NO EMPLOYEE WILL BE ALLOWED TO START WORK UNTIL ALL PAPERWORK IS COMPLETED.
**DRUG POLICY**
In order to Provide a safe place for our company, clients, as well as your personal safety. We require drug testing as part of our employment
Your Name*
First Last
Date Of Birth*
MM
DD
YYYY
Email
Applicant Address*
Street Address Address Line 2 City State ZIP Code
Date Of Application*
Date Format: MM slash DD slash YYYY
Your Phone Number*
Emergency Contact*
First Last
Emergency Contact Phone*

All prospective employees must come to the office to fill out their paperwork. Every prospective employee must have at least two forms of identification: -Valid Current Driver's License -Valid State Picture Identification - Social Security Card -Valid Permanent Resident Card -Valid Work Authorization Card -Birth Certificate Have all information for references. We reserve the right to check these references: Former employer names, phone numbers, dates of employment, etc. We practice safety according to OSHA guidelines. Anyone not following safety procedures is subject to reprimand, written warning and/or termination. Weekly Safety Meetings are held on the jobs. All employees are required to attend. Revised 9.22.15
Consent*
I agree that I have read

Hard Hats, Boots, Long Pants, and Shirts with sleeves are required on all DMG Jobsites. All employees are required to provide their own tools. -Bricklayers must have: Trowel, Hammer, Tape Measure, Ruler, Jointer, Level, Wire Cutters, and Rake. -Laborers must have: Squared Shovel, Hammer, Tape Measure, and Band Cut. Employees may be required to travel a radius of at least 75 miles in and around the Metroplex. (We strive for year round work, but it won't be at your back door.) Work hours are determined by the Foreman on the job, depending on the time of the year. Bricklayers normal workday is eight (8) hours and Laborers eight and a half (8 h). A ten (10) minute break is given each morning. You will have a thirty (30) minute lunch time. Be at the jobsite on time to be at your position at starting time. If you are late to work, you are subject to a verbal warning. If you are late repeatedly, you are subject to termination. If you cannot be at work, you must call the office or your Foreman prior to report time. Someone is in the office by 6:00 a.m. daily. Pay periods end on Sunday. Paychecks go to the jobsites on Fridays. We hold back one week, as is customary. Any Accidents sustained by you must be reported to your Foreman immediately or DMG will not be responsible for payment of treatment.
Consent*
I agree that I have read

Wage Agreement - Applies to 1st 90Days of employment
I understand and agree that my pay rate for the final pay period of my employment will be my usual pay rate, if I give at least two weeks' advance written notice of resignation to DMG and return all company property that has been issued to me within "3" days of my final day of work. If I voluntarily quit or am fired, I understand and agree that my pay rate for the final pay period of my employment will be at least minimum wage, as required by law. I, also understand, that this agreement concerning my compensation does not modify the at- will employment relationship between myself and DMG Masonry; does not constitute a commitment by DMG Masonry to employ me for any particular length of time: does not commit me to remain with DMG Masonry for any particular length of time; and does not restrict either DMG Masonry or myself from ending the employment relationship at any time for any reason, with or without notice. One or more of the following conditions met by an employee is a voluntary quit and unemployment benefits may be denied. I. ) Failure or refusal to accept suitable work assignment based upon pay, qualifications or location. 2.) Failure to report to work for two consecutive days without notification to the office or immediate supervisor. 3.) Failure to submit to a random drug test.
Name*
First Last
Todays Date*
MM
DD
YYYY
Consent*
I have read and agree to these terms.

