PERSONAL INFORMATION

In order to be paid for work performed at the client’s location, the below information is required from
you:

Full Time Part Time _

YOUR AVAIBILITY

SELECT AVAILABLE DAYS: Monday Tuesday Wednesday Thursday Friday Saturday Sunday

FIRST NAME NAME

_ _ _
ADDRESS:
Number Street Number

City Province Code

TELEPHONE: HOME: _CELLULAR:

D.O.B

Expiry

DRIVER’S LICENSE NUMBER _______________________________________________

IN CASE OF EMERGENCY PLEASE CONTACT

CONTACT 1 NAME: RELATIONSHIP:

CONTACT HOME PHONE: CELLULAR:

CONTACT 2 NAME: RELATIONSHIP:

CONTACT HOME PHONE: CELLULAR:

I certify the information I provide in this application is correct and true to the best of my knowledge
 __

SIGNATURE DATE
NO CALL/NO SHOW POLICY

Timely and regular attendance is a performance expectation of all Citrus Personnel assignment
employees, to ensure adequate staffing for our client(s), and to reinforce a positive image of our
organization with our client(s). Assignment employees will be held accountable for adhering to their
provided work schedule. In the event that an assignment employee is unable to meet this
expectation, they are required to inform Citrus Personnel, a minimum of 24 hours in advance of any
requestedschedule change for approval.
Assignment employees are also required to notify a member of the client’s leadership team, a minimum of 24
hours in advance of their required schedule change / work shift absence.
• An assignment employee is deemed “unapproved absent” when time-off was not
scheduled/approved in advance, as per the above requirement.
• An assignment employee will be recorded as “No-Show” if they fail to report for their
assigned work shift and do not call Citrus Personnel and a member of the client’s leadership
team prior to the shift start time.
Incidents and disciplinary Action for not following attendance and reporting absence expectations will
be addressed through the below Progressive Discipline process:

1st Occurrence - written warning

2nd Occurrence - 3 days suspension

3rd Occurrence - Termination

Assignment employees who fail to call in or report to work for three (3) consecutivescheduled work
days, will be terminated - Job Abandonment.

Acknowledgment:
I have read and understand the attendance / call-in expectations and agree to abide by the policy.

Signature:

Date:
WORKPLACE HARASSMENT, DISCRIMINATION AND VIOLENCE

Citrus Personnel has a zero-tolerance policy to employee behavior of workplace harassment of any kind,
including sexual harassment, and discrimination. We are committed to providing a work environment that is free
from harassment and/or discrimination. Discrimination and harassment because of race, ancestry, place of origin,
color, ethnic origin, citizenship, creed, sex, sexual orientation, gender identity, gender expression, age, record of
offences, marital status, family status, disability or any other protected characteristic under the applicable Human
Rights legislation is strictly prohibited.

Examples of harassment and discrimination include but are not limited to the following behavior:
• Verbal conduct such as derogatory jokes, slurs or comments;
• Visual conduct such as derogatory posters, photographs cartoons, drawings, or gestures;
• Retaliation for having reported or threatened to report harassment.

Sexual harassment of a co-worker, client, or other individual will not be tolerated. Citrus Personnel will take prompt,
appropriate and effective remedial and/or disciplinary action in response to allegations of sexual harassment.

Citrus Personnel takes claims of harassment and/or discrimination very serious. All reports are investigated by
Human Resources and addressed based on findings of fact. Based on the results of the investigation, remedial
and/or disciplinary action, up to, and including, termination of employment, will result. Employee personal legal and
financial liability may result as well, depending on the individual case.

Human Resources will consider the report and take the appropriate action where there is evidence of violence or
harassment.

Employee Acknowledgement:
I acknowledge that I have read, and understand the Workplace harassment and discrimination policy. I agree to
adhere to this policy, such that Citrus Personnel has zero-tolerance for such behaviors in the workplace. I
understand that if I violate the rules set forth by this policy, I will face disciplinary action, up to and including
Termination of employment.

