Peery v. Nixon Engineering,llc

Western District of Texas, txwd-6:2018-cv-00358

Exhibit E - Declarants' Acknowledgements and Statement

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2 EXHIBIT E 2 The message has been sent from 68.203.180.64 (United States) at 2017­12­29 21:59:46 NOTE TO EMPLOYEE: Please read this Employee Handbook and keep it handy for future reference. You are required to sign this sheet and return it to your supervisor within ten (10) days after receipt of this Handbook. I acknowledge that I have access to all of the rules and information contained in the Nixon Engineering's Employee Handbook dated December 20, 2016 and The Accident Prevention Plan on Nixon Engineering's Intranet Portal/website located at support.nixon­engineering.com (do not type in "www" or "htpp"). I acknowledge and agree that the terms and conditions of my employment with Nixon Engineering are governed, in large part (but not exclusively), by the policies, procedures and description of benefits provided in the is Handbook, and I agree to abide by these policies and procedures. I understand that Nixon Engineering reserves the right to modify, delete or add to the information contained in this Handbook, and that I will be notified of any such changes by the Company. I understand that this Handbook supersedes all previously dated Handbooks and/or materials. I understand that nothing contained in this Handbook shall be construed as a contract of employment and that I am employed by the Company at­will, with either me or the Company having the right to terminate the employment relationship at any time and for any reason, with or without notice. I understand that Nixon Engineering enforces its policy prohibiting harassment, including sexual harassment. I agree that if I witness an act of harassment, or if I am subject to an act of harassment, I will immediately report that conduct as required by the Company's policy. I specifically agree to the Company's Confidentiality, Nondisclosure, Non­Solicitation, Non­Competition and Inventions Agreement contained in the Company Employee's Handbook dated December 20, 2016. I understand that I am either a Flagger or a Driver or a Lead Crew Member or one or a combination of two or combination of all three. I agree to comply with the applicable description of Flagger, Lead Crew Member and/or Driver. In the event I have a valid Driver's License and be pre­approved to be a Company Driver. If I am designated at any time and am the Lead Crew Member, then I agree to comply with all the descriptions of a Lead Crew Member. At all times, I agree to the descriptions of Flagger. The Flagger, Lead Crew member and driver descriptions, along with their respective duties, policies and procedures which are found in the Forms Sections of this Employee Handbook. I understand that my Company email can be used only for Company purposes and no other purpose. All uses of my Company email must be appropriate and proper. Name­First Ashton Name­Last Neal 2 Electronic signature Date 12/29/2017 Referrer http://nixon­engineering.com/employee/statement­of­employee/ Entry ID 62 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 4 of 52 Account Details Employee Name Ashton Neal Email ashton.neal@nixon-engineering.com Rating Employee ID 1427 Phone (-2649 Employee Application Details Your Name Account Ashton Neal Your Address 3532 HWY 21 E Madisonville, TX 77864 How Long at Current Residence? 10yrs Cell Phone Number (-7503 Do you have a smart phone? Yes Date of Birth SSN# If Under 18, What is your age? Have you ever been convicted of a crime? If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation: Do you have a driver's license? Yes DL# State of Issue Tx Type of Driver's License Operator Expiration Date 03/01/2025 Have you had any accidents or moving violations during the last 3 Yes years? How Many? 1 Explain Moving Violations if Needed Speeding https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 1/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 5 of 52 Reference One Name stephen culp Reference One Phone (-0739 Relationship Step father Reference Two Name Elizabeth price Reference Two Number (-4487 Relationship Ref Two Ex coworker Previous Employer Niixon Previous Manager Name Alisa Previous Employer Phone (-2525 Previous Job Title Crew leader Reason for Leaving Family issues How Long Did You Work There? 