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A Driver Operator

Location:
Lake Elsinore, CA, 92530
Posted:
March 15, 2023

Contact this candidate

Resume:

CPC Logistics

***** *. ***** **

Rd Suite ***

Chesterfield, MO 63017

877-***-****

**-**-**** *:03:50PM CDT

IntelliApp

Thank you for your interest in CPC Logistics. 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 Michael James Skaggs

Current Address 1904 Sage Ave

City, State/Province Zip/Postal Corona, CA 92882

Country United States

Residence 3 years or longer (If No,

previous addresses shown below)

Yes

SSN/SIN 6536

Date of Birth

Primary Phone 951-***-****

Cell Phone 951-***-****

Email advxxb@r.postjobfree.com

Yes, I agree to receive information

concerning future opportunities or

promotions from CPC Logistics by email or

other commercial electronic

communications.

Yes

Would you like to receive communication

from CPC Logistics 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 CPC

Logistics's service provider receives in real

time and logs your text messages with

CPC Logistics.

Yes

1

Company Questions

GENERAL INFORMATION

Are you legally eligible for employment in

the United States?

Yes

Are you currently employed? No

What date did your last employment end? 02-03-2023 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:

How did you hear about us? Job Board - Indeed

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 10+ years

Tractor and Semi-Trailer 10+ years

Doubles 2-3 years

Tanker None

Other Tow truck experience

Heavy haul trucks

Low boy trailers

Flatbed trailers

Curtain van trailers

Reefers

Worklist

Recruiter

2

Licenses

License Number 978

Licensing Authority CA

Country US

License Class Class A

License Expiration Date 02-15-2026

Physical Expiration Date 06-01-2023

Current License Yes

Commercial Driver License Yes

Endorsements None

Employment / Unemployment

Unemployment

Start Date 02-2023

End Date 03-2023

Comment I'm ready to go back to work.

Tci Trucking

Company Tci Trucking

Start Date 06-2021

End Date 02-2023

Address 4950 triggs st.

City, State/Province Zip/Postal Commerce, CA 90022 Country United States

Phone 323-***-****

Fax 504-***-****

Position Held Class A driver

Reason for leaving? LAID OFF

Were you terminated/discharged/laid off? Yes

Termination Explanation We lost the account I was working( Amazon Fresh)and their was no other

accounts hiring

Is this your current employer? No

May we contact this employer at this time? Yes

Yes

3

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?

Yes

Did you perform any safety sensitive

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Yes

Areas Driven All of So Cal, Phoenix,Las Vegas

Miles driven weekly 1500-2000

Most common truck driven Day Cab Conventional

Most common trailer Reefer Trailer

Trailer length 53 feet or more

Legacy Supply Chain Services

Company Legacy Supply Chain Services

Start Date 01-2018

End Date 06-2021

Address 1000 s Cucamonga ave.

City, State/Province Zip/Postal Ontario, CA 91761

Country United States

Phone 909-***-****

Fax 909-***-****

Position Held Class A Driver

Reason for leaving? Not enough hours

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 Southern Ca

4

Miles driven weekly 1500-2000

Most common truck driven Day Cab

Most common trailer Van

Trailer length 53 feet or more

Tamo Trucking

Company Tamo Trucking

Start Date 06-2013

End Date 01-2018

Address 8545 peacan ave.

City, State/Province Zip/Postal Rancho Cucamonga, CA 91739 Country United States

Phone 909-***-****

Position Held Class A Driver

Reason for leaving? Company went out of business

Were you terminated/discharged/laid off? Yes

Termination Explanation Company lost contract and went out of business

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 Southern Ca

Miles driven weekly 1000-1500

Most common truck driven Day Cab

Most common trailer Reefer Trailer

Trailer length 45 to 52 feet

Staffmark Transportation

Company Staffmark Transportation

Start Date 03-2010

5

End Date 06-2013

Address 1801 excise ave.

City, State/Province Zip/Postal Aurora, CO 91761

Country United States

Phone 909-***-****

Position Held Class a driver

Reason for leaving? Was hired on to permanent position 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?

