Table Of ContentAPPLICATION FOR EMPLOYMENT
We are an equal opportunity employer. We do not discriminate in hiring, promotion, or other employment decisions on the basis of race, sex, color,
pregnancy, religion, national origin, sexual orientation, marital status, disability, age, veteran, or any other basis protected by law. Equal access to programs,
services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process
should notify a representative of the Human Resources Department.
PLEASE PRINT (USE INK)
PERSONAL:
Name:___________________________________________________________________
(Last) (First) (Middle)
Current Address:___________________________________________________________________ Telephone:_________________________
(Street) (City) (State) (Zip Code) (Include Area Code)
Permanent Address (if different)
_________________________________________________________________________________ Telephone:_________________________
(Street) (City) (State) (Zip Code)
Have you ever applied for employment here before? _____ Yes _____ No If yes, when?_______________________________________________
Have you ever worked for our company before? _____ Yes _____ No If yes, where?______________________________________________
Dates of Employment__________________________________________ Reason for Leaving _________________________________________
WORK EXPERIENCE:
PRESENT OR MOST RECENT EMPLOYMENT
Company_____________________________________ Address ___________________________________________________________________
(Street) (City) (State)
May We Contact Your Present Employer? _____ Yes _____ No
Name and Title of
Telephone______________________ Kind of Business_________________________ Immediate Supervisor________________________________
(Include Area Code)
Employed From _______________________ to _________________________ Job Title___________________________________________
(Mo., Yr.) (Mo., Yr.)
Duties Performed____________________________________________________________________________________________________________
Starting Hourly Wage___________ Final Hourly Wage_____________ Reason for Leaving_______________________________________________
WORK EXPERIENCE:
Are you a licensed plumber in the State of New Hampshire? ______ Yes ______ No
If you are an apprentice plumber, are you registered with the state? ______ Yes _____ No What year apprenticeship are you in? _________
Do you have a NH Gas License? ______ Yes _____ No What Type? _________________________________________________________
Do you have your CFC certification? _______ Yes ______ No What Type? _____ 1 _____2 _____3 _____ Universal
Please describe or list any pipe fitting and or pipe welding experience you have:
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Please describe or list any refrigeration and or air conditioning experience you have:
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Page 1 of 3
WORK EXPERIENCE:
Please describe or list any gas and or oil burner experience you have:
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Please describe or list any temperature controls or electrical experience you have:
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Please describe or list any sheet metal or ductwork experience you have:
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Please describe or list any additional experience you have that may be relevant to the position you are applying for:
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
PREVIOUS EMPLOYMENT:
Company_____________________________________ Address ___________________________________________________________________
(Street) (City) (State)
Name and Title of
Telephone______________________ Kind of Business_________________________ Immediate Supervisor________________________________
(Include Area Code)
Employed From _______________________ to _________________________ Job Title___________________________________________
(Mo., Yr.) (Mo., Yr.)
Duties Performed____________________________________________________________________________________________________________
Starting Hourly Wage ___________ Final Hourly Wage ____________ Reason for leaving______________________________________________
PREVIOUS EMPLOYMENT:
Company_____________________________________ Address ___________________________________________________________________
(Street) (City) (State)
Name and Title of
Telephone______________________ Kind of Business_________________________ Immediate Supervisor________________________________
(Include Area Code)
Employed From _______________________ to _________________________ Job Title___________________________________________
(Mo., Yr.) (Mo., Yr.)
Duties Performed____________________________________________________________________________________________________________
Starting Hourly Wage___________ Final Hourly Wage_____________ Reason for leaving_______________________________________________
Page 2 of 3
PREVIOUS EMPLOYMENT: (Use additional sheets if necessary to describe all previous employment)
Company_____________________________________ Address ___________________________________________________________________
(Street) (City) (State)
Name and Title of
Telephone______________________ Kind of Business_________________________ Immediate Supervisor________________________________
(Include Area Code)
Employed From _______________________ to _________________________ Job Title___________________________________________
(Mo., Yr.) (Mo., Yr.)