Signature Date
RABBIT/SONIM (Hand Held) Unit Terms & Conditions

Restrictions on Use
The hand-held devices shall not be used in any manner or for any purpose for which they are not designed or
intended. There shall be no physical alteration to the units without written consent from a member of our client’s
leadership team. There shall be no affixing of, attaching to, or installing of any accessory equipment or device in
connection with the units that might interfere with the operations of the unit. If such an incident occurs the unit will
be restored to its original condition at the assignment employee’s expense.

RABBIT/SONIM Units are not to be used in any manner other than for accepting orders, updating orders, GPS or
communicating with the client’s dispatch team. The units are capable of sending and receiving text messages,
incoming and outgoing calls, domestically within Canada. Drivers identified as abusing these privileges will
lose access to the extra features.

Risk of Loss
The units have property and casualty insurance. In all instances of loss, damage, or theft, the assignment
employee shall be responsible for the replacement cost ($1000.00 Canadian dollars). Damage is deemed as
negligence towards the unit by the assignment employee.

Warranty/Maintenance/Repair
Instances will occur where non-sturdy parts may break or something does not work on the unit. Breakage of parts
will result in an investigation to identify the root cause / accountability. Units will break if they are handled roughly.
Should a unit break for any reason, report it immediately to a member of the client’s leadership team in order to
receive a new one.

ALL UNITS MUST BE HANDED IN AT THE END OF YOUR SHIFT

Signature Date
AUTHORIZATION FOR DEDUCTIONS FOR TRAFFIC VIOLATION

All assignment employees must follow the client’s Vehicle Policy and the Ontario Ministry of Transportation
standards.

It is the assignment employee’s responsibility to operate the client’s company vehicle in a safe manner and in
compliance with all applicable highway traffic laws, to ensure one’s health and safety, and to prevent any vehicle
damage.

All assignment employees are responsible for paying traffic fines for breaking traffic signals and other traffic
violations, while operating a client’s company-provided vehicle.

I have read, understand and agree with the terms of the above-noted conditions. I acknowledge that I will be
responsible for the vehicle during my shift when working at a Citrus Personnel client location.

Signature Date
EMPLOYEE AGREEMENT AND CONSENT FORM TO DRUG AND ALCOHOL TESTING

I hereby agree, upon a request made by Citrus Personnel, to submit to a drug or alcohol test and to furnish a
sample of my urine, breath, and/or blood for analysis. I understand and agree that if I, at any time, refuse to submit
to a drug and/or alcohol test, or if I otherwise fail to cooperate with the testing procedures, I will be subject to
immediate termination. I further authorize and give full permission to have the Company and/or its identified
physician send the specimen or specimens collected to a laboratory to be screened for the presence of any
prohibited substances under policy, and for the laboratory or other testing facility to release any and all
documentation relating to such test to the Company and/or to any government entity involved in a legal proceeding
or investigation connected with the test.

I understand that only duty-authorized Company officers, employees, and agents will have access to information
furnished or obtained in connection with the test, that they will maintain and protect the confidentiality of such
information to the greatest extent possible, and that they will share such information only to the extent necessary to
make employment decisions and to respond to inquiries or notices from government entities.

I will hold harmless the Company, its company physician, and any testing laboratory the Company might use,
meaning that I will not sue or hold responsible such parties for any alleged harm to me that might result f rom such
testing, including loss of employment or any other kind of adverse job action that might arise as a result of the drug
and/or alcohol test, even if a Company or laboratory representative makes an error in the administration or analysis
of the test or the reporting of the results. I will further hold harmless the Company, its company physician, and any
testing laboratory the Company might use for any alleged harm to me that might result from the release or use of
information or documentation relating to the drug or alcohol test, as long as the release or use of the information is
within the scope of policy and the procedures as explained in the paragraph above.

