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Click here or scroll down to respond to this candidateLazer Spot, Inc.Street Address Shiloh RdSuite Street Address
Alpharetta, GA Street Address
PHONE NUMBER AVAILABLEStreet Address -30-2024 4:57:09AM CDTIntelliAppApplicant opted out of D&A release authorization for the following individual employers / educational institutions.Laser logisticsThank you for your interest in Lazer Spot, Inc.. To apply for a driving position, please complete our online application for employment. Incomplete information will delay the processing of your application or prevent it from being submitted. In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.Position City State/ProvinceYard Spotter / CDL A Driver Gainesville GAPersonal InformationReferral Code: referrerName Alexander Jr BrooksResidence 3 years or longer (If No,previous addresses shown below)YesCurrent Address 645 Sw Troy StreetCity, State/Province Zip/Postal Lake City, FL 32024 Country United StatesResidence 3 years or longer (If No,previous addresses shown below)YesSSN/SIN 1289Date of BirthPrimary Phone PHONE NUMBER AVAILABLEPreferred method of contact Primary PhoneBest time to contact you AnyEmail EMAIL AVAILABLEYes, I agree to receive informationconcerning future opportunities orpromotions from Lazer Spot, Inc. by emailor other commercial electronicYes1communications.Would you like to receive communicationfrom Lazer Spot, Inc. via text message?By participating, you consent to receivetext messages sent by an automatictelephone dialing system, which maycontain recruiting/advertising messages.Consent to these terms is not a conditionof being hired, contracted, or leased. Youmay opt out at any time by texting STOP tounsubscribe. You also agree that LazerSpot, Inc.'s service provider receives inreal time and logs your text messages withLazer Spot, Inc..YesCompany QuestionsGENERAL INFORMATIONWhat position are you applying for? Company Driver What location are you applying for? FL, JACKSONVILLE Are you legally eligible for employment inthe United States?YesHow many years of relevant experience doyou have?20 yearsDo you have the relevant license/permitrequired for this position?YesHas your license/permit been denied,suspended, or revoked for any reason?NoAre you willing to submit topre-employment background screeningsincluding pre-employment drugscreenings?YesAre you currently employed? YesWhat date did your last employment end?Do you read, write, and speak English? YesPlease select additional languages spokenbesides English:NoneIf other selected above, please enter otherlanguage below.Have you ever worked for this companybefore?YesEnter start and end dates, location,position, rate of pay, and reason forleaving:08/13/2023 until 02 21 20242Do you have a current TWIC card? NoExpiration date:Please enter the names of any relativesemployed here:NoneHave you ever been known by any othername?NoEnter name:How did you hear about us? OtherIf "Driver Referral", please enter thedriver's nameNoneIf "Other", please explainIn case of Emergency, notify (list name,relation, and phone):Erica Jeanette Cooks wife PHONE NUMBER AVAILABLEDRIVING EXPERIENCEFor each class of equipment, enter type of equipment (van, reefer, tank, etc.), start and end dates, and approximate number of total miles. If no experience in a class, enter"NONE".Straight Truck NoneTractor and Semi-Trailer 20 yearsTractor - Two Trailers NoneOther TankerWhich safe driving awards do you hold andfrom whom?NoneEDUCATIONList highest grade completed: GEDList last school attended (name, city, andstate):Madison county high SchoolCOVID-19To mitigate the risk of potential COVID-19 exposures, Lazer Spot is requesting that all visitors complete the following acknowledgement form before visiting a site. Answering yes to any of these questions will not preclude employment. It may, however, be reason to postpone an applicant's interview, road test, or other on-site visit. Are you experiencing ANY of followingsymptoms within the last 48 hours: fever,sore throat, cough, shortness of breath,fatigue, body aches, headache, loss oftaste/smell, congestion/runny nose,nausea/vomiting and/or diarrhea?NoHave you tested positive for COVID-19 inthe past 10 days?NoNo3Have you been in close contact with aperson who tested positive with COVID-19in the past 10 days?Are you currently awaiting results from aCOVID-19 test?NoAre you willing to follow government and/orcustomer mandates relating to masks,testing and/or vaccination?YesRecruiterLicensesLicense Number 