New Sales Reps and New Helper Drivers

1. Certification of Violations/Annual Review of Driving Record

2. MVR Release/Request Form

3. Certificate of Compliance

4. Driver Certificate of Other Compensated Work

5. Regulatory Agency compliance Policy Statement

6. Drivers Statement of on Duty Hours

7. Drivers Application for Employment (4 pages) must be filled out completely

8. Alcohol/Drug Consent Form

9. FMCSA safety record (PSP online)

10. Safety history from previous employers ( one per employer for previous 3 years)

11. Training outline/record and certificate of road test

12. Receipt of FMCSR Handbook

13. Legible copy of current drivers' license (photo from phone is great)

14. Medical Examiners Certificate (Medical Card) and long form

15. Results of Drug screen must be in Safety office before being approved to drive

The safety office must have received all forms correctly completed prior to issuance of

certification to drive a Bonnie truck.

Stephen D. HarmonSafety Director

MOTOR VEHICLE DRIVER'SCertification of Violations/Annual Review of Driving Record

MOTOR CARRIER INSTRUCTIONS: Each motor carrier shall at least once every 12 months, require each driver it employs to prepare and furnish itwith a list of all violations of motor vehicle traffic laws and ordinances (other than violations involving only parking) of which the driver has beenconvicted, or on account of which he/she has forfeited bond or collateral during the preceding 12 months (Section 391.27). Drivers who have providedinformation required by Section 383.31 need not repeat that information on this form.

DRIVER REQUIREMENTS: Each driver shall furnish the list as required by the motor carrier above. If the driver has not been convicted of, or forfeitedbond or collateral on account of any violation which must be listed, he/she shall so certify (Section 391.27).

COMPLETED BY DRIVER - CERTIFICATION OF VIOLATIONS

NAME OF DRIVER: (PRINT) ID NUMBER

HOME TERMINAL (CITY AND STATE) DRIVER'S LICENSE NUMBE

DATE OF EMPLOYMENT

:R STATE EXPIRATION DATE

I certify that the following is a true and complete list of traffic violations required to be listed (other than those I haveprovided under part 383) for which I have been convicted or forfeited bond or collateral during the last 12 months.

(If you have had no violations, check the following box - [ | None.)

DATE OFFENSE LOCATION TYPE OF VEHICLE OPERATED

If no violations are listed above, I certify that I have not been convicted or forfeited bond or collateral on account of anyviolation (other than those I have provided under Part 383) required to be listed during the past 12 months.

Date nf Certification Driver's Sianature

COMPLETED BY MOTOR CARRIER - ANNUAL REVIEW OF DRIVING RECORD

MOTOR CARRIER INSTRUCTIONS: Review the Certification of Violations listed above and other information described inSection 391.25 of the Federal Motor Carrier Safety Regulations. Complete the information requested below.

I have hereby reviewed the driving record of the above named driver in accordance with Section 391.25 and findthat he/she (check one):

| [ Meets minimum requirements for safe driving I I Is disqualified to drive a motor vehicle pursuant to Section 391.25

| I Does not adequately meet satisfactory safe driving performance

Action taken with driver

Reviewed by:Signature

Jamie PadgettDate

Transportation Compliance OfficerPrinted Name

Bonnie Plants, Inc.Title

1727 Hwy 223, Union Springs, AL 36089Motor Carrier Name Motor Carrier Address

MAINTAIN THIS DOCUMENT IN THE DRIVER'S QUALIFICATION FILE. THIS DOCUMENT MAY BE PURGED AFTER 3 YEARS FROM DATEOF EXECUTION.

© Copyright 2008 J.J. KELLER & ASSOCIATES. INC., Neenah, Wl • USA • (800) 327-6868 www.jjkeller.com 643-F 3685 (11/08)

BONNIE PLANTS, INC.

Motor Vehicle Record ( MVR ) Release / Request Form

I understand that as a condition of operating any Bonnie Plants, Inc. Insured Vehicle,my Motor Vehicle Record will be requested. This information is used to ensure the safetyof employees and the general public.

I hereby authorize Bonnie Plant Inc. to access and evaluate my Motor Vehicle record. Iagree to provide whatever information is required in order to facilitate access.

