT CAN BE TERMINATED FOR ANY REASON, AT ANY TIME, AT THE OPTION OF EITHER THE COMPANY OR MYSELF.

IT IS AGREED AND UNDERSTOOD THAT THE EMPLOYER OR HIS AGENTS MAY INVESTIGATE THE APPLICANT’S BACKGROUND TO ASCERTAIN ANY AND ALL INFORMATION OF CONCERN TO APPLICANT’S RECORD, WHETHER SAME IS OF RECORD OR NOT, AND APPLICANT RELEASES EMPLOYERS AND PERSONS NAMED HEREIN FROM ALL LIABILITY FOR ANY DAMAGES ON ACCOUNT OF HIS FURNISHING SUCH INFORMATION.

IT IS ALSO AGREED AND UNDERSTOOD THAT UNDER THE FAIR CREDIT REPORT ACT, PUBLIC LAW 91-500, I HAVE BEEN TOLD THAT THIS INVESTIGATION MAY INCLUDE AN INVESTIGATING CONSUMER REPORT, INCLUDING INFORMATION REGARDING MY CHARACTER, GENERAL REPUTATION, PERSONAL CHARACTERISTICS, AND MODE OF LIVING.

I AGREE TO FURNISH SUCH ADDITIONAL INFORMATION AND COMPLETE SUCH EXAMINATIONS AS MAY BE REQUIRED TO COMPLETE MY EMPLOYMENT FILE.

THIS CERTIFIES THAT THIS APPLICATION WAS COMPLETED BY ME, AND THAT ALL ENTRIES ON IT AND INFORMATION IN IT ARE TRUE AND COMPLETE TO THE BET OF MY KNOWLEDGE.

I. NOTICE TO DRIVERS The Commercial Motor Vehicle safety act of 1986 provides for stronger controls over drivers of commercial vehicles. The new law applies to all drivers operating vehicles and combinations with a Gross Vehicle Weight Rating over 26,000 pounds, and to any vehicle, regardless of weight, transporting hazardous materials in a quantity requiring placarding.

The following provisions of this legislation became effective July 1, 1987:

1. No driver may possess more than one license, and no motor carrier may use a driver having more than one license.

2. A driver convicted of a traffic violation (other than parking) in any vehicle must notify the motor carrier AND the state which issued the license to that driver of the conviction within 30 days.

3. Any person applying for a job as a commercial vehicle driver must inform the prospective employer of all previous employment as the driver of a commercial vehicle for the past 10 years, in addition to any other required information about the applicant's employment history.

4. The Federal Motor Carrier Safety Regulations require that a driver who loses any privilege to operate a commercial vehicle, or who is disqualified from operating a commercial vehicle, must advise the motor carrier the next business day after receiving notification.

PENALTIES - Any violation of the above is punishable by a fine not to exceed $2,500. Willful violation of (1) or (3) above, or failure to notify the motor carrier within 30 days of the loss of any privilege to operate a commercial vehicle can result in criminal penalties not to exceed $5,000 and/or 90 days in jail.

II. CERTIFICATION BY DRIVER I hereby certify that I have read the above and understand the driver provisions of the Commercial Motor Vehicle Safety Act of 1986, which became effective on July 1, 1987.

In connection with my application for employment (including contract for services) with you, I understand that consumer reports which may contain public record information may be requested from DAC Services - Tulsa, Oklahoma. These reports may include the following types of information: names and dates of previous employers, reason for termination of employment, work experience, accidents, etc. I further understand that such reports may contain public record information concerning my driving record, workers' compensation claims, credit, bankruptcy proceedings, criminal records, etc., from federal, state and other agencies which maintain such records; as well as information from DAC concerning previous driving record requests made by others from such state agencies, and state provided driving records.

I AUTHORIZE, WITHOUT RESERVATION, ANY PARTY OR AGENCY CONTACTED BY DAC TO FURNISH THE ABOVE-MENTIONED INFORMATION.

I have the right to make a request to DAC, upon proper identification, to request the nature and substance of all information in its files on me at the time of my request, including the sources of information; and the recipients of any reports on me which DAC has previously furnished within the two year period preceding my request. I hereby consent to your obtaining the above information from DAC, and I agree that such information which DAC has or obtains, and my employment history with you if i am hired, will be supplied by DAC to other companies which subscribe to DAC Services.

I hereby authorize procurement of consumer report(s). If hired (or contracted), this authorization shall remain on file and shall serve as ongoing authorization for you to procure consumer reports at any time during my employment (or contract) period.

While employed with Industry Specific Solutions, I understand that I may not seek full or part-time employment with any customer, facility or domicile site that Industry Specific Solutions dispatches me to directly or indirectly for a period of six months upon my termination from ISS. If I have completed an application with a customer facility or domicile that Industry Specific Solutions services within 3 months prior to seeking employment with Industry Specific Solutions the above rule shall be excluded.