Medical Authorization
I authorize full access to copies of medical records, radiology reports, drug/alcohol screenings and documents of any kind relating to my past or present injury/illness to DMG. I hereby agree to release this information and hold all such medical providers harmless from the release this information as set forth in this authorization. If you do not sign this form and/or disagree with any of the above statements, do not continue with this application.
Consent*
I have read and agree to these terms.
Name*
First Last
Todays Date*
MM
DD
YYYY

SUBSTANCE ABUSE POLICY
The welfare and success of DMG the "Company", depends on the physical and psychological health of all its employees. While the company is committed to maintaining a safe and productive workplace, it is the responsibility of both the company and the employees to create and maintain a safe, healthful, and efficient working environment. Therefore, for the protection of its clients, employees, property, and the general public, the company has adopted this Substance Abuse Policy. l.) PURPOSE: The purpose of this Policy is to maintain a safe, healthful, and efficient working environment by eliminating any abuse of legal and illegal drugs, alcohol, and inhalants on the company premises or at any time while on company business, and requiring all employees of the company to be free from the effects of legal or illegal drugs, alcohol, and inhalants while on the company premises or at any time while on company business. This Policy applies to all employees of this company; (a) At all times on the company premises, (b) During the course and scope of their employment regardless of location, and (c) During any company-sponsored activities. 2.) DISCIPLINARY ACTION AND PROHIBITED CONDUCT: An employee's failure to comply with any part of this policy will result in disciplinary action, which may include verbal warning, written warning, probation, and temporary suspension of employment, enrollment in substance abuse treatment programs or termination of employment. Any employee will be subject to the disciplinary measures of the above paragraph for any of the following: a.) The manufacture, distribution, possession, use or sale of alcohol, inhalants, unauthorized or illegal drugs or the misuse of any legal or prescription drugs on company business or during any company-sponsored activities. b.) Being under the influence of any substance described above in section (a), which impairs judgment, performance, or behavior while on company premises, or during company- sponsored activities. c.) Conviction under any criminal statue for the possession, use or sale of drugs or alcohol or any related activity. d.) Refusing to submit to a medical evaluation, including drug or alcohol testing as provided for in section 3 of this policy. e.) Generating test results, which indicate any drug, alcohol, or other substance. 3.) TESTING: For the purpose of this policy, "drug" is defined as any alcoholic beverage, illegal inhalant, illegal drug or other substance, the use, possession, manufacture, distribution, or dispensation of which is prohibited by any state or federal law or regulation and any drug or substance obtained by prescription, over the counter or otherwise. 4.) APPLICABILITY OF DRUG TESTING: a.) All persons applying for a position with the company may be required to submit to a drug test as a condition of employment. b.) All current and future employees must submit to a drug test upon the request of the company under the following circumstances: I. ) When special safety considerations attendant to certain jobs indicate that such testing presents a reasonable means to assure a safe working environment. 2.) When the employee either sustains an injury in the course and scope of employment or contributes to or causes another employee to sustain an injury in the course and scope of employment. 3. ) When the employee causes, indirectly or directly, damage to the company's property or to the property of another. 4.) When the employee contributes or causes injury to any third party while the employee is in the course and scope of employment. 5.) When the employee is convicted under and criminal drug statue for a violation occurring during the course and scope of employment. If such a conviction occurs; it is the employee's responsibility to notify the company within (5) days of the conviction. This requirement includes finding of guilt, guilty plea, plea of no contest or imposition of sentence or any other penalty whatsoever by any court of competent jurisdiction or otherwise in connection with any state or federal criminal statue involving the manufacturer, distribution, dispensation, use or possession of any controlled substance or drug, including alcohol. 6.) When the company, in its sole discretion, determines that it is in the company's best interest to conduct such a drug test. 5.) TESTING PROCEDURES: a.) Drug testing requires that the employee submit a urine sample for laboratory analysis to detect drugs. Testing for alcohol use requires a blood sample. In addition, any other accepted and reasonable testing method may be used for alcohol or drug testing. b.) Testing will be conducted by a laboratory or medical facility designated by the company. All costs for testing shall be paid by the company. c.) Refusal to submit to a drug test or alcohol test shall result in the same consequences as a positive drug or alcohol screen as outlined in the above paragraph. 6.) POSITIVE RESULTS: a.) If a test result is positive, it is reported directly to the employer. b.) If the applicant or employee believes the test results are inaccurate, the applicant or employee shall have an immediate opportunity to fully and fairly explain why the applicant or employee believes the test result is inaccurate. c.) If the applicant or employee refuses to contest the test results, or if the company finds the applicant or employee's explanation was unsatisfactory, the initial test result will be denied conclusive. d.) If an applicant's positive test result is deemed conclusive, The Company shall refuse the applicant employment. If an employee's positive test result is deemed conclusive, the employee shall be subject to disciplinary action, up to and including termination of employment. e.) The company shall not be responsible for and makes no representations or warranties on behalf of the laboratory or medical facility conducting the drug test. 7.) MISCELLANEOUS PROVISIONS a.) Reporting: Each employee is responsible for promptly reporting to the Appropriate company offices. b.) Other procedures: The Company will establish such other procedures as it finds necessary to effectively enforce this policy. This may include a requirement that employees cooperate in personal or facility searches when there is reason to believe drugs or alcohol are present, when their performance is impaired or when their behavior is erratic. Refusing to cooperate with company procedures may be cause for disciplinary action.
Consent*
I have read and agree to these terms.
Name*
First Last