Printed Name:_

Date:

Date of Birth:

Social Security Number:_

Drivers License Number and State of Issuance:

Date of Hire:

Signature:

Phone Number:

Alternate Phone Number:

Email:

Supervisor:

Motor Vehicle Driver's

CERTIFICATION OF COMPLIANCEWITH DRIVER LICENSE REQUIREMENTS

MOTOR CARRIER INSTRUCTIONS: The requirements in Part 383 apply to every driver whooperates in intrastate, interstate, or foreign commerce and operates a vehicle weighing26,001 pounds or more, can transport more than 15 people, or transports hazardousmaterials that require placarding.

The requirements in Part 391 apply to every driver who operates in interstate commerce andoperates a vehicle weighing 10,001 pounds or more, can transport more than 15 people, ortransports hazardous materials that require placarding.

DRIVER REQUIREMENTS: Parts 383 and 391 of the Federal Motor Carrier SafetyRegulations contain certain driver licensing requirements that you as a driver must complywith, including the following:

1) POSSESS ONLY ONE LICENSE: You, as a commerical vehicle driver, may notpossess more than one motor vehicle operator's license.

2) NOTIFICATION OF LICENSE SUSPENSION, REVOCATION OR CANCELLATION:Sections 391.15(b)(2) and 383.33 of the Federal Motor Carrier Safely Regulationsrequire that you notify your employer the NEXT BUSINESS DAY of anyrevocation or suspension of your driver's license. In addition, Section 383.31requires that any time you violate a state or local traffic law (other than parking),you must report it within 30 days to: 1) your employing motor carrier, and 2) thestate that issued your license (If the violation occurs in a state other than the onewhich issued your license). The notification to both the employer and the state mustbe in writing.

3) CDL DOMICILE REQUIREMENT: Section 383.23(a)(2) requires that yourcommercial driver's license be issued by your legal state of domicile, where youhave your true, fixed, and permanent home and principal residence and to whichyou have the intention of returning whenever you are absent. If you establish anew domicile in another state, you must apply to transfer your CDL within 30days.

The following license is the only one I will possess:

Driver's License No. State Exp. Date

DRIVER CERTIFICATION: I certify that I have read and understood the above requirements.

Driver's Name (Printed):

Driver's Signature: Date

Notes:(This form is not required for DOT compliance)

90-F 1617© Copyright 2008 J.J. KELLER & ASSOCIATES, INC., Neenah, Wl • USA (800) 327-6868 • www.jjkeller.com Printed in the United States (REV 3/08)

DRIVER CERTIFICATION FOR OTHER COMPENSATED WORK

INSTRUCTIONS: When employed by a motor carrier, a driver must report to thecarrier all on-duty time including time working for other employers. The definition ofon-duty time found in Section 392 paragraphs (8) and (9) of the Federal Motor CarrierSafety Regulations includes time performing any other work in the capacity of, or in theemploy or service of, a common, contact or private motor carrier, also performing anycompensated work for any non-motor carrier entity.

Are you currently working for another employer? YESNO

At this time do you intend to work for another employer while YESNOstill employed by this company:

I hereby certify that the information given above is true and I understand that once Ibecome employed with this company, if I begin working for any additional employer(s)for compensation that I must inform this company immediately of such employmentactivity.

Driver's Signature Date

Witness:Company Representative Date

OUR ROOTS RUN DEEP/

REGULATORY AGENCY COMPLIANCE POLICY STATEMENT

Bonnie Plants is committed to a policy of strict adherence to all local, state, and

federal laws.

As an associate of Bonnie Plants, I understand that I am expected and required to

adhere to all local, state, and federal laws and those specifically outlined in the

Federal Motor Carrier Safety Regulations of the U. S. Department ofTransportation.

I further understand that any deviation from the above policy will not be

tolerated and could result in disciplinary action up to and including termination.

I, , acknowledge receiptand understand the above policy statement.

Date:

Associate:

Witness:

DRIVER STATEMENT OF ON-DUTY HOURS(For Newly Hired Drivers)

INSTRUCTIONS: Motor Carriers when using a driver for the first time shall obtain fromthe driver a signed statement giving the total time on-duty during the immediatelyprecending? days and time at which such driver was last relieved from duty prior tobeginning work for such carrier. Rule 395.8(j)(2) Federal Motor Carrier SafetyRegulations NOTE: Hours for any compensated work during the preceding 7 days,including work for a non-moor carrier entity must be recorded on this form.

