A Driver Contract
Resume:
Unusual Carriers Inc
Chicago, IL 60616
**-**-**** **:58:44AM CDT
IntelliApp
Thank you for your interest in Unusual Carriers Inc. 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.
Personal Information
Name Antuan L Durham
Current Address 208b Taintor Hill Rd
City, State/Province Zip/Postal Colchester, CT 06415 Country United States
Residence 3 years or longer (If No,
previous addresses shown below)
No
Addresses Over last 3 years 6 William St, Waterford, Ct, 06385 SSN/SIN 9876
Date of Birth
Primary Phone 860-***-****
Cell Phone 860-***-****
Email adu17z@r.postjobfree.com
Yes, I agree to receive information
concerning future opportunities or
promotions from Unusual Carriers Inc by
email or other commercial electronic
communications.
Yes
Would you like to receive communication
from Unusual Carriers Inc via text
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 Unusual
Carriers Inc's service provider receives in
Yes
1
real time and logs your text messages with
Unusual Carriers Inc.
Company Questions
GENERAL INFORMATION
What position are you applying for? Company Driver If you answered "Owner Operator" or
"Fleet Owner", select yes.
No
EQUIPMENT (OWNER/OPERATORS ONLY)
Equipment Description (Tractor):
Type:
Year:
Make:
Model:
Color:
VIN:
Weight
Mileage
Fifth Wheel Height
What location are you applying for? Chicago
Are you legally eligible for employment in
the United States?
Yes
Are you currently employed? No
What date did your last employment end? 08-09-2022 Do you read, write, and speak English? Yes
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:
Do you currently work for another
company?
No
2
Do you need Occupational insurance from
Unusual Carriers Inc?
Yes
How did you hear about us? Facebook
If "Driver Referral", please enter the
driver's name
If "Other", please explain
DRIVING EXPERIENCE
For each class of equipment, select years of experience. If no experience in a class, select "None".
Straight Truck 4-5 years
Tractor and Semi-Trailer 4-5 years
Tractor - Two Trailers 4-5 years
Other
EMERGENCY CONTACT
Emergency Contact Name Earnestine Moore
Emergency Contact Phone Number 860-***-****
Emergency Contact Relationship Mother
Licenses
License Number 157
State/Province CT
Country United States
License Class Class A
License Expiration Date 11-12-2018
Physical Expiration Date 07-16-2019
Current License Yes
Commercial Driver License Yes
Endorsements
Tanker Endorsement Yes
HAZMAT Endorsement Yes
Hazmat Expiration Date 11-12-2019
X Endorsement Yes
Doubles Triples Endorsement Yes
Other Endorsement No
3
Employment / Unemployment
Unemployment
Start Date 08-2022
End Date 09-2022
Comment
MB Global Logistics
Company MB Global Logistics
Start Date 04-2022
End Date 08-2022
Address 240 E Lake St # 307, Addison,
Address 2 #307
City, State/Province Zip/Postal Addison, IL 60101
Country United States
Phone 847-***-****
Position Held Contract Driver (1099)
Reason for leaving? Resigned
Were you terminated/discharged/laid off? Yes
Termination Explanation Failed Urine Screen
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?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven Lower 48
Miles driven weekly 2500-3000
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Total Transportation of Mississippi LLC
Company Total Transportation of Mississippi LLC
4
Start Date 10-2021
End Date 03-2022
Address 125 Riverview Dr
City, State/Province Zip/Postal Richland, MS 39218 Country United States
Phone 601-***-****
Fax 601-***-****
Position Held Company Driver - Dedicated
Reason for leaving? Still 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
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven Mid-west, South, SE, NE
Miles driven weekly 2500-3000
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Total Transportation Inc
Company Total Transportation Inc
Start Date 07-2019
End Date 09-2021
Address 125 Riverview Dr
City, State/Province Zip/Postal Jackson,, MS 39218 Country United States
Phone 800-***-****
Fax 601-***-****
Position Held Company Driver
5
Reason for leaving? Still 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
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven Louisiana, mid-west, & NE
Miles driven weekly 2500-3000
Most common truck driven Tractor-Trailer
Most common trailer Doubles
Trailer length 53 feet or more
Total Transportation Logistics, Inc. (M01057)
Company Total Transportation Logistics, Inc.
(M01057)
Start Date 11-2018
End Date 06-2019
Address 125 Riverview Dr
City, State/Province Zip/Postal Jackson, MS 39218 Country United States
Phone 601-***-****
Position Held Company Driver
Reason for leaving? Still 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
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
Yes
6
this employer/contractor?
