Diamond Transportation (9249-7833 quebec Ine.)


ANNUAL REVIEW OF DRIVING RECORD

Note:

Daily Inspection

Including; The Pre-Trip, during the work shift and post trip

The Company

APPLICATION FORM

If a curriculum vitae is available, annex it to this service offer

Diamond Transportation

(9249-7833 Quebec: Inc. ).

Also enter driver and owner operator details that we need these documents from them .


For Driver we need

  • 3 YEAR EXPERIENCE
  • CLEAN ABSTRACT
  • CRIMINAL SEARCH RECORD
  • MEDICAL
  • FOR US - PASSPORT COPY
  • US VISA COPY
  • DRIVER'S LICENSE

For Owner Operator we need

  • COOPERATION PAPER
  • IFTA
  • INSURANCE PAPER
  • NIR
  • TRUCK/TRAILER REGISTRATION
  • INSPECTION
  • COMPANY PAPERS

Diamond Transportation (9249-7833 quebec Ine.)


DRUG AND ALCOHOL TESTING PROGRAM
To all drivers, subcontractors and subcontractor drivers


MEDICAL CONDITION

Certain precautions must be taken regarding the usage of any medication prescribed by your physician (382.213). It is in your interest, as well as in the interests of the company and road-network users, that you comply with the following guidelines:


  • Have with you, af a// I/mas, a letter from your attending physician (*) confir‹ztlng your need to take the medication(s) indicated and, abova a//, always follows the instructions regarding the prescribed medication(s);
  • Your physician (*) musf declare that usage of the medication(s) In question does not and will not in any way affect your ability to carry out safety-related taaks [382.213(a)];
  • Upon request, your pharmacist will provide you with the applicable medication code so that you know what precautlons to take regarding usage of over-the-counter medications. You must ensure fhat any such medications you consume do not and MII not In any way affect your ablllly to carry out safety-related tasks;
  • You must inform the program director about the usage of any madlcatIon(s) prescribed by your physician (*) or pharmaclst [382,213(c)] and have with you (as required) a Prescr/0ed Medication
  • In tha event of an accident, you authorlze that the information conalned in I e pre cription(s) In question be made available to your employer or the appropriate medical staff person.

(*) Licensed physician as defined In sacf/on 082.107


Diamond Transportation (9249-7833 quebec Ine.)

ACCUSE DE RECEPTION

(A conserver au dossier confidentiel de l'employe)
(To be preserved in the confidential file of the employee)

Politique sur
LES STUPEFIANTS ET ALCOOL
Policy on
DRUG AND ALCOHOL 982.601(A)(1)


Attestation du Chauffeur

Moreover, I agree to familiarize and respect it.


Signatures

Diamond Transportation (9249-7833 quebec Ine.)


MEDICAL DECLARATION

On March 30,1999 United States Federal Motor Carrier Safety Regulation medical requirements for Canadian drivers of commercial motor vehicles operating in the United States were revised. | acknowledge there is no requirement for a completed United States medical fitness report. This revision does require that a Canadian driver must comply to the medical requirements of the province in which their commercial drivers license is issued and that a medical fitness report is completed on the frequency as required by license issuing province.


requirement to operate a commercial motor vehicle in the United States, that | am not impaired to operate a commercial motor vehicle by any of the following :


  • I have no established medical history or clinical diagnosis of diabetes mellitus currently requiring insulin for control (administered by injection).
  • I have no established medical history or clinical of epilepsy.
  • I have no impaired hearing, first perceives a forced whispered voice in the better ear at not less than 5 feet with or without the use of a hearing aid or, if tested by use of an audiometric device, does not have an average hearing loss in the better ear greater than 40 decibels at 500 Hz, 4000Hz and 2000Hz with or without a hearing aid when the audiometric device is calibrated to American National Stardard (formerly ASA Standard) Z224.5-1951.

I also agree to inform the company should my medical status change, and if any of the above impairments are subsequently diagnosed to the level of affecting my fitness to operate a commercial motor vehicle in the United States.


Diamond Transportation (9249-7833 quebec Ine.)

Notice to drivers and driver's certification of non
motor carrier compensated work


Notice to drivers

In accordance with 395.2 of the Federal Motor Carrier Safety Regulations, Title 49 of the Code of Federal Regulations, as amended in a Final Rule issued on October 23, 1987 (53 Fed. Reg. 41718), carriers and drivers are to includes as “on duty” the time a driver spends :” (9) Performing any compensated work for any non motor carrier entity”


Driver’s certification of non motor carrier compensated work

| hereby certify that | have read the foregoing “Notice to drivers” and understand that any time | spend performing any compensated work for a non motor carrier entity must be included as “on duty time” under the federal hours of service regulations.


I further certify that: (Check appropriate block)


Currently I am not performing any compensated work for any non motor entity:in the event I do perform work for any non motor carrier entity for which, I have been or will be compensated, that I will Immediately notify
I am performing work for a non motor carrier entity for which I am being or will be compensated and have or will provide details about the nature of that work to

Diamond Transportation (9249-7833 quebec Ine.)


"Fair Credit Reporting Act Disclosure Statement

In accordance with the provisions of Section 604(b)(2)(A) of the Fair Credit Reporting Act, Public Law 90-508, as amended by the Consumer Credit Reporting Act of 1996 (Title Il, Subtitle D, Chapter |, of Public Law 104-208), you are being informed that reports verifying your previous employment, previous drug and alcohol test results, and your driving record may be obtained on you for employment purposes. These reports are required by Sections 382.413, 391.23, and391.25 of Federal Motor Carrier Safety Regulations.


Diamond Transportation (9249-7833 quebec Ine.)