Driver Name (Print)

Social Security Number

Driver's License: State_

Class

Number

Endorsement(s) Restrictions(s)

DAY

DATE

HOURSWORKED

1yesterday

2 3 4 5 6 7

TotalHours

I hereby certify that the information given above is correct to the best of my knowledge andbelief, and that I was last relived from work at

A.M.P.M. On

Time Day Month Year

Drivers Signature Date

DRIVER'S APPLICATIONFOR EMPLOYMENT

Applicant Name Date of Application

Company

Address

City State Zip

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for allpositions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related

disability, or any other protected group status.

TO BE READ AND SIGNED BY APPLICANT

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history andother related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regardingmedical history will be made only if and after a conditional offer of employment has been extended.) I hereby releaseemployers, schools, health care providers and other persons from all liability in responding to inquiries and releasinginformation in connection with my application.

In the event of employment, 1 understand that false or misleading information given in my application or interview(s)may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.

1 understand that information I provide regarding current and/or previous employers may be used, and those employer(s)will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and(e). I understand I have the right to:

• Review information provided by previous employers;

• Have errors in the information corrected by previous employers and for those previous employers to re-send thecorrected information to the prospective employer; and

• Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannotagree on the accuracy of the information.

Signature Date _

FOR COMPANY USE

PROCESS RECORD

APPLICANT HIRED REJECTED

DATE EMPLOYED POINT EMPLOYED

DEPARTMENT CLASSIFICATION

(IF REJECTED, SUMMARY REPORT OF REASONS SHOULD BE PLACED IN FILE)

SIGNATURE OF INTERVIEWING OFFICER

TERMINATION OF EMPLOYMENT

DATE TERMINATED DEPARTMENT RELEASED FROM

DISMISSED VOLUNTARILY QUIT OTHER

TERMINATION REPORT PLACED IN FILE SUPERVISOR

This form is made available with the understanding that J. J. Keller & Associates, Inc.® is not engaged in rendering legal, accounting, or other professional services.J. J. Keller & Associates, Inc.® assumes no responsibility for the use of this form or any decision made by an employer which may violate local, state or federal law.

"• CopynghtlOlI J J KELLER & ASSOCIATES. INC.®. Neenah, WI - USA ]5F (Rev I ' l l ) 691(800) 327-6868 • vvwwijkdlcr com • Printed in the United States

APPLICANT TO COMPLETE(answer all questions - please print)

Position(s) Applied forName Social Security No.

Last First Middle

List your addresses of residency for the past 3 years.

Current AddressStreet City

Phone How Long?State Z'P c°de yr./mo.

Previous How Long?Addresses Street City State & Zip Code yr./mo.

How Long?Street City State & Zip Code yr./mo.

How Long?Street City State & Zip Code yr./mo.

Do you have the legal right to work in the United States? __

Date of Birth Can you provide proof of age?(Required for Commerical Drivers)

Have you worked for this company before? Where?

Dates: From To Rate of Pay Position

Reason for leaving

Are you now employed? If not, how long since leaving last employment?

Who referred you? Rate of pay expected

Have you ever been bonded? Name of bonding company(Answer only if a job requirement)

Is there any reason you might be unable to perform the functions of the job for which you have applied [as described in theattached job description]?

If yes, explain if you wish.

EMPLOYMENT HISTORY

All driver applicants to drive in interstate commerce must provide the following information on all employersduring the preceeding 3 years. List complete mailing address, street number, city, state, and zip code.

Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide anadditional 7 years' information on those employers for whom the applicant operated such vehicle.(NOTE: List employers in reverse order starting with the most recent. Add another sheet as necessary.)

EMPLOYER

NAME

ADDRESS

CITY

CONTACT PERSON

STATE

WERE YOU SUBJECT TO THE FMCSRst WHILE EMPLOYED?

WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTIONAND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40?

ZIP

PHONE NUMBER

DATE

FROM TO

MO. YR. MO. YR.

