Employment Application

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Louisa Mason
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1 Last First MI Dat of Application Employmnt Application Th Nlrod Company dba Fox Enrgy Spcialists Is An Equal Opportunity Employr Fox Enrgy Spcialists 3109 Lubbock Avnu Fort Worth, TX

2 Instructions For Complting Application 1. Plas includ corrct nams, addrsss and information askd for in this application. 2. Application must b typd or clarly printd in black or dark blu ink. Th application must b signd and datd in ink. Any application that contains information which is illgibl will b disqualifid. 3. A résumé may b attachd to th application, but will not tak th plac of th mploymnt application. Th résumé will b considrd as an addndum to th application. Howvr, all qustions in th application must b answrd fully and without rfrnc to th résumé. 4. Aftr a formal mploymnt offr has bn mad by Fox Enrgy Spcialists, you will nd to supply documntation stablishing your mploymnt idntity and ligibility within thr businss days in accordanc with Immigration and Naturalization Srvic (INS) rquirmnts. Lists of accptabl documnts may b found on pag 3 of fdral form I-9 locatd at: 5. Application, addndums, attachmnts, and any supplmnts to th application will not b rturnd to th applicant. Applications will rmain currnt for sixty (60) days. 6. All partis intrstd in rqusting an application or furthr information should contact Mllany D. Sllrs, Human Rsourc Managr at th addrss blow or call (817) xt Plas snd application, résumé (if dsird), and/or othr attachmnts, to th following addrss: Human Rsourc Dpartmnt Fox Enrgy Spcialists 3109 Lubbock Avnu Fort Worth, TX Mllany@Nlrod.com FAX: (Attn: Human Rsourc Dpt.) Not: Th Nlrod Company dba Fox Enrgy Spcialists and its agnts rsrv th right to rqust additional information from slctd Applicants whn dmd to b in th bst intrst of th Company.

3 Position: Dat Availabl: Nam: Last First M.I. Prsnt : Zip Tim at abov : / (Yars/Months) Currnt Tlphon Numbr: Altrnat Phon Numbr: Typ of mploymnt dsird: Full-tim Part-Tim Tmporary Prvious : List chronologically all your rsidncs for th past 10 yars. Includ addrsss whil attnding school or away from hom. Ys No Ar you lgally authorizd to work in th U.S.? (You will b rquird upon mploymnt to submit vrification of your lgal right to work in th Unitd s.) Ys No Ar you 18 yars old or oldr? If no, can you provid a work prmit if ncssary? Ys No Hav you bn convictd of a crim? If ys, plas xplain: (Conviction will not ncssarily disqualify an applicant from mploymnt.).) Ys No Hav you workd for Fox Enrgy Spcialists bfor? If ys, giv dats: Ys No Can you work wknds, vnings, shifts? Ys No Do you smok? (Txas applicants only) Ys No Can you travl, if rquird? Currnt Drivr s Licns Numbr: of Issu: Expiration Non-Commrcial Commrcial Endorsmnt: Ys No Has your privilg to oprat a motor vhicl vr bn suspndd or rvokd, or hav you vr bn convictd of driving undr th influnc (D.U.I.)? If ys, xplain fully blow (giv dats and incidncs): Pag 1 of 5

4 WORK HISTORY Employr: Dats Employd Tlphon: ( ) FROM TO : Job Titl: Bginning Hourly Rat/Salary Suprvisor and Titl: $ Pr Rason for Laving: Ending Hourly Rat/Salary May w contact for rfrnc? Ys No $ Pr Rsponsibilitis: Employr: Dats Employd Tlphon: ( ) FROM TO : Job Titl: Suprvisor and Titl: Rason for Laving: Bginning Hourly Rat/Salary $ Pr Ending Hourly Rat/Salary May w contact for rfrnc? Ys No $ Pr Rsponsibilitis: Employr: Dats Employd Tlphon: ( ) FROM TO : Job Titl: Suprvisor and Titl: Rason for Laving: Bginning Hourly Rat/Salary $ Pr Ending Hourly Rat/Salary May w contact for rfrnc? Ys No $ Pr Rsponsibilitis: Commnts: (Includ xplanation of any gaps in mploymnt) Hav you vr bn dismissd or askd to rsign from any mploymnt or position you hav hld? Ys No Employr s Nam, and Dat If Ys, giv rason: Pag 2 of 5

5 Educational Background A. List last thr (3) schools attndd, starting with most rcnt. B. List numbr of yars compltd. C. Indicat dgr or diploma arnd, if any. D. Grad Point Avrag or Class Rank E. Major fild of study. F. Minor fild of study (if applicabl). A. School/Location B. Yars Compltd C. High School Diploma/GED Crtificat/Dgr D. GPA E. Major F. Minor Profssional Rfrncs List nam and tlphon of thr businss/work rfrncs that ar not rlatd to you and ar not prvious suprvisors. If not applicabl, list thr school or prsonal rfrncs that ar not rlatd to you. Nam Tlphon Yars Known Additional Information ( ) ( ) ( ) List profssional, trad, businss, or civic associations and any offics hld. Exclud mmbrships that would rval Sx, Sxual Orintation, Rac, Rligion, National Origin, Ag, Color, Disability, or any similarly protctd status. Organization Offic Hld Skills and Exprinc: (Chck Any That Apply To You.) Bookkping/Accounting Microsoft PowrPoint Businss Multi-lin Tlphon Microsoft Word Microsoft Outlook Othr Microsoft Excl Microsoft Publishr Othr Rsidntial Crtifications: (Chck Any That Apply To You.) HERS Ratr LEED AP-Homs RESNET Quality Assuranc Dsign (QAD) BPI Building Analyst Profssional BPI Multi-Family Building Analyst Profssional NGBS Grn Vrifir LEED Grn Ratr IECC Rsidntial Enrgy Inspctor/Plans Examinr Othr (list blow) Commrcial Crtifications: (Chck Any That Apply To You.) Crtifid Enrgy Managr (CEM) LEED AP-BD+C Crtifid Watr Efficincy Profssional (CWEP) LEED Grn Associat (GA) IECC Commrcial Enrgy Inspctor IECC Commrcial Enrgy Plans Examinr IgCC Crtifid Inspctor OSHA Crtifid Othr (list blow) Pag 3 of 5

