HomeMy WebLinkAboutemployment screening services 2013 V
Employ =ment Screening & Human Resource Solutions
SERVICE AGREEMENT
FOR EMPLOYMENT SCREENING SERVICES
This Service Agreement for Employment Screening Services ( "Agreement ") is made by and between VeriCORP Incorporated,
("VeriCORP"),
Kentucky_ 402a Kentucky y couoration w its •rind. place of busi - :s 410 Commercial Drive, Suite 201, Louisville
�� -T f • ("Client") located at
1 'e i kt 1 -0 1 c3 1) subject to the
following terms and conditions:
1. SERVICES PROVIDED: VeriCORP agrees to furnish to Client investigative reports and other background information
( "consumer report ") on job applicants /employees, as requested by the Client. Client certifies that the primary use of this
employment screening service is to obtain investigative reports in connection with the evaluation of individuals, for
employment, promotion, reassignment or retention as an employee. Clients shall request investigative reports from time to
time, pursuant to procedures prescribed, for reasons listed above and no other purpose. The investigative reports listed on the
Description of Searches, Addendum A (subject to change); include public and non - public reports provided by government and
private entities.
VeriCORP will provide Client with sample letters, pro forma documents and consent forms to assist Client in complying with
its obligations under the Fair Credit Reporting Act (FCRA), as well as those applicable state laws known to VeriCORP or that
VeriCORP becomes aware of in the ordinary course of business or by notice from the Client. VeriCORP does not warrant the
accuracy or completeness of these documents and the Client is encouraged to have them reviewed by its counsel before
proceeding to use them.
VeriCORP will use its best efforts to deliver the consumer reports requested in an expeditious manner, however, VeriCORP
shall have no obligation or liability to Client for any delay or failure to deliver consumer reports caused by the parties
providing data or information to VeriCORP, or by any other third - party. VeriCORP is a federally regulated Consumer
Reporting Agency (CRA) as defined by the Fair Credit Reporting Act for the purpose of providing pre- employment screening
information in accordance with all applicable guidelines and confidentiality as stipulated within applicable statutes.
2. DISCLAIMER OF WARRANTY /LIMITATION OF LIABILITY: The consumer report obtained by VeriCORP is derived
from databases and records that have been created and maintained by various government agencies, private companies, and
other contributors that are not under the control of VeriCORP. Responsibility for the accuracy of the information contained in
the consumer report and these databases and records rests solely in the contributor. The Client waives any and all claim or
claims against VeriCORP arising out of or related to the accuracy of the consumer report, databases and records.
3. USE OF EZyCHECKIM SOFTWARE: EZyCHECK'IM software users agree to terms and conditions of Addendum B.
4. CLIENT'S ACKNOWLEDGMENT OF COMPLIANCE WITH THE FAIR CREDIT REPORTING ACT: Client certifies that
it is properly licensed for business and is the End User. Client acknowledges that the consumer reports are furnished in strict
confidence for the exclusive use by the Client only for the purposes of direct employment, work to be performed under
contract, volunteer work or position, promotion and/or reassignment. No other permitted uses are implied or intended and the
consumer reports shall not be reproduced or resold in whole or part in any manner whatsoever.
The Fair Credit Reporting Act (FCRA) governs the activities of consumer reporting agencies, as well as the users of the
information procured from these agencies. A consumer report contains information on a job applicant /employee's character,
reputation, and other personal data; therefore, use of such information is strictly regulated by the FCRA. Among other things,
the FCRA prohibits employers from obtaining consumer reports unless the employer discloses to the applicant, in writing, that
such a report may be acquired, and obtains the written authorization of the applicant /employee to inquire into this background
information. The FCRA also requires employers to take additional steps when they make an employment decision based in
whole or part on the background information. These steps are intended to give the applicant the opportunity to dispute any
information contained in the background or consumer report. See Addendum C, FCRA Compliance Flow Chart.
Unless requested by a client or by government regulation, VeriCORP will provide the criminal records for a minimum of
seven years. VeriCORP urges all employers to review the restrictions and requirements of the FCRA. The Act's citation is
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•
y oizcoRp
Employment Screening & Human Resource Solutions
SERVICE AGRF,J MENT
JYOR EMPLOYMENT SCREENING SERVICES
i This Service Agreement for Tctrp}nyrncnt Screening Services ("Agreement') is made; by and between YcriCORP Incorporated,
f Vc CORI"), a Kentucky • •. ation wits jis in ' place of busi .s at 410 Commercial Drive Suite 201 Louisville
IC.entuck 40273: find _ U 4C .. > '
• 4 _ u, MK_ `�i `' 1 • ("Client') located
at
Cu • > *r ' subject to thc
following terns and conditions
I i
I. SERVICES PROVIDED: VeriCORP agrees to fusalialt to Client investigative reports and other background information
("ronsumcr report ") on job applicants/employees, as requested by the Client. Client certifies that the primary trsc of this
employment screening Service is to obtain investigative reports in connection with the evaluation of individuals, for
employment, promotion, reassignment or retention as an employee. Clients sha11 request investigative reports from time to
time, pursuant to procedures prescribed, for reasons fisted :above and no other purpose. The investigative reports listed on the
Description of Searches, Addendum A (subject to change ); include public and nisi - public reports provided by government and
private entities.
VeriCORP will provide Client with sample letters, pro forma docurnentrr Cncl c;onwnt forms to assist Client in complying with
ita obligations under the Fair Credit Reporting Act (FCRA), as well as those applicable state laws known to VcriCORP or that
VeriCORP becomes aware of in the ordinary coarse of bosiness or by notice from the Client. VeriCORP fa not warrant the
accuracy or complete:mac of these documents and the Client is encouraged to have them reviewed by its counsel before
proceeding to use them_
VeriCORP will use its best efforts to deliver Cho consumer reports requested in an expeditions manner, however, VeriCORP
shall have no obligation or liability to Client for any delay or failure to deliver e(xrtiurner reports caused by the parties
providing data or information to VeriCORP, or by any other third -pia ty. VcriCORP is a federally regulated ConSutrer
Retorting Agency (CRA) as defined by the Fair Credit Reporting Act fnr the purpose: of providing pre screening
information in accordance with all applicable guidelines and confidentiality as stipulated within applicable statute a,
2. DISCLAIMER OF WARRANTY/LIMITATION OF LIABILITY: The consumer report obtained by VeriCORP is derived
from databases and records that have been created and maintained by various government agencies, private companies, and
other contributors that are not under the control of VeriCOlu'. Responsibility for the accuracy of the information contained in
the consumer report nnci these databases and records rests solely in the coati ibutor, The Client waives any and all claim or
dahlia VeriC()RP arising out at' o or retitled to the accuracy of the consumer report, t(nlnhnsea and records.
3, US1:i OF BZyCHECK SOFTWARE,: i✓yc 11F.CKThr software users agree to terms find conditions of Addendum R.
•
4. CLIENT'S ACKNOWLEDGMENT OF COMPLIANCE WITH THE FAIR CREDIT REPORTING ACT: Client. czrti Fes that
it is properly licensed for business and ix thc End User. Client acknowledges that the consumer repottt3 are furnished in strict
confidence for the exclusive use by the Client only for the purpascs of direct employment, work its be performed under
contract, volunteer work or position, promotion and/or reassignment. No other permitted uses are implied or intended and thc
consumer report); shall not be reproduced or resold in whole or part in any manner whatsoever.
The Fair Credit Reporting Act ( governs the acrivitiet of consumer reporting agencies, as well as the users of the
information procured from these agencies. A consumer report contains information on a job applicant /crilptoyce's character,
reputation, and other personal data; therefore, use (latch information is strictly regulated by the FCRA. Among other things,
the FCRA prohibits employers from obtaining consumer reports unless the employer discloses to the applicant, in writing, that
such a report may be acquired, and obtains the written authorization of the applicant/employee to inquire into this background
information. The FCRA also requires employers to take Udclitiuurr,l stubs when they make an employment decision based in
whole or pait on the background inforntntion. These. steps. un: intended to give the applicant the opportunity to dispute any
infornittlion contained in the background or consumer report. Sec Addendum C, FCRA Coniplinnce Flow Chart.
