Driver's License Motor Carrier

Location:

Bridgman, MI, 49106

Salary:

$26-$28

Posted:

April 08, 2025

Contact this candidate

Resume:

Advanced Driver & Logistics Solutions Application

Date of Application: Applicant Signature:

Last Name: First Name: Middle:

Address:

City: State: ZIP:

Home Phone #: Cell Phone #:

Emergency Contact: Name Phone #:

SSN: Date of Birth:

CDL Driver's License #: State: Expiration Date: (The Federal Motor Carrier Safety Regulations 49 CFR 397 Subpart E requires that all driver applicants pass certain medical examinations before they are hired to drive a motor vehicle) Yes No

Medical Exam: Date of Issue: Expiration Date: Do you Have Medical Card? If at above residence less than three years, please list below all addresses at which you have resided for the past three years: Address: City : State: Zip: Years:

Address: City : State: Zip: Years:

Endorsements and Certifications: (check all that apply) Hazmat: Tanker : Tanker / Hazmat Combo: Doubles / Triples: TWIC: Equipment Experience: (check all that apply)

Dry Van Doubles: Tanker: Reefer: Triples: Motor Coach: Flatbed: Intermodal: Car Carrier: Roll-off: : Dump:

Commercial Driving Experience:

(#of Month’s exp.) Tractor Trailer: Straight Truck: Have you ever been convicted of/or have a pending DWl/DUI? Yes: No: If yes, when? Are you authorized to work in the United States? Yes: No: Truck Driving Position Applying for: Part Time: Full Time: How did you hear about us? Have you worked for ADVANCED DRIVER LOGISTICS & SOLUTIONS before? Yes: No: If Yes, please provide the dates of previous employment: From: To: Reason for leaving? Are you currently employed? Yes: No: If NO, how long since leaving last employment?

Email Address:

100 N Blackhorse Pike Suite 300-301

Williamstown NJ 08094

04/11/25 Tyeast Tyeast Alexander (Mar Alexander 11, 2025 15:32 EDT) Alexander Tyeast Lashawn

858 Pipestone st.

Benton Harbor MI 49022

269-***-**** 269-***-****

269-***-**** Mother

***-**-**** 12/17/72

A 425-***-***-*** MI 12/17/27

10/14/24 10/14/26 4

4 4

4 4 4 4

12 12

Indeed

10/2024

***************@******.***

Have you been subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed? Yes: No: Have you been you subject to the US DOT alcohol and controlled substances testing requirements? Yes: No: Explain reason for any gaps greater than 30 days:

Employer: From: To: Address:

City: State: ZIP: Phone: Supervisor: Salary:

Equipment Operated: Position Held: Reason for Leaving: Education:

High School Attended: City: State: Graduated? Yes: No: College/Trade School Attended: City: State: Graduated? Yes: No: Driving School Attended: City: State: Completion Date: Employment Record:

Please start with the most recent employer. In accordance with FMCSR 391.21 & .23, an applicant must list all previous work experience for the three (3) years prior to the date of the application shown on page one, as well as all commercial driving experience for the seven (7) year period prior to those three years, for a total of 10 years. Include your job description, date of employment, reason for leaving and whether you were subject to FMCSA & U.S. DOT alcohol and controlled substance testing requirements for each job listed. Please start with the most recent employer. Include self-employment or time leased to another carrier. Use an additional sheet if needed. Any gaps in employment

(including unemployment or retirement) must be explained. Employer: From: To: Address:

City: State: ZIP: Phone: Supervisor: Salary:

Equipment Operated: Position Held: Reason for Leaving: Have you been subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed? Yes: No: Have you been you subject to the US DOT alcohol and controlled substances testing requirements? Yes: No: Explain reason for any gaps greater than 30 days:

Employer: From: To: Address:

City: State: ZIP: Phone: Supervisor: Salary:

Equipment Operated: Position Held: Reason for Leaving: Munising High

Ross

Munising

Benton Harbor

03/11/23

Kalin 03/14/24 10/21/24 2663 York Ave

Sodus MI 49126 269-***-**** Andy $23

Tractor Trailer/ Dump trucks Driver seasonal

Self 01/01/18 03/11/25 858 Pipestone st. Suite 6

Benton Harbor MI 49022 269-***-**** Ty Varies

Clippers Barber started driving

Employment Record cont.