I UNDERSTAND THAT THE COMPANY WILL REQUIRE A DRUG SCREEN AND/OR ALCOHOL TEST UNDER
THIS POLICY WHENEVER I AM INVOLVED IN AN ON-THE-JOB ACCIDENT OR INJURY UDER
CIRCUMSTANCES THAT SUGGEST POSSIBLE INVOLVEMENT OR INFLUENCE OF DRUGS OR ALCOHOL IN
THE ACCIDENT OR INJURY EVENT, AND I AGREE TO SUBMIT TO ANY SUCH TEST.

Employee’s Signature Date

CONFIDENTIALITY AGREEMENT

This agreement set out details of the confidentiality terms and conditions relating to your assignment
employment, and the duties and responsibilities associated with your temporary/assignment employment with
our client.

Restrictions: Confidentiality.
(i) You shall not, during the continuance of your assignment, or at any time thereafter, disclose any private,
confidential or secret information relating to our client, or their business, suppliers, customers, trade secrets,
methods, plans, technical designs, internal organization, personal or finances, to any person without prior
written consent of our client, or use such information for any reason other than the purposes of your work
assignment at our client’s location.

(ii) All notes, materials, records (whether electronic or not) and writing made by you relating to the business of
our client shall be and remain the property of our client to whose business they relate and shall be delivered
by you to our client which they belong forthwith upon request.

SIGNATURE OF ACCEPTANCE:

Employee’s Signature Date

COMPANY VEHICLE POLICIES & PROCEDURES

Eligibility to Drive a Company Vehicle

Prior to vehicle assignment with our client, eligible assignment employees must prove that they
have avalid driver’s license which is not suspended or revoked. Citrus Personnel will also review
your driving record and will periodically request an updated driving abstract, at the assignment
employee’s expense, as a requirementof our client’s insurance carrier, during your assignment of
a vehicle.

Driver Responsibilities
Assignment employees are responsible for driving our client’s assigned vehicle in a safe and
professional manner. Assignment employees (drivers) must know and abide by all driving laws
in all areas where they operate our client’s company vehicle. Additionally, assignment
employees must maintain a current, valid driver’s license for the province in which they are
living. If for any reason, an assignment employee’s driver’s license is revoked, suspended, or
restricted, it is mandatory to notify Citrus Personnel and a member of our client’s leadership
team immediately.

Safety Guidelines
It is mandatory that seat belts be used by all occupants of our client’s company vehicle at all
times,without exception. It is the assignment employee’s (drivers) responsibility to ensure that all
occupants fasten their seat belts prior to operating the vehicle. Any malfunctioning seat belt
should be reported for repair by the assignment employee (driver) immediately. Citrus Personnel
reserves the right to revoke the driving privilege of any driver not complying with this policy. In
addition, Citrus Personnel. expects all assignment employees (drivers) to drive defensively
during business and personal travel, to obey all traffic laws, and prohibits assignment employees
from driving under the influence of drugs and alcohol, including prescription drugs. Our client’s
company vehicles should not be used to transport flammable items, firearms, or other hazardous
materials. Texting while driving is not allowed in our client’s company vehicles.

Traffic Violations
Should an assignment employee, for any reason, receive a summons for a traffic violation or a
parking ticket, you must pay it as soon as possible. All traffic violations and parking tickets
should be reported to the client’s dispatcher as quickly as possible. Under no circumstances will
traffic and parking fines to be charged to Citrus Personnel, it is the responsibility of the
assignment employee to pay said fines.
Citrus Personnel also prohibits the following:
• The transportation of a hitchhiker or stranger in our client’s vehicle.
• The use of the client’s vehicle for any purpose other than the tasks pertaining to
their assignment duties and responsibilities.
• The acceptance of any form of compensation from any individual for carrying
passengers or material.
 • Smoking is not allowed in company leased vehicles.
• The client’s company vehicle should not be fitted with a trailer hitch to pull a trailer or boat
without prior authorization from the client’s Operations Manager.
• No bumper or window stickers should be affixed to our client’s company vehicle, unless
prior consent is received from the client’s Operations Manager.

