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| | Click here or scroll down to respond to this candidateExxact Transport, Inc.Street Address Street Address
Lakeland, FL Street Address
PHONE NUMBER AVAILABLEStreet Address -18-2020 9:26:40AM CDTIntelliAppThank you for your interest in Exxact Transport, 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.Personal InformationName Cynthia Andrea CorneliusResidence 3 years or longer (If No,previous addresses shown below)YesCurrent Address 1328 Josephine CtCity, State/Province Zip/Postal Sebring, FL 33875Country United StatesResidence 3 years or longer (If No,previous addresses shown below)YesSSN/SIN 2037Date of BirthPrimary Phone PHONE NUMBER AVAILABLECell Phone PHONE NUMBER AVAILABLEPreferred method of contact Primary PhoneBest time to contact you AnyEmail EMAIL AVAILABLEYes, I want to receive information andcommunications from Exxact Transport,Inc. concerning future opportunities orpromotions.YesWould you like to receive communicationfrom Exxact Transport, Inc. via textmessage?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. YouYes1may opt out at any time by texting STOP tounsubscribe. You also agree that ExxactTransport, Inc.'s service provider receivesin real time and logs your text messageswith Exxact Transport, Inc..Company QuestionsGENERAL INFORMATIONWhat position are you applying for? Driver for Owner Operator If you answered "Owner Operator", selectyes.NoEQUIPMENT (OWNER/OPERATORS ONLY)Equipment Description (Tractor):Type:Year:Make:Model:VIN:WeightMileageWhat location are you applying for? Lakeland, FLAre you legally eligible for employment inthe United States?YesAre you currently employed? YesWhat date did your last employment end?Do you read, write, and speak English? YesHave you ever worked for this companybefore?NoEnter start and end dates, location,position, and reason for leaving:Do you have a current TWIC card? NoExpiration date:Please enter the names of any relativesemployed here:Have you ever been known by any othername?NoEnter name:Were you referred by a driver? Yes2Please enter driver's name: Leonard FaisonHow did you hear about us? OtherIf "Other", please explain: Leonard FaisonIn case of Emergency, notify (list name,address, and phone):Brenda Wilson 1328 Josephine Court,Sebring, FL 33875PHONE NUMBER AVAILABLEDRIVING EXPERIENCEPlease select your amount of Tractor andSemi-Trailer experience:1 - 3 yearsIf you have other driving experience,please list the type of equipment andapproximate length of driving time for eachtype:Which safe driving awards do you hold andfrom whom?EDUCATIONList highest grade completed: High School DiplomaList last school attended (name, city, andstate):South Florida state collegeLicensesLicense Number 520State/Province FLCountry United StatesLicense Class Class ALicense Expiration Date 02-12-2027Physical Expiration Date 02-26-2020Current License YesCommercial Driver License YesEndorsements NoneEmployment / UnemploymentDVL Express IncCompany DVL Express IncStart Date 02-2020End Date 03-2020Address 2064 West 167th St.3City, State/Province Zip/Postal Markham, IL 60428Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held Temp team driver with boyfriendReason for leaving? Looking for permanent workWere you terminated/discharged/laid off? NoIs this your current employer? YesMay 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 48 statesMiles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer VanTrailer length 53 feet or moreTurf care - sunshine staffingCompany Turf care - sunshine staffingStart Date 07-2019End Date 01-2020Address 4200 Webster turner drCity, State/Province Zip/Postal Sebring, FL 33875 Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held Local DriverReason for leaving? Temporary assignmentWere you terminated/discharged/laid off? NoIs this your current employer? NoYes4May we contact this employer at this time?Did 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 LocalMiles driven weekly 0-500Pay Range (cents/mile)Most common truck driven Yard HorseMost common trailer VanTrailer length 53 feet or moreJohn Christner TruckingCompany John Christner TruckingStart Date 10-2018End Date 06-2019Address 19007 W HIGHWAY 33City, State/Province Zip/Postal Sapulpa, OK 74066Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held OTR driverReason for leaving? Need to get local jobWere 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?YesYes5Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?Areas DrivenMiles driven weeklyPay Range (cents/mile)Most common truck driven Tractor-TrailerMost common trailer Reefer TrailerTrailer length 53 feet or moreWestern ExpressCompany