EMPLOYEE HANDBOOK POLICY & PROCEDURES
A LEVEL ABOVE THE REST™
EMPLOYEE HANDBOOK POLICY & PROCEDURES
A LEVEL ABOVE THE REST™
VERSION 1.0.2
JOB DESCRIPTION I acknowledge receipt of the JOB DESCRIPTION for Company Driver position classification sheets (four)
and that I am responsible for following the listed procedures. I understand that I am a company driver and may be used in whatever capacity LEVEL UP TRUCKING LLC deems appropriate and necessary.
APPLICANT’S SIGNATURE____________________________
PASSENGER AUTHORIZATION
I __________________________ will not allow any passengers to enter any part of the equipment. No one under the age of thirteen will be allowed in a truck at any time. I understand that if I fail to adhere to the above requirements I may be subject to disciplinary action including but not limited to termination.
APPLICANT’S SIGNATURE____________________________ POLICIES RECEIVED
I __________________________have received a copy of the Drug and Alcohol Policy as well
as the Hours of Operating Policy and I understand the consequences if I in violation of either one.
APPLICANT’S SIGNATURE____________________________
DRIVER’S APPLICATION FOR EMPLOYMENT Applicant Name _________________________________________________ Date of Application ___________________ Company ____________________________________________________________________________________________________ Address _________________________________________ City _____________________State __________ZIP ______________
In compliance with Federal and State equal employment opportunity laws, qualifies applicants are considered for all positions without regard to race, color religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.
TO BE READ AND SIGNED BY APPLICANT
I authorize you to make such investigations and inquires of my personal employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquires regarding medical history will be made only if and after a conditional offer of employment has been extended.) l hereby release employers, school, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information found in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. l understand that information I provide regarding current and/or previous employers may be used and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:
• Review information provided by previous employers;
• Have errors in the information corrected by previous employers and for those previous employers to
resend the corrected information to the prospective employer; and • Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
Signature ____________________________________________________________________ Date ____________________ ________
MOTOR VEHICLE DRIVERS CERTIFICATION OF COMPLIANCE WITH DRIVERS LICENSE REQUIREMENTS MOTOR CARRIER INSTRUCTIONS: The requirements in Part 383 apply to every driver who operates in intrastate, interstate, or foreign commerce and operates a vehicle weighing 26,001 pounds or more, can transport more than 15 people, or transports hazardous materials that require placarding. The requirements in Part 391 apply to every driver who operates in interstate commerce and operates a vehicle weighing 10,001 pounds or more, can transport more than 15 people, or transports hazardous materials that require placarding. DRIVER REQUIREMENTS: Parts 383 and 391 of the Federal Motor Carrier Safety Regulations contain some requirements that you as a driver must comply with. They are as follows:
1) POSSESS ONLY ONE LICENSE: You, as a commerical vehicle driver, may not
possess more than one motor vehicle operator’s license.
2) NOTIFICATION OF LICENSE SUSPENSION, REVOCATION OR CANCELLATION:
Sections 391.15(b )(2) and 383.33 of the Federal Motor Carrier Safety Regulations require that you notify your
employer the NEXT BUSINESS DAY of any revocation or suspension of your driver’s license. In addition, Section
383.31 requires that any time you violate a state or local traffic law (other than parking), you must report it
within 30 days to: 1) your employing motor carrier, and 2) the state that issued your license (If the violation
occurs in a state other than the one which issued your license). The notification to both the employer and
the state must be in writing.
The following license is the only one I will possess:
Driver’s License No. _____________________State _____________________Exp. Date _____________________ DRIVER CERTIFICATION: I certify that I have read and understood the above requirements.
Driver’s Name (Printed):_________________________________ Driver’s Signature: _________________________________ Date _____________
NOTICE TO DRIVERS CERTIFICATE OF COMPLIANCE (NOTE: ORIGINAL TO BE RETAINED BY CARRIER, COPY FOR DRIVER)
The commercial Motor Vehicle Safety Act of 1986 provided for stronger controls over drivers of
commercial vehicles. The low applies to all drivers operating vehicles and combinations with Gross Vehicle Weight Rating over 26,000 pounds, and to any vehicle, regardless of weights, transporting hazardous materials in a quantity requiring placarding.
The following provisions of this legislation become effective July I, 1987:
1. No driver may possess more than one license, and no matter carrier may use a driver having
more than one license.