7 months List Any Allergies Aspirin List Any Medical Conditions Emergency Contact Name Steve culp Emergency Contact Phone (-0739 Emergency Contact Relation Step dad Habla Espanol? No Are you a US Citizen? Yes By signing below you are consenting to Nixon Engineering obtaining your driving and criminal background records. Date of Application 05/26/2019 Completed No Image of Social Security Card https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 2/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 6 of 52 Image of Driver's License Identifier 535 Accident Prevention Plan Accident Prevention Plan Details https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 3/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 7 of 52 Employee Name (APP) Account Ashton Neal Date Hired 05/26/2019 Company Safety Policy Statement 05/26/2019 Company Safety Policy Statement Initials Alcohol and Controlled Substance Policy Date 05/26/2019 Alcohol and Controlled Substance Policy Initials Employee Safety Responsibilities Date 05/26/2019 Employee Safety Responsibilities Initials Hazards associated with the job Date 05/26/2019 Hazards associated with the job Initial General and job specific safety rules Date 05/26/2019 General and job specific safety rules Initials Emergency Procedures Date 05/26/2019 Emergency Procedures Initials Personal Protective Equipment Requirements Date 05/26/2019 Personal Protective Equipment Requirements Initials Hazard Communication Training Date 05/26/2019 Hazard Communication Training Initials https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 4/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 8 of 52 TEEX Certification Date 05/26/2019 TEEX Certification Initials Return to Work Policy Date 05/26/2019 Return to Work Policy Initials Proper Lifting Techniques Date 05/26/2019 Proper Lifting Techniques Initials I have been trained in each of the above subject areas and will comply with all the policies, procedures and rules set forth. Date 05/26/2019 Rich Text I acknowledge that I have received a copy of the Accident Prevention Plan. I also acknowledge that the provisions of the Policy are part of the terms and conditions of my employment, and I agree to abide by them. I acknowledge that I have received a copy of the Accident Prevention Plan. I also acknowledge that the provisions of the Policy are part of the terms and conditions of my employment, and I agree to abide by them. Acknowledged Date 05/26/2019 Identifier Alcohol Drugs and Controlled Substance Policy Details Your Name I acknowledge that I have received a copy of the Alcohol and Controlled Substances Policy located in the Employee Handbook on page 14. I also acknowledge that the provisions of the Policy are https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 5/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 9 of 52 part of the terms and conditions of my employment, and I agree to abide by them. Date 05/26/2019 Account Ashton Neal Self Identification Form Details Your Name Date 05/26/2019 Gender Female Are you Hispanic or Latino? No If No, Please Choose From The List Below White (Not Hispanic or Latino) Account Ashton Neal Code of Conduct Details Your Name Signature Date 05/26/2019 Account Ashton Neal I9 Details Your Name Address 3532 HWY 21 E Madisonville, TX 77864 Date of Birth SSN Your Phone Number (-7503 I am aware that federal law provides for imprisonment and/or fines agree for false statements or use of false documents in connection with https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 6/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 10 of 52 the completion of this form. I attest, under penalty of perjury, that I am (check one of the following boxes): Signature Today's Date 05/26/2019 Account Ashton Neal Job Classification and Pay Details Signature of Employee Employee Name Date Employee Signed 05/26/2019 Nixon Engineering Representative Date Supervisor Signed 05/26/2019 Account Ashton Neal Employee Handbook Acknowledgement Details Your Name Signature Date 05/26/2019 Account Ashton Neal PAYMENT INSTRUCTIONS/AUTHORIZATION Details https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 7/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 11 of 52 Payment Options I choose to have my payroll payment deposited onto the following prepaid debit card, and I am aware and agree to pay any and all fees associated with the deposit to this account and to pay any and all related fees to use this account; further I have knowledge and agree that Nixon Engineering will not be required to pay any fees associated with my ownership and use of this account Direct Deposit Bank Name Direct Deposit Account Number Paystub Address Direct Deposit Signature Direct Deposit Date 05/26/2019 Option 2 Prepaid Card Name Current Option 2 Bank Name Choice financial group Option 2 Routing Number 091302966 Option 2 Account Number Option 2 Signature if Chosen Option 3 Mail My Check To This Address: Option 3 Signature if Needed Your Name https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 