Employment Application

Below, give the names of three persons you are not related to whom you have known at least one year.

“I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION O FALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE AND RELEASE THE COMPANY FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION. I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE.”

List below your last three employers starting with the most recent one first.

INSTRUCTIONS: PLEASE COMPLETE IN FULL. PRINT ALL INFORMATION. FALSE INFORMATION IS CAUSE FOR REJECTION OR DISMISSAL.

I UNDERSTAND THAT ALL INFORMATION SUBMITTED AND CONSIDERED IS SUBJECT TO VERIFICATION. I UNDERSTAND AND HEREBY AUTHORIZE AND GIVE PERMISSION FOR AACA TO CONDUCT VERIFICATION OF MY CRIMINAL HISTORY, DRIVING RECORD, EMPLOYMENT HISTORY, AND OTHER INVESTIGATIONS RELATED TO MY EMPLOYMENT WHICH ARE NECESSARY TO DETERMINE MY QUALIFICATIONS FOR A JOB. I UNDERSTAND THAT IF I AM HIRED, I MAY BE SUBJECT TO A CRIMINAL HISTORY, DRIVING RECORD CHECK. I CERTIFY THAT ALL STATEMENTS AND ANSWERS TO ALL QUESTIONS IN THIS APPLICATION ARE TRUE, COMPLETE AND CORRECT AND ARE MADE IN GOOD FAITH.

DISCLOSURE REGARDING CONSUMER REPORT BACKGROUND CHECK Associated Air Conditioning & Appliances, Inc. dba AACA Parts & Supplies (“The Company”) may obtain information about you from a third party consumer reporting agency for Employment Purposes. Thus, you may be the subject of a “consumer report” which may include information about your character, general reputation, personal characteristics, and/or mode of living. These reports may contain information regarding your credit history, criminal history, social security verification, motor vehicle records (“driving records”). You have the right, upon written request made within a reasonable time, to request whether a consumer report has been run about you and to request a copy of your report. These searches will be conducted by IntelliCorp Records, Inc., 3000 Auburn Drive, Suite 410, Beachwood, Ohio 44122; Tel. No. 1.888.946.8355; www.intellicorp.net.

ACKNOWLEDGMENT AND AUTHORIZATION FOR BACKGROUND CHECK I acknowledge receipt of the separate stand alone Disclosure and certify that I have read and understand it and this authorization. I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” by Associated Air Conditioning & Appliances, Inc. dba AACA Parts & Supplies at any time after receipt of this authorization and throughout my employment, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by IntelliCorp Records, Inc., 3000 Auburn Drive, Suite 410, Beachwood, Ohio 44122; Tel. No. 1.888.946.8355; www.intellicorp.net. I authorize you to contact, through IntelliCorp Records, Inc., my current employer for Employment and Reference Verifications. I also consent to have any legally required notices sent electronically.