Online Application Form 2023

Date
MM slash DD slash YYYY
Hidden
OSHA Certificate
- Yes
- No
Hidden
JLA Badge
- Yes
- No
Hidden
TWIC Card
- Yes
- No
Hidden
Location - ignore
Please choose the office location where you would like your application to received.
Employment Location*
- Clearwater
- Orlando
- Tampa
Please choose the office location where you would like your application to received.
Personal Information
Be sure to enter your FULL LEGAL name. This entry will be used for IRS forms that require your FULL LEGAL name.
Name*
First Last Middle Initial
Address*
Street Address City State ZIP Code
Cell Phone*
Home Phone
Email
Trade
Hidden
Driving License?
- Yes
- No
Hidden
Driver's License #
Hidden
Driver's License Expiration Date
MM slash DD slash YYYY
Hidden
Vehicle Make
Hidden
Vehicle Model
Hidden
Vehicle Color
Hidden
Vehicle Year

Please complete a required 2 of 3 previous employment starting with the most recent.
Previous Employment #1
From*
MM slash DD slash YYYY
To*
MM slash DD slash YYYY
Name of Employer*
Employer Phone No.*
Position*
Pay per Hour*
Reason for leaving*
Add another employment?
- Yes
- No
Previous Employment #2
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Name of Employer
Employer Phone No.
Position
Pay per Hour
Reason for leaving
Add another employment?
- Yes
- No
Previous Employment #3
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Name of Employer
Employer Phone No.
Position
Pay per Hour
Hidden
Reason for leaving

Trade Schools
Trade School #1
Name of School
Study
Year Graduated
Trade School #2
Name of School
Study
Year Graduated

DISCLOSURE REGARDING BACKGROUND INVESTIGATION DISCLOSURE AND ACKNOWLEDGMENT [IMPORTANT — PLEASE READ CAREFULLY BEFORE SIGNING ACKNOWLEDGMENT]

Construction Contractor Services Inc. (CCS) May obtain information about you from a consumer reporting agency for employment purposes. Thus, you may be the subject of a "Consumer report" and/or an "investigative consumer report” which may include information about your character, genera, reputation, personal characteristics, and/or mode of living, and which can involve personal interviews with sources such as your neighbors, friends, or associates. These reports may include employment history and reference checks, criminal and civil litigation history information, motor vehicle records driving records, sex offender status, credit reports, education verification, professional licensure, drug testing, Social Security Verification, and information concerning workers compensation clams (only rate of conditional over of employment has been made). Credit history will only be requested where as such information is substantially related to the duties and responsibilities of the position for which you are applying. You have the right, upon written request made within a reasonable time after receipt of this notice, to request whether a consumer report has been run about you, and the nature and scope of any investigative consumer report, and request a copy of your report. Please be advised that the nature and scope of the most common form of investigative consumer report obtained with record to applicants for employment is an investigation into your education and/or employment history conducted by Construction Contractor Services Inc., and or an outside organization. The scope of this notice and authorization, all‐encompassing, however, allowing Construction Contractor Services Inc. to obtain from any outside organization, all manner of consumer reports and investigative consumer reports now and, if you are hired. Throughout the course of your employment to the extent permitted by law. As a result, you should carefully consider whether to exercise your right to request disclosure of the nature and scope of any investigative consumer report.
ACKNOWLEDGMENT AND AUTHORIZATION

I acknowledge receipt of the NOTICE REGARDING BACKGROUND INVESTIGATION and A Summary OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and certify that I have read and understand both of those document and hereby authorize the obtaining of “consumer reports” and/or "investigative consumer reports" at any time after receipt of this authorization and, if I am hired, throughout my employment. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private) information service bureau, employer, or insurance company to furnish any and all background information requested by CCS. And/ or, another, outside organization acting on behalf of, Construction Contractor Services, Inc. t agree that a facsimile {"tax'), electronic or Photocopy of this Authorization shall‐ be as valid as the original.

