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In completing this application form, I understand that Patrick Industries may conduct an investigation of my background. Patrick Industries may utilize a third party reporting agency to conduct an investigation including a consumer report or an investigative consumer report, and in that instance, other documents regarding disclosure and authorization will be provided to me. By my signature below, I authorize all persons, schools, companies, consumer reporting agencies, and other organizations to supply all truthful information requested by Patrick Industries in association with the investigation including information regarding my educational background, work history, skills and personal character. hereby release and hold harmless all persons, companies, schools, agencies and other parties from all claims related to the provision of accurate and truthful background information provided about me.

I understand that any false statements or omissions of requested information will disqualify me from employment with Patrick Industries. Should 1 become an employee and it is later found out that I have misrepresented or omitted requested information, I understand that I will be discharged.

I understand and agree that, if hired, my employment with Patrick Industries is for no definite period and may be terminated at any time for any reason without prior notice. Just as I may resign my employment at any time, for any reason, Patrick Industries will have full right and authority to terminate my employment within its sole discretion. I understand and agree that the terms and conditions of my employment, if hired, can only be varied from this "at-will" arrangement through written contract signed by the President of Patrick Industries. I understand, agree, and acknowledge that any reliance on any statements by any other representative of Patrick Industries contrary to this "at-will" arrangement is unreasonable and may not form any basis for my reliance thereon. I also understand and agree that Patrick Industries has the right to modify, amend, or terminate policies, procedures, rules, and benefit plans in its discretion as long as the changes are in a manner consistent with requirements imposed by law.

I acknowledge and agree that, should I receive an initial offer of employment, such offer is preliminary and contingent upon my successful completion of a medical examination which will include testing for the use of drugs and alcohol and will confirm my ability to perform the essential functions of the position for which I am being hired. I understand that my refusal to undergo such examination in its entirety will preclude me from obtaining and continuing employment with Patrick Industries. I understand that a failure of the drug/alcohol test will cause my offer of employment to be rescinded. Further, I hereby authorize and agree that all medical information obtained in association with this post offer pre-placement examination shall be released from the appropriate medical personnel to Patrick Industries. I release and hold harmless all persons, companies, and other entities conducting such examination from all liability (ies) and damages experienced as a result of the information provided to Patrick Industries.

I understand that this application for employment shall be considered active for a period of time not to exceed sixty (60 days. I understand that, if I wish to be considered for employment beyond this time, I should contact Patrick Industries to inquire as to whether applications are being accepted for positions at such time

Your signature below constitutes your legally binding acceptance of the above policies and conditions. Patrick Industries is relying upon your agreement (signature) in accepting your employment application and resume.

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