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Cordova Twic Card

Location:
Rancho Cordova, CA
Salary:
$26.00/Hr.
Posted:
June 16, 2021

Contact this candidate

Resume:

Centerline Drivers, LLC.

**** *. ****** **, ***** 340

Santa Ana, CA 92701

844-***-****

**-**-**** *:08:48PM CST

IntelliApp

Thank you for your interest in Centerline Drivers, LLC. To apply for a driving 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.

If due to a dissability, I am unable to complete the application process, I agree to notify the Company so that we may discuss options for a reasonable accomodation. Personal Information

Referral Code: website

Name David R Tigue

Residence 3 years or longer (If No,

previous addresses shown below)

Yes

Current Address 4654 Village Mill Way

City, State/Province Zip/Postal Rancho Cordova, CA 95742 Country United States

Residence 3 years or longer (If No,

previous addresses shown below)

Yes

SSN/SIN 3915

Date of Birth

Primary Phone 916-***-****

Cell Phone 916-***-****

Preferred method of contact Cell Phone

Best time to contact you Afternoon

Email adm6lo@r.postjobfree.com

Cell Phone Provider AT&T

Yes, I agree to receive information

concerning future opportunities or

promotions from Centerline Drivers, LLC.

by email or other commercial electronic

communications.

Yes

Would you like to receive communication

from Centerline Drivers, LLC. via text

Yes

1

message?

By participating, you consent to receive

text messages sent by an automatic

telephone dialing system, which may

contain recruiting/advertising messages.

Consent to these terms is not a condition

of being hired, contracted, or leased. You

may opt out at any time by texting STOP to

unsubscribe. You also agree that

Centerline Drivers, LLC.'s service provider

receives in real time and logs your text

messages with Centerline Drivers, LLC..

Company Questions

Ad Number Recruiter

GENERAL INFORMATION

What location are you applying for? CA, Sacramento If hired, can you present evidence of your

right to work in the U.S.?

Yes

Are you currently employed? No

What date did your last employment end? 06-26-2020 Are you able to perform the essential

functions of the job for which you are

applying, either with or without reasonable

accommodation?

Yes

Please describe the functions that cannot

be performed. (Note: We comply with the

ADA and consider reasonable

accommodation measures that may be

necessary for eligible

applicants/employees to perform essential

functions. Hire may be subject to passing

a medical examination, and skill and/or

agility tests.)

Have you ever worked for this company

before?

No

Enter start and end dates, location,

position, and reason for leaving:

Do you have a current TWIC card? No

Expiration date:

Have you ever been known by any other

name?

No

Enter name:

How did you hear about Centerline? Email

2

If you chose "Referral" or "Other", please

explain:

Not applicable

DRIVING EXPERIENCE

For each class of equipment, enter type of equipment (van, reefer, tank, etc.), start and end dates, and approximate number of total miles. If no experience in a class, enter

"NONE".

Straight Truck 3/12/1918 to 6/3/1919

5000 miles

Tractor and Semi-Trailer 6/24/1920 to 6/26/2020

16,000,000 miles

Tractor - Two Trailers 5/2/88 seasonal

10,000 miles

Other Forklift 6 months

EDUCATION

List highest grade completed: College - 4

List last school attended (name, city, and

state):

Phil.college of criminology-Philippines

EMERGENCY CONTACT

Name: Madelyn tigue

Phone Number: 916-***-****

Google Tracking

Licenses

List all driver licenses that you have held in the past License Number 888

State/Province CA

Country United States

License Class Class A

License Expiration Date 02-03-2026

Physical Expiration Date 02-03-2022

Current License Yes

Commercial Driver License Yes

Endorsements None

3

Employment / Unemployment

Aramark Uniform Services

Company Aramark Uniform Services

Start Date 02-2011

End Date 02-2021

Address 7620 Wilbur way

City, State/Province Zip/Postal Sacramento, CA 95828 Country United States

Phone 818-***-****

Fax 818-***-****

Position Held Truck driver - shuttle

Reason for leaving? Retired

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

vehicle?

