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Washington Works - DuPont

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Contract Administration Initiated: 07/1992 CAG-07Site Conditions SC1 Revised: 05/2013 Monitor: John SorokaRetention: 3 yrs after obsolete or superseded Revision Due: 10/2015 Page 38( EXAMPLE )APPENDIX BE. I. du Pont de Nemours and CompanyFebruary 20, 2012E. I. du Pont de Nemours and Company8480 <strong>DuPont</strong> Road<strong>Washington</strong>, WV, 26181To: <strong>DuPont</strong> <strong>Washington</strong> <strong>Works</strong> Security;( Fax: 304-863-2814 )The named individuals below have completed the following requirements with no noted discrepancies or ifthere is a discrepancy, the date of the accepting email from “Date <strong>DuPont</strong> Approval” is provided:1. Prothonotary's office / County Courthouse search of criminal records for the past seven (7) year period(misdemeanor & felony)2. National Criminal File Search / Multi-State Criminal File Search3. Legal Authorization to work (I-9, E-Verify)4. Social Security Number verification and validation (the SSN is good and belongs to the personpossessing the number)5. Completed a ( 7 ) panel Drug Screen with negative result in compliance with <strong>DuPont</strong> Policy.Contractor Employee Name(s):Name of Employee(As shown on Photo ID)Previously assigned to:(<strong>DuPont</strong> Site Name)William P. Reiter Jr. 1Donald J Ostmann Belle 1-1-2012 2Lorraine S. Parker 02/6/12 3Robert T. Williams – National Database Only 5Date of <strong>DuPont</strong>ApprovalXavier R. SmithHuman Resource ManagerCopyright © 2012 E. I. du Pont de Nemours and Company. All rights reserved

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