APPLICANT CERTIFICATION AND AT-WILL STATEMENT
(Applicant must read the following and acknowledge by signing below.)
Under Michigan law only, employers must make accommodations to disabled applicants and employees where the employee makes their need known to the employer, requests accommodation and such accommodation does not impose an undue hardship on the employer. Under Michigan law only, disabled applicants and employees may request an accommodation of their disability by notifying the firm in writing of the need for accommodation within 182 days of the date the disabled individual knows or should know that an accommodation is needed. This requirement does not apply to an individual's rights under the Americans with Disabilities Act. Failure to properly notify the firm may preclude any claim that the employer failed to accommodate the disabled individual.
Upon the signing of this application, I certify that I have read and understood all of this employment application and that all of the information now or hereafter given by me in support of my application is true and complete. It is agreed and understood that the employer and his agents may investigate my background to ascertain any and all information of concern to my employment history, whether same is of record or not. I authorize the employer to verify any information concerning my background, including but not limited to employment, education, credit history, driving record, education, criminal history, or medical history (post-offer only), with the appropriate individuals, companies, institutions or agencies, and I authorize them to release such information as you require, including my prior disciplinary employment record without any obligation to give me written notice of such disclosure. I also authorize you to release any information (including medical information) requested by any of my prospective or subsequent employers without any obligation to give me written notice of such disclosure. I hereby release you and them from any liability whatsoever as a result of any such inquiries and disclosures, and this release from liability, except as prohibited by law, does not waive or prohibit an individual from filing a charge of discrimination under the laws enforced by the EEOC.
I agree that any false or incomplete information that causes my application to be misleading may subject me to discharge at any time during the period of my employment. I also understand that an offer of employment extended by you may be contingent upon the results of a physical examination and drug test satisfactory to the employer in its sole discretion and upon my acceptance of such offer of employment I authorize and consent to such examination and drug test. I understand that the results of such examination and drug test shall be maintained on separate medical forms and in medical files and that such confidential information shall only be disclosed to managers, supervisors, first aid and/or safety personnel regarding necessary restrictions or accommodations with respect to assigned work or for safety and/or medical purposes or to human resources department or the company's legal representatives as required in the ordinary course of business.
I agree that my employment, if hired by Rauhorn Electric, Inc. and/or it's related entities, is "at-will" and either party may terminate the employment relationship, with or without cause, at any time, and I further agree that this arrangement may only be altered in writing directed to me personally and signed by the president of this company. I agree that I shall be bound by the other rules, policies, regulations and terms and conditions of employment of the firm as they are from time to time changed, and no additional obligations can be imposed on the company except which have been acknowledged in writing, by the president or his designated representatives.
I agree that any action (excluding governmental, statutory administrative proceedings) or suit against the company and its agents or employees, arising out of my employment or termination, including but not limited to, claims arising under State and Federal Law, but not Federal civil rights statutes containing a separate limitations period, must be brought within 180 days of the event giving rise to the claim or the applicable statute of limitations, or be forever barred unless the applicable statues of limitations period is shorter than 180 days in which case I will continue to be bound by the shorter limitations period. I waive any limitation periods to the contrary with the exception being that this agreed to limitations period does not supersede the Federal Equal Employment. Opportunity Commission or other applicable statutes or regulations that may extend this period as provided by law. I further agree that if I should bring any non-statutory action or claim arising out of my employment against the company, in which the company prevails, I will pay to the company any and all such costs incurred by the firm in defense of said claims or actions, including attorney fees. I acknowledge that this Arbitration Policy and 180 day limitation on actions form an Agreement between myself and Rauhorn Electric, Inc.
I agree to furnish such additional information and complete such examinations as may be required to complete my employment file. I also understand that misrepresentation or omission of information or facts may results in my rejection or dismissal.
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.