HBC TRANSPORTATION INC Hiring checklist for applicant 11. Application form (Physical) ‘a. Application for Employment [Page 1105 b._ Driver certificate of violations | Page 6 ©. Driverstatement of on-duty hours | Page 7 d. Hours of Service Test [Pagestoo . fe. Memo Signoff [ Page 10to 17 Information for insurance | Page 18, &- Health and Dental EDGE Form | Page 19 2. Application form (Online) | Page 20 to 22 (Instructions) 3. CVOR (Commercial Vehicle Operator Record) 4, MVIR (3/5 Year Driver Record) 5. Driving License 6. Passport 7. Other ID (PR Card, FAST Card, Work Permit, Indian Status Card etc) & MELT Certificate 9. Transcript Document 110. Certificate of incorporation (Complete set of your business documents f applicable) 111. GST/HST Number of your incorporation (applicable for Company Drivers only) 12, Police Clearance Certificate (Recelpt if report Is pending) 13. Drug Test Report (Receipt f report Is pending) 14, Experience letter issued by your previous employer(s) Note: ‘© Sr. No. 3, 4—The date on the abstract should be NO earlier than 30 days of submission of physical application form. © Sr.No. 8, 9 ~ Document issued by your driver training school. information required if applicant has less than 2 years of verifiable and continuous driving experience on AZ/Class 1 license. Sr. No. 12, 13 For more information, please refer to www.truckworidmcl.com ‘Regarding Police Clearance Certificate (PCC) and Drug Test, please refer to below table: Driver Css] Drug Test Pace Clearance Gy (Loca No No Canada No No |Yes (If FAST card not available) Manet = No (if FAST card avalable)east Phone Tost ‘canrtenet__} * Current Address, an : ‘Bieet cay ‘Sis “*tettnachove restence toe than Ovo yor, tet below olrexgencoa fart postewes youn. Auch a separa cheettfeecessay. « “Aew you curontiy omployod?___st ct, how tone ein tating tae emptoynont? ‘A. Have you over dontod a Beanse, parm or plage to oporiio a mstor wohile? YES_ NO__ ‘Hyes, oxptatn, ' Hes eny feonso, porn or page over boon suapénded er roveknd? YES NO, ttyes, exptan : eoveanton Circe ighestgrade complet 123466780 101112 — comog 1 234 Lost echoc!etonded 1: (DRIVER EXPERIENCE AND QUALIFICATIONS ‘Tha Fedor Meter Carter Guty Requisiora UOCFRSO1.2 () (2) reqs tat ver ppcents ean ar daa ef bth and 68. Dato ofBith______ ‘Social Secutty Number "montivdayiyeqr--, ALOGHCL AND CONTROLLED SUBSTANCE STATEMENT ol wt Sor a eaten : Jesmmarcial ‘a ror ca sy tocar OPED gn pone gr ag pan ig Wahi the last two yours, | ba | rteated positive, of refused to | pre-employment drug ot alcohol tact Sense am erga wh You ed, Ps ot et sone Seer rec ae) Vet no ato year, hap you oor ated pote or refed io tt, onary ype TAG! et eared yan employer fer tach you prone eaoy.esave oo ae - 3} ttyou answared yos to other 1 er 2 above, can: andlor obtain have euccesetily completed tho Quy yoo Zeon, con you proto proof that you — Aelicants Signatur: Date, + Rianneed EY Date: DRIVER'S LOENDE IitrORMATION conse Nanter Tye xptation Dato ‘A+ Havo you avor boon dented a Goonse, ponnit er privings to operata.n motor vahicis? = = Yex___No __ 8. Han ony Geaneo, pom r peviage ovr been euapendes o rook? Yeu . Have you over been dlsquaiied for vietations of Federal Motor Cantor Safety Reguistions?: Uyetemand Yor AB Gy esos aan gang oe, tae ‘ORIVO EXPERIENCE (toes of eatprnont ‘Typoot ates Approximate : (Won, Tank, Pit ota) Prom To ‘Total Mies" (Straight Teuck, —— ‘Tresor and Sont-Trator win =— Ober Ust cttos eparated tn dung tho tet vo years: ‘Uist postal courses or training that wl holp you as a iver: Lsteata diving awards ald end who ewarés wero preanted by: ——DRIVER EXPERIENCE AND QUALIFICATION (oontinued) ‘AcowmerastoRY ‘Accident Review fr tho past 8 youre (xtiach a separate choot of paper if mare epaco ie needod), Dato ‘Natu of Acidont . (Woadon Rants Upon os) @Fcitiog —@intutes © @Vehkton Towed Chon teound? : SMOTOR VEHIOLE DRIVING RECORD GAVE + Traffic Convictiona and Forfottures forthe paat 3 years other than parking vitations, Dato Location cage *__ Panaty EMPLOYMENT RECORD - Be Fo ets Cue Sut Regan, 21 roi th eps wing on snarl ey ot ‘idlyere escteutemn Tyo teceacea an Moroes Stat wih tho last or caveat and work back (iach soparta chest tf bacnnuty) You eo rogue tet the copa nang oddone cbt nantes ey, cao and a coco Curest erployer, Supervoors Name! ‘Addex Prose ( +, Poslion Ri Feta a. sa Ronson er Leaving. Proviown Employer, Supervoers Nome Aatnos, Phoos: (—T. Penton HE To— Mo. ni. iy, Reason for Lean Pravin Emetayer, Suparors Names een Fr Fie, an rm ——s rc ‘Maas Fe, eaten for Lear Previous Erplayer uperare None Paste eosin Fa _—— "Fo ot Ronson for Leaving ‘Supervisors Name =< Phos , From _To_ Mo, nvr. alay,APPLICANT MUST READ AND SIGN .‘MOTOR VECHICLE DRIVER'S CERTIFICATION OF VIOLATIONS/ANNUAL REVIEW OF DRIVING RECORD CARER HSTUTIONS: sch ct cat ht eos ons oy tm mech es prepare and Eee aso etait a cist ear a ra con oe cet eft ea benign oe fag png Stay bres eo har pode inser isecan SR en cerepa een oO DRIVER REQUIREHENTS: Each ever chal fumtshtho Baten oqutod by the motor canter above Hf te chver bas nt been convicted ct, bend ee ofoha chal cay atta ing ares i cee kona vog z (provided under Part 263) i hatebs cose feted bod ores tg part tes DATE Orme LOCATION ‘TWPE CF VERICLE OPERATED yeu have had no visions, check the ellowing box-C] ena) : SS Hoo victations ere ated ehovo; Leary thet | have not been comcted or forfeted bond or oellsiora en account of any violation ondor Part 38) required to be Distod curing tho past 12 months, . aa nna {Seem qc fora ig leagues to ctve a meter vehico prsumnt to Docs nat adequately mec sataactry ou ding portance ‘atin aan wth ever, Reviewed | St nn a EERE Safety & ComplianceDRIVER STATEMENT OF ON-DUTY HOURS @or Newly Hired Driver) INSTRUCTIONS: otrcatas, wn wang diver forth fst tine, must ota om tho diver a giving the total on- day during the immediately receding cen ya nd ha ine of hh ve we et dim daypisetns ‘work for the carter, as required by section 395.8 (2) of the Fodarel Motar Canter Safety Say compensa wo ig tis rong” ayo wer or nowt eae eal, mtb revoke ca ‘This foom should Fiat scl be comptod on the yt divers acto to begin ving commer mote eis, and mast ‘Dever Name (Print). ‘Banployee Ed Number by cei hatin gen shovel coret ton best of ny known ed bated tat Ts AM. ee =—" a a —— et Bas ap ia se he Wodag fir er cape ‘Ths hain far ay tas ead a Be and () of tha Fede! Motar Canter Sfety Regulations, iclates tine performing any other war inthe copacty of or inthe employ or service ‘of acommne, contrat er pvt mata canter, also = ' working for another employer? ott ‘Arts tan dal werk fr another ill is : you intend to employer | \eanployed by vet tat the nfmtion gen above stro aI undentand that came become employed wih his company, Heder any adttanal employer() for [eters emotion is coupcy imate a” i Bae wns, Sag Rapes 7 Darina Cecelia Hoop he‘Bours of Service Test (For Canada) Note: Tick the appropriate answer (all questions are mandatory) 1. All time spent behind the whee! is considered driving time. BP ee on - spge f Bese £ : a i . 7 8 a g i i i peer 8 i Drivers must ensure that the ts always updated and property tard tothe lt change ofa Sian Tr. b False rs7. Your health doem’t play a part in the safe operation of « commercial motor vehicle, a b ‘True: Fabso 8. Genorally, most adults need how many hours of uninterrupted sleep to feel well-rested. Check,HBC TRANSPORTATION INC Terms of Engagement 1. Payout a. Single will be pald @ 60c/mile + HST b. Team will be paid @ 30c/mile + HST Any extra pickup/delivery, driver will be paid 60 CAD (Single) and 30 CAD (Team) d. Any Canadian pickup/delivery, driver will be paid 60 CAD (Single) and 30 CAD (Team). . Any clean inspections, driver will be pald CAD 50 (single/tear). 