Human Resources Company

Location:

Cypress, TX

Posted:

July 22, 2014

Contact this candidate

Resume:

MBI Energy Services **-**-**** **:**:**AM CDT

***** **** ****** **

Belfield, ND 58622

701-***-****

IntelliApp

Thank you for your interest in MBI Energy Services. To apply for a position, please

complete our online application for employment. Incomplete information will delay the

processing of your application or prevent it from being submitted.

In compliance with Federal and State equal employment opportunity laws, qualified

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.

Position City State/Province

Water Truck Driver Lignite ND

Personal Information

Referral Code: indeed

Name Monica Ann Mattox

Residence 3 years or longer (If No, No

previous addresses shown below)

Address 8200 Sunbury Lane

Address 2 Apt #1006

City, State/Province Zip/Postal Houston, TX 77095

Addresses Over last 3 years Address 1

8200 Sunbury Lane

Houston, TX 77095

08-2013 to 11-2013

Address 2

2404 South Voss Road # C204

Houston, TX 77057

09-2000 to 08-2013

Country United States

SSN/SIN 2765

Date of Birth

Primary Phone 832-***-****

Cell Phone 832-***-****

Preferred method of contact Email

Best time to contact you Any

Email **************@*****.***

Company Questions

GENERAL INFORMATION

Are you legally eligible for employment in Yes

the United States?

Are you currently employed? Yes

What date did your last employment end?

Have you ever worked for this company No

before?

Enter start and end dates, location,

position, and rate of pay

Have you ever worked for a subcontractor No

of MBI?

Enter start and end dates, location,

position, and rate of pay

Please enter the names of any relatives

employed here:

How did you hear about us? Rigzone

Who referred you (first and last name)? Stephanie Ayers

If you listed "other" above, please

describe?

If you have a Skype account, please list

your Skype name:

Have you ever been convicted of a No

felony?

Please explain

PROSPECTIVE EMPLOYEE QUESTIONNAIRE

Do you possess a current CDL Class A Yes

drivers license?

How many years of Class A CDL driving 10.75

experience do you have?

Mark yes for which endorsements you currently have on your Class A CDL

Tanker? Yes

Doubles/Triples? Yes

Hazmat? Yes

Do you have experience driving 13, 15, or Yes

18 speed transmissions?

Mark yes on those that apply. Has most of your Class A CDL driving experience been

OTR 48 states Yes

Regional Yes

Local Yes

Do you have experience adjusting brakes Yes

on a Class A tractor trailer combination?

Have you ever chained the tires on a Yes

Class A commercial tractor trailer

combination?

Please explain Donner Pass, CA WY other DOT points

during OTR driving...varied.

Do you possess good mechanical skills? Yes

Please explain Pre and Post Trip jury rigging Water

Trucks with KBR in

Bagram Air Field...on a Military Air Base as

a Civilian Contractor

in an active war zone grew up in our

family business:

Town and Country Butane..Texas...

Do you have tanker experience? Yes

Mark yes on the following tanker configurations applicable in your previous tanker

experience

Tanker Truck Yes

Fifth wheel tractor pulling a tanker trailer Yes

Tanker truck pulling a tanker trailer No

If applicable, please list any other tanker Mercedes Up Armoured Units @

configuration that you may have driven KBR/Iraq with JP8 jet fuel trucks...

Please mark yes on the types of liquid you have hauled in these tankers

Water Yes

Fuel Yes

Crude Oil No

Acids No

If applicable, please list any other liquids Water Truck Route: Bagram Air Field:

that you have hauled Potable and Non Potable Water

as a Civilian Contractor on an "inside the

wire" route..Night Shifts

with Afghani Locals as "ground guides" in

tight areas including

Camp Alpha US Army, Air Force,

etc...Navy...

Do you have pneumatic tank trailer

experience?

Please mark yes on the items that you have hauled with a pneumatic trailer

Sand No

Cement No

Soda Ash No

If applicable, please list any other items I'm a quick student and can learn/adapt

that you may have hauled with a OTJ on the job training..

pneumatic trailer

Do you have previous oil field driving No

experience with a Class A tractor trailer

combination?

Please describe

Do you have winch truck experience? No

Please describe

Do you have experience driving a Class A Yes

tractor and trailer in extreme winter

conditions including ice, snow, strong

winds and subzero temperatures?

Please describe Bagram Air Field: Afghanistan WINTER,

Spring Summer and Fall..

