Position: Driver

I hereby authorize you to release all information concerning employment, to include alcohol test with a concentration result of 0.04 or greater, positive controlled substance test and/or refusals to submit to testing. I also authorize the release of any assessments of my job performance and work history. I release you from any and all liability in providing this information to Baldwin Redi-Mix.

By my signature below, I authorize Baldwin Redi-Mix Co., Inc., the current insurance carrier for Baldwin Redi-Mix Co., Inc., and any prospective insurance carrier for Baldwin Redi-Mix Co., Inc. to order a copy of my Driving Records. The contents of this report can be discussed among those parties listed above for the purpose of determining my acceptability as a driver of company vehicles owned, leased, rented or borrowed by Baldwin Redi-Mix Co., Inc. At my written request, I can receive a copy of this report. This authorization remains in effect until rescinded by me in writing.