2, Any parking related violations to be pald by the driver. 3. Any violation/vehicle damages/traffic related incident to be reported to HBC office immediately. (Any failure to inform on such events to the HBC office may result in disciplinary action ‘amounting to fine, and/or driver bearing repair charges and/or may also lead to termination of services as deemed appropriate by the management of the company) 4, Any vehicle if found not to be clean from inside at the time of return (yard parking), the driver ‘will have to pay for the shampoo/cleaning expenses. Note ~All monetary figures are in CAD Signed and agreed, Name of Applicant ‘Signature of Applicant Date 73 Commodore Dr, Brampton, ON, LEXOT4 | (416)-948-5054 loHBC TRANSPORTATION INC PRE-TRIP INSPECTIONS Please be informed that any defects found when a trucks operation must be recorded on the trip Inspection report as required by the law and informed to the safety department immediately. + Tels unsafe dveavehice wlth defects andi the responsi ofthe dvr “porensiire-heiotishe:ls operating safe equipment’s at all times. By signing below you agree to comply the above rules. Drivers Signature Print Name Date. ‘73 commodore Dr, Brampton, ON L6XOT4 Contact: 416-948-5054 "HBC TRANSPORTATION INC Hand-held devices while driving. ‘Ontario’s ban on hand ~held devices while driving has taken effect as of February 2010. ‘The new law will make it illegal for drivers to talk, text, type, and dial or email ee entertainment devices. Using a hands-free device is permitted as long ds thie device Is: Placed securely‘i-or mount the motor vehicle so that it does not move while the vehicle sin motion and the driver can see It at quick glance and easily reach It ‘without adjusting his or her driving position. For.example, {t could be secured ina cell phone holster, placed in the vehicle’s cup holder, or fastened to the dashboard, Wt should not be sitting unsecured on the passenger's seat. By signing below you agree to comply the above rules. 73 commodore Dr, Brampton, ON LEXOT# Contacts#16-948-5054HBC TRANSPORTATION INC FATIGUE DRIVING ‘We acknowledge many safety risk associated with Driver Fatigue. Consequently the Safety management has developed the following. ZERO TOLERANCE ‘Effective immediately: No driver shall:operate any equipment for or on behalf of the Company while he orshe's in a fatigue state. Ifa drivers in such Fatigued state, he or she shall contact the dispatch Immediately and take rest.HBC TRANSPORTATION INC HOURS OF SERVICE RULES © Drivers must ensure that the dally og ls always updated and properly recorded to the Orcs nt eras hat ey reaps toll fuel/ Border crossing décuments is . ensure jon the-drlver log and original or coples of the recelpts are left n the ‘trip envelopes for compliance reasons. CANADIAN RULES: © 7OHoursin7 dayscyde . Bahomrdl"oadeg tae 2 bent coon ff pb att Drivers: mustihave no Dreers must have 36 hours “off-duty” for 70 hour Note: Canadian értcors mast in cdmpliance with the U.S HOS before entering ln the United States ee USA~PROPERTY CARRYING RULES ‘ToHours In 8 days oye car ‘© 21. Hours of driving time — after 10 consecutive hours off : ‘1hoursef straight of duty. + CHANGES TO US HOS EFFECTIVESULY 2.2013, . Tatton OF DF bee heat NOTE: Conadion drivers most take 36 hours reset to comply with Canadian Hours of Service, Drfvers Name DriversSignature =. Date, ‘73 commodore Dr, Brampton, ON L6XOT¢ Contact: 416-948-5056 4HBC TRANSPORTATION INC important Information Concerning U.S. Country Wide Policy Regarding Alcohol and Commercial Motor Vehicle Por section 582.5 ofthe Federal Motor Carter Sefety Reguiations, the U.S, has a ZERO TOLERANCE policy regarding acolc! in a commercial motor vehite. This means the folowing: 