POSITION HELD

SALARY/WAGE

REASON FOR LEAVING

n YES n NOIN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG

n YES D NO

PAGE 2 15F (Rev 1/11) 691

EMPLOYMENT HISTORY (continued)

EMPLOYER

NAME

ADDRESS

CITY

CONTACT PERSON

STATE

WERE YOU SUBJECT TO THE FMCSRst WHILE EMPLOYED?

WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTIONAND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40?

ZIP

PHONE NUMBER

DATE

FROM TOMO YR MO YR.

POSITION HELD

SALARY/WAGE

REASON FOR LEAVING

n YES n NOIN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG

n YES n NOEMPLOYER

NAME

ADDRESS

CITY STATE

CONTACT PERSON

WERE YOU SUBJECT TO THE FMCSRst WHILE EMPLOYED?WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTIONAND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40?

ZIP

PHONE NUMBER

DATE

FROM TO

MO. YR MO YR

POSITION HELD

SALARY/WAGE

REASON FOR LEAVING

n YES n NOIN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG

n YES n NOEMPLOYER

NAME

ADDRESS

CITY STATE

CONTACT PERSON

WERE YOU SUBJECT TO THE FMCSRst WHILE EMPLOYED?WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTIONAND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40?

ZIP

PHONE NUMBER

DATE

FROM TOMO YR. MO YR

POSITION HELD

SALARY/WAGE

REASON FOR LEAVING

n YES n NOIN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG

Q YES n N°

EMPLOYER

NAME

ADDRESS

CITY STATE

CONTACT PERSON

WERE YOU SUBJECT TO THE FMCSRst WHILE EMPLOYED?WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTIONAND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40?

ZIP

PHONE NUMBER

DATE

FROM TO

MO. YR MO YR

POSITION HELD

SALARY/WAGE

REASON FOR LEAVING

D YES D NOIN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG

n YES n NOEMPLOYER

NAME

ADDRESS

CITY STATE

CONTACT PERSON

WERE YOU SUBJECT TO THE FMCSRst WHILE EMPLOYED?WAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTIONAND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40?

ZIP

PHONE NUMBER

DATE

FROM TOMO. YR. MO YR

POSITION HELD

SALARY/WAGE

REASON FOR LEAVING

D YES D NOIN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG

n YES Q NO* Includes vehicles having a GVWR of 26,001 Ibs. or more, vehicles designed to transport 16 or more passengers (including thedriver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

t The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstatecommerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 pounds or more, (2) isdesigned or used to transport 8 or more passengers (including the driver), OR (3) is of any size and is used to transport hazardousmaterials in a quantity requiring placarding.

PAGE 3 15F (Rev 1/11) 691

ACCIDENT RECORD FOR PAST 3 YEARS OR MORE (ATTACH SHEET IF MORE SPACE IS NEEDED) IF NONE, WRITE NONE

DATES

LAST ACCIDENT

NEXT PREVIOUS

NEXT PREVIOUS

NATURE OF ACCIDENT

(HEAD-ON, REAR-END, UPSET, ETC.) FATALITIES INJURIES

HAZARDOUS

MATERIAL SPILL

TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS) IF NONE, WRITE

NONE

LOCATION DATE CHARGE PENALTY

(ATTACH SHEET IF MORE SPACE IS NEEDED)

EXPERIENCE AND QUALIFICATIONS - DRIVER

Driver

licenses or

permits held

in the past

3 years

STATE LICENSE NO. CLASS ENDORSEMENT(S) EXPIRATION DATE

A. Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

B. Has any license, permit, or privilege ever been suspended or revoked?

IF THE ANSWER TO EITHER A OR B IS YES, GIVE DETAILS

YES

YES

NO

NO

DRIVING EXPERIENCE CHECK YES OR NO

CLASS OF EQUIPMENT

STRAIGHT TRUCK DYES QNO

TRACTOR AND SEMI-TRAILER Q YES Q NO

TRACTOR - TWO TRAILERS d YES Q NO

TRACTOR - THREE TRAILERS DYES QNO

MOTORCOACH - SCHOOL BUS DYES D NO ™°^*

MOTORCOACH - SCHOOL BUS DYES D NO Moretha"15passengers

OTHER

CIRCLE TYPE OF EQUIPMENT

(VAN,TANK,FLAT,DUMP,REFER)

(VAN,TANK,FLAT,DUMP,REFER)

(VAN,TANK,FLAT,DUMP,REFER)

(VAN,TANK,FLAT,DUMP,REFER)

DATES

FROM(M/Y) TO(M/Y)

APPROX. NO. OF MILES

(TOTAL)

LIST STATES OPERATED IN FOR THE LAST FIVE YEARS:

SHOW SPECIAL COURSES OR TRAINING THAT WILL HELP YOU AS A DRIVER:

WHICH SAFE DRIVING AWARDS DO YOU HOLD AND FROM WHOM?