8/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 12 of 52 Direct Deposit Routing Number Account Ashton Neal Payroll Payment Deadlines and Rule Details Your Name Signature Date 05/26/2019 Account Ashton Neal Safety and Vehicle Policy Details Your Name Signature Date 05/26/2019 Account Ashton Neal Statement of Employee Details Your Name Signature Date 05/26/2019 Account Ashton Neal Tech Support and Call Center Details Your Name Signature https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 9/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 13 of 52 Date 05/26/2019 Account Ashton Neal TMA Workshop Details Your Name Signature Date 05/26/2019 Account Ashton Neal Unauthorized Movement Policy Details Your Name Signature Date 05/26/2019 Account Ashton Neal W4 Details Your Name SSN Address 3532 HWY 21 E Madisonville, TX 77864 Filing Choice Single Total number of allowances Additional amount if required https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 10/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 14 of 52 Signature Date 05/26/2019 Account Ashton Neal Wage Deduction Agreement Details Your Name Signature Date 05/26/2019 Supervisor Signature Supervisor Date 05/26/2019 Account Ashton Neal Uniform Deposit Agreement Details Uniform Deposit Agreement Name Date 05/26/2019 Your Name Ashton neal Safety Vest Quantity Safety Vest Deposit 0.00 Hard Hat Hard Hat Quantity Hard Hat Deposit 0.00 Pants Pants Quantity https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 11/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 15 of 52 Pants Deposit 0.00 Total Deposit 0.00 Deduct Total Deposit From Paycheck No Employee Signature Nixon Engineering Authorized Signature Master New Hire Account Ashton Neal Personal Relationship Agreement Details Employee 1 Signature Employee 2 Signature Date 05/26/2019 Supervisor Name Alisa Bernhardt Approved? Yes Approval Date 05/26/2019 Master New Hire Your Name Account Ashton Neal https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 12/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 16 of 52 Workers Comp Policy Details Your Name Signature Signed Date 05/26/2019 Master New Hire Account Ashton Neal New Employee Job Safety Record Details Company Safety and Policy Statement Date 05/26/2019 Alcohol and Controlled Substance Policy Date 05/26/2019 Hazards Associates with the Job Date 05/26/2019 General and Job Specific Safety Rules Date 05/26/2019 Emergency Procedures Date 05/26/2019 Personal Protective Equipment Requirements Date 05/26/2019 TEEX Certification Proper Lifting Techniques Date 05/26/2019 Daily Safety Affirmations Date 05/26/2019 Daily, Weekly, Monthly Employee Vehicle and Equipment Safety Review Date 05/26/2019 Your Name Ashton neal Signature Date Signed 05/26/2019 Master New Hire Account Ashton Neal EEO Form Details Your Name Ashton neal https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 13/14 5/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 17 of 52 Signature Date Signed 05/26/2019 Master New Hire Account Ashton Neal Everify Details Your Name Ashton Neal Signature Date 05/26/2019 https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3290f80137cd085171ba64/ 14/14 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 18 of 52 Account Details Employee Name Vernon Heath Email vernon.heath@nixon-engineering.com Rating Employee ID 2082 Phone Employee Application Details Your Name Vernon Heath Account Vernon Heath Your Address 522 s. Mary st Madisonville, Tx 77864 How Long at Current Residence? 2 yrs Cell Phone Number (-9405 Do you have a smart phone? Yes Date of Birth SSN# If Under 18, What is your age? Have you ever been convicted of a crime? If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation: Do you have a driver's license? Yes DL# State of Issue Tx Type of Driver's License Operator Expiration Date 06/13/2020 Have you had any accidents or moving violations during the No last 3 years? How Many? https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 1/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 19 of 52 Explain Moving Violations if Needed Reference One Name Brandy Toland Reference One Phone (-2224 Relationship Girlfriend Reference Two Name Sonny Plotts Reference Two Number (-2007 Relationship Ref Two Landlord Previous Employer Pizza hut Previous Manager Name Adam Carter Previous Employer Phone (-5511 Previous Job Title Dishwasher Reason for Leaving Laidoff How Long Did You Work There? 