1. Drivers aie forbidden to use or possess slcohol at any time in a commercial motor vehicte, * 2 Alcohol cannot be amnethare on or tn 2 commercial vehicle. It does not matter Ifthe ‘lcohol is sealed, cut of reach of the driver, or in the tratier, a Tere espns purse of kal et ty fon fie tye ty on US. sol of tf purchased tn Canada for export tothe US. the afeoho! restriction sil 4 Overman ety ar pete commana meter vse thay beset wth tnthe past ours. S. Thesame nies apply toany workers, passenger, or co-drivers transported ina commercial motor vehide, (Consequences of vislating these nutes inetude the following, 11 Devers placed out of service and cannot move the truck for 24 hours. 2. Devers toed atchet by few anforcoment( amount vartes by hursdction) 3, Outof sence inspection impacts Companys Safestat score which can lead to compliance ‘reviews and higher insurance premiums. 4 Enforcement ction can be taken against company through an onsite compilance review. This ‘can Include fines or suspension af a company’s ability to operate. sone) nis Pere terra ‘Retell panexsd er sad by passer ef obser. ‘Tea no eg sed so omscrd” vl ed stl tr ven fer perl oan (eager tg 8 trecerwthet testo it tote spree treeperttea) For mora tformaton soa 3025 of ts neitiot wmafinesndetaoy ‘The consequences are not worth the risk — Do Not operate in the U.S. with alcoho! Orivers Name Drivers Signature Date 73 commodore Dr, Brampton, ON L6XOT¢HBC TRANSPORTATION INC DRIVER ACKNOWLEDGEMENT ‘L RECEIPT / REVIEW / UNDERSTANDING OF MANUAL Weme_ Ce \ hereby acknowledge receipt of my Professional Driver's Manual. | hove read is contents, Junderstond ta cummaion provided and Ihave had the cppertettyto ack questions concerning the contents of \ agree to shide by the company polices and procedures descrited inthis manval, Furthermore, 1 understand the possible penalfes for viteton of company polices, procedures and guidlines. cect (2 RECEIPT OF ITEMS ASSIGNED Uhereby: of the thems }to me, and 11 temintoncfryearececs HBC Transportation ine. starageese De ine. mayhotd beck my final settioment, pending thelr receipt: PLEASE CHECK, AS APPLICABLE: Diop ercte, yard other) D crete conts Clrunning authorty Book and Permits O stretuto ‘Stgnature:, ‘Signatures rtvar Company Ofital 73 commodore Dr, Brampton, ON L6X0T¢HBC TRANSPORTATION INC ‘SPEED LIMITS ‘The company's madmum speed limit is 160 Kesh Ao tines eter he pated sn ator th corgny Et tb eesti rat al times operate their vehices at speeds that are reasonable and prusent, taking Into “consideration traffic, weather, and road conditions. When traveling mare slowy that the general (afc low, such ag when cling long hills, four-way flashers are to be used, ‘By signing below driver ednowtedge that he/she will obey the company speed fmt alltime. Drivers Signature Print Name Date. 73 commodore Dr, Brampton, ON L6XOTS Contact: 416-948-5056 7(Owwer Operetta wo tthe ed pets abe, Beee BILLING DIVISION NO.: re |e Penne pelo FULLNAME OF EMPLOYER: HOC TRASEORTATIONNE TRANSACTION TYPE: Blew Subscriber Retire First day of coversee: ‘SUBSCRIBER (EMPLOYEE) INFORMATION: =e Sumame: ) Pvate DFemale trols bueteditoes (JL) = fe coverage please sign here. Youdo not need to complete the balance of this form. Signed ( Blessersge Waived To we [i= Signature of Employee: ates | orfyia we been chen an crperunty to paris n my empl slan Compu coverace cent eed om and/or mt deercets der another | ovo plan, understan tht i enae to be eoveres under her plo and enw to partite ey employer lan |wthave te complete h aooeaon seta 3 cvs cc of coverage: I apt fo overage et rade win 31 day | il be Feud le uc 2 my sha epee, evfence of suai | tifactry tothe cures and al eves sniect to er approval Onbehal ef wal and my cepencents authorize The Cope Bens a al sures to exchanes {he formation dete st applatin, and ny ether