NEW HIRE PAPERWORK - Intertekcdn.intertek.com/mail/images/hr/_files/newHirePaperwork.pdf · NEW HIRE PAPERWORK Instructions: Please ... save it; and email it to [email protected]

NEW HIREPAPERWORK

Instructions: Please complete this packet and return it to the Intertek Human Resources Shared Services Center.

You may either:

• Complete the form digitally (instructions on the next page); save it; and email

it to [email protected].

• Print the packet; complete it; scan it; and email it to [email protected].

If you experience any problems, please call 1-877-694-8543, option 5.

If you are working in the US and currently here on an employment authorization card (EAC) or Visa, and you are not subject to US taxation, please provide a copy (front and back) of either your EAC or Visa. Without supporting documentation, your payroll taxes will be adversely impacted.

Legal Name:

Physical Work Location:

Position Hired For:

Hiring Manager:

Start Date:

New Hire Paperwork

New Hire Paperwork

Employee Agreements & Paperwork

ADP Direct Deposit Authorization ................................................................................ 3Payroll Deduction Authorization .................................................................................. 4Direct Deposit Authorization (Expense Reimbursement) ............................................ 5Emergency Contact Information ................................................................................... 6Employee Handbook Receipt ........................................................................................ 7Code of Ethics Agreement ............................................................................................. 8Anti-Harassment Policy .................................................................................................. 9IT Acceptable Use Policy ............................................................................................... 13Drug-Free Workplace Policy ........................................................................................ 15

Invitation to Self-Identify ............................................................................................. 18

Voluntary Self-Identification of Disability .................................................................. 20

How To Create a Digital SignatureA digital signature is an electronic version of a hand written signature. In order to be able to electronically sign documents, you must first set up a digital ID. Once you complete the digital ID set up process, you are ready to begin signing documents electronically. The exact language used varies slightly for each Adobe version, but the basic set up process is as follows:

1. Click in the signature field for one of the forms.

2. Select “Create a new Digital ID” (phrasing may vary depending on your version of

Acrobat).

3. Specify where to store the Digital ID – Select New PKCS#12 (PKCS#12 is more secure since

it requires you to enter your password each time you digitally sign a document), and click

Next.

4. Type your personal information (name, organization unit, organization name and email

address) - leave the settings as they are, leave the Enable Unicode Support box blank, and

click Next.

5. Enter a file location and password for your new ID file – either use the default file

location or enter a different location if you prefer, create and enter password into both

password fields, then click Finish.

Note: You will be required to save the document after each individual signature. This is to ensure that the document itself does not change once you sign the document. This is a normal behavior for digital signatures. You may overwrite the document each time you save.

First Name◄ Middle Initial Last Name◄ Suffix

Employee ID◄ OR: Employee File Number ◄ AND Comp. Code (Pay Group) Date of Hire

Employee Signature:Signature◄ Date of Request◄

Contact Email Address◄ Contact Telephone Number◄

Select Account Type:

Amount of Net Pay (indicate amount OR check "Balance"):

Account Six (6) Details -- Check One:

Enter Bank Transit Routing Number (series of nine (9) numbers, NOT starting with a "5") :

Enter Bank Account Number:




Account Five (5) Details -- Check One:




Account Four (4) Details -- Check One:



By signing below, I authorize the above-named company and/or its representative to initiate direct deposit (credit) entries. If funds to which I am not entitled are deposited to my account, I authorize ADP COS and/or its representatives to direct the bank to return said funds (debit). I understand that my bank must be a member of the “Automated Clearing House (ACH)” in order for my net pay to be processed via Electronic Funds Transfer (EFT). I understand I will be notified if there is a problem with my ACH account transaction during pre-note as stated above. This authorization is to remain in effect until it is changed or canceled by me via the Direct Deposit Authorization Form or my employment terminates (Client reserves the right to cancel Direct Deposit on termination). I understand that I must allow sufficient time as noted above for the processing of such changes or cancellation.

