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Position(s) Applying For *

Date Of Application *

Acknowledgement and Certification

Drug Free Workplace Notice To All Applicants

                Soukup Construction and its subsidiaries require drug and alcohol testing of all employees.
Newly hired employees must complete a post offer drug and alcohol test prior to reporting to duty at their normal job site. In addition,
all employees are subject to random drug and alcohol testing at any time. These tests are highly sophisticated and capable of
detecting trace amounts of various drugs.
If you test positive on your initial post-offer drug and alcohol test, you will face immediate dismissal. You will be eliminated from
consideration for all employment for a minimum of six (6) months, or until you provide satisfactory proof of successful completion of
an accepted drug and alcohol abuse treatment program.
If subsequent random test results indicate the presence of drugs or alcohol in your body, in order to continue employment with the
Company, you will be required to comply with the provisions of our drug and alcohol policy, including counseling with our Employee
Assistance Provider (EAP) and completion of any recommended course of treatment.
This company will not conduct confirmatory testing of Drug and Alcohol screening except as provided by law. However, you may
arrange for the re-testing of any previously submitted specimens at your own expense. If re-testing indicates that the initial results
were erroneous, the company will reimburse you for the cost of confirmatory testing and will reinstate your employment.
My signature on this application form indicates that I understand and accept the Company?s Drug Free Workplace policy
requirements.        

Acknowledgement And Certification Statement

                I certify that this application was completed by me, and that all entries on it and information in it is accurate and complete to the best
of my knowledge. The Company may investigate all statements contained in this application. If I am hired, I understand that any false
or misleading information provided during the application or interview process will be grounds for immediate dismissal, regardle ss of
when it is discovered.
I authorize the Company to make a thorough investigation of my past employment, education and job-related activities and I release
from all liability all persons, companies, and corporations providing such information, either in writing or orally. I indemnify this
Company against any liability which might result from such investigation. I authorize the Company to supply my employment record,
in its sole discretion, in whole or in part, to any prospective employer, government agency, or other party, with an interest that the
Company deems appropriate. I understand that the information in this application will be used and prior employers will be contacted
to conduct investigations as required by Sec. 391.23 of Department of Transportation regulations, if applicable.
I understand that this application is not a contract of employment. If I am hired, my employment will be terminable-at-will, regardless
of any representations made to the contrary. The Company and I will remain free to end our employment relationship at any time, for
any or no reason. Any changes in this employment relationship must be made in writing.
I understand that any offer of employment may be conditioned upon a health evaluation to determine whether I can perform the
essential functions of the job. This health evaluation will be completed by a Company-selected doctor. In addition, I understand a drug
or alcohol test is required.        

Applicant Signature *

Date *

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