Employer: From: To: Address:

City: State: ZIP: Phone: Supervisor: Salary:

Equipment Operated: Position Held: Reason for Leaving: Employer: From: To: Address:

City: State: ZIP: Phone: Supervisor: Salary:

Equipment Operated: Position Held: Reason for Leaving: Employer: From: To: Address:

City: State: ZIP: Phone: Supervisor: Salary:

Equipment Operated: Position Held: Reason for Leaving: Employer: From: To: Address:

City: State: ZIP: Phone: Supervisor: Salary:

Equipment Operated: Position Held: Reason for Leaving: Commercial Driver's License Information:

Driver License List each driver's license held in the past 3 years. List the issuing state, number and expiration date of each unexpired commercial motor vehicle operator's license or permit that has been issued to you. State License # Class Endorsements Expiration Date Have you had any motor vehicle accidents in the last 3 years? Yes No (attach additional sheets if needed) if yes, please provide details:

Date State Description of Accident

Have you had any tickets in the last 3 years? Yes No. (Other Than Parking Violations) If yes, please provide details: Date State Convictions: Forfeited,

Bond, or Collateral

Penalty

Michigan A 425-***-***-*** CA NT 12/17/27

10/2024 MI car hit me from behind/ I was not at Fault n

Background:

IMPORTANT- APPLICANTS MUST READ & ANSWER THE FOLLOWING QUESTIONS: 1. Have you ever been denied a license, permit or privilege to operate a motor vehicle? Yes: No: 2. Has any license, permit or privilege ever been suspended or revoked? Yes: No: 3. Have you ever been disqualified for violations of the Federal Motor Carrier Safety Regulations? Yes: No: If "Yes" to any of the above, please give details: 4. Have you ever been convicted of a felony? Yes: No: If "Yes", Please explain:

(A conviction record will not necessarily be a bar to employment. Felony and misdemeanor convictions wíll be considered only to the extent to which they relate to your suitability for the position for which you have applied.) 5. Have you ever been known by another name? Yes: No: If "Yes", under what name?:

6. Have you ever been convicted of/or have a pending DW1/DUl? Yes: No: If "Yes", when?

7. Drug conviction: Yes: No: If "Yes", when?

8. Have you ever tested positive or refused a drug and or alcohol test? Yes: No: If “Yes”, when? Company Name:

9. Have you ever been cited for 15 mph + over the speed limit in a commercial vehicle? Yes: No: If yes, date(s) of speeding conviction(s):

Applicant Signature Date Tyeast Tyeast Alexander Alexander (Mar 11, 2025 15:32 EDT) 03/11/25 in 1990 I was convicted for poss;Drugs

02/01/90

Previous Pre-Employment Employee Alcohol & Drug Test Verification: Advanced Driver Logistics & Solutions Inc.

100 N. Black Horse Pike, Suite 304

Williamstown, NJ 08094

856-***-**** - Phone 856-***-**** Fax

As the employer, you must also ask the employee whether he or she has tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which the employee applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years. lf the employee admits that he or she had a positive test or a refusal to test, you must not use the employee to perform safety-sensitive functions for you, until and unless the employee documents successful completion of the return-to-duty process (see paragraphs (b)(5) and (e) of this section). The Federal Motor Carrier Safety Regulations (49 CFR 40.25) requires all persons applying for a driving position requiring a commercials driver's license to answer the following questions: 1. Within the last two (2) years, have you ever tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety-sensitive transportation work? Yes: No:

2. Within the last two (2) years, have you ever tested positive, or refused to test, on any type of drug or alcohol test administered by an employer for which you performed safety-sensitive transportation work? Yes: No: If “Yes” When:

Date:

Prospective Employee Name:

Prospective Employee Signature:

Witness Name(print) Witness Signature Tyeast Tyeast Alexander Alexander (Mar 11, 2025 15:32 EDT) 03/11/25