8 months List Any Allergies List Any Medical Conditions Emergency Contact Name Christine Heath Emergency Contact Phone -6500 Emergency Contact Relation Mother Habla Espanol? No Are you a US Citizen? Yes By signing below you are consenting to Nixon Engineering obtaining your driving and criminal background records. Date of Application 01/27/2019 Completed No Image of Social Security Card Image of Driver's License Identifier 63 Accident Prevention Plan https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 2/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 20 of 52 Accident Prevention Plan Details Employee Name (APP) Vernon Heath Account Vernon Heath Date Hired 01/27/2019 Company Safety Policy Statement 01/27/2019 Company Safety Policy Statement Initials Alcohol and Controlled Substance Policy Date 01/27/2019 Alcohol and Controlled Substance Policy Initials Employee Safety Responsibilities Date 01/27/2019 Employee Safety Responsibilities Initials Hazards associated with the job Date 01/27/2019 Hazards associated with the job Initial General and job specific safety rules Date 01/27/2019 General and job specific safety rules Initials Emergency Procedures Date 01/27/2019 Emergency Procedures Initials Personal Protective Equipment Requirements Date 01/27/2019 Personal Protective Equipment Requirements Initials https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 3/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 21 of 52 Hazard Communication Training Date 01/27/2019 Hazard Communication Training Initials TEEX Certification Date 01/27/2019 TEEX Certification Initials Return to Work Policy Date 01/27/2019 Return to Work Policy Initials Proper Lifting Techniques Date 01/27/2019 Proper Lifting Techniques Initials I have been trained in each of the above subject areas and will comply with all the policies, procedures and rules set forth. Date 01/27/2019 Rich Text I acknowledge that I have received a copy https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 4/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 22 of 52 of the Accident Prevention Plan. I also acknowledge that the provisions of the Policy are part of the terms and conditions of my employment, and I agree to abide by them. I acknowledge that I have received a copy of the Accident Prevention Plan. I also acknowledge that the provisions of the Policy are part of the terms and conditions of my employment, and I agree to abide by them. Acknowledged Date 01/27/2019 Identifier Alcohol Drugs and Controlled Substance Policy Details Your Name Vernon Heath I acknowledge that I have received a copy of the Alcohol and Controlled Substances Policy located in the Employee Handbook on page 14. I also acknowledge that the provisions of the Policy are part of the terms and conditions of my employment, and I agree to abide by them. Date 01/27/2019 Account Vernon Heath Self Identification Form Details Your Name Vernon Heath Date 02/12/2019 Gender Male Are you Hispanic or Latino? No If No, Please Choose From The List Below White (Not Hispanic or Latino) Account Vernon Heath Code of Conduct Details Your Name Vernon Heath Signature https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 5/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 23 of 52 Date 02/12/2019 Account Vernon Heath I9 Details Your Name Vernon Heath Address 522 s. Mary st Madisonville, Tx 77864 Date of Birth SSN Your Phone Number (-9405 I am aware that federal law provides for imprisonment agree and/or fines for false statements or use of false documents in connection with the completion of this form. I attest, under penalty of perjury, that I am (check one of the following boxes): Signature Today's Date 01/27/2019 Account Vernon Heath Job Classification and Pay Details Signature of Employee Employee Name vernon heath Date Employee Signed 02/12/2019 https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 6/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 24 of 52 Nixon Engineering Representative Date Supervisor Signed Account Vernon Heath Employee Handbook Acknowledgement Details Your Name vernon heath Signature Date 02/12/2019 Account Vernon Heath PAYMENT INSTRUCTIONS/AUTHORIZATION Details Payment Options I choose to have my payroll payment direct deposited to the following bank account and Nixon Engineering is authorized to make the ACH payments as provided herein and below. Direct Deposit Bank Name Citibank Direct Deposit Account Number Paystub Address 522 S. Mary st Madisonville, tx 77864 Direct Deposit Signature Direct Deposit Date 02/12/2019 Option 2 Prepaid Card Name Option 2 Bank Name Option 2 Routing Number Option 2 Account Number Option 2 Signature if Chosen Option 3 Mail My Check To This Address: https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 7/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 25 of 52 Option 3 Signature if Needed Your Name vernon Heath III Direct Deposit Routing Number Account Vernon Heath Payroll Payment Deadlines and Rule Details Your Name Vernon Heath Signature Date 