Section 2: Account Details

For a bank account, use reference below to locate your Bank Account Number and Bank Transit Routing Number. If you only have one (1) account in the direct deposit program, the entire amount of the Net Pay will be deposited into that account if you select Balance. If you select a set amount, the balance will be issued in a live check. If you specify two (2) or three (3) accounts, a portion of your Net Pay will be deposited into the other account(s) that is/are designated as dollars ($). Any remaining net pay will then be deposited into the account designated as balance or issued in a live check.

Account One (1) Details -- Check One◄:



Enter Bank Transit Routing Number (series of nine (9) numbers, NOT starting with a "5")◄ :

Enter Bank Account Number◄ :

Account Three (3) Details -- Check One:

Select Account Type◄:

Amount of Net Pay (indicate amount OR check "Balance")◄:

Note: "Employee ID" is a required field. If your "Employee ID" is not displayed on your Pay Statement (in the "Miscellaneous" section), you must provide your "Company Code (Paygroup)" AND "Employee File Number" (from the top left corner of your Pay Statement). If you do not have an "Employee ID" or "Employee File Number" please include your "Date of Hire".



Account Two (2) Details -- Check One:



IntertekPO Box 17120 Augusta, GA 30903



Direct Deposit Authorization Form (Add, Change, Delete)

Instructions: This form is completed to add a new, change or delete a Direct Deposit account. To ensure prompt processing, provide all required information. All

fields with the (◄) symbol indicate information is required for processing.

Section 1: Employee Information

New Change Cancel

Balance

New Change Cancel

Balance

New Change Cancel

Balance

New Change Cancel

Balance

New Change Cancel

Balance

New Change Cancel

Balance

PR024Copyright (c) 2011 ADP Comprehensive Outsourcing Services. All rights reserved.

Page 1 of 112/2012

Payroll Deduction Authorization Employee Handbook, Effective 2012

Payroll Deduction Authorization

Payroll Deduction Authorization

I understand and agree that Intertek may deduct money from my pay from time to time for reasons that fall into the following categories:

1. My share of the premiums for health and welfare benefits elected by me from the benefits offered by Intertek.

2. Contributions to Intertek’s 401k plan.3. Installment payments on pay advances or loans made to me by Intertek, and if there is a

balance remaining when I leave the Company, the balance of such advances or loans.4. If I receive an overpayment of wages for any reason, repayment to the Company of such

overpayments. (The deduction will equal the entire amount of the overpayment, unless Intertek and I agree in writing to a series of smaller deductions in specified amounts).

5. The cost to the Company of personal long-distance calls I may make, or messages I may send, using Company phones (land lines and cell phones) or Company accounts, of personal faxes sent by me using Company equipment or Company accounts, or of non-work-related access to the Internet or other computer networks by me using Company equipment or Company accounts.

6. The cost of repairing or replacing Intertek equipment intentionally damaged by me.7. The cost of replacing Intertek equipment which I fail to return or which I take with me

without authorization upon separation from employment. 8. Overused PTO: If I take paid vacation, sick or personal leave (PTO) in advance of the date

I have earned and accrued that PTO, and I separate from the Company before accruing time to cover such advance leave, the value of such leave taken in advance.

9. Repayment of loans requested by me through the 401(k) plan. If a loan is still outstanding upon termination of employment, Fidelity will notify me of my options.

10. Personal expenses charged to Intertek.

11. Any other sums that may be owed by me to Intertek.

I understand that I have authorized the Company to make deductions from my wages in any or all of the above circumstances, and that deductions may be made from my final paycheck as well as from paychecks during the course of my employment. I also understand that in making deductions, the Company will not reduce my pay below minimum wage if I am an hourly employee, or below the minimum salary required by state or federal law if I am an exempt employee. (Deductions for benefit premiums or 401(k) deferrals may result in pay below minimum wage or salary.) This authorization will only be enforced and applied to the extent permitted by applicable state and federal law.

Employee Signature: Date:

Employee Full Name (Printed):

Direct Deposit Authorizationt V01 Effective May 2011

Direct Deposit Authorization

This form is not directly related to payroll. However, it must be completed in order to be reimbursed for expenses.

Once this form is received, it will take approximately 5- 7 business days before the account set up is in effect.