ACCIDENTS / INJURIES PROCEDURES
The following procedures must be followed for all work related injuries. All accidents/injuries must be reported immediately to your foreman or supervisor, even if no medical attention is required. A report of employee injury/accident must be completed whether or not medical attention is required. It will be placed in their medical file for future reference in case of problems. 2.) A Supervisors Report of Accident must be completed by the supervisor, or the person you report to on your assignment, at the same time the employee accident report is being filled out, regardless of whether medical attention is required. Both reports need to be faxed to DMG office at (8 17) 468-8868 and the original sent to the office. 3.) If the injury requires medical attention and is not an emergency situation, have your supervisor call (817) 784-0880 before going to a medical facility. In case of an emergency, have your supervisor call and report which medical facility you are transported to. We need to authorize treatment, arrange for proper billing, and determine that the facility follows proper procedures. 4.) If an employee must be off on disability, he/she must notify their DMG supervisor. Upon receiving a release to return to work, you must call the office. 5.) Anytime an employee is on light duty, the doctor's restrictions must be followed. The employee may return to his regular duties only when released writing by your doctor. It is your responsibility to tell the doctor that DMG has light duty work. 6.) A drug screen is required for all injuries. In accordance with state law, a positive result relieves DMG from all responsibility for any medical costs. Costs incurred prior to the drug screed results may be deducted from your final check (s). Refusal to submit to a drug screen will result in the same consequences as a positive drug or alcohol test. 7.) I understand and agree to abide by the above accident procedures. I understand that any payments to me or anyone else for expenses in connection with my accident and resulting injury is not an admission of liability on the part ofDMG. In the event of an injury, I authorize full access to copies of medical records, radiology reports, drug/alcohol screenings, and documents of any kind relating to my past or present injury/illness to DMG. I hereby agree to release this information and hold all such medical providers harmless from the release of this information as set forth in this authorization.
Consent*
I have read and agree to these terms.
Name*
First Last

SAFETY POLICY AND WORK PRACTICES GUIDELINES
DMG MASONRY, LTD. strives to provide a safe, healthy and productive work place for all employees. DMG Masonry, Ltd. follows the regulations provided by Federal and State Occupational Health and Safety Administration (OSHA). DMG Masonry, Ltd. expects all employees to take an active role in insuring safety on the job. Each employee is expected to: Know the job instructions, follow the instructions and think before acting. Know location of jobsite barricades and warning signs. Observe all jobsite barricades and warning signs. Use all safety devices required for the job, examples are: hardhat, eye protection, gloves, safety shoes, and lifeline. Inspect and maintain safety equipment prior to each use. Examples: ladders, scaffolding, safety belts, lanyards, and lifelines. Follow safety and operating instructions provided by equipment manufactures Keep the work site orderly: pathways clear of tools, materials and scrap. Report and unsafe equipment, situation, or act to the supervisor immediately. Refrain from any unsafe act that may endanger people, material, or equipment Be alert around moving equipment and loads. Stand clear of operating equipment. Handle material with the proper equipment. Limit loads lifted personally and use the legs, not the back. Store material properly braced and secured. Perform assigned work in a responsible manner. "Horseplay" on job-site will not be tolerated. Report and personal injury to the supervisor immediately
Consent*
I have read and agree to these terms.
Name*
First Last
Todays Date*
MM
DD
YYYY

