APPLICANT CERTIFICATION THAT INFORMATION IS ACCURATE AND COMPLETE: I attest that the information provided on this application (and
accompanying resume if applicable) is true and complete. I understand that any false information, misrepresentation, or omission – oral or written – may
disqualify me from further consideration for employment and, if hired, may result in discipline or dismissal if discovered at a later date.
APPLICANT’S CONSENT TO VERIFY INFORMATION AND RELEASE: I authorize McCullough Excavating to investigate my employment history and all
statements contained in this application, including records of any former employers and other references or sources concerning me. I authorize all references
and sources to provide this information to McCullough Excavating and release such references and sources from liability for doing so. I waive my right to any
written notice of the release of such records that may be required by state or federal law.
APPLICANT’S CONSENT TO INVESTIGATIVE CONSUMER REPORT: I understand that due to the nature of the jobs at “McCullough Excavating an
investigative consumer report may be made whereby information is obtained through interviews with various third parties. These inquires may include
information as to criminal, credit, driving record, character, general reputation, personal characteristics and mode of living, whichever may be applicable. I
understand I have the right to make a written request to McCullough Excavating within a reasonable period of time for additional information concerning the
nature and scope of any investigation conducted. I also acknowledge receipt of the previous statement regarding investigative consumer reports.
EMPLOYMENT POLICIES: I understand that this application will remain active for consideration for six (6) months (180 days). If at the conclusion of this
period, I want McCullough Excavating to continue to consider me for employment, I must reapply. I understand that as a condition of employment I agree to
comply with McCullough Excavating’s employee policies and work rules, including but not limited to its confidentiality and conflict of interest policies.
EMPLOYMENT-AT-WILL: I understand that the McCullough Excavating is an “at-will” employer. As such, employment with McCullough Excavating may be
terminated at the will of either party, with or without cause, and without prior notice. I understand that no supervisor or representative of McCullough Excavating,
except appointed by the Owner and only when in writing (signed and dated by both parties), can enter into an employment contract, either written or verbal.
JOB FUNCTIONS: I attest that I can perform the essential functions of the job, with or without reasonable accommodation. I understand that under Indiana
law, if I am a qualified individual who is disabled and requires an accommodation, I understand that it is my responsibility to request an accommodation within
182 days after the date I knew or reasonably should have known that an accommodation was needed.
STATUTE OF LIMITATIONS: I understand that as a condition of employment I agree to commence any action or suit relating to my employment
relationship with McCullough Excavating within the lesser of the applicable statute of limitations or 182 calendar days after the date that I knew or should
have known about the incident giving rise to the action or suit. Furthermore, I agree to waive any statute of limitation to the contrary.