California applicants or employees only: By signing below, you also acknowledge receipt of the DISCLOSURE REGARDING BACKGROUND Investigation PURSUANT TO CALIFORNIA LAW. Please check this box if you would like to receive a copy of an investigative consumer report or consumer credit report if one is obtained by the Company whenever you have a right to receive such a copy under California law

Minnesota and Oklahoma applicants or employees only: Check this box if you would like to receive a free copy of a Consumer report if one is obtained by the Company. New York and Maine applicants or employees only: You have the right to inspect and receive a copy of any investigative consumer report requested by the Company by contacting the consumer reporting agency identified above directly. You may also contact the Company to request the name, address and telephone number of the nearest unit of the consumer reporting agency designated to handle inquiries, which the Company shall provide within 5 days, By signing below, you also acknowledge receipt of Article 23‐A of the New York Correction law.

Washington State applicants or employees only: You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act.
Social Security Number*
To verify, please enter the last 4 digits of the Social Security Number*
XXX-XX-
Full Name*
Signature*
If you are on a mobile device, turn your device to display a larger signature area.

IRS Form I-9 | Employment Eligibility Verification
Please read the IRS Form I-9 Employment Eligibility Verification instructions carefully before completing this form. Click here to download the IRS Form I-9 instructions.

ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) they will accept from an employee. The refusal to hire an individual because the documents have a future expiration date may also constitute illegal discrimination.
Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment , but not before accepting a job offer.)
Name*
First Last Middle Initial
Other Names Used (if any)
Address
Street Address Apt # City State ZIP Code
Date of Birth*
MM slash DD slash YYYY
U.S. Social Security Number*
Email Address
Telephone Number*
I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.
I attest, under penalty of perjury, that I am (check one of the following):*
- A citizen of the United States
- A noncitizen national of the United States (See instructions)
- A lawful permanent resident
- An alien authorized to work until
Alien Registration Number/USCIS Number*
Expiration date, if applicable
MM slash DD slash YYYY

Some aliens may write "N/A" in this field. If so, leave this field blank. (See instructions)
Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number:*
- I will provide Alien Registration Number/USCIS Number
- I will provide Form I-94 Admission Number
- I will provide a Foreign Passport Number
Alien Registration Number/USCIS Number*
Form I-94 Admission Number*
Did you obtain your admission number from CBP in connection with your arrival in the United States
- Yes
- No
Please enter your Foreign Passport Number
Country of Issuance

Some aliens may write "N/A" on the Foreign Passport Number and Country of Issuance fields. (See instructions)
Signature of Employee*
If you are on a mobile device, turn your device to display a larger signature area.
Date*
MM slash DD slash YYYY
Preparer and/or Translator Certification
To be completed and signed if Section 1 is prepared by a person other than the employee.
I attest, under penalty of perjury, that I have assisted in the completion of this form and that to the best of my knowledge the information is true and correct.
Signature of preparer or translator
If you are on a mobile device, turn your device to display a larger signature area.
Date
MM slash DD slash YYYY
Name
First Middle Last
Address
Street Address City State ZIP Code

Co-Employment Notice and Acknowledgement
Employer Company
Please select the company applying to:
Date of Birth*
MM slash DD slash YYYY
Name*
First Middle Last
Social Security Number*
Address*
Street Address Apt. City State ZIP Code
Home Phone
Cell Phone
Email
For check stub delivery
Employee Signature*
If you are on a mobile device, turn your device to display a larger signature area.
Date
MM slash DD slash YYYY
Emergency Contact
Name*
Relationship*
Phone Number*
Evening Phone Number
Address*
Street Address Address Line 2 City State ZIP Code

IRS Form W-4 | Employee's Withholding Allowance Certificate
Please read the IRS Form W-4 Employee's Withholding Allowance Certificate instructions carefully before completing this form. Click here to download the IRS Form W-4 instructions.

