Careers – LionBG, Inc

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- Do you have a minimum age of 24 years? *

Yes No

- Do you have 2 years of verifiable over the road experience? *

Yes No

- Do you have valid CDL Class A? *

Yes No

- Do you have more than 3 moving violations in the past 3 years? *

Yes No

- Do you have a DUI or DWI in the last 5 years? *

Yes No

- Are you able to complete satisfactory D.O.T. physical and drug test? *

Yes No

Let us contact you

We are very sorry, but based on the answers you gave, we could not offer you any position. Good luck and don’t give up.

Applicant name: *

Date of application: *

Company:

Lion Bg Inc

Address:

650 E 107th Street Ste.200B, Bolingbrook, IL 60440

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.

TO BE READ AND SIGNED BY APPLICANT

I hereby authorize release of information from my Department of Transportation regulated drug and alcohol testing records by my previous employer listed in Section IA, to the employer listed. This release is in accordance with DOT regulation 49 CFR Part 40, Section25. I understand that information to be released in Section II-A by my previous employer, is limited to, the following items in for the past two years:

Alcohol tests with a result of 0.04 or higher
Verified positive drug tests;
Refusals to be tested;
Other violations of DOT agency drug and alcohol testing regulations.
Documentation, if any, of completion of the return-to-duty process following a rule violation;
Information obtained from previous employers of a drug and alcohol rule violation.

THE BELOW DISCLOSURE AND AUTHORIZATION LANGUAGE IS FOR MANDATORY USE BY ALL ACCOUNT HOLDERS IMPORTANT DISCLOSURE REGARDING BACKGROUND REPORTS FROM THE PSP

Online Service In connection with your application for employment with _Lion Bg Inc_(“Prospective Employer”), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA). When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report. When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act. Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication. Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report. The Prospective Employer cannot obtain background reports from FMCSA without your authorization. AUTHORIZATION If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below: I authorize _Lion Bg Inc_ (“Prospective Employer”) to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am authorizing the release of safety performance information, including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee. I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication. I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on my PSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.

Sign here: *

I accept the terms of this agreement.

I authorize Lion Bg Inc to request my work history from my previous employers.

Answer all questions

Cell phone: *

Email: *

Date of birth: *

Social security number: *

Emergency contact

First name: *

Last name: *

Phone number: *

Relationship: *

List your addresses of residency for the past 5 years:

Address #1 : (the most recent)

Street: *

City: *

State: *

Zip code: *

How long? *

Years

Months

Have worked for this company before? *

Yes No

Date from: *

Date to: *

Reason for leaving?

Position: *

Are you now employed? *

Yes No

If not, how long since leaving last employment? *

Who referred you?

Have you been bonded? *

Yes No

What is the name of bonded company? *

Is there any reason you might be unable to perform the functions of the job for which you have applied [as described in the attached job description]? *

Yes No

Explain if you wish:

EMPLOYMENT HISTORY

All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state, and zip code. Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional 7 years' information on those employers for whom the applicant operated such vehicle. (NOTE: List employers in reverse order, starting with the most recent Add another sheet as necessary.)

* Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding. * The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport 8 or more passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

How many years of CDL driving experience you have?: *

Sorry, we are not able to hire you at this moment. Thank you for applying with us.

We have found these gaps in your employment history, please tell us why?

ACCIDENT RECORD ТRAFFIC CONVICTIONS FOR PAST 3 YEARS OR MORE

Please write NONE if none accidents, or type in EXTRA if more space is needed.

Please write NONE if none accidents

Accident on:

Nature of accident:

HEAD-ON

REAR-END

UPSET

Other

Write "NONE" here if none:

Fatalities?

Injuries?

Hazardous material spill?

TRAFFIC CONVICTIONS

and forfeitures for the past 3 years or more. (write NONE if none, or type in EXTRA if more space is needed)

Please write NONE if none convictions

Conviction #1 (the most recent)

Location

Date:

Charge

Penalty

EXPERIENCE AND QUALIFICATIONS - DRIVER

CERTIFICATION OF COMPLIANCE WITH DRIVER LICENSE REQUIREMENTS

You, as a commercial vehicle driver, may not possess more than one license.
If you currently have more than one license, you should keep the license from your state of residence, and return the additional licenses to the state that issued them. Destroying a license does not close the record in the state that issued it; you must notify the state. If a multiple license has been lost, stolen, or destroyed, you should close your record by notifying the state of issuance that you no longer want to be licensed by that state.
Sections 392.42 and 383.33 of the Federal Motor Carrier Safety Regulations require that you notify your employer the NEXT BUSINESS DAY of any revocation or suspension of your driver's license. In addition, Section 383.31 requires that any time you violate a state or local traffic law (other than parking), you must report it to your employing motor carrier and the state that issued your license within 30 days.

DRIVER CERTIFICATION:

I certify that I have read and understand the above requirements.

CDL #: *

CDL expiration date: *

State: *

Class: *

Class A

Endorsement(s):

Double/triples

HazMat

Other

A: Have you ever been denied a license, permit, or privilege to operate a motor vehicle? *

Yes No

Give details: *

B: Has any license, permit, or privilege ever been suspended or revoked? *

Yes No

Give details: *

C: Have you ever been convicted of any criminal act involving the use of a CMV or while driving a CMV? *

Yes No

D: Have you ever been convicted of a felony? *

Yes No

E: Have you ever refused to be tested for drugs or alcohol for DOT-mandated test? *

Yes No

F: Have you ever tested positive for drugs or alcohol on DOT-mandated test? *

Yes No

G: Have you ever tested positive for drug or alcohol for any DOT-mandated pre-employment test for a job you applied for but did not obtain? *

Yes No

- Do you have a DUI or DWI on your driving record? *

Yes No

- Do you have any felony convictions? *

Yes No

WHAT TYPE OF EXPERIENCE DO YOU HAVE?

[YOU CAN SELECT MORE THAN ONE TYPE]

53' Dry Van

53' Reefer

Flatbed

Other

Over the Road

Regional

Local

Other

PLEASE UPLOAD COPIES OF YOUR MEDICAL CARD AND CDL.

Here is my medical card

Here is my CDL