Start Date Fiber Optic

Travis Allen’s Employment Application

Application Date: 9/16/2023

Job Title: Rig Hands

Job Location: Longview

Personal Information

First Name: Travis

Last Name: Allen

Email: adzsc6@r.postjobfree.com

Contact Information

Mobile: 501-***-****

Address: 7738 Samples Rd

City: Benton

State: AR

Zip Code: 72019

Current Compensation: $22.50 hourly

Desired Compensation: $22.50 hourly

Position Applying For: Floor Hand

If "other" above, please list the position you are applying for: n/a When are you available to start? n/a

Were you referred to Fortis Energy Services? No

If you were referred to Fortis Energy Services, by whom? n/a Describe any special training, skills, qualifications or other experience that relate to the position(s) applied for: n/a Is there any reason you are unable to perform all of the tasks of the job you are applying to?*: No Are you at least 18 years of age? Yes

Are you legally authorized to work in the United States without employer sponsorship? Yes Preferred geographic location(s): South (East TX, AR, LA, OK) Have you been convicted of a crime which conviction has not been ordered expunged, sealed or impounded by a court of competent jurisdiction? If so, list when and the nature of the offense and whether or not there are any probationary or other restrictions placed upon you. Yes If yes, please explain including dates: Drug paraphernalia Note: Criminal convictions will not absolutely prohibit employment but will be considered in relation to the specific job requirements, work environment and other factors the Company deems appropriate. Job Title: Fine Draw

Employer Name: Tokusen

Currently Employed? n/a

Start Date: 2021-09-16

End Date: 2023-05-16

Please describe your job duties: Draw wire, replace, dies, and perform maintenance Job Title: Operator

Employer Name: Vision utility

Currently Employed? n/a

Start Date: 2016-09-16

End Date: 2021-09-16

Please describe your job duties: Ron fiber optic cable By submitting this application, I understand that, prior to being offered employment, I may be requested to take an employment examination. In the event I have a disability that will affect my ability to take the test, I will inform the Firm prior to the administration of the test so that a reasonable accommodation can be made. The Firm reserves the right to require documentation regarding the need for accommodation. I represent to Fortis Energy Services, Inc., known as the "Company", that all of the information now or hereafter given by me in support of my application is true and complete to my knowledge and understand that if employed, falsified or omitted information on this Application may result in termination of the hiring process or employment relationship. I hereby authorize investigation of all statements contained in this application for any employment-related purpose. I release the listed references and all employers, except those specifically excepted, * to provide you with any and all applicable information they may have. I hereby release these references and former employers from all liability for any information they may give you, and I waive any requirement that the reference and former employer provide me with written or verbal notice of their response to your inquiry. I hereby consent for Fortis, through an authorized testing source of its choice, to collect blood, urine, or saliva samples from me and to conduct any other necessary medical tests to determine the presence of alcohol, drugs or controlled substances, and I hereby release Fortis from any liability arising out of such tests or results. Further, I give my consent for the release of the test results and other relevant medical information to authorized Fortis management for appropriate review. I agree that if hired, my employment status is at will, and that either party may terminate the employment relationship, with or without cause at any time, and I further agree that this arrangement may only be altered in writing directed to me personally and signed by the President of Fortis Energy Services, Inc. I agree that any action or suit against Fortis Energy Services, Inc. as a result of my employment or termination of employment, must be brought within 182 days of the event giving rise to the claims, complaint, action or suit, or no later than the applicable limitations period established by statute, whichever is less. I certify that my answers to all questions are true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application or during the pre-employment process may be grounds for my immediate termination. Acceptance: I have read and agree to this statement current_date

Privacy Policy Acknowledgement

By checking this box, you acknowledge and consent to terms of the privacy policy which applies to the applicant tracking service being offered by Paycor on behalf of Fortis Energy Services. The privacy policy offers an explanation of how and why your data will be collected, how it will be used and disclosed, how it will be retained and secured, and what legal rights are associated with that data (including the rights of access, correction, and deletion). The policy also describes legal and contractual limitations on these rights. The specific rights and obligations of individuals living and working in different areas may vary by jurisdiction.

Acceptance: I have read and agree to this statement

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