Consent to Drug Testing
CONSENT FOR PRE-EMPLOYMENT, RANDOM, OR REASONABLE SUSPICION DRUG TEST SCREEN AND RELEASE COVENANT NOT TO SUE AND INDEMNITY AGREEMENT.
I hereby CONSENT to allow any medical center retained by Utility One Services, LLC to take a specimen of my hair, urine, or blood and submit it for a pre-employment, random, or reasonable suspicion drug test screen at any point in the pre-employment or employer-employee relationship. I FURTHER CONSENT to allow the laboratory testing service to make the results of such screen available to the prospective or current employer, Utility One Services, LLC.
In consideration for such services being rendered on my behalf, I hereby RELEASE the laboratory testing service, its officers, agents, and employees, from any and all claims which I might otherwise have due to such results being made so available. I hereby CONSENT NOT TO FILE ANY ACTION at law or in equity against Utility One Services, LLC, the laboratory testing service, their respective officers, agents or employees in connection with the results of such screen being made so available, and I hereby agree to INDEMNIFY and SAVE HARMLESS Utility One Services, LLC, the laboratory testing service, their respective officers, agents, and employees from all damages, expenses, reasonable attorney's fees, and costs of court which they or any of them may suffer or incur, jointly or severally, due to the results of such screen being made so available.
Authorization & Signature
I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in said documents will be cause for denial of employment or immediate termination of employment regardless of the timing or circumstances of discovery.
I understand that submission of an application does not guarantee employment. I further understand that, should an offer of employment be extended by Utility One Services, LLC that such employment is at will, for no specified duration and may be terminated by either Utility One Services, LLC or myself at any time, with or without cause or notice. I understand that none of the documents, policies, procedures, actions, and statements of Utility One Services, LLC or its representatives used during the employment process is deemed a contract of employment real or implied. I understand that no representative of Utility One Services, LLC except the owner has the authority to enter into any agreement guaranteeing any conditions of employment or any agreement contrary to the foregoing statements and that any such agreements must be made in writing and signed by the owner of Utility One Services, LLC.
In consideration for employment with Utility One Services, LLC, if employed, I agree to conform to the rules, regulations, policies and procedures of Utility One Services, LLC at all times and understand that such obedience is a condition of employment. I understand that due to the nature of Utility One Services, LLC business, attendance and punctuality are considered essential requirements of every job at Utility One Services, LLC and that poor attendance or tardiness will result in disciplinary action, up to and including termination.
I understand that if offered a position with Utility One Services, LLC, I may be required to submit to a pre-employment medical examination, drug screening, driving record and background check as a condition of employment. I understand those unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of these pre-employments tests and checks will result in withdrawal of any employment offer or termination of employment if already employed.
I herby authorize any and all schools, former employers, references, courts and any others who have information about me to provide such information to Utility One Services, LLC and/or any of its representatives, agents or vendors and I release all parties involved from any and all liability for any and all damage that may result from providing such information.
I understand that this application is considered current for three months. If I wish to be considered for employment after this period I must fill out and submit a new application.
BY SIGNING BELOW I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE STATEMENTS.