Balad Air Field: Iraq OUTSIDE the wire and

inside...

sandstorms, rain and direct and indirect fire

from the Al-Qaida

Do you have experience driving a Class A Yes

tractor and trailer on dirt and gravel

roads?

Please describe Bagram Air Field Afghanistan

Deaton Truck Lines..some oil field LIVE

unloads in a flatbed

OTR driving State Side..

Do you have experience driving a Class A Yes

tractor trailer in muddy conditions

Please describe See above

and also Bagram Air Field and Balad Air

Field..

See above...

Do you have experience driving a tractor Yes

and trailer on steep grades?

Please describe see above

and also OTR with JB Hunt and MS

Carriers

NC/SC and Western States...state side...

Have you ever worked out of doors in Yes

extreme cold and other adverse weather

conditions?

Please describe Afghanistan: Bagram Air Field

Iraq: Balad Air Field

"outside the wire" in sandstorms during

medi-vac conditions

afghanistan in the Hindu Kush Mountains

north of Kabul in

Blizzards and Sandstorms, Winter snow

and heavy dangerous winds...

sometimes during direct and indirect fire

from the Taliban

Do you have flatbed experience? Yes

Do you have heavy equipment No

experience?

Please describe

Have you interacted with customers and Yes

do you possess good customer services

skills?

Please describe JB Hunt DCS dedicated: Budweiser 3.5yrs

plus..and Goodman...9 months

KRB: Iraq and Afghanistan: with the US

Army under Escort "outside the wire" and

also same in Afghanistan i.e. Camp Alpha

@ ECP points Military Check Points with

the Marines, Army and US Navy under

FULLY armed escort with Afghani Locals as

"Ground Guides" in TIGHT night time

conditions near Insurgent Prisoners and

Military Surveillance...actively

monitored...Yes

Are you able to take direction from Yes

dispatch and from MBI customers?

Do you have log book experience? Yes

Do you have experience with electronic Yes

logs?

Please describe Transport America: OTR...with onboard

QualComm and also

JB Hunt PeopleNet DCS local

dedicated...with P.Net

Do you possess basic computer skills? Yes

Mark yes on one term that best describes you

Risk taker No

Analytical Yes

Timid No

Creative Yes

Are you willing to relocate for this job Yes

position?

If hired, what shift would you prefer? Night Shift

Mark yes on one term that best describes your lifestyle?

Metro No

Rural Yes

Suburban Yes

Do you have experience in the logging No

industry?

Have you hauled hazardous material? Yes

Please list any other commercial driving Dedicated with: Roads West Albertson's

experience

DRIVING EXPERIENCE

For each class of equipment, enter type of equipment (straight, tanker, etc.), start and

end dates, and approximate number of total miles. If no experience in a class, enter

"NONE".

Straight Truck Class 8 CDL-A..10.5yrs..OTR and

Local freightliners,

internationals,etc...currently...11/2013 11

/2012..

(international civilian contractor work:

Iraq/Afghanistan)

1/2008-9/2011...

(college one semester HCCS)

1/2012-5/2012.

job searching 9/2011...1/2012...

PRIOR experience CDL A

resumes 2/2008 4/1996

combined experience: nearly 1,000,000

miles safe driving...

Straight/Bobtail Truck Tank Straight Trucks:3/96'-4/96 St Rose

Nursery New Orleans Area

Straight Trucks: 9/91'-5/92 Sara Lee

(Leggs) Display Merchandiser

Route Relief/Warehouse Denver area,

Rocky Mtns, and WY,NE

PRIOR in film/tv production: grip/electric

equipment trucks...

Straight Truck Tanker Pulling a Tanker none

Pup (Doubles)

Tractor and Two Trailers Doubles BEK Foods/Houston-San

Antonio Shuttle...4/05'-11/05

reefers...

Do you have any flatbed experience? Yes

Do you have reefer experience? Yes

Do you have gravel truck experience? No

Do you have box van experience? Yes

List any liquid tank trailer or pneumatic none

tank trailer experience, please include

company name(s), dates and product

hauled. If none, please enter "none".

Which safe driving awards do you hold JB Hunt: Smith System Safe Driving

and from whom? multiple years

Transport America: Safe Driving multiple

years..

MS Carriers: Safe Driving multiple years

Sara Lee/(Leggs) Defensive Driving

Straight Truck and Award

EDUCATION

List highest grade completed: College - 4

List last school attended (name, city, and Houston Community College System

state):

If you attended college, list your major, Photography, 4yrs, B.A. Degree

how may years you attended, and your

degree type.