AGREEMENT TO ARBITRATE CLAIMS
This Agreement to Arbitrate Claims ("Agreement") is being entered into by the parties named below, pursuant to the terms and conditions stated herein. RECITALS DMG Masonry, Ltd. ("DMG") has determined that it is in the best interest Of DMG and the undersigned employee ("Employee") to implement a dispute resolution procedure that will resolve any disputes between DMG and Employee in a timely and cost-efficient manner. Employee understands that his or her agreement to this plan is a condition to his or her employment with DMG. Employee understands that by signing this agreement he or she agrees with DMG to the resolution, through arbitration, of all claims or controversies between Employee and DMG, officers, managers, partners, directors, staff, or agents whether or not arising out of Employee's employment with DMG or termination ofemployment by DMG. NOW THEREFORE, DMG and Employee agree as follows AGREEMENT l. Except as otherwise limited herein, any and all legal disputes, controversies, or claims arising between DMG and Employee, including, but not limited to any claims that arise out of or relate to Employee's application or candidacy for employment or cessation of employment with DMG or one of its affiliates, shall be settled exclusively by final and binding arbitration before a neutral, third-party arbitrator selected in accordance with the terms of this Agreement. Arbitration shall apply to any and all such disputes, controversies, or claims whether asserted by or against any employee, officer, manager, partner, alleged agent, director, or affiliate company. All previously unasserted claims of Employee or DMG arising under federal, state, or local statutory or common law shall be subject to arbitration pursuant to this Agreement. Merely by way of example, claims that shall be subject to arbitration include, but are not limited to claims arising under the Age Discrimination in Employment Act of 1967 ("ADEA"), Title VII of the Civil Rights Act of 1964, as amended, including the amendments of the Civil Rights Act of 1991, the Americans with Disabilities Act of 1990 ("ADA"), the Fair Labor Standards Act ("FLSA"), Equal Pay Act of 1963, 42 U.S.C. 1981, as amended, including the amendments of the Civil Rights Act of 1991, the Employee Polygraph Protection Act, the Employee Retirement Income Security Act ("ERISA"), the National Labor Relations Act ("NLRA"), The Consolidation Omnibus Budget Reconciliation Act of 1985 ("COBRA"), The Occupational Safety and Health Act of 1970 ("OSHA"), The Immigration Reform and Control Act of 1986 ("IRCA"), Texas Commission on Human Rights Act, state discrimination statutes, state statutes and/or common law regulating employment termination, the law Of contract or the law of tort; including, but not limited to, claims for malicious prosecution, wrongful arrest/wrongful imprisonment, intentional/negligent infliction of emotional distress or defamation. Claims by Employee for state employment insurance (e.g., unemployment compensation, workers' compensation, worker disability compensation) shall not be subject to arbitration. Statutory or common law claims alleging that DMG retaliated or discriminated against Employee for filing a state employment insurance claim, however, shall subject to arbitration pursuant to this Agreement. Nothing in this Agreement shall prevent or prohibit a party from filing a complaint with any applicable govemment agency, including, but not limited to, the Equal Opportunity Commission, the National Labor Relations Board, the Texas Workforce Commission, or their successors. Notwithstanding the above agreement to arbitrate disputes, DMG shall have the right to make application to a state or federal court of competent jurisdiction for the limited purpose Of obtaining such injunctive relief against Employee as may be necessary for DMG to (i) protect its business from irreparable harm by Employee, (ii) prevent the disclosure of confidential or proprietary information Of DMG by Employee. 2. Any arbitration conducted pursuant to this Agreement shall be conducted in Tarrant County, Texas, and conducted in accordance with the current employment arbitration procedures of the American Arbitration Association (AAA). The costs of arbitration shall be shared by DMG and Employee, provided, however, Employee's share of the arbitrators' fees and filing fees shall be no more than the then current filing fee in the District Courts of Tarrant County, Texas. Each party shall bear their own costs related to arbitration including attorney fees. The arbitration shall be final and binding on DMG and Employee. This Agreement shall survive termination Employee's employment. This Agreement in no way alters the at-will nature of Employee's employment with DMG. DMG Masonry Construction, Ltd. Its general partner, DMG Masonry Construction Management, LLC
Consent*
I have read and agree to these terms.
Name*
First Last
Todays Date*
MM
DD
YYYY