Employee Name: Work Location:

Work Email Address: Phone Number:

I authorize Intertek to deposit my check into my checking/savings account as designated above. Employee Signature: Date:

HR USE ONLY

PeopleSoft Setup: Date:

AP USE ONLY

Verified by Date:

Reconciled by: Date:

Name of Financial Institution:

Bank Routing: Account #:

Please attach a voided check or include a photo. (No deposit slips, please.)

Please note that only the original and voided check will be accepted or a clear photo of a voided check.

Accounts Payable - Expense Reimbursement

Emergency Contact

Emergency Contact

Emergency Contact Information

Please provide your emergency contact information below. Please PRINT clearly.

Employee Legal Name: Social Security Number:

Employee Common Name: Date of Birth:

Physical Home Address (No P.O. Boxes):

Mailing Address:

Phone Number:

Primary Emergency ContactPrimary Contact: Relation:

Home Phone: Mobile Phone: Work Phone:

Secondary Emergency ContactSecondary Contact: Relation:

Home Phone: Mobile Phone: Work Phone:

U.S. Employee Handbook Effective 1/1/2010; Revised 3/1/2012

Employee Handbook

Receipt of Employee Handbook

I have received the January 2012 revision of the Employee Handbook.

The Employee Handbook describes important information about Intertek and I understand that I should consult Human Resources regarding any questions not answered in the handbook. I have entered into my employment relationship with Intertek voluntarily and acknowledge that there is no specified length of employment. Accordingly, either I or Intertek can terminate the relationship at will, with or without cause, at any time, so long as the reason(s) for such termination would not violate applicable federal or state law.

Since the information, policies, and benefits described here are necessarily subject to change, I acknowledge that revisions to the handbook may occur, except to Intertek’s policy of employment-at-will. All such changes will be communicated through official notices, and I understand that revised information may supersede, modify, or eliminate existing policies. There will be no exceptions or revisions to Intertek’s policy of employment-at-will.

I acknowledge that this handbook is not a contract of employment. I have received the handbook, and I understand that it is my responsibility to read and comply with the policies contained in this handbook and any revisions made to it.

The employee handback can be downloaded at any time at:http://cdn.intertek.com/mail/files/hr/employeeHandbook.pdf

Employee Name: Location:


Code of Ethics - version 6/10/14 Code of Ethics Agreement_v1.0_280514

Code of Ethics

Code of Ethics Agreement

All those working for, or on behalf of Intertek, are required, as a condition of employment, to document their acceptance and understanding of the Intertek Code of Ethics before commencing work on our behalf and on a periodic basis thereafter. It is the responsibility of each Intertek employee or person acting on Intertek’s behalf to understand and apply the Intertek Code of Ethics in their part of the business and location.

The Intertek Code of Ethics is available for download online at: http://www.intertek.com/investors/governance/

Customers, agents, employees or third parties who are aware of or suspect any breaches of the Code of Ethics, or have any questions about it, should contact Intertek’s Group Head of Legal on either of the following:

Telephone: +44(0) 20 7396 3400Post: Intertek Group plc

25 Savile Row London W1S 2ES UK

Code of Ethics CertificationThis is to certify that I have read the Intertek Code of Ethics as referred to above and understand its intention and meaning and my responsibilities thereunder. I have had the contents explained to me and have had the opportunity to ask questions and seek clarification.



http://www.intertek.com/investors/governance/

Anti-Harassment Effective 1/1/2010; Revised 1/1/2015

Anti-Harassment

Anti-Harassment

Intertek is committed to maintaining a workplace that is free of illegal harassment. Illegal harassment of any form, including sexual harassment, will not be tolerated. Harassment can occur in the workplace or in other settings which are part of the scope of employment with the Company.

Harassment DefinedHarassment is any physical or verbal conduct directed at a person because of his/her race, religion, age, gender, marital status, national origin, disability, sexual orientation, gender identity, veteran status or any other classification, status, or activity protected by federal or applicable state law. Harassment based on gender can be sexual or non-sexual in nature.

Examples of actions that may rise to the level of illegal harassment are: • An employee who is teased, harassed and/or made fun of by one or more employees

because of gender or other characteristics, so much so that it creates an intimidating and hostile work environment.