EXPERIENCE AND QUALIFICATIONS - OTHER

SHOW ANY TRUCKING, TRANSPORTATION OR OTHER EXPERIENCE THAT MAY HELP IN YOUR WORK FOR THIS COMPANY

LIST COURSES AND TRAINING OTHER THAN SHOWN ELSEWHERE IN THIS APPLICATION

LIST SPECIAL EQUIPMENT OR TECHNICAL MATERIALS YOU CAN WORK WITH (OTHER THAN THOSE ALREADY SHOWN)

CIRCLE HIGHEST GRADE COMPLETED: 1 2 3 4 5 6 7 8

LAST SCHOOL ATTENDED (NAME)

EDUCATION

HIGH SCHOOL: 1 2 3 4

(CITY, STATE)

COLLEGE: 1 2 3 4

TO BE READ AND SIGNED BY APPLICANT

This certifies that this application was completed by me, and that all entries on it and information in it are true andcomplete to the best of my knowledge.

Signature: Date:PAGE 4 15F (Rev. 1/11) 691

BONNIE PLANT, INC.1727 HIGHWAY 223

UNION SPRINGS, ALABAMA 36089

ALCOHOL /DRUG SCREEN CONSENT

I, , hereby authorize Bonnie Plant Farm toconduct breath/blood alcohol test, hair test, and/or urine drug test.

I understand, without waiving any right I may have to challenge the test or the test result,that the results of that test(s) may be used for decisions determining my employment.

Employee Social Security Number

Date

Witness

THE BELOW DISCLOSURE AND A UTHORIZA TION LANGUA GE IS FOR MANDA TOR Y USE BY ALLA CCOUNT HOLDERS

IMPORTANT DISCLOSURE

REGARDING BACKGROUND REPORTS FROM THE PSP Online Service

In connection with your application for employment with j 'OOOfV rA/n!? -KtL. ("Prospective Employer"), ProspectiveEmployer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection historyfrom the Federal Motor Carrier Safety Administration (FMCSA).

When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSAin a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provideyou with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit ReportingAct before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safetyreport, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on thisreport.

When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employeruses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regardingyou, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronicnotification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, andthe toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provideyou the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copyof the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of adriver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, togetherwith proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rightsunder the Fair Credit Reporting Act.

Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correctany safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request tohttps://dataqs. fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct thisdata. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.

Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, orimply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crasheswere reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. Statecitations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of lawwill also appear, and remain, on a PSP report.

The Prospective Employer cannot obtain background reports from FMCSA without your authorization.

AUTHORIZATION

If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:

I authorize ODOf))-^ HflLpHj 4/X— ("Prospective Employer") to access the FMCSA Pre-Employment Screening Program (PSP)system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. Iunderstand that I am authorizing the release of safety performance information including crash data from the previous five (5) yearsand inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist theProspective Employer to make a determination regarding my suitability as an employee.

I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information hasthe capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data bysubmitting a request to https://dataqs. fmcsa.dot.gov. If I challenge crash or inspection information reported by a State, FMCSA cannotchange or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.

1 understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report,or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crasheswere reported to FMCSA, regardless of fault. Similarly, I understand all inspections, with or without violations, will appear on myPSP report, and State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, andremain, on my PSP report.

I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if Isign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I herebyauthorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.

Date:

Signature

Name (Please Print)

NOTICE: This form is made available to monthly account holders by NIC on behalf of the U.S. Department of Transportation,Federal Motor Carrier Safety Administration (FMCSA). Account holders are required by federal law to obtain an Applicant's writtenor electronic consent prior to accessing the Applicant's PSP report. Further, account holders are required by FMCSA to use thelanguage contained in this Disclosure and Authorization form to obtain an Applicant's consent. The language must be used in whole,exactly as provided. Further, the language on this form must exist as one stand-alone document. The language may NOT be includedwith other consent forms or any other language.

