Apply Now

J.B. Coxwell Careers

J.B. Coxwell Contracting, Inc. is regularly filling positions for field personnel such as truck drivers, equipment operators, and laborers. Please apply online by filling out the form below or come to our local office and apply in person. We are an equal opportunity employer and proud to be a drug-free workplace. Screening tests for illegal drug use are required as a condition of employment.

Driver Application

Step 1 of 14

JB COXWELL CONTRACTING

6741 Lloyd Road West
Jacksonville, FL 32254
904.786.1120
Personal Information
TO BE READ AND SIGNED BY APPLICANT
I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:
- Review information provided by current/previous employers;
- Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and
- Have a rebuttal statement attached to the alleged erroneous information if the previous employer(s) and I cannot agree on the accuracy of the information.
Sign Here*
Date*
Name*
First Middle Last
Social Security No.*
Phone Number*
Date Of Birth*
Hire Date
Actual Address*
Street Address City State / Province / Region ZIP / Postal Code
Number of Years at Your Actual Address
Past 3 Years Address
Street Address City State / Province / Region ZIP / Postal Code
Number of Years at That Address

EXPERIENCE AND QUALIFICATION
Driving Experience
Driving experience in the last 3 years*
- Yes
- No
CLASS OF EQUIPMENT #1: Straight Truck
Dates (From - To)
Approximate Number of Miles (Optional)
CLASS OF EQUIPMENT #2: Tractor & Semi-Trailer
Dates (From - To)
Approximate Number of Miles (Optional)
CLASS OF EQUIPMENT #3: Tractor – Two Trailers
Dates (From - To)
Approximate Number of Miles (Optional)
CLASS OF EQUIPMENT #4: Tractor – Three Trailers
Dates (From - To)
Approximate Number of Miles (Optional)
CLASS OF EQUIPMENT #5: Motorcoach - School Bus (Greater than 8 passengers)
Dates (From - To)
Approximate Number of Miles (Optional)
CLASS OF EQUIPMENT #6: Motorcoach - School Bus (Greater than 15 passengers)
Dates (From - To)
Approximate Number of Miles (Optional)
Other Class And Type of Equipment
Class And Type of Equipment
Dates (From - To)
Approximate Number of Miles (Optional)

Accident History (3 years)
Any accident in the last 3 years*
- Yes
- No
Accident #1
Date (Month/Year)
NATURE OF ACCIDENT (head-on, rear end, upset, etc.)
NUMBER OF FATALITIES
NUMBER OF INJURIES
HAZARDOUS MATERIALS SPILL
- Yes
- No
Accident #2
Date (Month/Year)
NATURE OF ACCIDENT (head-on, rear end, upset, etc.)
NUMBER OF FATALITIES
NUMBER OF INJURIES
HAZARDOUS MATERIALS SPILL
- Yes
- No
Accident #3
Date (Month/Year)
NATURE OF ACCIDENT (head-on, rear end, upset, etc.)
NUMBER OF FATALITIES
NUMBER OF INJURIES
HAZARDOUS MATERIALS SPILL
- Yes
- No

Traffic Convictions and Forfeitures (3 years)
Traffic convictions and/or forfeitures in the last 3 years*
- Yes
- No
1- DATE CONVICTED (Month/Year)
1- VIOLATION (other than violations involving parking only)
1- STATE OF VIOLATION
1- PENALTY
2- DATE CONVICTED (Month/Year)
2- VIOLATION (other than violations involving parking only)
2- STATE OF VIOLATION
2- PENALTY
3- DATE CONVICTED (Month/Year)
3- VIOLATION (other than violations involving parking only)
3- STATE OF VIOLATION
3- PENALTY

License Information
Driver licenses or permits held in the past 3 years
1- Licensing Authority (State/Province/Territory)*
1- License No.*
1- Class*
1- Endorsements*
1- Expiration Date*
2- Licensing Authority (State/Province/Territory)
2- License No.
2- Class
2- Endorsements
2- Expiration Date
3- Licensing Authority (State/Province/Territory)
3- License No.
3- Class
3- Endorsements
3- Expiration Date
A- Have you ever been denied a license, permit, or privilege to operate a motor vehicle*
- Yes
- No
B- Has any license, permit or privilege ever been suspended or revoked*
- Yes
- No
IF THE ANSWER TO EITHER A OR B IS YES, GIVE DETAILS:

SAFETY PERFORMANCE HISTORY RECORDS REQUEST
RECIPIENT EMPLOYER: The individual identified in SECTION 1 below has indicated that you employ(ed) or use(d) them within the last 3 years in a position that involved the operation of a commercial motor vehicle.