Unless requested by it client or by government regulation, VcriCORP will provide the criminal records for a minimum of
seven years. VeriCORP urges all em 'ptoyers to review the restrictions and requirements of the FCRA. The Act's citation is
1
Public Law 91 -508, Title 15, U.S.C. Sections 1681, et seq. Please note, particularly, the Permissible Purposes of Reports, as
well as requirements on Users of Consumer Reports and Obtaining Information Under False Pretenses.
a. Permissible Purposes: By signing this document, Client certifies that it is requesting VeriCORP to provide screening
services only for the purposes indicated below and for no other purposes. Please check the permissible purpose(s) for
which this data will be used:
Employment Screening Tenant Screening Business Need _X_
b. Applicant's Authorization Obtained: By signing this document, Client certifies that prior to requesting VeriCORP to
provide screening services for employment purposes on an applicant/employee, it has provided the
applicant/employee with a clear and conspicuous written disclosure, in a document consisting solely of the
disclosure, that a consumer report is being requested for employment purposes, and it has obtained the written
authorization from the applicant/employer to obtain a consumer report for employment purposes.
c. Pre- Adverse Action: By signing this document, Client certifies that before taking adverse action (e.g., refusing to hire
or promote an applicant /employee), based in whole or part on information contained in the consumer report, it will
first:
I. Provide the applicant/employee with a copy of the consumer report;
I1. Provide the applicant /employee with a copy of "A Summary of Your Rights Under the Fair Credit Reporting
Act ", in the format approved by the Federal Trade Commission (FTC). A copy of this notice may be
obtained from the FTC website at www.ftc.gov /credit or from VeriCORP; and
III. Provide the applicant with ample time to dispute any information contained in the consumer report.
d. Adverse Action: By signing this document, Client certifies that after providing the applicant/employee with the Pre -
Adverse Action information contained above, and after it has given the applicant /employee "ample time" to dispute
the information, the Client will send the applicant a follow -up notification that the Client is taking adverse action
(e.g., refusing to hire or promote an applicant/employee) based on the information contained in the consumer report.
e. Client certifies that it will comply with all applicable state laws concerning consumer reports. If Client is a
California, Minnesota or Oklahoma -based employer, Client certifies that it will also provide applicants copies of their
report in compliance with CA Codes 1785.20.5, 1786.16(a)(5)(b)(l ), & 1786.22; MN Code 13C Subdivision 2; OK
Code 24 O.S. § 148.
f. Confidentiality and Use of Information: By signing this document, Client certifies that it acknowledges the sensitivity
and confidentiality of the information contained in the consumer report and Client agrees that information obtained
from a consumer report will not be used in violation of any applicable state or federal equal employment opportunity
laws. VeriCORP suggests a minimum of a six (6) year record retention policy for Clients for any record arising out of
or relating to a consumer report provided by VeriCORP, including without limitation the applicant's resume, the
applicant's employment application, any background check form completed by the applicant, the background check
disclosure form, the background check authorization form, the completed background check, any communication
relating to the background check and hiring decision, any adverse action notices provided to the applicant, and
communication relating to any applicant dispute of information contained in the background check. This suggested
record retention policy would be applicable regardless of whether the record retained is a paper or electronic record.
g. Indemnification /Hold Harmless: By signing this document, Client acknowledges that it has read and understands the
requirements of the Fair Credit Reporting Act, Client agrees that it will comply with all such requirements, and Client
agrees that it shall defend, indemnify and hold VeriCORP, its directors, officers, employees, agents, successors and
assigns, harmless from any and all claims, liability, costs or damages whatsoever arising out of or related to Client's
failure to comply with the requirements of the FCRA. Client further agrees that it shall defend, indemnify and hold
VeriCORP, its directors, officers, employees, agents, researchers and researchers' affiliates, successors and assigns,
harmless from any and all claims, liability or damages whatsoever arising out of or related to the accuracy or use of
the services or data provided under this Agreement.
5. PAYMENT REQUIREMENTS /COLLECTION: Client agrees to pay VeriCORP the applicable charges for the various
services rendered to Client. Client agrees to pay all applicable charges within fifteen (15) days of date of invoice. All
monetary obligations to VeriCORP for services rendered which are past due fifteen days or more nay, at the election of
VeriCORP, bear interest at the rate of one and one -half percent (1 -1 /2 %) per month; eighteen percent 18% per annum. In the
event that legal action is necessary to obtain the payment of any monetary obligations to VeriCORP, the Client shall be liable
to VeriCORP for all costs and reasonable attorneys' fees incurred by VeriCORP in collection of such obligations. VeriCORP
2
Public Law 91 -508, Title 15, U.S.C. Sections 1681, et seq. Please note, particularly, the Permissible Purposes of Reports, as
well as requirements on Users of Consumer Reports and Obtaining Information Under False Pretenses.
a. Permissible Purposes: By signing this document, Client certifies that it is requesting VeriCORP to provide screening
services only for the purposes indicated below and for no other purposes. Please check the permissible purpose(s) for
which this data will be used:
Employment Screening X_ Tenant Screening Business Need
b. Applicant's Authorization Obtained: By signing this document, Client certifies that prior to requesting VeriCORP to
provide screening services for employment purposes on an applicant/employee, it has provided the
applicant/employee with a clear and conspicuous written disclosure, in a document consisting solely of the
disclosure, that a consumer report is being requested for employment purposes, and it has obtained the written
authorization from the applicant/employer to obtain a consumer report for employment purposes.
c. Pre - Adverse Action: By signing this document, Client certifies that before taking adverse action (e.g., refusing to hire
or promote an applicant/employee), based in whole or part on information contained in the consumer report, it will
first:
I. Provide the applicant/employee with a copy of the consumer report;
II. Provide the applicant/employee with a copy of "A Summary of Your Rights Under the Fair Credit Reporting
Act ", in the format approved by the Federal Trade Commission (FTC). A copy of this notice may be
obtained from the FTC website at www.ftc.gov /credit or from VeriCORP; and
III. Provide the applicant with ample time to dispute any information contained in the consumer report.
d. Adverse Action: By signing this document, Client certifies that after providing the applicant/employee with the Pre -
Adverse Action information contained above, and after it has given the applicant /employee "ample time" to dispute
the information, the Client will send the applicant a follow -up notification that the Client is taking adverse action
(e.g., refusing to hire or promote an applicant/employee) based on the information contained in the consumer report.
e. Client certifies that it will comply with all applicable state laws concerning consumer reports. If Client is a
California, Minnesota or Oklahoma -based employer, Client certifies that it will also provide applicants copies of their
report in compliance with CA Codes 1785.20.5, 1786.16(a)(5)(b)(1), & 1786.22; MN Code 13C Subdivision 2; OK
Code 24 O.S. § 148.
f Confidentiality and Use of Information: By signing this document, Client certifies that it acknowledges the sensitivity
and confidentiality of the information contained in the consumer report and Client agrees that information obtained
from a consumer report will not be used in violation of any applicable state or federal equal employment opportunity
laws. VeriCORP suggests a minimum of a six (6.) year record retention policy for Clients for any record arising out of
or relating to a consumer report provided by VeriCORP. including without limitation the applicant's resume, the -
applicant's employment application, any background check form completed by the applicant, the background check
disclosure farm, the background check authorization form, the completed background check, any communication
relating to the background check and hiring decision, any adverse action notices provided to the applicant, and
communication relating to any applicant dispute of information contained in the background check. This suggested
record retention policy would be applicable regardless of whether the record retained is a paper or electronic record.
g. Indemnification /Hold Harmless: By signing this document, Client acknowledges that it has read and understands the
requirements of the Fair Credit Reporting Act, Client agrees that it will comply with all such requirements, and Client
agrees that it shall defend, indemnify and hold VeriCORP, its directors, officers, employees, agents, successors and
assigns, harmless from any and all claims, liability, costs or damages whatsoever arising out of or related to Client's
failure to comply with the requirements of the FCRA. Client further agrees that it shall defend, indemnify and hold
VeriCORP, its directors, officers, employees, agents, researchers and researchers' affiliates, successors and assigns,
harmless from any and all claims, liability or damages whatsoever arising out of or related to the accuracy or use of
the services or data provided under this Agreement.
5. PAYMENT REQUIREMENTS /COLLECTION: Client agrees to pay VeriCORP the applicable charges for the various
services rendered to Client. Client agrees to pay all applicable charges within fifteen (15) days of date of invoice. All
monetary obligations to VeriCORP for services rendered which are past due fifteen days or more may, at the election of
VeriCORP, bear interest at the rate of one and one -half percent (1 -1/2 %) per month; eighteen percent 18% per annum. In the
event that legal action is necessary to obtain the payment of any monetary obligations to VeriCORP, the Client shall be liable
to VeriCORP for all costs and reasonable attorneys' fees incurred by VeriCORP in collection of such obligations. VeriCORP
2
has the right to change the payment period according to the client's credit rating (score), financial status or account payment
record.
6. ARBITRATION: Any controversy or claim arising out of or relating to this Agreement, or the breach thereof, shall be settled
by arbitration in Louisville, Kentucky in accordance with the Commercial Arbitration Rules of the American Arbitration
Association, and judgment upon the award rendered by the arbitrator(s) may be entered in any court having jurisdiction
thereof.
7. ATTORNEYS FEES AND COSTS: In the event a dispute arises with respect to this Agreement, the party prevailing in such
dispute shall be entitled to recover all expenses, including, without limitation, reasonable attorneys' fees and expenses
incurred in ascertaining such party's rights, and in preparing to enforce, or in enforcing such party's rights under this
Agreement, whether or not it was necessary for such party to institute suit or submit the dispute to arbitration.
8. GOVERNING LAW: This Agreement shall be governed by and construed in accordance with the laws of the Commonwealth
of Kentucky.
9. WAIVER: The failure of either party to insist in any one or more cases upon the strict performance of any term, covenant or
condition of this Agreement will not be construed as a waiver of a subsequent breach of the sane or any other covenant, term
or condition; nor shall any delay or omission by either party to seek a remedy for any breach of this Agreement be deemed a
waiver by either party of its remedies or rights with respect to such a breach.
10. SUCCESSORS: This Agreement shall inure to the benefit of and bind the heirs, personal representatives, successors, and
assigns of the parties.