160Licensing Authority FLCountry USLicense Class Class ALicense Expiration Date 06-16-2027DOT Medical Card Expiration Date 03-25-2025Current License YesCommercial Driver License YesEndorsementsTanker Endorsement YesHAZMAT Endorsement NoX Endorsement NoDoubles Triples Endorsement YesOther Endorsement NoEmployment / UnemploymentC&t TruckingPLEASE DO NOT CONTACTCompany C&t TruckingStart Date 12-2022End Date 05-2024Address 3720Williams Dairy RoadCity, State/Province Zip/Postal Charlotte, NC 27406 Country United States4Phone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held DriverReason for leaving? MisunderstandingWere you terminated/discharged/laid off? YesTermination Explanation MisunderstandingIs this your current employer? NoMay we contact this employer at this time? NoDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven FloridaMiles driven weekly 1500-2000Pay Range (cents/mile) 53Most common truck driven Tractor-TrailerMost common trailer Tank TrailerTrailer length 53 feet or moreLaser logisticsCompany Laser logisticsStart Date 07-2023End Date 03-2024Address 65257 Shiloh Rd #900City, State/Province Zip/Postal Alpharetta, GA 30005 Country United StatesPhonePosition Held DriverReason for leaving? Will explainWere you terminated/discharged/laid off? YesTermination Explanation We'll explainIs this your current employer? No5May we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven FloridaMiles driven weekly 500-1000Pay Range (cents/mile)Most common truck driven Day CabMost common trailer Reefer TrailerTrailer length 53 feet or moreWilliams Dairy TruckingCompany Williams Dairy TruckingStart Date 03-2013End Date 05-2022Address 409 Red Oak RdCity, State/Province Zip/Postal Baxley, GA 31513Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held DriverReason for leaving? Company went out of businessWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesDid you operate a commercial motorvehicle?YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?YesYes6Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?Areas Driven FloridaMiles driven weekly 1500-2000Pay Range (cents/mile) 53Most common truck driven Tractor-TrailerMost common trailer Tank TrailerTrailer length 53 feet or moreMotor Vehicle Record1. Has any license, permit or privilege everbeen denied, suspended or revoked forany reason?No2. Have you ever been convicted of drivingduring license suspension or revocation, ordriving without a valid license or an expiredlicense, or are any charges pending?No3. Have you ever been convicted for anyalcohol or controlled substance relatedoffense while operating a motor vehicle, orare any charges pending?No4. Have you ever been convicted forpossession, sale or transfer of an illegalsubstance (including but not limited to,marijuana, amphetamines, or derivativesthereof) while on duty, or are any chargespending?No5. Have you ever been convicted ofreckless driving, careless driving orcareless operation of a motor vehicle, orare any charges pending?No6. Have you ever tested positive, orrefused to test on a pre-employment drugor alcohol test by an employer to whomyou applied, but did not obtainsafety-sensitive transportation workcovered by DOT agency drug and alcoholtesting rules in past three years, or haveyou ever tested positive or refused to teston any DOT-mandated drug or alcoholtest?No7Vehicle Accident RecordWere you involved in any accidents/incidents with any vehicle in the last 5 years (even if not at fault)?No AccidentsTraffic Convictions \ ViolationsHave you had any moving violations or traffic convictions in the past 3 years? No ViolationsCriminal RecordHave you ever been convicted of a crime? NoDo you have any deferred prosecutions? NoDo you have criminal charges pending? NoHave you ever pled "guilty" to, beenconvicted of, or pled "no contest" to afelony?NoIf you have any felony convictions, do youcurrently hold a minister's permit to enteror exit Canada?NoHave you, within the last five years, pled"guilty" to, been convicted of, hadprosecution deferred in connection with, orpled "no contest" to a misdemeanor?NoSignatureFull Name Alexander Jr BrooksIP Address 2601:348:601:1e1Signature Date/Time 05-30-2024 4:57 AMBy signing my application below, I agree to use an electronic signature to demonstrate my consent. An electronic signature is as legally binding as an ink signature. 