02/12/2019 Account Vernon Heath Safety and Vehicle Policy Details Your Name Vernon Heath Signature Date 01/27/2019 Account Vernon Heath Statement of Employee Details Your Name Vernon Heath Signature Date 02/12/2019 Account Vernon Heath Tech Support and Call Center Details https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 8/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 26 of 52 Your Name Vernon Heath Signature Date 02/12/2019 Account Vernon Heath TMA Workshop Details Your Name Vernon Heath Signature Date 01/27/2019 Account Vernon Heath Unauthorized Movement Policy Details Your Name Vernon Heath Signature Date 01/27/2019 Account Vernon Heath W4 Details Your Name Vernon Heath SSN Address 522 s. Mary st Madisonville, Tx 77864 Filing Choice Single Total number of allowances 3 Additional amount if required https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 9/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 27 of 52 Signature Date 01/27/2019 Account Vernon Heath Wage Deduction Agreement Details Your Name Vernon Heath Signature Date 01/27/2019 Supervisor Signature Supervisor Date Account Vernon Heath Uniform Deposit Agreement Details Uniform Deposit Agreement Name Vernon Heath Date 01/27/2019 Your Name Vernon Heath Safety Vest Safety Vest Quantity 1 Safety Vest Deposit 19.25 Hard Hat Hard Hat Hard Hat Quantity 1 Hard Hat Deposit 12.75 Pants Pants Quantity 1 Pants Deposit 21.00 Total Deposit 53.00 Deduct Total Deposit From Paycheck Yes https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 10/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 28 of 52 Employee Signature Nixon Engineering Authorized Signature Master New Hire Account Vernon Heath Personal Relationship Agreement Details Employee 1 Signature Employee 2 Signature Date 01/27/2019 Supervisor Name Approved? No Approval Date 01/27/2019 Master New Hire Vernon Heath Your Name Vernon Heath Account Vernon Heath Workers Comp Policy Details Your Name Vernion Heath Signature Signed Date 02/12/2019 Master New Hire Account Vernon Heath New Employee Job Safety Record Details Company Safety and Policy Statement Date 02/17/2019 https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 11/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 29 of 52 Alcohol and Controlled Substance Policy Date 02/13/2019 Hazards Associates with the Job Date 02/13/2019 General and Job Specific Safety Rules Date 02/13/2019 Emergency Procedures Date 02/13/2019 Personal Protective Equipment Requirements Date 02/13/2019 TEEX Certification 02/13/2019 Proper Lifting Techniques Date 02/13/2019 Daily Safety Affirmations Date 02/13/2019 Daily, Weekly, Monthly Employee Vehicle and Equipment 02/13/2019 Safety Review Date Your Name Vernon Heath Signature Date Signed 02/18/2019 Master New Hire Account Vernon Heath EEO Form Details Your Name Vernon Heath Signature Date Signed 02/12/2019 Master New Hire Vernon Heath Account Vernon Heath https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b32931a0137cd085171c990/ 12/12 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 30 of 52 Account Details Employee Name John Swinner Email john.swinner@nixon-engineering.com Rating Employee ID 1732 Phone Employee Application Details Your Name John Swinner Account John Swinner Your Address 2485 F.M. 350 S. Trlr.#13 Livingston, Tx 77351 How Long at Current Residence? 1 yr. Cell Phone Number (2410 Do you have a smart phone? Yes Date of Birth SSN# If Under 18, What is your age? Have you ever been convicted of a crime? If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation: Do you have a driver's license? Yes DL# State of Issue Tx Type of Driver's License Operator Expiration Date Have you had any accidents or moving violations during the No last 3 years? How Many? https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 1/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 31 of 52 Explain Moving Violations if Needed Reference One Name William Swinner Reference One Phone -8121 Relationship brother Reference Two Name Patrick Roberts Reference Two Number (-2437 Relationship Ref Two friend Previous Employer Hutto logging Previous Manager Name Jim Hutto Previous Employer Phone (-4520 Previous Job Title driver Reason for Leaving no work How Long Did You Work There? 