PROFESSIONAL REFERENCES

List name, address, city, state, phone number, and relationship:

First Reference:

Full Name Stephanie Ayers

Relationship Friend

Company Oil & Gas Process Engineer

Address Copperfield/Northwest Houston

Phone number 832-***-****

Second Reference:

Full Name Bettina Stap

Relationship Friend

Company Stap Studios: Graphics

Address Houston:relocated recently to Washington

Phone number 713-***-****

Third Reference:

Full Name Melissa Murry

Relationship Friend

Company U of H Graduate Student

Address #803 The Palms: Houston, TX 77057

Phone number 713-***-****

JOBehaviors score:

Licenses

License Number 436

State/Province TX

Country United States

License Class Class A

License Expiration Date 09-09-2015

Physical Expiration Date 09-09-2015

Current License Yes

Commercial Driver License Yes

Endorsements

Tanker Endorsement Yes

HAZMAT Endorsement Yes

Hazmat Expiration Date 09-09-2015

X Endorsement Yes

Doubles Triples Endorsement Yes

Other Endorsement No

Employment / Unemployment

JB Hunt

Company JB Hunt

Start Date 11-2012

End Date 10-2013

Address 623 N Bloomington Dr

City, State/Province Zip/Postal Lowell, AR 72745

Phone 800-***-****

Position Held CURRENT: DCS driver local

Reason for leaving? CURRENT employed

Were you terminated/discharged/laid off? No

Is this your current employer? Yes

May we contact this employer at this time? Yes

Did you operate a commercial motor Yes

vehicle?

Were you subject to the Federal Motor Yes

Carrier or Transport Canada Safety

Regulations while employed/contracted by

this employer/contractor?

Did you perform any safety sensitive Yes

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Areas Driven Local Houston-Dallas...etc.

Miles driven weekly 1500-2000

Pay Range (cents/mile) 33cpm then hour rate

Most common truck driven Conventional Tractor

Most common trailer Van

Trailer length 53 feet or more

Transport America

Company Transport America

Start Date 06-2012

End Date 11-2012

Address 1715 Yankee Doodle Rd

City, State/Province Zip/Postal Eagan, MN 55121

Phone 651-***-****

Position Held OTR driver..

Reason for leaving? "re-qualifying for JB Hunt.commute

hou-dallas

Were you terminated/discharged/laid off? No

Is this your current employer? No

May we contact this employer at this time? Yes

Did you operate a commercial motor Yes

vehicle?

Were you subject to the Federal Motor Yes

Carrier or Transport Canada Safety

Regulations while employed/contracted by

this employer/contractor?

Did you perform any safety sensitive Yes

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Areas Driven 48 states OTR

Miles driven weekly 2000-2500

Pay Range (cents/mile) 30 cpm

Most common truck driven Conventional Tractor

Most common trailer Van

Trailer length 53 feet or more

Unemployment

Start Date 10-2011

End Date 05-2012

Comment Returned home from Overseas Civilian

Work..job hunting, prepping for college in

Spring Semester...Name/Gender Change

awaiting Court Datein Texas then college

FULL TimeSpring

Semester...HCCS...Digital

Communications...

Fluor Government Group

Company Fluor Government Group

Start Date 04-2010

End Date 09-2011

Address FLUOR - POL

City, State/Province Zip/Postal Greenville, SC

Phone 864-***-****

Position Held AFGHANISTAN: water truck and cleaning

dept

Reason for leaving? minor issue: perfect records PRIOR

Were you terminated/discharged/laid off? Yes

Termination Explanation minor issue: perfect records

PRIOR..LOGCAP III to IV conversion KBR

lost the contract we transferred to FLOUR

on base

also: americans vs foreign labor..there

where redundant and dishonest monitored

policies to "Squeeze out Americans for

LESS pay vs FOREIGN labor @ 1/2 pay

rates perfect record..no write ups and

they skipped 3 steps in the HR policy

Is this your current employer? No

May we contact this employer at this time? Yes

Did you operate a commercial motor No

vehicle?

Were you subject to the Federal Motor

Carrier or Transport Canada Safety

Regulations while employed/contracted by

this employer/contractor?

Did you perform any safety sensitive

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Areas Driven

Miles driven weekly

Pay Range (cents/mile)

Most common truck driven

Most common trailer

Trailer length

KBR

Company KBR

Start Date 03-2008

End Date 03-2010

Address 601 Jefferson Street

City, State/Province Zip/Postal Houston, TX 77002

Phone 713-***-****

Fax 866-***-****

Position Held JP8 Driver,IRAQ, AFGHANISTAN water

truck

Reason for leaving? LOGCAP III to IV

conversion AFGHANISTAN

Were you terminated/discharged/laid off? No

Is this your current employer? No

May we contact this employer at this time? Yes

Did you operate a commercial motor Yes

vehicle?