Vehicle Maintenance
Every driver of our client’s company vehicle is expected to maintain their assigned vehicle in a
safe operating condition. Maintenance schedules outlined in your vehicle’s owner manual/daily
sheets should be adhered to, along with documentation showing completed service work.
Particular attention should be paid to the maintenance requirements for keeping the warranty of
your vehicle in effect.
You are required to keep the client’s vehicle maintenance records in the glove box and present
when service is needed. The client recommends oil changes every 5,000 to 7,000 kilometers
(depending on the vehicle/manufacturer specifications) with tire rotation every other oil change.
The transmission should be serviced around 60,000 kilometers or based on manufacturer
specifications. If the vehicle needs to be towed, you are required to call the client’s on-duty
dispatcher who will assist with CAAservice or tow operator assistance.
It is prohibited to leave a client’s company vehicle at a service facility without specific instructions
as to what work needs to be done. It is the assignment employee’s (driver) responsibility to call the
client’s on-duty dispatcher for pre-approval of all work (beyond the normal routine maintenance
requirements, such as oil changes and tire rotation.)

Gas PIN
All client drivers are provided a unique gas PIN to purchase gas for their vehicle – ONLY. You
are only to put Regular gas in the vehicle. Should a driver put any other grade of gas in the
vehicle in error, the difference is cost will be charged to the driver – negligent behavior.

Safeguarding Client’s Vehicle and its Content

When driving our client’s vehicle, you are responsible for ensuring all necessary precautions
are taken to prevent damage and theft of to the client’s company vehicle and/or its contents at
all times.
Do not leave merchandise and equipment in open view inside the vehicle, which may tempt a
break-in. Lock all valuable items inside the trunk when the vehicle is left unattended.
When traveling outside your residential/business area, make sure to take reasonable
precautions to safeguard the vehicle and its contents. When possible, select an off- street,
lighted area close to a business or hotel entrance where normal police surveillance or security
protection exists.
Client’s Vehicle Odometer
The client’s company vehicle odometers shall be governed in accordance with the
following Federal and Provincial odometer laws and regulations:
• Change of mileage indicated on the odometer is prohibited. No person shall
disconnect, reset or alter the odometer of any motor vehicle with intent to change the
number of kilometers indicated thereon.
• Operation of a motor vehicle with knowledge of disconnected or nonfunctional
odometer is prohibited.
• No person shall, with intent to defraud, operate a motor vehicle on any street or
highway knowing that the odometer of such vehicle is disconnected or non-functional.

Criminal penalties: Any person who knowingly and willfully commits any of the items listed
above is liable to be fined or imprisoned or both as per local police officials.
Any Citrus Personnel assignment employee who knowingly violates the federal/provincial laws
specified above will be immediately terminated.

Insurance
Insurance cards will be kept in the glove box at all times. Only you, the approved driver of
our client’s vehicle is authorized to drive the vehicle.

What to do in case of an accident (steps to follow)

The assignment employee (driver) must notify local police and/ the client’ dispatchers/operations manager
immediately of any accident they encounter.
If you are involved in an accident, it is necessary to follow the procedure outlined below:
• If anyone is hurt, call for 911/the client’s dispatcher/operations manager.
• Immediately following an accident, stop and investigate what damage might have occurred to the vehicle.
• Get the names and addresses of the owner(s) and driver(s) involved, license number and
registration number of the car(s) involved and the names and addresses of any
passengers in the vehicles connected with the accident.
• Get the name of the other party’s insurance company and insurance policy number.
• Get the names and addresses of witnesses, if any.

