Page 1Rev. 08/16

PERSONAL INFORMATION

JOB INTERESTS/SKILLS

Last Name

Yes No� �

Full Time � Part Time � Temporary �

First Name &Middle Name

Address City

State SocialSecurity #

Home Phone # ( ) Work Phone #

DriversLicense #

Cell Phone # E-MailAddress

ZIP

State Expiration Date Class

Date availableto start work

mm dd yy

( )

PLEASE PRINT LEGIBLY

( )

Is there any additional information that relates to your change ofname, use of an assumed name,or nickname, that you mustprovide to enable a check on your work and educational record?

Yes No� �Have you ever used another name(s)?

Yes No� �Ever worked for Dunn-Edwards before?

Yes No� �Was termination voluntary?

Yes No� �Are you related toanyone in the Company?

If so, please list all previously-used names:

Postition(s)applied for

Facility/location whereemployment is desired Salary desired

Reason(s) for leaving

If yes:His/her name

Yes No� �Were you referred for the position you are applying for?

If yes:Name of person that referred you

To ensure compliance with our motor vehicle insurance carrier, are you at least 21 years of age if applying for a delivery postion?

Type of employment requested:

$

EMPLOYMENT APPLICATION

Page 2Rev. 08/16

Yes No� �

Yes No� �

Was termination voluntary?

Yes No� �May we contact this employer? Are you still employed with this employer?

Reason(s)for leaving

Yes No� �

Yes No� �

Was termination voluntary?

Yes No� �May we contact this employer? Are you still employed with this employer?

Reason(s)for leaving

EDUCATION

EMPLOYMENT HISTORY

1

2

High School

College or University

Other Education

PLEASE PRINT LEGIBLY

$ $

Former employer name

Street Address

City, State, ZIP

Job Title

Job Duties

Immediate supervisor

Employment dates Salary

( )

Beginning with your current (or, if you are not currently employed, your most recent) job, please list your last two (2) employers over the last 15 years. Be sure to account for all periods of time including military service and any period of unemployment. If self-employed, give firm name and supply business references. You may not substitute your resume for this list. Use additional sheets if necessary.

Name

From To Starting Ending

Position Phone #

$ $Salary

( )Name

From To Starting Ending

Position Phone #

Fully explain any gaps inyour employment history

Former employer name

Street Address

City, State, ZIP

Job Title

Job Duties

Immediate supervisor

Employment dates

Name & Location Years attended(eg. 1998-2002)

Degrees, Diplomas, Certificates & Honors

Page 3Rev. 08/16

ELIGIBILITY STATUS

Printed Name

Signature

Today’s Date

If Yes, please give the date(s) and details: If Yes, please give the date(s) and details:

Have you ever pled guilty or “no contest” to, or been convicted of, a misdemeanor or felony within the past seven (7) years?

APPLICANTS residing in and/or applying for a position in SAN FRANCISCO, CALIFORNIA: DO NOT ANSWER CRIMINAL HISTORY BACKGROUND questions at this time. You may be asked to answer these questions after a first interview, if any, occurs.

Yes No� �

Yes No� �

Yes No� �

Have you been arrested for any matters for which you currently are out on bail or on your own recognizance pending trial?

Do you have adequate transportation to and from work?

CERTIFICATION: I hereby certify that the above criminal history information is true and correct. I understand that the failure to disclose any conviction, pleas, or other requested disclosures (other than those legally protected from disclosure) may be grounds for withdrawing an offer of employment or termination of my employment, if hired.

ALL APPLICANTS: Do not include any conviction(s) for certain misdemeanor marijuana-related offenses, including violations of sections 11357(b), 11357(c), 11360, 11364, 11365, and/or 11550 of the California Health and Safety Code, or any predecessor thereof, that occurred two (2) years ago or longer; Do not include any infractions that are not misdemeanors or felonies; Do not include any conviction(s) for which the record has been judicially ordered, sealed, expunged, or statutorily eradicated; Do not include any misdemeanor conviction(s) for which probation has been successfully completed or otherwise discharged and the case has been judicially dismissed; Do not include any arrest(s) or detention(s) that did not result in a conviction; Do not include any arrest for which a pretrial diversion program has been successfully completed; Do not include any referral(s) to, or participation in, any pretrial or post trial diversion program(s); Do not include any misdemeanor or felony convictions if a full pardon has been granted.”

NOTE: Answering “Yes” to either or both of these questions is not an absolute bar to employment. The number of conviction(s), pending criminal charge(s), and/or arrest(s), their nature and gravity, their recentness, evidence of rehabilitation, and the relationship between any criminal activity identified and important elements of the position(s) applied for will be considered. Any inquiry, even though neutral on its face, which has an adverse impact on persons on any protected basis enumerated in the Fair Employment and Housing Act (“FEHA”) or Title VII of the Civil Rights Act of 1964, is permissible only if it is sufficiently related to an essential job function to warrant its use.

