I, ________________________, hereby acknowledge that I have received a copy of the Costco Drug and Alcohol-Free Workplace Policy, which sets forth Costco’s policy and procedures regarding alcohol misuse and illegal drug use by applicants and employees. I understand that I am responsible for reading and complying with the policy. I also understand that I am encouraged to contact the Home Office Human Resources Department if I have any questions. I understand that: My compliance with the policy is a condition of my (continued) employment; I may be subject to drug and/or alcohol testing under the policy; Costco has the right to inspect all parts and aspects of its premises for illegal drugs, drug paraphernalia, alcohol, inhalants, or other contraband; and I will be subject to appropriate disciplinary action up to and including termination of employment and other appropriate conditions as determined by Costco if I refuse to cooperate in a drug and/or alcohol test, test positive for drugs and/or alcohol, or otherwise violate the policy. I agree to abide by the terms of the policy. Print Your Name ______________________ Employee Number ______________________ Your Signature ______________________ Date ______________________