Team Senior Vehicle Inspection Checklist
| Purpose of Inspection | New Hire - MVR REQUEST |
| Location |
6616 13201 Pond Springs Rd ste 102 Austin, TX 78729 |
| Date | January 5, 2022 |
| Driver First Name |
Noah
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| Driver Middle Name | |
| Driver Last Name |
Vasquez
|
| Vehicle Owner's Name | Other |
| Name of Owner |
Tricia Vasquez
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| Photo of Drivers License | |
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| Driver's License State | Texas |
| State | |
| Drivers License# |
44213925
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| Was Driver licensed in another state? | No |
| State | |
| License Plate Number |
Pwf4181
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| License Plate State | Texas |
| Multiple Choice | |
| Photo of registration | |
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| INSURANCE | |
| Photo of insurance card | |
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| Insurance Company |
Geico
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| Policy Number |
6055421934
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| Expiration Date | March 4, 2022 |
| Vehicle | |
| Year |
2021
|
| Make |
Ford
|
| Model |
F-150
|
| Mechanical | |
| Seat Belts | Pass |
| What needs to be fixed? | |
| Brakes | Pass |
| What needs to be fixed? | |
| Horn | Pass |
| What needs to be fixed? | |
| Windshield and wipers | Pass |
| What needs to be fixed? | |
| Tires (Safe Thread Depth-Use a penny to show depth) | Yes |
| Photo | |
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| Both headlights (High and Low Beam) | Pass |
| What needs to be fixed? | |
| Back-Up Lights | Pass |
| What needs to be fixed? | |
| Brake lights | Pass |
| What needs to be fixed? | |
| Both tail lights | Pass |
| What needs to be fixed? | |
| Turn signals (Front and Back, Left and Right) | Pass |
| What needs to be fixed? | |
| Vehicle image: | Pass |
| Front of Vehicle Exterior | |
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| Rear of Vehicle Exterior | |
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| Driver's Side Exterior | |
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| Passenger Side Exterior | |
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| Vehicle Interior | |
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| Are there any failures on this inspection? | No |
| Is the driver being pulled from the road? | |
| Re-Inspection Date | |
| Driver's Signature | |
| COMMENTS: | |
| Inspecting Person's Name |
Frank Flores
|
Inspecting Person's Signature
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| Text | |
| Domino's Delivery Experience Driver App Acknowledgement | |
| 1. In furtherance of maintaining a high level of customer service to its customers, SS (the "Company") is requiring its drivers to use a mobile device installed with the Domino's Driver app with each delivery made during working hours. The Driver App is enabled with Global Positioning System ("GPS") location tracking capabilities that allow customers and others to track the location of other drivers and their delivery orders. 2. By using a mobile device installed with the Driver App, you authorize and consent to the use of GPS location-tracking capabilities and the collection and monitoring of GPS location and Driver App information and data by customers, the Company and its parents, subsidiaries, affiliates, personnel, and vendors, Domino's Pizza LLC and its parents, subsidiaries, affiliates, personnel, and vendors, and all other entities and personnel involved in any way in the process of allowing customers to track the location of delivery orders, product and service quality and training purposes, or the use, assessment, maintenance, or modification of the Driver App (collectively, the "Users"). 3. You understand that you will be subject to GPS location-tracking, Driver App information and data collection, and monitoring by the Users when using a mobile device installed with the Driver App. You waive any right to privacy of your location or use of the Driver App. GPS location and Driver App information and data will be used for purposes that include, but are not limited to, allowing customers and others to track the location of drivers and their delivery orders, product and service quality and training purposes, performance management, and assessment, maintenance, and modification of the Driver App. By using a mobile device installed with the Driver App, you agree to the Domino's Privacy Policy available at https://www.dominos.com/en/#/content/privacy/. 4. When using a mobile device installed with the Driver App, you agree to follow safe driving practices and observe applicable traffic and parking laws. This includes, but is not limited to, NOT using a mobile device to send, read, enter any type of electronic message (such as email or text) or content (such as websites or social media), or talk while operating a vehicle. You understand and agree that any routing information made available in the Driver App is only a suggestion and that you must determine the actual route taken based upon current road and traffic conditions and weather before you begin driving. You may not engage in any unsafe driving behavior such as taking your eyes off the road to look at the Driver App. You must pull over to a safe location to use your mobile device for any reason. If at any time you are encouraged or pressured to engage in unsafe conduct, you must immediately contact Chris Senior 512-554-7323. 5. You agree that you will only use the Driver App during working hours and understand that you are responsible for complying with this requirement. You will timely and accurately log into and out of the Driver App using your own Domino's Pulse system user identification and password. You will not share your password, use or attempt to use another individual's password, allow another individual to use a Driver App you are logged into, attempt to use a Driver App another individual is logged into, or otherwise engage in the misuse or falsification of Driver App information or data. If you believe that any of these actions have been taken with respect to your password or information or data, you must immediately contact Chris Senior 512-554-7323. 6. You agree that you will not use a mobile device installed with the Driver App until after you have completed the Company's Driver App training and executed this Acknowledgment. You understand that violation of this Policy may result in disciplinary action up to and including discharge. 7. Subject to the conditions set forth below, you will use your personal mobile device installed with the Driver App for which there will be reimbursement from the Company for its use. You understand and agree that your employment with the Company does not require that you have or use a personal mobile device. 8. You may only use your personal mobile device installed with the Driver App upon the following conditions: (1) you would have purchased the mobile device, data plan, and any peripheral equipment for personal use even if you were not employed with the Company; (2) your mobile device meets any minimum capabilities set by the Company; (3) you will install the Driver App and any updates to the Driver App and the mobile operating system on your mobile device using the store Wi-Fi system; (4) you will use the store Wi-Fi system when using the Driver App at the store; and (5) you will immediately follow the process set forth below to notify the Company of any unreimbursed expenses associated with the use of your personal mobile device installed with the Driver App. 9. Should you elect to use your personal mobile device installed with the Driver App, you will receive reimbursement from the Company for the use of the device. If you believe that you have incurred expenses greater than the amount for which you have been reimbursed, you must contact your supervisor or Franchisee and provide documentation supporting the request for additional reimbursement within 60 days of incurring the expense. 10. You must immediately contact Chris Senior 512-554-7323 with any questions or issues regarding the Driver App or this Policy, including the process to notify the Company of any unreimbursed expenses. | Yes |
| I am the legal owner of the vehicle I will be using while at SS Pizza, Inc. | No |
| If Team Member is not legal owner of the vehicle, insert photo here of acknowledgement signature, date and printed name of legal owner. If Team Member is legal owner insert photo of their signature, date and printed name here. | |
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| Photo of the current vehicle mileage | |
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| Photo of Social Secury Card | |
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