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1 9027 Blewett Road Beaumont, TX (Office) (Fax) Please scan or take a picture of documents below. Driver s License/ ID Card (Required for employment) Social Security Card (Required for employment) TWIC Card (Optional) ISTC/ Safety Council Badge (Optional) NCCER (Optional) all documents to hr@sigindserv.com or fax to with provided cover sheet

2 9027 Blewett Road Beaumont, TX (Office) (Fax) Please fill out all highlighted sections of application. Please fully complete W-4 document. If you have any question with application please call and ask for Human Resource Department. Thank You.

3 9027 Blewett Road Beaumont, TX (Office) (Fax) To: HR Department From: Number of Pages Including Cover Sheet: 11 Notes: Please Fax form to Please call if you have any questions.

APPLICATION FOR EMPLOYMENT PRE EMPLOYMENT QUESTIONNAIRE EQUAL OPPORTUNITY EMPLOYER PERSONAL INFORMATION NAME (LAST): (FIRST): (MIDDLE INITITAL): HOME TELEPHONE: MAILING ADDRESS: CITY: STATE: ZIP CELL

4 APPLICATION FOR EMPLOYMENT PRE EMPLOYMENT QUESTIONNAIRE EQUAL OPPORTUNITY EMPLOYER PERSONAL INFORMATION NAME (LAST): (FIRST): (MIDDLE INITITAL): HOME TELEPHONE: MAILING ADDRESS: CITY: STATE: ZIP CELL TELEPHONE: ADDRESS: OTHER TELEPHONE: HAVE YOU EVER BEEN CONVICTED OF A FELONY: DRIVERS LICENSE #: IF YES PLEASE EXPLAIN: REFERED BY: EMPLOYMENT DESIRED POSITION: DATE YOU CAN START SALARY DESIRED: ARE YOU EMPLOYED? YES NO WHERE?: IF SO, MAY WE INQUIRE OF YOUR PRESENT EMPLOYER? HAVE YOU EVER APPLIED TO THIS COMPANY BEFORE?: WHERE?: WHEN?: EDUCATION TYPE NAME AND LOCATION OF SCHOOL DID YOU GRADUATE? SUBJECT STUDIED HIGH SCHOOL COLLEGE TRADE, BUSINESS OR CORRESPONDENCE SCHOOL GENERAL INFORMATION SUBJECTS OF SPECIAL STUDY/RESEARCH WORK OR SPECIAL TRAINING/SKILLS: U.S. MILITARY OR NAVAL SERVICE: DO YOU HAVE A CURRENT 40 HOUR HAZWOPER CERTIFICATION?: HAVE YOU HAD A CURRENT PHYSICAL?: DOU YOU HAVE A CURRENT TWIC CARD? ARE YOU CURRENT WITH ANY ISTC SITE SPECIFICS? RANK: DATE OF HAZWOPER: DATE OF PHYSICAL: ARE YOU CURRENT WITH ISTC BASIC? IF SO, WHAT ISTC SITE SPECIFICS?

5 FORMER EMPLOYERS (LIST BELOW LAST FOUR EMPLOYERS, STARTING WITH THE LAST ONE FIRST) DATE/MONTH/YEAR NAME AND ADDRESS OF EMPLOYER SALARY POSITION REASON FOR LEAVING FROM TO FROM TO FROM TO FROM TO REFERENCES NAME ADDRESS BUSINESS YEARS KNOWN AUTHORIZATION "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I understand and agree that no representative of the company has any authority to enter into any agreement for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. I further understand that employment is contingent upon completing and passing a drug screen. Signature Industrial Services has a "zero" tolerance drug policy. Signature Industrial Services also conducts random drug tests and a Positive result on a drug screen at any time during employment shall be grounds for dismissal. All positions will require Background/Driving checks in order to obtain entrance to our customer's facilities. I acknowledge that my signature below gives Signature Industrial Services permission to run a background and driving check with the information I have provided, if necessary to my position. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. SIGNATURE: DATE:

6 Srcxnnrnr INnusrRIAt SERVICES il r (-l'olc.i l(1tr lnt){;srplal Nttl)s EMPLOYEE INFORMATION FU[I. T{AME: Lest First M.t. t{ickname MAIII]{G ADDRESS: (Same as W-4 address) Street Address Apt/Unitf City State zlp CONTACT INFORMATIOIT: Home Phone CellPhone Address PERMAilEilTADDRESS: Street Address ApVunitfl City State 7ip RACE: E aslan fl lfrican American fj caucaslan I Hispanic I amerlcan Indlan I racific lslander I Other PIACE OF BIRT}I: u.s.crnzer{? Dves f] ro Filo,wHATCOUtrrRY: PTEASE GHEGK OtfE: n OisaUteO Veteran I Amea Fortes Service Medal Veteran fl UrA"A Armed rolrces Servlce Medal Veteran f] ottrer Protected Veteran n ilon-veteran [ recently Separated MARITAI STATUS: lgnefe nmarnea flolvorced f]wldoweo [unkno*t SFOUSPS EMPLOYER: spousgs worl( PHot{E: FUIL ]{AMC: tast Flrst M.t. Relatlonshlp ADDRESS: Street Address Apt/Unit f ciw State zlp COIITACT IT{FORMATION: Home Phone Ahernate Phone Address