Yes

Were you subject to the Federal Motor

Carrier or Transport Canada Safety

Regulations while employed/contracted by

this employer/contractor?

No

Did you perform any safety sensitive

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Yes

Areas Driven Local Northern California

Miles driven weekly 2000-2500

Most common truck driven Tractor-Trailer

Most common trailer Van

Trailer length 53 feet or more

Trucking School

Start Date 09-1919

End Date 12-1919

School Driving school academy

City, State/Province Sacramento, CA

4

Country US

Phone

Did you graduate? Yes

Were you subject to the Federal Motor

Carrier or Transport Canada Safety

Regulations while attending this truck

school?

No

Did you perform any safety sensitive

functions at this truck school, regulated by

DOT, and subject to drug and alcohol

testing?

Yes

GPA 85

Hours of Instruction 160

Border Crossing Yes

Log Books Yes

Federal Motor Carrier Regulations Yes

Hazardous Materials Yes

FMCSR

Under FMCSR 391.15, are you currently

disqualified from driving a commercial

motor vehicle? [49 CFR 391.15]

No

Has your license, permit or privilege to

drive ever been suspended or revoked for

any reason? [49 CFR 391.21(b)(9)]

No

Have you ever been denied a license,

permit, or privilege to operate a motor

vehicle?[49 CFR 391.21(b)(9)]

No

Within the past two years, have you tested

positive, or 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? [49 CFR 40.25(j)]

No

In the past three(3) years, have you ever

been convicted of any of the following

offenses: [49 CFR 391.15]:

Driving a commercial motor vehicle

with a blood alcohol concentration

("BAC") of .04 percent or more

Driving under the influence of

alcohol, as prescribed by state law

No

5

Refusal to undergo drug and

alcohol testing as required by any

jurisdiction for the enforcement of

Federal Motor Carrier Safety Act

regulations

Driving a commercial motor vehicle

under the influence of any 21

C.F.R. 1308.11 Schedule I

identified controlled substance, an

amphetamine, a narcotic drug, a

formulation of an amphetamine, or

a derivative of a narcotic drug

Transportation, possession, or

unlawful use of a 21 C.F.R.

1308.11 Schedule I identified

controlled substance,

amphetamines, narcotic drugs,

formulations of an amphetamine, or

derivatives of narcotic drugs while

you were on duty driving for a

motor carrier

Leaving the scene of an accident

while operating a commercial motor

vehicle

Or any other felony involving the

use of a commercial motor vehicle

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

Signature

Full Name David R Tigue

IP Address 2601:204:df00:bf

Signature Date/Time 02-23-2021 3:08 PM

By signing my application below, I agree to use an electronic signature to demonstrate my consent. An electronic signature is as legally binding as an ink signature. 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 best of my knowledge. 6

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 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 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.

Signed Date: 02-23-2021 3:08 PM

Signed:

Federal FCRA Summary of Rights Acknowledgment

By checking this box, I (a) acknowledge

that I have read and understand the

federal FCRA Summary of Rights and

have been given the opportunity to

copy/print the Summary of Rights and (b)

agree to use an electronic signature to

demonstrate my consent. An electronic

signature is as legally binding as an ink

signature.

Yes

CALIFORNIA DISCLOSURE REGARDING BACKGROUND CHECKS DOCUMENT By checking the box, I 1) agree to use an

electronic signature to demonstrate my

consent, 2) agree that an electronic

signature is as legally binding as an ink

signature, and 3) acknowledge that I have

read and understood this California

Disclosure Regarding Background Checks

document.

Yes

California Consumer Copy Request

If you live or work in California, Minnesota,

or Oklahoma, please check this box if

you'd like to receive a copy of a consumer

report if one is obtained.

