to conduct Full query of the FMCSA Commercial Driver’s License Drug and Alcohol Clearinghouse to determine whether drug or alcohol violation information about me exists in the Clearinghouse.

I understand that this consent gives my Full permission for Carriers Concepts, LLC to run a query/receive any additional information that may show up on me in the Clearinghouse on my Company’s behalf at any point during my employment.

must prohibit me from performing safety-sensitive functions, including driving a commercial motor vehicle, as required by FMCSA’s drug and alcohol program regulations.

Witness Signature: _________________________________ Date:_________________________________