11. CANCELLATION: Client can cancel the account with VeriCORP by sending notification in writing two weeks in advance.
However, Client is obligated and must adhere to the FCRA despite cancellation. VeriCORP recommends that all Disclosure
and Release forms be kept on file in a secure location for a period of at least six (6) years.
The, Client hereby has read and agreed to the terms and conditions of this agreement.
`-'
4\1 rSoo o ‘ / /e
Compan} Name
0 0 Q ur" _Aff -e • C&S+-er CO,Lq -
Street Address
KA Qrsc)6> 0 1l e I N q 7
City, State, Zip Code
(gi a) c .' -A _ . 3d53 (' ) c 5 _ � 4 Q 0
Telephone Number Fax Number
s • j A * .; V14 ar
Client Represen "Printed ,ame Title
-0V-1-------- Lt- ri- 0
Client Represent utive — Signature Date
VeriCORP Representative — Printed Name & Title
VeriCORP Representative — Signature Date
Post Office Box 436054, Louisville, Kentucky 40253 -6054
Phone: 502.554.9999 / Fax: 502.254.4929
www.vericorphr.com Rev. 6/2012
3
05/02/2013 18:55 N0.340 #004
II, has the right to change the `t
g $ ttytttatt pion aceondittg [v the client's c�ctiit rating (score), financial status Or acnclt►ctt payment
record.
ARBITRATION, Any; 0. nay or claim arising out of or relating to this Agreement, or the breach thereof; shall b ' ! i
- -by arbitra.ioa: tudcy m �xirdancc with the Commercial Arbitration Rules of tlo American Ar
. li
4� , ♦ S� ^ ^ xt � :
' h• the award rendered by the arbitrator(s) may be entered m any - tout having jurist loa i
*� ..t 4 thereof. I
t �' r R i ' " K kip t3. } ' Fu e { r ;' i1k �- 5� ,
c. . .
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.' . • In the event a dispute arises with re. m
t to this At, tom' 'Iii i s ub
{ (i r z 4.- ` 11 r a ' ; e r i ` all expenses, including, without Iunitation, reasonable at f� d e q���y`
'f',..-.1. y � , i ' u ' e rights, and In preparing to enforce, or in enforcing '
e for f'�.�, to N /� p�� (y���n (, g� rights rights nnunder this _ !
,' ,,:;
+ i j +. �k . '51 ' ' , a ' inry lol such party to institute suit or subnuet the d sspuie /� to tebt + 4tfon
a - 1R ., mac-' i w '..%1'-,-..,`1,.. .: t ft f--.
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ilf 3 t f k VBRNING L A W : i r ? ' _ t shall be governed by tend construed in accordance with the Iaws of the Commonwcalth ' ik a 3E �f 4c ,1; utlO :E K VG 4WIM1i1GU iM it W 3�IY{;{ Vl it �l tV I t:ltUl:lll NGi1L71 Ul lf7C 1�1i17G ex a Tty titnC r C ov "Ic'Z III' term '�' ' , {f r condition; ntr shall d of otniss t
iion by either party to seek a remedy for any breach of this Agreement be deemed a
. } . waiver by ei therta riy of itzi itineetes or rights with respect. to such a breach.
'
IQ_ SUCCESSORS: This Agreen)ent si►all inure to the benefit of and bind the heirs, personal representatives, successors, uitcl
assigns of the parties.
11. CANCELLATION: Client can cancel the account with VeriCORP by trending nolifcation in vomiting two weeks in advance.
However, Cheat is obligated and must adhere to the FCRA despite cancellation. VeriCt7RP recommends that all Disclosure
and J. e1eusc forms be kept on file in a secure Iocation for a period of at least six (6) years.
The, Client hereby has read and agreed to the terms and conditions of this agrcenient.
Chi - -e e'er'.'. 01 /4,-,
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Campan Name
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V ' ►•IRP Represent° • — Frinttd Name & Title
1 i Mid► 44 T 3a ,-/ S .
Vet' ' - ' errese'nt. ti • — Signature Date
1
Post C)ffikc Box 436054, Louisville, Kentucky 40253 -6054 �
Phone: 502.5511.9999 / Fax: 502,254 4929 f
►vww.vcricorphr_com Rev. 6/2012 i,
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CUSTOMER CERTIFICATION AND CREDIT APPLICATION
Company Name: CA c — S r) t I i.c
Street Address: EDC) G t).C>.A-e x iY-C). 4@ x CA--
City, State, Zip Code: ., ( 1 II 1 3
Telephone Number: ( I Q} 'C) - 3;; IS_ Fax Number: (5b9 s - c o
Web Site Address: k.50 t . LA 1 ()
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Primary Contact Name: ��1 . �Lt
< t Cm1cN�"1CL`('U. Primary Contact Email: c1Y1(�1�'cl - fo("C„) fir, ,.' ek
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Ownership (please check box): atrt
Corporation Partnership Proprietorship
Federal Tax ID# or Social Security #: 1 35(Q Ci3 1 bD'7 Date Incorporated:
Principals or Officers
1. ILA 1 k O Title: «2Q
Link .
2. pt r j Title: 1,Jl,\ 0 FZIPOJYLEP,
Bank Information
Bank Name: 'i 0 W{ Co m ryLl,[..I'L6 k� az_ n,
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Street Address: .O 1 W . ( L y - + 14V P.Xl
City, State, Zip Code: 3 2 So nV k 1 Q l 1.1 1 6-41--1, 3 0
Telephone Number: ( l'a• ) °t Ss ► - - A 10 tp Account Number: 5C1 1 VD-
Credit Card Information (only provide if paying for services via credit card).
Visa Discover
Master Card American Express
Card Number: 3 -Digit Card Security Code:
Expiration Date: Name as it Appears:
Credit Card Billing Address (if different than above Company address)
Street Address:
City, State, Zip Code:
VeriCORP P.O. Box 436054 Louisville, KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502.254.4929 www.vericorphr.com
1
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ADDENDUM A
EMPLOYMENT SCREENING SERVICES
Description of Searches
Social Security Number Search (SSN) When hiring an employee or screening a volunteer, an important step
is to begin to verify the individual's identity by conducting a Social Security Number (SSN) Search. This search
provides information on an applicant's name, past addresses and movement patterns based on the SSN
provided to us (NOTE: information from the Social Security Administration is not used in this report). In
addition to returning information on a SSN, this search provides a report with the following: Full name and /or
alternate names used by an applicant, dates at listed addresses, age /date of birth, and available phone
information. This is an investigative starting point that provides a more complete background search when
combined with additional screening services. Turnaround Time: Instant
SSN Match DirectTM
Processes the Form SSA -89 to retrieve 100% accurate results on Social Security Numbers. SSN Match
DirectTM is the only way to receive data directly from the SSA. Features include:
• Provides "Match ", "No Match ", or "Deceased" result
• Requires consent Form SSA -89
• US Patriot Act compliant
• Fulfills FACTA Red Flag Rule requirement
Turnaround time: 24 hours
County Criminal Search Based on the candidate's address history, the County Criminal Search is considered
the most accurate and comprehensive criminal background search. VeriCORP utilizes a team of researchers
to access criminal records directly from the courthouses in the county (ies) you are requesting. We
utilize public access terminals or "hand pulled" criminal searches to directly examine county criminal felony
and /or misdemeanor court records, rather than using an aggregated criminal database. Multiple counties may
be selected per applicant and the counties may be found by county name, city, zip code or use our convenient
Auto Search button. It is recommended searching the county of residence and /or prior counties of residence,
employment or education. Turnaround Time: Average 1 -3 days
State Criminal Search
Repository — Administrative Office of the Court (AOC) Report Accesses the statewide criminal repository,
if available, in a given state. Statewide Criminal Searches provide access to public criminal records from the
applicable state. Search results may include felony, misdemeanor, and /or traffic -case information. The type of
data and number of years of information will vary state to state. It is important to know that not every county
may report to the state level, leaving voids. This report should not be the sole source of criminal information.