• Creating an intimidating work environment or demonstrating favoritism. • Religious harassment stemming from jokes, teasing or coercion about religious beliefs,

practices or clothing.• Gender harassment involving conduct, behaviors and conversations that demean

someone because of gender. • Age harassment involving negative treatment on the basis of age, including exclusion,

restrictions or coercing someone to retire.• Racial harassment involving offensive stereotyping through words, jokes and gestures.• Harassment stemming from bias against one’s national origin, such as when a person’s

gestures, comments, symbols, customs, or accent are under attack.

Sexual HarassmentSexual harassment is unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature when:

• Submission to such conduct is made, either explicitly or implicitly, a term or condition of an individual’s employment;

• Submission to, or rejection of, such conduct by an individual is used as the basis for employment decisions affecting said individual; or,

• Such conduct has the purpose or effect of creating an intimidating, hostile, or offensive work environment.

Sexual harassment is behavior that occurs because of the victim’s sex, and is unwelcome, personally offensive, offensive to a reasonable person, and severe or pervasive, such that it alters the terms and conditions of employment and so creates a hostile work environment. Examples of sexual harassment include, but are not limited to the following:


Anti-Harassment• An employee who is told by a supervisor that refusing to submit to advances or engage in

sexual activity will result in termination;• An employee who is terminated or demoted from employment as a result of refusing to

submit to a supervisor’s sexual advances;• An employee who is promoted or given a raise, as a result of submitting to a supervisor’s

sexual advances; or,

• An employee is subjected repeatedly to sexual advances, jokes or comments.

Those Covered by this PolicyThis policy covers all U.S. employees of the company. Intertek will not tolerate illegal harassment of employees or third parties by any of its employees. In addition, Intertek will not tolerate illegal harassment at work of its employees by any person who is not an employee, such as a customer, independent contractor, vendor or visitor. Illegal harassment will not be tolerated at any of Intertek’s work locations or in any other work-related settings such as business trips or social events. Employees have the responsibility to conduct themselves in an appropriate manner and are encouraged to promptly report all information regarding harassment by following the process outlined in the following sections.

Reporting HarassmentIn circumstances or situations in which a victim of perceived harassment feels comfortable doing so, he or she should firmly, clearly and directly tell the harasser to stop and that the behavior in question is inappropriate and unwanted. This is often enough to stop the harassment. However, while such a direct statement of the unwelcome nature of the speech or conduct may resolve the problem, Intertek recognizes that the facts of any particular situation may make such a statement unrealistic or undesirable.

Regardless of whether the person who feels victimized has expressed such feelings to the perceived harasser -- anyone who believes that he/she has been harassed, or anyone who is aware of or believes he or she has witnessed an act of harassment, should promptly report such harassment to any one of the following:

• The employee’s direct supervisor or manager;

• The manager of the location where the employee works; and/or,

• The Human Resource Department; and/or,

• The Intertek Hotline – 1-855-315-0770 or www.IntertekHotline.com

The employee or Manager must immediately notify the Human Resource Department of any complaints regarding harassment.

Upon a report of alleged harassment, Intertek will conduct an investigation of the allegations, including interviews of appropriate individuals (e.g., the person complaining, the alleged harasser, possible witnesses). All complaints and information regarding harassment will be taken seriously and will be investigated promptly and thoroughly. Intertek requires that


Anti-Harassmentemployees fully cooperate during investigations, including answering questions and/or providing a witness statement upon request. Upon completion of an investigation, Intertek will take corrective action, if appropriate, consistent with the results of the investigation. Corrective action may include any of the following: Verbal warning; written warning; mandatory sensitivity and harassment training; other disciplinary action; and/or, termination of employment.

Intertek will make every reasonable effort to conduct investigations into harassment complaints in a confidential manner. To the extent that the nature of the complaint and the investigation permits, only those involved in the investigation process, including the alleged harasser or any witnesses, will be informed of the alleged victim’s identity or the nature of the complaint. However, in certain circumstances, the Company may need to disclose identifying information concerning individuals involved in complaint allegations to ensure that a thorough investigation is conducted.

Intertek may impose any one or more of the corrective actions set forth above, or any alternative response as the Company deems appropriate, at any time, if it is determined that harassment has occurred. While this policy is designed to address illegal harassment, the policy is not intended to limit Intertek’s authority to discipline or take remedial action for workplace conduct which is deemed unacceptable, regardless of whether that conduct satisfies the definition of illegal harassment.

