Industrial Builders, Inc.

Commercial Services Crane Rental Demolition Groundwater Remediation Heavy Civil Work Heavy Industrial Highway Services Marine Work Deep Foundations Heavy Industrial Machinery & Equipment Moving & Rigging

History Accreditation Awards

Current Openings
Online Application

Application For Employment

Simply fill out the form below and we will respond as soon as possible.

Personal Information

First Name:		Last Name:
Address:		City:
State:		Zip Code:
Phone:		Cell Phone:

Are you eligible to work in the United States?

Yes No

Are you able to be away from home for extended periods of time?

Yes No

Do you have any limitations that preclude you from performing any work for which you will are being considered?

Yes No

If "Yes", please describe:

IBI Position

Position(s) interested in:
Referred by:
Have you been employed with us before?	Yes No
If yes, when? What Position?
List friends or relatives that work for us:

Education

High School:
Diploma:		GED:
College:
Degree:
Special Training/Certifications:

Skills

List any special skills, machines, equipment, experiences, or training that you possess that may be related to the job for which you are applying:

Work Classification

Give years of experience in each classification
Laborer:		Truck Driver CDL
Carpenter:		Truck Driver - Heavy Equip.
Form Setter:		Equipment Operator:
Concrete Finisher:		Cranes:
Welder (State Cert.):		Mechanic:
Please list types of equipment:

Drivers License and Driving Information

Valid Drivers License?
*if CDL is selected, you must complete the CDL portion of this application.

Regular CDL None

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

Yes No

If "Yes", provide details:

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

Yes No

If "Yes", provide details:

Endorsements:
H - hazardous material	N - liquid or gaseous material
P - transport 16+ people	M - motorcycle
S - school Bus	T - tow double/triple trailers
Other:

Personal References

Reference 1
Name:		Address:
Occupation:		Phone:

Reference 2
Name:		Address:
Occupation:		Phone:

Past Employment Information

All applicants must provide the following information on all employers during the past three (3) years. Applicants to drive a commercial motor vehicle shall also provide an additional seven (7) years information. Complete mailing address, street number, city, state, and zip code are required. There can be no gaps in employment.

Employer 1

Name:

Start Date:

Address:

End Date:

Hourly Rate / Salary:

Phone:

Supervisor

Job Title:

Reason for leaving:

While employed by this employer, were you subject to the Federal Motor Carrier Safety Regulations?	Yes No
Was this job designated as a safety sensitive function in any DOT regulated mode subject to alcohol and controlled substances testing requirements as required by 49 CFR part 40?	Yes No

Employer 2

Name:

Start Date:

Address:

End Date:

Hourly Rate / Salary:

Phone:

Supervisor

Job Title:

Reason for leaving:

While employed by this employer, were you subject to the Federal Motor Carrier Safety Regulations?	Yes No
Was this job designated as a safety sensitive function in any DOT regulated mode subject to alcohol and controlled substances testing requirements as required by 49 CFR part 40?	Yes No

Employer 3

Name:

Start Date:

Address:

End Date:

Hourly Rate / Salary:

Phone:

Supervisor

Job Title:

Reason for leaving:

While employed by this employer, were you subject to the Federal Motor Carrier Safety Regulations?	Yes No
Was this job designated as a safety sensitive function in any DOT regulated mode subject to alcohol and controlled substances testing requirements as required by 49 CFR part 40?	Yes No

Traffic Convictions and Forfeitures

Only complete this section if you will be asked to drive for Industrial Builders Inc.

If you are asked to drive for Industrial Builders, Inc., you are required to list any traffic violations you have had in the past 3 years. I certify the following is a true and complete list of traffic violations (other than parking tickets) for which i have been certified or forfeited bond or collateral.