It is also understood that a customer may agree to hire an Industry Specific Solutions Contractor after the requirements have been met by that contractor. However, the customer nor Industry Specific Solutions obligates themselves to this option and shall not be held to any such agreement at any time a contractor is assigned.

Please sign below to confirm that you have read and agree to the above Industry Specific Solutions Contractor Disclosure and Release Policy.

Grounds for Immediate Termination:

Falsification or misrepresentation of employment records, application for employment, tie card documents, company/customer reports or statements.

Drinking alcoholic substances, controlled substance abuse, fighting or physical abuse on the premise of Industry Specific Solutions or any customer of the company. Carrying weapons on any kind on our premises or customer's premises.

Theft of company, customer, or employee property.

Sabotage or deliberate interference with company projects, products, or operations.

Failure to surrender an out of state CDL, and obtain Michigan CDL 30 days after hire.

Violation of any safety riles that place other employees or self in danger.

4 points on your motor vehicle record.

More than 1 preventable accident.

Harassment of any kind whether physical, emotional, or verbal.

Accepting load and not showing up.

Reporting to any customer location without the approval of Industry Specific Solutions Dispatch.

Being made a Do Not Use at a customer location due to performance issues.

Repeated absences or tardiness.

Failure to represent company in a professional manner or discourteous behavior towards our customers or employees of Industry Specific Solutions.

Failure to follow management directives or insubordinate behavior.

Careless or negligent handling of company or customer properties.

Failure to perform duties to expected levels.

Inability to be contacted for work assignments and or not calling in at designated time periods for work assignments.

Failure to check in for assignments at designated call-in times.

Please sign below to confirm that you have received a copy of the company code of conduct policy.rules for termination.

Per Federal Motor Carrier Safety Regulations, it is mandatory that the following items are included in a Commercial Driver’s D.O.T. File: MOTOR VEHICLE RECORD, CRIMINAL REPORT, PRE-EMPLOYMENT DRUG SCREEN, and CURRENT PHYSICAL EXAMINATION.

Industry Specific Solutions pulls Motor Vehicle Records semi-annually-(every six months). Criminal Records are pulled once before hire. Prior to hire, it is mandatory that Driver’s pass a pre-employment D.O.T. Physical Examination and regulated Drug Screen. Industry Specific Solutions does not pay for the cost of these items. You will not have to pay for these fees at the time of testing. We will deduct the fees from your first paycheck. Upon the expiration date of your Physical Examiner’s Certificate we will deduct the fees again. Per DOT Regulations Industry Specific Solutions is enrolled in a Random Drug Screening Pool.

If you have a current Long Form Physical that satisfies D.O.T. requirements, please submit a copy to us, and we will not deduct the fee from your paycheck.. Note: This deduction will show up weekly on your paycheck under the Y-T-D (Year to Date) column for the remainder of the year for record keeping purposes!. IT IS NOT BEING DEDUCTED EACH TIME YOU RECEIVE A PAYCHECK.

Below is a list of current Driver Fees (Subject to change): MVR (2 Annually) - $ 20.00; Criminal Reports - 20.50; Pre-Employment Drug Screens - $59.00; DOT Physical Examinations - $69.50

We arrange all Drug Screens and Physicals to be taken through Concentra Medical Centers. Concentra has several locations throughout the area. Your Recruiter will give you full directions along with the telephone number and address. Please sign below to confirm that you understand that taking the physical and drug screen is mandatory and the automatic deduction will come out of your first two paychecks.

In connection with my application for employment (including contract for services) with you, I understand that consumer reports which may contain public record information may be requested from DAC Services - Tulsa, Oklahoma. These reports may include the following types of information: names and dates of previous employers, reason for termination of employment, work experience, accidents, etc. I further understand that such reports may contain public record information concerning my driving record, workers’ compensation claims, credit, bankruptcy proceedings, criminal records, etc., from federal, state and other agencies which maintain such records; as well as information from DAC concerning previous driving record requests made by others from such state agencies, and state provided driving records.

I AUTHORIZE, WITHOUT RESERVATION, ANY PARTY OR AGENCY CONTACTED BY DAC TO FURNISH THE ABOVE-MENTIONED INFORMATION.

I have the right to make a request to DAC, upon proper identification, to request the nature and substance of all information in its files on me at the time of my request, including the sources of information; and the recipients of any reports on me which DAC has previously furnished within the two year period preceding my request. I hereby consent to your obtaining the above information from DAC, and I agree that such information which DAC has or obtains, and my employment history with you if I am hired, will be supplied by DAC to other companies which subscribe to DAC Services.

I hereby authorize procurement of consumer report(s). If hired (or contracted), this authorization shall remain on file and shall serve as ongoing authorization for you to procure consumer reports at any time during my employment (or contract) period.