6 List othr work-rlatd licnsing or crtifications: List any additional information you would lik us to considr: Y:\_Nlrod Prsonnl\Application FOX\2015 Fox Enrgy Emp. Application FINAL doc Pag 4 of 5

7 Disclosurs, Disclosur Authorization, and Rlas I Undrstand and Agr That: If I am mployd, any misrprsntation or matrial omission mad by m on this application will b sufficint caus for cancllation of this application or immdiat discharg from Th Nlrod Company dba Fox Enrgy Spcialists, whnvr it is discovrd. Th Nlrod Company dba Fox Enrgy Spcialists dos not discriminat in mploymnt and no qustion on this application is usd for th purpos of limiting or xcluding any application from considration for mploymnt on a basis prohibitd by local, stat, fdral law. Th Nlrod Company dba Fox Enrgy Spcialists dos not discriminat on th basis of sx, sxual prfrnc, rac, rligion, color, national origin, ag, disability, vtran status, or any othr protctd class or status. If mployd, I may rsign at any tim, with or without notic or caus and th mployr rsrvs th right to trminat or modify th rlationship at any tim with or without notic or caus, xcpt as may b rquird by law or as ngotiatd by mploy contract. I agr to conform to th ruls and rgulations of Th Nlrod Company dba Fox Enrgy Spcialists and I undrstand that this application dos not constitut an agrmnt or contract for mploymnt for any spcifid priod or dfinit duration. I undrstand that no rprsntativ of th mployr, othr than th Prsidnt/CEO and th Excutiv Vic Prsidnt, has th authority to mak any writtn or vrbal commitmnt of mploymnt with th Company. I furthr undrstand that any such assurancs must b in writing and signd by th Prsidnt/CEO or Excutiv Vic Prsidnt. As a condition of mploymnt or my continud mploymnt, I will b rquird to provid proof of idntity, and may b rqustd to submit to a urinalysis, drug scrn, and/or othr tsts and that my failur to tak such tst(s) whn rqustd to do so or unsatisfactory tst rsults will disqualify m from considration for mploymnt, or if I am thn mployd, may rsult in my immdiat dismissal. I furthr undrstand that any mploymnt offr and/or my continud mploymnt may b conditionally basd upon satisfactory compltion of background chcks and polic rports, and any information rquird to complt th mploymnt procss. Th Nlrod Company dba Fox Enrgy Spcialists may obtain a slf-chck rport through Employmnt Vrification (E-Vrify) on-lin program and a consumr rport that includs, but is not limitd to, my crditworthinss or similar charactristics, mploymnt and ducation vrifications, social scurity vrification, criminal and civil history, prsonal intrviws, DMV rcords, any othr public rcords and any othr information baring on my crdit standing, crdit capacity, charactr, gnral rputation, prsonal charactristics and trustworthinss. Although managmnt attmpts to accommodat individual circumstancs, including rligious obsrvanc rquirmnts, businss nds may at tims mak th following conditions rquird: ovrtim, rotating work schdul, or work schdul that includs Saturday and Sunday. I giv Th Nlrod Company dba Fox Enrgy Spcialists and/or its authorizd rprsntativs th right to contact and obtain information from all rfrncs, mployrs, ducational institutions, and to othrwis vrify th accuracy of th information containd in this application. In xchang for considration of my mploymnt application, I rlas Th Nlrod Company dba Fox Enrgy Spcialists and its rprsntativs and any organization or individual it may contact from any and all damags, liabilitis, or claims that may xist or aris rlating in any way to th rlas or rcipt of information as providd hrin. I furthr agr not to fil or pursu any complaints, claims, or lgal actions of any kind against any organization or individual that provids work-rlatd information about m to th Company or any of its mploys, rprsntativs, or agnts arising out of thir fforts to obtain work-rlatd information about m. I undrstand that, pursuant to th Fdral Fair Crdit Rporting Act, Th Nlrod Company dba Fox Enrgy Spcialists will provid m with a copy of any such rport of th information containd in such rport is, in any way, to b usd in making a dcision rgarding my fitnss for mploymnt with Th Nlrod Company dba Fox Enrgy Spcialists. I furthr undrstand that such rport will b mad availabl to m prior to any such dcision bing mad, along with th nam and addrss of th rporting Agncy that producd th rport. I rprsnt and warrant that I hav rad and fully undrstand th forgoing and sk mploymnt undr ths conditions. I crtify that th facts I hav providd in this mploymnt application ar tru and complt. Signatur of Applicant: / / Typd or Printd Full Nam: Plas provid a copy of your currnt drivr s licns and Social Scurity Card. NELROD OFFICIAL USE: Authorizd Signatur Dat Pag 5 of 5

Green Ontario Fund (GreenON)

Green Ontario Fund (GreenON) Grn Ontario Fund (GrnON) BUSINESS CASE SUMMARY submission du March 15/18 List all of th rtrofit and rnovation rpairs idntifid in your submission, including stimatd costs and proposd timlins (commncmnt