Were you subject to the Federal Motor No

Carrier or Transport Canada Safety

Regulations while employed/contracted by

this employer/contractor?

Did you perform any safety sensitive Yes

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Areas Driven IRAQ: MSR I, inside the

wire..AFGHANISTAN on base.

Miles driven weekly 0-500

Pay Range (cents/mile) salary...

Most common truck driven Conventional Tractor

Most common trailer Tank Trailer

Trailer length 45 to 52 feet

JB Hunt

Company JB Hunt

Start Date 05-2004

End Date 02-2008

Address 623 N Bloomington Dr

City, State/Province Zip/Postal Lowell, AR 72745

Phone 800-***-****

Position Held Houston DCS Budweiser

Reason for leaving? Overseas Offer KBR Iraq/Afghanistan

Were you terminated/discharged/laid off? No

Is this your current employer? No

May we contact this employer at this time? Yes

Did you operate a commercial motor Yes

vehicle?

Were you subject to the Federal Motor Yes

Carrier or Transport Canada Safety

Regulations while employed/contracted by

this employer/contractor?

Did you perform any safety sensitive Yes

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Areas Driven TX/LA & Houston-Waco-Dallas,etc.

Miles driven weekly 1500-2000

Pay Range (cents/mile) 33cpm & drop pay

Most common truck driven Conventional Tractor

Most common trailer Van

Trailer length 53 feet or more

Southwest Traders Inc.

Company Southwest Traders Inc.

Start Date 12-2003

End Date 04-2004

Address 27711 Diaz Rd.

Address 2 Houston Starbucks Route Local

City, State/Province Zip/Postal Temecula, CA 92590

Phone 951-***-****

Fax 951-***-****

Position Held Starbucks' Route local Houston

Reason for leaving? Ben E Kieth Offer

Were you terminated/discharged/laid off? No

Is this your current employer? No

May we contact this employer at this time? Yes

Did you operate a commercial motor Yes

vehicle?

Were you subject to the Federal Motor Yes

Carrier or Transport Canada Safety

Regulations while employed/contracted by

this employer/contractor?

Did you perform any safety sensitive Yes

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Areas Driven Starbuck's Route Local Houston Nights

Miles driven weekly 0-500

Pay Range (cents/mile) 19-21$hr...

Most common truck driven Straight Truck

Most common trailer Other

Trailer length Other

Ben E Kieth

Company Ben E Kieth

Start Date 04-2003

End Date 12-2003

Address 5505 Kaepa Court

City, State/Province Zip/Postal San Antonia, TX 78018

Phone 210-***-****

Position Held Shuttle Driver

Reason for leaving? scraped guard rail enroute minor

Were you terminated/discharged/laid off? Yes

Termination Explanation scraped a guard rail avoiding wild animals

enroute I-10 east minor issue...NOTHING

prior...good driving record good

performance good safety record..

Is this your current employer? No

May we contact this employer at this time? Yes

Did you operate a commercial motor Yes

vehicle?

Were you subject to the Federal Motor Yes

Carrier or Transport Canada Safety

Regulations while employed/contracted by

this employer/contractor?

Did you perform any safety sensitive Yes

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Areas Driven Houston-San Antonio-Houston shuttle..

Miles driven weekly 1000-1500

Pay Range (cents/mile) 13.50$hr...etc..

Most common truck driven Day Cab Conventional

Most common trailer Doubles

Trailer length 31 feet or less

Education

School Name Houston Community College System:

Start Date 01-2012

End Date 05-2012

City, State/Province Houston, TX

Country United States

Phone 713-***-****

Graduation Date 06-2012

Motor Vehicle Record

1. Has any license, permit or privilege ever No

been denied, suspended or revoked for

any reason?

2. Have you ever been convicted of driving No

during license suspension or revocation, or

driving without a valid license or an expired

license, or are any charges pending?

3. Have you ever been convicted for any No

alcohol or controlled substance related

offense while operating a motor vehicle, or

are any charges pending?

4. Have you ever been convicted for No

possession, sale or transfer of a an illegal

substance (including but not limited to,

marijuana, amphetamines, or derivatives

thereof), or are any charges pending?

5. Have you ever been convicted of No

reckless driving, careless driving or

careless operation of a motor vehicle, or

are any charges pending?