2. A driver convicted of a traffic violation ) 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 comercial driving employment for the past 3 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 are punishable by a fine not exceed 2500$.Willful violation of (1) or (3), above, failure to notify the motor carrier within 3 days of the loss of any privilege to operate a commercial vehicle can result in criminal penalties not to exceed $5000 and/or 90 days in jail.
CERTIFICATION BY DRIVER
I hereby certify that I have read above and understand the driver provisions of the Commercial Motor Vehicle Safety Act of 1986 DRIVER’S NAME PRINT _____________________ SOCIAL SECURITY _____________________ DRIVER’S LICENSE _____________________STATE_______EXPIRATION DATE_____________________ DRIVER’S ADDRESS ____________________________CITY ___V__________________ STATE_______ ZIP _________
COMMERCIAL DRIVER APPLICATION
FILL IN ALL BLANKS & PROVIDE ALL INFORMATION REQUESTED--PRINT OR TYPE
Name _____________________________________________________ Phone _____________________________________ Address _______________________________________________ City_________________ State ______ Zip_______________ Date of Birth _________________________ Social Security ______-_ _ _ _ _ _ _ _ _- ____ _ _ _ _ _ _ _ _ Date ____________________ If your above address is less than 3 years continue listing them below to cover the previous 3 year period: Dates: From___________to__________
Address _______________________________________________ City_________________ State______ Zip_______________ Dates: From___________to__________
Address _______________________________________________ City_________________ State______ Zip_______________ Dates: From___________to__________
Address _______________________________________________ City_________________ State______ Zip_______________ Driver’s License Information: all held, last 3 years:
State__________________ DL Number___________________________________ Expiration Date_________________ State__________________ DL Number___________________________________ Expiration Date_________________ State__________________ DL Number___________________________________ Expiration Date_________________ Experience:
_________________________________________ _____________to___________ _____________________________________ Type of vehicle driven
Dates
Approximate mileage driven
_________________________________________ _____________to___________ _____________________________________ Type of vehicle driven
Dates
Approximate mileage driven
_________________________________________ _____________to___________ _____________________________________ Type of vehicle driven
Dates
Approximate mileage driven
All accidents, last 3 years: (If none, write NONE)
Date_______________ Describe _____________________________________ Fatalities____________ Injuries ____________ Date_______________ Describe _____________________________________ Fatalities____________ Injuries ____________ Date_______________ Describe _____________________________________ Fatalities____________ Injuries ____________
List all traffic violation convictions in last 3 years: (If none, write NONE)
Date___________ Violation _____________________________________ State _________Commercial Vehicle:
YES
NO
Date___________ Violation _____________________________________ State _________Commercial Vehicle:
YES
NO
Date___________ Violation _____________________________________ State _________Commercial Vehicle:
YES
NO
Date___________ Violation _____________________________________ State _________Commercial Vehicle:
YES
NO
Date___________ Violation _____________________________________ State _________Commercial Vehicle:
YES
NO
Has your CLASS A LICENSE been suspended, revoked, canceled or lost in last 10 years?
YES
NO
If yes list State, and explain: _________________________________________________________________________ _______________________________________________________________________________________________________
Has your CLASS A LICENSE been suspended, revoked, canceled or lost in last 10 years?
TERMINATION OF EMPLOYMENT RESIGNATION POLICY
LEVEL UP LLC. employees may resign their position at any time. A written notice of resignation should be submitted to the office at least two weeks prior to the effective date.
Drivers are encouraged to include the reasons for leaving in the letter of resignation. Drivers must bring the truck and trailer for inspection prior to leaving LEVEL UP LLC. at 825 Sierra Vista Drive, Las Vegas, NV 89169. Drivers failed to do so is subjected to penalties - up to $1,000.00
APPLICANT’S SIGNATURE _______________________________________________ DATE___________________
FAIR CREDIT REPORTING ACT DISCLOSURE STATEMENT In accordance with the provisions of Section 604(b)(2)(A) of the Fair Credit Reporting Act, Public Law 91-508, as amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter I, of Public Law 104-208), you are hereby notified that reports verifying your previous employment, drug and alcohol test results, and your driving record may be obtained on you for qualification purposes. These reports are required by section 382.413,391.23 and 391.25 of the FEDERAL MOTOR CARRIER SAFETY REGULATIONS
APPLICANT’S SIGNATURE _________________________________ DATE___________________
DRIVER AGREEMENT OF AUTOMATIC PAYROLL DEDUCTIONS I ____________________________________________________________ acknowledge and understand that I am giving my consent/permission to deduct from each weekly payroll any of the following that may apply.