Turnaround Time: Repository: Varies by state, average 1 -3 days
Civil Records Search These relate to non - criminal lawsuits by or against a person or company. County Civil
courts are searching Upper courts and are based on the dollar amount of the action. The dollar amounts will
vary by state and /or county. Civil search of court records for, but not limited to: Wrongful terminations, litigated
workers' compensation suits, personal injury suits, product - liability suits, sexual harassment, fraud,
embezzlement, judgments for nonpayment of goods, and litigation related to divorce, marriage, and child
custody and other civil actions. Federal Civil actions relate to Federal statutes and would include EEOC, EPA,
Treasury or SEC fraud, Civil Rights, etc. Turnaround Time: 1 -3 days
VeriCORP P.O. Box 436054 Louisville, KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502.254.4929 www.vericorphr.com
1
Federal Criminal Search Reports the records of crimes committed against Federal criminal laws. This
information is not included on a county or statewide record, (i.e. bank robbery, interstate theft, kidnapping,
etc.). This report is especially relevant for screening management and executive candidates for white - collar
crimes. Turnaround Time: 1 -3 days
ProScan Multi- Jurisdiction Database Search An extensive report that includes an instant multi -state
search of criminal records. This search accesses over 400 databases and 200 million files containing criminal
records from:
• State repositories and archives (in some states)
• Department of Corrections (DOC) files (where available)
• County court houses
• Sex offender registries
• Administrative Office of Court records
• Traffic violations and infractions involving warrants
Per the FCRA, when using reports for employment permissible purposes, this search is only used as a locator
search to provide locations of possible records and not the actual case information (must be verified).This
report should not be the sole source of criminal information. Turnaround Time: Instant
ProScan Plus
Combines multiple, powerful reports into one unique search. An extensive report that includes an instant multi-
state search of criminal records. This search accesses over 400 databases and 200 million files containing
criminal records from participating:
• State Repositories and Archives
• Administrative Office of the Court Records
• Department of Corrections (DOC) Files
• County Court Houses
• Sex - Offender Registries
• Traffic violations and infractions involving warrants
ProScan Plus uncovers names, addresses and dates of birth as well as known aliases including maiden
names as revealed by our SSN Search. All discovered name variations are then automatically searched
through our high speed, multi - jurisdictional data repository, including sex offender screening & terrorist list. Per
the FCRA, when using reports for employment permissible purposes, this search is only used as a locator
search to provide locations of possible records and not the actual case information (must be verified).This
report should not be the sole source of criminal information.
Turnaround Time: Instant
SentinelTM Security Report This service helps you meet federal Office of Foreign Assets Control (OFAC)
identification requirements and helps impede terrorists by identifying individuals linked to terrorism or classified
on government watch lists, improving compliance with the Patriot Act. An extensive report that includes
information from the following data sources: Office of Foreign Assets Control (OFAC) of the U.S. Department
of the Treasury Specially Designated Nationals (SDN) and Blocked Persons, OFAC Sanctioned Countries
including Major Cities and Ports, Non - Cooperative Countries and Territories, Department of State Trade
Control (DTC) Debarred Parties, U.S. Bureau of Industry & Security (formerly BXA), Unverified Entities List,
Denied Entities List, Denied Persons List, FBI Most Wanted Terrorists and Seeking Information, FBI Top Ten
Most Wanted, INTERPOL Most Wanted List, Bank of England Sanctions List, Office of the Superintendent of
Financial Institutions Canada (OSFI) - Canadian Sanctions List, United Nations Consolidated Sanctions List,
Politically Exposed Persons List, European Union Terrorism List, and World Bank Ineligible Firms. Turnaround
Time: Instant
VeriCORP P.O. Box 436054 Louisville, KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502.254.4929 www.vericorphr.com
2
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OIG -GSA National Level Search of the Department of the Health and Human Services Office of Inspector
General's (OIG) database for any individual or entity that has committed any type of fraud against Medicare,
Medicaid, or any other Federally- funded healthcare program. Also includes General Services Administration
(GSA) search by name of firms or individuals that have been suspended, debarred, placed on probation,
received letters of reprimand, license terminations or otherwise excluded from Federal Procurement and Non -
procurement Programs. Also includes search of disciplinary actions taken by Federal agencies as well as
those taken by over 700 licensing and certification agencies in all 50 states. Check histories of individuals and
entities for adverse actions and for sanctions and exclusions from Federal healthcare programs. Includes OIG,
GSA, Food and Drug Administration (FDA), Drug Enforcement Agency (DEA), TriCare and OFAC, also
referred to as the Terrorism Sanction Watch List. Meets the Federal Governments' requirements as outlined in
the OIG Compliance Program. Turnaround Time: 1 day
National Sex Offender Registry The national sex offender registry search is critical for professionals and
volunteers who will interact with youth or work in childcare, education, healthcare and human services
environments. The search includes sex offender registration records from all 50 states plus the District of
Columbia, Guam & Puerto Rico. Please note that the types of crimes that require registration vary by state.
Therefore, not all individuals convicted of a sex crime in one state may be included in another state's registry.
Turnaround Time: Average 1 -2 days
Prior Employer Verification Direct verification of claimed previous employment. Verify dates of service, job
title, job duties, performance, attendance, reason for leaving, rehire status and general comments. Turnaround
Time: 1 -3 days
Education Verification Direct verification of applicant's educational records including dates attended and
degree, certificate or diploma received at the provided educational institution. High School or GED
Turnaround Time: 1 -3 weeks Secondary Turnaround Time: 1 -3 days
Reference Check and Verification Relevant inquiries of personal or professional references, provided by the
applicant, to obtain an assessment of your candidate. Turnaround Time: 1 -3 days
Professional License /Certification Verification Professional licensing searches research information on
individuals who need state licenses or certifications to engage in a professional activity, including medical
professionals, attorneys, CPAs and educators. (Licensed professions may vary by state.) Reports may include
such information as the name and address of the licensee; the licensing agency; license type, number, and
class; license classification (business or personal); status of license: issue and expiration dates; restrictions
and any adverse or disciplinary action. Turnaround Time: 1 day
Workers' Compensation Claims History of Workers' Compensation claims. Each state limits the data they
report. This report can only be generated after a "conditional job offer" has been made. Turnaround Time:
Varies by state, 1 day to 4 weeks
Motor Vehicle Report (MVR) Driving record, including offenses and citations, provided by the specified state
in which the applicant holds a valid license. The data reported and number of years included will vary slightly
by state. Companies should order driving history reports for all employees who drive company or personal
vehicles for business. Turnaround Time: Varies state to state; majority are instant
Employment Credit Reports The employment credit report search illustrates patterns in your candidates'
financial behavior. Employment credit report information is gathered from a major credit bureau, providing
information regarding trade accounts, payment history, collections and public records. Turnaround Time: 1 day
VeriCORP P.O. Box 436054 Louisville, KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502.254.4929 www.vericorphr.com
3
ADDITIONAL SERVICES
Drug Screening and Alcohol Testing VeriCORP partners are the leading providers of diagnostic testing. To
further ensure accuracy, all non- negative results may be confirmed using Gas Chromatography /Mass
Spectrometry (GC /MS) technology and reviewed by an accredited Medical Review Officer (MRO). A wide
variety of tests are available to match your requirements. Turnaround Time: 5 Panel Test within 15 minutes,
electronic results. Lab based test; 24 -48 hours.
Social Media Screening FORA compliant background screening service that enables employers to navigate
the complicated legal landscape of social media with clear, consistent, and insightful results. Using a
combination of automated and manual review processes, these reports ignore information that is not legally
allowable in the hiring process, such as the "protected class" characteristics defined by federal anti-
discrimination law (race, religion, national origin, age, sex, familial status, sexual orientation, disability status,
and other qualities that are not allowed to be used as decision points). Therefore, job candidates are protected
from discrimination based on these characteristics and, in turn, employers are protected from allegations of
discrimination. The Executive report is a detailed report that contains all information that is found online on the
candidate. This report accounts for non -user generated content such as media hits in addition to the already
included pre- defined employer criteria. With the report employers receive a 360 - degree view of their
candidate's online profile. Turnaround Time: 1 -3 days
E- Verify and Form 1 -9 Management Incomplete records and lack of compliance can cost your company hefty
fines and penalties. Automated processing reduces your risk. E- Verify is a system created by the government
to verify the Social Security Number, Employee Address and supporting documents are for the correct person.
The system is designed to notify employers if there is some discrepancy or issue that might cause the
employer to hire an illegal immigrant. The Immigration Reform and Control Act (IRCA) require employers to
hire only persons who may legally work in the U.S. The employer must verify the identity and employment
eligibility of anyone to be hired, which includes completing the Form 1 -9.
Fingerprinting Services VeriCORP has partnered with 3M Cogent, a world -wide provider of electronic
fingerprint services and technology, and proudly introduces the eGAPS service. The eGAPS service provides a
quicker, easier way to complete selected State, Federal and Corporate fingerprint based background checks.
FBI Channeling Service In response to the growth of federal and state legislation requiring mandatory
criminal history searches for select positions, 3M Cogent has been selected by the FBI as an authorized
Channeling Agency. 3M Cogent is authorized to provide criminal history searches (i.e. fingerprint -based
background checks) for non - criminal applicants using the applicants' own fingerprint records. The capturing of
applicant fingerprints is achieved through the use of FBI - certified 3M Cogent LiveScan device. Each captured
applicant fingerprint record is transmitted to the FBI as a digitized electronic record, in compliance with the
Electronic Fingerprint Transmission Specification (EFTS). Once received by the FBI, applicant fingerprint
images are compared against the FBI's known criminal fingerprint database to determine if any criminal history
exists.
Human Resource Solutions We provide support to start -ups and small companies that need help covering
basic Human Resource and employee relations needs. We also provide consulting solutions to mid -size and
large companies who have internal HR staffs but need occasional assistance with short or long -term projects.
The Please tell us...Employee HOTLINE Having a confidential reporting hotline is becoming a necessity for
any organization. Employee relations and regulatory issues require companies to look for better employee
reporting methods.
VeriCORP P.O. Box 436054 Louisville, KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502.254.4929 www.vericorphr.com
4
• When employees encounter sexual harassment, discrimination or other workplace dilemmas, they often
feel that they cannot confide in normal internal channels without fear of retaliation. Instead, they frequently
turn to outsiders for intervention which can lead to costly lawsuits or government investigations —even
negative publicity.
