EMPLOYMENT HISTORY

Begin with the most recent employer, and fill in all the blanks. Attach current resume if available, at the end of this form, but not in place of completing the required information.

ARBITRATION

I agree that all claims between the parties will be presented to a neutral arbitrator for final and binding decision after investigation procedures with the Equal Employment Opportunity Commission or an appropriate state agency are complete. Nothing in this agreement affects my right of the Company's right of access to National Labor Relations Board proceedings or petition for judicial review of a decision issued by a state agency after an administrative hearing. This agreement, including any contest to the validity or enforceability of this agreement, shall be governed by the Federal Arbitration Act and AAA National Rules for the Resolution of Employment Disputes.

I also agree that if any court of competent jurisdiction declares that any part of the Arbitration Agreement is illegal, invalid, or unenforceable, such a declaration will affect the legality, validity, or enforceability of the remaining parts of the Agreement, and the illegal, invalid, or unenforceable part

(s) will no longer be part of the Agreement.

THIS AGREEMENT IS A WAIVER OF ALL RIGHTS TO CIVIL COURST ACTION FOR TERMINATION, UNLAWFUL HARASSMENT, DICRIMINATION, DEMOTION OR REFUSAL TO HIRE. ONLY THE ARBITRATOR, NOT A JUDGE OR JURY, WILL DECIDE THE CLAIM OR DISPUTE.

APPLICANT STATEMENT

US Petroleum Partners, LLC policy is to fill every position without regard to race, color, religion, creed, sex, marital status, age, national origin, ancestry, disability, medical condition, or any other consideration made unlawful by applicable federal, state or local laws. US Petroleum Partners is an equal opportunity employer and selects employees on the basis of qualifications. Please contact the Human Resources Department of US

Petroleum Partners if you have any questions or complaints regarding this policy.

I authorize investigation of all statements contained in this application. I understand that falsification, misrepresentations or omission of facts requested will result in immediate dismissal removal of my application for consideration. I authorize US Petroleum Partners to secure information about my experience with former employers, educations institutions, and agencies and for those parties to provided information concerning my history.