E V A N S N E T W O R K O F C O M P A N I E S

Transcription

1 E V A N S N E T W O R K O F C O M P A N I E S AGENT: Scan ALL forms and documents except as noted below in red. Driver Application Part 1 (Pre-Qualification) Application and PSP Disclosure and Authorization Form (scan all 5 pages plus any attachments) Reference Check Request and HireRight (scan all 4 pages) Driver Application Part 2 (Sign-On Forms) UPDATED 3/31/2017 Form I-9: Employment Eligibility Verification (scan pages 1 and 2) revised 3/31/2017 ALL PREVIOUS VERSIONS OF THE I-9 ARE NOW EXPIRED Disclosure and Authorization to Obtain Consumer Reports (scan 1 page) Last 7 Driver Statement of On-Duty Hours (scan 1 page) OneBeacon Occupational Accident Insurance Enrollment Form (scan 1 st page only applicant keeps 2 nd page) Scan even if declining or ineligible for coverage, but write DECLINE across form Drivers Legal Plan Application (scan 1 st page only applicant keeps 2 nd page) Scan even if declining enrollment, but write DECLINE across form Orientation Call: Information & Agenda (1 page, do NOT scan applicant keeps for the call) Company Policy Receipt (scan 1 page) revised 8/25/2016 Driver Application Part 3 (Policies) UPDATED 8/25/2016 Company Safety Policies. 34 pages, do NOT scan. Keep one hard copy available in your office for review by applicants and provide an electronic copy to applicants upon request. There is no need to print a hard copy of the policies for each applicant. (A hard copy is provided in the driver s binder upon sign-on.) Additional Documents Commercial Driver s License (front and back) Social Security Card (front only) Medical Card or Certificate (front and back and/or all pages) Security Awareness Training (scan the confirmation of passing score) Direct the applicant to log in as a guest at to take the training and quiz. HazMat Online Training (scan the confirmation of passing score, if applicant is HazMat endorsed) Direct the applicant to log in as a guest at to take the training and quiz. Fast, Sealink, and/or TWIC ID Cards (if applicant possesses such) Green Card (if used as identification for Form I-9) Driver s own Occupational Accident Insurance Certificate or Worker s Compensation Insurance Certificate covering driver (only if declining or ineligible for our Occupational Accident Insurance program) Accident Report(s) (if any in the last 5 years and/or as required by Safety Department) Background Check documents (if required by Safety Department or volunteered by applicant) Chain of Custody document for drug screen (if available) Driver Statement (if required by Safety Department or volunteered by applicant) Probation Agreement (if required by Safety Department) The Safety Department will scan: DAC and PSP reports; Drug Screen Results; and, if applicant enrolls in our program, the Occupational Accident Insurance Certificate. Rev. 3/31/2017 DO NOT SCAN THIS PAGE

2 Employment Eligibility Verification Department of Homeland Security U.S. Citizenship and Immigration Services USCIS Form I-9 OMB No Expires 08/31/2019 START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically, during completion of this form. Employers are liable for errors in the completion of this form. ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ an individual because the documentation presented has a future expiration date may also constitute illegal discrimination. Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer.) Last Name (Family Name) First Name (Given Name) Middle Initial Other Last Names Used (if any) Address (Street Number and Name) Apt. Number City or Town State ZIP Code Date of Birth (mm/dd/yyyy) U.S. Social Security Number Employee's Address Employee's Telephone Number - - I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form. I attest, under penalty of perjury, that I am (check one of the following boxes): 1. A citizen of the United States 2. A noncitizen national of the United States (See instructions) 3. A lawful permanent resident (Alien Registration Number/USCIS Number): 4. An alien authorized to work until (expiration date, if applicable, mm/dd/yyyy): Some aliens may write "N/A" in the expiration date field. (See instructions) Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number. QR Code - Section 1 Do Not Write In This Space 1. Alien Registration Number/USCIS Number: OR 2. Form I-94 Admission Number: OR 3. Foreign Passport Number: Country of Issuance: Signature of Employee Today's Date (mm/dd/yyyy) Preparer and/or Translator Certification (check one): I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1. (Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.) I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct. Signature of Preparer or Translator Today's Date (mm/dd/yyyy) Last Name (Family Name) First Name (Given Name) Address (Street Number and Name) City or Town State ZIP Code Employer Completes Next Page Form I-9 11/14/2016 N Page 1 of 3

3 Employment Eligibility Verification Department of Homeland Security U.S. Citizenship and Immigration Services USCIS Form I-9 OMB No Expires 08/31/2019 Section 2. Employer or Authorized Representative Review and Verification (Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's first day of employment. You must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists of Acceptable Documents.") Employee Info from Section 1 Last Name (Family Name) First Name (Given Name) M.I. Citizenship/Immigration Status List A OR List B AND List C Identity and Employment Authorization Identity Employment Authorization Document Title Document Title Document Title Issuing Authority Issuing Authority Issuing Authority Document Number Expiration Date (if any)(mm/dd/yyyy) Document Number Expiration Date (if any)(mm/dd/yyyy) Document Number Expiration Date (if any)(mm/dd/yyyy) Document Title Issuing Authority Document Number Additional Information QR Code - Sections 2 & 3 Do Not Write In This Space Expiration Date (if any)(mm/dd/yyyy) Document Title Issuing Authority Document Number Expiration Date (if any)(mm/dd/yyyy) Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee, (2) the above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the employee is authorized to work in the United States. The employee's first day of employment (mm/dd/yyyy): (See instructions for exemptions) Signature of Employer or Authorized Representative Today's Date(mm/dd/yyyy) Title of Employer or Authorized Representative Last Name of Employer or Authorized Representative First Name of Employer or Authorized Representative Employer's Business or Organization Name Employer's Business or Organization Address (Street Number and Name) City or Town State ZIP Code Section 3. Reverification and Rehires (To be completed and signed by employer or authorized representative.) A. New Name (if applicable) B. Date of Rehire (if applicable) Last Name (Family Name) First Name (Given Name) Middle Initial Date (mm/dd/yyyy) C. If the employee's previous grant of employment authorization has expired, provide the information for the document or receipt that establishes continuing employment authorization in the space provided below. Document Title Document Number Expiration Date (if any) (mm/dd/yyyy) I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presented document(s), the document(s) I have examined appear to be genuine and to relate to the individual. Signature of Employer or Authorized Representative Today's Date (mm/dd/yyyy) Name of Employer or Authorized Representative Form I-9 11/14/2016 N Page 2 of 3

4 LISTS OF ACCEPTABLE DOCUMENTS All documents must be UNEXPIRED Employees may present one selection from List A or a combination of one selection from List B and one selection from List C. LIST A Documents that Establish Both Identity and Employment Authorization LIST B LIST C Documents that Establish Employment Authorization OR Documents that Establish Identity AND 1. U.S. Passport or U.S. Passport Card 2. Permanent Resident Card or Alien Registration Receipt Card (Form I-551) 3. Foreign passport that contains a temporary I-551 stamp or temporary I-551 printed notation on a machinereadable immigrant visa 4. Employment Authorization Document that contains a photograph (Form I-766) 5. For a nonimmigrant alien authorized to work for a specific employer because of his or her status: a. Foreign passport; and b. Form I-94 or Form I-94A that has the following: (1) The same name as the passport; and (2) An endorsement of the alien's nonimmigrant status as long as that period of endorsement has not yet expired and the proposed employment is not in conflict with any restrictions or limitations identified on the form. 6. Passport from the Federated States of Micronesia (FSM) or the Republic of the Marshall Islands (RMI) with Form I-94 or Form I-94A indicating nonimmigrant admission under the Compact of Free Association Between the United States and the FSM or RMI 1. Driver's license or ID card issued by a State or outlying possession of the United States provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address 2. ID card issued by federal, state or local government agencies or entities, provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address 3. School ID card with a photograph 4. Voter's registration card 5. U.S. Military card or draft record 6. Military dependent's ID card 7. U.S. Coast Guard Merchant Mariner Card 8. Native American tribal document 9. Driver's license issued by a Canadian government authority For persons under age 18 who are unable to present a document listed above: 10. School record or report card 11. Clinic, doctor, or hospital record 12. Day-care or nursery school record 1. A Social Security Account Number card, unless the card includes one of the following restrictions: (1) NOT VALID FOR EMPLOYMENT (2) VALID FOR WORK ONLY WITH INS AUTHORIZATION (3) VALID FOR WORK ONLY WITH DHS AUTHORIZATION 2. Certification of Birth Abroad issued by the Department of State (Form FS-545) 3. Certification of Report of Birth issued by the Department of State (Form DS-1350) 4. Original or certified copy of birth certificate issued by a State, county, municipal authority, or territory of the United States bearing an official seal 5. Native American tribal document 6. U.S. Citizen ID Card (Form I-197) 7. Identification Card for Use of Resident Citizen in the United States (Form I-179) 8. Employment authorization document issued by the Department of Homeland Security Examples of many of these documents appear in Part 8 of the Handbook for Employers (M-274). Refer to the instructions for more information about acceptable receipts. Form I-9 11/14/2016 N Page 3 of 3

5 DISCLOSURE AND AUTHORIZATION TO OBTAIN CONSUMER REPORTS Please read the disclosure carefully before signing the authorization. DISCLOSURE Under the Fair Credit Reporting Act ( FCRA ), before Evans Delivery Company, Inc. ( the Company ) can obtain a consumer report or investigative consumer report about you, the Company must have your written authorization. In considering your application and, if retained, your continued retention, the Company may request and rely upon one or more consumer reports or investigative consumer reports, consisting of motor vehicle records, about you that the Company obtains from consumer reporting agencies. The Company will monitor your driving record and license status on an ongoing basis. AUTHORIZATION I have read and understand the foregoing Disclosure, and authorize the Company to obtain and rely upon consumer reports or investigative consumer reports, obtained from consumer reporting agencies consisting of motor vehicle records, in consideration of my application and, if retained, my continued retention. By my signature below, I authorize the Company to obtain any such motor vehicle records. This authorization shall serve as an ongoing authorization to procure consumer report information, including motor vehicle records, on an ongoing basis. I further agree that this Disclosure and Authorization in original, faxed, photocopied, or electronic (including electronically signed) form will be valid for any consumer reports or investigative consumer reports the Company may request about me. šdi01=œ By providing the following information, I am authorizing the Company to obtain consumer reports about me as detailed in this Disclosure and Authorization. Name (please print): Date of Birth: Address: City: State: Zip: Driver License #: State of Issue: Signature: Date: Rev. 12/01/2015

6 šl701!œ DRIVER STATEMENT OF ON-DUTY HOURS (for Newly Hired Drivers) Driver's record of duty status. (j)(2) Motor carriers, when using a driver for the first time or intermittently, shall obtain from the driver a signed statement giving the total time on duty during the immediately preceding 7 days and the time at which the driver was last relieved from duty prior to beginning work for the motor carriers. (k)(2) The driver shall retain a copy of each record of duty status for the previous 7 consecutive days which shall be in his/her possession and available for inspection while on duty. (j) Drivers used by more than one motor carrier. (1) When the services of a driver are used by more than one motor carrier during any 24 hour period in effect at the driver's home terminal, the driver shall submit a copy of the record of duty status to each motor carrier. The record shall include: Definitions. On duty, time means all time from the time a driver begins to work or is required to be in readiness to work until the time the driver is relieved from work and all responsibility for performing work. On duty time shall include: (8) Performing any other work in the capacity, employ, or service of a motor carrier; and (9) Performing any compensated work for a person who is not a motor carrier. NAME: SSN#: LIC STATE: LICENSE NO.: CLASS A EXPIRES: ENDORSEMENTS: DAY: DATE: TOTAL HOURS BELOW: HOURS WORKED: I hereby certify that the information given above is correct to the best of my knowledge and belief, and that I was last relieved from work/duty at the following time and date: TIME: AM PM DATE: LOCATION: Print and sign your name: Are you currently leased to or are working in any capacity for another carrier/company?... Yes At this time, do you intend to work for another carrier/employer and still work for this company?... Yes No No I hereby certify that the information given above is true and I understand that once I contract/lease to this company, if I begin working for any additional carrier/employer(s) for compensation that I must inform this company immediately of such lease or employment activity. Print and sign your name: Date: Co. witness/representative: Date: Rev. 12/01/2015

7 šos01\œ OneBeacon America Insurance Company Canton, Massachusetts Driver Enrollment and Beneficiary Form Truckers Occupational Accident Insurance West Motor / Evans Delivery Network Policy PLEASE PRINT Name FIRST MIDDLE LAST SUFFIX (IF ANY) Social Security # Date of Birth Male Female Street Address City State Zip Home Phone Cell Phone Address LogID CDL State CDL# Agent Code Truck# Name of Beneficiary Beneficiary Address Relationship of Beneficiary Best Phone Contact Contracted by: The Evans Network of Companies, W Columbia Street, Schuylkill Haven, PA 17972, Phone , Fax Operating Division Date of Lease FRAUD STATEMENT Any person who knowingly and with intent to defraud any insurance company or other person, files an application for insurance or a statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and will also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. In providing this information, I, the undersigned, understand and hereby state that: 1. to the best of my knowledge and belief, all information on this Form is complete and truthful; 2. this coverage being is not a contract for Statutory Workers Compensation Insurance, and neither I nor my carrier become participants in the Workers Compensation system by purchasing this insurance; and 3. if, based on the information supplied in this Form, I am not eligible for coverage, premium will be refunded and no claims will be payable. By my signature below, I, the undersigned, also authorize any licensed physician, medical practitioner, hospital, clinic, or other medical or medically related facility, insurance company, or any other organization, institution, or person that has my records, including any medical records, to furnish such information or copies of records to OneBeacon America Insurance Company, the motor carrier or the motor carrier s designee. A photographic copy of this authorization shall be as valid as the original. IF THE INFORMATION PROVIDED IN THIS FORM IS FRAUDULENT, THE INSURERER HAS THE RIGHT TO RETURN PREMIUM AND CANCEL COVERAGE. In order to verify the information provided in this Form, I the undersigned, give the Insurer authority to examine the records that are maintained by the motor carrier. I certify that I am an independent contractor, paid by a 1099 tax form, not as a W-2 employee. Driver s Signature Date Motor Carrier Representative s Signature PAYMENT AUTHORIZATION: I authorize the above named motor carrier, with whom I have a contract, to take weekly or monthly deductions for this insurance coverage, from my settlement account on my behalf, and to remit these funds to OneBeacon America Insurance Company. I UNDERSTAND THAT THE COST OF THE INSURANCE IS MY SOLE OBLIGATION AND RESPONSIBILITY, regardless of the above arrangement of premium payment. I agree that I will forward any amount due and owing to OneBeacon America Insurance Company, upon demand, for any insurance at any time my account remains unpaid. Signature Date Rev. 5/2/2016

8 AGENT: Do not scan this page. Give to driver/applicant to keep. Truckers Occupational Accident Insurance coverage is available for drivers (independent contractors only) who are not otherwise covered by their own Occupational Accident policy or by a Worker s Compensation policy This summary of benefits is provided for your convenience only and is subject to change and/or correction. For current coverage details, please refer to the One Beacon policy document, which is available on the Evans PitStop Driver Portal. Accidental Death Benefit Up to age 75 Age 75/Older Principal Sum... $50, $50,000 Accident Commencement Period days days Survivor s Benefit Principal Sum... $250, $150,000 Monthly Benefit Percentage % % Monthly Benefit Amount... $2, $1,500 Accidental Dismemberment Benefit Principal Sum... $300, $200,000 Accident Commencement Period days days Paralysis Benefit Principal Sum... $300, $200,000 Accident Commencement Period days days Temporary Total Disability Benefit Disability Commencement Period days days Waiting Period... 7 days... 7 days Benefit Percentage... 70% of AWE... 70% of AWE Minimum Weekly Benefit Amount... $ $125 Maximum Weekly Benefit Amount... $ $400 Maximum Benefit Period weeks weeks Maximum Benefit Period for Hernia weeks weeks Maximum Benefit Period for Hemorrhoids weeks weeks Maximum Benefit Period for Occupational Cumulative Trauma and/or Repetitive Conditions weeks weeks Continuous Total Disability Benefit Waiting Period... Maximum Benefit Period for Temporary Total Disability... N/A Benefit Percentage... 70% of AWE... N/A Minimum Weekly Benefit Amount... $50... N/A Maximum Weekly Benefit Amount... $ N/A Maximum Benefit Period... to age N/A Accident Medical Expense Benefit Medical Commencement Period days days Deductible Amount... $0... $0 Maximum Benefit Period weeks weeks Dental Maximum... $3,600 per accident... $3,600 per accident Maximum Benefit Amount per Accident... $2,000, $1,000,000 Lifetime Maximum Benefit... $2,000, $1,000,000 Limits on Accident Medical Expense Benefits Services provided by a chiropractor or acupuncturist, not including physical, occupational, or work hardening therapy... $1,000 per injury Ambulance... one round trip to/from a hospital, maximum $1,000 per accident Air Ambulance... one round trip to/from a hospital, maximum $7,000 per accident Hernia, Hemorrhoid, and Occupational Cumulative Trauma and/or Repetitive Conditions Coverage... combined lifetime maximum benefit of $50,000 YOUR COVERAGE EFFECTIVE DATE: If you are an owner-operator (Class I) or contract driver (Class II), your coverage under the policy begins on 1) the policy effective date; 2) the date you become a member of an eligible class; or 3) the date your completed enrollment form is received by the Evans Safety Department; whichever is later. Your coverage will not become effective until the first premium payment is paid when due. If premium is paid when due, coverage is effective on the later of 1, 2 or 3 above. If premium is not paid when due, coverage will not be in effect. YOUR COVERAGE TERMINATION DATE: Your coverage under the policy ends on 1) the date the policy is terminated; 2) the premium due date, if premiums are not paid when due, subject to any grace period; 3) the date you request, in writing, that your coverage be terminated; 4) the date you cease to be a member of an eligible class; or, if you are a contract driver, the date the Owner-Operator, with respect to whom you are under contract, ceases to be a member of an eligible class; whichever is earliest. A change in your coverage under the policy, due to a change in your eligible class or benefit selection, becomes effective on the later of: (a) the date the change in your eligible class or benefit selection occurs; or (b) if the change requires a change in premium, the date the first changed premium is paid. However, a change in coverage applies only with respect to covered accidents that occur after the change becomes effective. Subject to the terms, conditions, exclusions and limitations of the policy, termination of coverage will not affect a claim for a covered loss that occurs either before or after such termination, if that covered loss results from an accident that occurred while your coverage was in force under the policy. Rev. 5/2/2016

9 šdl01cœ EVANS NETWORK WEST MOTOR AGENT CODE DRIVER LOG ID P L E A S E P R I N T DRIVER TYPE: Owner Operator Contracted Driver Company Driver DRIVER FIRST MI LAST SUFFIX, IF ANY ADDRESS CITY STATE ZIP PHONE SOCIAL SECURITY # CELL PHONE DRIVER S LICENSE NUMBER STATE DATE OF BIRTH DISPATCH NUMBER NON-CDL DRIVER'S SPOUSE OR NON-CDL EMPLOYEE PLAN NON-CDL DRIVER'S SPOUSE OR NON-CDL EMPLOYEE FIRST MI LAST ADDRESS CITY STATE ZIP PHONE SOCIAL SECURITY # NON-CDL DRIVER S LICENSE NUMBER STATE DATE OF BIRTH WORK NUMBER SELECT COVERAGE: Driver Only $2.98 weekly Add Non-CDL Spouse/Employee +$1.50 weekly Decline SETTLEMENT DEDUCTION FROM TRUCK/UNIT # I hereby apply to participate in DRIVERS LEGAL PLAN and AUTHORIZE you to deduct from my earnings the necessary plan fee as set forth above to be paid to DRIVERS LEGAL PLAN or its designate. I hereby authorize DRIVERS LEGAL PLAN to employ any attorney to represent me, and sign my name, with my full authority and discretion to resolve any matter in connection with any and all traffic tickets and/or DataQ challenges I may have. In order to fulfill my obligation under the Federal Motor Carrier Safety Regulations and my employer/lessor s safety policy, I hereby authorize DRIVERS LEGAL PLAN to communicate with my employer/lessor regarding my case. I also understand that if I am no longer employed by or leased to this participating company or lessor, my participation will be cancelled. This authority is to remain in effect until revoked by me in writing. X Signature of Driver Date Fax completed application to Safety Department at (570) , attention SAFETY USE ONLY: Effective Cancellation Notes Rev. 5/2/2016

10 AGENT: Do not scan this page. Give to driver/applicant to keep The Protection You Need a Price You Can Afford Answers from Drivers Legal Plan to Frequently Asked Questions Why does a professional truck driver need this service? Your career depends on it. In the CSA era, drivers must challenge all points that might affect MVR or CSA SMS scores. Regulation and revenue driven enforcement agencies will issue citations and inspections, which will directly affect your employability and your company s DOT scrutiny. With more than 300,000 cases defended, we are the most experienced CDL Defense Law Firm in the country. Only $2.98/week? How is Drivers Legal Plan so inexpensive? Drivers designed it so that if you never use it, you are just not out much money, thereby rewarding the good driver. If you do need an attorney, perhaps to save your job, you get to hire the nation s most experienced CDL defense Law Firm, start-to-finish, for any moving, non-moving, or DOT violation for only $100, and save enough on legal fees to pay for membership for years to come. As a member of Drivers Legal Plan, what do I do if I get a ticket or inspection report? You call directly to our law firm at 1 (800) Our legal assistant will give you a quick, free, and accurate assessment of your legal situation what that violation will do to your MVR and CSA SMS if you were to just pay it or be found guilty. I have a perfect driving record, and don t break the law, why would I need Drivers Legal Plan? Simple answer; because you have the most to protect. You can t afford to take the chance of losing that perfect record to an unwarranted ticket. I m an owner operator, and need to budget every penny. Is Drivers Legal Plan worthwhile for me? Certainly. As an owner operator, it is perhaps even more critical that you contest every citation and inspection report. As you know, your truck payment will not be suspended just because your CDL has been. What violations are covered? All moving, non-moving, and DOT violations anything that can affect your CDL or CSA SMS. We are a law firm, with no exclusions or limitations. Our first priority is always the CDL you make a living with, but we ll also be able to help your wallet, via fine reductions. Does the Plan cover me in my personal car? Yes. You are covered 24/7, in any vehicle you drive that affects your CDL, including cars, motorcycles, boats, RVs, 4-wheelers, etc. Will I have to appear in court? It s always at the discretion of the court, but our current stats show that 94% of the time you will not have to appear. As a result, you can keep driving and making money, and our law firm will handle everything else. What can you do to help with CSA? CSA makes it mandatory that you defend your record from career-crippling SMS points, and protect your employability. Our law firm defends you, the member driver, in traditional traffic court, where we have historically had a 95% favorable affect rate. Our ATTORNEYS then use that judgment as precedent to automatically and for FREE file a DataQ Challenge on your behalf. Are you the same as PrePaid Legal, or the other legal plans that we see at truck stops? Absolutely not. We are the actual law firm that does the work, while the others are referral plans that refer a driver to a local lawyer, who may or may not have any CDL experience. It s highly unlikely that lawyer will be any help with your CSA SMS. That referral lawyer may also take advantage of policy limitations and exclusions in order to make more money off the driver. Evans Network of Companies Safety Department option 7, Fax Drivers Legal Plan 1101 Sovereign Row, Oklahoma City OK Rev. 12/30/2015