LAST UPDATED 12/22/2015

Safety Performance History Records RequestSECTION 1: TO BE COMPLETED BY PROSPECTIVE EMPLOYEE

I, (Print Name)First, M.I., Last Social Security #

Hereby authorize that:Previous EmployerStreetCity,State, Zip

Phone:_Fax

May release and forward information requested below concerning my job verification/drug & alcohol controlled substances testing recordsto:Bonnie Plant Farm Attn: Cathy Thomas 1727 HWY 223 Union Springs, AL 36089 (334)783-0064I further understand that Bonnie will request from all employers covering the previous three years of employment whether or not theemployer listed is the current employer, regardless of whether or not consent was given on the employment application. This information isbeing requested in compliance with Department of Transportation Regulations §40.25(g) and §382.405(f) and (h), release of this informationmust be made in a written form that ensures confidentially, such as fax, email or letter.Confidential FAX Number (334) 460-9985 or email cathv.thomas@bonnieplants.com

Applicant's Signature Date

SECTION 2: DRUG & ALCOHOL INQUIRY TO BE COMPLETED BY PREVIOUS EMPLOYERIf driver was NOT subject to Department of Transportation testing requirements while employed, please check here CI, sign below, andreturn or complete as required.Under Department of Transportation testing requirements: YES NO1. Has this person had an alcohol test with the result of .04 or higher Alcohol concentration?2. Has this person had a verified positive drug test?3. Has this person refused to be tested (including verified adulterated or substituted drug test results?4. Has this person committed other violations of DOT agency drug and alcohol testing regulations?5. If applicable and the person violated DOT drug/alcohol regulations, do you have documentation

of this person's successful completion of DOT return to duty requirements? If YES, please providedetails.

6. Have you received information from a previous employer that this individual violated DOT drugand alcohol regulations? (Please send documentation back with this form is applicable.)

7. If applicable, after successful completion of a SAP program, has this individual subsequently hada refusal or a verified positive breath alcohol or drug test?

Name:Company:Street:City, State, Zip:_ Phone:

Section 2 & 3 completed by: DATE:Signature

SECTION 3: JOB VERIFICATION - TO BE COMPLETED BY PREVIOUS EMPLOYER:1. Dates of employment with your company: FROM TO2. Position Held? If Driver: Tractor Trailer Straight Truck Twins

3. (List other details pertaining to the data below on a separate sheet)_Other (Specify)

# of reportedaccidents

Date of Accident City/Town & StateAccident Occurred

#ofInjuries

#ofFatalities

List Any Haz- Mat Spilled

4. Was this person's driver's license suspended while in your employment?5. Why did this employee leave your company? Resigned Discharged6. Is this person eligible for rehire/ YES NO

Laid Off OTHER:

SECTION 4: TO BE COMPLETED BY PROSEPCTIVE EMPLOYER OR AGENTThis form was (check one) CI Faxed to Previous Employer1st Attempt: 2nd Attempt:Sent to Previous Employer By:

CI Mailed (Date)3rd Attempt_

TRAINING OUTLINE

List Below Is A Training Outline Schedule. Circumstances May force Some Alterations,But The Outline Must Be Followed As Close As Possible.

Dayl:A. Get to know each other and tell the trainee what to expect.

B. Stress the importance of performing a pre-trip inspection.C. Stress the importance of performing a post-trip inspection.D Stress the importance of defensive driving and safety.E. Have trainee familiarize themselves with the truck.1. Use of Jake Brake and Hand Brake2. Importance of correct use of the clutch3. How to check the tires4. How to check the oil5. Correct RPM for the gear6. Use of Brake and Engine to slow vehicle rather than use of brake all the

time.

Day 2:Add these to above:

A. Trainee to begin drivingB. Stress the importance of hours of service LogsC. Stress trainee on easy backing situationsD. Stress to trainee to favor the center line.