• If law enforcement officers are present at the scene, note their names, badge and
precinct numbers. If no police officers are present, try to have one called to the scene of
the accident.
• Express no opinion as to who was at fault. Give no information except as required by law
enforcement officers.
• Sign no statements for anyone except an identified representative of our client’s
insurance company covering the company vehicle.
 • Contact the client’s dispatcher/operations manager within the first 24 hours preceding
the accident so a preliminary accident report may be taken.
• Keep a copy of the client’s authorized accident reporting form for your records.
• Complete all reports required by local law enforcement authorities. If you need help
completing these reports, request help from your local police department/ client’s
operations manager.
• If any demand, claims or summons is served to an assignment employee involved
in an accident, asserting liability against them, contact the client’s dispatcher/
operations manager immediately.
• If the collision involves an unattended vehicle, you must attempt to notify the owner.If that
is not directly possible, attach a note to the vehicle asking the owner to contact you. Notify
the police immediately telling them that you have attempted to make contact with the
owner.
There are NO EXCEPTIONS to the above requirements.

Stolen Vehicle
If the client’s company vehicle is stolen, report the theft immediately to the local police and to
the client’s dispatcher/ operations manager.
Obtain a copy of the police report filed and maintain a copy for your personal files and submit
another to the dispatcher/ operations manager.
Any attempted break-in or theft of items from our client’s company vehicle must be reported to
the local police and to the client’s dispatcher/operations manager to include the following
information:
• The name, badge and precinct number of the police officers responding to your call.
• A list by model and serial number of any equipment which was stolen. The date and
location of where the theft occurred.

SIGNATURE OF UNDERSTANDING AND ACCEPTANCE:

SIGNATURE DATE
 DRESS CODE POLICY

Citrus Personnel requires all assignment employees to present themselves in a professional manner,
with regards to attire,personal hygiene and appearance. These standards commensurate with our
organizational practices of appropriate business conduct, professionalism and dress code.

Drivers and Warehouse Associates:

Assignment employees who drive for our client are required to wear blue or black clothing that is clean,
professional and without logos. (shorts/jeans/cargo pants are permitted).

Assignment employees who drive for our client and warehouse employees who work at one of our client’s
locations are required to wear client issued safety vests at all times when on shift to aid in their
identification,enhance security, and promote the professional image of the organization.

CSA certified safety shoes are required to be worn by all assignment employees who drive for our clients or who
work in our client’s warehouse.

Personal Protective Equipment – COVID Protocol

• Facemask is mandatory to be worn at all times.

Every Citrus Personnel assignment employee is responsible for exercising sound judgment and common sense
for their attire at all times. If an assignment employee is deemed to be wearing inappropriate attire, the client
will notify you and will send you home. Under no certain circumstances are sweet pants allowed to be worn when
on shift at our client’s location.

Compliance
Departure from this policy may result in employee counseling and/or disciplinary action up to and including
termination of assignment.

SIGNATURE DATE
 RELEASE OF INFORMATION CONSENT FORM

Consent to Disclose Personal Information

Pursuant to the Personal Information Protection and Electronic Documents Act (PIPEDA)

I, the assignment employee authorize Citrus Personnel

To disclose my personal information to the following

parties:

Their Clients

My personal information:

Personal information Initials

SIN#
Date of Birth
Hours of Work
Rate of Pay / Paid Time off / Pay Stub
Criminal Background result
Drivers Abstract
Driver license

I understand that the purpose for disclosing this personal information to the party noted
above is for their compliance requirements (audit) with their client.

Signature:

Date:
AUTHORIZATION FORM FOR PAYROLL DEDUCTION

A requirement of our client is that all staff, including assignment employees must wear a client provided Safety Vest
throughout the entirety of their shift. Assignment employees are provided a vest on their first day at the client’s
location. Assignment employees are required to pay for this vest through payroll deduction from their first pay.

All assignment employees (drivers) are required to follow all road laws and regulations and are not authorized to drive
on any toll highways (407). Should an assignment employee incur any road fines (speeding tickets, parking tickets,
etc), it is the responsibility of the assignment employee to pay for said fines.

By signing this document, the assignment employee is acknowledging the above requirements and authorizing
payroll deduction for the Safety Vest ($25) as well as payroll deduction for violating parking and traffic infractions.

Signature:

Date:
CONDITION & CLEANING OF COMPANY VEHICLE POLICY

The client’s company vehicle assigned to you represents a substantial investment in you and your temporary job
assignment. You have the responsibility to drive the vehicle safely and to comply with all vehicle-operating
requirements as stated in law, this policy and the manufacturer’s handbook.

