HOME ABOUT US COLOR CHARTS SERVICES SERVICE AREAS CONTACT US CAREERS CAREERS WORK WITH US! To apply for a job with Mini Concrete, please send a cover letter together with your C.V. to: mcm@miniconcrete.com, or fill the contact form below. Name * First Middle Last Address * City * State & Zip Code * Date of Birth * Social Security No. * Hire Date * Phone Number * Email Address * LICENSE INFORMATION Section 383.21 FMCSR "No person who operates a commercial motor vehicle shall at any time have more than one driver's license". I certify that I do not have more than one motor vehicle license, the information for which is listed below. State * License No. * Type * Expiration Date * DRIVING EXPERIENCE Class of Equipment * Straight Truck Tractor and Semi-trailer Tractor - Two Trailers Other Type of Equipment * From (date) * To (date) * Approx. No. of miles (total) * Class of Equipment * Straight Truck Tractor and Semi-trailer Tractor - Two Trailers Other Type of Equipment * From (date) * To (date) * Approx. No. of miles (total) * Class of Equipment * Straight Truck Tractor and Semi-trailer Tractor - Two Trailers Other Type of Equipment * From (date) * To (date) * Approx. No. of miles (total) * ACCIDENT RECORD FOR PAST 3 YEARS OR MORE Accident Date Nature of Accident Number Fatalities Number Injuries Chemical Spills Yes No Accident Date Nature of Accident Number Fatalities Number Injuries Chemical Spills Yes No Accident Date Nature of Accident Number Fatalities Number Injuries Chemical Spills Yes No TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS Other than parking violations Date Convicted Violation State of Violation Location Penalty Date Convicted Violation State of Violation Location Penalty Date Convicted Violation State of Violation Location Penalty Have you ever been denied a license, permit, or privilege to operate a motor vehicle? * Yes No If yes, why? Has any license, permit, or privilege ever been suspended or revoked? * Yes No If yes, why? EMPLOYMENT RECORD Applicants that desire to drive in intrastate/interstate commerce must provide the following information on all employers during the previous three years. You must give the same information to all employers you have driven a commercial motor vehicle for the seven years prior to the initial three years (total of ten years employment record). Last Employer Name * Address * Phone * Position Held and Salary * From * To * Reasons for Leaving * Any gaps in employment and/or unemployment must be explained Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer? * Yes No Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40? * Yes No Second Last Employer Name * Address * Phone * Position Held and Salary * From * To * Reasons for Leaving * Any gaps in employment and/or unemployment must be explained Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer? * Yes No Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40? * Yes No Third Last Employer Name * Address * Phone * Position Held and Salary * From * To * Reasons for Leaving * Any gaps in employment and/or unemployment must be explained Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer? * Yes No Was the previous job position designated as a safety sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40? * Yes No I authorize you to make sure investigations and inquiries to my personal, employment, financial, or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended). I hereby release employers, schools, health acre providers and other persons from all liability in responding and releasing information in connection with application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23 (d) and (e). I understand that I have the right to: Review information provided by current/previous employers Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. Applicant's Full Name * Date * This verifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. Applicant's Full Name * Date * Note: A motor carrier may require an applicant to provide information in addition to the information required by the Federal Motor Carrier Safety Regulations. AGREEMENT AND CONSENT TO DRUG AND/OR ALCOHOL TESTING I understand that MINICONCRETE MATERIALS, Inc. ("MINICONCRETE" or the "Company") has a policy against the possession, use, sale and transfer of illegal drugs by its employees and applicants for employment. I further understand that MINICONCRETE is committed to a drug and alcohol free workplace and has adopted a drug testing program as one method of implementing this policy. I hereby agree, upon a request made under the drug/alcohol testing policy of MINICONCRETE as set forth in the Employee Handbook, to submit to a drug and/or alcohol test and to furnish a sample of my urine, breath, and/or blood for analysis. I further authorize and give full permission to have MINICONCRETE and or its Company physician send the specimen(s) collected to a laboratory for a screening test for the presence of any prohibited substances under the policy, and for the laboratory or other testing facility to release any and all documentation relating to such test to MINICONCRETE. I further understand that MINICONCRETE may request proof that I am taking a controlled substance as directed pursuant to a lawful prescription issued in my name. If requested, I must provide such proof within seventy-two (72) hours of the request. If I failed to disclose the prescription drug prior to the drug test or a fail to provide proof of such prescription at any time, then I am subject to immediate termination or rejection of my employment application. I understand that the duly-authorized Company officers, employees, and agents will have access to information furnished or obtain in connection with the test set; that they will maintain and protect the confidentiality of such information to the greatest extent possible; and they will share such information only to the extent necessary to make employment decisions and to respond to inquiries or notices from government entities. I understand that as a condition of my employment MINICONCRETE reserves the right to require an alcohol and drug test at any time during my employment, including but not limited to, whenever I am involved in an on-the-job accident or injury under circumstances that suggest possible involvement or influence of drugs and/or alcohol, for reasonable suspicion, as part of an investigation, randomly, or for any other legitimate business reason. I further understand and agree that if I test positive for alcohol and/or drugs in both violation of company policy, if I refuse to submit to a drug or alcohol test, or if I otherwise failed to cooperate with the testing procedures, I will be subject to immediate termination or rejection of my employment application. This policy and authorization has been explained to me in a language I understand, and I have been told that if I have any questions about the test or the policy, they will be answered. Applicant's Full Name * Social Security Number * HEAD OFFICE 15001 Horizon Blvd, El Paso, TX 79928 mcm@miniconcrete.com Tel: (915) 852-4468 Fax: 915-852-3199 EMPLOYMENT To apply for a job with Mini Concrete, please send a cover letter together with your C.V. to: mcm@miniconcrete.com HELPFUL LINKS SERVICES ABOUT PROJECTS CONTACT SERVICE AREAS EL PASO MONAHANS ORLA PECOS GET A QUOTE 432-448-3568