Yes

7

PSP Disclosure and Authorization

By checking the box, I (a) acknowledge

that I have read and understand the PSP

Disclosure and Authorization and also

have been given the opportunity to

copy/print it, and (b) agree to use an

electronic signature to demonstrate my

consent. An electronic signature is as

legally binding as an ink signature.

Yes

FCRA Disclosure

By checking the box, I (a) acknowledge

that I have read and understand the above

and also have been given the opportunity

to copy/print it, and (b) agree to use an

electronic signature to demonstrate my

consent. An electronic signature is as

legally binding as an ink signature.

Yes

FCRA Authorization

By checking the box, I (a) acknowledge

that I have read and understand the above

and also have been given the opportunity

to copy/print it, and (b) agree to use an

electronic signature to demonstrate my

consent. An electronic signature is as

legally binding as an ink signature.

Yes

Employment Verification Acknowledgment and Release (DOT Drug and Alcohol) By checking the box, I (a) acknowledge

that I have read and understand the above

and also have been given the opportunity

to copy/print it, and (b) agree to use an

electronic signature to demonstrate my

consent. An electronic signature is as

legally binding as an ink signature.

Yes

Clearinghouse Release

By checking the box, I (a) acknowledge

that I have read and understand the above

and also have been given the opportunity

to copy/print it, and (b) agree to use an

electronic signature to demonstrate my

consent. An electronic signature is as

legally binding as an ink signature.

Yes

8

Summary of Rights Under 15 U.S.C. Section 1681m(a) By checking this box, I represent that I

understand and agree to the above

language.

Yes

User Requested Copy

User requested a copy to be sent to this

email address adm6lo@r.postjobfree.com.

Yes

9

Centerline (the "Company") may request, for lawful employment purposes, background information about you from a consumer reporting agency in connection with your employment or application for employment (including independent contractor assignments, as applicable). This background information may be obtained in the form of consumer reports and/or investigative consumer reports (commonly known as "background reports"). An "investigative consumer report" is a background report that includes information from personal interviews (except in California, where that term includes background reports with or without information obtained from personal interviews), the most common form of which is checking personal or professional references. These background reports may be obtained at any time after receipt of your authorization and, if you are hired or engaged by the Company, throughout your employment or your contract period, as allowed by law.

Asurint, or another consumer reporting agency, will prepare or assemble the background reports for the Company. Asurint is located and can be contacted by mail at P.O. Box 14730, Cleveland, OH, 44145, and Asurint can be contacted by phone at 800-***-****. Information about Asurint's privacy practices is available at https://www.asurint.com/#compliance.

The background report may contain information concerning your character, general reputation, personal characteristics, and mode of living. The types of information that may be obtained include, but are not limited to: employment history

(e.g., dates of employment, final salary information, performance-related information, reasons for departure, etc.); personal and professional reference checks; and other information bearing on your character, general reputation, personal characteristics, and mode of living.

This information may be obtained from private and public record sources, including, as appropriate: government agencies and courthouses; educational institutions; former employers; and, for investigative consumer reports, personal interviews with sources such as neighbors, friends, former employers and associates; and other information sources provided as references. The Company is not intending to collect, and will not be requesting, any information bearing on your credit worthiness, credit standing, or credit capacity, unless it otherwise notifies you prior thereto in writing. You may request more information about the nature and scope of an investigative consumer report, if any, by contacting the Company.

A summary of your rights under the Fair Credit Reporting Act is also being provided to you. Printed Name:

David R Tigue

Social Security #:

3915

Signed Date: 02-23-2021

David R Tigue

4654 Village Mill Way

Rancho Cordova, CA 95742

916-***-****

Gender:

DISCLOSURE REGARDING BACKGROUND INVESTIGATION 10

ACKNOWLEDGMENT AND AUTHORIZATION

I have carefully read and understand the Disclosure Regarding Background Investigation and the attached summary of rights under the Fair Credit Reporting Act. By my signature below, I consent to preparation of background reports by a consumer reporting agency such as Asurint, and to the release of such background reports to the Company and its designated representatives and agents, for the purpose of assisting the Company in making a determination as to my eligibility for employment, promotion, retention or for other lawful employment purposes. I understand that if the Company hires me, my consent will apply, and the Company may, as allowed by law, obtain additional background reports pertaining to me, without asking for my authorization again, throughout my employment or contract period from Asurint and/or other consumer reporting agencies. I also understand that nothing herein shall be construed as an offer of employment.