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven Mid-west, South, SE, NE
Miles driven weekly 2500-3000
Most common truck driven Tractor-Trailer
Most common trailer Van
Trailer length 53 feet or more
Encore Express LTD
Company Encore Express LTD
Start Date 08-2017
End Date 10-2018
Address 11818 MAHONING AVENUE
City, State/Province Zip/Postal North Jackson, OH 44451 Country United States
Phone 330-***-****
Position Held Driver DOT 1806915
Reason for leaving? Stii 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
vehicle?
Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while employed/contracted by
this employer/contractor?
Yes
Did you perform any safety sensitive
functions in this job, regulated by DOT,
and subject to drug and alcohol testing?
Yes
Areas Driven United Statez
Miles driven weekly
Most common truck driven
Most common trailer Doubles
Trailer length 53 feet or more
7
Harry's Taxi
Company Harry's Taxi
Start Date 07-2016
End Date 07-2017
Address 158 Montauk Ave
City, State/Province Zip/Postal New London, CT 06320 Country United States
Phone 860-***-****
Position Held Driver
Reason for leaving? Current Employer
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
vehicle?
No
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?
No
Areas Driven
Miles driven weekly
Most common truck driven
Most common trailer
Trailer length
Cloud Technologies
Company Cloud Technologies
Start Date 09-2014
End Date 06-2016
Address 315 Riggs St
Address 2 Bldg A Ste 6
City, State/Province Zip/Postal Oxfordq, CT 04478
Country United States
Phone 203-***-****
8
Position Held Technician
Reason for leaving? Changes in Policy/Pay Descrepancy Were you terminated/discharged/laid off? Yes
Termination Explanation Complained of Short Pay check and was let go for failure to complete task to
company standard
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
No
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?
No
Areas Driven
Miles driven weekly
Most common truck driven
Most common trailer
Trailer length
Trublue Inc
Company Trublue Inc
Start Date 09-2014
End Date 09-2014
Address 1015 A St
City, State/Province Zip/Postal Tacoma, WA 98402
Country United States
Phone 800-***-****
Position Held Temp Varies
Reason for leaving? Temo
Were you terminated/discharged/laid off? No
Is this your current employer? No
May we contact this employer at this time? Yes
No
9
Did you operate a commercial motor
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
Most common truck driven
Most common trailer
Trailer length
TMI (Total Media Installations)
Company TMI (Total Media Installations)
Start Date 03-2013
End Date 08-2014
Address
City, State/Province Zip/Postal E. Hartford, CT
Country United States
Phone
Position Held Technician
Reason for leaving? Quit
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?
No
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?
No
Areas Driven
Miles driven weekly
10
Most common truck driven
Most common trailer
Trailer length
Mastec
Company Mastec
Start Date 09-2011
End Date 02-2013
Address 800 Douglas Rd
City, State/Province Zip/Postal Coral Gables, FL
Country United States
Phone 518-***-****
Position Held Technician
Reason for leaving? Argument w/Supervisor
Were you terminated/discharged/laid off? Yes
Termination Explanation Had argument with a Supervisor because I needed equipment to complete work
assignments and he repeatedly failed to
provide it due to shortages. That same
Supv. was discharged for physically
fighting another employee
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
No
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?
No
Areas Driven
Miles driven weekly
Most common truck driven
Most common trailer
Trailer length
Dollar Tree
Company Dollar Tree
11
Start Date 08-2010
End Date 09-2011
Address 117 Boston Post Rd
City, State/Province Zip/Postal Waterford, CT 06385 Country United States
Phone 860-***-****
Position Held Cashier
Reason for leaving? New Job
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?
No
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
Most common truck driven
Most common trailer
Trailer length
FTD
Company FTD
Start Date 06-2009
End Date 09-2011
Address 40 Main St
City, State/Province Zip/Postal Centerbrook, CT 06409 Country United States
Phone 860-***-****
Position Held Customer Service Rep.
Reason for leaving? New Career Opportunity
Were you terminated/discharged/laid off? No
12
Is this your current employer? No
May we contact this employer at this time? Yes
Did you operate a commercial motor
vehicle?
No
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?
No
Areas Driven
Miles driven weekly
Most common truck driven
Most common trailer
Trailer length
Trucking School
Start Date 05-2017
End Date 07-2017
School A B Tractor Training Center
Address
Address 2
City, State/Province Waterford, CT
Country United States
Phone 860-***-****
Did you graduate? Yes
Were you subject to the Federal Motor
Carrier or Transport Canada Safety
Regulations while attending this truck
school?