Day 3:Add these to aboveA. Increase trainee's driving timeB. Explain to trainee accident reportingC. Allow trainee accident reportingD. Stress to trainee safety in turning and mirror useE. Explain to trainee the equipment maintenance program

Day 4:Add these to above

A. Increase trainee's driving time to include drivingB. Stress to trainee safety habits to use when backingC. Re-stress the importance of paperwork and procedures to the trainee

If further training beyond the 4 DAYS is necessary, notify the Station Manager so that thetrainee's future status can be determined.

Trainer Signature Trainee Signature

Date Training Began Date of Training Completion

RECORD OF ROAD TESTDriver's Name

License No.

Checked From

Address

State Equipment Driven:

To

TruckTractor Trailer

Date

For those items that apply, checkmark ( P ) if driver's performance is satisfactory, mark with an X if driver's performance is unsatisfactory.Explain unsatisfactory items under Remarks. Use not applicable (NA) for items that do not apply.

PART 1 - PRE-TRIP INSPECTION AND

EMERGENCY EQUIPMENT

Checks general condition approaching unit

Looks for leakage of coolants, fuel, lubricants

Checks under hood - oil, water, general condition

of engine compartment, steering

Checks around unit - tires, lights, trailer hookup,

brake and light lines, body, doors, horn,

windshield wipers

Tests brake action, tractor protection valve, and

parking (hand) brake

Checks horn, windshield wipers, mirrors, emergency

equipment, reflectors, flares, fuses, tire chains

(if necessary), fire extinguisher

Checks instruments for nonnal readings

Checks dashboard warning lights for proper functioning

Cleans windshield, windows, mirrors, lights, reflectors

Reviews and signs previous report

PART 2 - COUPLING AND UNCOUPLING

Lines up units

Connects glad hands to trailer to apply trailer

brakes before coupling

Connects glad hands and light line properly

Couples without difficulty

Raises landing gear fully after coupling

Visually checks king pin assembly to be

certain of proper coupling

Checks coupling by applying hand valve or

tractor-protection valve (trailer air supply

valve) and gently applying pressure by

trying to pull away from trailer

Assure that surface will support trailer before

uncoupling

PART 3 - PLACING VEHICLE IN MOTION AND

USE OF CONTROLS

A. ENGINE

Places transmission in neutral before starting engine

Starts engine without difficulty

Allows proper warm-up

Understands gauges on instrument panel

Maintains proper engine speed (rpm) while driving

Does not abuse motor

B. CLUTCH AND TRANSMISSION

Starts loaded unit smoothly

Uses clutch properly

Times gearshifts properly

Shifts gears smoothly

Uses proper gear sequence

C. BRAKES

Knows proper use of tractor protection valve

Understands low air warning

Tests service breaks

Builds full air pressure before moving

D. STEERING

Controls steering wheel

Good driving posture and good grip on wheel

E. LIGHTS

Knows lighting regulations

Uses proper headlight beam

Dim lights when meeting or following other traffic

Adjusts speed to range of headlights

Proper use of auxiliary lights

PART 4 - BACKING AND PARKING

A. BACKING

Gets out and checks before backing

Looks back as well as uses mirror

Gets out and rechecks conditions on long back

Avoids backing from blind side

Signals when backing

Controls speed and direction properly while backing

C. PARKING (City)

Does not hit nearby vehicles or stationary objects

Parks proper distance from curb

Sets parking brake, puts in gear, chocks wheels,

shuts off motor

Checks traffic conditions and signals when

pulling out from parked position

Parks in legal and safe location

C. PARKING (Road)

Parks off pavement

Avoids parking on soft shoulder

Uses emergency warning signals when required

Secures unit properly

13F 652

(Rev. 5/02)

PART 5 - SLOWING AM) STOPPINGUses gears properly ascendingGears down properly descending

Stops and restarts without rolling backTests brakes before descending gradesUses brakes properly on gradesUses mirrors to check traffic to rear

Signals following traffic

Avoids sudden stops

Stops smoothly without excessive fanning

Stops before crossing sidewalk when coming out ofdriveway or alley

Stops clear of pedestrian crosswalks

PART 6 - OPERATING IN TRAFFIC PASSING AND TURNINGA. TURNING

Signals intention to turn well in advanceGets into proper lane well in advance of rumChecks traffic conditions and turns only

when intersection is clearRestricts traffic from passing on right when

preparing to complete right hand rumCompletes turn promply and safely and does not

impede other traffic

B. TRAFFIC SIGNS AND SIGNALSApproaches signal prepared to stop if necessaryObeys traffic signalUses good judgement on yellow lightStarts smoothly on greenNotices and heeds traffic signsObeys "Stop" signs