1 yr List Any Allergies List Any Medical Conditions Emergency Contact Name Tiffany Swinner Emergency Contact Phone (-1388 Emergency Contact Relation Wife Habla Espanol? No Are you a US Citizen? Yes By signing below you are consenting to Nixon Engineering obtaining your driving and criminal background records. Date of Application 01/27/2019 Completed No Image of Social Security Card https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 2/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 32 of 52 Image of Driver's License Identifier 20 Accident Prevention Plan Accident Prevention Plan Details Employee Name (APP) John Swinner Account John Swinner Date Hired 05/01/2018 Company Safety Policy Statement 01/27/2019 Company Safety Policy Statement Initials Alcohol and Controlled Substance Policy Date 01/27/2019 Alcohol and Controlled Substance Policy Initials Employee Safety Responsibilities Date 01/27/2019 Employee Safety Responsibilities Initials https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 3/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 33 of 52 Hazards associated with the job Date 01/27/2019 Hazards associated with the job Initial General and job specific safety rules Date 01/27/2019 General and job specific safety rules Initials Emergency Procedures Date 01/27/2019 Emergency Procedures Initials Personal Protective Equipment Requirements Date 01/27/2019 Personal Protective Equipment Requirements Initials Hazard Communication Training Date 01/27/2019 Hazard Communication Training Initials TEEX Certification Date 01/27/2019 TEEX Certification Initials Return to Work Policy Date 01/27/2019 Return to Work Policy Initials Proper Lifting Techniques Date 01/27/2019 Proper Lifting Techniques Initials https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 4/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 34 of 52 I have been trained in each of the above subject areas and will comply with all the policies, procedures and rules set forth. Date 01/27/2019 Rich Text I acknowledge that I have received a copy of the Accident Prevention Plan. I also acknowledge that the provisions of the Policy are part of the terms and conditions of my employment, and I agree to abide by them. I acknowledge that I have received a copy of the Accident Prevention Plan. I also acknowledge that the provisions of the Policy are part of the terms and conditions of my employment, and I agree to abide by them. Acknowledged Date 01/27/2019 Identifier Alcohol Drugs and Controlled Substance Policy Details Your Name John Swinner I acknowledge that I have received a copy of the Alcohol and Controlled Substances Policy located in the Employee Handbook on page 14. I also acknowledge that the provisions of the Policy are part of the terms and conditions of my employment, and I agree to abide by them. Date Account John Swinner https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 5/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 35 of 52 Self Identification Form Details Your Name John Swinner Date 01/27/2019 Gender Are you Hispanic or Latino? No If No, Please Choose From The List Below White (Not Hispanic or Latino) Account John Swinner Code of Conduct Details Your Name Signature Date 02/18/2019 Account John Swinner I9 Details Your Name John Swinner Address 2485 F.M. 350 S. Trlr.#13 Livingston, Tx 77351 Date of Birth SSN 0 Your Phone Number (-2410 I am aware that federal law provides for imprisonment agree and/or fines for false statements or use of false documents in connection with the completion of this form. I attest, under penalty of perjury, that I am (check one of the following boxes): Signature https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 6/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 36 of 52 Today's Date 01/27/2019 Account John Swinner Job Classification and Pay Details Signature of Employee Employee Name John Swinner Date Employee Signed 01/27/2019 Nixon Engineering Representative Date Supervisor Signed Account John Swinner Employee Handbook Acknowledgement Details Your Name John Swinner Signature Date 01/27/2019 Account John Swinner https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 7/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 37 of 52 Payroll Payment Deadlines and Rule Details Your Name John Swinner Signature Date 01/27/2019 Account John Swinner Safety and Vehicle Policy Details Your Name John Swinner Signature Date 01/27/2019 Account John Swinner Statement of Employee Details Your Name John Swinner Signature Date 01/27/2019 Account John Swinner https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 8/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 38 of 52 Tech Support and Call Center Details Your Name John Swinner Signature Date 01/27/2019 Account John Swinner TMA Workshop Details Your Name John Swinner Signature Date 01/27/2019 Account John Swinner Unauthorized Movement Policy Details Your Name Signature Date 02/18/2019 Account John Swinner W4 Details Your Name John Swinner SSN https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 9/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 39 of 52 Address 2485 F.M. 350 S. Trlr.