Please list all employment, beginning with present or most recent employer. All information must be completed. Please also upload a file of your resume, if you have one.

Please provide information on any driver's licenses you've held within the last three years:

Please provide information for emergency contacts during work hours:

It is the policy of Robar Enterprises, Inc., Daily Transit Mix, LLC and AgCon, Inc. to afford equal opportunity for employment training, compensation and promotion to all individuals without regard to race, color, creed, religion, sex (including gender harassment and harassment based on pregnancy, childbirth or related medical condition), age, disability, sexual orientation, veteran status, or any other consideration made unlawful by federal, state or local laws.

As a component of the screening process, applicants shall be required to undergo drug and/or alcohol screening. Refusal or failure to submit to drug and/or alcohol screening at the time specified will disqualify applicants for further consideration for employment.

I voluntarily agree to submit to drug and/or alcohol screening as part of my application for employment.

I certify that the information I have given on this application is true and complete. I understand that omissions, misrepresentations, or falsifications of information will result in rejection of this application and/or will be sufficient grounds for immediate termination.

I authorize the release of all high school, college and other educational records pertaining to my attendance, course work and other school activities at any educational institute attended by me at any time.

I acknowledge by my signature that my former employer is released from any and all claims, demands or liabilities arising out of or in any way related to the disclosure of any and all information relating to my present and former employment, and I request all current and former employees to supply such information to Robar Enterprises, Inc., Daily Transit Mix, LLC and/or AgCon, Inc. upon its request. Additionally I waive and release Robar Enterprises, Inc., Daily Transit Mix, LLC and/or AgCon, Inc. and its agents from any liability for any action taken due to information provided by any current or former employer.

I agree that, if hired, I will conform to all rules, regulations and procedures of Robar Enterprises, Inc., Daily Transit Mix, LLC and/or AgCon, Inc. I further understand and agree that if I am hired, my employment with Robar Enterprises, Inc., Daily Transit Mix, LLC and or/AgCon, Inc. is for an indefinite period and may, regardless of the time and manner of payment of my wages and salary, be terminated at any time by Robar Enterprises, Inc., Daily Transit Mix, LLC and/or AgCon, Inc. or me, with or without prior notice or warning.

I further understand that this Application for Employment and any policies and procedures communicated or followed by Robar Enterprises, Inc., Daily Transit Mix, LLC and/or AgCon, Inc. during the term of my employment are not intended to be and are not a contract of employment, and that any such policies and procedures any be modified, disregarded or eliminated at any time, with or without notice to me, at the Company's sole discretion.

I understand that this application for employment shall be considered active for a period of time not to exceed 90 days from this date and that if I wish to be considered for employment. Beyond that date, I must submit another employment application.

IMPORTANT – PLEASE READ CAREFULLY BEFORE SIGNING AUTHORIZATION

DISCLOSURE REGARDING BACKGROUND INVESTIGATION:

Robar Enterprises ("the Company") may obtain information about you for employment purposes from a third party consumer reporting agency. Thus, you may be the subject of a "consumer report" and/or an "investigative consumer report" which may include information about your criminal history, social security verification, motor vehicle records ("driving records"), verification of your education or employment history, or other background checks. An investigative consumer report may include information about your character, general reputation, personal characteristics and/or mode of living, and which can involve personal interviews with sources such as your neighbors, friends, or associates. Please be advised that the nature and scope of the most common form of investigative consumer report obtained is an investigation into your education and/or employment history. You have the right upon written request made within a reasonable time, to request whether a consumer report has been run about you, and disclosure of the nature and scope of any investigative consumer report, and to request a copy of your report.

The report may be generated by Universal Background Screening (7720 North 16th Street, Suite 200, Phoenix, AZ 85020, 1-877-263-8033, www.universalbackground.com) or another outside organization. The scope of this notice and authorization is all-encompassing however, allowing the Company to obtain from any outside organization all manner of consumer reports and investigative consumer reports now and, if you are hired, throughout your employment to the extent permitted by law. As a result, you should carefully consider whether to exercise your right to request disclosure of the nature and scope of any investigative consumer report.

New York and Maine applicants or employees only: You have the right to inspect and receive a copy of any investigative consumer report requested by the Company by contacting the consumer reporting agency identified above directly. You may also contact the Company to request the name, address and telephone number of the nearest unit of the consumer reporting agency designated to handle inquiries, which the Company shall provide within 5 days.

New York applicants or employees only: Upon request, you will be informed whether or not a consumer report was requested by the Company, and if such report was requested, informed of the name and address of the consumer reporting agency that furnished the report. By signing below, you also acknowledge receipt of Article 23-A of the New York Correction Law.

Oregon applicants or employees only: Information describing your rights under federal and Oregon law regarding consumer identity theft protection, the storage and disposal of your credit information, and remedies available should you suspect or find that the Company has not maintained secured records is available to you upon request.

Washington State applicants or employees only: You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act.

ACKNOWLEDGMENT AND AUTHORIZATION
I acknowledge receipt of the DISCLOSURE REGARDING BACKGROUND INVESTIGATION (above) and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT (separate document) and certify that I have read and understand both of those documents. I hereby authorize the obtaining of "consumer reports" and/or "investigative consumer reports" by the Company at any time after receipt of this authorization and, if I am hired, throughout my employment, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by Universal Background Screening, another outside organization acting on behalf of the Company, and/or the Company itself. I agree that a facsimile ("fax"), electronic or photographic copy of this Authorization shall be as valid as the original.

New York applicants or employees only: By signing below, you also acknowledge receipt of Article 23-A of the New York Correction Law.

Minnesota and Oklahoma applicants or employees only: Please check this box if you would like to receive a copy of a consumer report if one is obtained by the Company.

California applicants or employees only: By signing below, you also acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION PURSUANT TO CALIFORNIA LAW. Please check this box if you would like to receive a copy of an investigative consumer report or consumer credit report at no charge if one is obtained by the Company whenever you have a right to receive such a copy under California law.

IMPORTANT NOTICE REGARDING BACKGROUND REPORTS FROM: PSP ONLINE SERVICE

1.  In connection with your application with Hi-Grade Materials ("Prospective Employer"), Prospective Employer, its employees, agents or contractors may obtain one or more reports regaring 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 Prosptective Employer uses any information it obtains from the FMCSA in a decision to not hire you or make any other adverse employment decision by 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 on your driving history or safety report, the Prospective Employer will notify you 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 any other means, if the Prospective Empllyer uses any informaion it obtains from FMCSA in a decision to not hire you or 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 bene 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 a driver record from the Prospective Employer who produced the report, then, within 3 business ndays of receving your request, together with proper identification, the Prospective Employer must send or provide you with a copy of your report and a summary of your rights under the Fair Credit Reporting Act.

The Prospective Employer cannot obtain background reports from FMCSA unless you consent in writing.

If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:

2.  I authorize Hi-Grade Materials ("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 consenting to the release of safety performance informaton including crash data from teh previous five (5) years and inspection history from the previous three (3) yeares. I understand and acknowlege that this release of informaiton may assist the Prospective Employer to make a determination regaring my suitability as an employee.

3.  I further understand that neigher the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the cabability to correct my safety data that appears to be incorrect. I understand I may challenge the accurace of the data by submitting a request to http://dataqs.fmcsa.dot.gov. If I am challenging 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.

4.  Please note: Any crash 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 Motoer Vehicle (CMV) crashes where you were a drive 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 FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.

I have read the above Notice Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this consent form, 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.