Pre-Employment Authorization and Acknowledgment

“In connection with my application for and potential employment with Southwaste Services, Inc., I hereby authorize Southwaste to obtain a consumer report containing background information about me, available from any and all sources, pertaining to consumer credit, prior or existing employment, motor vehicle operation, criminal and/or drug use matters, and any other matters deemed relevant by Southwaste. In the event that information from the report may lead to an adverse decision with regard to my potential employment, Southwaste will provide me with a copy of the consumer report and a description in writing of my rights under the law before making a final decision regarding my potential employment.

“Further, I acknowledge that as part of the consumer report, Southwaste may obtain an investigative report including information as to my character, general reputation, personal characteristics, and mode of living. I acknowledge that I have the right to request, in writing, within a reasonable time, a complete and accurate disclosure of the nature and scope of the information requested. Such disclosure will be made to me within five days of the date on which Southwaste receives my request for the report or within five days of the time the report was first requested, whichever is later in time.

“I hereby authorize any and all third parties to release to Southwaste any and all information requested by Southwaste. I hereby hold Southwaste harmless from and against any liability resulting from the use or disclosure of the information obtained by Southwaste in this regard.

“I understand that Southwaste may use any and all such information as a basis for its decision to extend to me an offer of employment.