• The Please tell us...Employee HOTLINE can support and enhance your employee relations program by
providing an impartial dispute resolution practitioner to provide independent, confidential and informed
assistance.
Please note, some courts and agencies may charge access fees in addition to the record fee. Prices are
subject to change, due to possible changes in state, county court and agency fees.
You must comply with FCRA guidelines and obtain a signed Background Release & Authorization Form
prior to ordering any consumer reports if used for employment permissible purposes. In addition provide the
applicant a copy of the Consumer Reports Notification.
Your signature indicates that you have read the ENTIRE document and will abide by the rules and
regulations of the Fair Credit Reporting Act (FCRA).
By: dAL. - 1 .■ By:
CLIENT Autho ized Representative VeriCORP Authorized Representative
i ik .
Date: " l it Date:
VeriCORP P.O. Box 436054 Louisville, KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502.254.4929 www.vencorphr.com
5
:'05/02/2013 18:59 110.340 #012
• When employees encounter sexual harassment, discrimination or othor workplace dilemmas, they often
} feel that they cannon confide in normal Internal channels without fear of retaliation. Instead, they frequently
tum to outsiders for intervention which can lead to costly lawsuits or government investigations -even
' j i _, _negative publicity �.
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.",.i. i` 4 : o `. The Please tell us: t. . :. HOTLINE can support and enhance your or l gee rel progra by
• ;: U i 3 �, , p roviding an kl >d .;.,-te , resolution practitioner to provide independent, con ential and informed
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sf t ; I it {} s • •• to Cha , ; j . ^so e : changos in state, county court and agency fees.
' '• oil must corn guidelines and obtain a signed Background Release & Authorization Form
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.„„ . , f : r to r to ottdenng any c rtsi n r reports if used for employment permissible purposes. In addition provide the
applicant a copy of the Consumer Reports Notification. •
Your signature Indicates that you have read the ENTIRE document and will abide by the rules and
regulations of the Fair Credit Reporting Act (FCRA).
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ProScan Suite of Products
Acknowledgment of Purpose and Release of Claims
Definition of Search and Purpose
The "ProScan Suite of Products" is a query made using the applicants identifiers to a criminal records
database containing a variety of criminal records information. It consists of data obtained from sources which
may include state-based department of corrections, administrative office of the courts, bureau of criminal
apprehension, department of criminal justice records, various county criminal records, sex offender registries,
and data from other applicable government agencies, where available.
When a potential match is found, it is returned as a jurisdiction to be searched without providing the underlying
criminal information. Once a jurisdiction has been identified, the Client should add the jurisdiction to the list of
counties identified via other screening sources (e.g. a Social Security Number Search) and then complete the
background screening process. This protocol is necessary as under the Fair Credit Reporting Act (FORA),
when a public record is used to make an employment decision, one can only rely on the current state of that
record necessitating a contemporaneous verification.
Acknowledgment of Purpose
The Client, by its authorized signature below, confirms that it understands that the "ProScan Suite of Products"
are not intended as a stand alone criminal search, nor is it promoted as such by VeriCORP Incorporated, but is
provided as a tool to locate jurisdictions with possible criminal records for subsequent verification at the
primary source(s).
Reliance on any information obtained solely through the use of "ProScan Suite of Products" with
contemporaneous primary source verification is not recommended as being prudent by VeriCORP
Incorporated and does not represent a comprehensive background check by background screening industry
standards.
Release of Claims
The Client is fully informed in these matters and chooses of its own accord to use and rely on the "ProScan
Suite of Products" with contemporaneous primary source verification. Therefore, ordering, use andior reliance
on "ProScan Suite of Products" reports provided to Client on a standalone basis shall be solely at Client's risk
and shall constitute a waiver of any claim against VeriCORP Incorporated.
. .
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Compan Na e
J___ AA OR._
Client Rep es-ntative — Printed Name & Title
i ke 40 iek,... W30/1_3
Client Representative — Signature Date
VeriCORP P.0 Box 436054 Louisville, KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502.254.4929 www.vericorohr.com
';e5/02/2013 19:00 NO.340 #014
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iti {, 1 �„ f i i j Olt': x - ::,,i0;,-1,::431i,,, . Prr earl ftevt Produgts:
t ' v � a p . , � g�left of Pttsss andfete�$e :iofIs. ,
f i.',.. t , 4 '- {..R•i .. 1 -d,t t t .e', • •
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, ;! r , 5 ; "��r4 p 0 . ts is a query made using .the appli Identifiers to a criminal r+eoords
4v,•1 . iv x1 itab Se a# 'at ety of cr ai.records Information. It c n sts o data obtaMod.from sources.Wh '
a a -1)- may includes q•b d 'artrhent of corrections, adminfstratiVe o#f(ce of .the WW I% bureau . of vtirrmr'rl
:, .apprehensiorr, depaatme u of criminal.Justice records, various .cdurlty ctfrntnaI records, sex.ot'tender registries,
and data froth other applicable government agenoles, •where available. .
When q potential match is found, it Is'returnOd as a jurisdiction to ba.soarchgd without providing the underlyin0
criminal information. Dice a Jurisdiction has boors - Identified, the C,tlef;i shOitld add the jurisdiction to the 110 :01
counties identified via other screening ourco (o g:.a SQaial Security Nurrtber'Searbh) and .Bien complete
background sOreoning pro o08. This prvtpcol is necessary as .tinder the Fr Credit Reporting Abt ='( RA), ' ,
when a public record Is used to make an employment decision, one can only rely on the current stato of j at •
turd noc ossitating a c ontemporanoous verification. •
Ack ig.w_1 dgment 9( Purpose
. - rho Ciiont, by Els authu iced signature below, confirms that it understands that the "PrrSoan Suite of Produets'
. ,, are not intended as a stand alone criminal search, nor is it promoted as such by VerICORP Incorporated, but Is
y proVidod ass a tool to lobate jurisdictions with possible criminal records for subsequent veri k at1on .at the
rL1 ,,,, primAry SO+urce s .
' ,$r�,} ' 1)' ellarxe on any information obtained sololy through the use of "ProScan Suite of Produufs" with
,, ' c " ,i fy, �conternporanoous primary source verification Is not recommended as being prudent by VertCORP
;, �, . , , ncoiporated and does not represent a comprohons1ve background check by background screening industry
,. j y(y�s yytandards•
1 ,
r elease of Clams
. - 4,i , � $ Ciian1: is fully ? 1r oniied ia. these matters and chooses of its overt accord to use and rely on the "'ro rr
-1 -''''. Suite of Products" with eonteniporaneous prirnary source verification. Therefore, ordering,•use and/or rellertce
• on "ProScan State of Products' reports provided to Client on a standalone basis shall be at Client's rink
and shalt constitute a waiver of any claim against VorICORP Incorporated. •
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Combat! N . -
Client Rep :� : tative — P , ed t■l: e & Title
f (7Z9/0 - 43 .
, L., -,
J.,
Chant Representathro — Signature Date
VariGORP P.O. BOX 434054 i •oufsvaie KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502.254.4929
y,m�vericojptx.com
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ADDENDUM B
El CHECKTM Software Users Agreement
The undersigned Client and Distributor hereby make the following agreement:
1. Recitals
Epic Concepts, LLC, ( "Epic Concepts ") is the owner of the computer software known as EZyCHECKTM and of all
copyrights, trademarks, trade secret rights and other rights and interests in EZyCHECKTM. The term EZyCHECKTM
also includes all written or printed documentation regarding EZyCHECKTM and the use of EZyCHECKTM. Epic
Concepts has granted a license to VeriCORP Incorporated ( "Distributor "), including the right to sub - license
EZyCHECKTM to others, and this Agreement is such a sub - license. For the purpose of this Agreement, Epic Concepts
and Distributor shall be referred to collectively as "Licensor ".
2. Sub - License
(a) Licensor hereby grants to Client a non - transferable, non - exclusive license to use EZyCHECKTM subject to the
terms, conditions, and restrictions set forth in this Agreement. Nothing in this Agreement shall be construed to
convey any title or ownership rights in EZyCHECKTM to the Client. Client has no title or ownership rights in the use
of the name EZyCHECKTM'
(b) The License is for the use of EZyCHECKTM only by the Client at the Client's business address set forth in the
Service Agreement. The Client may copy EZyCHECKTM solely for backup purposes and only so long as all
copyright and other notices are reproduced and included on the copy. The Client may not distribute copies of
EZyCHECKTM or its documentation. The Client shall not sublease, assign, or transfer all or any part of the License
and any attempt to do so is void.
(c) The License continues in effect until terminated as set out in the Service Agreement. This License will also
terminate if the Client fails to comply with any term or condition of this License. In the event the License is
terminated, Client will destroy all originals and copies of EZyCHECKTM and its documentation, in all forms.
3. Warranties and Remedies
(a) In the event EZyCHECKTM fails to conform to the documentation provided by Distributor to Client, Licensor's sole
obligation shall be to correct such errors or malfunctions that exist in EZyCHECKTM, and Licensor shall have no
liability for any claims whatsoever which result from such errors or malfunctions. Further, Licensor shall have no
liability whatsoever for any claims which result from any alteration or modification to EZyCHECKTM by Client or as
a result of the use of EZyCHECKTM in combination with other computer programs or data not furnished by
Licensor.