Yes

Did you perform any safety sensitive

functions in this job, regulated by DOT,

and subject to drug and alcohol testing?

Yes

Areas Driven Southern Ca

Miles driven weekly 1000-1500

Most common truck driven Day Cab Conventional

Most common trailer Van

Trailer length 53 feet or more

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

No

6

obtain, safety-sensitive transportation work

covered by DOT agency drug and alcohol

testing rules? [49 CFR 40.25(j)]

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

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

·

No

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

7

Signature

Full Name Michael James Skaggs

IP Address 2603:8000:2c01:7

Signature Date/Time 03-13-2023 7:03 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.

Signed Date: 03-13-2023 7:03 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

8

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

Yes

9

consent. An electronic signature is as

legally binding as an ink signature.

1681m

By checking this box, I represent that I

understand and agree to the above

document.

Yes

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 advxxb@r.postjobfree.com.

Yes

10

DISCLOSURE FOR CONSUMER REPORTS

In connection with your employment or owner-operator (independent contractor) application, CPC Logistics 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:

Michael James Skaggs

Social Security #:

6536

Signed Date: 03-13-2023

Michael James Skaggs

1904 Sage Ave

Corona, CA 92882

951-***-****

Gender:

11

AUTHORIZATION FOR CONSUMER REPORTS

I authorize CPC Logistics 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:

Michael James Skaggs

Social Security #:

6536

Signed Date: 03-13-2023

Michael James Skaggs

1904 Sage Ave

Corona, CA 92882

951-***-****

Gender:

12

IMPORTANT DISCLOSURE

REGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with CPC Logistics ("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 CPC Logistics ("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:

Michael James Skaggs

Signed Date: 03-13-2023

13

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

I hereby provide consent to CPC Logistics 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 CPC Logistics 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 CPC Logistics to conduct a limited query of the Clearinghouse, CPC Logistics 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 CPC Logistics indicates that drug or alcohol information exists about me in the Clearinghouse, the FMCSA will not disclose that information to CPC Logistics unless I give additional specific consent within the Clearinghouse. However, I understand that CPC Logistics 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. 03-13-2023

Michael James Skaggs Date

14

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 03-13-2023

Date

X 6536

Social Security Number

Michael James Skaggs

1904 Sage Ave

Corona, CA 92882

951-***-****

Gender:

X Michael James Skaggs

Print Name (First, MI, Last)

X

Signature

I, the above mentioned signer, hereby authorize Tci Trucking To release and forward in accordance with the following regulation, all known information pertaining to my alcohol and controlled substances testing/training records to CPC Logistics

DISCLOSURE AND AUTHORIZATION UNDER 49 C.F.R. PART 391.23 INCLUDING DOT DRUG AND ALCOHOL INFORMATION

For purposes of an investigation in accordance with 49 C.F.R. Part 391.23, I authorize my previous employers, contractors (if owner-operator), and trucking schools, as applicable, to release and forward to CPC Logistics ("Company") the following information for the past three (3) years:

1. DOT alcohol and controlled substance information in accordance with Parts 382 and 40 of the Federal Motor Carrier Safety Regulations (49 CFR Part 382 and 49 CFR Part 40, Section 40.25) limited to the following DOT regulated testing items, including pre-employment testing results: (i) alcohol tests with a result of 0.04 or higher; (ii) verified positive drug tests; (iii) refusals to be tested;

(iv) other violations of DOT agency drug and alcohol testing regulations; (v) information obtained from previous employers of a drug and alcohol rule violation; and (vi) documentation, if any, of completion of the return-to-duty process following a rule violation. 2. Safety performance history information in accordance with 49 CFR Part 391.23, which includes: employment dates, work history

(which may include position held, reason for leaving, any termination information, whether subject to the Federal Motor Carrier Safety Administration regulations, equipment experience, area driven, and other information as applicable) and accident information

(including accident date, nature of accident, whether it was preventable, whether there were injuries, fatalities, or hazardous materials involved, and copies of any accident report).