EDUCATION
Highest level of education completed*
- College/University
- Some College
- Technical/Trade School
- High School
Name and Location*
Degree/Diploma*

EMPLOYMENT HISTORY
Account for all periods of employment/unemployment, if not covered, List our most recent Job history first. in a ten year span prior to making a application with this company.
Name of Employer
Supervisors Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
From Date
Date Format: MM slash DD slash YYYY
To Date
Date Format: MM slash DD slash YYYY
Company Phone Number
Job Title & Description Of Work
Reason For Leaving

EMPLOYMENT HISTORY
Account for all periods of employment/unemployment, if not covered, List our most recent Job history first. in a ten year span prior to making a application with this company.
Name Of Employer
Supervisors Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
From Date
Date Format: MM slash DD slash YYYY
To Date
Date Format: MM slash DD slash YYYY
Company Phone Number
Job Title & Description Of Work
Reason For Leaving

FAIR CREDIT REPORTING ACT PRE NOTIFICATION
This is to inform you that as part of our procedure for processing your application, an investigative report may be made whereby information is through personal interviews with third parties, such as family members, business associates, financial sources, friends, neighbors, or others with whom you are acquainted. This inquiry includes information as to your character, reputation, personal characteristics and mode of living, whichever may be applicable. You have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation. THIS APPLICATION IS NOT AN OFFER OF EMPLOYMENT. OFFERS OF EMPLOYMENT WILL BE MADE WITHOUT SPECIFIC DURATION UNLESS INDICATED OTHERWISE, IN WRITING. It is understood that false statements on this application may be considered cause for dismissal
Consent*
I agree that I have read
Name*
First Last

FMLA - FAMILY AND MEDICAL LEAVE ACT NOTICE
The Family and Medical Leave Act (FMLA) is designed to provide employees temporary job security when faced with certain health-related care responsibilities that preclude them from working. The FMLA compels employers who employ 50 or more employees to grant qualifying employees up to 12 weeks of unpaid leave for: •Birth and care of the employee's child, or placement for adoption or foster care of a child with the employee; •Care of an immediate family member (spouse, child, parent) who has a serious health condition; or •Care of the employee's own serious health condition. For an employee to be eligible for FMLA, they must (1) have worked at least 12 months (which do not have to be consecutive) for the employer and (2) have worked at least 1 ,250 hours during the 12 months immediately before the date FMLA leave begins.