WAGE AGREEMENT FORM EMPLOYMENT INFORMATION EMPLOYEE NAME: DATE OF HIRE: EMPLOYEE JOB TITLE: SEASONAL PERMANENT LEVEL: PHONE #: EMAIL ADDRESS: LOCATION(S) OF EMPLOYMENT: DIRECT SUPERVISOR:

7 WAGE AGREEMENT FORM EMPLOYMENT INFORMATION EMPLOYEE NAME: DATE OF HIRE: EMPLOYEE JOB TITLE: SEASONAL PERMANENT LEVEL: PHONE #: ADDRESS: LOCATION(S) OF EMPLOYMENT: DIRECT SUPERVISOR: SEASONAL/TEMPORARY STATUS: FULL TIME PART TIME PAYROLL INFORMATION HOURLY FIELD PAY: RATE: SALARY (EXEMPT) RATE: SALARY (NON-EMEPT) RATE: HOURLY SHOP PAY: RATE: VEHICLE ALLOWANCE (1): Equipment: Truck: Phone: (list type) Fuel Card: American Express: Uniform: Computer: Other: PHONE ALLOWANCE (2): EQUIPMENT/PPE ISSUED Description: EMPLOYEE SIGNATURE: DATE: SUPERVISOR SIGNATURE: DATE:

8 Form W-4 (2OL2) Purpose, Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Consider completing a new Form W-4 each year and when your personal or financial situation changes. Exemption trom withholding. lf you are exempt, complete only lines 1,2,3, 4,and 7 and signthe form to validate it. Your exemption for 20'12 expires February 18, See Pub. 505, Tax Withholding and Estimated Tax. Note. lf another person can claim you as a dependent on his or her tax return, you cannot claim exemption from withholding if your income exceeds $950 and includes more than S300 of unearned income (for example, interest and dividends). Basic instructions. lf you are not exempt, complete the Personal Allowances Worksheet below. The worksheets on page 2 fudher adjust your withholding allowances based on itemized deductions, certain credits, adjustments to income, or two-earners/multiple jobs situations. [ if: I t. Yo, Future developments. The IRS has created a page on lrs.gov for information about Form W-4, at Information about any future developments affecting Form W-4 (such as legislation enacted after we release it) will be posted on that page. Nonwage income. lf you have a large amount of nonwage income, such as interest or dividends, consider making estimated tax payments using Form ES, Estimated Tax for Individuals. Otherwise, you may owe additional tax. lf you have pension or annuity Enter "1" for yourself if no one else can claim you as a dependent A income, see Pub. 505 to find out if you should adjust your withholding on Form W-4 or W-4P. Two earners or multiple jobs, lf you have a working spouse or more than one job, figure the total number of allowances you are entitled to claim on all jobs using worksheets from only one Form W-4. Your withholding usually will be most accurate when all allowances are claimed on the Form W-4 for the highest paying job and zero allowances are claimed on the others. See Pub. 505 for details. Nonresident alien. lf you are a nonresident alien, see Notice 1392, Supplemental Form W-4 Instructions for Nonresident Aliens, before completing this form. Check your withholding. After your Form W-4 takes effect, use Pub. 505 to see how the amount you are having withheld compares to your projected total tax tor See Pub. 505, especially if your earnings exceed $130,000 (Single) or $180,000 (Manied). Complete all worksheets that apply. However, you may claim fewer (or zero) allowances. For regular wages, withholding must be based on allowances you claimed and may not be a flat amount or percentage of wages. Head of household. Generally, you can claim head of household filing status on your tax return only if you are unmanied and pay more than 50% of the costs of keeping up a home for yourself and your dependent(s) or other qualifying individuals. See Pub. 501, Exemptions, Standard Deduction, and Filing Information, for information. Tax credits, You can take projected tax credits into account in figuring your allowable number of withholding allowances. Credits for child or dependent care expenses and the child tax credit may be claimed using the Personal Allowances Worksheet below. See Pub. 505 for information on converting your other credits into withholding allowances. are single and have only one job; A. or I or B You are married, have only one job, and your spouse does not work; I. Your wages from a second job or your spouse's wages (or the total of both) are $1,500 or less. Enter "1" for your spouse. But, you may choose to enter "-0-" if you are married and have either a working spouse or more than one job. (Entering "-0-" may help you avoid having too little tax withheld.) C D Enter number of dependents (other than your spouse or yourself) you will claim on your tax return. E Enter "1" if you will file as head of household on your tax return (see conditions under Head of household above) F Enter "1 " if you have at least $1,900 of child or dependent care expenses for which you plan to claim a credit (Note. Do not include child support payments. See Pub. 503, Child and Dependent Care Expenses, for details.) Chifd Tax Credit (including additional child tax credit). See Pub.972, Child Tax Credit, for more information. r lf your total income will be less than $61,000 ($90,000 if married), enter "2" for each eligible child; then less "1" if you have three to seven eligible children or less "2" if you have eight or more eligible children. Enter "1" B c D E F G o ' child. lf your total income will be between $61,000 and $84,000 ($90,000 and $1 19,000 if manied), enter " 1 " for each eligible G H Add lines A through G and enter total here. (Note. This may be different from the number of exemptions you claim on your tax return.) o lf you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductions For accuracy, and Adjustments Worksheet on page 2. complete all lf you are single and have more than one job or are married and you and your spouse both work and the combined earnings from all jobs exceed $40,000 ($10,000 if manied), see the Two-Earners/Multiple Jobs Worksheet on page 2 to worksheets avoid having too little tax withheld. that apply. o lf neither of the above situations applies, stop here and enter the number from line H on line 5 of Form W-4 below. H ). Separate here and give Form W-4 to your employer. Keep the top part for your records, ,.,' lllf'4 Department of the Treasury lnternal Revenue Seryice Employee's Withholding Allowance Gertificate 2@12 > Whether you are entitled to claim a certain number of allowances or exemption from withholding is subiect to review by the lrs. Your employer may be required to send a copy of this form to the lrs. 2 Your social security number (number and e fl singte I uarried Married, but withhold at higher Single rate. Note. lf manied, but legally separated, or spouse is a nonresident alien, check the lf your last name diflers from that shown on your social security card, check here. You must call 1-8/} tor a replacement card. ) Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) Additional amount, if any, you want withheld from each paycheck I claim exemption from withholding tor 2012, and meet both of the following conditions for exemption.. Last year I had a right to a refund of all federal income tax withheld because I had no tax liability, and. This year I expect a refund of all federal income tax withheld because I expect to have no tax meet both conditions, write "Exempt" here Under oenalties this certificate and, to the best of my knowledge and belief, it is true, correct, and complete. Employee's signature flhis form is not valid unless you sign it.) I OMB No Employer's name and address (Employer: Complete lines Date > I identification number (ElN) and 10 only if sending to the lrs.) fndustriaf Services, LLC, PO Box22977, Beaumont, TX77720 For Privacy Act and Paperwork Reduction Act Notice, see page 2, Cat. No Form

