Application Information

Name Barnhart MR, Keith Allen Primary Phone 636-***-**** [Cell]

Secondary Phone (n/a) Date of Application 07-25-2021 Application ID 222501 Email Address adoxe4@r.postjobfree.com Address 177 PRISM DRIVE, HIGHLANDVILLE.

MO

City, State, Zip Code,

Country

HIGHLANDVILLE, MO, 65669, USA

County (n/a) Referral Source Internet Career Website Referral Name Indeed Driver's License

Number

(n/a)

Driver's License State License Expiration Date (n/a) Education

Institution ITT Technical Institute-StLouis

mo,Graduate School,Sunset hills,

MO,USA,(n/a)

Dates Attended (n/a)

Attended As (n/a) Major/Minor (n/a)

Degree technical degree GPA (n/a)

Graduated Yes

Institution Valley park,High School,Valley park,

MO,USA,(n/a)

Dates Attended (n/a)

Attended As (n/a) Major/Minor (n/a)

Degree (n/a) GPA (n/a)

Graduated Yes

Institution ITT Technical Institute-StLouis

mo,Graduate School,St. Louis,

MO,USA,(n/a)

Dates Attended (n/a)

Attended As (n/a) Major/Minor (n/a)

Degree Associates GPA (n/a)

Graduated Yes

Employment

Employer MIDWEST EQUIPMENT,(n/a),Fenton,

MO, 63026, USA,636-***-****

Dates of Employment 03/25/2011 To Present

10 Years 4 Months

Job Title Service Technician/Driver Job Duties (n/a) FARMER BROS CO

Client: Application for Route Delivery Professional - 222501 Generated (7/25/2021 7:23 PM) Page 1 of 4

Can Contact? Yes

(Danny Williams )

Reason for Leaving Better opportunitys

Current Employer Yes

Employer Chrysler Corporation

(FCA),(n/a),Fenton, MO, 63026,

USA,636-***-****

Dates of Employment 09/25/1995 To 10/01/2010

15 Years 6 Days

Job Title Auto worker Job Duties (n/a)

Can Contact? No

(Marty hill)

Reason for Leaving Closed plant

Current Employer No

Employer Weinhardt Party Rentals,(n/a),Des

Peres, MO, 63022, USA,(636) 822 -

9000

Dates of Employment 06/05/1978 To 09/05/1995

17 Years 3 Months

Job Title Warehouse Supervisor Job Duties (n/a)

Can Contact? Yes

(Ed weinhardt )

Reason for Leaving Better opportunity

Current Employer No

References

Questions

Question Group 1

Are you 18 years of age or older? Yes

Are you legally authorized to work in the U.S? Yes Do you now, or will you in the future, require immigration sponsorship for work authorization (e.g., H-1B)? (If hired, verification will be required consistent with federal law).

No

Can you provide the necessary documentation to prove that you are a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States?

Yes

If extended a job offer, are you willing to submit to a detailed background check and drug screen?

Yes

Do you have a high school degree/GED or higher? Yes Question Group 2

Client: Application for Route Delivery Professional - 222501 Generated (7/25/2021 7:23 PM) Page 2 of 4

How did you hear about us? Service technician

Have you worked for this Company before? No

Do you have any relatives employed by this organization? No When are you available to start? 2 weeks

What is your desired salary/pay range? Please provide a specific numeric amount. 55000 - 60000 Do you have an active non-compete or employer agreement? No What percent are you willing to travel? 30 - 75%

Are you in the beginning, middle or end of your career search? Middle - applying for new opportunities Statement

PLEASE READ EACH PARAGRAPH CAREFULLY BEFORE SIGNING I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment. I understand, where permissible under applicable state and local law, I may be subject to a pre-employment drug test after receiving a conditional offer of employment, and must receive a negative result for illegal drug use before being permitted to commence work with Company. I understand, where permissible under applicable state and local law, I may be subject to a pre-employment medical examination after receiving a conditional offer of employment, and must meet the qualifications for the position, with or without reasonable accommodation, before being permitted to commence work with Company. I understand, where permissible under applicable state and local law, I may be subject to a pre-employment background check after receiving a conditional offer of employment to investigate my criminal background and other matters related to my suitability for employment. I hereby certify that the information given by me is true in all respects. I authorize Company and its representatives to contact my prior employers and all others (with the exception of my current employer, only if I have marked "May we contact your present employer" on this applicable as "No") for the purpose of verification of the information I have supplied and release same from any liability resulting from the information released. I authorize, employers, schools and other persons named on this application to provide any information or transcripts requested.

I understand employment with Company is also contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States.

If employed, I understand that as a condition of employment that I may be required to agree to and sign a non-solicitation, non-disclosure, and/or other similar agreements. I also agree to notify the organization during the pre-employment process of any non-solicitation, non- disclosure, and/or other similar agreements that I may have already signed with current and former employers. I expressly understand and agree that, if employed, my employment, having no specified term, is based upon mutual consent and may be terminated at will, with or without cause, by either party (Company or me) without prior notice to the other, unless otherwise prohibited by law.

I understand that no representation, whether oral or written, by any representative or agent of Company, at any time, can constitute an implied or express contract of employment. I further understand no representative or agent of Company has the authority to enter into an agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other terms or condition of employment other than in a document signed by an authorized representative. I understand that the technical processing and transmission of the application, including my personal information, may involve (a) transmissions over various networks, including the transfer of this information to the United States and/or other countries for storage, processing and use by Company, its affiliates, and their agents; and (b) changes to conform and adapt to technical requirements of connecting networks and devices. Accordingly, I agree to permit such parties to make such transmissions and changes, and hereby provide the necessary consent for the same.

State Specific Notices

Massachusetts Applicants: IT IS UNLAWFUL IN MASSACHUSETTS TO REQUIRE OR ADMINISTER A LIE DETECTOR TEST AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. AN EMPLOYER WHO VIOLATES THIS LAW SHALL BE

Client: Application for Route Delivery Professional - 222501 Generated (7/25/2021 7:23 PM) Page 3 of 4

TO CRIMINAL PENALTIES AND CIVIL LIABILITIES.

Maryland Applicants: UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A POLYGRAPH EXAMINATION OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.

I certify that all of the above information is true and complete, and I understand that any falsification or omission of information may disqualify me from further consideration for employment or, if hired, may result in termination regardless of the time elapsed before discovery.

Note: An offer of employment is conditioned upon complying with Company's requirements including, but not limited to, signing a consent to conduct a background investigation.

Acknowledged

Yes

Signature

Keith Barnhart [10/5/2021]

Client: Application for Route Delivery Professional - 222501 Generated (10/5/2021) Page 4 of 4

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