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.8Signed Date: 05-30-2024 4:57 AMSigned:Federal FCRA Summary of Rights AcknowledgmentBy checking this box, I (a) acknowledgethat I have read and understand thefederal FCRA Summary of Rights andhave been given the opportunity tocopy/print the Summary of Rights and (b)agree to use an electronic signature todemonstrate my consent. An electronicsignature is as legally binding as an inksignature.YesPSP Disclosure and AuthorizationBy checking the box, I (a) acknowledgethat I have read and understand the PSPDisclosure and Authorization and alsohave been given the opportunity tocopy/print it, and (b) agree to use anelectronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.YesAdditional Consent or CertificationBy checking the box, I (a) acknowledgethat I have read and understand the aboveand also have been given the opportunityto copy/print it, and (b) agree to use anelectronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.YesFCRA DisclosureBy checking the box, I (a) acknowledgethat I have read and understand the aboveand also have been given the opportunityto copy/print it, and (b) agree to use anelectronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.Yes9FCRA AuthorizationBy checking the box, I (a) acknowledgethat I have read and understand the aboveand also have been given the opportunityto copy/print it, and (b) agree to use anelectronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.YesEmployment Verification Acknowledgment and Release (DOT Drug and Alcohol) By checking the box, I (a) acknowledgethat I have read and understand the aboveand also have been given the opportunityto copy/print it, and (b) agree to use anelectronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.YesClearinghouse ReleaseBy checking the box, I (a) acknowledgethat I have read and understand the aboveand also have been given the opportunityto copy/print it, and (b) agree to use anelectronic signature to demonstrate myconsent. An electronic signature is aslegally binding as an ink signature.YesUser Requested CopyUser requested a copy to be sent to thisemail address abrooks1289@gmail.com.Yes10DISCLOSURE FOR CONSUMER REPORTSIn connection with my application for employment (including contract) with Lazer Spot, Inc., I understand consumer reports will be requested by Lazer Spot, Inc. ("Company"). These reports may include, as allowed by law, the following types of information, as applicable: names and dates of previous employers, reason for termination of employment, work experience, education, accidents, licensure, credit, etc. I further understand that such reports may contain public record information such as, but not limited to: my driving record, CDLIS, workers' compensation claims, judgments, bankruptcy proceedings, criminal records, etc., from federal, state, and other agencies that maintain such records.In addition, investigative consumer reports (gathered from personal interviews, as applicable, with former employers or landlords, past or current neighbors and associates of mine, etc.) to gather information regarding my work or tenant performance, character, general reputation and personal characteristics, and mode of living (lifestyle) may be obtained. If I am hired (or contracted), I understand that Company can use this disclosure and authorization to continue to obtain such consumer reports throughout my employment or contract period. Printed Name:Alexander Jr BrooksSocial Security #:1289Signed Date: 05-30-2024Alexander Jr Brooks645 Sw Troy StreetLake City, FL 32024PHONE NUMBER AVAILABLE11AUTHORIZATION FOR CONSUMER REPORTSI hereby authorize procurement of consumer report(s) and investigative consumer report(s) by Company. If hired (or contracted), this authorization shall remain on file and shall serve as ongoing authorization for Company to procure such reports at any time during my employment or contract period. I authorize without reservation, any person, business or agency contacted by any consumer reporting agency retained by Company to furnish the above-mentioned information. This authorization is conditioned upon the following representations of my rights: I understand that I have the right to make a request to any consumer reporting agency ("Agency") that supplied the report to the Company upon proper identification, to obtain copies of any reports furnished to Company by the Agency and to request the nature and substance of all information in its files on me at the time of my request, including the sources of information, and the Agency, on Company's behalf, will provide a complete and accurate disclosure of the nature and scope of the investigation covered by any investigative consumer report(s). The