By my signature below, I certify the information I provided on and in connection with this form is true, accurate, and complete. I agree that this form in original, faxed, photocopied or electronic (including electronically signed) form, will be valid for any background reports that may be requested by or on behalf of the Company. Printed Name:

David R Tigue

Social Security #:

3915

Signed Date: 02-23-2021

David R Tigue

4654 Village Mill Way

Rancho Cordova, CA 95742

916-***-****

Gender:

DISCLOSURE REGARDING BACKGROUND INVESTIGATION 11

IMPORTANT DISCLOSURE

REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Centerline Drivers, LLC. ("Prospective Employer"), Prospective Employer, its employees, agents or contractors 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. 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. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.

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 Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report. The Prospective Employer cannot obtain background reports from FMCSA without your authorization. AUTHORIZATION

If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below: I authorize Centerline Drivers, LLC. ("Prospective Employer") 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 authorizing 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.

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 challenge 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. I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, 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:

David R Tigue

Signed Date: 02-23-2021

DISCLOSURE REGARDING BACKGROUND INVESTIGATION 12

Consent for Limited Queries of the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol Clearinghouse

I hereby provide consent to Centerline Drivers, LLC. to conduct a limited query of the FMCSA Commercial Driver's License Drug and Alcohol Clearinghouse to determine whether drug or alcohol violation information about me exists in the Clearinghouse. I understand this consent shall remain on file and shall serve as ongoing consent for Centerline Drivers, LLC. to conduct multiple limited queries of the Clearinghouse at any time during my employment or contract period without asking me for additional consent. I understand that if I refuse to provide consent for Centerline Drivers, LLC. to conduct a limited query of the Clearinghouse, Centerline Drivers, LLC. is required to prohibit me from performing safety-sensitive functions, including operating a commercial motor vehicle. I understand that if the limited query conducted by Centerline Drivers, LLC. indicates that drug or alcohol information exists about me in the Clearinghouse, the FMCSA will not disclose that information to Centerline Drivers, LLC. unless I give additional specific consent within the Clearinghouse. However, I understand that Centerline Drivers, LLC. will be required to conduct a full query of the Clearinghouse within 24 hours after a limited query indicates that drug or alcohol information exists and that if I do not grant consent within the Clearinghouse for that full query I will be removed from performing safety-sensitive functions, including operating a commercial motor vehicle.

02-23-2021

David R Tigue Date

DISCLOSURE REGARDING BACKGROUND INVESTIGATION 13

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

X 02-23-2021

Date

X 3915

Social Security Number

David R Tigue

4654 Village Mill Way

Rancho Cordova, CA 95742

916-***-****

Gender:

X David R Tigue

Print Name (First, MI, Last)

X

Signature

I, the above mentioned signer, hereby authorize Aramark Uniform Services To release and forward in accordance with the following regulation, all known information pertaining to my alcohol and controlled substances testing/training records to Centerline Drivers, LLC. DOT DRUG AND ALCOHOL RELEASE

I authorize, per 49 CFR Part 40, the release of information from my DOT regulated drug and alcohol testing records by the carriers (company/school) listed to Asurint or other designated provider for the sole purpose of transmitting such records to Centerline Drivers, LLC or directly to Centerline Drivers LLC. 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. Additionally, Record of safety performance history, including employment dates, work history and accidents, in accordance with Part 391 of the Federal Motor Carrier Safety Regulations (49 CFR Part 391). DISCLOSURE REGARDING BACKGROUND INVESTIGATION 14

Summary of Rights Under 15 U.S.C. Section 1681m(a) You are hereby provided a summary of the following provisions of the Fair Credit Reporting Act, 15 U.S.C. 1681m(a): The following consumer reporting agencies will prepare the background report / consumer report for Centerline Drivers, LLC.