6. Have you ever tested positive, or No

refused to test on a pre-employment drug

or alcohol test by an employer to whom

you applied, but did not obtain

safety-sensitive transportation work

covered by DOT agency drug and alcohol

testing rules in past three years, or have

you ever tested positive or refused to test

on any DOT-mandated drug or alcohol

test?

Vehicle Accident Record

Were you involved in any accidents/incidents with any vehicle in the last 3 years (even

if not at fault)?

No Accidents

Traffic Convictions \ Violations

Have you had any moving violations or traffic convictions in the past 3 years?

No Violations

Federal FCRA Summary of Rights Acknowledgment

By checking this box, I acknowledge that I Yes

have read and understand the FCRA

Statement of Rights.

Pre-Employment Screening Program Important Notice

I acknowledge that I have read and Yes

understand the above Important Notice of

Rights and also have been given the

opportunity to copy/print the notice.

User Requested Copy

User requested a copy to be sent to this Yes

email address

**************@*****.***.

By my check of this box, I represent that I Yes

understand and agree to the above and

that I intend to execute this document by

electronic signature in checking this box.

Signature

Full Name Monica Ann Mattox

Social Security Number 2765

Date of Birth

IP Address 108.226.181.182

Signature Date/Time 10-21-2013 10:52 AM

Notification and Authorization for Consumer Reports and Investigative

Consumer Reports

Pursuant to the Fair Credit Reporting Act, Title VI [15 U.S.C. 1681]

This document shall serve as notification to you that MBI Energy Services and/or any of its subsidiaries (hereinafter collectively

referred to as the "Company") may request that a consumer reporting agency prepare consumer reports or investigative consumer

reports regarding you for the purpose of considering your application for employment or making other employment decisions. In

addition, the Company may independently conduct background checks on you.

The consumer reports, investigative consumer reports and/or background checks may include, but not be limited to, information

regarding your education, employment history, credit history, training, motor vehicle records, references, and criminal history. If an

investigative consumer report is conducted, the report may include information obtained through personal interviews regarding your

character, general reputation, personal characteristics, or mode of living. If an investigative consumer report is requested, you are

entitled to obtain, by written request to the MBI Energy Services Human Resources Department, disclosure of the nature and scope of

the report. If the Company takes adverse employment action against you wholly or partly because of information obtained in a

consumer or investigative consumer report, you have the right to request and receive from the consumer reporting agency a free copy

of a consumer report concerning you if you make a written request to the consumer reporting agency within 60 days of receiving

notice of the Company's adverse employment action, and to dispute and correct any item of information contained in the consumer

reporting agency file.

By signing this document, you consent to the Company's obtaining one or more consumer reports and/or investigative consumer

reports on you and further consent to the Company's independently conducting one or more background checks on you. Such reports

or checks may be obtained or conducted in connection with your application for employment and from time to time thereafter during

your employment with the Company. Your failure or refusal to consent may be considered by the Company in evaluating your

application for employment or in making other employment decisions.

I hereby authorize the Company to obtain consumer reports and/or investigative consumer reports and/or conduct background checks

on me from time to time for purposes of making hiring and other employment decisions about me. I acknowledge that I have read this

entire document and understand the same. This consent and authorization shall be effective unless I expressly revoke it in writing and

deliver such revocation to MBI Energy Services Human Resources Department.

Printed Name: Monica Ann Mattox

8200 Sunbury Lane

Monica Ann Mattox

Apt #1006

Social Security #: Houston, TX 77095

2765 832-***-****

Gender:

Signed Date: 10-21-2013

TO BE READ AND SIGNED BY APPLICANT

This certifies that this application was completed by me, and that all entries on it and information on it are true and complete to the best of

my knowledge.

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related

matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if

and after a conditional offer of employment has been extended.) I hereby release employers, schools, 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 given 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. I 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 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 re-send 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.

Printed Name: Monica Ann Mattox Signed Date: 10-21-2013

Social Security #: 2765

Signed:

IMPORTANT NOTICE REGARDING BACKGROUND REPORTS FROM THE PSP

Online Service

1. In connection with your application for employment with MBI Energy Services ("Prospective Employer"), it may obtain one or more

reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA).

When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a

decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with

a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before

taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the

Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report.

When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses

any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the

Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that

adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free

telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the

specific reasons why the adverse action was taken; and that you may, upon providing proper identification,request a free copy of the

report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver

record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with

proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the

Fair Credit Reporting Act.

The Prospective Employer cannot obtain background reports from FMCSA unless you consent in writing.