• All cash advances. I understand that I will be reimbursed for items that I have had prior approval from my supervisor
and present a proper receipt
• All citations, penalties, fines and associat ed costs that the company pays on my behalf. Also the costs associated
with getting the unit legal, not limited to towing company bills, the cost of having another driver come to my aid and
all other costs that the company may incur on my behalf.
• If a driver abandons the truck and/or trailer he/she will be charged $2.00 per mile for recovery fees so that the
equipment can be brought back to the main office. The recovery fees are calculated from the distance from
LAS VEGAS, NEVADA to the location of the abandon equipment and back. The driver will also be charged for any
unauthorized mileage on the equipment. The unauthorized mileage will be charged at $2.00 per mile.
• I acknowledge financial responsibility for company property promising to return a11 company property and pay
any monies owned the company upon termination of employment, including but not limited to charges pertaining to
the pre-qualification physical and drug screen if I do not remain with the company for more than 3 months. A
minimum of $300 will be deducted from my pay.
I further agree to return all equipment to LEVEL UP LLC.
APPLICANT’S SIGNATURE _______________________________________________ DATE___________________
CERTIFICATION OF VIOLATIONS/ ANNUAL REVIEW OF DRIVING RECORD MOTOR CARRIER INSTRUCTIONS: Each motor carrier shall at least once every 12 months, require each driver it cmployes to prepare and furnish it with a list of all violations of motor vehicle traffic laws and ordinances (other than violations involving only parking) of which the driver has been convicted, or on account of which he/she has forfeited bond or collateral during the preceding 36 months. Drivers who have provided information reqnired by Section 383.3 l need not repeat that information on this form. DRIVER REQUIREMENTS: Each driver shall furnish the list a, required by the motor carrier above. If the driver has not been convicted of, or forfeited bond or collateral on account of any violation which must be listed, he/she shall so certify (Section 391.27)
COMPLETED BY DRIVER - CERTIFICATION OF VIOLATIONS NAME OF DRIVER
SSN
HOME TERMINAL (CITY, STATE)
DATE OF EMPLOYMENT
DL NUMBER
IS THIS A COMMERCIAL DRIVERS LICENSE?
YES
STATE
EXPIRATION DATE
DATE OF BIRTH
NO
l certify that the following is a true and complete list of traffic violations required to be listed (other than those I have provided under Part 383) for which I have been convicted or forfeited bond or collateral during the past 36 months. If no violations, write NONE. DATE
OFFENSE
LOCATION
TYPE OF VEHICLE
1f no violarons are listed above, I certify that I have not been convicted or forteited bond or collateral on account of any violation ( other than those I have provided under Part J83) required to be listed during the past 36 months. DATE OF CERTIFICATION
COMPLETED BY MOTOR CARRIER~ ANNUAL REVIEW OF DRIVING RECORD
SIGNATURE
SALARY CONFIDENTIALITY POLICY INTENT
It is the objective of this policy to establish the importance of discretion and confidentiality in terms of salary information. Salary is determined considering a large array of factors which may not
be immediately apparent to every employee. As such, in an attempt to minimize any feelings of
confusing or doubt in regards to the application of fairness in the levels of compensation provided
to our employees, LEVEL UP LLC. has adopted this policy in an effort to provide clear guidelines of the expectations for confidentiality. As the provision of competitive wages is paramount to our success, LEVEL UP LLC. strives to ensure that we provide appropriate and faire wages for our employees in an
effort to retain, motivate and provide maximum benefit for our staff. As such, our wages and other forms of compensation are determined based on a large number of factors (e.g. performance reviews, years of experience, years worked at LEVEL UP LLC., etc.)
POLICY
All LEVEL UP LLC. salary information is confidential and should not be disclosed for any reasons, other
than as required for appropriate financial reporting purposes. LEVEL UP LLC. requests that all employees keep their wages, benefits, bonuses and any other forms of compensations confidential and avoid
providing or otherwise broadcasting this information with other LEVEL UP LLC. employees or with any
third-party that does not have a bona fide need to know. Any unauthorized disclosure of confidential information by employees may impede our ability to effectively compete for talent, may create
unnecessary conflict and disputes and could lead to disciplinary action up to and including termination of employment.
