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Acknowledgements

I do hereby authorize the furnishing, without liability, of records and other information that Maxum Petroleum may request in its evaluation of my qualifications for employment.

In consideration of my employment, I agree to conform to the rules and regulations of Maxum Petroleum, Inc. and its subsidiaries. I also agree that my employment and compensation can be terminated at will (i.e. with or without cause, and with or without notice, at any time, at the option of either the firm or myself). I understand that no manager or representative of Maxum Petroleum, Inc. other than the President and CEO, has any authority to enter into any agreement for employment other than on an at-will basis.

This certifies that this application was completed by me, and that all entries on it and the information in it are true and complete to the best of my knowledge. I understand that any false information contained in this application is cause for discharge at any time during my employment.

Applicant’s Name (Please Print) ____________________________________________________________________________________

Applicant’s Signature

_____________________________________________________________________

Date

_______________________

2011 Maxum Petroleum, Inc.

500 River East Drive | Belle, WV 25015 | (304) 926-3002 | www.maxumpetroleum.com

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