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EMPLOYEE AND APPLICANT CONSENT
<br />I V VKUG AnurvK ALCUMUL i EST AND
<br />AU I Ii V KIGA I ION JP UK
<br />HEAD THIS FORM CAREFULLY
<br />I do nercoy certiry that I nave receivM -.a .v-tlr: �t�e=ee Kc.0crttim Florida, Inc.'s ("FirstService
<br />Residential") L,rug-rree wortcplace rrogram ana roiicies resarn:ng auostance Aomc ..-.e
<br />mbuse.
<br />I freely and voluntarily agree ;o submit to a drub screen -urinalysis or hair sample for all drugs excepi alcohol
<br />(..!venal to ae tc.,tem n, wood or D. c..Ih samplc) if ry-ired, as pari of my application for employment. I understand that
<br />ciuterto-;;t)m:t to lfta 8 wb ae, e.-. or Fite, to yarm.- y nccvrainb to the minimum standards established by
<br />FirstService rtesltienual for tnis me f -nt Mailer eonsiacration I0rcn71,10yment.
<br />I furiher understand that after emptoyment negins wiM rirslService resitientiai, t ay to
<br />submit -10 a drub screen. 1 understand that refusal to take a requested drug screen or ,allure to meet Me minimum
<br />standards set for the screen may result in immediate suspension or discharge.
<br />t -a:.Iler5ta.-A MI ,I I t.....aic- an or t. -.a lite I=ts, I .at be employed, and if an employee, will be subject to
<br />appropriaie corrective action, up to ants i-.letiins a:.-nwbc, a - L1 rintacr.:a n�,:ifcnti..l', sole discretion, required to
<br />comply with the terms of a last cnance agreement.
<br />1 understand that I shall report any Drug conviction wi[run live says from Ine trate of �unvtefl.wn.
<br />F: stScRicc Kmidential may reF ii the conviction to any federal, state or local agency with which the employer Has a
<br />canUoct ..nd i5 otnerrrise rcyairea by Ir.W to rcp.,rt. A failure to report a drub conviction may result in corrective action.
<br />L un0crstanti ulat aft information, :.terv;ew., , e,,wrts, Mate c.-.ts,-c.-o.—a......3 a .b -free test results through
<br />the 1=irstService Residential's orug testing rrogram are conntlentiar communications --a ma, net ve -r8 U.:Im I
<br />consent to release of such information oras otherwise required or allowed in accoMance wiur slate anti fetierat tai-,. artt
<br />regulations.
<br />1 ..:u Do t1i,cctca to provfiae a erirc, 5.....th, n.,ir and/or blood specimen at a medical or specimen collection
<br />facility cnosen Dy rirsl5e ce rte itio.-.tiws.
<br />I will be allowed to provide a urine specimen privately except mat it f-rpe,..- to oe tryi.:j. to
<br />substituted, altered, or adulterated specimen, or have attempted to provide suc0 a specimen previously or otnerwise.
<br />If I naive... to b� ..ttemptinb to tamper with the collection process, I may be required to provide an observed
<br />.pev.ma-...-We.-.,et: j=( to Co..cch-e avtion or discharlic.
<br />t will oe alloweti, il`I cnoose, to oiscrose e.-. Rte we, al Me Cn..i.-. at Cestan, fora, rm., micclic.liar. I u3c.
<br />After collection, my urine, hair and/or blood specimen will oc sent to a iaooratory cnosen oy
<br />Residential to les; for detectable amounts of controlled substances, inctuaing marijuana, cocaine, ampnct_ :-es, rGr,
<br />my urine, oreaQl, antiio.- w000 also Willow unl4 to tioteRn'sc WnZcr Me pr`,c.acc of alcohol :n m, System
<br />equals or exceeds .04 percent or whatever level is set By Me particu tar state or locm I_w ;nere t —F
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