Disclosure and Authorization Form

Bela Flor Nurseries Inc (the "Company") may request from a consumer reporting agency nnd for cmploymcnH·elated purposes, a "consumer report(s)" (commonly known as "background repmls") containing background information about you in connection with your employment, or applictltion for employment, or engagement for services (including independent contractor or volunteer assignments, as applicable). HireRight, LLC ("l-lireRight") will prepare or assemble the background reports for the Company. HireRight is located and can be contacted at 3349 ?vfichelson Drive, Suite 150, Irvine, CA 92612, (800) 400-2761, www.hireright.com. The background report(s) may contain information concerning your character, general reputation, personal characteristics, mode of living, or credit standing. The types of background information that may be obtained include, but are not limited to: criminal history; litigation history; motor vehicle record and accident history; social security number verification; address and alias history; credit history; verification of your education, employment and earnings history; professional licensing, credential and certification checks; drug/alcohol testing results and history; military service; and other information.