9 TEMPORARY/SEASONAL EMPLOYEE ACKNOWLEDGEMENT FORM The employee handbook describes important information about SIGNATURE INDUSTRIAL SERVICES. I understand that I should consult the Human Resource Department if I have any questions that are not answered in the handbook. I became an employee at SIGNATURE INDUSTRIAL SERVICES voluntarily. I understand and acknowledge that I am classified as a seasonal or temporary employee and there is no specified length to my employment at SIGNATURE INDUSTRIAL SERVICES and that my employment is at will. I understand and acknowledge that "at will" means that I may terminate my employment at any time, with or without cause or advance notice. I also understand and acknowledge that "at will" means that SIGNATURE INDUSTRIAL SERVICES may terminate my employment at any time, with or without cause or advance notice, as long as they do not violate federal or state laws. I understand and acknowledge that there may be changes to the information and policies in the handbook. The only exception is that SIGNATURE INDUSTRIAL SERVICES will not change or cancel its employment-at-will policy. I understand that SIGNATURE INDUSTRIAL SERVICES may add new policies to the handbook as well as replace, change or cancel existing policies. I understand that only the Executive Managers of SIGNATURE INDUSTRIAL SERVICES can authorize handbook changes. I understand and acknowledge that this handbook is neither a contract of employment nor a legal document. I have received the handbook and I understand that it is my responsibility to read and follow the policies contained in the handbook and any changes made to it. PLEASE INITIAL BELOW VIDEO STATEMENT I certify that this policy handbook has been verbally reviewed with me and I understand my rights and responsibilities contained within. I have reviewed and understand SIGNATURE INDUSTRIAL SERVICES safety, drug and alcohol policies. EMPLOYEE S NAME (printed): EMPLOYEE S SIGNATURE: DATE:

Separate here and give Form W-4 to your employer. Keep the top part for your records. Employee s Withholding Allowance Certificate

Separate here and give Form W-4 to your employer. Keep the top part for your records. Employee s Withholding Allowance Certificate Form W-4 (2017) Purpose. Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Consider completing a new Form W-4 each year and when your personal or financial