Tyeast Alexander

Pre-qualification Drug Testing OE Consent Form

I,, Understand as required by federal regulation (subpart H of 49 CFR,part 391) and Advanced Driver Logistics & Solutions Inc., Driver Substance Abuse Policy for a Drug and Alcohol-Free workplace, I am being required to a pre-employment drug test screening. I understand driver applicants confirmed as testing positive for drug use prohibits me from obtaining employment with Advanced Driver Logistics & Solutions Inc. I understand Advanced Driver Logistics & Solutions Inc., will maintain the result of drug test(s), (MRO) Medical Review Officer and reported to Advanced Driver Logistics & Solutions Inc., as a negative or positive result.

I further understand that I may request the test results from the Medical Review Officer within 60 days of my notification of the test result and that the test results will be made known to any Advanced Driver Logistics

& Solutions Inc. Customers who request these results. I agree that a reproduced copy of this consent and release form shall have the same force and effect as the original.

I have carefully read the foregoing and fully understand its contents. I acknowledge that my signing of this consent and release form is a voluntary act on my part and that I have not been coerced into signing this document by anyone.

Under the guidelines established above, I hereby agree to submit to a drug test urinalysis. Applicant Name:

Applicant Signature:

Date:

Tyeast Tyeast Alexander (Alexander Mar 11, 2025 15:32 EDT) Tyeast Alexander

Tyeast Alexander

03/11/25

Background Inquiry Release Form:

I,, authorize Advanced Driver Logistics & Solutions Inc. and its agencies to make such investigation of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons for all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment decision, I understand that false or misleading information given in my application or interview(s) may result in discharge, I understand that information I provide regarding current and/or previous employers may be used, and those employers will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (c). I understand that I have the right to:

● Review information provided by previous employers.

● Have errors in the information corrected by the previous employers and for those employers to re-send the corrected information to the prospective employer.

● Have a rebuttal statement attached to the alleged erroneous information, if the previous employer and I cannot agree on the accuracy of the information. I authorize, without reservation, any part or agency contacted to furnish the above mentioned information. I hereby release employers, health care providers, schools, and other persons from any and all liability in responding to inquiries and releasing information in connection with my application. 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.

Last Name: First Name: Middle:

Address: City: State: ZIP:

SSN: Date of Birth: Driver Licenses #: State Issued: Applicant Signature: Date:

Tyeast Tyeast Alexander Alexander (Mar 11, 2025 15:32 EDT) Tyeast Alexander

Alexander Tyeast Lashawn

858 Pipestone st. Suite 6 Benton Harber Michigan MiMi 490**-********* 12/17/72 A 425-***-***-*** Mi

03/11/25

Certification of Compliance with Driver License Requirements: MOTOR CARRIER INSTRUCTIONS: The requirements in Part 383 apply to every driver who operates in intrastate, interstate, or foreign commerce and operates a vehicle weighing 26,001pounds or more, can transport more than 15 people, or transports hazardous materials that require placarding. The requirements in Part 391 apply to every driver who operates in interstate commerce and operates a vehicle weighing 10,001pounds or more, can transport more than 15 people, or transports hazardous materials that require placarding.

DRIVER REQUIREMENTS: Parts 383 and 391 of the Federal Motor Carrier Safety Regulations contain some requirements that you as a driver must comply with. These requirements are in effect as of July 1, 1987. They are as follows:

1) POSSESS ONLY ONE LICENSE:

You, as a commercial vehicle driver, may not possess more than one motor vehicle operator's license. If you have more than one license, keep the license from your state of residence and return the additional licenses to the states that issued them. DESTROYING a license does not close the record in the state that issued it; you must not if the state. If a multiple license has been lost, stolen, or destroyed, close your record by notifying the state of issuance that you no longer want to be licensed by that state. 2) NOTIFICATION OF LICENSE SUSPENSION, REVOCATION OR CANCELLATION: Sections 391.15(b)(2) and 383.33 of the Federal Motor Carrier Safety Regulations require that you notify your employer the NEXT BUSINESS DAY of any revocation or suspension of your driver's license. In addition, Section 383.31 requires that anytime you violate a state or local traffic law (other than parking), you must report it within 30 days to: 1) your employing motor carrier, and 2) the state that issued your license (if the violation occurs in a state other than the one which issued your license). The notification to both the employer and state must be in writing.