#13 Livingston, Tx 77351 Filing Choice Married but withhold at single rate Total number of allowances 0 Additional amount if required Signature Date Account John Swinner Wage Deduction Agreement Details Your Name John Swinner Signature Date 01/27/2019 Supervisor Signature Supervisor Date Account John Swinner Uniform Deposit Agreement Details Uniform Deposit Agreement Name Date 02/18/2019 Your Name John Swinner Safety Vest Safety Vest Quantity 1 Safety Vest Deposit 19.25 Hard Hat https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 10/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 40 of 52 Hard Hat Quantity Hard Hat Deposit 0.00 Pants Pants Quantity Pants Deposit 0.00 Total Deposit 19.25 Deduct Total Deposit From Paycheck Yes Employee Signature Nixon Engineering Authorized Signature Master New Hire Account John Swinner Personal Relationship Agreement Details Employee 1 Signature Employee 2 Signature Date 01/27/2019 Supervisor Name Approved? No Approval Date 01/27/2019 Master New Hire John Swinner Your Name John Swinner Account John Swinner https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 11/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 41 of 52 Workers Comp Policy Details Your Name Signature Signed Date 02/18/2019 Master New Hire Account John Swinner New Employee Job Safety Record Details Company Safety and Policy Statement Date 02/17/2019 Alcohol and Controlled Substance Policy Date Hazards Associates with the Job Date General and Job Specific Safety Rules Date Emergency Procedures Date Personal Protective Equipment Requirements Date TEEX Certification Proper Lifting Techniques Date Daily Safety Affirmations Date Daily, Weekly, Monthly Employee Vehicle and Equipment Safety Review Date Your Name john Swinner Signature Date Signed 02/17/2019 https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 12/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 42 of 52 Master New Hire Account John Swinner EEO Form Details Your Name John Swinner Signature Date Signed 02/18/2019 Master New Hire John Swinner Account John Swinner https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3291fc0137cd085171c06c/ 13/13 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 43 of 52 Account Details Employee Name William Swinner Email william.swinner@nixon-engineering.com Rating Employee ID 2099 Phone Employee Application Details Your Name William Swinner Account William Swinner Your Address 5325 Strawther Rd North Zulch, Tx 77872 How Long at Current Residence? 10 Cell Phone Number (-8121 Do you have a smart phone? Yes Date of Birth SSN# If Under 18, What is your age? Have you ever been convicted of a crime? If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation: Do you have a driver's license? No DL# State of Issue Type of Driver's License Expiration Date Have you had any accidents or moving violations during the No last 3 years? How Many? https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3293290137cd085171ca05/ 1/10 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 44 of 52 Explain Moving Violations if Needed Reference One Name Alisa Barnhart Reference One Phone (-8121 Relationship Friend Reference Two Name Eathen Craft Reference Two Number Relationship Ref Two Friend Previous Employer Previous Manager Name Previous Employer Phone Previous Job Title Reason for Leaving How Long Did You Work There? List Any Allergies List Any Medical Conditions Emergency Contact Name John Swinner Emergency Contact Phone -2410 Emergency Contact Relation Brother Habla Espanol? No Are you a US Citizen? Yes By signing below you are consenting to Nixon Engineering obtaining your driving and criminal background records. Date of Application 02/27/2018 Completed No Image of Social Security Card https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3293290137cd085171ca05/ 2/10 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 45 of 52 Image of Driver's License Identifier 22 Accident Prevention Plan Accident Prevention Plan Details Employee Name (APP) William Swinner Account William Swinner Date Hired 02/27/2018 Company Safety Policy Statement 01/27/2019 Company Safety Policy Statement Initials Alcohol and Controlled Substance Policy Date 01/27/2019 Alcohol and Controlled Substance Policy Initials Employee Safety Responsibilities Date 01/27/2019 Employee Safety Responsibilities Initials Hazards associated with the job Date 01/27/2019 Hazards associated with the job Initial General and job specific safety rules Date 01/27/2019 General and job specific safety rules Initials https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3293290137cd085171ca05/ 3/10 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 46 of 52 Emergency Procedures Date 01/27/2019 Emergency Procedures