Duties Performed____________________________________________________________________________________________________________
Starting Hourly Wage___________ Final Hourly Wage_____________ Reason for Leaving_______________________________________________
EDUCATION: Degree Received Type of Degree
Name City/State Yes or No Diploma or GED Major
High School ____________________________ __________________________ __________ ____________________ __________________
College ____________________________ __________________________ __________ ____________________ __________________
Other ____________________________ __________________________ __________ ____________________ __________________
Trade School ____________________________ __________________________ __________ ____________________ __________________
Certifications or additional trade programs completed: ______________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
GENERAL:
Are you authorized to work in the United States? ______ Yes ______ No (Proof of citizenship or immigration status will be required upon employment.)
Are you 18 years old or older? ______ Yes ______ No How did you happen to contact our company?_______________________________________
Are you available to work full-time ______ part-time ______ temporary ______? If part-time, indicate maximum hours per week _________________
What position are you applying for?_____________________________________________ Starting salary desired_____________________________
Can you perform the essential functions of the job with or without reasonable accommodation? ______ Yes ______ No
Are you currently on layoff or leave from another employer? ______ Yes ______ No
Do you have a valid driver’s license? ______ Yes ______ No
CONVICTION INFORMATION:
Have you ever been convicted of a crime that has not been annulled, except for minor traffic violations? ______ Yes ______ No (If yes, please fill in
information below.)
Conviction information will not necessarily bar an applicant from employment.
Date Reason Disposition of Case Place
1. __________________ ______________________________ ____________________________________ ____________________________
2. __________________ ______________________________ ____________________________________ ____________________________
NOTICE: PLEASE READ BEFORE SIGNING
I understand that as a condition of my employment I must pass a drug test and a fitness for duty physical examination.
If I am hired, I agree to abide by the rules and policies of the Company.
I understand that if I am hired, my employment will be for no definite period, and that my employment and compensation can be terminated with or
without cause and without notice, at any time, at the option of either the Company or me.
I authorize all persons, companies, prior employers, schools, credit bureaus, and government agencies to supply any information concerning my
background, education, and employment, and release all parties from all liability for any damage that may result from furnishing same to you. I also
release the Company and its agents from all liability from damages arising from this research of my background.
I certify that the information contained in this application is complete and correct to the best of my knowledge and understand that falsification of
this information is grounds for dismissal in accordance with Company policy.
I certify that all of the information that I provide on this application or in any interview will be complete, true, and accurate. I understand that if I
am hired, and any such information is later found to be incomplete, false, or misleading in any respect, I may be discharged.
I have read and fully understand the above Notice Section.
______________________________________ ______________________________________________________ __________________________
(Print Name) (Signature) (Date)
Page 3 of 3
Job Description: Apprentice Plumber Exempt or Non-Exempt
This position provides help and support along with hands on training in plumbing and piping installation at job
sites under the direct report of a journeyman plumber and the field foreman.
Critical responsibilities include effective communication with co-workers, project foreman and other
contractors/subcontractors on-site; adherence to safety procedures; quality production & cost control; and other
duties as necessary to facilitate the completion of assigned jobs in a timely manner.
Experience/Certifications Required:
NH Apprentice Plumbing License.
Enrolled and actively completing an approved plumbing classroom program.
10 hour OSHA card.
NH Gas Trainee license after 6 months of employment.
Tools:
Must have all tools listed on the E&J required tool list.
Work Environment: Noise, dust, welding flash, temperature variations and difficult-to-access areas are a part
of some job sites. When necessary, protective gear is required.
Key Duties:
Responsible for listening, following direction and asking questions if you are unsure on what or how to
do something safely or correctly.
Responsible for showing the desire to learn and perform quality work.
Responsible for taking the initiative to keep busy and learning what the next step is. As you progress
through your apprenticeship, you will be expected to work towards the knowledge and responsibilities
of a journeyman plumber.
Responsible for learning plumbing & mechanical installations and making sure that you have the
information and materials you need to perform your duties efficiently and correctly.
o ALL installations are per the project plans and specifications.
o ALL installations are per the state & local codes:
Plumbing Code; Mechanical Code; Gas Code; ADA; Energy Code.
o ALL installations are per submittals & manufacturer’s installation instructions.
o ALL installations meet E&J standard of quality.
o Any questions, concerns or discrepancies must be brought to the project foreman’s attention.