ACKNOWLEDGMENT AND AGREEMENT
I________________________________________acknowledge that l have read and understand the salary
confidentiality Policy of further, I agree to adhere to this policy and will ensure that employees working
under my direction adhere to these guiding principles. I understand that if I violate the rules/ procedures outlined in this policy, I may face corrective action up to and including termination of employment.
APPLICANT’S SIGNATURE _______________________________________________ DATE___________________
PRE-QUALIFICATION AGREEMENTS AND REQUIREMENTS APPLICANT’S NAME ______________________________________________________________ PLEASE READ THE FOLLOWING PAGES CAREFULLY AND SIGN AND DATE EACH SECTION. IF YOU HAVE ANY QUESTIONS PLEASE ASK.THIS IS NOT A CONTRACT OF EMPLOYMENT. QUALIFICATION IS AT WILL.
I understand that qualification at LEVEL UP LLC. is at-will, and may be terminated by the applicant or LEVEL UP LLC. at any time for reason. I further understand that the first 90 days of qualification are probationary. During this period LEVEL UP LLC. will determine my qualifications and suitability for truck and qualification with LEVEL UP LLC. During this period, I may be disqualified without further recourse or may qualification may be terminated without reason. If necessary, the probationary period may be extended. Drivers must meet the following requirements before and during employment:
• Be able to pass U.S. DOT Controlled Substances and Alcohol Testing
• Be able to pass FMCSA physical requirements
• Have a valid commercial driver license(CDL) in the STATE of primary residence, if not,
must obtain with 30 days.
• No alcohol or drug related offenses within the past 5 years, state or federal
• No felony conviction(s) within the past 5 years (any convictions beyond 5 years is
subject to company review).
• No previous accidents resulting from a rear end, lane change/sideswipe, rollover (all
other accidents and accident while contracted by LEVEL UP LLC. will be reviewed
on a case by case basis).
• Be able to drive/operate in all lower 48 states.
• Adhere to all company policies
• Not have any serious traffic violations within the past three years including excessive speeding of 15 mph or more
above the posted speed limit (all traffic violations obtained while contracted will be reviewed on a case by case basis dependent
upon the seriousness of the violations, safety record and time with the company)
• No reckless driving and/or erratic driving
• No hit and run accidents or failure to report an accident.
I understand the above requirements and agree to familiarize myself with the Driver Handbook and Drug & Alcohol policy given to me at orientation. I understand that I am responsible for following the company policies and procedures in these manuals. APPLICANT’S SIGNATURE _______________________________________________ DATE___________________
DRUG TEST POLICY RESONABLE SUSPICION
recommended treatment. In addition, the driver will be required to
LEVEL UP LLC will require a driver to submit to a drug and/or
submit to a Return-To-Duty controlled substance and/ or alcohol
alcohol test when a supervisor or company officer trained as per
test as well as Follow-Up drug and alcohol tests as prescribed by
§382.603 has reasonable suspicion to believe that the LEVEL UP
the SAP.
LLC. driver has violated the prohibitions of the drug and alcohol policy and maybe under the influence of drugs and/or alcohol.
REFUSAL TO TEST
As required by §382. 307(b) the reasonable suspicion will be
If any driver refuses to test as defined by Part 382.107, the refusal
based on. “specific, contemporaneous, articulable observations
will be treated as a positive result, and the driver will be subject to
concerning the appearance, behavior, speech or body odors
consequences of a positive test.
of the driver. The observations may include indications of the chronic and withdrawal effects of controlled substances”.
RECORD RETENTION AND SAFEGUARDING All records pertaining to the Drug & Alcohol Policy, testing
RETURN-TO-DUTY
processes and results are maintained as required by§ 382.401
Return-to-duty tests will be conducted as required by 49 CFR Part
in a secure location with controlled access. Record will only be
40.
released as required and approved by 49 CFR.
DRIVER NOTIFICATION OF SCHEDULED TEST
DESIGNATED EMPLOYER CONTACTS
If a driver is scheduled for one of the above types of tests, he/
TESTING: MARINA COBZAC is the company’s designated person
she will be notified by phone or in person that he/she has been
for providing information on implementation of the alcohol/
selected for a drug and/or alcohol test. The driver will be given a
controlled substances program and scheduling tests. Questions
DOT Drug Testing Compliance form (example attached) to notify
should be directed to her at + 1 702 972-8805.
him/her of the scheduled appointment time and place. LEVEL UP LLC. and MARINA COBZAC have received the required • CONSEQUENCES OF PROfilBITED CONDUCT/POSITIVE TEST RESULT
training regarding reasonable suspicious.