In accordance with 49 CFR §391.23, we are hereby requesting that you supply us with the Safety Performance History of this individual.

Under DOT rule §391.23(g), you must respond to this inquiry within 30 days of receipt.

APPLICANT: Complete SECTION 1 and submit to prospective employer.
SECTION 1: TO BE COMPLETED BY PROSPECTIVE EMPLOYEE
I, (Print Name):
Name*
First Middle Last
Social Security*
Date of Birth*
hereby authorize:
Previous Employer*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Email*
Phone*
FAX No.
To release this information in a written form that ensures confidentiality, such as fax, email, or letter, to: JB COXWELL CONTRACTING
Attention
Telephone
Address
Street Address City State / Province / Region ZIP / Postal Code
Prospective employer’s confidential FAX number
Prospective employer’s confidential Email address
Signature*
Date*

EMPLOYMENT INVESTIGATION VERIFICATION
Please complete the following fields if:
Driver has been employed with current employer for three (3) years or more.
And/Or
Driver noted they did not have any previous employment experience working in a DOT regulated position in the preceding three (3) years, other than the current employer.
Driver's Name
First Last
Company Name
Driver’s Hire Date
Date Driver Began Driving for Current Employer (if different from hire date)
Supervisor’s Signature
Date
This is to fulfill Section 391.23/40.25 of the Federal Motor Carrier Safety Regulations relating to investigating into previous employment.

DRIVER’S LICENSE INFORMATION REQUEST
Company Name
Location Name
Employee Name
Employee Code
Please complete the following information exactly as it appears on the driver’s license:
Name
First Middle Last
Date of Birth
Driver’s License Number
State of License/Province
Issue Date
Expiration Date
Endorsement
Class
CDL Information
- CDL
- Non CDL
Utilizing CDL
- Yes
- No
Primary Method of Logging Hours
- Time Sheets
- Grid Logs
Company Representative Signature

ACKNOWLEDGMENT AND AUTHORIZATION FOR BACKGROUND CHECK
I acknowledge receipt of the separate document entitled DISCLOSURE REGARDING BACKGROUND INVESTIGATION, DISCLOSURE REGARDING INVESTIGATIVE BACKGROUND INVESTIGATION and A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT and certify that I have read and understand both of those documents. I hereby authorize the obtaining of “consumer reports” (i.e. driving records, criminal history, social security verification, and/or education history) and/or “investigative consumer reports” (i.e. employment and/or education verification) by EMPLOYER (“Employer”) at any time after receipt of this authorization and throughout my employment, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by J. J. Keller & Associates, Inc., PO Box 368, Neenah, WI 54957-0368, (877)-564-2333, www.jjkeller.com and/or Employer. I agree that a facsimile (“fax”), electronic or photographic copy of this Authorization shall be as valid as the original.
Employer Name*
Name*
First Middle Last
Date of Birth*
Social Security Number (SSN)**
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Signature*
Date*
**SSN is required for the state of Illinois