The following license is the only one I will possess: Driver License #: State: Issued Expiration Date

DRIVER CERTIFICATION: I certify that I have read and understood the above requirements. Last Name: First Name: Middle:

Applicant Signature: Date:

Tyeast Tyeast Alexander (Alexander Mar 11, 2025 15:32 EDT) A 425-***-***-*** MiMi 12/17/27

Alexander Tyeast Lashawn

03/11/25

Certification of Violations/Annual Review of Driving Record: MOTOR CARRIER INSTRUCTIONS: Each motor carrier shall at least once every 12 months, require each driver it employs to prepare and furnish it with a list of all violations of motor vehicle traffic laws and ordinances (other than violations involving only parking) of which the driver has been convicted, or on account of which he/she has forfeited bond or collateral during the preceding 12 months

(Section 391.27). Drivers who have provided information required by Section 888.31 need not repeat that information on this form. DRIVER REQUIREMENTS: Each driver shall furnish the list as required by the motor carrier above. If the driver has not been convicted of, or forfeited bond or collateral on account of any violation which must be listed, he/she shall so certify (Section 391.27). COMPLETED BY DRIVER - CERTIFICATION OF VIOLATIONS COMPLETED BY DRIVER - CERTIFICATION OF VIOLATIONS Name of Driver:

Social Security Number:

Date of Employment:

Home Terminal (City & State)

Driver's License Number: State: Expiration Date:

I certify that the following is a true and complete list of traffic violations required to be listed (other than those I have provided under Part 383) for which I have been convicted or forfeited bond or collateral during the past 12 months.

(If you have had no violations, check the following box) - None. Date Offense Location Type of Vehicle Operated

If no violations are listed above, I certify that I have not been convicted or forfeited bond or collateral on account of any violation

(other than those I have provided under Part 383) required to be listed during the past 12 months. Date of Certification: Driver's Signature:

COMPLETED BY MOTOR CARRIER -ANNUAL REVIEW OF DRIVING RECORD MOTOR CARRIER INSTRUCTIONS: Review the Certification of Violations listed above and other information described in Section 391.25 of the Federal Motor Carrier Safety Regulations. Complete the information requested below. I have hereby reviewed the driving record ofthe above named driver in accordance with Section 391.25 and find that he/she (check one):

Meets minimum requirements for safe driving Is disqualified to drive a motor vehicle pursuant to Section 391.15 Does not adequately meet satisfactory safe driving performance. Action taken with driver: Reviewed by(print): Date: Signature: Date: Title Advanced Driver Logistics & Solutions Inc. 100 N. Black Horse Pike Suite 304, Williamstown, NJ 08110 Tyeast Tyeast Alexander (Mar Alexander 11, 2025 15:32 EDT) Tyeast Alexander

369787137

3/14/24

Benton Harber, Michigan 49022

A 425-***-***-*** Mi 12/17/27

03/11/25

Notification and Agreement:

PLEASE READ BEFORE SIGNING I CERTIFY THAT ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE AND COMPLETE, I UNDERSTAND THAT THE FALSIFICATION, MISREPRESENTATION OR OMISSION OF FACT ON THIS APPLICATION (OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS) WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF EMPLOYMENT, REGARDLESS OF WHEN OR HOW DISCOVERED.

Questions regarding this statement should be directed to any employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed. It is the policy of the company to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status or pregnancy, and to afford equal opportunities to disabled veterans, veterans of the Vietnam era, and individuals with a disability, any and other characteristic protected by Federal, State or Local law. I authorize the investigation of a/I statements and information contained in this application. I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making on investigation. I hereby certify that all of the facts and information listed on this employment application are true and complete. I understand that any false, incomplete or misleading information given by me on this application is sufficient cause for rejection of this application. I also understand and agree that any such false, incomplete, or misleading information discovered on this application at any time after I am employed may result in dismissal.