Agency will also disclose the recipients of any such reports on me which the Agency has previously furnished within the two year period for employment requests, and one year for other purposes preceding my request(California three years). I hereby consent to Company obtaining the above information from such Agencies. I understand that I can dispute, at any time, any information that is inaccurate in any type of report with the Agency by contacting the Agency directly. I may view the Agency's privacy policy at their website. I understand that I can also contact the Company at 6525 Shiloh Rd Suite 900, Alpharetta, GA, PHONE NUMBER AVAILABLE to request information about the nature of any consumer reports or investigative consumer reports supplied by an Agency.Agency Contact Information:HireRightAttn: Consumers Department14002 E. 21st Street, Suite 1200Tulsa, OK 74134PHONE NUMBER AVAILABLEhttp://www.hireright.com/applicantsiiX1716 Briarcrest DriveSuite 200Bryan, TX 77802PHONE NUMBER AVAILABLEAsurintCompliance DeptPO Box 14730Cleveland, Ohio 44114PHONE NUMBER AVAILABLEEmail: EMAIL AVAILABLETenstreet120 W. 3rd StreetTulsa, OK 74103PHONE NUMBER AVAILABLEEMAIL AVAILABLEDriverIQ4500 S 129th E Ave, Suite 127Tulsa, OK 74134PHONE NUMBER AVAILABLEEMAIL AVAILABLE12As a California applicant, I understand that I have the right under Section 1786.22 of the California Civil Code to contact the Agency during reasonable hours (9:00 a.m. to 5:00 p.m. (CTZ) Monday through Friday) to obtain all information in Agency's file for my review. I may obtain such information as follows: 1) In person at the Agency's offices, which address is listed above or, if not listed above, obtained by contacting Tenstreet by phone. I can have someone accompany me to the Agency's offices. Agency may require this third party to present reasonable identification. I may be required at the time of such visit to sign an authorization for the Agency to disclose to or discuss Agency's information with this third party; 2) By certified mail, if I have previously provided identification in a written request that my file be sent to me or to a third party identified by me; 3) By telephone, if I have previously provided proper identification in writing to Agency; and 4) Agency has trained personnel to explain any information in my file to me and if the file contains any information that is coded, such will be explained to me. I understand that if the report is provided to an employer in the State of Washington, that I can contact the following office for more information regarding my rights under Washington state law in regard to these reports: State of Washington Attorney General, Consumer Protection Division, 800 5th Ave, Ste. 2000, Seattle, Washington 98104-3188, (206) 464-7744. Printed Name:Alexander Jr BrooksSocial Security #:1289Signed Date: 05-30-2024Alexander Jr Brooks645 Sw Troy StreetLake City, FL 32024PHONE NUMBER AVAILABLE13IMPORTANT DISCLOSUREREGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Lazer Spot, Inc. ("Prospective Employer"), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration(FMCSA).When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report. When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act. Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report. The Prospective Employer cannot obtain background reports from FMCSA without your authorization. AUTHORIZATIONIf you agree that the Prospective Employer may obtain such background reports, please read the following and sign below: I authorize Lazer Spot, Inc. ("Prospective Employer") to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication. I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above. Printed Name:Alexander Jr BrooksSigned Date: 05-30-202414Consent for Limited Queries of the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol ClearinghouseI hereby provide consent to Lazer Spot, Inc. to conduct a limited query of the FMCSA Commercial Driver's License Drug and Alcohol Clearinghouse to determine whether drug or alcohol violation information about me exists in the Clearinghouse. I understand this consent shall remain on file and shall serve as ongoing consent for Lazer Spot, Inc. to conduct multiple limited queries of the Clearinghouse at any time during my employment or contract period without asking me for additional consent. I understand that if I refuse to provide consent for Lazer Spot, Inc. to conduct a limited query of the Clearinghouse, Lazer Spot, Inc. is required to prohibit me from performing