ACKNOWLEDGMENTS
COMPLETION OF THIS PAGE IS REQUIRED

Please read and initial each of the following:
1. I certify that all statements I have made in this application are true and agree that any misrepresentation or omission of facts requested may be sufficient cause for cancellation of my application or immediate dismissal from the Company if I have been employed. In the event I am employed, I agree to conform to the rules and policies of the Company. Understand that these rules and policies may be changed, interpreted, withdrawn, or added to at the Company's option at any time without notice.
INITIALS*
2. I understand that employment is contingent upon meeting the physical requirements of the job and passing, to the Company's satisfaction, a drug screen. Depending upon the nature of the job for which I am applying, I understand that the satisfactory completion of post-hire physical examination may also be required.
INITIALS*
3. I acknowledge the Company's notification to me that a background investigation or an investigative consumer report on me may be made. I understand and agree that successful completion to the Company's satisfaction of such investigation(s) is required for employment or continued employment. I, hereby, authorize the Company to conduct or have conducted the investigation(s) described above, and to prepare or cause to be prepared a report based on such information. Further understand that, upon my written request, a complete disclosure of the nature and scope of the investigation(s) conducted will be provided to me.
INITIALS*
4. I understand that my employment may be terminated, with or without cause, and with or without notice, at any time, at the option of either the Company or me. I acknowledge that I do not have a contract of employment with the Company and that, in the future, I will not have any contractual rights of employment unless such rights are made part of a written agreement executed by me and by a Vice President or higher level officer of the Company.
INITIALS*
5. I agree that the Company's liability to me for wages is limited to the amount earned by me as of the date of such termination. I also authorize the Company to deduct at any time any monies owed by me to the Company whenever such deduction is not prohibited by law.
INITIALS*
6. I understand that federal law prohibits the employment of unauthorized aliens and that all persons hired must submit satisfactory proof of employment authorization and identity, generally within three days of being hired. I further understand that the failure to submit such proof within the required time will result in immediate dismissal from the Company if I have been employed.
INITIALS*
7. I understand that my disclosure of prior convictions for criminal or traffic offenses will not necessarily prevent my employment with the Company; however, the omission of this requested information will be sufficient cause for the cancellation of my application or my immediate dismissal from the Company.
INITIALS*
8. I have read and agree to the above acknowledgments.
INITIALS*
Signature*
Date*

ALCOHOL AND CONTROLLED SUBSTANCE POLICY EMPLOYEE ACKNOWLEDGEMENT FORM
1- I do hereby acknowledge that I have received and read the J.B. Coxwell Contracting, Inc. Alcohol and Contolled Subatnce and Testing Policy.
Initials*
2- I understand that if my performance indicates it is necessary, or in the case of random testing, I will submit to a substance abuse test.
Initials*
3- I also understand that failure to comply with a substance abuse test request, or a positive result may lead to termination of employment and denial of unemployment benefits.
Initials*
4- I understand that failure to submit to a substance abuse test, or a positive test result may affect my right to obtain workers' compensation benefits.
Initials*
5- I further agree to and hereby authorize the release of the results of said tests to the company. Nothing in this consent form is to be construed as a contract between the parties.
Initials*
Date*

Applicant Certification
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
Applicant's Signature*
Date*
This form is made available with the understanding that JB COXWELL CONTRACTING is not engaged in rendering legal, accounting, or other professional services. JB COXWELL CONTRACTING assumes no responsibility for the use of this form, or any decision made by an employer which may violate local, state, or federal law.

Copyright 2024 JB COXWELL CONTRACTING., 6741 Lloyd Road West, Jacksonville, FL 32254 • 904.786.1120

This link ( https://www.floridablue.com/members/tools-resources/transparency ) leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to access and analyze data more easily.

Apply Now – Driver

Apply Now

Driver Application

Step 1 of 14

JB COXWELL CONTRACTING

Personal Information

TO BE READ AND SIGNED BY APPLICANT

Employment History

Current or Last Employer

Second Last Employer

Third Last Employer

Fourth Last Employer

Fifth Last Employer

Sixth Last Employer

EXPERIENCE AND QUALIFICATION

Driving Experience

Accident History (3 years)

Traffic Convictions and Forfeitures (3 years)

License Information

SAFETY PERFORMANCE HISTORY RECORDS REQUEST

SECTION 1: TO BE COMPLETED BY PROSPECTIVE EMPLOYEE

EMPLOYMENT INVESTIGATION VERIFICATION

DRIVER’S LICENSE INFORMATION REQUEST

ACKNOWLEDGMENT AND AUTHORIZATION FOR BACKGROUND CHECK

ACKNOWLEDGMENTS

COMPLETION OF THIS PAGE IS REQUIRED

Please read and initial each of the following:

VOLUNTARY AFFIRMATIVE ACTION INFORMATION

Completion of this page is voluntary.

ALCOHOL AND CONTROLLED SUBSTANCE POLICY EMPLOYEE ACKNOWLEDGEMENT FORM

Applicant Certification