� Criminal History Background

Page 4Rev. 08/16

Printed Name

Signature

Today’s Date

Store & Outside Sales positions may have physical requirements that include, but are not limited to:

(1) Lifting of Items, such as sundries or containers of paint weighing from 5 to 65 pounds

(2) Use of electronic equipment including but not limited to computers, point of sale devices, communication devices

(3) Driving a motor vehicle

(4) Climbing ladders

(5) Walking on uneven surfaces, e.g., active construction sites

(6) Interactions with customers, both face-to-face and on the telephone

(7) Interaction with customers relating to color

(8) Standing for long periods of time

(9) Use of a respirator

Some positions in Distribution, Labs, & Manufacturing may have physical requirements that include, but are not limited to:

(10) Lifting of items up to 65 pounds

(11) Use of a respirator

Corporate Office positions may have physical requirements that include, but are not limited to:

(12) Lifting of items up to 10 pounds

(13) Manual dexterity & visual acuity

By signing below, you do acknowledge that you are aware of the physical requirements of this position. You do further acknowledge that it is your responsibility to use proper lifting mechanics and follow all safety precautions.

Yes No� �Are you able to perform the physical requirement(s) of the position for which you are applying?

Yes No� �Do you require any reasonable accommodation(s) to perform the position for which you are applying?

If No, please indicate which physical requirement(s) by number:

� Positions’ Physical Requirements Disclosure

ELIGIBILITY STATUS (cont.)

Printed Name

Signature

Today’s Date

Printed Name

Signature

Today’s Date

Do you wish to receive a copy of any report that is prepared? �(Initials)Yes

�No

I understand that Dunn-Edwards may obtain a “consumer report” or an “investigative consumer report” for all permissible employment-related purposes, which include but are not limited to: employment history verification; education verification; social security number verification; driving records, and criminal court records. Such investigations shall be conducted and reports prepared by Celestial Searches (32700 SE Leewood Lane #67, Boring, OR 97009, 323.638.9442).

I hereby authorize and consent Celestial Searches to obtain the information referred to above in connection with the processing of my application or re-application. For conducting any investigation and preparing any reports, I release Dunn-Edwards, its employees and agents, and all individuals, corporations, or other private or public entities providing information, from any liability for damages that may incur to me as a result of furnishing or attempting to furnish such information.

This application will be considered active for a maximum of thirty (30) days. If you wish to be considered for employment after that time you must reapply. I declare under penalty of perjury that the facts contained in this application, in any resume submitted, in this authorization or in any other accompanying documentation submitted are true and complete to the best of my knowledge. I understand that, fraudulent or false information, documents or other material or significant omissions may disqualify me from further consideration for employment and will be justification for the termination of my employment if discovered at a later date.

In the event of my employment to a position in this Company, I will comply with all rules and regulations of this Company. I understand that the Company reserves the right to require me to submit to a test for the presence of drugs in my system prior to employment and at any time during my employment, to the extent permitted by law. I also understand that any offer of employment may be contingent upon the passing of a physical examination. I consent to the disclosure of the results of any physical examination and related tests to the Company. I also understand that I may be required to take other tests such as personality and honesty tests, prior to and during my employment. I understand that should I decline to sign this consent or take any of the above tests, my application for employment may be rejected or my employment may be terminated. I understand that bonding may be a condition of hire. If it is, I will be so advised either before or after hiring and a bond application will have to be completed.

I further understand that the Company may contact my previous employers. I authorize those employers to disclose to the Company all records and information pertinent to my employment with them. In addition to authorizing the release of any information regarding my employment, I hereby waive any rights or claims I have or may have against my former employers, their agents, employees, and representatives, as well as other individuals who release information to the Company, and release them from any and all liability, claims, or damages that may directly or indirectly result from the use, disclosure, or release of any such information by any person or party, whether such information is favorable or unfavorable to me. I authorize the persons named herein as personal references to provide the Company with any pertinent information they may have regarding myself.

If hired, I agree as follows: My employment and compensation is terminable at-will, is for no definite period, and my employment and compensation may be terminated by either the Company (employer) or me at any time and for any reason whatsoever, with or without good cause.

This is the entire agreement between the Company and me regarding the length of my employment, and the reasons for termination of employment, and this agreement supersedes any and all prior agreements regarding these issues. It is further agreed and understood that any agreement contrary to the foregoing must be entered into, in writing, by the President of the Company. No supervisor or representative of the Company, other than its President, has any authority to enter into any agreement for employment for any specified period of time or make any agreement contrary to the foregoing. Oral representations made before or after you are hired do not alter this Agreement.

If any term or provision, or portion of this Agreement is declared void or unenforceable it shall be severed and the remainder of this Agreement shall be enforceable.

IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK A COMPANY REPRESENTATIVE BEFORE SIGNING.