Retaliation is PhohibitedIt is unlawful to retaliate against an employee for filing a complaint of, or cooperating in, an investigation of harassment., Individuals who file a complaint or cooperate in an investigation in good faith will not be subjected to corrective action or to any other adverse treatment based on the filing of a complaint or participation in an investigation. Retaliation or attempted retaliation is a violation of this policy and anyone who engages in such actions will be subject to disciplinary action, up to and including termination.

The name, address and phone number of Federal and State agencies responsible for handling complaints of harassment are posted at each Intertek branch per state and federal regulations, or are available from the Human Resource Department.

SPECIAL NOTE FOR EMPLOYEES IN THE U.S. VIRGIN ISLANDS – REGARDING COMPLAINTS OF DISCRIMINATION AND/OR HARASSMENT:

Employees who believe that their complaints have not been adequately resolved within INTERTEK may file claims with the Virgin Islands Department of Labor on St. Croix at 2203 Church Street, Christiansted, St. Croix, 00820 -4612 ; Tel:(340) 773-1994 ; Fax No.: (340) 773-1858; the Virgin Islands Department of Labor on St. Thomas at 54A-B Kronprindsens Gade, St. Thomas, Virgin Islands 00802 – Tel: (340)776-3700; Fax No.: (340) 774-5908; the Virgin Islands Civil Rights Commission at (340) 774-5666; or the United States Equal Employment Opportunity Commission at 525 F.D. Roosevelt Ave.; Plaza Las Americas, Suite 1202; San Juan, Puerto Rico 00918-8001; (787) 771-1464; Fax (787) 771-1485.


Anti-Harassment

I have read and understood the Anti-Harassment Policy.



IT Acceptable Use Policy revised: 3/1/12

IT Acceptable Use Policy

Information Technology Acceptable Use Policy

This Acceptable Use Policy applies to all Intertek Group plc (“Intertek”) personnel, without exception, and to those others offered access to Intertek Systems. Intertek has an Acceptable Use Policy in place to ensure that we can use technology to provide better customer service and to protect our reputation. For the purposes of this document “Intertek Systems” is defined as including but not limited to: desktop PCs, laptop PCs, servers, terminals, software, printers, modems, hubs, network cards, tape drives, diskette drives, photocopiers, scanners, Internet access, software media and telephone systems.

General Principles1. Intertek provides access to Intertek Systems with supporting documentation for the

performance of Intertek employees’ and contractors’ work duties.

2. The use of Intertek Systems for personal reasons is to be kept to a minimum, and

must not interfere with Intertek’s business. The Company reserves the right to limit or

discontinue personal use of Intertek Systems if it is determined that an employee or

contractor has abused this policy.

3. All equipment provided by Intertek is solely owned by Intertek, unless advised otherwise

in writing by an Intertek senior manager.

4. Intertek Systems must not be removed from the premises of Intertek without the express

permission of an Intertek senior manager, or the IT Department. Specifically, unless such

permission is given, removal of laptops is permitted only by the users who are allocated

them for business use.

5. The software used by Intertek has been licensed to Intertek from the manufacturers. Use

of improperly licensed software is strictly prohibited.

6. All information transmitted by, received from, or stored in Intertek Systems, on any type

of storage media, for example, hard drives, optical drives and magnetic media, is the

property of Intertek or of Intertek’s Clients where agreements on title exist.

7. Authorised Intertek personnel may from time to time, where local legislation allows,

monitor usage of Intertek Systems. This may include, but is not limited to, accessing

e-mails, monitoring Internet access, monitoring telephone usage, viewing stored files,

listening to voice mails and using location awareness technologies.

8. Intertek regularly audits all PCs and servers by the use of specialised software.

9. Users should have no expectation of privacy in the use of any information transmitted by,

received from, or stored in Intertek Systems.

10. Intertek owns the Intellectual Property Rights on all software and procedures developed

by any employee or contractor during company time, using Intertek systems, and/or in

fulfilling the scope of their contract agreement.