You are expected to keep the vehicle clean and tidy at all times. Kept in good order, the vehicle will reflect a good
image of both you and our client.

All of our client’s company-provided vehicles are designated as “non-smoking” areas. You are expected to keep
your vehicle in a clean and well-maintained condition.

Smoking is not permitted in any of our client’s company provided vehicles.

Although eating in the client’s company provided vehicle is permitted, it is the assignment employee’s responsibility
to ensure that all food/beverage empty container/leftovers are removed from the van at the end of their shift.

Do not leave any disposables and litter in the vehicle.

Employee Acknowledgement:

I have read and understand and will abide by the condition/cleanliness of vehicle policy. I agree to abide by the
policy guidelines. I further understand that the vehicle received by me will be in a clean, tidy and roadworthy
condition and that I am to return the vehicle, in the condition that it was received, at the end of the work shift. Any
costs incurred by the client to return the vehicle to its’ normal condition will be charged to the assignment
employee.

Employee Signature:

Date:
CELLULAR PHONE POLICY

Personal Cell phones

• Assignment employees are directed to avoid making or receiving personal calls during work time, and use
personal cell phones only during scheduled breaks or lunch periods in non-working areas.

• Citrus Personnel is not liable for the loss of personal cell phones brought into the workplace.

• Citrus Personnel strictly prohibits the use of cell phones or similar devices while at any work siteat which
the operation of such device would be a distraction to the user and/or could create an unsafe work
environment. Such work sites must be secured or the device used only by an employee who is out of
harm's way at such work environments.

• Citrus Personnel assignment employees are strictly prohibited from using cell phones for any other
available purpose (e.g. internet access, gaming, texting, music) during business hours. These functions
may be used during scheduled breaks or lunch periods in non-working areas.

• Citrus Personnel employees are strictly prohibited from using any cellular phone or similar deviceas an
unauthorized media storage device for the storage or transportation of Citrus Personnel business
information.

• For privacy reasons, Citrus Personnel employees are prohibited from taking photographs ofcompany
facilities or personnel using any camera functions on their cell phone without first obtaining express written
permission from the company.

USE OF CELLULAR PHONE WHILE DRIVING

• Citrus Personnel strictly prohibits the use of mobile phones and all other electronic devices while
operating our client’s vehicles.
• The use of hands-free mobile phones should be kept to a minimum when driving.
• To make or receive calls:
o o Pull over and stop;
o Allow a passenger to operate the phone;
o Use voice mail and respond to the call at a safer time; or
o Let someone else drive, freeing you up to make or receive calls.

Assignment employees are solely responsible for any fines and or charges laid by the authorities for illegal
use of a phone or other electronic device while operating a vehicle in the course of their work assignment with
our client.
Assignment employees who choose to violate the policy, or face legal responsibility if in the course and
scope of their duties they are involved in a car accident and there is evidence that they were using their cell
phone while driving, and the Citrus Personnel is sued.

SIGNATURE OF UNDERSTANDING AND ACCEPTANCE:

SIGNATURE DATE
REMOVE IT – CLOSE IT – LOCK IT POLICY

Our Client’s Mission is to consistently deliver excellence by executing a high standard of delivery across various
verticals of the delivery business. Ensuring that they safeguard the client’s product from theft is paramount to
delivery excellence. Drivers play a critical role in protecting our client’s Customer’s product as they perform their
job duty.

All assignment employees (drivers) are required to consistently turn off the fleet/vehicle ignition and lock the
fleet/vehicle doors when making customer deliveries, and when the fleet/vehicle is unattended.

Drivers will be audited daily/weekly and those who are observed leaving the fleet/vehicle running and/or unlocked
when unattended are in breach of policy and will be subject to the following disciplinary action.

• 1 st offence will result in suspension (3 days)

• 2 nd offence will result in termination of employment

SIGNATURE DATE