Western ExpressStart Date 06-2018End Date 10-2018Address 7135 Centennial PlaceCity, State/Province Zip/Postal Nashville, TN 37209 Country United StatesPhone PHONE NUMBER AVAILABLEFax PHONE NUMBER AVAILABLEPosition Held OTR driverReason for leaving? Better jobWere 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?YesDid you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?YesAreas Driven All 48Miles driven weekly 2500-3000Pay Range (cents/mile)Most common truck driven Tractor-Trailer6Most common trailer VanTrailer length 53 feet or moreUnemploymentStart Date 05-2018End Date 05-2018CommentUnemploymentStart Date 12-2016End Date 02-2018Comment Drove over the road with Andrew riding inthe truck and assisted with all paperwork,coupling and uncoupling trailers, Gpsdirections, etc.UnemploymentStart Date 02-2016End Date 01-2018Comment Drove over the road as a passengerUnemploymentStart Date 02-2016End Date 12-2016CommentSoutheast claims serviceCompany Southeast claims serviceStart Date 01-2004End Date 02-2016Address 2 Au SoleilCity, State/Province Zip/Postal Boynton Beach, FL 33435 Country United StatesPhone PHONE NUMBER AVAILABLEPosition Held Admin asstReason for leaving? Owner retiredWere you terminated/discharged/laid off? NoIs this your current employer? NoMay we contact this employer at this time? YesNo7Did you operate a commercial motorvehicle?Were you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while employed/contracted bythis employer/contractor?Did you perform any safety sensitivefunctions in this job, regulated by DOT,and subject to drug and alcohol testing?Areas DrivenMiles driven weeklyPay Range (cents/mile)Most common truck drivenMost common trailerTrailer lengthTrucking SchoolStart Date 02-2018End Date 04-2018School South Florida State CollegeCity, State/Province Avon Park, FLCountry United StatesPhone PHONE NUMBER AVAILABLEDid you graduate? YesWere you subject to the Federal MotorCarrier or Transport Canada SafetyRegulations while attending this truckschool?NoDid you perform any safety sensitivefunctions at this truck school, regulated byDOT, and subject to drug and alcoholtesting?NoGPA 4.0Hours of Instruction 200Border Crossing NoLog Books YesFederal Motor Carrier Regulations YesHazardous Materials Yes8FMCSRUnder FMCSR 391.15, are you currentlydisqualified from driving a commercialmotor vehicle? [49 CFR 391.15]NoHas your license, permit or privilege todrive ever been suspended or revoked forany reason? [49 CFR 391.21(b)(9)]NoHave you ever been denied a license,permit, or privilege to operate a motorvehicle?[49 CFR 391.21(b)(9)]NoWithin the past two years, have you testedpositive, or refused to test, on apre-employment drug or alcohol test by anemployer to whom you applied, but did notobtain, safety-sensitive transportation workcovered by DOT agency drug and alcoholtesting rules? [49 CFR 40.25(j)]NoIn the past three(3) years, have you everbeen convicted of any of the followingoffenses: [49 CFR 391.15]:Driving a commercial motor vehiclewith a blood alcohol concentration("BAC") of .04 percent or moreDriving under the influence ofalcohol, as prescribed by state lawRefusal to undergo drug andalcohol testing as required by anyjurisdiction for the enforcement ofFederal Motor Carrier Safety ActregulationsDriving a commercial motor vehicleunder the influence of any 21C.F.R. 1308.11 Schedule Iidentified controlled substance, anamphetamine, a narcotic drug, aformulation of an amphetamine, ora derivative of a narcotic drugTransportation, possession, orunlawful use of a 21 C.F.R.1308.11 Schedule I identifiedcontrolled substance,amphetamines, narcotic drugs,formulations of an amphetamine, orderivatives of narcotic drugs whileyou were on duty driving for amotor carrierLeaving the scene of an accidentwhile operating a commercial motorvehicleOr any other felony involving theuse of a commercial motor vehicleNo9Vehicle Accident RecordWere you involved in any accidents/incidents with any vehicle in the last 3 years (even if not at fault)?Type of Accident / Incident Non-InjuryDate of Accident / Incident 01-2020Hazmat Accident / Incident NoWas the vehicle towed away? NoCity VersaillesState/Province KYWere you in a commercial vehicle? YesIf yes, was this a Department ofTransportation recordable accident?NoWere you at fault? NoWere you ticketed? NoDescription another Driver in personal vehicle hit the rear corner back of my trailer. Caused nodamage to the trailer. little damage to therecar. Received no ticket.Traffic 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? YesComment 2004 for drug parafanaliaDo 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 No10"guilty" to, been