Any driver who engages in conduct prohibited by Part §382 will be immediately removed from performing
Additional Information
any safety sensitive function. In addition, the driver will be subject
The following pages contain information regarding the symptoms
to immediate termination from his/her
and effects of the use of alcohol
employment with LEVEL UP LLC. Under the company’s current
and controlled substances as well as FEDERAL DRUG& ALCOHOL
policy, the driver who tests positive may be offered a once
TESTING REGULATIONS.
per lifetime last chance to be reinstated. This last chance
All employees are encouraged to be familiar with these additional
reinstatement will be subject to the driver submitting to a
documents and with the
treatment needs assessment by an authorized Substance
requirements of the Federal Motor Carrier Safety Regulations,
Abuse Professional {SAP), and following and completing the
particularly 49 CFR Part 382.
The following definitions are as defined in 49 CFR Part 382 and I, _____________________________________________________have been provided and have read
are used throughout the Policy:
a copy of the LEVEL UP LLC. Drug & Alcohol Policy.
► A “safety-sensitive function” refers to all time from the point a
I acknowledge that I am required to adhere to this policy as a
driver begins to work or is
condition of my employment with
required to be ready to work until the time he or she is relieved
LEVEL UP LLC. and notify LEVEL UP LLC. immediately in the event of
from work and all
a
responsibilities for performing work.
criminal offense involving drugs or alcohol as required by the policy.
USE FOLLOWING AN ACCIDENT
PURPOSE OF POLICY
No driver shall use alcohol for eight hours following an accident
While POWER EXPRESS INC recognizes that drug and alcohol
that occurred while driving a CMV
abuse may be a sign of chemical
for POWER EXPRESS INC until he/she undergoes a post -accident
dependency and that substances abuse can be successfully
alcohol test, whichever occurs
treated with professional help, it is our
first.
duty to ensure the health and safety of our employees as well as
Drug and Alcohol testing is an integral part of assuring compli-
the public.
ance to this policy.
For these reasons as well as to meet requirements of the Federal
As a result, POWER EXPRESS INC has contracted with MED-STOP
Motor Carrier Safety
consortium and professional
Administration (‘”FM CSA”), POWER EXPRESS INC has implement-
testing facilities in order to ensure that our testing procedures
ed the following Drug&
are conducted legally and
Alcohol Policy. Compliance with this policy is mandatory and
professionally.
required as a condition of gaining
Drivers subject to testing
and continuing employment with POWER EXPRESS INC.
All employees who hold a Commercial Driver License(CDL), who
DEFINITIONS
work part time or full time for
PERFORMING EN-ROUTE VEHICLE INSPECTIONS 1) An en-route inspection is a check of the rig’s systems and
Listen for audible leaks in the air lines
controls during the trip. Most often1 this is done while fueling or
Check that air and electrical lines are property secured
during rest stop. Items checked during en-route inspections are
Check the air pressure in the air break system
to ensure safety. There are three parts of en-route inspection:
D) Make sure the coupling at the fifth wheel is securely attached
a) Vehicle Safety Inspection
to the
b) Cargo
tractor. Inspect the:
c) Hazmat (if appropriate)
King pin
Once you have the steps down you can do the inspection in just
Locking jaws
a few minutes.
Locking jaws release arm
The time you spend can save hours of downtime by avoiding a
Position of the fifth wheel glide plate
breakdown.
Trailer apron
Inspect the brakes by looking for a 90 degree angle and rod
2) Do a safety inspection every time you stop by
following these steps:
travel
of 1 ½ to 1 ¾
A) Check all lights on tractor before dark.
Check at every stop when driving at night.
Look for overheated brakes
E) Perform same checks on the trailer tires as those done on
Check for damage and that they are clean and work
property. This includes:
tractor tires.
Dashboard lights
F) Check all trailer lights when checking tractor lights, four-way
Headlights (high and low beams)
flashers and
Four way flashers and signal lights
signal lights, turn signals (trailer sides and rear including the top
(front and rear of tractor)turn signals
of the
rear of the trailer)
B) Use an air pressure gauges to check tires
on the tractor. On each tire Vcheck for the following:
G) Check rear doors of trailer for: security of latch, damage to
Air pressure of 110 PSI or pressure that is recommended by
parts, security
manufacture in owner’s manual or on sidewall of the tire
of load seal.
