PERMISSION FOR BACKGROUND CHECK FOR MEDICAL CLEANING SYSTEMS/ PINNACLE BUILDING SERVICES PROSPECTIVE EMPLOYEE

In connection with my application for employment with  Medical Cleaning Systems/Pinnacle Building Services I hereby agree as follows:

1. GENERAL CONSENT TO BACKGROUND INVESTIGATION

As a condition of the Company’s consideration of my employment application, I give permission to Medical Cleaning Systems/ Pinnacle Building Services to investigate my person and employment history.  I understand that this background investigation will include, but not limited to verification of all information on my employment application.

2. CONSENT TO CONTACT PAST EMPLOYERS

I specifically give permission to Medical Cleaning Systems/Pinnacle Building Services to contact all of my prior employers for references.  I further give permission to all current or previous employers and/or managers or supervisors to discuss my relevant personal and employment history with Medical Cleaning Systems/ Pinnacle Building Services, consent to the release of such information orally or in writing, and hereby release them from all liability and agree not to sue them for defamation or other claims based upon any statements they make to any representative of  Medical Cleaning Systems/Pinnacle Building Services.  I further waive all rights I may have under law to receive a copy of any written statement provided by any of my former employers to Medical Cleaning Systems/ Pinnacle Building Services.  I further agree to indemnify all past employers for any liability they may incur because of their reliance upon this Agreement.

3. CONSENT TO CONTACT GOVERNMENT AGENCIES

I further give permission to Medical Cleaning Systems/ Pinnacle Building Services to receive a copy of any information obtained in the file of any federal, state, or local court, or governmental agency concerning or relating to me.  I further consent to the release of such information and waive any right under law concerning notification of the request for a release of such information.  In the event a law does not provide for prospective employers to understand that the scope of this investigation will be limited as required by applicable law.

4. COOPERATION WITH INVESTIGATION

I agree to fully cooperate in Medical Cleaning Systems/ Pinnacle Building Services background investigation, and to sign any waivers or releases that may be necessary or desirable to obtain access to relevant information.  In the event that any former employer or federal, state, or local government agency will not release reference information or criminal history information directly to the employer, I agree to personally request such information to the extent permitted by law.

5. MISCELLANEOUS

This Agreement represents the entire understanding and agreement relating to its subject matter.  Medical Cleaning Systems/Pinnacle Building Services shall be entitled fully to rely on this Agreement.  I understand that I have no guarantee of employment and that Medical Cleaning Systems/ Pinnacle Building Services may determine not to hire me for any lawful reasons.

6. DATE OF BIRTH

Date of Birth is optional information.  Medical Cleaning Systems/Pinnacle Building Services is requesting date of birth for identification purposes ONLY.  There is no implied discriminatory motive in using age or date of birth as and identifying characteristic.  Medical Cleaning Systems/Pinnacle Building Services recognizes and abides by the Age Discrimination In Employment Act (ADEA) as well as state and local Equal Employment Opportunity Commission (EEOC) laws.

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Applicants Signature                       Date of Birth                         Date