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DRIVING RECORD REVIEWS <br />r1nt Ftirm' <br />All prospective operators of City ofF✓ugenevehicles must hold a current and valid State of0regoridriver's license with the proper class of <br />license for the equipment operated. It is the policy of the City that no employee will be authorized to operate a vehicle for which he/she does <br />not have the appropriate classification of driver's license. <br />The City ofEugenesubscribes toOregon's Department of Transportation Automated Reporting System. All new driver applicants will have a <br />review of their driving record prior to operating City equipment or driving personal vehicles while on City business. Drivers who experience a <br />change in their operator's license status should report that change to their supervisor immediately- -the City will be notified through the <br />Automated Reporting System. <br />All City employees should.remember that their coverage by the City applies only when City vehicles are used with permission and only during <br />the course and scope of their duties. This means that the use of City vehicles for private benefit may subject the user to full.personal liability <br />in the event of any type of accident. <br />Successful applicants for positions requiring a Commercial Driver's License must pass a federally mandated pre - employment physical <br />examination, including drug and alcohol testing under certain circumstances (see page 2, CDL procedures). <br />[Reco OTE: OUT - - STATE LICENSES PLEASE READ CAREFULLY! <br />a prospective employee holds an out -of- - state driver's license, he/she must provide a current coU of their driving record, reflecting a <br />inimum three -year . history, to Risk Services for review prior to receiving authorization to operate a City vehicle. In addition, a Driving <br />Review form; with a copy of the employee's Oregonlicense, must be submitted to Risk. Services within 30 days of the date -of -hire to <br />continue the authorization to operate City vehicles.. The employee shall obtain a copy of theOregonDriver Manual, available through DMV, <br />their supervisor, or Risk Services, and become familiar with Oregondriving law before operating a City vehicle. <br />I, the undersigned, authorize the City ofEugeneto review my driving record. I understand operating a City vehicle may be a requirement of <br />employment with the City, and failure to comply with City standards could jeopardize my employment. I further understand that any accident <br />or moving violation not yet recorded on my driving record at the time of initial review may subsequently disqualify me from operating a City <br />vehicle and could lead to possible termination if driving is a requirement of my employment. A copy of this form shall.have the same effect as <br />the original and will be effective without expiration. <br />Name rinted <br />ODL # S�iS 5 s 2: j —� LICENSE CLASS —� DOB F� <br />-- ,�I L <br />State <br />THE FOLLOWING MUST BE COMPLETED BY THE SUPERVISOR <br />SUPERVISOR (print) <br />EXT <br />Completed Training Video & <br />Fueling Statement CDL REQUIRED <br />Y r Y N <br />SUPERVISORS <br />EMPLOYM STATUS (Select One) I <br />Intern <br />Temp <br />Route this completed form directly to the Safety/Loss Control Program, Risk Services Division, 101 E Broadway, Suite 450. <br />For assistance, please call X5665. <br />DO NOT ATTACH FORM TO PAP * * * * * * * * * ** <br />