(b) Client agrees that the amount of any liability of the Licensor under this Agreement, or otherwise, shall not exceed
the license fee paid by the Client for EZyCHECKTM. No action by Client against Licensor arising out of the
transactions under this Agreement may be brought by the Client more than one (1) year after the date of the
transaction which is the subject of that legal action.
(c) In no event will licensor be liable to Client for any consequential, incidental, direct or indirect damages, including,
without limitation, loss of data, loss of profits, lost savings or other incidental or consequential damages arising out
of the use or inability to use EZyCHECKTM, even if licensor or any of its representatives has been advised of the
possibility of such damages, or for any claim by any third party. Licensor shall not under any circumstances, be
liable for any loss of files, pertinent business information, or information as a result of data conversion. Any written
or oral representation or warranty not expressly set forth in this agreement shall not be enforceable by the Client.
(d) The parties agree that this is an Addendum to the primary Service Agreement that Client has signed with
Distributor and all provisions of the primary agreement shall apply.
(e) In the event that the Distributor is required to engage the services of legal counsel to enforce its rights under this
Addendum, the Distributor shall be entitled to reasonable attorneys' fees and cost from the Client. In the event of
litigation, such fees and cost shall include those for trial, appeal, and to any bankruptcy proceeding. Jurisdiction for
any legal action related to this Addendum will be in Jefferson County, Kentucky.
(f) The invalidity or nenforceability of any provision in this Addendum shall not in any way affect the validity or
enforceability of y other provision and this Addendum shall be construed in all respects as if such invalid or
unenforcea•le I . ision had nev: been in the Addendum.
(g) This Adden.0 r all be governef� by and interpreted under the laws of the Commonwealth of Kentucky.
By: By:
CLIENT Aut orized Represe tative VeriCORP Authorized Representative
Date: / 3. Date:
VeriCORP P.O. Box 436054 Louisville, KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502.254.4929 www.vericorphr.com
- 85/02/2013 19:00 N0.340 !#013
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ADDENDUM
�. r fl AUM B
`' E x "+ HECK Software are Users Agreement
• „ ' The undersigned Client and Distrtbutar hereby make the following agreement:
l ` ) t• I ` recitals; computer softv,rare known as FZyCNECK and of all
' x 1 * ' ., ' Concepts") is the ownet of the com
. , , ,. ._ `: cxot rights and other rights and interests in E7ICIIPCKT The term EZyCI - IECK T
' r+ ` { ' � � s ' documentation regarding C IECKTM and the us`e o! EZyCHECKT''". Epic
+3g s t gaging
,� �k�� f ��rnc� des ��� _ - ��
the right to Suh•1K�se
,' t•; 4 �, '` • Qar pis has ' a' license to VeriCQRP Incorporated ( "Distributor inducing g
EyGNECKT" to othei'S,tol Otis Agreement is such a sublicense. For the purpose of this Agreement, Epic Concepts
ee -.,6 , and Distributer shall beltforeed to collectively as "Licensor ".
Y•
i 1 e d '� ne 2. Sub- License ,,
e �� to Gent anon- transferable, non•excfusive license to use tEZyCHECK subject to the
3 y4 r x , ' (a) Licensor hergbY � aril shalt be construed tC
r rs Y terms, cofKons, a .tv trictions set forth in this Agreement. Nothing in this Agreement "' ' � t� or rights in EZyCI-IECK 1 to the Client. Client has no title or ownership fights in tho use
• tit �t :: # �' `� �? � � of the name,EZyC C .
` :1 convey � ���
_ ° Y •
s . ; The L} ' s f th use Of EZyCH "i only by the Client at the Client`s business address set forth In >thc
_ a ,�,f t . � ,� � °�� EzycHrcKTM and' only so tanq•�s all
:, ECK solely for backup pvrp0
+� =� � ;�• �., Service nom; �a Client may copy yCN
copyright and other notices aro reproduced and included an the copy. The Client may not distribute copies of
EZyCHECKtM or its documentation. The Lient shall not sublease, assign, or transfer an or any part of the License
and any attempt to do so is void.
(c) c The license continuos in offoet until terminated as set out in the Service ce Agree em he This i License
the R will also
Is
terminate if the Client faits to comply with any term or condition of this
: terminated, Client will destroy all originals nnci nopies of FlyCHFCK' and its documentation, in all forms.
Warranties and Remedies
. ,. i ,- � (a) In the even! FZ l•ECK tails to conform to the documentation provided by Distributor to Client, Licensor's sole
{) I YC
obligation shall be to correct such errors or malfunctions that exist in yUHE KTm, a nd Licensor shalt have a
', liability for arty claims whatsoovor which reedit !ruin such errors or malfunctions.
i liability whatsaevcr for any claims which result from any alteration or modification to EZyC-tECKT by Client or as
- -I _ a result of tho use of t.ZyCHECKT In combination with other computer pr rams or data not furnished by
t Licensor.
t - • (b) Client agrees .that.the amount of any liability of the Licensor under This Agreement, or otherwise,
shall not excel
i The C l ient fo F7,yCHECKTM. No action by Client against Licensor arising out of the
; the license Ise pa by. more 1
i r ,,
ee.s. , transactions under this Agreement may be brought by the Clie nt o re than one (1) year after the date of the
transaction which Is the subject of that legal action.
(e ) in no event will license be Iiable to Client for any consequential, incldentel, direct consequential r i nd ti damages arising ncdin
! wit limitation, loss of data, less of profits, last savings or other incidental or cq
r r of the use or inability to use EZyCHECK!^M, even it licensor or any of its representatives has been advise b
possibility of such damages, or for any claim by any third party. Licensor shall not under any
i liable for any loss of files, pertinent business information, or information as a result of data conversion. Any written
:.vi K or oral representation or warranty not expressly sot forth in this agreement shall not be onforooable by the Client.
The artier that this is an Addendum to the primary Service Agreement that Client has signed with
(d) Distributor and rovisions of the primary agreement shall apply.
a ) in the event that the Distributor is required to engage the services of legal counsel to enforce its i gn the under t is
Addendum, the Distributor shall be entitled to reasonable attorneys foes and cost from t of
litigation, such fees and cost shall include those for trial. appeal, and to any bankruptcy proceeding. Jurisdiction for
any legal action rotated to this Addendum will bo irnJefferson County, Kentucky. way affect the validity or
{f} The invalidity or nerriorceability of any provision du �e const tied In all a raspects as if such invalid or
enforceability o' - • other provision and this Adde
4 , unertforco •le • IP Ision had nevee been in the Addendum.
F This Adde , ati be govornc j- by and interpreted under the laws of the Commonwealth of Kentucky.
L. i 1 By: kill"
( 7`; CL1 E T ' ut rized Represe tative a /
• • ORP t orized Representative
w Da t e:. .. ._ D - •
: V RP P.O. BOX 436054 Louisvills, KY 40'261 Phone: 5x2.554.9999! 877.717.3515 Fox: 502.234.4929 www verio_0. r.com
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Verifv Affidavit
Pursuant to Indiana Code 22-5-13-11, the Contractor entering into a contract with the City is
required to enroll in and verify the work eligibility status of all its newly hired employees through
the E-Verify program. The Contractor is not required to verify the work eligibility status of all its
newly hired employees through the E-Verify program if the E-Verify program no longer exists.
The undersigned, on behalf of the Contractor, being first duly sworn, deposes and states that the
Contractor does not knowingly employ an unauthorized alien. l'hc undersigned further affirms that
prior to entering into its contract with the City, the undersigned Contractor will enroll in and agrees
to verify the work eligibility status of all its newly hired employees through the E-Verify program.
. i
(Contractor): V -0 1 "r't p —141 (.„.. ,.."
CiC '
By (Written Signature): Cl1' ,) . /''''' i
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(Printed Name): ( 731, i r ....., t
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(Title): ‘ i 1,2C- I t ti- iCik
Im riant - Nolo- , Si rnature and Seal Re aired in the S .ace Below
STATE OF 7 :1‘ , ,,.... t kcc,,,AC.„0 : ,
.
SS:
— , ....
COUNTY OF
,
Subscribed and sworn t before me this (,,,: day of
20
Vly commission expires: - '- s - L3 _ (Signed)
Residing in ,,cs.,C•i-,k.„S\j, ‘ „,\C: 1.
- 1,i y
Count, State of ::::s v ----) t, 0 CO
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eV'IOLS $%
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4.40.03,410004*
Reference Services VeriCorp
(1 4. „0
Driving Record - $12.50 Driving Record — IN $13.50
Driving Record — KY $11.00
Receiving 15% discount so $11.48 & $9.35 L:1 ;4?
respectively
Manual County - $15.00 Manual County - $13.60 (access fees </
if applicable)
Nation Wide Criminal - $24.50 Pro Scan Plus - $8.50
Includes SSN traces w /aliases, 50 State
Criminal & Sex Offender Registries,
National Criminal w /aliases & Terrorist
Watch List
Basic Charges - $52.45 Basic Charge — IN - $33.58 — KY - $31.45
(6:A\1
Difference between $18.87 and $21.00 per check between Reference Services and VeriCorp.