convicted of, hadprosecution deferred in connection with, orpled "no contest" to a misdemeanor?SignatureFull Name Cynthia Andrea CorneliusIP Address PHONE NUMBER AVAILABLESignature Date/Time 03-18-2020 9:26 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.Signed Date: 03-18-2020 9:26 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.Yes11Additional 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 Disclosure and 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.YesSummary of Rights Under 15 U.S.C. Section 1681m(a) By checking the box, I (a) acknowledgethat I have read and understand theSummary of Rights Under 15 U.S.C.Section 1681m(a) and have been giventhe opportunity to copy/print the 1681mSummary of Rights and (b) agree to usean electronic signature to demonstrate myconsent. An electronic signature is asYes12legally binding as an ink signature.User Requested CopyUser requested a copy to be sent to thisemail address cdlcindyc@gmail.com.Yes13DISCLOSURE AND AUTHORIZATION REGARDING BACKGROUNDINVESTIGATION FOR EMPLOYMENT PURPOSESDisclosuresExxact Transport, Inc. (the "Company") may request from a consumer reporting agency and for employment-related purposes, a"consumer report(s)" (commonly known as "background reports") containing background information about you in connection with your employment, or application for employment, or engagement for services (including independent contractor or volunteer assignments, as applicable).HireRight, LLC ("HireRight") will prepare or assemble the background reports for the Company. HireRight is located and can be contacted at 3349 Michelson Drive, Suite 150, Irvine, CA 92612, (800) 400-2761, www.hireright.com. The background report(s) may contain information concerning your character, general reputation, personal characteristics, mode of living, or credit standing. The types of background information that may be obtained include, but are not limited to: criminal history; litigation history; motor vehicle record and accident history; social security number verification; address and alias history; credit history; verification of your education, employment and earnings history; professional licensing, credential and certification checks; drug/alcohol testing results and history; military service; and other information. AuthorizationI hereby authorize Company to obtain the consumer reports described above about me. Printed Name:Cynthia Andrea CorneliusSocial Security #:2037Signed Date: 03-18-2020Cynthia Andrea Cornelius1328 Josephine CtSebring, FL 33875PHONE NUMBER AVAILABLEGender:14IMPORTANT DISCLOSUREREGARDING BACKGROUND REPORTS FROM THE PSP Online Service In connection with your application for employment with Exxact Transport, 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 Exxact Transport, 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:Cynthia Andrea CorneliusSigned Date: 03-18-202015Consent for Limited Queries of the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol ClearinghouseI hereby provide consent to Exxact Transport, 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 Exxact Transport, 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 Exxact Transport, Inc. to conduct a limited query of the Clearinghouse, Exxact Transport, 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 Exxact Transport, Inc. indicates that drug or alcohol information exists about me in the Clearinghouse, the FMCSA will not disclose that information to Exxact Transport, Inc. unless I give additional specific consent within the Clearinghouse. However, I understand that Exxact Transport, 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.03-18-2020Cynthia Andrea Cornelius Date16OTHER DISCLOSURES, ACKNOWLEDGMENTS & AUTHORIZATIONS REGARDING BACKGROUND INVESTIGATION FOR EMPLOYMENT PURPOSES DisclosuresInvestigative Consumer Report:Exxact Transport, Inc. (the "Company") may request an investigative consumer report about you from HireRight, LLC ("HireRight"), a consumer reporting agency, in connection with your employment, or application for employment, or engagement for services(including independent contractor or volunteer assignments, as applicable). An "investigative consumer report" is a background report that includes information from personal interviews (except in California, where that term includes background reports with or without information obtained from personal interviews), the most common form of which is checking personal or professional references through personal interviews with sources such as your former employers and associates, and other information sources. The investigative consumer report may contain