Yes
Did you perform any safety sensitive
functions at this truck school, regulated by
DOT, and subject to drug and alcohol
testing?
Yes
GPA
Hours of Instruction 200
Border Crossing No
13
Log Books No
Federal Motor Carrier Regulations Yes
Hazardous Materials No
FMCSR
Under FMCSR 391.15, are you currently
disqualified from driving a commercial
motor vehicle? [49 CFR 391.15]
Yes
Please provide additional detail:
Referred to SAP
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
•
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
•
No
14
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 5 years (even if not at fault)?
Type of Accident / Incident Non-Injury
Date of Accident / Incident 08-2019
Hazmat Accident / Incident No
Was the vehicle towed away? No
City
State/Province CT
Were you in a commercial vehicle? Yes
If yes, was this a Department of
Transportation recordable accident?
No
Were you at fault? Yes
Were you ticketed? No
Description Turn to sharply in private parking lot and broke cab extender
Traffic Convictions \ Violations
Have you had any moving violations or traffic convictions in the past 3 years? Violation Date 08-2019
Charge / Description Failure to Obey Signal
Violation State/Province MD
In Commercial Vehicle Yes
Fined? Yes
License Suspended?
License Revoked?
15
Perform Community Service?
Other Penalty?
Fine Amount (if any): 100 - $199
Comments:
Signature
Full Name Antuan L Durham
IP Address 2601:194:400:102
Signature Date/Time 09-06-2022 11:58 AM
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.
Signed Date: 09-06-2022 11:58 AM
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
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
16
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
1681m
By checking this box, I represent that I
understand and agree to the above
document.
Yes
17
INVESTIGATIVE CONSUMER REPORT DISCLOSURE
By checking this box, I represent that I
understand and agree to the above
document.
Yes
User Requested Copy
User requested a copy to be sent to this
email address adu17z@r.postjobfree.com.
Yes
18
DISCLOSURE FOR CONSUMER REPORTS
In connection with your employment or owner-operator (independent contractor) application, Unusual Carriers Inc may order one or more consumer report(s) (commonly known as "background reports" or "background checks") about you from one or more consumer reporting agencies. If you are hired or engaged as an owner-operator (independent contractor), additional consumer reports may be obtained in connection with and throughout your employment for employment purposes or for the legitimate business purpose of evaluating you as an owner-operator.
To the extent allowed by law, the consumer reports may include information concerning your character, general reputation, personal characteristics, mode of living, drug and alcohol test results, motor vehicle records, driving records, criminal history, public court records, employment history (including names and dates of previous employers, reason for termination of employment, work experience, and accidents), social security number validation, education, licensure, or verification of other information supplied by you. Such reports may be obtained from private and public record sources, including sanctions databases, CDLIS (including but not limited to CDLIS Central Site, CDLIS Master Pointer Record data and your driver record from the jurisdiction identified in the CDLIS data, in accordance with applicable state law and the Driver Privacy Protection Act), former employers, public court records, and federal, state, and other government agencies that maintain such records. Printed Name:
Antuan L Durham
Social Security #:
9876
Signed Date: 09-06-2022
Antuan L Durham
208b Taintor Hill Rd
Colchester, CT 06415
Gender:
19
AUTHORIZATION FOR CONSUMER REPORTS
I authorize Unusual Carriers Inc to obtain one or more consumer report(s) or investigative consumer report(s) about me. If hired or engaged as an owner-operator (independent contractor), I understand this authorization shall remain on file and shall serve as ongoing authorization for additional consumer reports or investigative consumer reports to be obtained from any consumer reporting agency at any time during my employment or contract period without asking me for authorization again. Printed Name:
Antuan L Durham
Social Security #:
9876
Signed Date: 09-06-2022
Antuan L Durham
208b Taintor Hill Rd
Colchester, CT 06415
Gender:
20
IMPORTANT DISCLOSURE
REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Unusual Carriers Inc ("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 Unusual Carriers Inc ("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, 21
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:
Antuan L Durham
Signed Date: 09-06-2022
22
Consent for Limited Queries of the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol Clearinghouse
I hereby provide consent to Unusual Carriers Inc 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 Unusual Carriers Inc 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 Unusual Carriers Inc to conduct a limited query of the Clearinghouse, Unusual Carriers Inc 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 Unusual Carriers Inc indicates that drug or alcohol information exists about me in the Clearinghouse, the FMCSA will not disclose that information to Unusual Carriers Inc unless I give additional specific consent within the Clearinghouse. However, I understand that Unusual Carriers Inc will be required to conduct a full query of the
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