This application provides information which enables us to determine whether an applicant has the qualifications and experience to be given additional consideration for employment. In most cases, circumstances will prevent a preliminary interview; therefore, the conscientious completion of this form is necessary inasmuch as it will supply much of the information normally covered in such a session. At the appropriate time you will be required to prove your citizenship or, if not a citizen, your eligibility for employment.

All statements made by applicants for employment on this application form will be carefully checked for accuracy. City Beverages offers equal employment opportunities to all persons without regard to race, color, religion, age, sex, marital status, national origin, disability or veteran status. The use of this application does not indicate the availability of positions, nor obligate City Beverages in any way.The application shall remain in an active file for a period of six months from the date of this application.

I certify and affirm that all the information furnished on this application is true, complete and correct. I understand and agree that any falsification, misrepresentation, misleading statement, or omission of fact on either this application or, during the pre-employment process shall be sufficient cause for: (1) my not being offered employment, or; (2) my dismissal at any time if I am employed. I authorize City Beverages to verify all information on this application including, but not limited to: employment history, educational background, credit records and motor vehicle records, and to acquire any and all criminal history record information pertaining to me which may be in the files of any Federal, State, or Local criminal justice agency in Florida or any other States.

I understand and agree that because of the nature of the business conducted by City Beverages, all information whether written, spoken, or otherwise communicated to me or obtained by me; and any information in any and all files and records of any and every description, relating to the business of City Beverages or to any person, persons, company or corporation with whom City Beverages has dealings, shall constitute privileged matters and shall be treated by me in a strictly confidential manner.I fully understand and agree that, if employed by City Beverages, I am not authorized to, and shall not at any time, communicate and/or reveal any business information, records, or files or any other matters relating to the business of City Beverages to any person or persons within City Beverages or to any person, persons, company or corporation outside City Beverages.I also understand and agree that any violation of this confidentiality shall constitute grounds for my termination.

I understand and agree that if employed by City Beverages, I shall comply with all rules and regulations as set forth in City Beverages' policy manual and any other communication distributed to employees by City Beverages.

I understand and agree that employment by City Beverages may be conditioned upon an acceptable fitness-for-duty medical and health evaluation which may include a physical examination paid for by City Beverages and conducted by a physician and/or medical organization selected by City Beverages.

I understand and agree that employment by City Beverages is conditioned upon an acceptable drug and/or alcohol screening test result. Such screening shall be conducted by a physician and or/or medical organization selected by City Beverages. I further agree to submit, at any reasonable time during my employment, and without prior notice, to a drug and/or alcohol screening test. I understand and agree that refusal on my part to take a requested drug and/or alcohol screening test may result in my immediate discharge.I further understand and agree that a positive drug and/or alcohol screening test result, may also result in my immediate discharge.

I authorize City Beverages to supply my employment record, in whole, or in part, to any prospective employer, governmental agency, and/or other party with a legal interest, and I release and hold harmless any and all such parties from any and all liability for direct or consequential damages resulting from such release and/or disclosure.

I understand that nothing in this employment application, City Beverages statements or personnel guidelines, or in my communication with any City Beverages official is intended to create an employment contract between City Beverages and me. I also understand that City Beverages has the right to modify its policies without giving me any notice of the change(s). No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon City Beverages unless it is made in writing and signed by a City Beverages officer. I understand that if an employment relationship is established, I have a right to terminate my employment at any time. I also understand that City Beverages retains the right to terminate my employment at any time.

I have read and, understand the foregoing, and by my signature below, accept the foregoing terms and conditions for employment, if offered such a position. I attest also by my signature below that all the information that I have provided on this application is true and complete.