Making sure you request equipment, materials and tools before you need them.
o Making sure daily materials and tool requests are given to your foreman by noon time.
o Making sure you are planning and looking ahead and your materials and tool request are 2 days
ahead of when you need them.
o It is your responsibility to help make sure tools, materials and equipment are on site when
needed.
o Making sure materials in the trailer and on the job site are organized.
Establish and maintain a positive relationship with co-workers, clients and on-site
contractors/subcontractors.
Follow all industry, state, job/client specific and OSHA safety standards.
Ensure maintenance and security of project documents, equipment, tools and materials.
o Help maintain an accurate list of tools assigned to the project.
o Take responsibility for using tools and equipment correctly and making sure they are organized
and locked up at the end of the day.
Maintain an accurate record of your time.
o Make sure your time card goes with you if you move from one job to another.
o Make sure you sign your time card each week and verify information is correct.
Taking a personal responsibility and pride in your work ethic and workmanship.
ECKHARDT & JOHNSON BENEFIT SUMMARY
EFFECTIVE 10-1-15
Eckhardt & Johnson will provide a defined monthly contribution toward the cost of employee benefits. The amount listed below
may be applied to the Medical, Dental, Vision and Accident plans.
Single: $382
Couple: $810
Employee & Child(ren): $741
Family: $1,095
Health Insurance
- Eligible 90 days after hire date.
- E&J offers three choices of Anthem Blue Cross/Blue Shield health plans.
o Anthem Elements Choice New England (Coverage within New England)
Single: $331.90 per month
Couple: $736.82 per month
Parent/Child(ren): $670.43 per month
Family: $1,008.97 per month
Single deductible: $5,900 – employee pays $4,900; employer reimburses remaining $1,000
Family deductible: $11,800 – employee pays $9.800; employer reimburses remaining $3,000
See plan documents for specific details and restrictions.
o Anthem Matthew Thornton Blue HMO (Coverage In New Hampshire Only)
Single: $436.64 per month
Couple: $969.35 per month
Parent/Child(ren): $882.01 per month
Family: $1,327.39 per month
Single deductible: $3,000 – employee pays $2,000; employer reimburses remaining $1,000
Family deductible: $9,000 – employee pays $6,000; employer reimburses remaining $3,000
See plan documents for specific details and restrictions.
o Anthem HMO New England (Coverage within New England)
Single: $463.06 per month
Couple: $1,027.99 per month
Parent/Child(ren): $935.37 per month
Family: $1,407.70 per month
Single deductible: $3,000 – employee pays $2,000; employer reimburses remaining $1,000
Family deductible: $9,000 – employee pays $6,000; employer reimburses remaining $3,000
See plan documents for specific details and restrictions.
Dental Insurance
- Eligible 90 days after hire date.
o Anthem Dental Insurance
Employee: $36.78 per month
Employee & 1 dependent: $74.14 per month
Employee & 2 or more dependents: $135.23 per month
See plan documents for specific details and restrictions.
Vision Insurance
Included with any of our Anthem Health plans; also available separately if you are not
enrolled in our health plan
Employee: $5.82 per month
Employee & 1 dependent: $10.19 per month
Employee & 2 or more dependents: $16.30 per month
See Plan for specific details and restrictions.
Accident Insurance
o TransAmerica Accident Plan
Single: $15.75 per month
Couple: $24.25 per month
Parent/Child(ren): $19.83 per month
Family: $29.33 per month
See plan documents for specific details and restrictions.
~~~~~
How to calculate the weekly cost of coverage, based on single coverage:
Elements health plan and Anthem Dental $368.67
Minus Employer Contribution (382.00)
Equals $ 0.00/month
Multiply by 12 months $ 0.00/year
Divide by 52 pay periods $ 0.00 weekly pre-tax deduction
~~~~~
How to calculate the weekly cost of coverage, based on family coverage:
Elements health plan and Anthem Dental $1,157.78
Minus Employer Contribution ( 1,095.00
Equals $ 62.78/month
Multiply by 12 months $ 753.36/year
Divide by 52 pay periods $ 14.49 weekly pre-tax deduction
~~~~~
Life Insurance
- Eligible following 90 days after hire date.
