Gs Customer

Gillmann Services, Inc.

Employee Consent to Drug and Alcohol Testing

Gillmann Services, Inc. has a strong commitment to their employees, customers and the community to provide a drug and alcohol- free work environment.

The primary purpose of drug and alcohol testing is to help establish and maintain a drug and alcohol-free work environment. In addition, Gillmann wants to ensure that public and personal safety of employees is not endangered because of drug and/or alcohol use by employees. To do this Gillmann has adopted a Drug Free Workplace Policy that requires drug and alcohol testing under specified circumstances. A copy of the Drug Free Workplace Policy is posted and a copy will be made available upon request. I understand that the term “Policy” means Gillmann’s Drug Free Workplace Policy. I agree to abide by the terms and conditions of the “Policy” as they now exist or may be amended in the future. I agree and consent to drug and/or alcohol testing as required by the “Policy” Further, I acknowledge that my continued employment is contingent upon my compliance with the “Policy” 1. I acknowledge the existence of the Drug Free Workplace Policy and I agree to abide by the terms and conditions of this policy as they now exist or may be amended in the future. Further, I acknowledge that my continued employment is contingent upon my compliance with this policy.

2. I acknowledge that I am also subject to the substance abuse/drug testing policy of any Gillmann customer to whom I am assigned.

3. I agree to take a drug screen upon request of Gillmann or the Gillmann customer where I am assigned. 4. I agree that Gillmann may share the results of my drug test with the customer where I am assigned and the customer may share the results of any drug test they perform with Gillmann. 5. I acknowledge that this policy is not an employment contract and does not alter my at-will employment status with Gillmann. I understand that my employment with Gillmann is on an at-will basis. This means that my employment with Gillmann is not guaranteed to last for any definite period of time. Either I or Gillmann can terminate my employment with Gillmann at any time, for any or no reason or cause. I further acknowledge that a negative result on a drug or alcohol screen does not in any way alter my at-will employment status and does not guarantee my employment with Gillmann for any specific period of time. By my signature below I acknowledge reading the sections above and understand I can request a copy of this consent form from my Gillmann supervisor.

gfedcb Electronic signature accepted Ventia D Cloud 08/19/2021 Signature Print Name Date

GS-014 11/16