IT Acceptable Use Policy

Users Shall Not:1. Use personal games software on Intertek Systems as it is strictly prohibited.2. Load company data or programs on home or personal computers, or any other equipment

not belonging to Intertek, unless approval has been obtained from an Intertek senior manager, and the relevant external computers are protected by the latest anti-virus files.

3. Take copies of Intertek company data off-site without prior approval from an Intertek senior manager.

4. Make unauthorised copies of software or software documentation.

5. Load software not approved by the IT

Confidentiality6. Access an Intertek owned PC or laptop unless authorised to do so by the main user or an

Intertek senior manager.7. Use a password to access a file, or retrieve any communication stored on Intertek Systems

unless authorised to do so by an Intertek senior manager.

Email8. Improperly use Intertek e-mail solutions, including the spreading of materials that are

offensive, obscene, defamatory, political, or religious in nature, or which is intended to annoy, harass or intimidate another person.

9. Solicit e-mails that are for personal gain.10. Represent personal opinions as those of the company.11. Register Intertek email addresses for personal use on non-business related third party

websites as this can lead to subsequent unsolicited e-mails (SPAM).

12. Forward any unsolicited e-mails (SPAM), or chain letters.

Internet13. Visit Internet sites that contain obscene, hateful or objectionable materials.14. Download any images or programs from the Internet, as this is the greatest cause of

software viruses. If such downloading is required to perform a valid business objective, users must have approval from their IT Department.

15. Download or stream video and/or music from the Internet as this consumes communications resources.

16. Make or post libellous or indecent remarks, proposals, or materials on the Internet.17. Connect personal computing devices to Intertek’s networks without approval from their

IT Department.

18. Deploy personal Internet WEB sites on Intertek Systems.

19. Play games on the Internet using Intertek Systems.

20. Download or view sexually explicit images from the Internet as this is strictly prohibited.

In this respect ‘Downloading’ is in effect ‘the making’ of images.


IT Acceptable Use PolicyUsers Shall:General

21. Notify an Intertek senior manager and/or the IT Department immediately if they learn ofany misuse of Intertek Systems.

22. Ensure that the use of Intertek Systems is consistent with Intertek business interests.23. Ensure that personal use of the Internet, and Intertek e-mail systems, is kept to a

minimum, and must not interfere with Intertek’s business. Intertek will, where necessary,implement technology as it deems appropriate to enforce this policy.

Confidentiality24. Ensure that all information regarding Intertek operations (including but not limited to:

financial information, new business and product ideas, marketing strategies and plans,database and the information contained therein, technical product information, customerlists, computer/network access codes, computer source codes, business relationships) iskept strictly confidential.

25. Ensure that passwords are:• Kept private (i.e. not shared with other staff)• Changed at least every 90 days• Made up of a mixture of alphabetic and numeric characters• A minimum of 10 characters in length• Committed to memory and not written down anywhere• Not stored or transmitted in clear text• Not composed of words found in a dictionary, proper names, geographic

locations, personal details, common acronyms, common sequences or user login

codes

Protect your reputation and your career Employees must follow the Intertek Group IT Acceptable Use Policy or risk disciplinary action and risk termination of employment. Contractors must follow the Intertek Group IT Acceptable Use Policy or risk termination of the contractor’s agreement. The company retains the right to report any illegal violations to the appropriate authorities. I acknowledge that I have read and understood the Intertek Group IT Acceptable Use Policy and that I agree to comply with all its terms and conditions whilst I am anemployee or contractor of any subsidiary of Intertek Group Plc.



Office Location:

Drug-Free Workplace revised 1/1/2015

Drug-Free Workplace

Drug-Free Workplace Policy

General OverviewIntertek recognizes that when employees abuse drugs and/or alcohol they are less productive, less dependable, and a critical threat to the safety, security and welfare of employees, customers, vendors and the general public.

It is the policy of Intertek to maintain a workplace free from the use and abuse of drugs and alcohol. Intertek will require all employees and applicants to consent and comply with the terms of the drug, alcohol and substance abuse policy as a condition of employment. If questions arise regarding this policy, contact the Human Resource Department.

After a conditional offer of employment has been made, applicants are required to consent to and take a pre-employment drug screen.

