Surname Given name Middle initial Address City Province Postal code

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1 Application for Employment Package We know that to retain our employees, our services, programs, and support must stand above the rest and separate us as leaders in the industry. Paul s Hauling Ltd. has made the commitment to source and train the right individuals to strengthen our on and off road teams. A clear understanding of your background and work history will aid us in placing you in the position that best meets your experience, qualifications and needs. Personal Information Surname Given name Middle initial Address City Province Postal code Phone number Basic Information Application date address Available start date Position(s) applied for Expected pay range /week Hours of work Full time Part time Part time specify days and hours of availability Have you worked for any of these companies in the past? Paul s Hauling Ltd. Gardewine Westcan Oak Point Service Northern Bulk Northern Leasing If yes, when? Record of Education School Courses of study last year completed Did you graduate? High Choose an item. Y N Post-secondary Choose an item. Y N Other Choose an item. Y N Diploma/ degree Record of Employment Name/ address and type of business From To Your position Weekly Mo Yrs Mo Yrs starting salary Weekly last salary Reason for leaving Professional References Applicants are asked not to list friends or relatives. Reference name Reference occupation Relationship Contact information FILE NAME: EMPLOYMENT APPLICATION FAX INFORMATION TO

2 Professional Driver Applicants Type of driving opportunity Company Driver Owner Operator Driving preference Single Double Partner Where did you receive commercial driver training? How many preventable accidents have you been in during the last 3 years? How many driving violations have you been cited for in the last 3 years? How many Driver Safety Rating points do you have on your driving record? Please attach Driver s Abstract document with your completed application Are you currently able to enter the U.S? Y N Have you been convicted of a crime which you have not received a pardon for? Y N Please attach Criminal Record Check with your completed application Have you failed any drug/alcohol test for a safety-sensitive position within the last two years? Y N License and Documents Do you hold a valid Class 1 license? Y N License number License issued by which province Do you hold a border-crossing card (F.A.S.T card)? Y N Year? Professional Experience Train type A Train type B Train type C Standard transmission Automatic transmission Mountain driving experience Double team driving experience City driving experience Regional driving experience Long haul driving experience Cross border driving experience Years Months Years Months Petroleum Propane pressure vessel (NH3) Anhydrous ammonia Asphalt End dump Calcium liquid Pneumatics Hoppers bottom Fertilizer - dry Fertilizer - liquid Vac truck Additional Information Are you at least 21 years of age? Y N Height Weight Any condition/ disability that may affect your ability to perform the intended work? Y N How much work time have you lost in the last 3 years due to illness/ injury? Have you been injured while at work? Y N FILE NAME: EMPLOYMENT APPLICATION FAX INFORMATION TO

3 Acknowledgment It is agreed and understood that the answers to the foregoing questions are true and correct, and that any misrepresentation of information given above shall be considered an act of dishonesty. It is agreed and understood that the employer or their 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 of any damages on account to their furnishing such information. The applicant agrees to furnish such additional information and complete such examinations as may be required to complete his employment file. It is agreed and understood that this application for employment in no way obligates the employer to employ the applicant. It is agreed and understood that if hired, the employee may be on a probationary period during which time they may be discharged without recourse. Applicant signature Date FILE NAME: EMPLOYMENT APPLICATION FAX INFORMATION TO

4 Employment Verification Personal Information Surname Given name Birth name (If different from surname) Date of birth Place of birth Phone number Social insurance number Sex Driver s license number ( ) M F Residential Information Current Residence Previous residence (If you have not resided at the above address for more than five (5) years) Consent to Disclose Employment history I,,declare that the information presented above, on my resume, and application form, and information provided verbally by me to Paul s Hauling Ltd. is complete and accurate. I understand that a false statement may disqualify me from employment or give the company cause for my dismissal if I am employed by it. I understand that a condition of employment with Paul s Hauling Ltd. is the completion of a background check, which will include the following: a) Verification of my employment background and history from any source and of all data provided on my resume and/or application. b) A check of criminal conviction records for which a pardon has not been granted, and conditional and absolute discharges, which have not been removed from the Canadian Police Information Center system in accordance with the Criminal Records Act. c) Driver record check for applicants applying for a position requiring a valid driver s license. A criminal conviction will not necessarily disqualify a candidate and only convictions relevant to the position applied for will be considered. I consent to the above information arising from the background check being collected for the purpose of conducting pre-employment due-diligence screening or where I am or have been employed, for the purpose of determining my suitability to perform security-sensitive services. I understand that the company will use the results of the background check for the purpose of conducting pre-employment due-diligence screening or where I am or have been employed, of screening my suitability to perform security- sensitive services. Where this information is being collected for the purpose of conducting pre-employment due-diligence screening, and if I am hired, I consent to the information being transferred to my employee file for the purpose of the employment relationship. If I am already employed by the company, I consent to the information being transferred to my employee file for the purpose of the employment relationship. FILE NAME: EMPLOYMENT APPLICATION FAX INFORMATION TO

5 I agree that the company may periodically update the background check and I agree that I shall immediately inform the company of any conviction for a criminal offence arising subsequently to completion of the initial background check. I hereby authorize the holder(s) of the information relating to the background check, including any updates thereof as provided in the previous statements, to disclose this information to the company and its authorized employees and/or the company s authorized agents and its agents, subcontractor and suppliers, and to any of the company s clients. I hereby release and forever discharge the holder(s) of information relating to the background check, including any updates thereof to the company, their clients and their respective affiliated entities and all of their former, current and future partners, directors, officers, employees, agent, successors, and assigns from any actions, claims, and demands of any kind whatsoever in any way relating to the collection, disclosure, and use of this information by the holder(s) of information relating to the background check, including any updates to the company or its clients. Drug and alcohol testing records I hereby authorize release of information from my Department of Transportation regulated drug and alcohol testing records by my previous employer, listed in Section I-B, to the employer listed in Section I-A. This release is in accordance with DOT Regulation 49 CFR Part 40, Section I understand that information to be released in Section II-A by my previous employer, is limited to the following DOT-regulated testing items: 1. Alcohol tests with a result of 0.04 or higher; 2. Verified positive drug tests; 3. Refusals to be tested; 4. Other violations of DOT agency drug and alcohol testing regulations; 5. Information obtained from previous employers of a drug and alcohol rule violation; 6. Documentation, if any, of completion of the return-to-duty process following a rule violation. Employment Verification Information Surname Given name Please provide employment information for the past five (5) years, if available. Your current employer will only be contacted if listed below. Employer name Address of employer Dates of employment Street address City Province From To Job title(s) Agreement of Consent To Disclose Applicant s signature Witness Date Witness signature For questions regarding completion of this form, please contact our driver support team via at drive@paulshauling.com or by phone at (204) Please return the completed form to the local driver support team. FILE NAME: EMPLOYMENT APPLICATION FAX INFORMATION TO