safety-sensitive functions, including operating a commercial motor vehicle. I understand that if the limited query conducted by Lazer Spot, Inc. indicates that drug or alcohol information exists about me in the Clearinghouse, the FMCSA will not disclose that information to Lazer Spot, Inc. unless I give additional specific consent within the Clearinghouse. However, I understand that Lazer Spot, Inc. will be required to conduct a full query of the Clearinghouse within 24 hours after a limited query indicates that drug or alcohol information exists and that if I do not grant consent within the Clearinghouse for that full query I will be removed from performing safety-sensitive functions, including operating a commercial motor vehicle. 05-30-2024Alexander Jr Brooks Date15Pre-Employment Drug Testing Consent And Release Form I hereby consent to submit to urinalysis and/or other tests as shall be determined by Lazer Spot in the selection process of applicants for employment, for the purpose of determining the drug content thereof. I agree that the local lab assigned by Lazer Spot may collect these specimens for these tests and may test them or forward them to a testing laboratory designated by the Company for analysis. I further agree to and hereby authorize the release of results of said test to the Company. I understand that it is the current use of illegal drugs that would prohibit me from being employed at this Company. In addition, a negative and dilute sample constitutes an immediate retest. I further agree to hold harmless Lazer Spot, Inc. and its agents (including the above-named physician or clinic) from any liability arising in whole or part, out of the collection of specimens, testing, and use of the information from said testing in connection with the Companys consideration of my application for employment.I further agree that a reproduced copy of this pre-employment 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. It is also my understanding that if I am not employed by Lazer Spot for more than 90 days, the total cost of the drug screen will be deducted from my last pay check. This includes situations where I falsely lead my employer into believing I had a drug screen when in reality I did not. I will still be charged as though I had one. Printed Name: Alexander Jr BrooksSocial Security #: 1289Signed Date: 05-30-2024Signed:1617Request/Consent for Information from Previous Employer(s)/Carrier(s) For Alcohol and Controlled Substances Testing RecordsAnd changes in Parts 390 and 391 of the FMCSAX 05-30-2024DateX 1289Social Security NumberAlexander Jr Brooks645 Sw Troy StreetLake City, FL 32024PHONE NUMBER AVAILABLEX Alexander Jr BrooksPrint Name (First, MI, Last)XSignatureI, the above mentioned signer, hereby authorize C&t Trucking To release and forward in accordance with the following regulation, all known information pertaining to my alcohol and controlled substances testing/training records to Lazer Spot, Inc.EMPLOYMENT / CONTRACTOR VERIFICATION ACKNOWLEDGEMENT AND RELEASEI hereby authorize my previous employers and trucking schools for the past three years to release and forward to Lazer Spot, Inc.("Company") all information regarding my:1. Record of Alcohol and Controlled Substance Testing/Training, in accordance with Parts 382 and 40 of the Federal Motor Carrier Safety Regulations (49 CFR Part 382 and 49 CFR Part 40, Section 40.25.). I understand that information to be released by my previous employer(s) is limited to the following DOT-regulated testing items: (i) alcohol tests with a result of 0.04 or higher; (ii) verified positive drug tests; (iii) refusals to be tested; (iv) other violations of DOT agency drug and alcohol testing regulations; (v) information obtained from previous employers of a drug and alcohol rule violation; and (vi) documentation, if any, of completion of the return-to-duty process following a rule violation. 2. Record of safety performance history, including employment dates, work history and accidents, in accordance with Part 391 of the Federal Motor Carrier Safety Regulations (49 CFR Part 391). To Be Read And Signed By Applicant For Independent Contractor or Driver Qualification It is understood that the information in this Authorization to Release Information form will be used and that prior employers and trucking schools will be contacted for purposes of investigation as required by Section 391.23 of the Motor Carrier Safety Regulations. It is agreed and understood that Company may investigate the applicant's background to |