If I am offered employment, I understand that such an offer will be conditioned upon satisfactory results of a background investigation and/or Comp ny medical examination or inquiry, including a pre-employment drug-screening test. I consent to the investigation, physical and drug test. I hereby authorize Advanced Driver Logistics & Solutions Inc. to investigate all statements contained in this application, to interview the references and previous employers listed in the application to be used for employment purposes. I authorize the references and previous employers listed to give the Advanced Driver Logistics & Solutions Inc. all facts, opinions and evaluations concerning my previous employment and any other information they may have, personal or otherwise, and release all such information to the Advanced Driver Logistics & Solutions Inc. including, but not limited to, any liability or invasion of privacy.

If I am applying for a position as a Driver with Advanced Driver Logistics & Solutions Inc., I understand that information I provide regarding current and/or previous employers may be used, and those employer's) contracted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to: Review information provided by previous employers; Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation con be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I further understand and voluntarily agree as a condition of employment or my continued employment, that I may be requested by the Company to submit to a urinalysis or other drug screen test and that my failure to take such test(s) when requested to do so or unsatisfactory test results will disqualify me from consideration for employment, or if I am then employed, may result in immediate dismissal by Advanced Driver Logistics & Solutions Inc. I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application by me.

APPLICANT SIGNATURE: DATE:

Tyeast Tyeast Alexander Alexander (Mar 11, 2025 15:32 EDT) 03/11/25 Advanced Driver Logistics & Solutions Inc.

REQUEST INFORMATION FROM PREVIOUS EMPLOYER:

I hereby authorize Advanced Driver Logistics & Solutions Inc. to contact my previous employer(s) in accordance with current USDOT rules and regulations as set forth in 49 CFR 382.413 to obtain the following information for the preceding two years: I fully understand the above, and do hereby give my consent to obtain the information required by 49 CFR 382.413. Company:

Address: City: State: ZIP:

Phone#: Fax#:

In accordance with Section 391.23, we are obligated to request the information below from all previous employers of the applicant that employed him/her to operate a commercial motor vehicle within the 3 years preceding the date above. Please complete the information below and return to us within 30 days, as required by Section 391.23(g). Please phone/fax/mail or email the following information to:

Requested by: Advanced Driver Logistics & Solutions Inc. Address: 100 N. Black Horse Pike, Suite 304

Williamstown, NJ 08094

Phone# 856-***-**** Fax # 856-***-****

Applicant Name: Applicant Signature:

SSN: Date:

Dear Sir/ Madam:

The above individual has made application to our company for a position as a and states that he/she was employed by you from to as a TO BE COMPLETED BY PREVIOUS EMPLOYER: - Safety Performance History: Did he/she drive a commercial motor vehicle for you? Yes No If Yes, what type? Straight Truck Tractor-Semi Trailer Bus Cargo Tank Doubles/Triples Flatbed Other (specify)

Reason for leaving your company: Discharged Resignation Lay Off Military Duty Check if there is no safety performance history to report, sign below and return. Accidents: Complete the following for any accidents included on your accident register (390.15(b)) that involved the applicant in the 3 years prior to the application date shown above.

Date Location # of injuries # of fatalities Hazmat Spill 1.

Enclosed is other accident information pursuant to the employer's internal policies for retaining minor accident information

(391.23(d)(2)(ii)).

Any other remarks:

If this person was not subject to 382 testing requirements while in your employ, please check here To your knowledge, at any time within the preceding two years, did this person ever:

(a) Had a blood alcohol test with a concentration result of 0.04 or greater? (as described in 49 CFR 382, subpart C) Yes No

(b) Test positive for a controlled substance (as described in 49 CFR 40.21)? Yes No

ADLS Witness: Date:

Tyeast Tyeast Alexander (Mar Alexander 11, 2025 15:32 EDT) Driver

3/14/24 10/21/24 Driver

Tyeast Alexander

369******-**/11/25

After finishing this application, you will be required to validate the email address you provided, failure to do so will result in the application not being filed.

Contact this candidate