Please check permissibl- , - : , s) for which this data will be used:
mployment Screening
Tenant Screening Business Need
Please provide a copy of one (1) of these four (4) items:
1. Articles of Incorporation 2. Business License 3. Voided Company Check or 4. Bank Statement
LIST THREE TRADE REFERENCES BELOW:
Name:
Phone: T 1"), - a$a - - 31 - 0(...
- 0A.st, CS ktp i VIA-Q. C5Lr p Fax:
Address:
Contact /Acct #:
q03 5 ri►n S-f
State, ZIP:
City: 1 1 41 .- 10
Name:
Phone: $la, - a--Tf -el ( 4 "1
P
.20o cc,.� 2 �-- � -e x Q u 1 m c. v1 L LC Fax:
k ■ Contact /Acct #:
Ad ress.
q *-5s rAtio 3 k State, ZIP:
City: I N3 (-41- l3 O
J t�- -�"5c� �n. v 4 i t..-e.
Name: Phone: $ I a- D-9 - LQ-V Lt t
UZO 't Sonr - Solk.l. 0►"S Fax:
Address: Contact /Acct #:
P 6 o x 1 Li 6
State, ZIP:
City: l N 4 ()
it
Client certifies to abide by the rules and regulations of the Fair Credit n Reporting Act as ad amended bint the Consumer Credit
Repo Act of 1996 and the Intelligence Reauthorization Act. Client
evaluation of individuals for employment, promotion, reassignment, retention as an employee, or other permissible purpose. The Fair
Credit Reporting Act (FCRA) governs the activities of consumer reporting
a
agencies, iformation procured other persona!
from these agencies. A consumer report contains information on a pp liant /employee
data; therefore, use of such information is strictly regulated by the FCRA. Among other that things,
a th FCRA prohibits aitsire employers fr
obtain consumer reports unless the employer discloses to the applicant, in writing, th such
loyers to
the written authorization of the applicant /employee to inquire into b whole or part on the background information. These are
take additional st: � ►s when they make an employment decision based i
intended to give applicant the opportunity to dispute any information contained in the background or consumer report. Please note,
particularly, the - missible Pur oses of Reports, as well as requirements on Users of Consumer Reports and Obtaining Information
Under Fals Pre - ses. For a ful copy of the FCRA, visit www. ftc.gov.
.
Company Office / Representative - Printed Name & Title
kl 1
11100 ge — Pati a g_. V/36// 3
ompany Officer / Represe tative - S Dat
VeriCORP P.O. Box 436054 Louisville, KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502.254.4929 www.vericorphr.com
2
•,,445/02/2013 18:57 N0.340 # 008
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I , ;14, t' 'I.'', ADDENDUM A 1
14 :` T is ii4'� - - +h :
a , 1 _ � -° - OY ENS EENINC SERVICES
'At pay ' i : * t = Descriptioh - of Searches .
.,
y t. ' , ° i
1
i 'art ro
,•:;,::;,'
�' . x ' ' x employee a or screening a volunteer, an Important step
�: `� �cNaal S� cur lt`t S2►rotZ When hiring an p Ye (SSW) Sic. Th seah
,.ir _ ` . -begin vonf ua tity by conducting a Social Security Number 1�;. � ien on the SSN
s ., " �, ,
f.v ' r , ° k r , • R s : infdrMeticirrt i , pike", s name, past addresses and movement patterns based ; r' +ed to us •motion from the Social Security Administration is not used in this report). n
' ' , f 0 1 0 :' 5, .: it a to retur�ngF , 4). on a SSN, this search provides a report with the following: Full name and/
li
i . r k : i ts 7 _ y
ate na m a . l ap icant, dates at listed addresses, age/dale of birth, ' and available phone
..*- f ' : u 1 e~S ` ^ 1 "�}I
4
�4M t > . lion Ti l 9; tgati�re starting point that provides a more complete background search n
k 4, - i . d with a• •r - b services. Turnaround Ti Instant
SSN Match Directru
Processes the Form SSA-89 to retrieve 100% accurate results on Social Security Numbers. SSN Match
Direct'"' is the only way to receive data directly from the SSA. Features include:
• Provides "Match", No Match ", or "Deceased" result
• Requires consent Form SSA -89
• US Patriot Act compliant
• Fulfills FACTA Rod Flag Rule requirement
Turnaround time: 24 hours
County criminal Search Based on the candidate's address history, the County Criminal Search is considered
, ,�.4, ,tae -most accurate and comprehensive criminal background search. VeriCUHF' utilizes U t�m fresearchers We
ii6o.. access criminal records directly from the courthouses in the county (ies) you requesting.
utilize public access terminals or "hand pulled " criminal searches to directly examine county criminal felony
. S and /or misdemeanor court records, rather than using an aggregated criminal database. Multiple counties may
T �'i:
; be selected per applicant and the counties may be found by county name, city, zip code or use our convenient
Auto Search button. it is recommended searching the county of residence and/or prior counties of residence,
''.. employment or education. Turnaround Time: Average 1 -3 days
om,
N, . l -- a C SoarChi
fv i
s . 1- • : itory Ad iir�istrativeOffiee of the Cour (AOC) Report Accesses the s criminal repository,
statewide crim
�r } '` '''` - "? tellable, in a given' tate6 St rtevvido Criminal Searches provide access to public criminal records from the
�r A .: , , -
F_;. •livable state. Beard, rests may include felony, misdemeanor, and/or traffic -case information. The type of
' nnct number of years of- information wits vary state to state. it is important to know that not every county
t It .E • � F l, leaving voids_ This report should not be the sole source of criminal information.
r report to the state'le
t Tum810und Time: Repository: Varies by state, average 1-3 days
Civil Records Search These relate to non- criminal lawsuits by or against a person or company. County Civil
courts aro searching Upper courts and are based on the dollar amount of the action. The dollar amounts will
vary by state and/or county. Civil search of court records for, but not limited to; Wrongful terminations, litlgated
workers' compensation suits, personal Injury suits, product - liability suits, sexual harassment, fraud,
embezzlement, judgments tor nonpayment of goods, and litigation related to divorce, marriage, and child
custody and other civil actions. Federal Civil actions relate to Federal statutes and would include EEOC, EPA,
Treasury or SEC fraud, Civil Rights, etc. Turnaround Time: 1 -3 days
VeriCORP P.O. 8ox 436054 Louisville, KY 40253 Phan; 502.55 ! 677.717.3515 Fax: 502.254.4929 ycw,yvpr rphr.com
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. ®5/02/2013 18:57 N0.340 #009
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. , '' federal Criminal a i Reports the records of crimes committed against Federal criminal laws. This
i: ' =',information is not ided on a county or statewide record, (i.e. bank robbery, interstate theft, kidnapping,
; c.). This report is,10ielaily relevant for screening managvmont and executive candidates for white - collar
. :1::.; limes Tumarourl Tito' 1 days
E , r c i 14r, { , includes an ictsrdet:nw�lti
state �,
: ` , T , i . f � `" '� ' r Database a Search An oxtensive roport that
j ,y '{�' r . � � �, �1�!{� i./V w�f*.►.7rL' ; . r . ..... . w : � �p F �14c:ri� i . -
f . . s . r 1.1
* tip or cr rni ' t � r We aver 400 databases and 200 million dos contakting criminal
4 ,_ . -: � rd frornt: ' " ': t`
i. • State repositorfesand and (in some states)
• Department of, Corrections (Doc) files (where available) ;
' ii m a?G,k d
* t ,- t ■
• County cows i
' + stneS
r • S offeFR��t �
' _i F Administrative Office Of Court records •
Traffic violations and infractions involving warrants
t
� } �, = "` -' - its for om Ia meat permissible purposes, this search is only used as a Iocator
; reports � possible p Y
! .,,' ., ,1i a the FORA, when u ss�ble rocards and not the actual case infarrnatbt (must be verified).This
report should not be the sole source of criminal information. Turnaround Time: Instant
FroScan Pius
Combines multiple, powerful reports into one unique search. An extensive report that includes an instant multi-
state search of criminal records. This search accesses over 400 databases and 200 million files containing
=Y:crirninal records from participating:
v.
.•,: ; .State Repositories afd;Alchives
• . Administrative Office of the Court Records
, Department of Corrections (DOC) Files
• County Court Houses
Sex- Offender Registries
4 , Traffic violations and infractions involving warrants
- . <<. >^k :, �j 'rbScen Plus uncovers nacries, 'addresses and dates of birth as wolf as Known aliases including maiden
+, Thames as revealed by our. SSN Search. All discovered name variations are then automatically searched
through our high speed, mufti - jurisdictional data repository, including sex offender screening & terrorist list. Per
u
' the FORA, when using reports for employment permissible purposes, this search is only used as a locator
. search to provide locations of possible records and not the actual case information (must be verif ied).This
report should not be the sole source of criminal Information.
. Turnaround Time: Instant ''
service helps you meet federal Office of Foreign Assets Control (OFAC)
: �Sentinei Security Report This .
