Employee Attendance Point Out System

Effective immediately: July 25, 2022

Points accumulate when an employee has an unscheduled or unapproved absences and/or tardies.


John calls in sick Monday, Tuesday, and Wednesday. John would be given 1 point. John can use PTO to cover the hours he missed; however, it would still be 1 point because it was unscheduled (If an employee shows a positive Covid test or valid doctor’s excuse, they will not receive any points). If John returns to work Thursday and called in sick Friday, John will receive another point in the same week.

Arriving late will also count as an unexcused tardy. Any employee that is 5 minutes or more late for their scheduled shift, will receive a verbal warning on the first offense, however, 3 or more tardies during the same quarter are equal to 1 unexcused absence and will result in 1 point.

If an employee fills out a Requests Time Off Form in the Employee Portal at (password: SSEmployee1234!) and that request has been approved, no points will be given.

If an employee fills out a Request Time Off Form in the Employee Portal at (password: SSEmployee1234!) and it is not approved, and the employee takes off anyway, 1 point will be given.

An employee who accumulates more than the allowed points in any quarter (3-month period, JanMar, April-June, July-Sept, Oct-Dec) will automatically be terminated.

*First 90 days-probationary period-allowed 1 point

*Quarterly (3-month period) allowed 3 points
Employee Name(Required)
MM slash DD slash YYYY


Employee Name(Required)
I have been notified that Single Source will offer Health insurance after 60 days of employment. Single Source will pay $200 of the monthly premium, and I am responsible for the remaining amount, which will be deducted in equal amounts from each of my paychecks.

After 60 days of employment, I will receive an insurance packet and an email invitation from to sign up for health insurance. It is my responsibility to check for the invitation email and respond within 10 days of receiving it. Please send my email invitation to:
Insurance Agreement


I understand that traveling out of town for work is a requirement at Single Source. The amount of travel out of town is determined by the work schedule. Out of town travel is any jobsite that it 100 miles or more away from Single Source Corporate Offices at 100 W. 2nd St., Peculiar, MO 64078.

When traveling out of town for work, a $25.00 a day per diem will be given to each employee from the foreman at the start of each day. Motel room is furnished by Single Source and may be shared with another employee on the crew.
Employee Name(Required)
MM slash DD slash YYYY


Please check each item indicating that you have these items and will wear all PPE daily to the job site.
I have all the required PPE and other equipment necessary to start work.


Important! Please read and sign before completing and submitting.

I hereby voluntarily authorize the Company named above (hereafter “Employer”), either directly or through its payroll service provider, to deposit any amounts owed me, by initiating credit entries to my account (s) at the financial institution (s) of my choice (hereinafter “Bank”) indicated on this form. Further, I authorize Bank to accept and to credit any credit entries indicated by Employer, either directly or through its payroll service provider, to my account. To the extent permitted by law, in the event that Employer or its payroll service provider deposits funds erroneously into my account (s), I authorize Employer, either directly or through its payroll service provider, to debit my account for an amount not to exceed the original amount of the erroneous credit.

To the extent permitted by law, I understand that I have the right to refuse consent or revoke authorization of direct deposit at any time without fear of retaliation, and I have the right to receive any payment owed to me by other means. This authorization is to remain in full force and effect until Employer and Bank have received written notice from me of its termination in such time and manner as to afford Employer and Bank reasonable opportunity to act on it.
Legal Name(Required)
Deposit/Account Information(Required)
Bank Name
Routing #
Account #
Checking or Savings?
Amount to deposit ($ or Full Net Amount)


● New Hires starting after 05/23/2022 will receive a 1-time advance in pay of $500.

● The employee will qualify for this after they have worked 40 hours.

● If employee quits or is terminated prior to working with Single Source for 6 months, the advance of $500 Will be deducted from their final paycheck, as well as the cost of the hard hat ($25.00), and any uniform shirts ($15.00 each).

● Once the employee has work 6 months, the advance in pay and any PPE would then be considered a bonus and the employee is not required to pay it back.
Eligible Employee(Required)