beat sted Hlration onsnad W fet rgarding me or my dapensen ster now orn te Ure, or pura of adminson afr matogenentel the hawance pes sed) theses. Employment Province: =P EMPLOYEE CONTACT DETAILS: Phone Number; ____ Em: pais: “HEALTH & DENTAL PLAN DESIGN: [1 “Health and Dental CiHeatth Uperade single CEnalish | Sonn : dental Upgrade Eicouple ElFrench (_S EEE Clore Uperade — Cramily Thaama top Up (asta reiant on Nets for Guede esc enly Ths EOCE Ue anvil est and ental plana docs ot rev ualtyig RANG ent rg comrage, oben mrtmalt a RAMEE dg ove rater soe. Sree = Poe RRS Uavaa? Gown => DEPENDENT INFORMATION: ‘Oni complete dependets feta be covered ting & dependent betwean the 36 021-25, plate stich proof offline student enrolment Date af Binh wo) FistName M/F Relationship Surname (diferent from subscriber) ‘AGREEMENT, DECLARATION & UNDERSTANDING SIGNATURE: By sunog this envolinant fern and by prong my pssnal lfratin to my molest are the information complete ard accurate to the best of my krowedes east am suthrted yy soo sole dependents dele and eet (rian about thom Unt used forthe butpoe of delenkng ely for beet. For fate lforason on our pvacy pole ne procedure plese se urbe Reevhind =x 4 Iherebyautheze ay feeaadphylcn a oher diel practioner, etal ot meesy leedfacthy tht hac any recone wrknoulede ofr ermy heal eta ofmyspoe/rarte: or an/Istedcepenents to exchange ary sch ffmaton Ss cds to dese benefit dans andor cones acirac of thelfornation wth Edt Eenefts he and Green ld Cans: A photog obi copy ot bir sutorstin shall be ald athe al! {eclte at ny stupider ard listed depeacema ae resets f Cats Who ae covered by provi government heal plan. 2 3. Lundentand tae falure ta ioe or alatheg information epucng my het ander thao my spauseparne and or ted dependent coud result meni f= dan ad the ences aemoaeston of te coverage 4. lamauhorzed oleic iermavon concerning my spoise/paries snd my épendent chills fo the purpoes of determing tele fer bot, 5 th ebenton to Info The Ee benef ie ofa charge my heath orate my Ited dependents gost elar uy ox nas which cena the dat ote appestion ad rertothe efecto sats ee poli. Grob sel Canda reserve th ight perform dalmaui a tine fone ta vey the accuracy a the media! Inormatin rode. {f Employee ts curertiy covered by an > ae me OEE EDGE plan or ls appving for any ater ign plays =o sened3t EDGE pan atthe ime of this subension Xe please provide: Signatureefemployer———~SCSC*~S*« ened Foley to: ~Adisor Nami (eiease rn (aseneeayOnline Application ProcessOnline Application Process (HBC Transportation Inc) Step.3—Read instructions and click West! 3)Online Application Process pa Enter i (anmtietom Note the entered infrmation should exactly be theseme as enteredin the pysieal aplication fxr Step 5 = Upan completion of onine application, em at $AFETVBHECTRANSPORTATION.COM notifying us on your sppliation submission. ‘Note “The eral subject line should have your driving license number fllowed by your complete name as on your driving license anOnline Application Process (HBC Transportation Inc) 1. Any communication with the applicant whether siready hired er under the process af hiring would be done at your mobile number 34 jndfor on your eghtred ema dnss tht you hav provded atthe tine of fing the application form, (2. Should there be any change to your registered email address or mobile number in due course of time, piease inform us by emafing us ‘St SAFETY@HBCTRANSPORTATION.COM. Please nate thet the company would not entxtain any verbal requests for updating/changes, tothe eratladtes, | ths veryinportant to provide scurate infamation tn pia appt farm and cle application fan. The applicant understands ‘att any escrepancy 8 fend ved formation entre in py! application form and anne spain form, the company ‘eserves gh treet the spyeaton without any farther eotition tothe eppizat.