Employer paid $ 10,000 term life insurance and AD&D policy.
Voluntary term life insurance can be purchased in $ 10,000 increments at group rates.
Maximum $ 300,000 per person, or 5 times base earnings, whichever is less
Subject to underwriting approval.
Disability Insurance
- Eligible following 90 days after hire date.
o Short- Term Disability
Employer paid short-term disability insurance
Eligible on the 8th day of an illness or accident
Maximum of 13 weeks of benefits
Maximum weekly benefit is 66.7% of your weekly earnings, up to $750 per week
o Long- Term Disability
Voluntary long-term disability insurance can be purchased.
Long-term disability starts when the short-term disability ends.
Weekly benefit can be any amount up to 60% of your monthly earnings, up to $ 5,000.00.
Open enrollment for voluntary products is October 1st of each year.
See Plan for specific details and restrictions.
Flexible Benefit Accounts
o Medical Savings Account
Eligible 90 days after hire date.
Employee can elect to have a weekly pre-tax amount deducted from his/her salary to be used
to pay for any medical necessary expenses.
Dental work, eye care, insurance & prescription co-pays, insurance deductible
payments, saline solution, cold medicine.
Medical Savings Account limit for 2015 is $2,550.00.
See plan documents for specific details and/or restrictions.
o Dependent Care
Eligible first of the month following 3 months after hire date.
Employee can elect to have a weekly pre-tax amount deducted from his/her salary to be used
to pay for day care expenses for your child, parent, or other qualified dependent.
Maximum account limit for 2015 is $ 5,000.00.
See plan documents for specific details and restrictions.
OPEN ENROLLMENT IS IN OCTOBER OF EACH YEAR, IF YOU DECIDE NOT TO PARTICPATE IN ANY OF THESE
PLANS YOU WILL NOT BE ABLE TO DO SO UNTIL OPEN ENROLLMENT, UNLESS YOU HAVE A LIFE STATUS
CHANGE, EX: CHILDREN BORN, MARRIAGE, DIVORCE, LOSS OF COVERAGE, ETC.
401-K Retirement Plan
- Eligible six months from date of hire quarterly – January, April, July and October, on the first day of the month.
- Employee can make pre-tax contributions up to the IRS limit. The limit for 2015 is $ 18,000.00
- You must be 18 years of age to participate, and work a minimum of 30 hours per week.
- Employer can make company option profit sharing contributions.
- The employer will match your contributions dollar-for-dollar on the first 3% of contributions, and $.50 on the next 2%.
- See plan documents for specific details and restrictions.
Vacation and Paid Holidays
o Holiday
Eligible for paid holidays 6 months after hire date.
New Year’s Day, Memorial Day, Independence Day, Labor Day,
Thanksgiving Day, Christmas Day
o Vacation
Eligible for one week vacation after 1 year of continuous employment.
Eligible for two weeks’ vacation after 2 years of continuous employment.
Eligible for three weeks’ vacation after 6 years of continuous employment.
Education and Training
o Registered Plumbing Apprentice Program
Company paid apprenticeship training
o Educational Assistance Policy
E&J offers an education assistance program that makes available $2,000.00 annually for
tuition reimbursement
o Tool Assistance Policy
E&J provides financial assistance for the purchase of tools to all eligible full-time employees,
to help obtain the tools required for their specific trade
Uniforms
o Service Department
Apprentices are given 10 logo t-shirts, to be worn at all times.
Service technicians are provided with Eckhardt & Johnson logoed uniforms, along with a
logoed jacket for cold weather.
All field personnel are provided with a hard hat, safety glasses and reflective vest.
o Field Personnel
All field personnel are given 10 logo t-shirts, to be worn at all times.
Service technicians are provided with Eckhardt & Johnson logoed uniforms, along with a
logoed jacket for cold weather.
All field personnel are provided with a hard hat, safety glasses and reflective vest.
Description:______ Yes ______ No What Type? _____ 1 _____2 _____3 _____ Universal. Please describe or list any pipe fitting and or pipe welding experience