Davco Electric

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Employee Application

Please print or type all information except signature.

Davco Electrical Contractors Corp. is committed to the principle of equal opportunity in employment. Davco does not discriminate on the basis of sex, race, color, creed, national origin, age, religion, sexual orientation, gender identity, gender expression, veteran status, or disability in employment.

Education

Type of School	Name of School	Town/State	Years Completed	Degree
High School or GED
College or Trade School
Graduate School

Special Honors:

N/A

Years of Electrical Experience

Military

Are you a veteran of the United States military service? Yes No

If yes, what branch

If yes, Date Entered

Date Discharged

If yes, please describe any special skills or training acquired while in the service:

N/A

Employment History

Give a COMPLETE RECORD of all employment information for at least the past three (3) years to include supervisor, phone number of company, salary history, and reason for leaving (note any time self or unemployed). All commercial driving experience is required for the past ten (10) years. Use an additional Employment History page, if necessary. Incomplete applications will not be considered.

Most Recent Employer	Job Title

Dates Employed From: To:	Salary or Hourly Rate Start: End:
Address:	Reason for Leaving:
Phone Number:	Supervisor:

Were you subject to the FMCSRs while employed here? Yes No

Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and
alcohol testing requirements of 49 CFR Part 40? Yes No

Employer	Job Title

Dates Employed From: To:	Salary or Hourly Rate Start: End:
Address:	Reason for Leaving:
Phone Number:	Supervisor:

Were you subject to the FMCSRs while employed here? Yes No

Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and
alcohol testing requirements of 49 CFR Part 40? Yes No

Employer	Job Title

Dates Employed From: To:	Salary or Hourly Rate Start: End:
Address:	Reason for Leaving:
Phone Number:	Supervisor:

Were you subject to the FMCSRs while employed here? Yes No

Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and
alcohol testing requirements of 49 CFR Part 40? Yes No

Employer	Job Title

Dates Employed From: To:	Salary or Hourly Rate Start: End:
Address:	Reason for Leaving:
Phone Number:	Supervisor:

Were you subject to the FMCSRs while employed here? Yes No

Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and
alcohol testing requirements of 49 CFR Part 40? Yes No

N/A

References

List two (2) professional references, other than family members, who have knowledge of your work.

Name:

Title:

Years Known:

Company:

Phone #:

Address:

Name:

Title:

Years Known:

Company:

Phone #:

Address:

Waivers And Disclosures

Please read each section carefully and sign where indicated.

AT-WILL EMPLOYMENT

It is my understanding that this employment application, or the granting of an interview, does not represent a contract of employment or a promise of future benefits by this organization. I understand and agree that, if hired, my employment will be at-will in nature and may be terminated, with or without cause, at any time, by either myself or my employer. I also understand that this written statement supersedes any and all oral representations made by agents or representatives of this organization.

CERTIFICATION OF TRUTH AND ACCURACY

I certify that the information in this application is true, complete and correct. I understand that false answers, statements, or significant omissions made by me on this form shall be sufficient cause for denial of employment or discharge.

I authorize personal references as well as developed references, other persons, companies, schools, and law enforcement agencies to furnish to Davco and/or its agents or representatives any information they have concerning me.

I understand that if I am employed by Davco I must conform to the rules of Davco. I understand that I may be required to work scheduled and unscheduled overtime and scheduled weekend and holiday work when required by Davco. I understand that no one other than the President of Davco has the authority to make any other agreement.

I understand that I am required to submit to pre-employment drug testing and that post hire I may be subject to drug testing and I agree to such testing. I also understand that I may be required to submit to a medical evaluation. Moreover, I understand that my failure or refusal to undergo such testing is a condition of my employment.

The Immigration Reform Act of 1986 requires that, after employment that employers verify the legal work authorization and identity of all new employees through e-Verify. An offer of employment will depend upon Davco's ability to verify the necessary information.

Additionally, I understand that if I am hired confidential information regarding Davco, and or its customers and employees may be available to me and that this information must not be disseminated or used except for Davco's benefit. If employed, I agree to keep all information about Davco, including such information regarding its business methods, protocols, customers and employees confidential and shall not disclose this information to any unauthorized personnel.

PLEASE SIGN HERE:

Clear Signature

Upload Resume Here: (Allowed file types: .doc, .docx, .pdf)

Date:

Thank you for completing this application form and for your interest in employment with us. Due to the volume of applications received we may not interview every applicant. In the event you are selected for an interview we will contact you.

STEP #1

General Information

Position Applied For:

Date:

Referal Source:

First Name:

Last Name:

Middle Name:

Address:

City:

State:

Zip:

Home Phone:

Home Cell:

Email:

Are you over the age of 18?

If yes, Are you available for full time employment?

Have you ever filed an application here before?

If yes, give date

Have you ever been employed here before?

If yes, give date

Are you currently employed?

If yes, may we contact your employer?

Are you able to submit verification of eligiblity to work in the United Stated?

Employment Desired:

When you are available for work?

What are your salary requirements?