Intertek reserves the right to inspect company vehicles, premises, property (including offices, desks, lockers and other repositories) and personal effects (such as lunch boxes/bags, purses, gym bags, backpacks, handbags, briefcases, packages or coats) with or without notice.

Policy ProhibitionsEmployees are strictly prohibited from engaging in the following conduct:

• Using, consuming, being under the influence of, testing positive for, or otherwise havingin one’s system, illegal drugs;

• Using, possessing, or being under the influence of illegal drugs or alcohol during workhours, or being under the influence of prescription medication which adversely affectsthe employee’s ability to perform the employee’s duties during work hours;

• Bringing and/or storing illegal drugs, alcohol, or drug in the workplace. This includesdesks, lockers, company vehicles, personal vehicles and other repositories.

• Transporting, distributing or attempting to distribute, manufacture, sell or dispenseillegal drugs;

• Abusing prescription drugs which includes exceeding the recommended prescribeddosage or using others’ prescribed medications;

• Switching, tampering with or adulterating any specimen or sample collected under thispolicy, or attempting to do so;

• Refusing to cooperate with the terms of this policy, which includes submitting toquestioning, drug testing, alcohol testing, medical or physical tests or examinations,when requested or conducted by the Company or its designee. A refusal to test includesconduct obstructing testing, such as failing to sign necessary paperwork, failing to reportto the collection site at the appointed time, submitting an adulterated or diluted sample,or failing to be reasonably available for testing;

• Failing to consent to, participate in and abide by the terms and recommendations of anyEAP program to which Intertek makes a referral, including but not limited to, failing tofollow recommendations, if any, regarding behavior modification and abstinence. Thesefailures are a violation of this policy, as is any failure to be available for any prescribedcontinuing or follow-up sessions;

Drug-Free Workplace revised 1/1/2015

Drug-Free Workplace• Failing to advise a supervisor or manager of the use of a prescription or over-the-counter

drug which may alter the employee’s ability to perform the essential functions of his orher job;

• Failing to notify his or her supervisor before going to work if he or she believes that heor she is under the influence of illegal drugs or alcohol, or prescription medication thatimpairs the ability to perform the employee’s duties; or,

• Failing to notify a supervisor or the Human Resource Department of a conviction or pleaof guilty relative to any criminal drug or alcohol-related offense in writing no later thanfive (5) calendar days after the event, unless such conviction or plea of guilty has beenexpunged;

Employees who violate this policy shall be subject to corrective action, up to and including termination of employment. An employee’s decision to seek professional assistance for an alcohol or drug-related problem does not bar the employee from job and performance-related corrective action or termination of employment.

Substance Abuse Testing Guidelines• Random - Where random substance abuse testing is not prohibited by applicable federal,

state, territorial or local law, the selection process is managed by a third-party vendor.• Reasonable Suspicion - Reasonable suspicion testing may be conducted where the

Company has a reasonable basis to believe the employee is working under the influenceof illegal drugs or alcohol or prescription drugs that impair the employee’s ability toperform the employee’s job duties. That reasonable basis may be based on evidenceprovided by third parties, and/or on observing characteristics, actions, or behaviorexhibited by the. All reasonable suspicion testing is under the control of the HumanResources Department or the local manager with approval from the Human ResourceDepartment.

• Return to Work - Intertek reserves the right to have an employee tested before returningto work after an illness or injury. The purpose for this testing is to determine whether acontrolled substance is present in the employee’s system and if the substance increasesthe risk of injury to the employee.

• Pre-Employment - After a conditional offer of employment is made and before beginningemployment, the candidate will submit to a drug and substance test.

• Post-Accident - A drug test may be conducted when an accident occurs in the workplace.

I have read and understood the Drug-Free Workplace Policy.



Intertek is an affirmative action/equal employment opportunity employer. Women, minorities, veterans and persons with disabilities are encouraged to apply.

Post Offer: Invitation to Self-Identify(Intertek) (“Company”) is a Government contractor subject to Executive Order 11246, which requires Government contractors to ensure equal employment opportunity for all persons, without regard to race, color, religion, sex or national origin, and the Vietnam Era Veterans Readjustment Assistance Act of 1974 (“VEVRAA”), as amended by the Jobs for Veterans Act of 2002, which prohibits discrimination against protected veterans and requires Government contractors to take affirmative action to employ and advance in employment qualified disabled veterans, recently separated veterans, active duty wartime or campaign badge veterans, and Armed Forces service medal veterans.

