9-DISC-TERM JERRY NASSO.pdf 9-DISC-TERM JERRY NASSO.pdf DEF00099

Asphalt Group, Inc.

14600 SW 136 Street

Miami, FL 33186

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Tel: (305) 255-5713

Fax: (305) 255-1935 TERMINATION OF EMPLOYMENT

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Supervisor's Name: Date: 0

Name of Employee: Date of Termination:

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[involuntary Termination

Explain Reason: Mff

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Voluntary Termination

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Corrective Measures Previously Taken:

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Warning Q Suspension Q Final Warning

If there were any Injuries (Explain):

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Uniform and/or Safety Equipment Status:

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dMG Equipment Status (tools, radios, beeper, etc.):

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Employee Signature Manager Signature

Case 1:22-cv-22343-KMM Document 111-12 Entered on FLSD Docket 09/24/2023 Page 1 of 3
9-DISC-TERM JERRY NASSO.pdf 9-DISC-TERM JERRY NASSO.pdf DEF00100

Asphalt Group, Inc.

14600 SW 136th Street

Miami, FL 33186

Tel.: (305) 364-3595

Fax'

(305) 364-3599

pTOJBieyee Accident / Disciplinary Report

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Name Division A.C>vVAt"

Location

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Action(s) to be Taken: [

] Warning ( | Suspension

Please documen!if Itiere were any injuries 1

| | Final Warning Termination Q Accident

This report is to be made part of the official record of the above employee.

Nature of Incident:

| Unexcused Absence

| | Tardiness

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| Insubordination

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Improper Conduct

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Failure to follow instructions

| |Leaving without permission

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Substandard work

| Violation of Safety Rules

| |Carelessness

| Destruction of company property

| Defective and improper work

| Violation of company rules

| | Theft

]Violation of Drug Free Workplace Policy

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Facts of incident: U-Q2.

Witnesses: ipOsJ^

Desired Outcome:

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Signature of Manager

I have read this report l

Signature of Employee

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Case 1:22-cv-22343-KMM Document 111-12 Entered on FLSD Docket 09/24/2023 Page 2 of 3
9-DISC-TERM JERRY NASSO.pdf 9-DISC-TERM JERRY NASSO.pdf DEF00101

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Case 1:22-cv-22343-KMM Document 111-12 Entered on FLSD Docket 09/24/2023 Page 3 of 3