DECLARATION OF TRAFFIC
OFFENCE

(To be completed once a year)


I certify that | was not fined and my licence was not suspended within the last twelve (12) months.
I was fined of offences against traffic regulation (other than for parking) or license suspended within the last twelve (12) months in Canada (excluding Quebec) and / or the United States is accurate and complete. Indicate in the following list

Diamond Transportation (9249-7833 quebec Ine.)


PROHIBITION / AUTHORIZATION OF PASSENGERS
ABOARD THE VEHICLES


Responsibility of the driver


  • a person assigned by the company (distributor, accountant, instructor or other);
  • a person needing emergency care (accident or emergency, a person committed for the monitoring of animals);

AUTHORIZATION for passenger to immediate family, only

The passenger who will have been authorized beforehand by the company. When this authorization is granted for the United States, the passenger must not have criminal record and must have an insurance cross-blue for the duration of the trip.


The driver, undersigned, commit themselves defraying The company for any loss, material, monetary, any delay or disadvantage attached closely or by far to the presence of the aforesaid passenger aboard vehicle.
The driver understands that The company will be able to retain any amount which it considers necessary for ends of compensation of loss or damage. This reserve could be carried out without obligation of setting in residence and will be regarded as damage interests liquidated in advance. In the case of any additional amount, The company will be able to directly proceed. The driver accepts as of signature of present that any procedures will be judged in the legal district of


Blue cross insurance
Passport
Proof of no criminal record
Parental authorization

Diamond Transportation (9249-7833 quebec Ine.)


DRIVER RELEASE & VERIFICATION OF
QUALIFICATION FORM ARTICLE 40.25(j)

SECTION 1
TO BE COMPLETED BY CANDIDATE


Will answer the following question :


Yes
No

If you have answered yes to the above question, you must provide documentation proving you have successfully complied with the return-to-duty process as required in Part 40, Subpart O. (You must provide proof of your S.A.P. evaluation, a negative return-to-duty drug and/or alcohol test result, and all follow-up drug and/or alcohol test results done in accordance with S.A.P. recommendation.) You must also provide any other documents related to the referral, evaluation and follow-up process.


If you answered yes to the above question and did not complete the required S.A.P. program, you hereby agree to complete this S.A.P. program.



SECTION 2
TO BE COMPLETED BY NEW EMPLOYER


Diamond Transportation ( 9249-7833 Quebec Inc.)

ON DUTY TIME (Driving and on duty time)
Previous 14 days before the hiring

(To be completed on the first day of service.)


Diamond Transportation (9249-7833 quebec Ine.)


Daily Inspection and
Authorization to sign the Inspection report

(Proof of Repair)



Note:

  • If a mechanical defect was noted at the time of departure, immediately report the Defect.
  • The Operator or Representative must sign the report without delay.
  • In some circumstances, a driver can sign the report on behalf of the operator and put him on his return (Ex.: leaving for several days, starting the night, etc.)

« We The Company» there by appoint Proxy - Driver

AND

Daily Inspection

Including; The Pre-Trip, during the work shift and post trip

The Company

Diamond Transportation (9249-7833 quebec Ine.)

Annual Review Of Driving Record

Instructions

In accordance with Section 391.25 of U.S. Department of Transportation's FMCSR, all carriers shall, at least once every 12 months, review the driving record each of the drivers in their employ operating motor vehicles in the United States to ensure they comply with the minimum requirements of safe driving or are no longer qualified for driving a commercial vehicle (Section 391.15).

In reviewing a driving record, the motor carrier must consider any evidence that the driver has violated applicable provisions of the F.M.C.S.R. and the Transportation of Hazardous Materials Regulations. He must also consider the driver's accident record and any evidence that the driver has violated laws governing the operation of motor vehicles. He must give great weight to violations such as speeding, reckless driving and operation while under the influence of alcohol or drugs, that indicate that the driver has exhibited a disregard for public safety.


Review for Period

I certify that I have reviewed the driving record of the above mentioned driver in accordance with Section 391.25 of FMCSR, and that this driver :

meets minimum requirements for safe driving
is disqualified to drive a motor vehicle pursuant to Section 391.15 of FMCSR

Diamond Transportation (9249-7833 quebec Ine.)

Request / Authorization

(To be kept in employee's confidential file)

For exchange of information between previous employers regarding

Drugs and Alcohol Tests

382.301 - 382.405(f) - 382.413 — 40.25


Part.1 Authorization of driver 482.413(a)(1)

I, the undersigned authorize the company (prospective employer) and/or it’s authorized representatives
(Name of representative(s) printed) to obtain from my previous employer(s) a copy of my file regarding the drug and alcohol testing program.

Part 2 Prospective employer

Part 3 Previous employer(s) (during past 36 months**) 382.413(a)(1)

Part 4 Driver's history (to be completed by person who signed Part 3) 382.413(b)

With regard to the driver whose name appears in Part 1, during the past three (3) years:

This person was employed in a safety-sensitive function that required alcohol and controlled-substances testing specified by 49 CFR Part 40 (if NO, skip this section)

Yes No

Diamond Transportation (9249-7833 quebec Ine.)

The previous employer did not provide signed release from driver (§40.321(b)). Therefore, drug/alcohol information cannot be provided.

Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No

Any drug or alcohol testing information obtained from previous employers under $40.25 or other applicable DOT regulations is included in this information. **

(Previous employer)

** Amendments to the FMCSR effective April 29, 2004

SPACE RESERVED FOR PROSPECTIVE EMPLOYER

Request made to previous employer on [date] By
Fax Mail
The prospective employer received the information on [date] By
Fax Mail Telephone Personal Interview