STATEMENT OF RELEASE

I understand that employment with Wiens & Company Construction, Inc. (the Company) is at-will, meaning that I or the Company may terminate my employment at any time, or for any reason consistent with applicable state or federal law. I authorize the Company to conduct an investigation of my employment and personal history to verify data submitted on this application and in any interviews. I authorize all individuals, institutions, schools, and firms named to provide any requested information and release them from any and all liability for providing the requested information. If I am offered employment I agree to submit to a medical examination and drug test before starting work. If employed, I also agree to submit to a medical examination or drug test at any time deemed appropriate by the Company and as permitted by law. I consent to such examinations and tests, and I request that the examining doctor disclose to the Company the results of the examination, which results shall remain confidential. I understand that my employment or continued employment is contingent upon satisfactory medical examinations and drug tests, and if I am hired a condition of my employment will be that I abide by the Company's Drug and Alcohol Policy.

I affirm that the information and statements I have provided herein are true, and complete to the best of my knowledge. I understand that if employed, any false statements on this application may result in termination.