Initials Personal Protective Equipment Requirements Date 01/27/2019 Personal Protective Equipment Requirements Initials Hazard Communication Training Date 01/27/2019 Hazard Communication Training Initials TEEX Certification Date TEEX Certification Initials Return to Work Policy Date 01/27/2019 Return to Work Policy Initials Proper Lifting Techniques Date 01/27/2019 Proper Lifting Techniques Initials I have been trained in each of the above subject areas and will comply with all the policies, procedures and rules set forth. Date 01/27/2019 Rich Text I acknowledge that I have received a copy of the Accident Prevention Plan. I also acknowledge that the provisions of the https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3293290137cd085171ca05/ 4/10 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 47 of 52 Policy are part of the terms and conditions of my employment, and I agree to abide by them. I acknowledge that I have received a copy of the Accident Prevention Plan. I also acknowledge that the provisions of the Policy are part of the terms and conditions of my employment, and I agree to abide by them. Acknowledged Date 01/27/2019 Identifier Alcohol Drugs and Controlled Substance Policy Details Your Name William Swinner I acknowledge that I have received a copy of the Alcohol and Controlled Substances Policy located in the Employee Handbook on page 14. I also acknowledge that the provisions of the Policy are part of the terms and conditions of my employment, and I agree to abide by them. Date 01/27/2019 Account William Swinner Self Identification Form Details Your Name William Swinner Date 01/27/2019 Gender Male Are you Hispanic or Latino? No If No, Please Choose From The List Below Account William Swinner Code of Conduct Details Your Name William3rdt Swinner Signature Date 01/27/2019 Account William Swinner https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3293290137cd085171ca05/ 5/10 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 48 of 52 I9 Details Your Name William Swinner Address 5325 Strawther Rd North Zulch, Tx 77872 Date of Birth SSN Your Phone Number (-8121 I am aware that federal law provides for imprisonment agree and/or fines for false statements or use of false documents in connection with the completion of this form. I attest, under penalty of perjury, that I am (check one of the following boxes): Signature Today's Date 01/27/2019 Account William Swinner Job Classification and Pay Details Signature of Employee Employee Name William Swinner Date Employee Signed 02/27/2018 Nixon Engineering Representative Date Supervisor Signed Account William Swinner Employee Handbook Acknowledgement Details Your Name William Swinner Signature https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3293290137cd085171ca05/ 6/10 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 49 of 52 Date 01/27/2019 Account William Swinner Payroll Payment Deadlines and Rule Details Your Name William Swinner Signature Date 01/27/2019 Account William Swinner Safety and Vehicle Policy Details Your Name William Swinner Signature Date 01/28/2019 Account William Swinner Statement of Employee Details Your Name William Swinner Signature Date 01/27/2019 Account William Swinner Tech Support and Call Center Details Your Name William Swinner Signature https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3293290137cd085171ca05/ 7/10 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 50 of 52 Date 01/27/2019 Account William Swinner TMA Workshop Details Your Name William Swinner Signature Date 01/27/2019 Account William Swinner Unauthorized Movement Policy Details Your Name William Swinner Signature Date 01/27/2019 Account William Swinner W4 Details Your Name William Swinner SSN Address 5325 Strawther Rd North Zulch, Tx Filing Choice Single Total number of allowances 0 Additional amount if required 0 Signature Date 01/27/2019 Account William Swinner https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3293290137cd085171ca05/ 8/10 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 51 of 52 Wage Deduction Agreement Details Your Name William Swinner Signature Date 01/27/2019 Supervisor Signature Supervisor Date Account William Swinner Personal Relationship Agreement Details Employee 1 Signature Employee 2 Signature Date 01/27/2019 Supervisor Name Approved? Yes Approval Date 01/27/2019 Master New Hire William Swinner Your Name William Swinner Account William Swinner https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3293290137cd085171ca05/ 9/10 2/26/2019 Nixon Engineering Case 6:18-cv-00358-ADA-JCM Document 28-5 Filed 2.0 06/14/19 Page 52 of 52 https://nixonengineering.knack.com/pluto#test-accounts/account-details/5b3293290137cd085171ca05/ 10/10