('Company'):

Tenstreet

120 W. 3rd Street

Tulsa, OK 74103

Phone: 877-***-****

Email: adm6lo@r.postjobfree.com

Web: http://www.tenstreet.com/drivers/

For Clearinghouse:

U.S. Federal Motor Carrier Safety Administration, of the Department of Transportation, ("FMCSA-DOT") 1200 New Jersey Avenue SE

Washington, DC 20590

Phone: 800-***-****, TTY 800-***-****

https://dataqs.fmcsa.dot.gov/Default.aspx

Asurint

Compliance Dept

PO Box 14730

Cleveland, Ohio 44114

Phone: 800-***-****

Email: adm6lo@r.postjobfree.com

Web: https://www.asurint.com/candidates

Workforce QA

1430 S. Main St

Salt Lake City, UT 84115

800-***-****

http://www.wfqa.com

No consumer reporting agency utilized by the Company makes adverse decisions relating to your employment or contract relationship and no consumer reporting agency utilized by the Company is able to provide any specific reasons to you why an adverse decision relating to your employment or contract relationship may be taken or was taken based on a consumer report.

15 U.S.C. 1681j provides for the right to obtain a free copy of a consumer report on you from the consumer reporting agency which prepared your background report, under various circumstances, including but not limited to where you receive notice that an adverse action has been taken toward you based on the consumer report. In that instance, Section 1681j provides a right to a free copy of the report provided that you make the request within 60 days of the date that you received notice of the adverse action.

15 U.S.C. 1681i provides for the right to dispute, with a consumer reporting agency the accuracy or completeness of any information in a consumer report furnished by the agency.

Printed Name:

David R Tigue

Social Security #:

3915

Signed Date: 02-23-2021

David R Tigue

4654 Village Mill Way

Rancho Cordova, CA 95742

916-***-****

DISCLOSURE REGARDING BACKGROUND INVESTIGATION 15

Centerline (the "Company") may request, for lawful employment purposes, background information about you from a consumer reporting agency in connection with your employment or application for employment (including independent contractor assignments, as applicable). This background information may be obtained in the form of consumer reports and/or investigative consumer reports (commonly known as "background reports"). An "investigative consumer report" is a background report that includes information from personal interviews (except in California, where that term includes background reports with or without information obtained from personal interviews), the most common form of which is checking personal or professional references. These background reports may be obtained at any time after receipt of your authorization and, if you are hired or engaged by the Company, throughout your employment or your contract period, as allowed by law.

Asurint, or another consumer reporting agency, will prepare or assemble the background reports for the Company. Asurint is located and can be contacted by mail at P.O. Box 14730, Cleveland, OH, 44145, and Asurint can be contacted by phone at 800-***-****. Information about Asurint's privacy practices is available at https://www.asurint.com/#compliance.

The background report may contain information concerning your character, general reputation, personal characteristics, and mode of living. The types of information that may be obtained include, but are not limited to: employment history

(e.g., dates of employment, final salary information, performance-related information, reasons for departure, etc.); personal and professional reference checks; and other information bearing on your character, general reputation, personal characteristics, and mode of living.

This information may be obtained from private and public record sources, including, as appropriate: government agencies and courthouses; educational institutions; former employers; and, for investigative consumer reports, personal interviews with sources such as neighbors, friends, former employers and associates; and other information sources provided as references. The Company is not intending to collect, and will not be requesting, any information bearing on your credit worthiness, credit standing, or credit capacity, unless it otherwise notifies you prior thereto in writing. You may request more information about the



Contact this candidate