As part of the Company’s affirmative action efforts, we request your cooperation in completing this voluntary identification form which allows us to comply with government requirements for record keeping and periodic reporting of this data. The information you provide will be treated confidential and will be used only in accordance with government reporting requirements. Failure to provide the information requested will not subject you to adverse treatment.

Employee Name: Date:

Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

American Indian or Alaska Native: A person having origins in any of the original peoples of North or South America (including Central America), and who maintains a tribal affiliation or community attachment.

Black or African American: A person having origins in any of the Black racial groups of Africa.

Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Two or More Races: A person who identifies with more than one of the above five races.

Gender: Male Female

Race/Ethnicity: (definitions below)Hispanic or Latino: Yes No

Race: (select all that apply)

American Indian or Alaskan Native Asian

Black or African American White

Native Hawiian or Other Pacific Islander Two or more races

Intertek is an affirmative action/equal employment opportunity employer. Women, minorities, veterans and persons with disabilities are encouraged to apply.

Post Offer: Invitation to Self-Identify

Disabled Veteran

Recently Separated Veteran (Date Discharged: )

Active Duty Wartime or Campaign Badge Veteran

Armed Forces Service Medal Veteran

I choose not to self-identify as a protected veteran

I am NOT a protected veteran

As a Government contractor subject to VEVRAA, we are required to submit a report to the United States Department of Labor each year identifying the number of our employees belonging to each specified “protected veteran” category. The protected veteran categories are defined as:

If you believe you belong to any of these categories of protected veterans, please indicate by checking the appropriate boxes below.

A request to benefit under this program may be made immediately and/or at any time in the future. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information provided will be used only in ways that are not inconsistent with the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended.

If you are a disabled veteran, it would assist us if you tell us whether there are accommodations we could make that would enable you to perform the essential functions of the job, including special equipment, changes in the physical layout of the job, changes in the way the job is customarily performed, provision of personal assistance services or other accommodations. This information will assist us in making reasonable accommodations for your disability.

The information you submit will be kept confidential, except that (i) supervisors and managers may be informed regarding restrictions on the work or duties of disabled veterans, and regarding necessary accommodations; (ii) first aid and safety personnel may be informed, when and to the extent appropriate, if you have a condition that might require emergency treatment; and (iii) Government officials engaged in enforcing laws administered by the Office of Federal Contract Compliance Programs, or enforcing the Americans with Disabilities Act, may be informed.

Disabled Veteran refers to a veteran of the U.S. military, ground, naval, or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under the laws administered by the Secretary of Veterans Affairs or who was discharged or released from active duty because of a service-connected disability.

Recently Separated Veteran means any veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty, in the U.S. military, ground, naval or air service.

Active duty wartime or campaign badge veteran means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized, under the laws administered by the Department of Defense.

Armed Forces service medal veteran refers to a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Voluntary Self-Identification of Disability Form CC-305 OMB Control Number 1250-0005

Expires 1/31/2017Page 1 of 2

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities.i To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.

Disabilities include, but are not limited to:

• Blindness • Autism • Bipolar disorder • Post-traumatic stress disorder (PTSD)• Deafness • Cerebral palsy • Major depression • Obsessive compulsive disorder• Cancer • HIV/AIDS • Multiple sclerosis (MS) • Impairments requiring the use of a wheelchair• Diabetes • Schizophrenia • Missing limbs or • Intellectual disability (previously called mental• Epilepsy • Muscular partially missing limbs retardation)

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Please check one of the boxes below:

______________________________ ____________________

Your Name Today’s Date

YES, I HAVE A DISABILITY (or previously had a disability)

NO, I DON’T HAVE A DISABILITY

I DON’T WISH TO ANSWER

Documents

NEW HIRE PAPERWORK - Intertekcdn.intertek.com/mail/images/hr/_files/newHirePaperwork.pdf · NEW HIRE PAPERWORK Instructions: Please ... save it; and email it to [email protected]