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Previous Experience

Disclosure and Release

In connection with my application for employment (including contract for services) with you, I understand that consumer reports which may contain public record information may be requested from Insurance Information Exchange (iiX). I understand that such reports may contain public record information concerning my driving record from federal, state and other agencies which maintain such records; as well as information from iiX concerning previous driving record requests made by others from such state agencies, and state-provided driving records. I AUTHORIZE WITHOUT RESERVATION, ANY PARTY OR AGENCY CONTACTED BY iiX TO FURNISH THE ABOVE-MENTIONED INFORMATION. I have the right to make a request to iiX, upon proper identification, to request the nature and substance of all information in its files on me at the time of my request, including the sources of information; and the recipients of any reports on me which iiX has previously furnished within the two year period preceding my request. I hereby consent to your obtaining the above information from iiX, and I agree that such information which iiX has or obtains, will be supplied by iiX to other companies which subscribe to iiX Services. I hereby authorize Cardinal Asphalt Co and their affiliated companies or its Insurance Agent, The Fedeli Group, or its assigns, to procure consumer reports(s) for employment purposes. If hired (or contracted), this authorization shall remain on file and shall serve as ongoing authorization for you to procure consumer reports at any time during my employment (or contract) period.

I hereby authorize Cardinal Asphalt Co and their affiliated companies or its Insurance Agent, The Fedeli Group, or its assigns, to procure consumer reports(s) for employment purposes. If hired (or contracted), this authorization shall remain on file and shall serve as ongoing authorization for you to procure consumer reports at ay time during my employment (or contract) period.