Are you on a lay-off and subject to recall?

Can you travel if a job requires it?

Do you have any relatives who work for Davco? If so, who?

Were you referred by a Davco employee? If so, who?

Please indicate any hours or days you cannot work:

Have you ever been convicted of, or plead guilty or nolo contendere to a crime?

*If the answer to either question is yes, please explain (state the date, type of crime, place of occurrence, disposition)

STEP #2

Education

Type of School	Name of School	Town/State	Years Completed	Degree
High School or GED
College or Trade School
Graduate School

Special Honors:

STEP #3

Years of Electrical Experience

STEP #4

Self Assessment & Certifications

Electric Circuits

Blue Print Reading

Systems (fire, sound, clock, call)

Conduit Installation

Motor Controls

High Voltage/Transformers

Are you an Apprentice?

Did you pass a Journeyman's Exam?

If so, Where? What year?

If so, Where?

Do you have a Lineman Certification or License?

Did you pass a Master's exam?

If so, Where?

Trainings below that you have received and are certified:

First Aid/CPR? If Yes, Expires:

Certified Climber

10 Hour OSHA

30 Hour OSHA

Forklift Certification, Expires:

Arial Lift Certification, Expires:

Backhoe Certification, Expires:

Crane Certification, Expires:

MOT Certified If Yes, please check level:

CDL If Yes, what class?

Have you held the license for at least three years? if no How long?

Other relevant training:

STEP #5

Military

Are you a veteran of the United States military service?

If yes, what branch

If yes, Date Entered

Date Discharged

If yes, please describe any special skills or training acquired while in the service:

STEP #6

Employment History

Most Recent Employer	Job Title

Dates Employed From: To:	Salary or Hourly Rate Start: End:
Address:	Reason for Leaving:
Phone Number:	Supervisor:

Were you subject to the FMCSRs while employed here?

Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?

Employer	Job Title

Dates Employed From: To:	Salary or Hourly Rate Start: End:
Address:	Reason for Leaving:
Phone Number:	Supervisor:

Were you subject to the FMCSRs while employed here?

Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?

Employer	Job Title

Dates Employed From: To:	Salary or Hourly Rate Start: End:
Address:	Reason for Leaving:
Phone Number:	Supervisor:

Were you subject to the FMCSRs while employed here?

Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?

Employer	Job Title

Dates Employed From: To:	Salary or Hourly Rate Start: End:
Address:	Reason for Leaving:
Phone Number:	Supervisor:

Were you subject to the FMCSRs while employed here?

Was your job designated as a safety-sensitive function in any DOT- regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?

STEP #7

Driving History (Only for positions which require driving)

Do you have a driver’s license?

State of issue:

Expiration date:

States I've held a DL in the last three years

Class

Vehicles I have Operated:

Have you had any accidents during the past three years? How many?

Have you had any moving violations during the past three years? How many?

List any accidents and/or Moving Violations in the past seven years here:

1. Violation/Accident Description:

Date:

2. Violation/Accident Description:

Date:

3. Violation/Accident Description:

Date:

COMMERCIAL DRIVERS (CDL) ONLY

The following questions are required by the US DOT, pursuant to 49 CFR part 40.25. In the last three years have you, for DOT-regulated testing:

1. Had an alcohol tests with a result of 0.04 or higher?

2. Had verified positive drug test?

3. Refused to be tested for drugs or alcohol?

4. Did you have other violations of DOT drug and alcohol testing regulations?

5. Did a previous employer report a drug and alcohol rule violation to you?

6. Is your Medical Card and License current?

7. If you answered “yes” to questions 1-5, did the you complete a SAP and return-to-duty process?

STEP #8

References

List two (2) professional references, other than family members, who have knowledge of your work.

Name:

Title:

Years Known:

Company:

Phone #:

Address:

Name:

Title:

Years Known:

Company:

Phone #:

Address:

STEP #9

Waivers And Disclosures

Please read each section carefully and sign where indicated.

AT-WILL EMPLOYMENT

CERTIFICATION OF TRUTH AND ACCURACY

SIGN:

Resume:

Date:

Services

Others

Contact Us

4885 Park Ridge Blvd.
Boynton Beach, FL 33426-8316
Phone: (561) 732-3434
Fax: (561) 732-3414

Email Us

State License: FL, EC-673 | GA, EN-215361

Davco Electric

Davco Electric

Davco Electric

Davco Electric

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General Information

Education

Years of Electrical Experience

Self Assessment & Certifications

Please check the training below that you have received and are certified:

Military

Employment History

Driving History (Only for positions which require driving)

List any accidents and/or Moving Violations in the past seven years here:

COMMERCIAL DRIVERS (CDL) ONLY

References

Waivers And Disclosures

General Information

Education

Years of Electrical Experience

Self Assessment & Certifications

Trainings below that you have received and are certified:

Military

Employment History

Driving History (Only for positions which require driving)

List any accidents and/or Moving Violations in the past seven years here:

COMMERCIAL DRIVERS (CDL) ONLY

References

Waivers And Disclosures

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