If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:

2. I authorize MBI Energy Services to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information

regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am consenting

to the release of safety performance information including crash data from the previous five (5) years and inspection history from the

previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a

determination regarding my suitability as an employee.

3. I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has

the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a

request to https://dataqs.fmcsa.dot.gov. If I am challenging crash or inspection information reported by a State, FMCSA cannot change or

correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.

4. Please note: Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report,

or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those

crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State

citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.

I have read the above Notice Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this

consent form, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and

its employees, authorized agents, and/or affiliates to obtain the information authorized above.

Printed Name: Monica Ann Mattox Signed Date: 10-21-2013

Social Security #: 2765

Signed:

RELEASE REGARDING CONSUMER REPORTS AND INVESTIGATIVE CONSUMER

REPORTS

In connection with my application for a position with MBI Energy Services and/or one of its affiliated companies (together, "MBI" or

"Company"), I have received notification that MBI may request that a consumer reporting agency prepare consumer reports or

investigative consumer reports regarding me for the purpose of considering my application for employment or making other employment

decisions. Further, I received notice that MBI may independently conduct background checks on me.

The consumer reports, investigative consumer reports and/or background checks may include, but not be limited to, information regarding

my education, employment history, credit history, training, motor vehicle records, references, and criminal history. If an investigative

consumer report is conducted, the report may include information obtained through personal interviews regarding my character, general

reputation, personal characteristics, or mode of living.

In a Notification and Authorization for Consumer Reports and Investigative Consumer Reports, I consented to the Company's obtaining

one or more consumer reports and/or investigative consumer reports on me and further consented to the Company's independently

conducting one or more background checks on me. Such reports or checks may be obtained or conducted in connection with my

application for employment and from time to time thereafter during my employment with the Company.

I hereby release the Company for any and all liability relating to or arising from such consumer reports and/or investigative consumer

reports and/or background checks. I acknowledge that I have read this entire document and understand the same.

Printed Name: Monica Ann Mattox Signed Date: 10-21-2013

Social Security #: 2765

Signed:

Request/Consent for Information from Previous Employer(s)/Carrier(s) For Alcohol and Controlled Substances Testing

Records

And changes in Parts 390 and 391 of the FMCSA

Monica Ann Mattox

10-21-201*-****

X X

8200 Sunbury Lane

Date Social Security Number

Apt #1006

Houston, TX 77095

832-***-****

Gender:

Monica Ann Mattox

X X

Print Name (First, MI, Last) Signature

I, the above mentioned signer, hereby authorize JB Hunt

To release and forward in accordance with the following regulation, all known information pertaining to my alcohol and controlled substances

testing/training records to MBI Energy Services

DISCLOSURE AND RELEASE

In accordance with DOT Regulation 49 CFR Part 391.23, I authorize the release of information from my DOT regulated drug and

alcohol testing records by the carriers (company/school) listed above to MBI Energy Services for the sole purpose of transmitting such

records to MBI Energy Services. I authorize release of the following information concerning DOT drug and alcohol testing violations

including pre-employment tests during the past three years: (i) alcohol tests with a result of 0.04 or higher; (ii) verified positive drug

tests; (iii) refusals to be tested (including verified adulterated or substituted results); (iv) other violations of DOT drug and alcohol

testing regulations; (v) information obtained from previous employers of a drug and alcohol rule violation(s); and (vi) documents, if any,

of completion of a return-to-duty process following a rule violation. I also authorize the carriers (company/school) listed above to

release information about names and dates of previous employers, reasons for termination of employment, work experience,

accidents, academic history, professional credentials and other information.

The information that I have authorized MBI Energy Services to review involves tests required by DOT. If any carrier (company/school)

listed above furnishes MBI Energy Services with information concerning items (i) through (vi) above, I also authorize that carrier

(company/school) to release and furnish the dates of my negative drug and/or alcohol tests and/or tests with results below 0.04 during

the three-year period and the name and phone number of any substance abuse professional who evaluated me during the past three

years.

Request/Consent for Information from Previous Employer(s)/Carrier(s) For Alcohol and Controlled Substances Testing

Records

And changes in Parts 390 and 391 of the FMCSA

Monica Ann Mattox

10-21-201*-****

X X

8200 Sunbury Lane

Date Social Security Number

Apt #1006

Houston, TX 77095

832-***-****

Gender:

Monica Ann Mattox

X X

Print Name (First, MI, Last) Signature

I, the above mentioned signer, hereby authorize Transport America