Have you had any traffic violations in the past three (3) years? Yes No
If "Yes", please describe
Violation 1
Date:		Charge:
Location:		Penalty:
Type of Vehicle Operated

Violation 2
Date:		Charge:
Location:		Penalty:
Type of Vehicle Operated

Have you had any motor vehicle accident in the past three (3) years? Yes No
If "Yes", please describe
Accident 1
Date:
Nature of Accident: (head on, rear end, etc.)
Fatalities / Injuries / Property Damage:
At Fault:

Accident 2
Date:
Nature of Accident: (head on, rear end, etc.)
Fatalities / Injuries / Property Damage:
At Fault:

Have you ever been convicted of a crime other than a minor traffic violation? Yes No
If "Yes", please describe
Date:
Offense:
Conviction:
* Convictions are not an absolute bar to employment, but will be considered in relationship to the job requirements.

CDL License

Complete this portion of the application if you have a CDL or have operated a commercial motor vehicle.

Date of Birth:

Have you ever tested positive or refused to be tested on a Pre-Employment Drug Screen for an employer that you did not go to work for?

Yes No

If Yes:

Name of employer:

Date:

Previous Addresses
Please list all address you have resided during the past three (3) years.

Address 1
Date From (mo/year): To (mo/year)
Street Address:	City:	State:

Address 2
Date From (mo/year): To (mo/year)
Street Address:	City:	State:

Address 3
Date From (mo/year): To (mo/year)
Street Address:	City:	State:

Driving Experience

Class of Equipment:		From:
Type of Equipment:		To:
Approx. # of miles (total) :

Class of Equipment:		From:
Type of Equipment:		To:
Approx. # of miles (total) :

Class of Equipment:		From:
Type of Equipment:		To:
Approx. # of miles (total) :

Class of Equipment:		From:
Type of Equipment:		To:
Approx. # of miles (total) :

Class of Equipment:		From:
Type of Equipment:		To:
Approx. # of miles (total) :

Class of Equipment:		From:
Type of Equipment:		To:
Approx. # of miles (total) :

Class of Equipment:		From:
Type of Equipment:		To:
Approx. # of miles (total) :

Class of Equipment:		From:
Type of Equipment:		To:
Approx. # of miles (total) :

AFFIRMATIVE ACTION VOLUNTARY INFORMATION – This company is committed to an Affirmative Action Program which includes giving full consideration for employment to qualified handicapped individuals, Vietnam-era veterans, disabled veterans, ethnic minorities and women. The following information is being requested for all applications for employment. Your providing this information is strictly VOLUNTARY. This self-identification request is made in compliance with the AFFIRMATIVE ACTION PROGRAM and to aid in complying with any required Governmental record keeping or periodic reporting.

This information is NOT part of your employment application, and will not be considered in the employment selection process. If you choose to provide the information please complete the following:

REFERRAL SOURCE

Walk In		Government Employment Agency

Employee		Private Employment Agency

Relative		Advertisement-Source

School		Job Service

Union		Other

Name of person who referred you (if applicable):

AFFIRMATIVE ACTION VOLUNTARY INFORMATION

SEX Female Male

RACE

White-origins in Europe, North Africa or Middle East
Asian-origins in Far East, SE Asia, India or Pacific Island
Black-origins in Africa
Hispanic-Mexican, Puerto Rican, Cuban, Central or South America
American Indian-origins in North America, to include Alaska

VETRANS/US Military Status
(0) Non-Veteran
(1) Pre-Vietnam Veteran with Service Incurred disability
(2) Pre-Vietnam Veteran
(3) Vietnam Era Veteran (8/5/64 – 5/7/75)
(4) Vietnam Era Veteran with Service Incurred disability
(5) Post Vietnam Veteran
(6) Post Vietnam Veteran with service incurred disability

ACTIVE NATIONAL GUUARD RESERVIST (check one)
Yes No

PHYSICAL CONDITION
(1) No Disability
(2) Physical Disability (No Facility Modification)
(3) Physical Disability (Facility Modification)
(4) Health Disability (Heart Attack, Diabetic, Epileptic Etc.)
(5) Mentally Disabled (Learning Disabled)