I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE SAME. (Do not sign until you have read the above statement & agreement.)

� Applicant’s Statement and Agreement

� Consumer Reports Authorization

Page 5Rev. 08/16

Invitation to Self IdentifyEQUAL EMPLOYMENT OPPORTUNITY/AFFIRMATIVE ACTION DATA

Dunn-Edwards is an Equal Opportunity/Affirmative Action Employer, and as such, is required by federal law to maintain and report certain information regarding its employees.

In order to comply with the law(s), you are invited to provide the following information voluntarily. This information will remain CONFIDENTIAL and will be used only for purposes allowed by law. Refusal to provide such information will not subject you to any adverse treatment, nor will it become part of your personnel file. When reported to the government, this data will not identify any specific individual.

Thank you for your cooperation.

Section 1: General Information

Section 2: Please check (❑ ) all that apply. See page 7 for definitions

• Race or Ethnic Identity • Gender • **Veteran Status

❑ Hispanic or Latino ❑ Male ❑ Vietnam Era

❑ White (not Hispanic or Latino ❑ Female ❑ Other Protected Veteran

❑ Black or African American (not Hispanic or Latino) ❑ Recently Separated Veteran

❑ Native Hawaiian or Pacific Islander (not Hispanic or Latino ❑ Armed Forces Service Medal Veteran

❑ Asian (not Hispanic or Latino)

❑ American Indian or Alaskan Native (not Hispanic or Latino) • **Other

❑ Two or More Races (not Hispanic or Latino)

❑ I don’t wish to answer

For Human Resources Use Only: Requisition # Job Group

Your Name Today’s Date

Postion Title

Supervisor or Manager

Rev. 08/16 Page 6

[**Editors note: According to 41 CFR 60-741.42, there are only two circumstances when an employer may ask a disabled applicant to self-identify on a pre-offer basis:(1) The invitation is made when the contractor actually is undertaking affirmative action for individuals with disabilities at the pre- offer stage; or (2) The invitation is made pursuant to a Federal, state or local law requiring affirmative action for individuals with disabilities.According to 41 CFR 60-250.42, there are only two circumstances under which an employer may ask applicants who are Special Disabled Veterans to self-identi-fy on a pre-offer basis:The invitation is made when the contractor actually is undertaking affirmative action for special disabled veterans at the pre- offer stage; or (2) The invitation is made pursuant to a Federal, state or local law requiring affirmative action for special disabled veterans. ]

EEOC RACE/ETHNIC IDENTIFICATION CATEGORIES

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

White (Not Hispanic or Latino)A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Black or African American (Not Hispanic or Latino)A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino )A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Asian (Not Hispanic or Latino)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.

American Indian or Alaska Native (Not Hispanic or Latino)A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.

Two or More Races (Not Hispanic or Latino)All persons who identify with more than one of the above five races.

Individual with a disability (under ADAAA) means any person who:• has an impairment that substantially limits one or more major life activities• a record of such an impairment, or• being regarded as having such an impairment• includes any impairment that is episodic or in remission if it would substantially limit a major life activity when active• prohibits consideration of the ameliorative effects of “mitigating measures” when assessing whether an impairment substantially limits a person’s major life

activities, with one exception

“Veteran of the Vietnam era” - a veteran of the U.S. military, ground, naval, or air service, any part of whose service was during the period August 5, 1964 through May 7, 1975, who served on active duty for a period of more than 180 days and was discharged or released with other than a dishonorable discharge, or was discharged or released from active duty because of a service-connected disability. “Vietnam era veteran” also includes any veteran of the U.S. military, ground, naval, or air service who served in the Republic of Vietnam between February 28, 1961 and May 7, 1975.

“Special disabled veteran” - a person who is entitled to compensation under laws administered by the Department of Veterans Affairs for a disability rated at 30 percent or more; or, rated at 10 or 20 percent, if it has been determined that the individual has a serious employment disability; or, a person who was dis-charged or released from active duty because of a service-connected disability.

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

“Recently separated veteran” - any veteran who served on active duty during the three-year period beginning on the date of such veteran’s discharge or release from active duty[5].

“Other protected veteran” - any other 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.

“Armed Forces Service Medal Veteran” - 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 (61 Fed. Reg. 1209).

Rev. 08/16 Page 7

Voluntary Self-Identification of DisabilityForm CC-305

OMB Control Number 1250-0005 Expires 1/31/2017

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.1 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.

Reasonable Accommodation NoticeFederal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

1Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

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 scierosis (MS) Impairments requiring the use of a wheelchair

Diabetes Schizophrenia Missing limbs or partially missing limbs

Intellectual disability (previously called mental retardation)

Epilepsy Muscular dystrophy

Please check one of the boxes below:

❑ Yes, I have a disability (or previously had a disability)

❑ No, I don’t have a disability

❑ I don’t wish to answer

Your Name Today’s Date

Rev. 08/16 Page 8