Overhitting
H) Check for damage and clean all: Glass, Mirrors, Reflectors.
Damage Tread depth Proper mounting Spacers and remove any objects trapped between dual tires C) Check the glad hands
CMV drivers involved in an accident while driving a CMV under
employment with POWER EXPRESS INC. Under the company’s
the employ ofLEVEL UP LLC will be tested according to the
current policy, the driver who tests positive
requirements of §382.303 (table below).
may be offered a once per lifetime last chance to be reinstated. This last chance reinstatement will be subject to the driver submitting to a treatment needs assessment by an authorized
~ RESONABLES SUSPICION
Substance Abuse
LEVEL UP LLC will require a driver to submit to a drug and/or
Professional {SAP), and following and completing the
alcohol test when a
recommended treatment. In addition, the driver will
supervisor or company officer trained as per §382.603 has
be required to submit to a Return-To-Duty controlled substance
reasonable suspicion to believe that the driver has violated the
and/ or alcohol test as well as Follow-Up
prohibitions of the drug and alcohol policy and maybe under the
drug and alcohol tests as prescribed by the SAP.
influence of
REFUSAL TO TEST
drugs and/or alcohol. As required by §382. 307(b) the reasonable
If any driver refuses to test as defined by Part 382.107, the refusal
suspicion will be based on.
will be treated as a positive
“specific, contemporaneous, articulable observations concerning
result, and the driver will be subject to consequences of a positive
the appearance, behavior, speech or
test.
body odors of the driver. The observations may include
• RECORD RETENTION AND SAFEGUARDING
indications of the chronic and withdrawal
All records pertaining to the Drug & Alcohol Policy, testing
effects of controlled substances”.
processes and results are maintained as
• RETURN-TO-DUTY
required by§ 382.401 in a secure location with controlled access.
Return-to-duty tests will be conducted as required by 49 CFR Part
Record will only be released as required
40.
and approved by 49 CFR.
DRIVER NOTIFICATION OF SCHEDULED TEST
~ DESIGNATED EMPLOYER CONTACTS
If a driver is scheduled for one of the above types of tests, he/she
TESTING:
will be notified by phone or in
MARINA COBZAC is the company’s designated person for
person that he/she has been selected for a drug and/or alcohol
providing information on
test. The driver will be given a DOT
implementation of the alcohol/ controlled substances program
Drug Testing Compliance form (example attached) to notify him/
and scheduling tests. Questions
her of the scheduled appointment
should be directed to her at + 1 702 972-8805.
time and place.
Additional Information
• CONSEQUENCES OF PROfilBITED CONDUCT/POSITIVE TEST RESULT
The following pages contain information regarding the symptoms
Any driver who engages in conduct prohibited by Part §382 will be
and effects of the use of alcohol
immediately removed from performing
and controlled substances as well as FEDERAL DRUG& ALCOHOL
any safety sensitive function. In addition, the driver will be subject
TESTING REGULATIONS.
to immediate termination from his/her
All employees are encouraged to be familiar with these additional
Commercial Motor Vehicle Drivers employed by LEVEL UP LLC are subject to the following types of tests.
or training to give such information to other
• PRE -EMPLOYMENT
investigation reports or consumer reports which
employment drug screen in order to be considered
would apply to my assignment to projects related
POWER EXPRESS INC will not allow a newly hired CMV
premises, and to handle its product, and other
by MED STOP OR OTHER MEDICAL INSTITUTION that a
authorize any law enforcement agency or court of
companies and carriers requesting such
information. Furthermore, there may be entities
the company does business with that may request
All new CMV driver applicants must pass a pre-
apply to my background. In this case, these reports
for the next steps in the hiring process.
to the customer, permission to be on the customer’s
driver to operate a CMV until notified
security concerns of the customer. I hereby
negative result has been received.
record to furnish Power Express Inc information
• RANDOM TESTING
felony or misdemeanor of which I have been
concerning my Motor Vehicle Report, or any
As required by §382.305, POWER EXPRESS INC will
convicted.
50% of drivers for controlled substances per year.