11 AGENT: Do not scan. Give to driver. Orientation Call: Information & Agenda Rev. 01/13/2017 You may attend the session of your choice. However, late callers will be asked to reschedule. Monday through Friday: 10:00 AM Eastern OR 2:00 PM Eastern Call-In Number: (No access code needed) Be sure to have this agenda in your possession when you call in Phone lines open 10 minutes prior to the call and close 10 minutes after the call begins. 1. PSP / CSA SCORECARD Discussion 2. HOURS OF SERVICE Record of Duty Status 30-Minute Break Previous 7 Days BigRoad Electronic Logs Incentives Timeline 3. FUEL DISCOUNT PROGRAM Fuelbook Discount Code (8120) 4. UNSAFE DRIVING Seatbelt Seatbelt Cover Speeding 1 to 5 and 6 to 10 Cellphone 6. VEHICLE MAINTENANCE Brakes, Lights, Tires Six-month Federal Inspection 7. DRIVER PROGRAMS Vehicle Maintenance Expos Truck Tire Financing Chassis Tire Liability Program Clean Gift Card Program 8. SECURITY Security Awareness Hazardous Materials 9. ACCIDENTS Procedures 10. QUESTIONS What questions do you have? 5. DRIVERS LEGAL PLAN (DLP) $2.98 Discounted Rates NEXT STEPS Using either Internet Explorer or Chrome, visit the Evans PitStop Driver Portal at Click Log In As Guest, enter your information, and click Go. Watch the Security Awareness Training and take the quiz. If HazMat-endorsed, watch the Hazardous Materials Training and take the quiz

12 Company Policy Receipt šcp01jœ The Evans Network of Companies provides written policies and procedures regarding a number of topics, which may be updated and/or revised from time to time. It is your responsibility to familiarize yourself with these materials and understand the consequences of violating any and/or all of them. You will receive the following materials upon completion of the application process: Federal Motor Carrier Safety Regulations Pocketbook (347, green pocketbook) including all revisions issued on or before September 4, Hazardous Materials Compliance Pocketbook (42456, red pocketbook), which details driver responsibilities and duties in the transportation of hazardous materials, as prescribed by the U.S. Department of Transportation in Title 49 CFR Parts 107, and Emergency Response Guidebook (14-ORS-2, orange pocketbook), detailing emergency response procedures developed jointly by Transport Canada, the U.S. Department of Transportation, and the Secretariat of Communication and Transport of Mexico with the assistance of many interested parties from the government and industry including the collaboration of CIQUIME of Argentina. Upon completion of the application process, you will also receive the following company policies, a hard copy of which is currently available for viewing at the terminal manager s office, or an electronic copy of which may be provided by and/or requested from the terminal manager. Company Safety Policies (compilation date 8/25/2016) includes: Unsafe Driving Policy, rev. 11/2/2015 Distracted Driving and Cell Phone Policy (all electronic devices), rev. 8/25/2015 Seat Belt Policy, rev. 8/25/2015 No-Stop Policy and Storage of Loaded Containers, rev. 8/25/2016 Policy on Hours of Service and Driver s Record of Duty Status Not Current, including FMCSR Part 395, rev. 8/25/2016 No Pets Policy, rev. 8/25/2015 Passenger Policy, rev. 8/25/2015 Periodic Inspection Policy, rev 8/25/2016 Accident, Incident, and Injury Reporting Policy and Procedures, rev. 5/10/2016 Written Explanation of Controlled Substances and Alcohol Use and Testing FMCSR Part 382 and Company Policy with Training Materials Discussing the Effective of Alcohol and Controlled Substance Abuse on an Individual s Health, Work, and Personal Life as required by FMCSR Section (b)(11) ( Drug & Alcohol Policy ), rev. 1/12/2015 I hereby agree to familiarize myself with the Federal Motor Carrier Safety Regulations (FMCSR) of the U.S. Department of Transportation, Parts 40, 380, 382, 383, 387, , 399 Subchapter B, Chapter 3, Title 49 of the Code of Federal Regulations as contained therein and with the above-listed company policies and procedures, which may be updated from time to time. I understand that if I do not receive any or all of these materials, it is my responsibility to request replacement copies. I further understand that any violation of these policies could be grounds for termination of my driver services and/or motor carrier lease agreement. Driver s Name (Please print) Driver s Signature Date Company Representative s Signature Date Rev. 08/25/2016