Whether you are entitled to claim a certain number of allowances or exemption from withholding is subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS. TIP: Use the downloaded document to get the information for this form.
Name*
First Name and Middle Initial Last Name
Your Social Security Number*
Address*
Home Address (number and street or rural route) City or Town, State and ZIP code
Marital Status*
- Single or Married filing separately
- Married filing jointly (or Qualifying widow(er))
- Head of household (Check only if you’re unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)
Multiple Jobs or Spouse Works
- Yes
(c) If there are only two jobs total, you may check this box. Do the same on Form W-4 for the other job. This option is accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld:
Will your income be $200,000 or less ($400,000 or less if married filing jointly)?
- No
- Yes
Number of children under age 17*
Number of other dependents age 17 or over?*
Hidden
Number of children calculation*
Hidden
Number of other dependents calculation*
Hidden
(3) Add the amounts above and enter the total here
Total calculated dependents.
Other income (not from jobs)
If you want tax withheld for other income you expect this year that won’t have withholding, enter the amount of other income here. This may include interest, dividends, and retirement income:
Deductions
If you expect to claim deductions other than the standard deduction and want to reduce your withholding, use the Deductions Worksheet on page 3 and enter the result here
Extra withholding
Enter any additional tax you want withheld each pay period
Under penalties of perjury, I declare that I have examined this certificate and, to the best of my knowledge and belief, it is true, correct, and complete.
Employee's Signature*
*This form is not valid unless you sign it. If you are on a mobile device, turn your device to display a larger signature area.
Date*
MM slash DD slash YYYY
*If you do not see the "NEXT" button, there is a field that you did not fill in or check a box. Please review the page.

Project Safety Requirements
The personal safety and health of all workers is of primary importance to our organization. The prevention of occupationally induced injuries and illnesses is of such consequence that it will be given precedence over operating productivity whenever necessary. The following safety rules shall apply.
1. Report any unsafe condition to the project superintendent or your foreman immediately.
2. Obey all Safety and warning signs.
3. Proper attire shall be worn, including long pants (no shorts or sweat pants), and a shirt with a minimum of four inch sleeve.
4. Hard hats and safety glasses are required 100% of the time while on any and all construction jobsites.
5. A full face shield shall be worn by any employee whose task requires him to cut, grind, saw, burn or weld.
6. Fall protection systems shall be worn in accordance to OSHA Standard 1926.501(2)(3) or a pre-approved safety plan specific to the scope of work.
7. All other forms of PPE including, but not limited to safety glasses, goggles, side shields, hard hats, hearing protection, dust masks, gloves, full body harnesses, life lines, lanyards, etc. necessary to perform the work safely must be maintained in good condition.
8. Hand Tools and small power tools must be kept in good repair and used only for the intended use. Tools that have frayed or damaged cords should be removed from service.
9. Good general housekeeping shall be maintained at all times. Work areas shall be kept free of debris, especially in aisles, walkways, in the vicinity of ladders, ramps, stairs, machinery and tools. Lay down areas shall be kept clean and neatly stockpiled for ease of access.
10. Empty containers, papers or debris of any kind should not be allowed to accumulate in areas used by personnel on the jobsite.
11. All injuries no matter the extent, are to be reported immediately to your supervisor.
12. Intoxicating beverages, drugs, and firearms are not to be brought onto the jobsite.
13. Anyone found intoxicated on any jobsite will be escorted off the property and reported.
14. All personnel are required to comply with OSHA rules and regulations at all times.
_______________________________
Name
First Last
Date
MM slash DD slash YYYY

CCS Online Application (2023)

Step 1 of 12 - Personal Information

Personal Information

Skills

Carpentry

Mechanical

Masonry

Previous Employment #1

Previous Employment #2

Previous Employment #3

Trade Schools

Trade School #1

Trade School #2

Employee Data Sheet

IRS Form I-9 | Employment Eligibility Verification

Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment , but not before accepting a job offer.)

I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.

Preparer and/or Translator Certification

Co-Employment Notice and Acknowledgement

Emergency Contact

Trion Solutions Inc. Electronic Pay Authorization Form

1. Employee Information

2. Direct Deposit

IRS Form W-4 | Employee's Withholding Allowance Certificate

Work Opportunity Tax Credit Program (WOTC)

Project Safety Requirements