Release & Acknowledgement
Have you reviewed the job description of the position for
which you are applying.
If so, can you perform any or all of the job functions
contained in the job description with or without reasonable
NOTICE OF RIGHTS FOR DISABLED PERSONS
If you have a physical, mental, or other impairment that would interfere with your ability to perform in a position but
which may be accommodated by, for instance, the purchase of equipment or devices, the provision of readers or
interpreters or the restructuring or altering of work schedules, the Michigan Persons With Disabilities Civil Rights Act
requires that you notify Merlo Construction (the “Company”) in writing of your need for accommodation within One
Hundred Eighty-Two (182) days after you become aware or should reasonably have known that the accommodation was
needed. All written requests for accommodation must be submitted to the President of the Company.
AUTHORIZATION, AGREEMENT, AND CERTIFICATION
I hereby request that all former employers, educational institutions, references provided on this application, reporting
agencies, and any other custodian of Background Information, give all information concerning my previous employment,
education, and/or pertinent information they may have, personal or otherwise, to Merlo Construction, and I hereby
consent to the release of such Background Information and release all such parties from all liability for any damage that
may result from the furnishing of same to Merlo Construction or third party designee. In particular, in connection with the
processing of my application for employment, and for the duration of my employment (or independent contract for
services) with the Company, I and my heirs, executors, administrators, successors and assigns, hereby release the
The company, its related affiliates, and the respective officials, administrators, and employees from any causes of action,
claims, liability and demands whatsoever, in law or equity, which I may have, or claim to have, against any or all of said
entities or individuals arising from, or occurring as a result of the investigation or any other action taken by the Company
relating to the request of my consumer report. I authorize, without reservation, any party or agency contracted by Merlo
Construction to furnish the above-mentioned information. I consent to the disclosure and use of the Background
Information by the Company and its retained professionals. I hereby waive my rights under the "Employee Right to Know
Act, “Act No. 397, Michigan Public Acts of 1975, to written notice of any disciplinary information disclosed by the
aforementioned employer or former employer pursuant to this authorization.
I acknowledge that if I am hired, I know that my employment with Merlo Construction is at-will. This means that both
Merlo Construction and I are free to terminate employment at any time, with or without reason or notice. No employee of
Merlo Construction can alter this at-will employment policy or enter into an employment contract for a specified period of
time, or make any agreement contrary to this policy, without written approval from Merlo Construction.
I understand and acknowledge that, except for the provisions of arbitration in the next paragraph, the policies, rules, and
practices of the Company may be changed unilaterally by the Company at any time without any notice to me, including
without limitation, unilateral adjustments in compensation, fringe benefits, and other terms and conditions of employment
including layoffs and terminations. If employed, I hereby agree to comply with all rules, regulations and the policies
established by the Company for its employees including such new or revised rules, regulations and policies as may be
I understand and agree that in the event that a dispute arises concerning my application for, employment with, and/or
termination from the Company, the sole and exclusive method for resolving any and all disputes arising out of my
application, employment or termination from the Company or in any way related to any alleged wrongful acts on the part
of the Company, its affiliates, directors, shareholders, agents, members, partners, officers or employees relating to my
employment, including but not limited to claims of breach of contract, wrongful discharge, retaliatory discharge claims,
tort claims, invasion of privacy, slander, defamation, and/or any statutory claim including but not limited to discrimination
or other violation under Title VII of the Federal Civil Rights Act, Age Discrimination in Employment Act, Americans With
Disabilities Act, Fair Labor Standards Act, Family Medical Leave Act, Michigan Persons With Disabilities Act, Whistle
Blowers Protection Act, Bullard-Plawecki Employee Right to Know Act and the Michigan Elliot-Larsen Civil Rights Act,
shall be through the procedures and policies of the American Arbitration Association; thereby waiving my right to
adjudicate these claims in a judicial forum. I agree not to bring, and expressly waive my right to bring any action or claim
under this Agreement as a member of any purported class or representative proceeding. Nothing in this Agreement,
however, shall be construed to prohibit me from filing a charge with or participating in any investigation or proceeding
conducted by the EEOC or a comparable state or local agency. Notwithstanding the foregoing, I agree to waive my right
to recover monetary damages awarded or resulting from any charge, complaint, or lawsuit filed by me or by anyone else
on my behalf. This agreement to arbitrate applies to all claims whether I become employed by the Company, whether
brought during my employment with the Company, or at any time after termination of employment with the Company.
Venue for any such arbitration hearing shall be Oakland County, Michigan. The parties hereby agree that the
determination of the arbitrator shall be binding and final upon all parties. The award of the arbitrator may be filed with the
Clerk of the Circuit Court for the County of Oakland County, Michigan and judgment may be rendered by the Court upon
the arbitration award and execution may be issued upon the judgment. The cost for arbitration shall be split equally
between myself and the Company, notwithstanding anything to the contrary in the employment rules of the American
Arbitration Association or otherwise. The arbitrator shall not have the power to change, modify or otherwise alter the "At
Will" nature of the employment relationship and the arbitrator's written determination shall be based solely upon the "At
Will" nature of such employment relationship. In any proceeding under this Agreement, the parties shall have the right to
representation by counsel at all steps of the procedure and reasonable discovery, including, but not limited to,
interrogatories, document requests, depositions and subpoenas in accordance with Michigan State court rules. The
parties may mutually agree that the arbitration therein be steno graphically recorded, provided that each party shall
equally share the cost of creating and printing the record.
I agree that any arbitration or judicial proceeding arising out of a dispute relative to my employment with the Company
shall not be brought unless the same is commenced within One Hundred and Eighty (180) days following the incident
giving rise to such dispute. My failure to commence such proceeding within the One Hundred Eighty (180) day period
shall result in the extinguishment of any rights I may have to prosecute such claims or actions. If any term or provision
contained in this Agreement is construed or held to be invalid, void or unenforceable by a court of confident jurisdiction
for any reason whatsoever, such term or provision shall be construed and enforced consistent with state or federal laws
to render such provision and the remainder of this Agreement enforceable. Such ruling shall not affect the validity of the
remainder of this Agreement.
I agree that if I should bring any action or claim arising out of my employment against the Company in which the
Company prevails, I will pay the Company any and all such costs incurred by the Company in defense of such claim or
action, including attorney fees, court costs, arbitration fees and all other costs associated with such action.
I hereby authorize the Company to deduct from my wages any sums loaned, advanced, or paid on my behalf by the
Company. I consent to such deduction freely and fully with the understanding that such deductions may substantially
reduce a particular pay check.
I acknowledge and agree that I have reviewed and entered into this Agreement knowingly and voluntarily as a condition
of application for employment, employment and/or continued employment with the Company. This Agreement can only
be changed or revoked by written agreement signed by both the applicant and the President of the Company.
Lastly, Merlo Construction is an equal opportunity employer and will not discriminate against any applicant on the basis
of any characteristic that is protected by federal, state or local law.