WORKPLACE HAZARDOUS CHEMICAL AWARENESS
DMG Masonry recognizes that in the course of your job you may be working around hazardous material. Being a safety orientated company; DMG will use administration and engineering to minimize the dangers. DMG will provide you with appropriate personal protection equipment as needed in the course of your job. DMG considers knowledge to be key to your "Personal Protection". The following materials are used on all jobs and you need to be aware of the hazards. Portland Cement Can cause dry skin, alkaline burns, allergic dermitius, and affect mucous membranes. Dust can irritate the eyes and upper respiratory system, inflammation of the lining of tissue of the interior ofthe nose and the cornea. Respirable crystalline silica can cause Silicosis. Unleaded Gas Harmful or fatal if swallowed. High concentrations may cause suffocation. May be harmful if inhaled or absorbed through the skin. Mist or vapor may irritate the eyes, mucous membranes, and the respiratory tract. Diesel Contact with eyes may cause mild irritation including stinging, watering, and redness. Possible skin cancer hazard. This material can enter lungs during swallowing and cause lung inflammation and damage. Employee's must adhere to all manufacture and DMG Masonry requirements. If you're not sure or don't understand these requirements you need to read the MSDS or talk to your Foreman. An interpreter will be provided.
Consent*
I agree that I have read
Name*
First Last

EMPLOYEE TRAVEL AGREEMENT
On occasion employees may be asked to work on jobsites that are outside of the DFW area. When an employee is sent to an out of state jobsite the company will provide lodging accommodations. Employees will be held accountable for any charges or damages accrued during that stay. By signing below you acknowledge that you have read this agreement and understand that should any charges occur you will be responsible. 1. Employee may no longer occupy and shall immediately vacate the premises should any of these events occur: a. The employer-employee relationship between Employer and Employee ends. b. Employee becomes unable to perform Employee's duties for Employer, regardless of the reason for or duration of that inability. c. Employer, for any or no reason, notifies Employee that Employee may no longer remain on the Premises. 2. Employee shall keep the premises and its grounds neat and clean. 3. Employee shall obey rules issued and as may be modified from time to time by Employer pertaining to the premises and Employee's occupancy thereof. 4. Employee shall not allow any other person to occupy the premises without Employer's prior written consent. 5. Employer and its agents at all reasonable times may enter and inspect the premises to ensure that the Employee is complying with this agreement. 6. Should any damages be incurred during the Employee's stay the Employee authorizes the Employer to deduct $50 weekly until the amount owed has been satisfied. If the Employee terminates before the damages have been paid the amount owed will be deducted from the Employee's final pay.
Consent*
I agree that I have read
Name*
First Last
Name
This field is for validation purposes and should be left unchanged.

Application For DMGMasonry Employment

Step 1 of 17

NO EMPLOYEE WILL BE ALLOWED TO START WORK UNTIL ALL PAPERWORK IS COMPLETED.

DRUG POLICY

Wage Agreement - Applies to 1st 90Days of employment

Medical Authorization

SUBSTANCE ABUSE POLICY

ACCIDENTS / INJURIES PROCEDURES

SAFETY POLICY AND WORK PRACTICES GUIDELINES

AGREEMENT TO ARBITRATE CLAIMS

EDUCATION

EMPLOYMENT HISTORY

EMPLOYMENT HISTORY

FAIR CREDIT REPORTING ACT PRE NOTIFICATION

FMLA - FAMILY AND MEDICAL LEAVE ACT NOTICE

WORKPLACE HAZARDOUS CHEMICAL AWARENESS

EMPLOYEE TRAVEL AGREEMENT

Application For DMGMasonry Employment

Step 1 of 17

NO EMPLOYEE WILL BE ALLOWED TO START WORK UNTIL ALL PAPERWORK IS COMPLETED.

**DRUG POLICY**

Wage Agreement - Applies to 1st 90Days of employment

Medical Authorization

SUBSTANCE ABUSE POLICY

ACCIDENTS / INJURIES PROCEDURES

SAFETY POLICY AND WORK PRACTICES GUIDELINES

AGREEMENT TO ARBITRATE CLAIMS

EDUCATION

EMPLOYMENT HISTORY

EMPLOYMENT HISTORY

FAIR CREDIT REPORTING ACT PRE NOTIFICATION

FMLA - FAMILY AND MEDICAL LEAVE ACT NOTICE

WORKPLACE HAZARDOUS CHEMICAL AWARENESS

EMPLOYEE TRAVEL AGREEMENT

DRUG POLICY