C. INTERSECTIONSAdjusts speed to permit stopping if necessary

Checks for cross traffic regardless of traffic controlsYields right-of-way for safety

D. GRADE CROSSINGS

Adjusts speed to conditionsMakes safe stop, if requiredSelects proper gear and does not shift gears while crossingKnows and understands federal and state rules

governing grade crossing

E. PASSINGPasses with sufficient clear space aheadDoes not pass in unsafe location: hill, curve, intersectionSignals change of lanes

Warns driver being passedPulls out and back with certaintyDoes not tailgateDoes not block traffic with slow passAllows enough room when returning to right lane

REMARKS:

F. SPEED

Speed consistent with basic ability

Adjusts speed properly to road, weather,traffic conditions, legal limits

Slows down for rough roads

Slows down in advance of curves, intersections, etc.

Maintains consistent speed

G. COURTESY AND SAFETYUses defensive driving techniques

Yields right-of-way for safetyGoes ahead when given right-of-way by othersDoes not crowd other drivers or force way through trafficAllows faster traffic to pass

Keeps right and in own laneUses horn only when necessary

Generally courteous and uses proper conduct

PART 7 - MISCELLANEOUS

A. GENERAL DRIVING ABILITY AND HABITSConsistently alert and attentive

Adjusts driving to meet changing conditions

Performs routing functions without taking eyes from road

Checks instruments regularly while driving

Willing to take instructions and suggestions

Adequate self-confidence in drivingIs not easily angered

Positive attitude

Good personal appearance, manner, cleanliness

Good physical stamina

B. HANDLING OF FREIGHT

Checks freight properlyHandles and loads freight properlyHandles bills properly

Breaks down load as required

C. RULES AND REGULATIONSKnowledge of company rules

Knowledge of regulations: federal, state, local

Knowledge of special truck routes

D. USE OF SPECIAL EQUIPMENT (Specify)

GENERAL PERFORMANCE:

QUALIFIED FOR: Truck

Satisfactory Needs Training Unsatisfactory

Tractor-Semitrailer Other

(Specify)

Signature of Examiner

CERTIFICATION OF ROAD TEST

Instructions to Carrier: If the road test is successfully completed, the person who gave it must complete the following certification in duplicate. The orsigned road test form and the original of the Certification of Road Test shall be retained in the driver qualification file of the person who was examined, andcopies provided to the person examined. Section 391.31 (e)(f)(g)(l)(2) of the Federal Motor Carrier Safety Regulations

Driver's Name Type of Power UnitSocial Security No. Type of Trailer(s)

Operator's or Chauffeur's Lie. No. State

This is to certify that the above-named driver was given a road test under my supervision on _

13F652(REV. 5/02)

If Passenger Carrier, Type of Bus

20 consisting of approximately milesof driving. It is my considered opinion that this driver possesses sufficient driving skill to operate safely the type of commercial motor vehicle listedabove.Signature of examiner OrganizationTitle Address of examiner

Copyright 2002 J.J. KELLER & ASSOCIATES, INC., Neenah, Wl - USA • (800) 327-6868 - www.jjkeller.com • Printed in the United Sta 6B 278(rev. 5/02)

**Driver's Receipt**

This issue of the FMCSR Pocketbook includes all revisions on or before June 8, 2015

I acknowledge receipt of this FEDERAL MOTOR CARRIER SAFETYREGULATIONS POCKETBOOK (347). In addition, I agree to familiarize myself withthe Federal Motor Carrier Regulations (FMCSR) of the U.S, Department ofTransportation, Parts 40, 380, 382, 383, 387, 390-397, 399 Subchapter B, Chapter 3, Title79 of the code of Federal Regulations, as contained therein.

DRIVER'S NAME (PLEASE PRINT) DATE

DRIVER'S SIGNATURE

SUPERVISOR OR CARRIER REPRESENTATIVE SIGNATURE

7/15

Note: This receipt shall be read and signed by the driver. A responsible companysupervisor or carrier representative shall countersign the receipt and place in the drive'squalification file.