Under the authority granted me by 49 CFR Parts
immediately prior to, during, or immediately after a
and require my previous and /or current employers
Random selections are made by the consortium
or company provided by me in writing or by verbal
INC have an equal chance of being tested.
whom I applied for employment in the three-year
randomly test 10% of drivers or alcohol and Random alcohol tests will be performed
40,382,391.23 and 391.53, I hereby authorize
driver performs a safety-sensitive functions.
specifically listed as well as any other person
and all drivers employed by POWER EXPRESS
interview by whom I was employed or to
period preceding the date of this application
to release the date, type of test, and result of all
VERIFICATION RELEASE
ding and alcohol test, also any information
I hereby authorize without liability any person or
substance test, had an alcohol test with a
organization including but not limited to any institutions, whose name I have given as a
reference or by whom I have been previously
employed to furnish LEVEL UP LLC e and information they may have concerning my character, habits, ability, financial responsibility, job
performance, reasons for leaving employment
and all information concerning my employment
regarding accidents in the Director of Driver
Personnel , or the Employment Placement Specialist assigned to process my application at Power
Express Inc if I tested positive on any controlled concentration of 0.04 or greater, or refused to take
any drug or alcohol test, I also authorize the release off all information concerning my refusal to
a Substance Abuse Professional (SAP)including all records pertaining to my evaluation and
treatment. I authorize this release by whatever means is more expedient and agree to hold
harmless any past employer or any person or
company I applied with as well as their employees,
authorization.
damage that may arise from the release of the
submit to a drug screen urinalysis.
agents, or representatives from all liability or information specifically authorized here.
APPLICANT NAME ____________________________________ APPLICANT SIGNATURE_______________________________ SSN ___________________________________________________ DATE__________________________________________________
I hereby agree to the conditions above and to
APPLICANT SIGNATURE_______________________________ DATE_______________________________
Past Pre-Employment Drug & Alcohol Testing Question
In accordance with 49 CFR Part 40.25(j) the employer is required to ask the employee:
DRIVER NOTIFICATION
This notice serves to fulfill the requirements of 49 CFR Part 39 I .23(i).
Each motor carrier must notify each driver, who is regulated by the Department of Transportation,
of their rights regarding investigative information that will be provided to a prospective employer. Drivers have:
• The right to review information provided by previous employers;
• The right to have errors in the information
corrected by the previous employer and for that previous employer to re-send the corrected information to the prospective employer;
• The right to have a rebuttal statement attached to the alleged erroneous information, if the
previous employer and the driver cannot agree on the accuracy of the information.
APPLICANT SIGNATURE_______________________________ DATE_______________________________
CONSENT FORM PRE-QUALIFICATION URINALYSIS
I UNDERSTAND THAS AS REQUIRED BY FEDERAL MOTOR CARRIER SAFETY REGULATIONS,
SECTION 391.103 and POWER EXPRESS INC policy, all prospective drivers must submit to a controlled substance test. The results will not be released to any additional parties without my written
• Have you ever tested positive, or refused to test, on any pre-employment drug or alcohol test
administered by an employer to which the employee applied for, but did not obtain, safetysensitive
transportation work covered by DOT agency drug and alcohol testing rules during the past two years?
APPLICANT SIGNATURE_______________________________ DATE_______________________________
Suggested Format: “Release of Information Form -49 CFR Part 40 Drug and Alcohol Testing”
Section I. To be completed by the new employer, signed by the employee, and transmitted to the previous employer:
Employee Printed or Typed Name:_____________________ __________
Employee SS or ID
Number:_______________________________
l hereby authorize release of information from my
Department ofTransportation regulated drng and alcohol testing records by my previous employer, listed in Section l-B, to the employer listed in
Section I-A. This release is in accordance with
DOT Regulation 49 CFR Part 40, Section 40.25. I understand that
information to be released in Section II-A by my
previous employer, is limited to the following DOT-
1. Did the employee have alcohol tests with a result
l. Alcohol tests with a result of0.04 or higher;
2. Did the employee have verified positive drug
regulated testing items:
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. Employee Signature:_______________________________ Date:_______________________________
Employee Signature:_______________________________ Date: _______________________________
Designated Employer Representative: _______________________________ Previous Employer Name:
_______________________________
Address: _________________________________________________ ____________________________________________ Phone#:_______________________________
Designated Employer Representative (if known): ____ _________________________________
Section II. To be completed by the previous
employer and transmitted by mail or fax to the new employer:
II-A. In the two years prior to the date of the
employee’s signature (in Section I), for DOTregulated testing -
of0.04 or higher? YES NO tests? YES NO
3. Did the employee refuse to be tested? YES NO
4. Did the employee have other violations of DOT agency drug and
alcohol testing regulations? YES NO
5. Did a previous employer report a dmg and alcohol mle
violation to you? YES NO
6. If you answered “yes” to any of the above items, did the
employee complete the return-to-duty process? NIA YES NO
NOTE: Ij~vou answered ‘yes” to item 5, you must provide the previous employer’s report. Ij’you answered “yes” to item
6, you must also transmit the appropriate return-
to-duty documentation (e.g., SAP report(s},followup testing record).