information concerning your character, general reputation, personal characteristics, mode of living, or credit standing. You may request more information about the nature and scope of an investigative consumer report, if any, by contacting the Company.Ongoing Authorization:If the Company hires you or contracts for your services, the Company may obtain additional consumer reports and investigative consumer reports about you without asking for your authorization again, throughout your employment or your contract period, as allowed by law.Additional State Law Notices:Please see the "Additional State Law Notices" for California, Massachusetts, Minnesota, New Jersey, New York, and Washington that are provided below, as applicable. A California disclosure and summary of your rights under California Civil Code Section 1786.22, and a copy of New York Article 23-A, are being provided to you separately. Summary of Rights under the Fair Credit Reporting Act: A summary of your rights under the Fair Credit Reporting Act is being provided to you separately. San Francisco Fair Chance Ordinance Official Notice: A copy of the San Francisco Fair Chance Ordinance Official Notice is being provided to you separately. HireRight Privacy Policy:Information about HireRights privacy practices is available at www.hireright.com/Privacy-Policy.aspx. Acknowledgments & AuthorizationI acknowledge that I have received and carefully read and understand the separate "Disclosure and Authorization Regarding Background Investigation for Employment Purposes"; and the separate "Summary of Rights under the Fair Credit Reporting Act" that have been provided to me by the Company. I also acknowledge receipt of and that I have carefully read and understand (as applicable), the separate California Disclosure and Summary of Rights under California Civil Code Section 1786.22; the separate New 17York Article 23-A; and the separate San Francisco Fair Chance Ordinance Official Notice that have been provided to me. By my signature below, I authorize the preparation of background reports about me, including background reports that are"investigative consumer reports" by HireRight, and to the furnishing of such background reports to the Company and its designated representatives and agents, for the purpose of assisting the Company in making a determination as to my eligibility for employment or engagement for services (including independent contractor or volunteer assignments, as applicable), promotion, retention or for other lawful employment purposes. I understand that if the Company hires me or contracts for my services, my consent will apply, and the Company may, as allowed by law, obtain from HireRight (or from a consumer reporting agency other than HireRight) additional background reports pertaining to me, without asking for my authorization again, throughout my employment or contract period. I understand that if the Company obtains a credit report about me, then it will only do so where such information is substantially related to the duties and responsibilities of the position in which I am engaged or for which I am being evaluated. I understand that information contained in my employment (or contractor or volunteer) application, or otherwise disclosed by me before or during my employment (or contract or volunteer assignment), if any, may be used for the purpose of obtaining and evaluating background reports on me. I also understand that nothing herein shall be construed as an offer of employment or contract for services.I understand that the information included in the background reports may be obtained from private and public record sources, including without limitation and as appropriate: government agencies and courthouses; educational institutions; and employers. Accordingly, I hereby authorize all of the following, to disclose information about me to the consumer reporting agency and its agents: law enforcement and all other federal, state and local government agencies and courts; educational institutions (public or private); testing agencies; information service bureaus; credit bureaus and other consumer reporting agencies; other public and private record/data repositories; motor vehicle records agencies; my employers; the military; and all other individuals and sources with any information about or concerning me. The information that can be disclosed to the consumer reporting agency and its agents includes, but is not limited to, information concerning my: employment and earnings history; education, credit, motor vehicle and accident history; drug/alcohol testing results and history; criminal history; litigation history; |