APPLICANT'S STATEMENT AND RELEASE OF INFORMATION PERMISSION

I certify that the answers given herein are true and complete to the best of my knowledge. For purposes of consideration of employment, I authorize and request that my current and former employers furnish CAP, LLC with information about my employment record, including a statement of the reason for termination of my employment, work performance abilities, and other qualities pertinent to my qualifications for employment, hereby releasing them and CAP, LLC from all liability and responsibility arising from any information provided. A copy of this release is valid as an original signature. I hereby understand and acknowledge that employment with CAP, LLC is at-will. That means either CAP, LLC or the employee may end the employment relationship at any time, for any reason or no reason at all. No oral representation by any CAP, LLC employee will create a contract of employment. No employment practice by CAP, LLC is intended to create a contract of employment. No changes in CAP, LLC’s employment-at-will policy will be effective unless executed in writing and signed by the President. In the event that I am employed by CAP, LLC, I understand that false or misleading information given in this application or during an interview may result in my discharge. I understand that I am required to abide by all the rules and regulations as set by CAP, LLC.

CAP LLC

Office: 507 7th Street Suite 600 Sioux City, IA 51101

Yard: 3150 Rustin Street Sioux City, IA 51105

Phone: 712-224-3545

Fax: 815-301-3764

Email: info@siouxcitycap.com

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