Statement of Agreement and indemnification;
authorize past or present employers to release any information
requested by the above carriers and hold them harmless of
all liability from release of said information. I (the name
that appears on the application) have personally filled
out and completed this application, and I have read,
understand and agree to the truth of this information and
this Statement of Agreement and Indemnification.
I hereby agree to indemnify and hold harmless the carrier (s) /
recruiting source (s) (whichever applies) that I submit this to, it's information providers licensors, licensees, consultants, contractors, agents, advertisers attorneys and employees from any and all liabilities, costs and expenses, including, without limitation, reasonable attorneys fees that may arise from my use of this site or application. Furthermore, I certify that all of the information in this application is true and correct.
I authorize the above recruiting source / carrier (s) to obtain any and all information (including, but not limited to, work history, criminal history, and drug (controlled substances) & alcohol testing, from any source to include past or present employers, Medical Review Officer (s) (MRO) or their agent (s) DAC services, and / or other consumer reports, in accordance with State and Federal laws.
with Federal and State equal employment opportunity laws,
qualified applicants are considered for all positions without
regard to race, color, religion, sex, national origin, age,
marital status, or non-job related disability.
clicking the Submit button, I agree to the terms and the
Statement of Agreement and Indemnification.