DRIVER RULES & INFORMATION WHAT TO DO WITH INSPECTION VIOLAION
vIMPORTANT
CALL IMMEDIATELY AFTER A DOT INSPECTION/TICKET/WARNING
IN CASE OF AN ACCIDENT MAKE SURE THAT EVERYONE IS SAFE. IN
FAX IMMEDIATELY DOT INSPECTIONS/TICKET/WARNINGS
CASE OF AN INJURY, YOU NEED TO CALL 911 IMMEDIATELY.
MAINTENANCE NEEDS TO BE SENT IN WITH REPAIR BILL
ALWAYS take PICTURES of the truck, trailer and everyone/
WHAT TO DO IN CASE OF ACCIDENT
everything involved in the accident. Exchange insurance and
ANY ACCIDENT/INCIDENT CALL US IMMEDIATELY
driver’s license information.
TAKE PICTURES/INSURANCE INFO/DRIVER INFO-SEND TO SAFETY
If the other person refuses to give you their insurance
ACCIDENTS WITHFATALlTY/VIOLATION/INJURY TOW AWAY NEED POST ACCIDENT TEST WITHINN 8 HOURS USE WHITE/GREEN FORM IN FOLDER (CHAIN OF COSTODY) DRUG & ALCOHOL TEST RANDOM DRUG&ALCOHOL TESTING DRUG & ALCOHOL TESTING WILL HAPPEN AT RANDOM ALCOHOL TESTING MUST TAKE PLACE IN LAS VEGAS, NEVADA
information, fake any available information (LICENSE PLATE NUMBER, VIN OR DRIVER’S NAME) Make sure to call the Local Police Department and LEVEL UP LLC office and let them know. Call the POWER EXPRESS INC office (safety department) at 702-832-9144 immediately, or no later than 1 hours after the time of the accident.
MAINTENANCE
You can email the accident fax it to 702-973-1078. or DRUG
DO PRE-TRIP/POST INSPECTION
AND ALCOHOL TEST MUST BE MADE WITHIN 8 HOURS AFTER THE
MAINTAIN TIRE PRESSURE AT 100-110 PSI
ACCIDENT. IF A DRIVER FAILS TO REPORT AN ACCIDENT WITHIN 24
CHANGE YOUR OIL EVERY 35000 MILLES (APPROVAL NEEDED
HOURS,THE DRIVER WILL BE CHARGED UP TO 1000$.
FROM SUPERVISOR) FAIL URE TO REPORT DAMAGES ON TRUCK/TRAILER WILL RESULT IN DRIVER BEING RESPONSIBLE FOR DAMAGES ALL REPAIRS NEED TO BE AUTHORIZED BY SUPERVISOR
APPLICANT SIGNATURE_______________________________
LOADS AND DISPATCH
DATE____________
FAILLING TO SCALE AND CALL THE OFFICE FOR ANY OVER WEIGHTDRIVER WILL BE FULLY RESPONSIBLE FOR TICKETS FAILURE TO SECURE YOUR LOAD NO CALLING SHIPPERS/RECEIVERS TO CHANGE APPOINTMENTS YOU NEED TO CALL DISPATCH IF RUNNING LATE CALL or SPA TCH FOR ANY ISSUES WITH A LOAD DRIVER MUST CALL DISPATCHER WITH IN/OUT TIMES FOR PICK UP /DELIVERY MUST LET DISPATCHER KNOW ABOUT LUMMPER/PALATE EXCHANGE/LATE FEE/RESTOCKING FEE/GATE FEE LUMPER/PALATE EXCHANGE/LATE FEE/RESTOCKING FEE/GATE FEE-NEED TO RETURN IN WITH METHOD OF PAYMENT.
EMPLOYEE HANDBOOK POLICY & PROCEDURES
A LEVEL ABOVE THE REST™