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Independent Contractor Application PDF

Independent Contractor Application PDF

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Published by mbarrientos123
Independent Contractor Application
Independent Contractor Application

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Published by: mbarrientos123 on Sep 10, 2012
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09/10/2012

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IndependentContractor Driver  Application 
Maria J. Barrientos
Vice-PresidentDirector of Safety and Operations
16710 Mandeville CourtSpring, Texas, 77379Tel. 832 797 7672Fax. 832 442 5652maria.barrientos@scheiron.comwww.scheiron.com
 
1
INDEPENDENT CONTRACTOR DRIVER REQUIREMENTS
 
Must be at least 21 years of age and have a valid class “A” CDL, from state of 
residence
 
 
Must have 1 year verifiable experience in the last 3 years, on the equipment they willoperate and an acceptable work history for the past 10 years.
 
 
No more than 2 moving violations in any type of motor vehicle in the last 3 years
 
 
No license suspension/disqualification for traffic convictions within the last 3 years
 
 
No more than 2 license suspensions for non-moving violations
 
 
 A copy of a valid long form physical and medical card performed in the last 12months
 
 
 A DOT drug test with a negative result is required in order for Scheiron Transportation, Inc. to enter into a contractual agreement with IndependentContractor Driver.
 
 
No drug or alcohol (DUI/DWI) related convictions/incidents within the last 5 years.Incidents over 5 years will be reviewed
 
 
No felonies in the past 5 years. Felonies over five years will be reviewed
 
 
No more than 1 preventable accident in the last 3 years
 
 
No contract termination for safety reasons from a previous contractual relationship ordischarge for safety reasons from past employer
 CONTRACT AGREEMENT / SIGN-ON PROCESS
Our goal in the sign-on process is to complete the requirements within the time ittakes to get the drug screen result. An expeditious process is only possible when completeand accurate information is received. The following steps will insure the Independent Contractor Application is processedexpeditiously and accurately:1.
 
Complete the Independent Contractor Application. Make sure all parts of contract/work history are completed and all gaps accounted for.2.
 
MVR, criminal background check, experience/work history will be requested once theapplication is received. Any failure to report information requested or any falsification or willful omission of pertinent facts of information on the Independent Contractor Application is serious and willbe cause for immediate termination of further consideration in establishing a contractualrelationship with Independent Contractor Driver and Scheiron Transportation, Inc.
 
2
Employment Application
Applicant Information
Full Name: Date:
Last First M.I.
 Address:
Street Address Apartment/Unit City State ZIP Code 
Phone: EmailSocial Security No.:
- -
Birth Date:Specialty (Flatbed,Van, etc.): Are you a citizen of the United States?
YES NO
If no, are you authorized to work in the U.S.?
YES NO
Have you ever worked for this company?
YES NO
If yes, when?Have you ever been convicted of a felony?
YES NO
If yes, explain:
Education
High School: Address:From: To: Did you graduate?
YES NO
Diploma:College: Address:From: To: Did you graduate?
YES NO
Degree:Other: Address:From: To: Did you graduate?
YES NO
Degree:

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