Disciplinary Occurrence & Action

*** Please Print Legibly***

INFORMATION ABOUT THE EMPLOYEE BEING DISCIPLINED:

FULL NAME: MARIUS PATRUNJEL JOB TITLE: OWNER OPERATOR’S DRIVER

INFORMATION ABOUT THE INCIDENT:

DATE: 12/22/2023 TIME:

LOCATION OF INCIDENT:

INDICATE BELOW THE PROBLEM THAT OCCURRED AND ACTIONS TAKEN TO INFORM THE EMPLOYEE AND
IF ANY DISCIPLINE ACTIONS WERE REQUIRED:

We would like to bring to your attention a critical safety concern observed recently. Backing up on a highway poses
an extreme risk to yourself and others on the road. Such actions can lead to accidents, injuries, and even fatalities.
Please adhere to traffic regulations and prioritize safety at all times. Avoid any maneuvers that jeopardize the
well-being of yourself and fellow road users. In light of this, we require you to undergo immediate retraining to
reinforce safe driving practices. Your cooperation is imperative to ensure the well-being of all road users. Failure to
comply with this mandatory retraining may result in further action. Please sign this letter to acknowledge that you
understood by Jan 03, 2024.

The Company reserves the right to impose a more severe form of discipline, up to and including suspension and discharge for more
serious forms of employee Behavioral infractions.
Supervisors are to report such incidents to their manager for final disposition.
PLEASE CHECK IF APPLICABLE WHICH DISCIPLINARY STEP WAS TAKEN:

Minor offense
XX Medium offense
Suspension
Termination
Anita Nesairudayam 12/28/2023 .
Supervisor Signature & Date
EMPLOYEE
I, MARIUS PATRUNJEL ,by signing below, indicate that I fully understand the problem that occurred and
what measures my immediate supervisor has taken to correct or discipline myself in this matter;

Employee Signature: Date: