Also enter driver and owner operator details that we need these documents from them .
Malling Address If different from address of residence
Previous address if less than 3 years at current address
Since how Long you Possess a driving licence?
Regarding the use of motorized vehicles, Have you had, during the past
5 years (last 3 years in the US)
If yes, Complete the following
Quebec - Canada (Abstract), provide a record dated less than 30 days.
Conduct review Policy for Heavy Vehicle driver
How many points appears in your driving record, heavy vehicle:
Duration of the Courses
For USA, 10 years of employment as part of a position related to driving a heavy
vehicle and for the transport of dangerous goods (verification required).
Please mention classes and practical experience
It is agreed that in the event i made a mistepresentation in.connection with my hiting
or I omitted to give the required _ information on this form, | am liable to a dismissal
as of the date the misrepresentation or omission was discovered, In” accordance with the
bond requirements contained in the terms and conditions of the job contract. It is agreed
and it is understood that if I am hired, I will subject as of the first working day, the
file of control emitted by the Societe de I'Assurance automobile du Quebec which makes
state of the suspensions, the revocations and the points of inaptitude.
Note : Please use one (1) form per employer called.
USA : In the case of drivers operating in the United States. Check the history of the
applicant with the employers of the last three (3) previous years plus seven(7) years
period which the applicant was an operator of a commercial motor vehicle.
Term Of Employment
What kind of attitude the employee had toward
(To be signed on the first date of service orat the annual review of driving record)
2. I further certify that, in accordance with section 519,7 of the Quebec Highway
Safety Code, I will immediately notify the company of any modification, suspension
OF cancellation of my driver's licence or my class of licence specifying the reasons
as soon as the modification,suspension OF cancellation takes effect.
3. In addition, | will notify my employer of the duration and the expiry date of
any modification or suspension affecting my driver's licence and, in the event of a
cancellation, | will notify him of the duration for which my licence or class of licence
will be cancelled.
4. On my employer's request, | undertake to supply him with a copy of my driver's
file every six (6) months or whenever he would like.
5. USA: if I am assigned to a position of driver operating in the United States
and I am fined in relation to an offence against traffic regulation - except for parking
- (FMCSR, section 383.31, b) when driving any vehicle, I undertake to notify my employer
in writing within thirty (30) days.
To insure the validity of your driving licence and keep the right to drive the company’s
vehicle, | (driver) confirm that the annual payment will be paid before the renewal, at the
anniversary date, and / or the monthly payment made in the period. Failure to comply, you
might be subject to disciplinary action.
Medical examination: When SAAQ notify you to conduct a medical examination, you have
to respect the delay, in order to ensure the validity of the driving license and retain
the right to drive a company vehicle.
Note :An owner or an operator who permits a vehicle to be operated,
not with standing notification of the suspension or cancellation of the driver's
licence as a result of a criminal offence pursuant to section 519.42 of the Highway
Safety Code or if the licence was suspended as per indicated in article 105, is
liable a fine of 700 $ to 2 100 $ (Sec. 519.42).
A driver who fails to notify his employer of the suspension, revocation or
cancellation of his licence is liable to a fine of 350 $ to 1050$ (Sec. 519.50).
(To be completed on the first day of service.)
As per article 519.24 of the Quebec Highway Safety Code, no carrier shall permit a
driver to exceed the number of driving or service hours prescribed by regulation.
519.25.Where the operator uses the services of a driver, obtain from the person who
supplies the driver the daily logs of hours of driving and of work.Please
complete the following chart by stating the number of driving and working hours you
have accumulated during the last 14 consecutive days(as the case may be).
Period from To
I attach to this statement a copy of my log of hours of driving and service for
my first day of service (if | worked for another employer on that day). To the best
of my knowledge, I certify that above information is accurate and that I have been
relieved of past duties.
NOTE: A carrier who permits a driver to exceed the number of hours of driving
or hours of service prescribed by regulation is liable to a fine of $700 to $2100
(section 519.53 of the Québec Highway Safety Code).
(proof of repair)
as our representative, within the meaning of section 5.7 of the Regulation respecting
mechanical inspection and safety standards for road vehicles, so that he signs on our behalf
the vehicle inspection register in the event (On the Road) a defect is discovered on the
vehicle and the or the person normally designated by him are unable to sign this register.»
Including; The Pre-Trip, during the work shift and post trip
NOTE: The purpose of this questionnaire is to give a general overview of your
current physical condition and information on your medical history. The information
you will disclose will be used only in order for us to ensure you have ifie
quaiivications and skills required for the job you apply for. This information
will determine whether you need a medical check-up, but does not imply you will
have to submit to one.
What is the weekly amount you take of: Did you use to take a larger amount
I declare that the information given in this questionnaire is accurate and complete
to the best of my knowledge. | understand and accept that any misrepresentation or
omission can result in the rejection of my application or the loss of my job or any
benefit related to a pension or an allowance in connection with my health condition.
Tractor / straight truck pre-trip inspection
Inspection of safety equipment
Tractor / Trailer pre-trip inspection
Departure with the Vehicles
Uphill and rough terrain start
Synchronization- Down and Up shifting
RPM while upgrading and downgrading gears
Progressive gear changing
Lane Changing and overtaking
Curves and intersections
Acceleration- Tailgation distance
Control in the curves
Signs - Compliance (speed, stop, etc.)
General driving and behavior
Reefer and verification