` identifying individuals linked to terrorism or classified
1 =ident tfication requirements and he i mpe d e terro rists by identify' g
on government watch lists, improving compliance with the Patriot Act. An extensive report that includes
information from the following data sources: Office of Foreign Assets Control (OFAC) of the U.S Department
of the Treasury Specially Designated Nationals (SDN) and Blocked Persons, OFAC Sanctioned Countries
- including Major Cities and Ports, Non- Cooperative Countries and Territories, Department of State Trade
,,Control (DTC) Debarred Parties, U.S. Bureau of industry & Security (formerly BXA), Unverttfied Entities List,
Denied Entities List, Denied Persons List, FBI Most Wanted Terrorists and Seeking Information, FBI Top Ten
flVlast Wanted, INTERPOL Most Wanted List, E3ank of England Sanctions list, Office of the Superintendent of
. .,Einata,7ai institutions Canada (OSFi) .. Canadian Sanctions List, United Nations Consolidated Sanctions List,
Politically Exposed Persons List, European Union Terrorism List, and World Bank Inetigiblo Firms. Turnaround
i. 'rime: Instant '
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VeriCORP P.O. lox 434054 t.ouisvine, KY 40253 Phone: 502.554 9999 / 377.717.3515 Fax: 502.254.4929 ; www.vericorohr.cnm '
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QIG -GSA National level Search of the Department of tho Health and Human Services e Office of Inspector
; General's (0K3) database for, any individual or entity that has committed any type frau d
"' • icaid or any other , FadOr' y- fund Also inCltddes General ed healthcare program. Af i _
Servis�es Administration,
'+" eL .) ' „ �. ` i e
lis that`jshave been suspended, d ,
le2tb s r f
F � � $ e t9 s by :,� Y ; c n e t�e�rrirliriations `or otherwise excluded from Fo : • o • a r9m t '1 ;
, ;,ri i �'; ides search of disciplinary actions taken y F �v
F� _-� rlcteS WA* '
... tr
rernent take n by over 7g and certification agencies In all 50 states. Check histories at individuals fit�d
entities for adverse iocts and for sanctions and exclusions from t Fe healthcare D programs.
and OFAC, also
. r :.A Food and Dnig sAdmipistfa ion (FDA), Drug Enforcement Agency
tiled to as the Terr `Sane bn Watch Lis!. Meets the Federal Governments' requirements as outlined in
f
^ i i q v, K Ftl� e �r �' y 9 . ,; Th maround Time: i day ,
tv l9i i►� �d
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i r 1340i tonal ;S ®x Otediee- The national sox offender registry seared is critical for professionals and
. , , a..af :,
vblimteers who' Wta. interact with youth or work in childcare, education, healthcare and human services
y s
� , • �,y �� = y � ;r��ri�n�entS . - 7he s�� includes sox offender registration records from all 50 states plus the Distract of
x:typos of crimes that require registration vary by state.
, f�o`ium�la, Guam & Rico. Please note that Puarto the typ
Therefore, not all individuals convicted of a sex crime in one state may be included in another state's registry.
Turnaround Time: Average 1-2 days
Prior Employer Verification Direct verification of claimed previous employment. Verily dates nt of se me ,,a
title, job duties, performance, attendance, reason for leaving, rehire status and general
Time: 1-3 days
Education Verification Direct verification of applicant's educational records Including hates School tnded and
degree, certificate or diploma received at the provided education al Q or GED
'1'' Turnaround Time: 1 -3 weeks Secondary Turnaround Time: 1 -3 days
Reference Check and Verification Relevant inquiries of personal or professional roforonces, provided by the
applicant, to obtain an assessment of your candidate. Turnaround Time: 1 days
•
{ rofess License/Certification Verification Professional licensing searches research information on
t . i ` Ividuals who need state ieonoes or certiflcations: to engage in a professional activity; including medicaid: osslonals, ai lol�►oys;•CPA� end educators. (Licensed pro fcs
u sions may vary by stair•) Reports may Inckkd
• license
ion as the name and address of the licensee; the licensing agency, type, number, and
uch information
t * _,:amass; iiccnse ciasslflcation (business or personal); status of license; lsSLlt' and expiration dates; restrictions
, . any adverse or disciplinary action. Turnaround Time: 1 day
u ,
f1
,. Tit : - rs t:orrratlon Clap ! of Workers' Compensation claims. Each slate limits the data they
r
'f„ k •rt. This report ban only be cionerated after a "conditional job offer" has been made. Turnaround Time:
' ' a fVVa ies by state, i day to 4 weeks
provided by the specified state
Motor Vehicle Report (MVR) Driving rerd,hecd� a reported and and citations,
ofyoars included will vary slightly
An which the applicant holds a valid license.
fay state. Companies should order driving history reports for all employees who drive company or personal
vehicles for business, Turnaround Time: Varies state to state; majority are Instant
Employment Credit Reports The employment credit report search illustrates patterns in your candidates'
financial behavior. Employment credit report information is gathered from
ce ads credit
bureau, providing
• Information regarding trade accounts, payment history, collection public
VeriCORP P.O. Box 135054 Loulsvllie, KY 40253 Phone: 502.554.9999 / 877.717.3515 Fax: 502254.4929 ? ww•verCorphr.COm
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i .L, � ...' ADDITIONAL SERVICES i
r the leading roviders of o uc�[t~ testing. �s �� r �3 ,; �9 ' , e ... �ttng liettCORP partners are t g I�j �� � C hrorna�og P Y
, .j 4 ; 7} , F , 'A'<, 1w � w s <, .a, gat� elts may be confirmed using A:
t � l F z � '` scs. ;"7;.:'' � � :� � e � C)fftccr RO).
-< , ,s ' ,' < 8 � an accredited Medical Revlo (
� �y` ,� .� � � � � ..y and reviewed by wide
i of tests are •' • ; - g 1ii?ltti h Your requirements. Turnaround 7Imc: 5 Panel Tort within 15 minutes, _ � � � � , F +�a 9 "k�` �r t't ~ �aricty a { � ",
. electronic results. Lab based test; 24 -48 hours.
- ' A ��
Cdfa Screen g compliant background screening service that enables employers to navigate
,�a�Social AR
. lie. -` } of sociai media with clear, consistent, and Insightftr! results. Using a
.,, motion of f ,automr�e� 2 ' t d 2n d manual review processes, these reports ignore Information that is not legally
. ; , a � � ,° ;�� � t� in #tae'
.. Y �, # � . «,. bination o
x1 . ;� „�iI..; ,, #t€rjr a� , such as the "protected class" characteristics defined by federal ant[-
,
t � i'a ;`
. ,, � fi _dfscrirnfnatbn taw (race, iiifigiore national origin, age, sex, familial status, sexual orientation, disability status,
3 ;, x eid other qualities that are not allowed to be used as decision points). Therefore, lob candidates are protected
�,` �, from discrimination based on these characteristics and, in turn, employers are protected from allegations of
online on the
discrimination. The Fxoc uttve report Is a detaired report that contains all Information that
ad f o u n the already
candidate. This report accounts for non -user generated content such as media
included pre - defined employer criteria. With the report employers receive a 360- degree view of their
candidate's online profile. Turnaround Time: 1-3 days
E-Verify and Form 1-9 Management incomplete records and lack of compliance ca n cost b the ment
fi hefty
i � #rocs and penalties. Automated processing reduces your risk. E- Verify g documents are for the correct person.
�t . -t !to verify the Social Security Number, Employee Address and supporting
. :-
� ` ' , ; The system is designed to notify employers if there is some discrepancy Act issue
require employers to the
'employer to hire an illegal immigrant eligibility of anyone to be The ImmigratleTReform per mull verity the identity and employment
` , hire only persons who c hirlegally whch Includes completing the Farm 1-9.
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, ,4 Services . VeriCOFif' has partnered with 3M Cogent, a wor he eGAPS service provides ic
i : . lingor p rint servic s and technology, and proudly introduces the eGAPS service.
q uicker, easier way to complete selected State, Federal and Corporate fingerprint based background checks.
` FBI Channeling Service In response to the growth of federal and state legislation requiring manil cry
criminal history searches for select positions, 3M Cogent has been se by the Channeling Agency. 3M Cogent is authorized to provide criminal history eaes (i.e. The dint _ ring of
background checks) for non - criminal applicants using the applicants own fingerprint
:: ti pp
licant fingerprints Is achieved through the use of FBi- certified 3M Cogent LiveScart device. Each captured
a licant fingerprint record is transmitted to the FBi as a digitized electnic record, in milli applicant fingerwith the
t
! octronic Fingerprint Transmission Specification (EFTS). Once received by the FBI,
images are compared against tho FBI's known criminal fingerprint database to determine if any criminal history
exists.
Human Resource Solutions We provide support to start -ups and small com thu tneed hemid-size p covering
ring to
large companies who have internal H
basic Human resource and employee staffs fs but n eed Gcasronal provide
ssistance with short or long -terra projects.
; :The Please tell us— Employee HOTLINE Having a confidential reporting hotline
s to becomin a ne ncessity
Yee
any organization. Employee relations and regulatory issues require companies
"' ;reporting methods.
RP P.O. Box 436054 Louisville, KY 40253 Phone: 502.554.9959 t 3!/.11'1.3515 Fa . 602.254.4929 www.vericorphr,com
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