Pursuant to Section 391.23(i) of the Federal Motor Carrier Safety Regulations, you have the following rights with regard to the information released:

1. You have the right to make a written request at any time to review the information provided by previous employers, contractors (if owner-operator), or trucking schools, as applicable. 2. You have the right to have errors in the information corrected by the previous employer, contractor (if owner-operator), or trucking school, as applicable and for that employer, contractor (if owner-operator), or trucking school to re-send the corrected information. 3. You have the right to have a rebuttal statement attached to the alleged erroneous information if the previous employer, contractor (if owner-operator), or trucking school and you cannot agree on the accuracy of the information. 15

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 03-13-2023

Date

X 6536

Social Security Number

Michael James Skaggs

1904 Sage Ave

Corona, CA 92882

951-***-****

Gender:

X Michael James Skaggs

Print Name (First, MI, Last)

X

Signature

I, the above mentioned signer, hereby authorize Legacy Supply Chain 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 CPC Logistics

DISCLOSURE AND AUTHORIZATION UNDER 49 C.F.R. PART 391.23 INCLUDING DOT DRUG AND ALCOHOL INFORMATION

For purposes of an investigation in accordance with 49 C.F.R. Part 391.23, I authorize my previous employers, contractors (if owner-operator), and trucking schools, as applicable, to release and forward to CPC Logistics ("Company") the following information for the past three (3) years:

1. DOT alcohol and controlled substance information in accordance with Parts 382 and 40 of the Federal Motor Carrier Safety Regulations (49 CFR Part 382 and 49 CFR Part 40, Section 40.25) limited to the following DOT regulated testing items, including pre-employment testing results: (i) alcohol tests with a result of 0.04 or higher; (ii) verified positive drug tests; (iii) refusals to be tested;

(iv) other violations of DOT agency drug and alcohol testing regulations; (v) information obtained from previous employers of a drug and alcohol rule violation; and (vi) documentation, if any, of completion of the return-to-duty process following a rule violation. 2. Safety performance history information in accordance with 49 CFR Part 391.23, which includes: employment dates, work history

(which may include position held, reason for leaving, any termination information, whether subject to the Federal Motor Carrier Safety Administration regulations, equipment experience, area driven, and other information as applicable) and accident information

(including accident date, nature of accident, whether it was preventable, whether there were injuries, fatalities, or hazardous materials involved, and copies of any accident report).

Pursuant to Section 391.23(i) of the Federal Motor Carrier Safety Regulations, you have the following rights with regard to the information released:

1. You have the right to make a written request at any time to review the information provided by previous employers, contractors (if owner-operator), or trucking schools, as applicable. 2. You have the right to have errors in the information corrected by the previous employer, contractor (if owner-operator), or trucking school, as applicable and for that employer, contractor (if owner-operator), or trucking school to re-send the corrected information. 3. You have the right to have a rebuttal statement attached to the alleged erroneous information if the previous employer, contractor (if owner-operator), or trucking school and you cannot agree on the accuracy of the information. 16

1681m

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 CPC Logistics

('Company'):

Tenstreet

120 W. 3rd Street

Tulsa, OK 74103

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

Email: advxxb@r.postjobfree.com

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

HireRight, LLC

Attn: Consumers Dept.

14002 E 21st Street

Suite 1200

Tulsa, OK 74134

Phone: 866-***-****

Fax: 918-***-****

Email: advxxb@r.postjobfree.com

Web: http://www.hireright.com/applicants

For Pre-Employment Screening Program (PSP) and 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

iiX

1716 Briarcrest Drive

Suite 200

Bryan, TX 77802

Phone: 800-***-****, Option 6

Web: https://www.verisk.com/iix/support/fcra-information/ Samba Safety

P.O. Box 92890

Albuquerque, NM 87199

Fax: 877-***-****

Web: https://www.safetyholdingsinc.com/consumer-dispute-instructions/ Explore Information Services, LLC

PO Box 21636

Saint Paul, MN 55121

Phone: 855-***-**** (toll free) Email: advxxb@r.postjobfree.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



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