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#PBT-7220-080963
Supplemental Questionnaire

Last Name
First Name

 

7220 Asphalt Finisher Supervisor I

(PBT-7220-080963)

SUPPLEMENTAL APPLICATION

The purpose of this Supplemental Questionnaire is designed to assess your education and/or experience as it/they relate to the knowledge, skills, and abilities linked to this position. The information you provide on this questionnaire will be used in evaluating whether you possess the education, and/or experience required for this position. This is subject to verification and must be included in your application/employment record. The hiring department may review this information as part of their selection process.

All of your information MUST be supplied in the spaces provided. Attachments or additional documents such as resumes, cover letters, or application will NOT be considered. (i.e. Writing “see resume/website/application” or “N/A” is not sufficient response.)


 

CERTIFICATION: I hereby certify that I am the author of this supplemental questionnaire and that all information presented is true and based on my education and experience and is consistent with the information in my employment application. I understand that any false, incomplete or incorrect statement may result in my disqualification or dismissal from employment with the City and County of San Francisco. I also understand and agree that any information provided is subject to verification.

Yes No
1

Indicate the selection that best matches the amount of your verifiable experience in street paving and repair work in class 7404 Asphalt Finisher.

No experience in class 7404 Asphalt Finisher.
Less than two years of verifiable experience in class 7404 Asphalt Finisher.
Two years of verifiable experience in class 7404 Asphalt Finisher
Over 2 years of verifiable experience in class 7404 Asphalt Finisher.
2

Indicate the selection that best matches your verifiable experience (check all that apply):

roadway base repair.
curb and gutter repair.
milling and preparing streets for resurfacing or overlay
street paving and repair work in class 7404 Asphalt Finisher
2a

Describe your experience and list the employer’s name(s), your title and dates of employment for EACH qualifying experience(s) checked above.

3

Indicate the selection that best matches the amount of your verifiable experience with INFOR/CMMS computer work order management system for tracking work assignments and status.

No experience.
Less than one year of verifiable.
Between one and two years of verifiable experience.
Over 2 years of verifiable experience.
4

Indicate the selection that best matches the amount of your verifiable experience as a lead worker for an asphalt paving crew.

No experience.
Less than one year of verifiable experience.
Between one and two years of verifiable experience.
Over 2 years of verifiable experience.
5

I possess and maintain a valid class C driver’s license.

Yes No
 

CERTIFICATION

I understand and agree to provide verification of experience, mentioned above, when requested. I also understand and agree that any information provided is subject to verification.

I hereby certify that I am the sole author of this application and that all information presented is true and based on my background, skills and experience and is consistent with the information in my application. I understand that any false, incomplete or incorrect statement may result in my disqualification or dismissal from employment with the City and County of San Francisco General Services Agency, Public Works at the Bureau of Street and Sewer Repair.

Yes No